Report of Pilot Study: Exploration of Email as a Therapeutic Modality

(Sohlberg, M.M., Ehlhardt, L., Fickas, S. & Sutcliffe, A., in submission)

There has been little user evaluation research investigating how adults challenged by cognitive-linguistic impairments cope with standard or specially designed assistive user interfaces. We conducted a preliminary study into the usability of a simplified email interface containing four different writing prompt conditions . E-mail was selected as the computer application for our study because of its potential to reduce social isolation. Eight individuals who displayed a variety of cognitive-linguistic impairments composed email to their partners or careproviders who were in a neighboring office. Their emails were composed using four different types of structured writing prompts. The email senders and receivers ranked their preferences for types of prompting and quality of emails.

An analysis of errors and user preferences for the prototype e-mail system was conducted on the emails generated by the 8 subjects. Errors fell into one of three categories: 1) lack on knowledge about functionality of keys for basic word-processing operations; 2) poor acquisition of a conceptual model for mouse/cursor operation; and 3) poor use of interface prompts. Multiple sources of writing composition problems were also identified. The results clearly suggested that a one-size-fits-all solution does not work for assistive interfaces as the subject preferences for email interfaces widely varied. Of note, all subjects were highly motivated to use email and time spent emailing exceeding their documented attention abilities. Implications of user email performance for interface design, rehabilitation and future research into assistive technology are discussed in the paper.