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Cited by 5Assistive Technology in Communication and MobilityTechnology Use by Older AdultsTechnology Adoption and User Behaviour

Use and acceptance of voice assistants among people with aphasia in Germany

Open access
Núñez Macías, Naizeth, Hielscher-Fastabend, Martina, Buschmeier, Hendrik·2023·Frontiers in Communication
DOI 10.3389/fcomm.2023.1176475
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Abstract

Aphasia is an acquired disorder that affects the ability to communicate. The increasing availability of voice assistants (such as Amazon Alexa or Google Assistant) provides new opportunities to support people with aphasia in a variety of tasks, from everyday communication to speech and language therapy exercises. To ensure accessibility and acceptance, it is important to involve people with aphasia in the development process. Using the Unified Theory of Acceptance and Use of Technology (UTAUT2) as a theoretical framework, this study examines their willingness to use voice assistants and explores which potential applications they consider useful for participation in social and cultural contexts. These questions were addressed through a survey. Eight people with aphasia took part in the study. Although the sample size does not allow for statistical analysis, the results provide valuable insights for further research. Most of the participants showed a general interest in using voice assistants, two of them were already users. The presence of physical limitations motivates the use of speech-based technology. Participants who already used voice assistants saw them as a practical support in everyday life, while non-users had lower expectations in this respect. Social influence was found to play an important role. Participants' perceptions of privacy and data security issues varied and do not allow for generalization. Finally, some participants showed a preference for communication support applications (e.g., word finding, sentence formation, grammar support) over applications used for therapy exercises such as word training.

AI snapshot

Written from the paper’s full text.

TL;DR

This survey study used an adapted UTAUT2 framework to examine how eight people with aphasia in Germany perceive and accept commercial voice assistants, two of whom were already users. Although the small sample precludes statistical analysis, users saw voice assistants as practical everyday support, social influence mattered, and communication-support applications were often preferred over therapy-exercise applications.

Key findings

  • Of 8 participants (3 male: A1–A3; 5 female: A4–A8), 2 (A4, A5) used voice assistants at the time of the survey; all had internet access and at least one internet-enabled device (computer/laptop n = 8, smartphone n = 7, tablet/iPad n = 3, smart TV n = 2). None had used voice assistants before their aphasia, and only A4 and A7 had used a therapy app.
  • Users A4 and A5 rated all proposed voice-assistant applications positively, while non-users’ ratings ranged from very positive to very negative. Some participants preferred communication-support applications (word finding, sentence formation, grammar support) over therapy applications such as word training; three participants (A1, A4, A5) considered replacement of speech therapy by voice assistants possible.
  • Social influence played an important role: both users had family or friends who used and recommended voice assistants and who supported their technology use; among non-users, only A7 knew people who used voice assistants, and they had not recommended them.
  • Physical limitations motivated speech-based technology use: both users and one non-user reported physical limitations that made mobile device use difficult. Views on privacy and data security varied and did not allow generalization, and four participants reported voice assistants being too expensive for them.

Methods

  • An online questionnaire was created with EFS Survey Software Unipark and approved by Bielefeld University’s ethics committee (reference no. 2021-222). It was distributed via self-help groups, the Stiftung Deutsche Schlaganfall-Hilfe, the Aphasia 4.2 Online Congress, and cooperating clinicians; data collection ran March–June 2022, with one telephone completion and two paper completions in October 2022.
  • Participants were 8 people with aphasia in Germany, regardless of current voice-assistant use. Age was reported in groups: 36–50 years (A1, A4, A5, A6), 51–65 years (A2, A3), and 66–80 years (A7, A8). A2 did not complete the survey, but available responses were analyzed.
  • The questionnaire contained 49–53 questions, mostly 5-point Likert items, mapped to the adapted UTAUT2 determinants: performance expectancy, effort expectancy, social influence, facilitating conditions, price value, habit, data security, connectivity, and relationship with the device. Responses were compiled into tables and analyzed by grouping participants into profiles and individual attitudes, preferences, or usage patterns rather than by statistical testing.

Limitations

  • Stated: the low participation rate does not allow statistical conclusions; COVID-19 restrictions limited in-person contact; some self-help groups did not forward the questionnaire due to assumptions about members’ age or lack of voice-assistant use; and the questionnaire was overwhelming for people with aphasia, especially online without researcher help. A2 likely interrupted because of difficulties answering questions, and only one participant contacted researchers for help.
  • Stated: the study could not explore the motivation behind Likert-scale evaluations, such as data-security/privacy concerns or the statement that voice assistants could replace speech and language therapy. The online survey also excluded people without internet-enabled devices or those limited in keyboard use by physical or visual impairments.
  • Evident: the sample of eight, mostly online recruitment, and single-country/culture focus limit generalizability; the authors note future research should adapt survey methods to participants’ preferences and extend the work to other languages and cultures.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.3389/fcomm.2023.1176475

Cites

26 of 26 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 37 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    Social influence plays an important role in the use of voice assistants by people with aphasia.

    “Social influence was found to play an important role.”
    Quote in the paperSubstantial claim
  • Findingown data

    Participants' perceptions of privacy and data security issues varied.

    “Participants' perceptions of privacy and data security issues varied and do not allow for generalization.”
    Quote in the paperSubstantial claim
  • Findingown data

    Two participants were already users of voice assistants at the time of the survey.

    “two of them were already users.”
    • Also stated in: § . Materials and methods · plain
      “Two participants (A4, A5) reported using voice assistants at the time of the survey.”
    Quote in the paperNot a substantial claim
  • Findingown data

    Some participants preferred communication support applications over therapy exercise applications.

    “some participants showed a preference for communication support applications (e.g., word finding, sentence formation, grammar support) over applications used for therapy exercises such as word training.”
    Quote in the paperNot a substantial claim
  • Findingown data

    Most participants showed a general interest in using voice assistants.

    “Most of the participants showed a general interest in using voice assistants”
    Quote in the paperSubstantial claim
  • May combine two claims. 52
  • Classified as probably not a substantial claim. 35

  • May combine two claims.

    Findingown data

    Participants who already used voice assistants saw them as a practical support in everyday life, while non-users had lower expectations in this respect.

    “Participants who already used voice assistants saw them as a practical support in everyday life, while non-users had lower expectations in this respect.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    A4 and A5 both have someone in their environment who has already used a voice assistant and recommended it to them, as well as someone who supports them in using technology.

    “A4 and A5 are unique in that they both have someone in their environment (family or friends) who has already used a voice assistant and recommended it to them, as well as someone who supports them in using technology.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    All participants reported having an internet connection and at least one internet-enabled device at home.

    “All participants reported having an internet connection and at least one internet-enabled device at home: Computer or laptop (n = 8), smartphone (n = 7, except for A1), tablet or iPad (n = 3), or smart TV (n = 2).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    A4 and A5 rated all proposed applications positively, whereas non-users' opinions ranged from very positive to very negative.

    “A4 and A5 rated all of the proposed applications positively, whereas the opinions of the participants who did not use voice assistants ranged from very positive to very negative.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Both A4 and A5 indicated that physical limitations make it difficult for them to use mobile devices.

    “In addition, both participants indicated that physical limitations make it difficult for them to use mobile devices.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingnone given

    Concerns about data security are partially present for A5, but not for A4.

    “Concerns about data security are partially present for A5, but not for A4.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    A3, A6, and A8 showed interest to use voice assistants at home in the future.

    “A3, A6, and A8 showed interest to use voice assistants at home in the future.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Non-users reported willingness to use functions: timer (n=3), reminder (n=4), call (n=1), listening to radio (n=3), audio books (n=2), controlling TV (n=1), lights (n=2), weather (n=2), addresses (n=3), texting (n=2), jokes (n=2).

    “Non-users reported willingness to use following functions: timer (n = 3), reminder (n = 4), call (n = 1), listening to the radio (n = 3), listening to audio books (n = 2), controlling TV (n = 1), controlling lights (n = 2), asking for the weather (n = 2), asking for addresses (n = 3), texting (n = 2), and asking for jokes (n = 2).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    A positive view on the potentials of voice assistants was found in the answers of even some people with aphasia, in accordance with Qiu and Abdullah (2021).

    “In accordance with Qiu and Abdullah (2021), a positive view on the potentials of voice assistants was found in the answers of even some people with aphasia.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Qiu and Abdullah (2021)

      Not checked in the free run.

  • May combine two claims.

    Findingown data

    A1 and A2 reported having concerns about data security, whereas A3 and A7 were neutral and A6 rejected having such concerns.

    “A1 and A2 reported having concerns about data security, whereas A3 and A7 were neutral about it and A6 rejected having such concerns.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Participants who were already users of voice assistants evaluated all proposed applications positively, while non-users' assessments ranged from very positive to very negative.

    “Additionally, we found that the participants who were already users of voice assistants evaluated all the proposed applications positively, while the assessment of non-users ranked from very positive to very negative.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    A1 and A2 affirmed finding it weird to talk to a machine, whereas A3, A6, and A7 rejected this statement. Only A8 found the idea amusing.

    “A1 and A2 affirmed finding it weird to talk to a machine, whereas A3, A6, and A7 rejected this statement.Only A8 found the idea of talking to a machine amusing.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    People with aphasia who already used voice assistants perceived them as a good support in everyday life, while people with aphasia without experience with voice assistants had low expectations in this regard.

    “We found that people with aphasia who already used voice assistants perceived them as a good support in everyday life, while people with aphasia without experience with voice assistants had low expectations in this regard.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    The participants who were already users of voice assistants reported different perceptions toward the difficulty of use; one perceived it as easy while the other was neutral about it, yet both perceived the voice assistant as a good support in everyday life.

    “The participants who were already users of voice assistants reported different perceptions toward the difficulty of use.One of them perceived it as easy while the other was neutral about it.Yet both perceived the voice assistant as a good support in everyday life.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingreasoning

    Users see the voice assistant only partly as a motivation to improve their language, whereas non-users showed very different opinions.

    “Nevertheless, users see the voice assistant only partly as a motivation to improve their language, whereas non-users showed very different opinions.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Users indicated that difficulties with writing and the possibility of asking for help without feeling ashamed were a motivation for using voice assistants.

    “Users indicated that difficulties with writing and the possibility of asking for help without feeling ashamed were a motivation for using voice assistants.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    A4 and A5 (both women, 36-50 years old) were users of voice assistants and evaluated all proposed use cases positively, whereas A1 (male, 36-50) did not use voice assistants and rejected being interested in the proposed applications.

    “A4 and A5 (both women, 36-50 years old) were users of voice assistants and evaluated all proposed use cases positively, whereas A1 (male, 36-50) did not use voice assistants and rejected being interested in the proposed applications.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Findingown data

    The same participant also reported having concerns about data security and not owning a smartphone.

    “The same participant also reported having concerns about data security and not owning a smartphone.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    A1 showed no interest in using voice assistants in the future and did not own a smartphone.

    “It should be noted that A1 showed no interest in using voice assistants in the future and did not own a smartphone, which could be interpreted as a general cautiousness toward the use of AI-based technology.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    One participant reported being highly interested in new technologies but was not willing to use voice assistants in the future.

    “Nevertheless, one participant reported being highly interested in new technologies but was not willing to use voice assistants in the future.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    The second user reported having difficulties writing, resulting in a greater reliance on speech-based technology.

    “In this case, the second user reported having difficulties writing, resulting in a greater reliance on speech-based technology.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The assessment of participants' own technology competence and the frequency with which they ask for help was highly variable among participants.

    “The assessment of their own technology competence and the frequency with which they ask for help was highly variable among participants.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    A general interest in technologies or a high self-assessment of technology affinity usually went hand in hand with a higher openness to voice assistants.

    “It was found that a general interest in technologies or a high self-assessment of technology affinity usually went hand in hand with a higher openness to voice assistants.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Only one participant was enthusiastic about the idea of talking to a machine, while others found this to be a strange idea or were neutral about it.

    “Only one participant was enthusiastic about the idea of talking to a machine, while others found this to be a strange idea or were neutral about it.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The participants who were users of voice assistants reported using them several times per day for a variety of functions, which denotes a strong habit.

    “The participants who were users of voice assistants reported using them several times per day for a variety of functions, which denotes a strong habit.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    One of the non-users reported knowing people who used voice assistants, however, they had not recommended the person with aphasia to do so.

    “One of the non-users reported knowing people who used voice assistants, however, they had not recommended the person with aphasia to do so.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    For some participants privacy concerns are a reason for not using voice assistants, while for other participants these concerns are only partial or non-existent.

    “While for some participants these sort of concerns are a reason for not using voice assistants, for other participants these are only partial or non-existent.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    One of the non-users reported having such difficulties and being interested in using voice assistants in the future.

    “Similarly, one of the non-users reported having such difficulties and being interested in using voice assistants in the future.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Users knew someone in their environment that was able to provide help in dealing with technology, while this was not always the case with non-users.

    “In addition to that, users knew someone in their environment that was able to provide help in dealing with technology, while this was not always the case with non-users.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    All participants had access to internet and to internet-enabled devices, yet only two out of eight participants were using voice assistants at the time of the survey.

    “All participants had access to internet and to internet-enabled devices, yet only two out of eight participants were using voice assistants at the time of the survey.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingnone given

    The participants who already used voice assistants also had family or acquaintances who used them and who recommended using them.

    “The participants who already used voice assistants also had family or acquaintances who used them and who recommended using them.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    One participant who answered the questionnaire on paper with researcher support expressed being particularly overwhelmed with a set of questions that used a Likert scale, and skipped these questions.

    “One of the participants who answered the questionnaire on paper with the support of one of the researchers expressed being particularly overwhelmed with a set of questions that used a Likert scale.In this case, the participant skipped these questions and continued answering the questionnaire.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Conversational agents are an alternative for older users and users with lower computer and smartphone literacy.

    “Olafsson et al. (2021) found that even though traditional tap and swipe user interfaces are often preferred over conversational interfaces for tasks under time pressure and for quick transactional tasks, conversational agents are an alternative for older users and users with lower computer and smartphone literacy.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Olafsson et al., 2021 source

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  • Probably not a substantial claim: may not pass S1 (asserted), S3 (load-bearing), S4 (based). May combine two claims.

    Premisecitation

    The National Aphasia Association recommends the use of commercial voice assistants, highlighting that such systems never tire.

    “The National Aphasia Association in the United States recommends the use of commercial voice assistants, highlighting the advantage that such systems never tire (National Aphasia Association, 2022).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites National Aphasia Association, 2022

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  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Voice assistants such as Alexa and Google Assistant provide access to their APIs, opening up the possibility of developing custom applications.

    “Voice assistants such as Alexa and Google Assistant provide access to their application programming interfaces (APIs), opening up the possibility of developing custom applications (Hoy, 2018;Coates, 2019;Walls, 2022).”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites Hoy, 2018 source

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    • cites Coates, 2019

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    • cites Walls, 2022

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    Premisecitation

    Functions such as reminders, Smart Home applications, infotainment, communication, health documentation, and managing shopping, to-do lists, or structuring the day can optimize the quality of life of people with physical, cognitive, and language or speech impairments and give them a sense of independence.

    “Functions such as reminders (Hellwig et al., 2018;Malapaschas, 2021), Smart Home applications, infotainment, communication (calls and messages; Hellwig et al., 2018), health documentation (Hellwig et al., 2018;Zhang et al., 2023), and managing shopping, to-do lists (Pradhan et al., 2018), or structuring the day (Kopp et al., 2018) can optimize the quality of life of people with physical, cognitive”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites Hellwig et al., 2018

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    • cites Malapaschas, 2021

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    • cites Zhang et al., 2023 source

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  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    The Tavistock Trust For Aphasia recommends the use of voice assistants and lists use cases such as practicing everyday phrases and simple conversations.

    “In Europe, The Tavistock Trust For Aphasia, a UK-based organization, also recommends the use of voice assistants and lists use cases such as practicing everyday phrases and simple conversations (Aphasia Software Finder, 2022).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Aphasia Software Finder, 2022

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  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Technology offers the advantage of never getting bored and potentially reducing feelings of shame about the language disorder.

    “Beals et al. (2016) highlight that technology offers the advantage of never getting bored and potentially reducing feelings of shame about the language disorder.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Beals et al., 2016

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  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The accuracy of speech recognition in a prototype Amazon Alexa skill for children with autism was insufficient for use in a clinical setting.

    “Allen et al. (2018) found that the accuracy of the speech recognition was insufficient for use in a clinical setting.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Allen et al., 2018 source

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    Premisecitation

    Family members of people with speech and language impairments perceived an improvement from interacting with voice assistants.

    “Their analysis of reviews of the Amazon Alexa Echo Show device showed that family members of people with speech and language impairments perceived an improvement from interacting with voice assistants.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Pradhan et al., 2018 source

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  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    When speech recognition succeeded and images were successfully retrieved, children with autism consistently followed the target directive.

    “However, when the speech recognition succeeded and the images were successfully retrieved, the participants (children with autism) consistently followed the target directive.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Allen et al., 2018 source

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  • Classified as probably not a substantial claim. May combine two claims.

    Interpretationcitation

    These studies suggest that voice assistants can be used as an assistive technology and increase participation in everyday life.

    “These studies suggest that voice assistants can be used as an assistive technology and increase participation in everyday life.”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites Masina et al., 2020 source

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    • cites Malapaschas, 2021

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  • May combine two claims.

    Premisecitation

    People with speech and language impairments are using voice assistants despite lower performance.

    “Despite lower performance, Pradhan et al. (2018) found that people with speech and language impairments are using voice assistants.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Pradhan et al., 2018 source

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  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    The study of Yu et al. (2018) reported a higher accuracy in retrieving visual content and an overall positive response by speech and language therapists.

    “The study of Yu et al. (2018) reported a higher accuracy in retrieving visual content and an overall positive response by the participants (speech and language therapists).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Yu et al., 2018

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  • Probably not a substantial claim: may not pass S1 (asserted), S2 (checkable).

    Premisecitation

    People with speech and language disorders can benefit enormously from the use of speech technology.

    “Opinion articles emphasize that people with speech and language disorders can benefit enormously from the use of speech technology, e.g., by providing a higher degree of participation and independence (Corcoran, 2018) or by making speech therapy more accessible (Kevin Wheeler, 2020), and criticize that this target group has not been taken into account in the design of the technology.”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Corcoran, 2018

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    • cites Kevin Wheeler, 2020

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  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given

    Data collection was anonymous and no compensation was offered.

    “Data collection was anonymous and no compensation was offered.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    A2 did not complete the survey, but their available responses are analyzed.

    “A2 did not complete the survey, but their available responses are analyzed in this study (as this was an online questionnaire, the reason for the interruption is unknown to the authors).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    The study was reviewed and approved by the internal ethics committee of Bielefeld University.

    “The study was reviewed and approved by the internal ethics committee of Bielefeld University (reference no. 2021-222).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based). May combine two claims.

    Interpretationreasoning

    The participants did not know about or did not consider the possibility of using voice assistants through devices they already own.

    “It can be inferred that the participants did not know about or did not consider the possibility of using voice assistants through devices they already own, e.g., smartphones and computers.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Interpretationown data

    A rejection of using the voice assistant as a tool for therapy may be related to a lack of knowledge about technological possibilities or to a preference for traditional therapy methods, given that only two participants had prior experience with other therapy apps.

    “It should be noted though that only two participants had prior experience with other therapy apps, which leads to the possibility that a rejection of using the voice assistant as a tool for therapy is related to a lack of knowledge about the technological possibilities or to a preference of traditional therapy methods.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductown data

    The study's low number of participants does not allow for a statistical evaluation, though the data provides insights usable as a reference for future research.

    “The rather low number of participants does not allow for a statistical evaluation, nevertheless, the data provides insights that can be used as a reference for future research.”
    • Also stated in: § . . Limitations and future directions · plain
      “A limitation of the study is the rather low participation rate, which does not allow us to draw statistical conclusions.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Interpretationreasoning

    The positive experience of A4 and A5 with voice assistants may have led to a higher trust in the capabilities of voice assistants, and therefore to the belief that such devices could replace traditional speech and language therapy.

    “On the other hand, the positive experience of A4 and A5 with voice assistants may have led to a higher trust in the capabilities of voice assistants, and therefore to the belief that such devices could be able to replace traditional speech and language therapy.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Interpretationreasoning

    Users may show a high acceptance of voice assistants in spite of facing difficulties with speech recognition, as long as the technology still offers an advantage over other technologies.

    “It is therefore possible that users may show a high acceptance of voice assistants in spite of facing difficulties with speech recognition, as long as the technology still offers an advantage over other technologies.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationcitation

    Voice assistants may have high potential as an assistive technology because people with aphasia can make use of such systems in spite of and not because of the language impairment, which makes the technology less stigmatizing than other assistive technologies.

    “This may also suggest a high potential of voice assistants as an assistive technology, since people with aphasia can make use of such system in spite and not because of the language impairment, which makes the technology less stigmatizing than other assistive technologies (Masina et al., 2020).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Masina et al., 2020 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationreasoning

    A1's lack of interest and lack of smartphone could be interpreted as a general cautiousness toward the use of AI-based technology.

    “which could be interpreted as a general cautiousness toward the use of AI-based technology.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S4 (based).

    Interpretationreasoning

    This lack of knowledge is expected to be related to the perceived difficulty of use.

    “This lack of knowledge is expected to be related to the perceived difficulty of use.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductown data

    The study did not gather information regarding knowledge about the price of smart speakers.

    “Nevertheless, we did not gather information regarding the knowledge about the price of smart speakers.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Another possible reason for the low participation rate is that the questionnaire was overwhelming for people with aphasia, particularly given that participants were sitting in front of an internet-enabled device without being able to ask the researchers for help.

    “Another possible reason for the low participation rate is that the questionnaire was overwhelming for people with aphasia, particularly given that participants were sitting in front of an internet enabled device without being able to ask the researchers for help.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductown data

    Because most answers were gathered via an online survey, the study was unable to reach participants who did not have access to internet-enabled devices, limiting information about their perceptions.

    “Since most of the answers were gathered via an online-survey, we were unable to reach out to participants who did not have access to such devices, which would have given us some information about the perceptions of people with aphasia who either have no access to the internet, do not feel able to use internet-enabled devices or decided against using them.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationown data

    The existence of physical limitations that make it difficult to use keyboards or touchscreen displays seems to increase openness to voice-based control and thus to voice assistants, emphasizing the potential of voice assistants as an assistive technology.

    “The existence of physical limitations that make it difficult to use keyboards or touchscreen displays seems to increase openness to voice-based control and thus to voice assistants, which emphasizes the potential of voice assistants as an assistive technology.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationreasoning

    The compatibility of the voice assistant with devices they already own may be an important factor for users.

    “This could indicate that the compatibility of the voice assistant with the devices they already own is an important factor for them.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductown data

    Some self-help groups did not forward the online questionnaire to their members due to assumptions that there would be no interest in the topic due to members' age and that participation would not be helpful because members were not using voice assistants yet.

    “Another difficulty was that some self-help groups did not forward the online questionnaire to their members, due to two assumptions: (1) there would be no interest in the topic of voice assistants due to members' age, and (2) participation would not be helpful for the study, because members were not using voice assistants, yet.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Premisecitation

    Relatives play a crucial role in increasing the participation of people with aphasia.

    “because relatives play a crucial role in increasing the participation of people with aphasia (Schneider et al., 2021).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Schneider et al., 2021 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The survey was limited in that it was not possible to explore the motivation behind the Likert scale evaluations, such as concerns regarding data security and privacy or the statement that voice assistants could replace speech and language therapy.

    “The conducted survey is also limited in that it was not possible to explore the motivation behind the Likert scale evaluations, such as the concerns regarding data security and privacy or the statement that voice assistants could replace speech and language therapy.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductreasoning

    People without access to internet-enabled devices and people limited in their use of keyboards due to physical or visual impairments could not participate in the study due to the online survey method.

    “Additionally, people without access to internet-enabled devices as well as people who are limited in their use of keyboards due to physical or visual impairments could not participate in the study due to the chosen method (online survey).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Only one participant contacted the researchers and asked for help in answering the questionnaire, which was provided through a telephone call.

    “Only one participant contacted the researchers and asked for help in answering the questionnaire, which was provided through a telephone call.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    People with aphasia would prefer an interaction with a maximum of five to six questions from the voice assistant.

    “It was shown that people with aphasia would prefer an interaction with a maximum of five to six questions from the voice assistant.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Núñez Macías, 2022

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The Master's thesis investigated the requirements posed by people with aphasia to a voice application such as an Amazon Alexa skill that provides support in searching for words.

    “The Master's thesis also investigated the requirements posed by people with aphasia to a voice application such as an Amazon Alexa skill that provides support in searching for words.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Núñez Macías, 2022

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

    Premisecitation

    The supported words should cover as many topics and be as specific as possible, and, optionally, provide visual support.

    “The supported words should cover as many topics and be as specific as possible, and, optionally, provide visual support (Núñez Macías, 2022).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Núñez Macías, 2022

      Not checked in the free run.

69 of 69

  • The authors state this as an assumption.

    No prior research exists on the attitudes and barriers that people with aphasia face when interacting with voice assistants.

    “To our knowledge, there are currently no studies on the attitudes and barriers that people with aphasia face when interacting with voice assistants, which are digital assistants that are primarily voice controlled.”
    “Previous research has analyzed the acceptance factors influencing the adoption of digital assistants by older people (Koon et al., 2020), but to our knowledge there is no research on the acceptance of such systems by people with aphasia.”

  • The authors state this as an assumption.

    A2 interrupted the survey because of difficulties answering the questions.

    “We can assume that A2 interrupted the survey because of difficulties answering the questions (in the online version of the questionnaire it was not possible to skip questions).”
2 of 2

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • In 2019, Amazon's Alexa was criticized for not being accessible to people with disabilities; its responses were not always clear or understandable, and its features were not always compatible with screen readers.

    “For instance, in 2019, Amazon's Alexa was criticized for not being accessible to people with disabilities.The voice assistant's responses were not always clear or understandable, and the assistant's features were not always compatible with screen readers [107].”

    From Ethical Framework for Harnessing the Power of AI in Healthcare and Beyond (2024) · cites this paper as [107]

Cites

Flagged first, then by citations

Research works printed but not linked: 14

  1. Coates, 2019, Voice Applications for Alexa and Google Assistant
  2. Hellwig, 2018, Sprachassisten in der Ambulanten Pflege: Ein Leitfaden für den Einsatz von Voice User Interfaces am Beispiel der Kommerziellen Sprachassistenzsysteme Amazon Echo und Google Home für Senioren und Pflegekräfte
  3. Kessler, 2017, How do potential users perceive the adoption of new technologies within the field of Artificial Intelligence and Internet-of-Things
  4. Klöß, 2021, Die Zukunft der Consumer Technology-2021
  5. Kopp, 2018, “Conversational assistants for elderly users –the importance of socially cooperative dialogue,”, 10
  6. 2022, Siri und der Sprachfehler: Apples Assistent soll Toleranter Werden
  7. Malapaschas, 2021, Voice assistants for people with cognitive impairments due to acquired brain injury
  8. Malchus, 2013, Einsatz Sozialer Roboter in der Sprachtherapie
  9. Nasirian, 2017, “AI-based voice assistant systems: evaluating from the interaction and trust perspectives,”
  10. Núñez Macías, 2022, Nutzung und Akzeptanz von Sprachassistenten bei Menschen mit einer Aphasie
  11. Paulsen, 2020, Beliebte Helfer: Sprachassistenten haben sich durchgesetzt
  12. Walls, 2022, “Build talking apps: develop voice-first applications for Alexa,”
  13. 2001, International Classification of Functioning, Disability and Health: ICF
  14. Yaghoubzadeh, 2015, “Socially cooperative behavior for artificial companions for elderly and cognitively impaired people,”, 15

Cited by

Sorted by citations

Related

Authors
Núñez Macías, N., Hielscher-Fastabend, M., & Buschmeier, H.
Affiliations
Bielefeld University (DE)
Corresponding author
Buschmeier, Hendrik
ORCID
Buschmeier, Hendrik
Venue
Frontiers in Communication
Publisher
Frontiers Media SA
Published
2023-06-20
Volume
8
ISSN
2297-900X (ISSN-L)
DOI
10.3389/fcomm.2023.1176475
OpenAlex
W4381436649
Semantic Scholar
6f4f9035956d5768fd9bbfbed4eb5f1a5283e8da
Cited by
5
References
26
Citations by year
2026: 3 · 2025: 1 · 2024: 1
FWCI
2.49
Type
journal article
Language
en
Open access
Licence
Locations
  • Frontiers in Communication (publishedVersion, cc-by)
  • Opin vísindi (Opin vísindi) (submittedVersion, cc-by-nc-sa)
  • Publikationen an der Universität Bielefeld (Universität Bielefeld) (submittedVersion, cc-by)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
  • Deutsche Forschungsgemeinschaft
  • Universität Bielefeld
Topics
  • Health Sciences › Health Professions › Occupational Therapy › Assistive Technology in Communication and Mobility
  • Social Sciences › Demography › Technology Use by Older Adults
  • Social Sciences › Decision Sciences › Information Systems and Management › Technology Adoption and User Behaviour
Keywords
aphasia, voice assistants, technology acceptance, UTAUT2, communication support, speech therapy, privacy concerns, data security, social influence, user preferences, assistive technology

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-09.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-09.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

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