1 AI and people with disabilities

3 Author: Evelia Gil Paredes*

5 Postgraduate Institute

6 University of Cordoba. Avda. Medina Azahara, 5. 14005 -Córdoba. Spain.

8 *corresponding author:

9 Evelia Gil Paredes

10 Phone: +34 615548711

12 e-mail: l82gipae@uco.es

13

14 Mailing address:

15 Postgraduate Institute

16 University of Cordoba. Avda. Medina Azahara, 5. 14005 -Córdoba. Spain.

17

18 Abstract

19 The development of new technologies has led to progress in all areas of human life, fostering the
20 development and increasing of the quality of people's lives from different social groups. Medicine
21 is one of the areas where technology has been highly successful due to the great development that
22 has brought, especially artificial intelligence (AI), a field of computer science that embraces logic
23 and learning, creating computer tools which learn and act like humans by using a set of rules and
24 parameters, the algorithms, an ordered set of systematic operations that allows a calculation to be
25 made and the result of the solution of a type of problem to be found. The AI is also capable of
26 learning through input and output of both positive and negative stimuli – like the human brain
27 function – which allows them to " take decisions " on certain specific situations. This makes it a
28 useful and valuable instrument in the bio-health field; on the one hand, it becomes an important
29 ally for the healthcare sector, its personnel and patients thanks to the numerous advantages and

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30 developments it offers and, on the other hand it allows new research and studies to be developed
31 to learn how to get the most efficient use of it. This work focuses on reviewing several published
32 research to know and expose how significant assistive technology (AT) based on AI can be to
33 help people with physical and mental disabilities. Considering the needs of this group of people,
34 the current paper also approaches people with some kind of disability, exposing their situation
35 and the different needs they have, and thereby bringing the reader closer to knowing how AI can
36 help the inclusion of these people in social, educational, and labour spheres, which are
37 fundamental for personal development.

38

39 Keywords: Disabilities, AI, discapacity, social inclusion, job inclusion, education, robotics,
40 technology assistance.

41

42 Contents

43 1. Introduction ................................................................................................................................ 2

44 2. Technology................................................................................................................................. 3

45 3. Artificial Intelligence ................................................................................................................. 4

46 4. AI History .................................................................................................................................. 4

47 5. AI in medical science ................................................................................................................. 5

48 6. People with disabilities .............................................................................................................. 6

49 7. Use of AI in people with Disabilities ......................................................................................... 7

50 8. Labour and educational inclusion .............................................................................................. 9

51 9. Social development and IA ...................................................................................................... 10

52 10. Conclusion ............................................................................................................................. 11

53 11. References .............................................................................................................................. 12

54

55 1. Introduction

56 In the latter decades of the 20th century, the development of information and communication
57 technologies has given rise to several studies and lines of research focusing on several aspects of
58 this branch of knowledge, especially in the fields of practical application. The analysis of the tools

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59 that have been drawn from technology has generated many controversial debates about their daily
60 usefulness and usage in everyday life.
61 On the one hand, one finds those who advocate the use of technology in the fields of bio-
62 health, education, marketing, finance, and so on, and on the other hand, one finds those who argue
63 that technology cannot replace humans and that its use is unnecessary. The question is, how could
64 machines think and act?
65 This paper attempts to approach technology and its use, especially AI, and to look for a use
66 beyond mere entertainment, focusing on people with physical or mental disabilities. The aim is
67 to show how beneficial AI is when talking about disabilities, what benefits it offers and the
68 possibilities of improving it. The article is based on a review of various works on technology
69 and assistive technology. In order to conduct this article, different research on the use of
70 technological tools and the Internet in educational centers, and subsequently in companies to
71 facilitate the inclusion of the minority group of people with disabilities in society, has been
72 analyzed. Thus, a technological immersion is advocated, which is considered necessary to
73 improve the quality of life of people from these minority groups.
74

75 2. Technology

76 New technologies, which have been developed especially in the 20th century, provide new
77 opportunities now for all social groups, through the development of more powerful and functional
78 devices. These include improvements in access to the labour and educational market, the spread
79 of a wider range of information, and the creation of new networks for interpersonal
80 communication, among others.
81 This technological development has become one of the major lines of research, searching new
82 ways to manage the development of the " modern information society ". It can be said that the
83 technological domain, which is part of everyday human life, is becoming a symbol of today's
84 society. According to Fraser et al. (2010) an emphasis on acquisition of literacy is an essential
85 key for a proper development of this new branch, i.e., the lines of research should focus on why,
86 when, who and to whom technology should be trained, to fulfil the new needs of digital citizens,
87 which are being active in the process of learning technological competences, its use and
88 knowledge of the usefulness of technologies (Pérez-Escoda, 2016).
89

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90 3. Artificial Intelligence

91 Artificial intelligence (AI) is a computer science branch that connects logic and learning, through
92 the design of computer software tools which simulate human intelligence processes (thinking,
93 reasoning, learning...) to act as such. These processes are performed by a sequence of sophisticated
94 algorithms, which allow them to learn and make decisions.
95 The behavior of machines originates from Mahoney's "information processing theory", which
96 holds that humans process information – from internal and external stimuli stored in their short
97 and long-term memory – to make decisions and give a feedback, it means, an action or response.
98 This theory states that since the experience is stored, the individual can respond in a similar way
99 to identical situations.
100 According to Mahoney, the categories of processing are attention (receiving, selecting and
101 assimilating stimuli), encoding (symbolising stimuli according to one's own mental constructs),
102 storage (in memory) of stimuli, and retrieval (later use of information in similar situations already
103 experienced). Therefore, human learning depends on stimuli, positive or negative, which are
104 repeated over time, and which generate the experience and knowledge that lead us to make
105 certain decisions based on logical thinking.
106 Machines can also make decisions based on logic, through the use of algorithms. In contrast
107 to humans, they process a larger amount of information (from a wide range of stimuli) more
108 quickly (they work 24 hours a day, every day), which allows them to act earlier. One of the most
109 important advantages of AI is machine learning, a branch that allows machines to learn without
110 being specifically programmed to do so, and to make their own predictions based on certain
111 patterns.
112

113 4. AI History

114 The history of AI research has gone through several stages, from the peak of enthusiasm to the
115 decline of financial support, especially due to the strong criticisms it has been facing. In spite of
116 this, and thanks to the efforts of a number of researchers, we can now say that it is a very
117 appealing and interesting area of knowledge, especially in its correlation with other areas
118 (psychology, biology, ethics, philosophy...), as AI has the power to solve real and complex
119 problems.
120 Its precedent comes from the 1940s (20th century). In 1943, Warren McCulloch and Walter
121 Pitss published an article in which they argued that neuronal events and their relationships can
122 be dealt with by means of propositional logic. It was not until 1956 that the first Artificial

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123 Intelligence Conference was held in Darmouth, forming what was called the first serious
124 reference to artificial neural networks.
125 However, one of the fundamental breakthroughs came in 1958 with Rosenblatt (from the ideas
126 of McCulloch and Pitts), when he developed the multilayer perceptron and the error back-
127 propagation (BP) learning algorithm, the machine learning process was performed in a similar
128 way to the human brain ones, through a series of stimuli, multiple layers, and errors. Artificial
129 neural networks (ANNs), which are called "processing elements" (PEs), are made of elements
130 that operate in a similar way to biological neural networks. Each of the PEs has dendrites (input
131 elements) that collect input impulses and are then developed by the processing element to
132 generate a response (Fig.1).
133 The output of the EP (called an axon) can be connected to the inputs of other PEs via
134 connections (similar to synapses in the brain). There are also a few tiers called layers, two of
135 which are in contact with the outside (the input layer that collects data from the network and the
136 output layer that returns a response to the outside) and the other are hidden, where the PEs are
137 organized.
138
139 The task of writing a computer program that allows the AI to make decisions is part of
140 robotics. A machine can be told what to do through input/source codes (a sequence of numbers
141 and zeros). According to the University of Nebrija, there are different levels of AI knowledge:
142 classical or symbolic (it is programmable and based on knowledge through the manipulation of
143 symbols) and connectionist (it is self-programmable and neural networks represent knowledge).
144 AI can learn through two methods (according to J.F. Avila-Tomás, M.A. Mayer-Pujadas and
145 V.J. Quesada-Varela, 2020):
146 1. "Learning with supervised data". The human determines the right and wrong machine inputs
147 and outputs relationships. This is done by labelling and categorizing the input data and
148 establishing an algorithm to make decisions and generate the different outputs.
149 2. “Machine learning". By means of a set of initial logical rules, the AI can learn and become
150 able to behave independently from the experience provided by the data. This requires initial
151 algorithms and a small amount of initial supervised training. With this method, the layers
152 generate their own rules by learning from previous experience. Unsupervised learning or
153 machine learning is the most researched, as it promotes the development of tools for people with
154 disabilities.
155
156 5. AI in medical science

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157 One of the fields that has particularly benefited from the development of AI is medicine, which
158 needs be continuously adapting to the new needs in the healthcare world, so the concept of
159 "health" has been changing. The main line of AI in medicine follows unsupervised or machine
160 learning, as the purpose is to create machines that make decisions on their own, if required. The
161 technologies are not only used to diagnose and monitor patients, but they can also help to process
162 medical data and improve health outcomes by increasing the information available to healthcare
163 workers.
164 In 1996, J. Edward Colgate and Michael Peshkin invented robots, now known as cobots, with
165 the goal of creating devices that help people in their work. These robots can predict or detect
166 errors in each situation and share the information with other cobots. In medicine, they are
167 extremely useful because, they allow a greater number of tests and analyses to be carried out in
168 laboratories, facilitating the detection and diagnosis of a disease. They can also transmit
169 information (associated with the codes assigned to patients) more quickly and accurately. Two
170 IBM Watson Health customers recently found that with AI they were able to reduce the number
171 of medical code lookups by more than 70%. In financial terms, the use of AI may help to reduce
172 the costs of research into new drugs by searching for potential drug combinations.
173 In addition, prosthetic limbs are made (due to 3D technology), they allow electrostimulation
174 or are used in surgery (the first robot-assisted neurosurgical procedure took place in 1985, which
175 led to the design of other robot assistants during surgical operations, enabling remote surgery or
176 minimally invasive surgery) and rehabilitation, to speed up the recovery of people with spinal
177 cord injuries by means of a "brain-spinal interface", i.e. a system of motors, breezy, levers or
178 hydraulics operated by a computer with the aim of restoring locomotion; however, this is still a
179 very recent line that is still in the process of experimentation.
180 Furthermore, the use of robots enables a greater number of patients to be treated with less time
181 spent in hospital – commonly known as hospitalization – the reason why is very simple, as they
182 have no basic needs and do not exhaust themselves, AI's machine learning model can be used to
183 track the vital signs of inpatients, alert doctors if there is any complication to look for and offer
184 early diagnosis of more complex conditions, such as cancer, through the use of medical imaging.
185 Finally, since AI can retain a large amount of information and store user preferences, it can offer
186 personalized recommendations to patients 24 hours a day. If research continues, we could be
187 talking about creating a virtual assistant that, based on patients' medical history, needs and
188 preferences, would answer all their questions clearly and accurately.
189
190 6. People with disabilities

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191 According to the United Nations definition, people with disabilities are those who face long-
192 term physical, intellectual or sensory challenges. Despite the barriers, these individuals try to be
193 as independent as possible and be part of society. Vicente-Herrero, M. T., T erradillos García,
194 M. J., Capdevila García, L. M., et al. (2010) states that there are differences between the concepts
195 impairment – the request or abnormality of a psychological, physiological or anatomical function
196 or structure–, disability – lack of ability to perform an activity “normal” due to a disability – and
197 handicap, which is a disadvantageous situation for a given person due to a disability or
198 impairment, may also refer to the social or economic situation of the impaired or disabled people.
199 Andrea Padilla Muñoz speaks about models on which disability is based (see “Disability:
200 Concept, Context and Models by Andrea Padilla Muñoz, 2010). The three models are:
201 1. Medical-biological model: disability is a problem that people have due to different causes and
202 it requires special medical care. Disabled people must adapt to social requirements.
203 2. Social model: it defends that disability is a social fact, not just the result of a person’s illness.
204 Evidence of disability is uncovered when the person interacts with a particular environment in
205 which he or she has limitations or disadvantages.
206 3. Colonized minorities model: this model incorporates the fight for the rights of persons with
207 disabilities, who find themselves in a state of marginalization, discrimination, and social
208 exploitation. The problem lies in the social inability to respond to the needs of this minority
209 group of people.
210 4. Universal model of disability: it states that disability is relative, since no one has all the skills
211 that society demands. Thus, the transition from ability to disability depends on the particular
212 social, political, and cultural context in which individuals exhibit particular social, physical and
213 psychological traits.
214 5. Biopsychosocial model: the relationship between the individual and the environment. This
215 model focuses on how an individual with a disability interacts with environmental factors, which
216 influence the level and extent of their functioning. Like previous models, disability is social
217 rather than individual.
218 As it is shown in these three models, disabilities, handicaps and impairment are positioned in
219 different elements: individuals and social environment, and depending on which they are upright,
220 specific measures, treatments and approaches are offered.
221
222 7. Use of AI in people with Disabilities

223 Technology must be easily accessible and understood by all social groups, as it has both physical
224 and mental advantages. This section discusses information and communication technologies that

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225 focus on improving the quality of life of people with disabilities, impairment, or handicaps, in
226 ways that promote a normalized life, develop skills, facilitate access to information and learning
227 and enable inclusion of minority groups.
228 According to Lorah et al. (2015), technologies allow greater freedom for people with
229 disabilities (and their families) as they can be more independent and have a higher quality of
230 life. Technologies are the key to improving and normalizing the lives of people with disabilities
231 and enable them to develop, both personally and in the workplace.
232 According to the World Health Organization (WHO), “disability is a complex phenomenon
233 that reflects a close and borderline relationship between the characteristics of the human being
234 and the characteristics of the environment in which he lives.” Thence the fact of the need to
235 create AI tools, also called assistive technologies (originally called rehabilitation technologies,
236 but since 1994 the connotations of ’rehabilitation' were changed) to save or reduce a person’s
237 impairment or disability as a result of the former, by reducing their social disadvantage. To
238 achieve this goal, effective (the design of materials should be simpler and more accessible in
239 content than normal, by using clear language, a screen not overloaded with information, the use
240 of graphic icons to help navigate, etc.) and adequately meet the need (s) for which they were
241 created. It should not be forgotten that AT (assisted technology) can also be a set of strategies,
242 services and practices that have the main goal of improving the quality of life of these people.
243 Boyce, Smither, Fisher and Hancock (2017) define that “ATs are technologies, equipment,
244 devices, appliances, services, systems, processes and environmental modifications used by
245 people with disabilities or older people to overcome social, infrastructural and other barriers that
246 impede independence, full participation in society and the ability to perform activities easily and
247 safely.”
248 For its part, the International Organization for Standardization defines technical aids as a set
249 of products, instruments or technical systems manufactured and available on the market to
250 prevent, compensate for or neutralize a deficiency, disability or handicap. These may be fiscal
251 (deductions or exemptions from taxes or fees), regulatory (the use of standards or reports),
252 manufacturing (depending on the type of product: mass-produced, custom-made) or consumer
253 (prostheses, orthotics, or assistive devices). These products or systems may be used by people
254 with disabilities, groups of people who need them for a certain period of time, due to injury,
255 illness, or accident, or by the elderly.
256 This “integral accessibility” seeks to ensure that a product, service, system or physical or
257 natural environment does not prevent a person with reduced mobility or strength, with disabilities
258 in seeing or hearing, limited ability to speak or limited ability to assimilate knowledge. The
259 European Commission DG XVIII (2001, p. 34) argues that assistive technology services refer
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260 to “the set of facilities, procedures and processes that act as intermediaries between the assistive
261 technology market and its users.”
262 Depending on the country, the system of service provision (the SPS) varies according to policy
263 developments, legislation, and available public resources, and not only between countries, within
264 a country, this service may be aimed at all individuals or a small group. A great number of
265 studies, such as Bibliometric Analysis: Artificial Intelligence and its Impact on the Life of
268 Persons with Disabilities” by Souza Godinho, Selediana and Nogueira da Silva, Adilton Cícero
267 or the Olivenza Report 2018, show a concern to generate contributions to a better quality of life
268 and social integration of persons with disabilities in society.
269
270 8. Labour and educational inclusion

271 Information and communication technologies (TICs) relate to the mastery of digital tools,
272 audiovisual media, the Internet and social media communication, and in turn encompasses the
273 new competences of multi-tasking, participation, problem solving and production and learning.
274 Multiple channels of information and media, as well as growing ethnic, cultural, and linguistic
275 diversity, mean that our education system has to adapt to new needs, where the use of technology
276 and its potential benefits for the inclusion of all students, which is one of the basic principles of
277 new training and education methods – based on the use of resources and materials focused on
278 what and how to teach – a system in which simultaneous learning in the use of these information
279 technologies and tools is the fundamental basis.
280 The educational community cannot ignore social changes, which take place above all in the
281 socializing dimension (the process whereby an individual learns to internalize sociocultural
282 contents while developing and affirming his or her personal identity under the influence of
283 external agents), since human education is not in his or her biological configuration (it is not
284 individual), but in his or her social field.
285 Through socialization, the human being is educated and manages to change his behavior, when
286 TICs are included in the educational sphere, new teaching and learning strategies emerge from
287 the use of flexible and adaptable content created with digital resources and materials, and the
288 skills needed to develop in the new social context surrounding the individual are developed.
289 Appropriate use of technology means that the school must cater to the whole student body by
290 promoting inclusive education (students with or without disabilities learn together, it means,
291 they are able to develop their skills at work and in daily life in the same institutions as others).
292 TIC-based education makes it possible to combat segregated education – the most widely used
293 to date –, which limits the possibilities for self-fulfillment (equal opportunities for all members

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294 of society), where not all pupils benefit from the same materials, resources and means. To
295 achieve this aim, there are some requirements: a school more open to community, greater
296 involvement of parents and institutions, a response to needs from the curriculum and a different
297 approach to teaching.
298 In brief, the means must be adapted to the needs of the recipients. The New Technologies has
299 become an educational resource that promotes full integration of people with any kind of special
300 educational need or educational compensation, so they can learn with non-disables students but
301 with their own rules and “tempo”. Raise awareness about these minority group situation and
302 make education professional teachers adapt to them is crucial.
303 Technology is a bridge between culture and context in the classroom and enables students to
304 build useful knowledge not only for solving problems in the classroom but also outside the
305 classroom, with the intention to make them apply the information acquired in real situations.
306 Today’s education presents many challenges if technological innovations are to serve
307 education and prove their pedagogical and educational relevance, while respecting linguistic,
308 cultural, and social diversity. The use of information and communication technologies must be
309 developed in accordance with educational objectives and the financial resources available,
310 linking infrastructure, training, content, and human resources.
311 Other fundamental elements in education are the teaching staff and the educational
312 community. Teacher training should focus on creating pedagogical models that allow for the
313 participation of all pupils in the classroom during classes, with the aim of adapting the school
314 and the media to the demands of the students, otherwise teachers will continue to consider
315 whether “different” children are not a problem in the classroom.
316 Strategies include improving educational practices for a higher quality of student learning,
317 promoting initial and continuing education and awareness of the teaching profession, generating
318 greater educational knowledge by fostering diversity, and building a community of learning and
319 experimentation that meets the educational needs of minority groups (the use of personalized
320 instruction emerges).
321
322 9. Social development and IA

323 Artificial intelligence (AI) can be used to tackle some of the world’s most challenging social
324 problems, above all impaired people social ability struggles. Applications such as Tik tok,
325 WhatsApp or Twitter can help disabled people to get an approach to the real world which
326 involves them, but the security measures should be tighten.

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327 Social networks can encourage contact between this minority group of people and others who,
328 perhaps, are also in the same situation, so they can “find their own tribe.” However, as already
329 mentioned, security measures should be stricter than for normal people, although it depends on
330 the type of disability they have, it is not the same to have mental and physical disabilities.
331 People with mental disabilities are at greater risk of being harassed or cheated on social media,
332 so vigilance needs to be increased. Applications need to be developed that allow them to use the
333 media and networks like everyone else, but at the same time protect them from all kinds of
334 malicious activity, whether by others or by the software itself. Although social networks are the
335 future, this is a field of the use of technologies and AI that has not yet been fully researched, as
336 other lines of research are open, and the recruits cannot handle all of them. Research into the use
337 of social media and people with disabilities is essential to allow the lives of people with
338 disabilities to be as normal as possible.
339
340 10. Conclusion

341 In short, the use of AI in medicine allows the development of new techniques and tools focused
342 on different groups with different needs. This arises to assistive technologies (ATs), which are
343 resources that have a positive impact on improving the quality of life of people with disabilities
344 in various areas. The use of these ATs varies according to the needs, abilities and abilities of
345 each person (disabled, impaired or have a handicap). But there is a need for a design of materials
346 that are simpler and more accessible in their contents, which include certain characteristics, such
347 as the use of clear language, the non-overloading of the screen with information, the use of
348 graphic or descriptive icons to help navigate, the use of alternative aids of comprehension by
349 means of auditory, graphics and/or text, etc. are common characteristics regardless of the
350 individual’s need, based on the concept of universal design of the as AT.
351 In medicine, they have not only allowed greater scientific and research progress, but they are
352 great tools for diagnosing (also for diseases that are difficult to detect) and treating patients and
353 providing more personalized care too. In addition, thanks to AI, medical staff are provided with
354 help that allows them to treat a larger number of people in a short time, thus benefiting the health
355 system. Financial inversion may allow investigations to continue in this field, until developing
356 robots which would be able to replace medicine personnel.
357 The use of technologies has enabled the development and educational inclusion of minority
358 groups, but for the insertion of ICTs and their recognition, it is necessary to explain the
359 advantages and disadvantages of these new pedagogical methods. In addition, the management
360 team needs to be aware that it is up to them to include AI in schools and to integrate students

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361 with disabilities (physically or intellectually), as they have the tools and authority to efficiently
362 implement the organization of resources. It is also responsible for promoting the formation of
363 the teaching team, providing spaces for research and innovation with the use of technology and,
364 in this way, rethinking the meaning of proposals and practices.
365 Currently there are many researchers who are working on artificial neural networks in
366 multidisciplinary groups (computers, mathematicians, neurologists, knowledge psychologists...)
367 that offer new perspectives and are looking for the so-called “universal design, technologies to
368 be used by as many users as possible. And AI is still expected to address more intractable
369 drawbacks and make the assessment and procedure of solutions based on AI more effective,
370 accurate and accessible to individuals, leading to a major revolution in the quality of life of
371 people with disabilities.
372 Finally, a deep investigation line about the use of technology and social media by impaired
373 people should be developed as soon as possible. This may be handy to able disabled people
374 being more open to their social environment, normalized their lives as much as they can be and
375 help them to develop their social and personal skills. Nevertheless, more tighten security
376 measures are required because this minority group of people can be scammed easily, or ordinary
377 (people without any kind of discapacity) could mock and ridicule them just because of their
378 physical aspect, for example.
379 Although it is impossible to predict the future of any area of knowledge with complete
380 confidence, great progress is expected in the use of AI among minority groups in a short period
381 of time. It is required to keep on in a society which is ruled by IA and communication and social
382 technology.
383 In order to achieve bigger breakthroughs, major investments are being made in the US, Japan
384 and Western Europe, which are aimed at developing new types of computer architecture and
385 new integrated circuit design techniques, so the economic and social level of societies will be
386 determined by how people can exploit the potential of these new technologies soon, hence the
387 need to exploit this field of research as much as possible.
388 Although there is still so much to do, and people who are deadly against TICs have so much
389 to say, investigations cannot stop. More money is required to be invested in studies and scientific
390 institutions and organizations should be granted with more public (or private) subsidies, because
391 future and technology has become one.
392
393 11. References

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475

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476 Legends
477 Figure 1: Example of a three-layer connection network (input, hide and output). The nodes
478 and connections, together with the processing direction, of Rosenblatt. Source: SEFA.

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 Hidden layer
Output Information

Output layer

Nod

Connexion
Input layer

Input Information
479 Figure 1

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