On the Benefits of Speech and Touch Interaction with
Communication Services for Mobility Impaired Users
Carlos Galinho Pires
, Fernando Miguel Pinto
Eduarda Mendes Rodrigues
and Miguel Sales Dias
Dept. Informatics Engineering, University of Porto, Porto, Portugal
Microsoft Language Development Center, Tagus Park, Porto Salvo, Portugal
ISCTE-Lisbon University Institute, Lisboa, Portugal
Abstract. Although technology for communication has evolved tremendously
over the past decades, mobility impaired individuals still face many difficulties
interacting with communication services, either due to HCI issues or intrinsic
design problems with the services. In this paper we present the results of a
usability study, conducted with a group of five mobility impaired users,
comprising paraplegic and quadriplegic individuals. The study participants
carried out a set of tasks with a multimodal (speech, touch, gesture, keyboard
and mouse) and multiplatform (mobile, desktop) prototype, offering an
integrated access to communication and entertainment services, such as email,
agenda, conferencing and social media. The prototype was designed to take into
account the requirements captured from these users, with the objective of
evaluating if the use of multimodal interfaces for communication and social
media services, could improve the interaction with such services. Our study
revealed that a multimodal prototype system, offering natural interaction
modalities, especially supporting speech and touch, can in fact improve access
to the presented services, contributing to a better social inclusion of mobility
impaired individuals.
1 Introduction
Over the past decades, computer-mediated means of communication have evolved
from simple text-based services, like Bulletin Board Systems (BBSs), Internet Relay
Chat (IRC) and e-mail, to more powerful, multimedia-enabled services such as audio-
video conferencing, instant messaging (IM) and, more recently, social media services
(SMSs). This communications revolution has made it virtually possible to reach,
anyone, anywhere, anytime, with great ease and, in most cases, with reduced cost,
when compared with traditional means of communication. Such evolution has led to
increased interaction between people, in general, and opens up opportunities for those
with mobility impairments to improve their social inclusion, thus reducing the impact
caused by real-world barriers. However, mobility-impaired individuals still face
several usability issues with current communication technologies [9].
This paper presents a prototype of multimodal applications, both for the desktop
and the mobile platform, that seamlessly integrates access to e-mail, agenda, audio-
Galinho Pires C., Pinto F., Mendes Rodrigues E. and Sales Dias M..
On the Benefits of Speech and Touch Interaction with Communication Services for Mobility Impaired Users.
DOI: 10.5220/0003342600600073
In Proceedings of the 1st International Living Usability Lab Workshop on AAL Latest Solutions, Trends and Applications (AAL-2011), pages 60-73
ISBN: 978-989-8425-39-3
2011 SCITEPRESS (Science and Technology Publications, Lda.)
video conference and social media services, with a unified user interface, specifically
designed based on the requirements of people with mobility-impairments (Pires et al.,
2010). The prototype applications are capable of accepting user input and producing
output through several modalities in a concurrent fashion, thus adapting to mobility
impaired individuals’ different requirements. This paper also presents a user study
that we conducted to evaluate our prototype, with the aim to uncover whether its
multimodal user interface offers benefits for mobility impaired individuals.
The methods applied in our usability evaluation study include open and semi-open
questionnaires, interviews and naturalistic observation [10], while the users performed
a set of pre-defined tasks, using several services and hardware devices, enabling
different HCI modalities. We considered several types of computer-mediated
communication services, namely, email, audio-video conference and social media
Our research reveals that multimodal interfaces, in particular the speech modality,
are capable of significantly improving the perceived usability of an application by
mobility impaired individuals. We have concluded that the multimodal interaction
approach helps bypassing recurring problems that were observed experimentally, such
as, difficulties in typing key combinations in the keyboard, or in hitting small buttons
on mobile user interfaces. The multimodal approach also helps reducing the impact
caused by an application’s learning curve, effectively allowing users to choose which
modality better suits their needs and limitations, depending on the use context.
The remainder of this paper is organized as follows. Section 2 presents some
background and related work in the area of inclusive technologies for mobility
impaired users. Section 3 gives a brief overview of the architecture and user interface
of the prototype multimodal application, including its requirements and constraints.
Section 4 describes the usability evaluation study, presenting details about the
participants, the tasks that were performed and the analysis methods. Section 5
presents and discusses the study results. Finally, Section 6 presents the conclusions
and draws some lines of future work.
2 Background and Related Work
Mobility impaired individuals have some physical limitations that influence the way
in which they interact with computers and other devices. Reduced ability to handle
input devices and corresponding HCI modalities, such as keyboards, mice, tactile
devices and gestures-based devices, restricts the mobility impaired individuals’ access
to ICTs. The interaction and technological barriers, coupled with mobility difficulties
in real-world environments, can severely limit these individuals’ independence as
well as lead to social isolation, which may originate a depressive state [12], [2].
To address some of these issues, several electronic inclusion initiatives have been
launched by the European Union (E.U.), especially since the year 2000, focusing on
aspects such as universal broadband access, accessibility enhancements, Ambient
Assisted Living, thus enabling a better quality of life for these individuals [4], [3].
Although interaction with computing devices has evolved from simple keyboard
and mouse, to more natural interaction modalities such as speech coupled with gesture
or touch [7], [1], in some situations, adopting more natural means of interaction does
not necessarily lead to better user interaction [9] . One way to overcome these issues,
as well as reducing the impact of some of the limitations disabled people face, is by
using multimodal interfaces [11], [8]. This approach allows users to interact through a
specific mixture of one or more HCI modalities, which are more appropriate to the
user’ interaction environment, to the semantic context of the dialog between the user
and the system, his/her personal preferences or even disabilities. Thus, with
multimodal user interfaces, should users be unable to speak, they could instead use a
gesture interface or, in situations where they could not properly coordinate their arms
or hands, a speech interface could be used instead. The advantage of multimodal
interfaces is not only the ability to enrich the usability experience by allowing
multiple means of interaction, but also the ability to use them in a seamless way,
without explicitly requiring users to specify upfront the type of interface to use.
Despite the advantages of this interaction paradigm and of natural interfaces,
designers should also take into account universal design guidelines [5], to ensure that
they are not excluding any user groups.
3 Prototype Design and Development
We developed a multimodal and multi-platform prototype that integrates access to e-
mail, agenda, audio-video conference and social media services, with a unified user
interface, specifically designed based on the requirements of mobility impaired
individuals. Such requirements were gathered through a prior user study [9], which
involved a group of paraplegic and quadriplegic individuals. This section summarizes
the guidelines and constrains that guided the prototype design and presents details
about the application development and its user interface.
3.1 Design Guidelines and Constraints
As general requirements, we specified that the prototype should be available on
mobile and desktop platforms, providing email, agenda, audio-video conference and
social media services. Also, we took into account the target users of the prototype,
and thus, we followed the guidelines and constraints regarding interface design for
mobility impaired individuals, which were unveiled in a prior user study [9]. In that
study participants initially answered a short questionnaire focusing on their current
ICT use patterns and difficulties, and subsequently performed a small set of scripted
tasks to evaluate their current use of ICTs and interaction modalities. They were
asked to use services, such as e-mail, agenda, audio-video conference and social
media services’ applications, as well as to use interaction devices enabling different
HCI modalities, like traditional keyboards and mice, touch screens, gesture with
smartphones equipped with accelerometers and speech recognition systems. From this
study, followed a set of design recommendations:
(1) Large graphic icons – The icons in the mobile and desktop interfaces should be
large enough to be correctly used by both target groups, and additionally, not
requiring precise movements and actions;
(2) UI readability at some distance – Additionally, the interfaces should be readable
at some distance, using large and clear text, allowing operation from fixed locations at
some distance from the user, such as quadriplegics’ wheelchair arms;
(3) Multi-touch interaction – Interaction through multi-touch should be carefully
implemented so as to not become a usability barrier for quadriplegic users who are
unable to perform these gestures with ease. Users should be able to perform the same
tasks offered through multi-touch with other available modalities;
(4) 3D gesture interaction – Special care should be taken in the design of the 3D
gesture interaction on the mobile platform, as most quadriplegic users aren’t able to
perform these gestures with ease or at all. It should be possible to disable 3D gesture
interaction, without compromising offered functionalities, by offering access to these
functionalities through other modalities;
(5) Key combinations – The desktop platform interface should avoid key
combinations, as most quadriplegic individuals have many difficulties using them;
(6) Unified multi-platform interface – The mobile UI should allow easy usage,
offering a feature set as close as possible to the desktop UI, in order to increase users’
(7) Use of HCI modalities – All interaction modalities should be concurrent on both
platforms, allowing users to resort to their preferred means of interaction. The most
traditional interfaces such as keyboard and mouse should be supported as alternative
means of interaction.
We also produced a set of recommendations regarding communication services’ HCI:
(1) Email interfaces should be similar to existing ones, but simpler, with just essential
features (subject, text, attach option and recipients);
(2) Conference interfaces must be simple, with clear separated audio call and video
call buttons (audio and video conference is an important service for mobility impaired
users, since it is easier and more convenient to use than instant messaging);
(3) Social media services interfaces must be simple enough to use and not resort to
service specific jargon;
(4) Social media services interfaces should be carefully designed to have a low
volume of information on each page/window to reduce the user’s learning curve.
3.2 Application Development
The need for mobility expressed by the participants, coupled with the requirement for
a portable system that can be easily installed in different kinds of systems with
minimal setup overhead, led to two possible architectural choices: a centralized
architecture, where every component in the UI, logic, and data storage layers would
have to be duplicated over all desired platforms, or a distributed architecture,
including several server-side and client-side elements. The latter was thus deemed
more favorable than the former due to a lower overhead in development, deployment
and client setup, as only a server-side component would be required to process speech
(both synthesis and recognition), modalities and some of the core logic and data
storage components such as service access, publishing and session maintenance
between devices. This architecture can be seen in greater detail in Figure 1.
Fig. 1. Prototype Physical Architecture.
The prototype is divided in two main regions: (1) home – which represents the
devices, equipment and HCI the user will have at home; and (2) backend – where
backend servers and services are located. At home we have a mobile device
(smartphone), a desktop device (touch screen computer) and a server (PLA server)
that works as a mediator between mobile, desktop and backend. On the backend we
have Exchange Server 2010 for agenda and email services and Office
Communications Server 2007 R2 for conference services. Backend services also
resorted to Microsoft’s SQL Server 2008 as a means to store social media service
credentials and configuration, as well as to several libraries that interact with service
Application Programming Interfaces (APIs) (in the current prototype version, we
support Twitter’s, TwitVid’s, TwitPic’s Bit.Ly’s and YouTube’s API).
Technology wise, the prototype’s server side components were built on a solid
Windows Server 2008 foundation. Unified Communications API (UCMA) was used
as a way to establish a voice channel between the desktop device and the speech
server running on the PLA server, enabled with Microsoft European Portuguese (pt-
pt) speech recognition and synthesis systems. Also, Exchange Web Service Managed
API was used by the PLA server, in order to interact with the Exchange Server. PLA
server offers a unified web service API to all device clients. Client wise, the desktop
application was developed using the Windows Presentation Foundation (WPF) and
the .NET framework. The mobile application was developed for Windows Mobile
devices, and also resorts to the .NET framework.
Taking into consideration the design recommendations in the previous section, we
have developed two prototype applications, one for each platform. Being multimodal
in their nature, all interfaces for these platforms, offer speech, touch and hardware
input capabilities. Mobile interfaces also have 3D gestures available, through an
accelerometer sensor. Figures 2 and 3 show the desktop application’s home screen
and social media service message authoring GUI, respectively. Here we can see the
use of large icons, text and user controls, as per design recommendations from [9].
These recommendations were also followed in the design of the mobile application, as
can be seen in Figures 4 and 5, which respectively represent the application’s home
screen and email authoring GUI on the mobile platform.
Fig. 2. Desktop home screen GUI. Fig. 3. Desktop message authoring GUI.
Fig. 4. Mobile home Screen GUI. Fig. 5. Mobile email sending service GU.
4 Usability Evaluation Study
To evaluate the usability of the prototype described in the previous section, and its
adequacy for mobility impaired individuals, we have carried out a small user study,
comprising of five individual user sessions. The study participants were asked to
complete a set of tasks with the prototype, focusing on the usage of email, agenda,
audio-video conference and social media services. The following HCI modalities
were always available, both in desktop and in mobility environments:
Keyboard and mouse (hardware devices)
Speech (in certain application contexts, command and control was enabled,
whereas in others, simple dictation was possible)
Additionally, 3D gestures could be issued by manipulating the mobile device, in
certain application contexts.
This section presents details about our user study methodology and results.
4.1 Participants
Five participants with mobility impairments, as well as a non-impaired control
participant, took part in the user study. All participants were recruited from a panel of
associate members of Associação Salvador (http://www.associacaosalvador.com/), a
non-profit social solidarity organization dedicated to support the interests and rights
of people with reduced mobility in Portugal, which is partnering this research.
Detailed information about the study participants is provided below (see Table 1).
Their profiles in terms of gender, age, professional activity and computer skills, were
Table 1. Participants of the User Study panel.
Participant Gender Age Career Impairment type Computer skills
Control Female 25 Assistant Manager None Medium
Subject 1 Male 28 General Manager Quadriplegia Medium
Subject 2 Male 26 Informatics Technician Paraplegia High
Subject 3 Female 54 Technical Assistant Paraplegia Low
Subject 4 Male 41 Informatics Engineer Quadriplegia High
Subject 5 Male 19 Student Paraplegia Medium
4.2 Analysis Methods
During each session, video and audio were recorded for further analysis. From the
structured tasks (email and agenda), quantitative results were extracted. We
considered the following: (1) time to complete a task (in minutes), from the time each
participant was instructed to do a task, until the task was completed; (2) number of
aids – number of times participants asked for an aid or were helped; (3) modality
count – number of times a modality was used to accomplish a single action (e.g. select
a text box or a button count). A modality was counted only when all three modalities
(keyboard + mouse; touch; speech) were available for the same action. All three
modalities were mutually exclusive and counted as well. In case of failure of one
modality, only the first chosen modality was counted. Quantitative results shouldn’t
be strictly interpreted, as the sample size isn’t statistically relevant, and are considered
as mere guidelines towards future evaluation.
As qualitative results we considered: (1) result – level of task completion; (2)
observations – our point of view of participants’ performance on doing the task; (3)
participants’ opinion – opinions given by participants while performing the tasks.
4.3 Study Tasks
Participants were asked to perform a set of pre-defined tasks, in order to properly use
the prototype functionalities. Since the prototype was available on mobile and
desktop, participants were invited to use both platforms. Also, participants were free
to choose which modality to use at any time, allowing us to better understand why
they chose a specific set of modalities in each use context. All tasks were performed
with no specific order, in order to minimize possible task sequence bias in the
interpretation of the results across participants. Prior to performing the study tasks,
each participant was given a brief overview (~5 minutes) of which features and
modalities the prototype offered. Participants were also invited to experiment with
modalities they hadn’t previously used, in order to familiarize themselves with the
prototype. The user tasks were performed in individual sessions with each participant
and in a controlled environment. The user tasks are described below.
In the email task, participants were asked to check their email inbox, create a new
email and send it to an existent contact and to an email address that wasn’t available
in the contact listing. In the agenda task, participants had to create a new appointment
and then delete it. They were also asked to navigate through their agenda. Both these
tasks were designed to be conducted on the desktop platform and the script was the
same for all participants, so that the execution times could be compared.
In the conference task, participants were asked to make an audio call and a video
call, using either the desktop or the mobile platform (see section 4 for details). This
task was designed with the purpose of testing if there are any advantages in using
mobile devices as extenders, that is, remote controllers for the desktop application.
In the mobile environment task, participants were invited to freely check their
mailbox, send an email to a contact, and create a new appointment on the agenda. As
the name implies, this task was conducted on the mobile platform, with the purpose of
giving participants the possibility to explore the prototype’s mobile version.
In the Social Media Services task, participants were asked to perform a set of
scripted activities from supported services like Twitter or YouTube, and derivatives
like TwitPic or TwitVid. The tasks conducted focused in the areas of message viewing
and publishing, as well as content viewing, search and publishing, namely, photos and
videos, both in on-line services and in a local gallery.
After executing these tasks, participants were asked to fill a small questionnaire to
gather information on how easy and pleasurable it was to use each HCI modality and
associated hardware, as well as each service.
5 Results and Discussion
5.1 Email Task (Desktop)
Being email a well-known application, most participants did not encounter major
problems when dealing with the interface. As shown in Figure 6, mean execution time
differences between paraplegics and quadriplegics are quite low (i.e., forty-five
seconds). Also, differences between the control subject (non-impaired individual) and
impaired participants are low (i.e., twenty-four seconds).
These results suggest that by giving mobility-impaired individuals a simpler and
multimodal-enabled email interface, we´ve managed to improve their interaction with
this kind of applications. Furthermore, participants used more often speech and touch,
rather than traditional hardware (keyboard + mouse) interfaces, especially
quadriplegics (see Table 2).
Fig. 6. Email task execution times.
Table 2. Email task modality count.
Participant Time to complete Modality count
Speech Touch Hardware (kbd+mouse)
Control 04:07
1 0
Subject 1 02:37
0 0
Subject 2 04:10 6
Subject 3 05:24 0
Subject 4 05:35 2
Subject 5 04:55 4
Regarding typing, there are some issues to consider with quadriplegics. When the
physical limitation level is higher and participants cannot use their hands and arms
(e.g., as it was the case of subject 1), they resort to speech. When the quadriplegia
level is lower (e.g., subject 4), they can resort to speech or touch, not only just to
write, but also to select items. Also, subject 4 said that it was easier for him to type
with a virtual keyboard rather than with dictation. Other participants, however, were
more interested in speech dictation interaction, rather than in other modalities. So, in
these cases, multimodality gives users the freedom of choice and the possibility of
alternating between modalities, as they see fit.
5.2 Agenda Task (Desktop)
Regarding the agenda interface, participants considered it easier to interact with, than
email, as well as with applications they usually deal with. Similarly to the email task,
in this task participants used more often alternative modalities (speech, touch) than
the traditional ones (see Table 3).
Execution time differences between quadriplegics and paraplegics (eleven
seconds) and between impaired and control participant (eight seconds) are considered
negligible. Taking into account that subject 4 has an advanced quadriplegia state, and
did not have problems dealing with the interface, we can consider that participants
managed to overcome their current limitations by using alternative modalities. Due to
the nature of this task, in which participants had to select items, touch and speech
seemed to be the best indicated modalities. As opposed to the previous task, we’ve
found that the current pt-pt speech engine works well for item selection and command
and control, rather than for dictation.
Table 3. Agenda task modality count.
Participant Time to complete Modality count
Speech Touch Hardware
Control 03:16
1 0
Subject 1 03:05
0 0
Subject 2 02:16 3
Subject 3 04:09 0
Subject 4 03:30 5
Subject 5 04:02
7 1
5.3 Conference Task
For this task we hypothesized the following: “if speech is not available on the
desktop, can a remote controller be used as a replacement?”. As observed in other
tasks, individuals with advanced quadriplegia can only use speech or gaze-based
devices. As such, what would be preferable if these modalities were not available? In
order to test this, the conference interface was only available on the desktop without
speech input, but it could be controlled using a smartphone.
Quadriplegics considered that this approach could have many advantages, namely
when they are away from their computer or simply cannot use speech. On the other
hand, paraplegics did not feel that this approach was very useful. Nonetheless, all
participants considered the interface and the overall interaction simple and easy.
5.4 Mobile Environment Task
In the mobile task, participants were invited to try email and agenda on the mobile
device, by doing common tasks like reading received email or creating a new
appointment, according to a previously elaborated script. Both email and agenda
offered similar functionalities to those offered on the desktop, but with reduced
functionality in some cases.
During this task we noticed that quadriplegics experienced difficulties using touch
on mobile devices with resistive displays and also using 3D gestures. 3D gestures
were available as a non-exclusive way of selecting items on lists. We observed that
quadriplegics unintentionally triggered 3D gestures events when handling the
Due to technical limitations, speech was only available by a “push-to-talk” (PTT)
feature, making the application a little harder, and in some way, confusing to use.
Also dictation mode was not available.
Despite these issues, all participants considered the interfaces simple and easier to
interact with, when compared with existing commercial applications, which allow
access to communications’ services, both in terms of interaction (taking into account
requirements such as buttons size) and interface. Also, having a set of important
functionalities to mobility-impaired individuals, available on a mobile device, was
considered to be very important.
5.5 Social Media Services Task
In this task, participants overall enjoyed the application, nding it easy to use, with a
low learning curve, having clear, large and easy to use UI controls. Participants
preferred to use modalities they were more used to, such as the keyboard, be it the
virtual on-screen variant or the physical keyboard. They felt, however, that touch
interaction was more natural, in detriment of the mouse, a tendency that was veried
in all participants, as the mouse wasn’t used at all during the proposed tasks.
With regard to speech interaction, several factors inuenced the overall
experience, such as the participant’s tone, volume and speech rate, among other
factors. Voice interaction in command-and-control mode proved very effective,
should the participant be able to project his or her voice with enough volume to be
captured by the device’s microphone. Depending on the subtask, dictation mode
either worked as expected, or didn’t produce adequate results.
Participants, however, felt that the combination of different input and output
modalities can signicantly improve their daily interaction with SMSs, attributing
advantages to this interaction approach such as the ability to change to more suited
modalities based on privacy needs, to perform tasks that they don’t know exactly how
to perform with a specic modality, to allow them to multi-task on their daily lives, or
to improve mobility, be it to interact with a mobile device while driving or while
5.6 Questionnaire
At the end of each individual session, we asked each participant to fill in a
questionnaire. First, we asked the participant to rate how difficult it was for them to
use each evaluated modality, according to a 6 point Likert scale [6], ranging from
Impossible (1) to Very Easy (6). As can be seen in Figure 7, participants overall found
the desktop modalities easier to use, as opposed to mobile, mainly due to the higher
definition of the desktop’s peripherals (microphone and screen), when compared to
the mobile device.
The second question focused on how much participants enjoyed using each
modality. This question also resorted to a 6 point Likert scale, ranging from Hated (1)
to Loved It (6). What we found here was that, overall, participants’ opinions matched
the results from the previous questions in all, but speech interaction, leading us to
believe that, due to certain limitations with speech dictation interaction, participants
were underwhelmed with how functional speech interaction could be to them. These
results can be seen in Figure 8.
Subsequently, we asked whether participants considered that the prototype
application would improve their daily tasks. The overall consensus was that it would.
However, some quadriplegic participants noted that they would find the mobile
prototype more useful to them, derived from their on-the-go communication needs.
Question 4 focused on the prototype’s UI ease of use. In this case, participants
also answered that they found the UIs easy to use.
Finally, when asked which additional features they would like the prototype to
offer, the majority of participants said they would like the prototype to offer access to
additional social media services, like Facebook, as well as to other types of services,
like daily newspapers, weather, movies, but also to other types of media content like
on-line and off-line music playback.
Fig. 7. Question 1 results.
Fig. 8. Question 2 results.
6 Conclusions and Future Work
In this paper we presented the results of a usability study conducted with a sample of
mobility-impaired users who were asked to carry simple tasks using a set of multi-
platform (desktop, mobility) and multimodal (keyboard + mouse, touch, speech,
gesture), prototype applications. The prototype followed design guidelines regarding
HCI identified in previous work [9].
As anticipated based on the results of previous work, we observed that the
preferred modalities for mobility-impaired individuals are speech and touch. It was
very interesting to observe that participants opted to use alternative HCI modalities
than the traditional ones, such as keyboard and mouse. Regarding 3D gestures and 2D
gestures quadriplegics had some issues when using them, and so, as recommended in
the design guidelines, those modalities had less obtrusive alternatives that offered the
same feature set in the prototype.
When dealing with email, agenda, conference and social media services,
participants felt these interfaces were simpler and easier to interact with, than current
ones. Regarding the mobile device, we note that enhanced speech interaction, namely
through the support of better dictation experience, can potentially improve the
perceived usability of this platform, and as such, this platform could have an
important role with quadriplegic individuals, by increasing their mobility.
As future work, besides improving the current prototype, to overcome some issues
with the mobile platform, feature set extensions should be taken into account, mainly
to support other kinds of services that were considered important by the study
participants. Further work should also focus on long-term studies, by evaluating how
the prototype works on participants’ daily lives, as well as to determine if the results
reported in this paper, can be extrapolated to a larger user audience and other
languages and cultures.
This work was co-funded by Microsoft and COMPETE - Programa Operacional
Factores de Competitividade and the European Union under QREN Living Usability
lab (http://www.livinglab.pt/), and the first and second authors contributed equally.
The authors would like to thank especially to Salvador Mendes de Almeida from
Associação Salvador (http://www.associacaosalvador.com/)
for mediating the recruitment of the study participants and the scheduling of the study
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