Facilitating use of speech recognition software for people with disabilities: a comparison of three treatments

The use of speech recognition technology by people living with amyotrophic lateral sclerosis: a scoping review

BACKGROUND

More than 80% of people living with Amyotrophic Lateral Sclerosis (plwALS) develop difficulties with their speech, affecting communication, self-identity and quality of life. Automatic speech recognition technology (ASR) is becoming a common way to interact with a broad range of devices, to find information and control the environment.ASR can be problematic for people with acquired neurogenic motor speech difficulties (dysarthria). Given that the field is rapidly developing, a scoping review is warranted.

AIMS

This study undertakes a scoping review on the use of ASR technology by plwALS and identifies research gaps in the existing literature.

MATERIALS AND METHODS

Electronic databases and relevant grey literature were searched from 1990 to 2020. Eleven research papers and articles were identified that included participants living with ALS using ASR technology. Relevant data were extracted from the included sources, and a narrative summary of the findings presented.Outcomes and Results: Eleven publications used recordings of plwALS to assess word recognition rate (WRR) word error rate (WER) or phoneme error rate (PER) and appropriacy of responses by ASR devices. All were found to be linked to severity of dysarthria and the ASR technology used. One article examined how speech modification may improve ASR accuracy. The final article completed thematic analysis of Amazon.com reviews for the Amazon Echo and plwALS were reported to use ASR devices to control the environment and summon assistance.

CONCLUSIONS

There are gaps in the evidence base: understanding expectations of plwALS and how they use ASR technology; how WER/PER/WRR relates to usability; how ASR use changes as ALS progresses.Implications for rehabilitationDevices that people can interact with using speech are becoming ubiquitous. As movement and mobility are likely to be affected by ALS and progress over time, speech interaction could be very helpful for accessing information and environmental control.However, many people living with ALS (plwALS) also have impaired speech (dysarthria) and experience trouble using voice interaction technology because it may not understand them.Although advances in automated speech recognition (ASR) technology promise better understanding of dysarthric speech, future research needs to investigate how plwALS use ASR, how accurate it needs to be to be functionally useful, and how useful it may be over time as the disease progresses.

A scoping review of literature using speech recognition technologies by individuals with disabilities in multiple contexts

PURPOSE

Speech recognition technology (SRT) is increasingly available and may provide opportunities for individuals with disabilities to participate in necessary activities and meaningful occupations. This inquiry methodically collects and reports on research related to SRT for individuals with disabilities and impairments.

MATERIALS AND METHODS

Using the Arksey and O'Malley framework and PRISMA guidelines, five databases were queried and indexes of 11 journals were hand-searched for relevant articles. Articles were included if they were published after 2005, involved SRT, written in English, and participants(s) had a disability. Articles were charted, categorised for level of evidence, and findings were summarised.

RESULTS AND CONCLUSIONS

Of the 78 articles that were retrieved, 13 met inclusion criteria and were organised into 4 categories: SRT in primary and secondary education, in post-secondary education, for daily living, and without a specified context. No included articles considered SRT in vocational contexts. It was determined that SRT is a tool that may improve participation and independence of individuals with disabilities in multiple contexts. Most studies reviewed were non-empirical. Opportunities exist for providers to continue to develop a rigorous body of knowledge for the use of SRT to meet educational, vocational and daily living needs.IMPLICATIONS FOR REHABILITATIONSpeech recognition technology (SRT) provides a method of access that is widely available in mainstream technology devices such as personal computers, smartphones and mobile devices, and smart speakers/daily living aids.SRT may improve participation and independence of individuals with disabilities in contexts such as primary and secondary education, post-secondary education, and with independent living tasks.Many studies examining SRT are non-empirical, and there is an opportunity for assistive technology professionals and other providers who use assistive technology to continue to develop a rigorous body of knowledge.

A qualitative study exploring the effect of communicating with partially intelligible speech

Few studies have investigated how individuals with partially intelligible speech choose to communicate, including how, when, and why they might use a speech-generating device (SGD). This study aimed to add to the literature by exploring how this group of individuals use different communication strategies. Qualitative interviews were carried out with 10 participants with partially intelligible speech with the aim of investigating participants' perceptions of modes of communication and communication strategies. Transcripts were analyzed using Framework Analysis to investigate the role of SGDs alongside other communication strategies. Factors that influence why, when, and how a person chooses to communicate were identified and these were interpreted as an explanatory model of communication with partially intelligible speech. Participants described how they made the decision whether to attempt to communicate at all and then which communication method to use. Decision-making was influenced by the importance of the message, how much time is available, past experience, and the communication partner. Each communication attempt adds to an individuals' experience of communicating and influences subsequent decisions. This study suggests that individuals with partially intelligible speech are at risk of reduced communication environments and networks and that current SGDs may not be designed in a way that recognizes their particular needs.

Integrating familiar listeners and speech recognition technologies into augmentative and alternative communication intervention for adults with down syndrome: Descriptive exploration

Many individuals with Down syndrome exhibit speech impairments that necessitate augmentative and alternative communication (AAC) intervention. AAC intervention allows for access to communication through means other than, or supplemental to, speech. This descriptive study provided initial insight into the feasibility of incorporating familiar listeners (e.g., family members) and speech recognition technology into AAC intervention to increase communication success for individuals with Down syndrome. Six adults with Down syndrome participated. The participants' intelligibility to a familiar listener, unfamiliar listeners, and speech recognition technologies (i.e., Google Speech-to-Text and Windows Speech Recognition) was evaluated. Additionally, consistency in word pronunciation was evaluated to examine the feasibility of future training of speech recognition technologies. The participating adults with Down syndrome experienced limited intelligibility to all listeners and technologies but were most intelligible to familiar listeners. The adults also demonstrated consistencies across their production of words, and across one another's productions. The findings suggest the promise in using familiar listeners as a current resource and speech recognition technology as a future resource in AAC intervention for adults with Down syndrome. However, intervention research and technological development are needed to thoroughly explore these approaches.

Text entry rate of access interfaces used by people with physical disabilities: A systematic review

This study systematically reviewed the research on assistive technology (AT) access interfaces used for text entry, and conducted a quantitative synthesis of text entry rates (TER) associated with common interfaces. We searched 10 databases and included studies in which: typing speed was reported in words per minute (WPM) or equivalent; the access interface was available for public use; and individuals with physical impairments were in the study population. For quantitative synthesis, we used only the TER reported for individuals with physical impairments. Studies also had to report the sample size, and the average and standard deviation for the TER data. Thirty-nine studies met the criteria for quantitative synthesis. Studies involved seven interface types: standard keyboard typing, on-screen keyboard (OSK) with cursor selection, OSK with scanning selection, automatic speech recognition (ASR), Morse code, brain-computer interface (BCI), and other. ASR, standard keyboard, cursor OSK, and scanning OSK had at least four studies and 30 subjects, with TER averaging 15.4, 12.5, 4.2, and 1.7 WPM, respectively. When combined with measurements of a particular client's text entry performance, the TER from this review can be used within an evidence-based decision-making process for selecting control interfaces.

Designing speech-based interfaces for telepresence robots for people with disabilities

People with cognitive and/or motor impairments may benefit from using telepresence robots to engage in social activities. To date, these robots, their user interfaces, and their navigation behaviors have not been designed for operation by people with disabilities. We conducted an experiment in which participants (n=12) used a telepresence robot in a scavenger hunt task to determine how they would use speech to command the robot. Based upon the results, we present design guidelines for speech-based interfaces for telepresence robots.

Enabling self-directed computer use for individuals with cerebral palsy: a systematic review of assistive devices and technologies

AIM

The purpose of this study was to systematically review published evidence on the development, use, and effectiveness of devices and technologies that enable or enhance self-directed computer access by individuals with cerebral palsy (CP).

METHODS

Nine electronic databases were searched using keywords 'computer', 'software', 'spastic', 'athetoid', and 'cerebral palsy'; the reference lists of articles thus identified were also searched. Thirty articles were selected for review, with 23 reports of development and usability testing of devices and seven evaluations of algorithms to increase computer recognition of input and cursor movements.

RESULTS

Twenty-four studies had fewer than 10 participants with CP, with a wide age range of 5 to 77 years. Computer task performance was usually tested, but only three groups sought participant feedback on ease and comfort of use. International standards exist to evaluate effectiveness of non-keyboard devices, but only one group undertook this testing. None of the study designs were higher than American Academy for Cerebral Palsy and Developmental Medicine level IV.

INTERPRETATION

Access solutions for individuals with CP are in the early stages of development. Future work should include assessment of end-user comfort, effort, and performance as well as design features. Engaging users and therapists when designing and evaluating technologies to enhance computer access may increase acceptance and improve performance.