2014 IEEE Int ernation al Symposium on Roboti cs and M anuf acturin g Autom ation

Extending Cultural Model of Assistive

Technology Design for Autism Treatment

Muhammad Nabil Moktar\ Amily Fikry2, Rosidah Musa3, Hamizah Hassan4 Sabarinah Sh. Ahmad5 Zulhabri Ismail6
Nusrah Samae Rugayah Hashims
!
PhD Postgraduate Student

Universiti Teknologi MARA, Malaysia

Faculty of Business Management

rosidahm@salam.uitm.edu.my

Universiti Teknologi MARA, Malaysia

Associate Professor

nabilmoktar@gmail.com
Senior Lecturer

5,

Senior Lecturer 6

Faculty of Architecture, Plannning and Surveying

2, 4, 7

Universiti Teknologi MARA, Malaysia

Faculty of Business Management

sabar643@salam.uitm.edu.my

Universiti Teknologi MARA, Malaysia

zulhabri@salam.uitm.edu.my

amily@salam.uitm.edu.my

hamiza013@salam.uitm.edu.my

Associate Professor

nusrah6294@salam.uitm.edu.my

Faculty of Administrative Science & Policy Studies

Professor

Universiti Teknologi MARA, Malaysia

gy@salam.uitm.edu.my

Arshad Ayub Business School

sense and or else impression [3]. With the help of technology,
treatment can be done effectively and efficiently with the help

Ahstract- This paper depicts the prominence of cnltnral on the

of assistive technology. Assistive technology is a tool, device

adoption of assistive technology, in terms of design, which are

particularly anticipated for autism treatment. The researchers
believe that cultural aspect should be considered in designing
assistive technology in treating autistic individual. It is necessary
to assess cultural differences critically so that assistive technology
can be accepted extensively. Occasional review on cultural
changes is also needed in countries with cultural diversity to
ensure that the technological growth is compatible with the
current recognition. This paper reviews on disability treatment
using assistive technology and proposes an extension for the
existing cultural model for assistive technology design.

or application developed to assist, support or treat autism

community and offer help in performing or learning certain
skill or task.
However,

in

their communication, customs, diversity, living style and

norms.

communication

autism

be

the researchers suggest to extend an existing

occurs within the culture that may affect utterly on existing

This paper provides a general review on previous related

studies and concepts especially the one which is closely

differs

related to cultural variances effects on technology adoption for

between

health treatment. Apart from price and accessibility, culture

excels out front to be the most critical aspects in order to

individuals, stretching from severe impairment to non-verbal

cognitive skills. WHO also estimated a global median of 62110

achieve a global scale acceptance. Periodical evaluation on the

000, that is 1:160 children has an ASD. Based on the past

cultural model should be done in parallel to technological

studies made since late 1960s and early 1970s, the occurrence

development over time.

of autism epidemiologic cases has increased twentyfold to

Offhand supervision on cultural

changes or development may result in failure in technological

thirtyfold numerically [2]. An autistic individual experiences

adoption. The researchers tend to extend an existing model

lifetime developmental disability such as visual sense, hearing

Due acknowledgement is accorded to the Ministry of Education
(MOE),Malaysia for the funds received through the Niche Research Grant
Scheme (NRGS), [Project File: 600-RMIINRGS 5/3 (14/2013)] and to the
Research Management Institute (RMI), Universiti Teknologi MARA (UiTM)
for the additional funds in the form of the Principal Support Initiative (PSI)
grant [Project File: 600-RMIlDANA 5/31PSI (76/2013) and Cumulative
Impact Factor Initiatives (CIFI) grant [Project File: 600-RMIIDANA 5/3/CIFI
(13/2013)].

978-1-4799-5765-1114/$31.00 2014 IEEE

should

assistive technology.

repetition of a stereotyped set of behavior. The level of

by

culture

entails the cultural difference, possibility of fluctuations that

and

temporary deterioration in communication, social skills and

caused

that

cultural model for assistive technology design. The model

of an autistic individual are delay in the development or

disability

believe

assistive technology for local or global community. In order to

treatment,

interaction,

researchers

attain global acceptance of assistive technology for autism

repetitive behavior or interest [1]. Some of the characteristics

intellectual

The

considered thoroughly in inventing, innovating or designing

INTRODUCTION

social

of technological advancement,

inventing or innovating assistive technology, in this case, for

World Health Organization (WHO) described autism as

complications

mist

autistic individual. Culture differentiates a group based on

Keywords-Autism; Assistive Technology; Design; Culture;

I.

in the

cultural aspects are yet to be considered within the process of

172

2014 IEEE International Symposium on Robotics and Manufacturing Automation

accordingly to fit the current cultural diversity in adopting

individual

assistive technology for autism treatment.

technology adoption increase as they share ideas and thoughts

is

exposed

to

other

culture

the

intention

of

and willingness to communicate to one another.

RELATED STUDIES

II.

Swar

In this section, the researchers review on related past

studies

about

the

adoption

of

assistive

technology

for

Hofstede's

impairments treatment, treatment for autism and cultural

spectrum

developmental

disorders

disabilities

communication,

social

(ASD)

identified

skills

and

is

with
by

band

repetitive

sets

the one with a higher ethnic identification due to their

of

difference in terms of response towards advertisement [15].

Effective use of assistive technology can be maximized by

are deceptive in the early developmental period. Nevertheless,

social

discrepancies

can

only

be

identified

as

matching device and support features with the need of the

the

users', preferences and environmental resources. Individuals

individual in unable to meet the social, educational, job

with

related or other demands in life.

The need for assistive in treating health problem has
devices,

strategies

impairments,

health

or

tools

that

problems

or

helps

people

disability.

and

environmental

communication,

controls,

computer-based

kinesis,

can

function

more

pursue education, employment and getting involved in civic

with

testing of assistive technology is important to achieve a higher

Assistive

assistive

module,

disabilities

affairs [16]. Incorporating cultural dimensions in localized

rate of acceptance for the technology itself [17].

technology can be categorized into a few clusters, such as;

access

developmental

independently with the support from assistive technology to

increased in the past decade. Assistive technology comprises

of

The study indicates that

lower ethnic identification must be targeted differently than

in

behavioral activities or interests [4]. Early signs or symptoms

the

dimensions.

compared to the one with dissimilarities. An individual with a

of

deficiencies

cultural

culturally similar countries tend to adopt technology better as

barriers in technology adoption.

Autism

[14] studied on the impact of national culture

towards diffusion and adoption of technology based on

heeding,

III.

setting,

CONSIDERING CULTURE IN ASSISTIVE

TECHNOLOGY DESIGN

software application, vision and sensory aids, recreation and

personal care [5]. It can be in form of a software application

Culture can cause positive and negative effects in the

on an iPad, such as Avaz for Autism or even a stand-alone

process of assistive technology adoption for autism treatment.

hardware, for instance, a humanoid robot, NAO [6]. This

The difference in culture

research

segmentation for the marketers to focus on in their promotion

is

focused

on

assistive

technology

for

autism

may provide a

better market

treatment [6][7][8] and how a small modification can alter a

for product or services [15]. However, drawbacks such as

technological changes from a failure to an outstanding success

misinterpretation of implied meaning may occur due to

[9].

cultural

technology, KitKanit,

a calculating aid tools help

differences

[14][15].

Almurayh

[18]

identifies

fundamental elements of culture that limits the adoption of

In [10], the researchers concluded that the use of assistive

assistive technology.

basic

calculation and math problem for dyscalculia students in their

learning process. The subjects of the research also stated that

-Consideration

-Compatibility

the use of interactive animation and colorful graphic increase

-Alternatives

-Enhancement

the interest and attention of the students to follow the

fCa

-Suitability

instructions throughout the learning process using assistive

technology. Some may also find language usage as one of the

-Facilities

-Privacy

difficulties in adopting assistive technology [11], especially in

localization testing process. It was discovered by Ping [11] as
they are testing the localization of software for deaf students.
Seven out of ten indicates that language problems are the main
drawbacks for the adoption of assistive technology.

-Acceptance

At its most basic level, culture is identified as shared

understanding, norms, and values in a communal collectivity.
Culture

plays

collaboration

vital

because

role
it

in

has

collective
an

interaction

astounding

impact

and

Figure 1. The cultural model of assistive teclmology design

The

factors of social interaction, self-actualization, verbal and

a.

affect their behavior in different ways that can either quicken

acceptance

of

model

above

is

the

one

which

classifies

the

four

proposed

by

fundamental

economy.

shown that the beliefs and values shared by group members

and

[18]

elements. Those elements are language, living, diversity and

technologies. Previous studies on culture and technology have

application

cultural

Almurayh

nonverbal communication as well as the way people use

the

"Input and output

on

affects interpersonal communication, influencing situational

hinder

"Translation

-Content Agreement

individual behavior and cultural expressions. Culture openly

or

"Appearance

-Change FlelCibility

assistive

LANGUAGE

There are over 7000 different spoken languages around the

technology [12]. The study in [13] indicates that the more the

world [19]. Language classifies an individual in certain group

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2014 IEEE International Symposium on Robotics and Manufacturing Automation

or domain which reflects their culture. Language may cause
hitches in the process of technology adoption as if it was
overlooked [11]. A language cannot be taught without the
grasp of its culture [20].
b.
The

LIVING

lifestyle

of

the

disabled

individual

should

be

considered in designing process as the use of assistive

technology may practice different approach as compared to
the real life situation.

This

may result in the disabled

individual to obstinate from a normal social interaction. Study

has been made [21] to form a behavioral adaptation to the
user's personality and spectrum.
c.

DIVERSITY

In order to succeed in capturing global scale acceptance,

diversity within the culture is also a vital subject to be

considered. Cultural diversity can be identified through belief,

Figure 2. The modified cultural model for Assistive Teclmology design

opinion, faith and thought [22]. Thus, some of the things that
can

be

considered

in

assistive

technology

are

ethics,

The modified model is proposed with additional element,

impressions, solicitude, dialogue, principles, practices and

design which consists of appearance, characteristics, usability

intellectuality [18].
d.

and interface design [24]. As compared to the earlier model,

the aspect of appearance was placed underneath the language

ECONOMY

aspect which is inappropriate as appearance does not reflect

Nevertheless, economical aspect is always prominence as

any lingual problems. Therefore, based on the study [24],

appearance is transferred underneath the new element, design.

assistive technology comes in as a lavish product or service.

Assistive technology is proven to be costly [23]. Individual
with disability may not be able to afford the assistive

Appearance of the assistive technology should be simple,

attractive and most importantly, reflect an added value to

technology on their own due to the high expense treatment,

convince users to buy it. Characteristic of the assistive

service or product.

technology should fit to the need for the treatment. It is closely

However, the lack of study [18] in focus on design or

related to the usability of the assistive technology where

modeling characteristics might cause implication towards the

modeling characteristics of the system output and input would

acceptance of the assistive technology. Regardless that the

either permit or prevent or inhibit a particular user to use it.

research [18] main focus is the visually impaired individuals,

The

it should consider the visual appearance to attract potential

buyers and create aesthetic value within the market as the
buyers does not reflect direct end-user such as the impaired

standard in order to have a convincing impression to the

individual. It might as well be an organization which offers the

performance,

treatment as a service.

procedures [25]. For example, ISO 9946: 1999 described the

assistive

technology

should

also

achieve

certain

market, especially towards the end-user. For instance, setting a

benchmark for standard using ISO in terms of vocabulary,
characteristics,

operational

process

and

guidelines and standards for presentation of characteristics for

IV.

industrial robot. The interface design is needed to ensure the

EXTENDING THE MODEL

attractiveness for the end-user throughout their experience of

As discussed in the previous section, the researchers found

using the assistive technology. An interface design is a general

that in order to attain a global scale acceptance in adoption for

assistive technology for autism treatment, a few alterations

term which expresses the method of interaction between the

users and the assistive technology. For instance, in the study

should be made based on the existing studies and concepts.

done by

Figure 2 illustrates the extended model for cultural model of

Poobrasert and Gestubtim

[10], the interactive

interface design allows a better attention grabber and user

assistive technology design.

friendly approach.
V.

CONCLUSION

As for the conclusion, this paper points out the importance

of cultural consideration for assistive technology design for
autism

treatment.

The assessment

on

past

research

and

assistive maneuvers demonstrates that assistive technology

usage can be restricted as if cultural consideration was
unheeded. The researchers propose an extension on the
existing cultural model for assistive technology design in
regards to adapt to current cultural acceptance for technology.

174

2014 IEEE International Symposium on Robotics and Manufacturing Automation

Likewise,

concern

over

the

expenditure

of

Education (ICEEE), 2013 Second International Conference on , vol., no.,

pp.60,63, 23-25 Sept. 2013 doi: 10.1109IICeLeTE.2013.6644348

assistive

technology is also noteworthy.

[11] Tan Ping Ping; Sharbini, H.; Chiu Po Chan; Julaihi, A.A., "Integration
of cultural dimensions into software localisation testing of assistive
techoology for deaf children," Software Engineering (MySEC), 2011 5th
Malaysian Conference in , vol., no., pp.136,140, 13-14 Dec. 2011 doi:
10.11091MySEC.2011.6140658

ACKNOWLEDGMENT

Due acknowledgement is accorded to the Ministry of

Education (MOE), Malaysia for the fund received through the

[12] Dongsong Zhang ; University of Maryland ; Vogel, D. ; Lowry, P.B.,

Minitack Introduction: Cross-cultural Issues in Collaboration
Techoology,
HICSS 2007. 40th Annual Hawaii International
Conference on System Sciences, 2007. II. doi:10.l109IHICSS.2007.344

Niche Research Grant Scheme (NRGS), [Project File: 600RMIINRGS 5/3 (14/2013)] and to the Research Management
Institute (RMI), Universiti Teknologi MARA (UiTM) for the

[13] Reem Ayouby, Anne Marie Croteau and Louis Raymond, Impact of
CulturalInfluences on Internet Adoption. 2013 46th Hawaii Intemational
Conference
on
System
Science.
2842-2851.
doi: 10.1109IHICSS.2013.258

additional fund in the form of the Principal Support Initiative

(PSI) grant [Project File: 600-RMIIDANA 5/31PSI (76/2013)
and Cumulative Impact Factor Initiatives (CIFI) grant [Project
File: 600-RMIIDANA 5/3/CIFI (13/2013)].

[14] Bobby Swar, Jedong Kim, Duk Hee Lee and Junghoon Moon. Impact of
Culture on Mobile Phone Service Adoption and Diffusion: A Cross
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doi:I0.1109IICCIT.2009.104

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175