AMI: An Adaptable Music Interface to Support the Varying Needs of People with Dementia
P. Frazer Seymour, Justin Matejka, Geoff Foulds, Ihor Petelycky, Fraser Anderson · 2017 · Proceedings of the 19th International ACM SIGACCESS Conference on Computers and Accessibility (ASSETS '17) · doi:10.1145/3132525.3132557
Summary
This paper presents AMI (Adaptable Music Interface), a tangible, modular music player designed to be reconfigured by caregivers to match the changing needs and preferences of individuals with dementia. Over 46 million people worldwide live with dementia, a progressive syndrome that erodes cognition, memory, and emotional control, with the number expected to double every 20 years. While listening to familiar music from childhood or early adulthood has well-documented therapeutic benefits for people with dementia — reducing anxiety and improving quality of life — modern touchscreen interfaces are unfamiliar and difficult for this population to use, potentially adding the very frustration and stress that music is meant to relieve. Traditional interaction design assumes users will become more competent with practice, but diminishing short-term memory makes this assumption invalid for people with dementia. AMI addresses this by providing a physical, modular system with three components: an iPad tablet for music display and playback, a set of interchangeable tangible input components (buttons, switches, knobs, sliders) that connect via ribbon cables to a chassis housing an Arduino microcontroller, which communicates with the iPad via serial connection. Thirteen modular input components were fabricated with varying physical properties — including professional knurled metal knobs, large colored buttons, toggle switches, rocker switches, and custom components with different sizes, shapes, activation forces, and haptic feedback.
Key findings
In feedback sessions with 10 people with dementia (8 completing personalized devices, 2 stopping early due to discomfort), six unique configurations emerged across the eight completed designs, demonstrating significant individual variation in preferences and abilities. For power control, four individuals selected rocker switches, three chose toggle switches, and one chose a button. For song selection, knobs and buttons were equally preferred (5 and 3 respectively). For volume, sliders were most popular (4 users), with others choosing knobs or buttons. Some users could not understand the affordance of certain components — one mistook colored buttons for knobs and tried to turn them — but the availability of alternatives allowed them to still complete a functional device. A participant with a musical background naturally selected a knob for volume, saying he would "crank it up," drawing on familiar metaphors from past experience. The researchers derived four design principles: (1) Adaptation — interfaces must adapt to specific individuals and change over time as abilities decline, with simple caregiver-driven reconfiguration; (2) Familiar Metaphors — input components should evoke prior experiences (jukeboxes, radios, 8-tracks) that may be more deeply encoded in memory; (3) Support Multiple Impairments — dementia often co-occurs with vision loss and motor impairments, so diverse input options and feedback modes are essential; (4) components should clearly signal their functionality since users may still operate a device at a later time even if they could not configure it during the session.
Relevance
AMI addresses a critical intersection of aging, cognitive impairment, and the therapeutic power of music. The core design insight — that interfaces for people with dementia must be adaptable rather than universal, and must evolve as the condition progresses — challenges the one-size-fits-all approach of most consumer products and even many assistive devices. The modular, plug-and-play hardware approach means caregivers with no technical background can swap components in and out as needed, without software configuration. This is important because dementia care often falls to family members who are already overburdened. For accessibility practitioners, AMI demonstrates that tangible interfaces can be more intuitive than touchscreens for populations with cognitive impairments, and that leveraging familiar interaction metaphors from a person's earlier life (turning a knob, flipping a switch) can tap into procedural and long-term memories that remain more intact than short-term recall. The design principles are broadly applicable to any assistive technology for progressive conditions where abilities change over time.
Tags: dementia · tangible interaction · music accessibility · personalization · aging · modular design · assistive technology · cognitive accessibility