Harnessing AI for Inclusive Education and Employment: New possibilities for physical, cognitive and communication access

Introduction

The National Rehabilitation Hospital (NRH) is the specialist complex neurorehabilitation service for Ireland. We work with adults and children who have complex neurological impairments due to acquired brain injury (ABI), spinal cord injuries or limb absence. The NRH assistive technology service explores technology available to support an individual’s communication, leisure, and return to work or education.

Assistive Technology refers to practical tools that enhance independence for people with disabilities and older people. It is

any item, piece of equipment or product system whether acquired commercially, modified or customised that is used to increase, maintain or improve functional capabilities of individuals with disabilities (World Health Organisation & World Bank, 2011).

Assistive technologies (AT) have presented significant equalising opportunities for many to access valued life roles and meaningfully participate in society (Shi et al, 2022). Artificial Intelligence (AI) holds immense promise in transforming education and work environments, particularly for individuals facing cognitive and communication challenges. The assistive technology service at the National Rehabilitation Hospital seeks to exploit these emerging technologies to support individuals with acquired neurological disorders to re-engage with education and work roles.

Returning to employment and education

Persons with disabilities are among the groups of people who are most likely to remain left behind in the context of education and employment. They have lower education achievements and consequently, face disproportionate unemployment (World Health Organisation and World Bank, 2011), depriving societies of an estimated 1.37–1.94 trillion US dollars in annual loss of GDP (Tebbutt et al., 2016). Ireland has one of the lowest employment rates for people with disabilities in the European Union, at 36%, while the average for the EU is 48.1% (Economic and Social Research Institute, 2021). Almost 55% of individuals with an ABI in community rehabilitation reported feeling able to find work, however, only 44% of this group were in employment (Acquired Brain Injury Ireland, 2021). This demonstrates a clear difference between the number of individuals with acquired brain injuries who feel able to work and those who are employed.

Return to work or education is often a crucial part of a person’s neurorehabilitation journey. Assistive Technology can offer value for money in terms of user satisfaction, increased quality of life and cost savings, support people to complete their education and to get and retain employment (O’Donnell et al, 2016). O’Donnell et al (2016)  identified and outlined how access to relevant and appropriate assistive technology can enable an individual with a disability to complete third level education or return to employment thereby actively contributing to the economy. 

Why is digital accessibility so important? According to a Central Statistics Office (CSO) report in 2023 Irish adults spend over 6 hours per day listening to, watching, reading or generally interacting with digital media. Technology is not just for play. We use technology every day to be successful at work, at school and in our lives. Research indicates the valuable role technology plays in reducing social inequality and exclusion (Shi et al, 2022).

We aim to demonstrate, through specific clinical use, cases how technologies including Microsoft Copilot and Otter AI can support individuals with acquired physical, cognitive and communication impairments post acquired brain injury. We hope to highlight the value of integrating these new and emerging technologies alongside existing technologies such as dictation and read aloud functions, in supporting return to education and employment.

Clinical Cases

We present 2 cases to highlight the potential of AI to support those with acquired brain injuries to re-engage with employment.

Case 1: Michael

Michael is a 51-year-old married father of 2 children. He had a left hemisphere stroke which resulted in word finding difficulties and challenging with formulating his thoughts and getting his message across in a clear and organised manner. At the time of his stroke, he worked as a freelance advertising copywriter, a job which he really enjoyed. He attended the NRH assistive technology service 10 months post-onset of his stroke.

Michael’s goals were:

• to be able to write appropriate work emails
• to generate appropriate text for ads

The following AI tools were introduced to support Michael with achieving his goals.

Goblin Tools

Goblin Tools AI is a programme that helps people with various tasks by using artificial intelligence. It can perform functions like writing, editing, or generating content based on what you need. It can act as a digital assistant that can understand and produce information or creative work for you. The Formalizer tool was helpful in allowing Michael to create more concise emails and text using its more to-the-point setting. The thesaurus mode offers single words based on verbal descriptions which was helpful when Michael experienced frustrating word finding difficulties.

Image 1: Goblin Tools app

Microsoft Copilot

Microsoft Copilot within Microsoft Edge browser uses artificial intelligence to provide suggestions, generate content, and automate repetitive tasks. The Compose function allows the user to easily select the tone, format and length of the text that you prompt it to generate. Using this feature, in tandem with inbuilt dictation and the read aloud function on Michael’s computer, allowed him to successfully write appropriate work emails in a timely and efficient manner.

Image 2: Microsoft Copilot 

Audiopen

Audiopen is an app and browser extension designed to simplify the process of converting spoken words into text. It leverages advanced speech-to-text technology to transcribe audio recordings and to convert messy thoughts into clear text. This allows for seemingly disorganised speech and text to be structured and organised into simple, usable content. This tool was beneficial to Michael in helping him to write well-structured, organised text for emails and copy for advertisements. He also used his device’s inbuilt read aloud function to support with proofreading the text he generated.

Image 3: Audiopen app

Case 2: Jane

Jane is a 44-year-old mother of 3 who was 2 years post-onset of a subarachnoid haemorrhage. She reported difficulties with handwriting due to reduced sensation and fatigue as well as challenges with dual tasking and attending to and processing lengthy conversations. Jane worked as a Human Resources executive in a bank which was a busy and demanding role. She was exploring returning to her job and reported concerns in relation to note-taking for meetings.

Jane’s goals were:

• to be able to take notes effectively and efficiently in meetings
• to manage her fatigue levels in the work environment

The following AI tools were introduced to support Jane with achieving her goals.

Otter AI

Otter AI is a tool that helps you take notes during meetings or interviews. It listens to conversations and turns them into written text automatically along with keyword summaries. It allows for audio recording and can generate a 30 second summary. It can also identify different speakers and allows you to organise and search through the notes later. If used in a meeting, you can easily review the transcript afterwards, share it with your colleagues who couldn’t attend, and highlight important action items without having to sift through handwritten notes. For Jane, Otter AI reduced the cognitive burden of note taking and reduced fatigue in the work environment. As with any audio recording or transcription tool consent to use it is required from all involved and data protection and privacy need to be considered in line with any employer policies and guidelines.

Image 4: Otter AI 

Conclusion

AI has become ever more prevalent in our lives, with potential to make tasks easier for all. This has implications for those with disabilities which might impact their potential to obtain or retain employment. For those with disabilities, this new frontier in technology may further level the playing field in terms of what is possible. Consideration certainly needs to be given to the potential for bias and errors as well as ethics and data protection requirements when using AI tools to assist with any task.

Selective implementation of AI technologies, focusing on personalised assistance and cognitive support while maintaining safeguards against potential drawbacks is key. This approach leverages AI's strengths, such as enhanced organisation, improved communication capabilities, and productivity increases, which can significantly aid in navigating workplace challenges. However, it is crucial to remain aware of the risks associated with over-reliance on technology and ensure that the individual continues to develop their skills and coping strategies. Additionally, measures should be taken to address privacy concerns and ensure consistent effectiveness of the AI tools to support the employee's unique needs fully. When used judiciously AI can be beneficial in enhancing the ability of individuals with ABI to regain independence and productivity in their professional lives.

For most people, technology makes things easier. But for people with disabilities, technology makes things possible. Mary Pat Radabaugh, Director of IBM National Support Center for Persons with Disabilities, 1988.