Elsevier

Computers & Education

Volume 130, March 2019, Pages 152-167
Computers & Education

Online e-learning and cognitive disabilities: A systematic review

https://doi.org/10.1016/j.compedu.2018.12.004Get rights and content

Highlights

  • Accessible online e-learning is an urging need for people with cognitive disabilities.

  • Few e-learning studies addressed the cognitive accessibility.

  • Their underpinning in terms of accessibility standards and special education is weak.

  • Their focus is oriented on specific disorder/disease instead of cognitive function.

  • Accessibility functions are learning activity-specific and few assessed with learners.

Abstract

For decades now, as the issue of social progress has come to the fore, the drive to improve access to education has been behind the growth in research into e-learning. The current systematic literature review raised the question of the existence of studies addressing the specific needs of persons with cognitive impairments. Indeed, e-learning is expected to be one of the critical tools for improving access to education and ultimately aiding social inclusion. The systematic literature review was performed through a four-step process including an exhaustive search of scientific literature databases, the selection of studies through exclusion and inclusion criteria, and literature analysis and synthesis. The main results are: 1) a lack of e-learning studies addressing the issue of accessibility for people with cognitive impairments (N = 29) with a purpose dominated by design guidelines rather than effectiveness assessment; 2) a weak inclusion of accessibility standards (N = 5) and 3) a weak inclusion of special education findings (N = 3), with a focus on specific neuropsychological disorders or syndromes (dyslexia, ADHD, etc.) rather than on impairments of cognitive function (attention, memory, etc.) as promoted by the International Classification of Functioning (World Health Organization, 2001); 4) the identification of five families of accessibility function (adaptive systems, game elements, accessible content, virtual agents and accessible interfaces or environments) and their dependency with activity-domain of learning. Results are discussed in terms of both design and assessment recommendations, promoting a multi-disciplinary approach combining educational sciences, cognitive sciences and computer science to develop more accessible e-learning systems.

Introduction

There are more than one billion persons with disabilities (PWDs) in the world (World Health Organization, 2011). Although the situation has evolved, notably through political decisions aimed at combating discrimination, there are still many areas where the opportunities for persons with disabilities lag behind those for society as a whole, as demonstrated by WHO reports. It is particularly the case for education: the representation of PWDs in education decreases drastically from primary school to higher education, leading to a lower level of qualifications. This situation is one of the causes of an adverse social consequence in the professional world where the unemployment rate for PWDs is much higher than the overall average (World Health Organization, 2011). It is even more important for persons with intellectual deficiencies or cognitive impairments because they are the least likely to be engaged in school or work. Therefore, the access barriers to learning opportunities reinforce the social exclusion of PWDs, as denounced by the CRPD ratified by 177 countries (Convention of Rights of People with Disability, (UN General Assembly, 2007)).

Advances in computer-based education are seen as an effective way of remedying this situation by providing assistance and compensation for learners with specific needs. Indeed, there has been a real revolution in computer-based approaches to education, driven by the explosive growth in Massive Open Online Courses (MOOCs): starting from 0 in 2011, at the end of 2017 there were more than 81 million registered users around the world.1 Such online e-learning systems radically change the way people approach learning and training. They offer access to learning content to everyone, regardless of where the learners are, and make these learners more active across their lifespan by allowing them to choose how, when and where to study. Since these platforms are available around the clock, learners can progress through the course at their own pace, reviewing concepts that have not been fully grasped and skipping those that have. These systems are also compatible with life-long training, allowing people to gain new skills and knowledge in order to adapt to an ever-changing job market. These factors provide great opportunities for creating learning environments which are beneficial to PWDs, notably those with cognitive impairments and limited learning activities, as they may offer the flexibility to adapt their training program to meet their specific needs.

Schelly, Davies, and Spooner (2011) have shown that a growing number of students are reporting specific learning disabilities, attention deficit and hyperactivity disorders, or mental/emotional disabilities. Such disabilities are encountered in numerous developmental (autism, epilepsy, attention disorders and hyperactivity, psychiatric diseases, etc.) or acquired (traumatic brain injury, stroke, tumor, etc.) neuropsychological disorders and can appear when aging (Craik & Salthouse, 2011). Although these impairments are common, they are often referred to as invisible disabilities because they are generally not apparent or well understood outside medical or specialized environments.

These two observations raise a question: are online e-learning systems sufficiently accessible to people with cognitive impairments, and do such people benefit from the use of these technologies? The purpose of this article is to explore this question and thus to contribute to the field by reviewing the current state of research into the accessibility of online e-learning that supports individuals with cognitive disabilities.

Section snippets

ICF framework and cognitive impairments

In this paper, we based our work on a functional view of disability following the biopsychosocial framework proposed by the International Classification of Functioning, Disability and Health, which is backed by the WHO and is widely used by disability experts (World Health Organization, 2001).

Firstly, this framework depicts disability as the negative outcome from a person's interaction with their social and physical environments. This emphasizes the role of environmental factors in creating

Related work

In this section, as a rationale of our systematic review, we present prior literature reviews related to our research question with a focus on systematic reviews. Most of the previous literature reviews we retrieved do not focus on the accessibility of online e-learning platforms, but rather on the use of assistive technologies in all learning situations.

In a review of 118 articles from education technology journals, Istenic Starcic and Bagon (2014) showed that the field of inclusion of people

Questions

Using a systematic literature search procedure, our goal is to explore the theoretical and applied aspects of accessibility of e-learning literature and describe the nature of the existing research activities with a focus on studies geared to individuals with cognitive impairments. The overview of the field will be addressed in terms of factual information through four sets of research questions in order to document the domain activity, the background scaffolding (accessibility standards and

Survey methodology

The methodology used was a systematic literature review according to Prisma international standards (Moher, Liberati, Tetzlaff, & Altman, 2010). Our objective was to identify a set of relevant studies in the field of accessible online e-learning systems for persons with cognitive impairment and to provide an analysis of the results of these studies. To do this, we conducted a four-step method depicted below (a flowchart of the paper selection process appears in Fig. 2). As a result of the paper

Results

The next step of the review was to perform a within-study and between-study analysis from the final corpus of selected articles to identify characteristics and answer the research questions defined for our review purpose. A summary of the main findings and the principal characteristics of the reviewed studies are provided in Table 5. For ease of reading, we have assigned an ID number to each study, so that the reader can refer to this table for further information.

Discussion and recommendations

This systematic review aimed to provide an overview of the current state of research on e-learning accessibility for persons with cognitive disabilities. The results showed a lack of use of both accessibility and special education references in the design process, and a focus on specific neuropsychological disorders or syndromes (dyslexia, ADHD, etc.) rather than cognitive function (attention, memory, etc.). The studies also exhibited a lack of effectiveness evaluation, which was mostly done

Limitations

This current systematic review has three main limitations. Similar to other reviews, the selection of the research keywords and the exclusion criteria was mostly subjective. However, the three authors participated in the final selection process to ensure a reduction of bias. Secondly, as the systematic review relies on literature databases, it is not fully exhaustive: studies not referenced in the selected databases are not reviewed. However, we reduced the bias by choosing a set of databases

Conclusion

The aim of our study was to contribute to laying the groundwork for a better understanding of online e-learning platform accessibility targeted at persons with cognitive impairments.

Four main conclusions can be formulated. Firstly, there is a paucity of studies that address the accessibility of e-learning for persons with cognitive impairments. Additionally, the studies available tend to focus more on design recommendations than on evaluating the effectiveness of e-learning systems.

Secondly,

Acknowledgements

This work was partially funded by a PhD Research Fellowship [Doctoral Contract n°2016-KB-01] from the Doctoral School of Society, Politics, Public Health (SP2) at the University of Bordeaux. The authors would like to thank Inria Learning Lab for its effective support during the overall research project.

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