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This paper presents key aspects and trade-offs that designers and Human-Computer Interaction practitioners might encounter when designing multimodal interaction for older adults. The paper gathers literature on multimodal interaction and assistive technology, and describes a set of design challenges specific for older users. Building on these main design challenges, four trade-offs in the design of multimodal technology for this target group are presented and discussed. To highlight the relevance of the trade-offs in the design process of multimodal technology for older adults, two of the four reported trade-offs are illustrated with two user studies that explored mid-air and speech-based interaction with a tablet device. The first study investigates the design trade-offs related to redundant multimodal commands in older, middle-aged and younger adults, whereas the second one investigates the design choices related to the definition of a set of mid-air one-hand gestures and voice input commands. Further reflections highlight the design trade-offs that such considerations bring in the process, presenting an overview of the design choices involved and of their potential consequences.

The paper presents the design of an assistive reading tool that integrates read-aloud technology with eye-tracking to regulate the speed of reading and support struggling readers in following the text while listening to it. The paper describes the design rationale of this approach, following the theory of auditory-visual integration, in terms of an automatic self-adaptable technique based on the reader's gaze that provides an individualized interaction experience. This tool has been assessed in a controlled experiment with 20 children (aged 8-10 years) with a diagnosis of dyslexia and a control group of 20 children with typical reading abilities. The results show that children with reading difficulties improved their comprehension scores by 24% measured on a standardized instrument for the assessment of reading comprehension, and that children with more inaccurate reading (N=9) tended to benefit more. The findings are discussed in terms of a better integration between audio and visual text information, paving the way to improve standard read-aloud technology with gaze-contingency and self-adaptable techniques to personalize the reading experience.

Joint narratives are often used in the context of reconciliation interventions for people in social conflict situations, which arise, for example, due to ethnic or religious differences. The interventions aim to encourage a change in attitudes of the participants towards each other. Typically, a human mediator is fundamental for achieving a successful intervention. In this work, we present an automated approach to support remote interactions between pairs of participants as they contribute to a shared story in their own language. A key component is an automated cognitive tutor that guides the participants through a controlled escalation/de-escalation process during the development of a joint narrative. We performed a controlled study comparing a trained human mediator to the automated mediator. The results demonstrate that an automated mediator, although simple at this stage, effectively supports interactions and helps to achieve positive outcomes comparable to those attained by the trained human mediator.

Poor lifestyle represents a health risk factor and is the leading cause of morbidity and chronic conditions. The impact of poor lifestyle can be significantly altered by individual behavior change. Although the current shift in healthcare towards a long lasting modifiable behavior, however, with increasing caregiver workload and individuals' continuous needs of care, there is a need to ease caregiver's work while ensuring continuous interaction with users. This paper describes the design and validation of CoachAI, a conversational agent assisted health coaching system to support health intervention delivery to individuals and groups. CoachAI instantiates a text based healthcare chatbot system that bridges the remote human coach and the users. This research provides three main contributions to the preventive healthcare and healthy lifestyle promotion: (1) it presents the conversational agent to aid the caregiver; (2) it aims to decrease caregiver's workload and enhance care given to users, by handling (automating) repetitive caregiver tasks; and (3) it presents a domain independent mobile health conversational agent for health intervention delivery. We will discuss our approach and analyze the results of a one month validation study on physical activity, healthy diet and stress management.

Building conversational agents have many technical, design and linguistic challenges. Other more complex elements include using emotionally intelligent conversational agent to build trust with the individuals. In this chapter, we introduce the nature of conversational user interfaces (CUIs) for health and describe UX design principles informed by a systematic literature review of relevant research works. We analyze scientific literature in conversational interfaces and chatterbots, providing a survey of major studies and describing UX design principles and interaction patterns.