Helping or Hindering: Inclusive Design of Automated Task Prompting for Workers with Cognitive Disabilities.

Of the ∼8.8 million working-age adults with cognitive disabilities in the United States, only 28.6% are employed, contributing to a poverty rate (26.1%) for people with cognitive disabilities (PwCDs) that is more than twice that for people without disabilities. PwCDs who are employed are often still marginalized via reduced hours and pay, largely due to their more limited capability to perform work efficiently and independently. As evidence, warehouse and shelf stocking jobs that serve as employment for a significant percentage of PwCDs, often require frequent intervention from a job coach in the workplace, impacting the pay and self-esteem of these workers. This study's objective was to remove barriers to employment for PwCD through inclusive design of technology supports in warehouse and similar settings. Specifically, a nonlinear context-aware prompting system (NCAPS) was developed, iteratively refined, and tested. In a pilot crossover study, subjects with cognitive disabilities participated in simulated work sessions, picking orders in a small warehouse environment using the NCAPS and industry standard paper tickets. Their performance was assessed in terms of errors and productivity, and their insights and perspectives were gathered. The resulting NCAPS prevented or corrected all errors for all but one participant. It also increased productivity for participants with the poorest baseline (paper ticket) performance, but decreased productivity for those with high baseline performance. No significant difference was observed in system usability scale (SUS) scores between methods. Topics emerging from user input highlighted the need for technological supports for PwCD to be simple and flexible in operation, and reliable to maintain user trust. By prioritizing robustness and intuitiveness, flexible technology supports can be developed to empower workers with a broad range of abilities, including those with temporary and situational impairments. Such tools would reduce barriers to employment, including stigma, discrimination, and other barriers to equity.