Processes of Reminding and Requesting in Supporting People with Special Needs: Human Practices as Basis for Modeling a Virtual Assistant? Antje Amrhein1 and Katharina Cyra1 and Karola Pitsch1 Abstract.1 The text reports findings of a case study based on the understandable request-reminder and its accomplishment. These investigation of reminding activities and request practices in the processes are closely interwoven and coordinated with an assistive specific context of supported living. These activities turn out to be social and institutional network. Set against this background the highly adaptive processes that are embedded in complex assistive integration of an assistive technology into already existing assistive networks. The process of reminding and requesting represents a networks carries a strong ethical issue with respect to the central practice deployed by the assistive institutional and social preservation of the individual autonomy [3]. environment. It suggests to provide a consistent structure that This study shows how ethnographic research serves as a valid meets individual needs in everyday life of cognitively impaired approach to user centered design respecting the Human Value people. In the light of the development and engineering of assistive Approach [4] and to gain deeper insights into the actual needs, technologies we discuss if and how human practices could serve as practices, daily routines and competences of the potential users. a basis for modeling an Embodied Conversational Agent (ECA) The investigation addresses the following questions: based assistive system for cognitively impaired people with respect A) How could the activities of reminding and the actual requests, to the adherence of their autonomy. i.e. acute reminders, in every day practice be described? B) How are reminders established in a meaningful way, so that their intent and consequences are understood and followed by 1   INTRODUCTION meaningful activities? People with cognitive impairments as well as elderly people (C) How could the reminding and requesting practices be require special assistance in managing their daily routines like implemented into an assistive technology and how could an ECA household activities or managing the everyday structures when as a daily-assistant be integrated into the social and institutional living independently. Cognitive or physical challenges often affect network that encompasses people with special needs? or lead to a decrease of the quality of life. Hence, maintaining an autonomous life in a familiar social environment and home for as 2   ETHICS AND TIME MANAGEMENT long as possible has become a central issue in today’s societies [1]. Research on technical assistive systems strives to suggest solutions for this social challenge, e.g., in the realm of Ambient 2.1   Ethical dimensions of assistive Assisted Living and Social Robotics. To this end, multimodal technologies dialogue systems represented by Embodied Conversational Agents seem particularly suited, as they can be easily integrated in private Based on sociological analyses of human activities and technology, homes using modern TV sets, allowing for intuitive human- Rammert speaks of “distributed action[s]” [5: 18] and “distributed machine interfaces, using means of natural communication when agency” [5: 5] and describes them as a multiplicity of actions which entering and managing appointments and being reminded of are distributed over temporal and factual dimensions. In this individual tasks or events [2]. context technical engineers, have to consider how system The question of autonomy arises when considering the influences human relations, hierarchies, competences and the integration of an assistive technology to support independent living division of work. Winner stresses that “The things we call and in the setting of supported living with distributed actions. ‘technologies’ are ways of building order in our world.” [6: 127] Results of ethnographic research in an institution of supported and so, they shape society, individuals and their actions. Thus, the living for people with cognitive impairments, i.e. people with design of technical systems always reflects implicit or explicit special needs in independent living, presented in this study, reveal values and can never be neutral. While the approach of Value practices of reminding and requesting as essential to preserve well- Sensitive Design suggests to integrate the needs of human users structured everyday routines. Besides the moment of acute and values [7] the Human Value Approach [4] goes one step further reminders, the complex process of reminding and requesting with the demand not only to consider the users’ needs but also to practices that precedes the actual reminder is relevant to form an apply the idea of Human Values to the technologies themselves and the development process and the disciplines involved in the design process. Human values are meant to be "ideas we all hold 1 Communication Studies Department, University of Duisburg-Essen, about what is desirable in different situations, societies and cultural Germany, email: {antje.amrhein, katharina.cyra, karola.pitsch}@uni-due.de contexts" [4: 35]. As these values differ individually it has to be modeling of technical systems regarding display of availability, made transparent in the design process of technological and recipiency and acknowledgement [17]. especially assistive systems which of them affect technology. In sum, linguistics, CA and HRI (Human Robot Interaction) In the design process of technical systems ethical issues have to research widely defines requests as represented by singular verbal be considered not only from the individual perspective but also utterances even though, there are hints at the influence of from an institutional and social viewpoint. The model for ethical contextual, interactional and sequential circumstances for the evaluation of socio-technical arrangements (MEESTAR) [3] is one production a singular utterance. Besides, especially research in care approach that is not only taking users’ needs into account but also settings has primarily focused on requests made by the care- the ethical evaluation of a technical system. MEESTAR suggests receiving party in face-to-face interaction. Our aim is to expand seven dimensions for the ethical evaluation of technical artifacts: this perspective by describing requests in a broader sense that takes care, autonomy, security, justice, privacy, participation and self- not only the sequential structure of interactions into account, but image. These dimensions are applied on an individual, also the social and institutional perspective. To provide valid organizational and social viewpoint to systematically carve out statements for the implications for an ECA-based assistant [2] [18] ethical issues and possible areas of conflict. we examine the requests made by the support worker. This In the area of assistive living, especially when focusing on perspective encompasses a highly ethical issue by asking how assistance in the field of time management and support of temporal requesting practices can be embedded into a technical system orientation by an ECA-based assistant, the dimension of autonomy without compromising the autonomy of the client. plays an essential role. Technical artifacts that remind, or request users to perform a task or to keep an appointment, and afterwards check the accomplishment of a task, raise the question of agency 3   STUDY & METHOD and autonomy on the one hand, but also contribute to various levels of individual security and participation. 3.1   Ethnographic Research & Data The research is based on focused ethnography [19] in an institution 2.2   Technology & time-management of supported living based in Germany where people with cognitive Human Computer Interaction (HCI) studies on time management impairments get individual in- or outpatient care as required. The support and calendars show how reminders can be designed as research was directed at gaining insights into individual, requests and argue to design them in a multimodal way to be institutional and social structures, that emerge from everyday effective, usable and accessible for a diverse user group [8] [9]. activities and routines. We especially explored the actual routines, However, the authors stress the right application of reminders to competences and strategies of people with special needs (clients) in work properly, which includes both the timing and the form of the independent living and focusing on the needs of assistance. The reminder. Going beyond these considerations, we will show that institution is located in the sector of integration aid (Fig. 1.) which not only timing and form of the reminder need consideration when is organized on two levels: a local 24-hour attendance service and modeling an assistive technical system, but also the right level of individual outreach work provided by support workers. (increasing) urgency and the need for adaptation to social [10] and interactional circumstances over the course of time. Though those HCI studies refer to context they do not show the dependencies and fine-grained coordinative practices of an assistive network [10] in the domain of time management. Our aim is to trace how reminders emerge in the context of everyday activities within a highly personalized and complex support network and to raise the question of whether and how a technical assistive system could be integrated into the complex structures. Figure 1. Support levels within in- and outpatient care 2.3   Requests in care & supported living Requests as a subject of research have a long tradition within The inspection of individual (outreach work) and institutional linguistics and there are several attempts to describe and define settings (attendance service) revealed that there is a differentiation requests [11] [12] [13] etc. However, these approaches mostly between required support levels depending on independence and describe requests from a speaker’s perspective not taking into autonomy of people with special needs. There are three merging account the interactional situatedness and procedures of production levels of support: care, assistance and integration (Fig. 1). Clients and narrowing requests down to singular utterances. Conversation with special needs in the care area are supported exclusively within Analysis (CA) considers the sequential procedures of interactions inpatient care and intensive social and physical support. Clients and reveals insights into the production processes of reminding and with special needs in the area of assistance live either in in- or requesting and what speakers consider when producing them. outpatient care with individually adjusted support depending on the Studies from various settings (care, medical, HCI etc.) show that area of support. On the support level of integration the clients with syntactical forms of requests hint at the speaker’s understanding of special needs are living in outpatient care mostly at their own the recipient’s capability to accomplish the request. Yet the homes and work in so-called sheltered workshops. syntactical form itself also reflects the entitlement of the speaker to To get a comprehensive overview of what assistive practices place a request [14] [15] [16]. These findings can be applied to the actually look like, how they are communicated and coordinated within the assistive social and institutional network of the client, social and institutional network: successive reminders that have an the ethnographic study took place in different areas and settings instructive character and acute reminders that function as requests. within the institution. As the integration aid is based on two forms of assistance, we first focused on the central office of the coordination of an assistive social and institutional network attendance service as the “center of coordination” [20] in the supported living institution. Here we examined how information is shared and transferred, appointments are made and tasks are coordinated. The second focus was on a more intimate setting of post-processing of appointment appointment appointment registration successive regular, mostly one-on-one, weekly assistance meetings with the reminders reminders: request support worker and the client. We accompanied three client- acute support worker-tandems repeatedly within a 4-month period. These meetings normally take place at the client’s home and are part of time the individual outreach work that among others, involve planning activities, post-processing of past events and assisted time Figure 2. Process of Reminding framed by an assistive network management to provide temporal orientation and structure. Further areas of the ethnographic research focused on a weekly communal Successive reminders appear to have a twofold function for the breakfast organized by the institution, everyday routines such as clients with special need in temporal orientation: in the long term assisted grocery shopping or leisure activities (e.g. multimedia they provide reliability regarding planning activities and support classes). temporal orientation on the one hand and on the other hand help to Following the principles of focused ethnography [19] the data anticipate acute reminders. Acute reminders have a request was collected during repeated stays in the field and contains a character due to their temporal proximity to appointments. When variety of data types, that are ethnographic field notes, observation comparing this with the findings regarding requests in care settings protocols, documents and photos gathered exclusively during we see a contrast in the performance of a request and the form not participatory observation in the central office. Further audio- and an isolated utterance, but embedded in a request context. The video-data was recorded during assistance meetings, the communal concept model of reminding as a process finishes with the actual breakfast, grocery shopping and leisure activities. appointment or optional post-processing. The fine-grained analysis of video data is based on CA and The process of reminding relies on highly complex and adaptive provides access to the understanding of micro-sequential processes assistance networks, involving official institutional staff as well as in interactions [16]. This approach relies on repeated analysis of an informal social environment involving family, friends and recorded data and detailed multimodal annotations of relevant colleagues. This highly personalized flexible support network is modalities of the interaction (e.g. verbal, gaze etc.) to sequentially being formed to respect and support the participants’ competences and capabilities. reconstruct the process of reminding and the interaction order with regard to the temporal interrelationship of modalities. The verbal transcripts are based on the conventions of second edition of the 5   PERSONAL SUCCESSIVE REMINDERS German Conversation Analytical Transcript System (GAT2) [21]. The following case study focusses on the process of successive reminding during an assistance meeting and is temporally located 4   REMINDING AS A PROCESS after the appointment registration and before the acute reminder (see chapter 6). The analyzed segment is a record of an assistance The ethnographic study reveals the activity of reminding within meeting where a support worker (S) and a client (C) discuss assisted time management in the context of an assistive living upcoming and past issues at C's home. C has no temporal institution as a process of reminding. It is framed and coordinated orientation and therefore depends on explicit and recurrent by a client's assistive network [10], encompassing both formal reminders and requests. S's successive reminding strategies are institutional assistance and informal assistance. The concept of the produced in different formats and temporal stages during the process of reminding contains essential social, institutional and assistance meeting with C (Fig. 3 I-IV). conversational practices and planning activities (Fig. 2.). (a) Announcement: first appointment reminder: After discussing These planning activities are closely connected to the individual needs and competences of the client and are embedded into the recent events S starts the first announcement on reminding C of an organizational structure of the assistive network. The data show upcoming appointment for an assistance plan meeting in three days that planning activities usually start with an appointment on a Thursday at one o’clock. The last assistance plan meeting was registration that can be initiated by the client herself/himself, by cancelled and the appointment has now been rescheduled. This her/his assistive network or external sources. Either way, this appointment involves not only C and S but also C's legal registration is communicated and coordinated with all involved representative. As there is an institutional network engaged there is parties. The joint planning of an appointment allows a maximum of the need for coordination. Another rescheduling or cancelling of transparency and agency for both, client and support worker. Joint the appointment due to a possible non-appearance of C would planning, that is part of the regular assistance meetings, is one imply additional organizational expenditure for the assistive aspect of legitimization of the support worker to apply the network. So, C's punctual appearance has an increased significance successive steps of the reminding process. in this context. A successive reminding process is central during We identified different steps that evolve as a process of assistance meetings and an essential key to assure a punctual reminding after the initial appointment registration. The core appearance to appointments. process consists of two essential practices applied by the assistive With his question (Fig. 3 I 01-03) S is reassuring and checking that C is already aware of the upcoming appointment for the assistance plan meeting. C confirms with yes. After the positive pause. After the short pause (IV 22) he repeats the day that he confirmation of C, S names the time. By using a conjunction and a already named before the parenthesis on wednesday right? temporal adverb he marks the time and this time at one (IV 22). He closes his utterance again with the sentence final o’clock (05) as deviating from the norm. After a short sequence question particle right, to claim a positive response which C in which C explains why she couldn’t make it to the appointment provides by producing a mhmh, in IV 23. last time S formulates a second appointment reminder. The analysis has shown how a successive process of reminding time unfolds at different points in the interaction and how precisely and appointment I announcement: first appointment reminder recurrently the upcoming appointment is referred to. The described registration minute 16:12- 16:20 strategies of successive reminding establish a basis for an 01 S: listen=ahm, you know that we have upcoming acute reminder on the one hand and they provide set of successive reminders during an assistance meeting: 02 the assistace plan meeting next 03 thursday, don’t you? 04 C: yes. planning certainty and reliability for C on the other hand. 05 S: and this time at one o’clock; II second appointment reminder + instruction minute 18:10-18:17 6   ACUTE REMINDERS 06 S: °h so then nothing will intervene 07 on THIs thursday right? The following analysis shows how an actual reminder is produced 08 C: ˇno:, mediate relevance 09 S: you can go there right after lunch as a process in its complexity of modalities and presuppositions in 10 break,- human-human-interaction. The extract was recorded after a regular III third appointment reminder communal breakfast organized by the operator of the external-care- appointment acute reminder: minute: 21:55-22:09 based assisted living. C2 is accompanied by her friend (F) who is immediate 11 S: so you’re all set for thursday; part of her informal support network. As mentioned in chapter 5, C relevancy 12 C: mhmh, 13 S: right, has no temporal orientation, whereas F is temporally oriented and referring to a further reminder keeps plans and appointments in mind. The acute reminder IV 14 15 S: C: but i’ll come- ((coughing)) sorry? emerges from the need to take the next bus. F's reminder strategies 16 17 S: but i’ll come over on wednesday again, (-) today I came here illustrate an interplay of attention getting and subtle reminder 18 exceptionally (-) because andrea is upgrade strategy. of appointment 19 sick; 20 C: mhmh, processing 21 S: and then i’ll remind you again 22 (-)on wednesday right? 23 C: mhmh, post- Figure 3. Personal Successive Reminders translated from German F C F C (b) Second appointment reminder + instruction: In the second stage (Fig. 3 II 06-10) S formulates another question to reassure 01 F_gaz: |@watch|~ | 03 F_gaz: |@C------------------------------| that C will keep the appointment (II 06-07) and adds an additional 02 Silence: |(1.0) |(0.2)| 04 05 F_ver: F_han: |the *BUS comes *in a moment;| *LH: C-shoulder* ! instruction by providing practical guidance so C can manage to get ! Figure 4. Multimodal display of the reminder activity to the appointment on time. By advising her to go to the appointment right after lunch break,- (II 09-10) he (a) Attention getting and embodied anticipation of a new uses a time category that is manageable for C and provides an activity: C is involved in a group interaction while F has put his understandable reference point in time. Due to C's difficulties with jacket on and then, joins the group. This preparatory action of temporal orientation the provided temporal link or ‘landmark’ is an putting the jacket on serves as a change of context and as a visual assistive verbal strategy that bridges C's difficulties with estimating cue for C. Besides the completion of breakfast, it initiates reminder durations. After a short discourse S initiates, the two final steps in activities in a subtle way without a manifest display of urgency. F the reminding process. initiates a first stage of reminder activities, i.e. attention getting (c) Third appointment reminder: In the final steps of the while C is involved in interaction: F stands behind C and taps on successive reminding process (Fig. 3 III, IV) S is not asking an C's back with both hands. This tapping could be interpreted as a explicit question like in step I and II but is making a statement subtle form of attention getting which is found in subsequent steps which is marked by a dropping pitch at the end of the sentence (III of reminder activities, too. However, its first occurrence is 11). However, after C confirms the statement with mhmh, S characterized by absence of verbal activity. The first steps of the transforms his statement into a question by adding the sentence acute reminder process serve as attention getting devices and do final question particle right, with a rising pitch. not contain explicit requests or a display of urgency. (IV) Referring to a further reminder: In the ensuing sequence S (b) First explicit naming of appointment: Explicit multimodal gives a prospect of further steps in the reminding process. He forms of a reminder are displayed not until F has got C's attention names the exact day on which he will come over for the next that becomes manifest through C's gaze [22] at F (Fig. 5). When assistance meeting (IV 16-17). After that, he inserts a parenthesis having C's attention, F gestures an external necessity by an explicit to explain why he came in today exceptionally and that he is look at his wristwatch followed by a verbal indirect request (the covering for another support worker who called in sick. C responds BUS arrives in a moment;) that emphasizes the external by producing the back channeling signal mhmh, and therefore necessity to leave. The verbal request is underlined by F's direct signals sustained attention to the interaction [15]. S links to his first gaze at C while speaking and by touching C's shoulder (Fig. 5). utterance (IV 16-17) by starting with a conjunction and then The reminder becomes a request through the implicit content of the i’ll remind you again (-) (IV 21) followed by a short utterance [23] that is only accessible for the two participants: it is a highly contextualized request that ensures the participants’ privacy 7   DISCUSSION AND IMPLICATIONS within the social situation. (c) Subtle reminder upgrade: F retries the multimodal request The study has revealed how reminder practices are produced and procedure in the subsequent interaction another three times after integrated in the everyday lives of people with special needs and monitoring C's reactions. The retries occur with rising frequency coordinated within their assistive networks in a German institution and appear as a subtle increase in urgency. The reminder procedure for supported living: shows a fine-grained coordination of modalities: The retries start (a) Personal Successive Reminders: The case study in section with F's observation of C's attention (head orientation, gaze) while 5 shows how a joint planning process of the supportive network she is involved in a conversational task. When C's head movement and the client emerges. The conversational practices applied by the becomes observable, F anticipates C's orientation towards him. C's support worker (e.g. explicit instructions and references to future change of orientation is followed by F's utterance of the request reminder steps) provide security, planning certainty and reliability and a tactile underlining (see section (b)) while F directs his gaze at for the client who needs support in planning and temporal C directly. It is noteworthy that F embeds the requests precisely in orientation. Joint planning is the basis for a meaningful and the ongoing interaction and respects C's conversational tasks: he transparent establishment of upcoming reminders and provide does not interrupt C's utterances, but uses multimodal options for individual information about the context of appointments. turn taking such as pauses, changes of C's bodily orientation and (b) Acute Reminders: Section 6 shows how appointments are gaze to secure her attention. So, though he works on the task of contextualized and how the participants' implicit knowledge about reminding, he is also involved in the overall interaction. The subtle consequences and meaningful activities work when a reminder upgrade as well as the precisely coordinated placement of occurs. The analysis shows the evolving micro-process and reminders ensures C's autonomy and role as a competent complex interplay of getting attention / securing contact and participant within the overall interaction. applying a subtle reminder upgrade strategy. The reminder process is highly adaptive and flexible and allows to react to changing circumstances within social situations based on close observation (or monitoring) practices. When applying the supportive network's tasks and practices to F the development of a technical system, the empirical data and concept model of the process of reminding give hints for C R F C R implications for system design but also raise issues for a discussion of assistive technologies in the light of ethics. 04 C_gaz: |~ |@F------------------- 01 F_gaz: |@C--------------------------| 05 C_ver: [YES-(.)] i must- (.) i MUST (c) Verbal practices and timing: Adaptive procedures 02 F_ver: *the BUS comes * in a moment* 03 F_han: *RH: C-shoulder* characterize human planning and reminding processes and ! 06 C_gaz: 07 C_ver: -------------------------|~ | not this- (.) i- (want) (.) activities of acute reminders. Following this model, an ECA needs ! technical and verbal structures to produce recurring successive Figure 5. Negotiating and relativizing the reminder-request reminders that lead to acute reminders and effective requesting strategies. The exact timing of these strategies bears not only a (d) Negotiating and relativizing the reminder-request: After a total of four reminder retries, F interrupts the interaction for a fifth technical challenge, but also regarding the design of actual reminder by varying the attention getting device: he skips the formulation and wording, i.e. interaction conceptualization to attention-securing via gaze and uses the tactile modality to get C's ensure that requests or interruptions by the ECA are not being attention and repeating the verbal request (Fig. 5). C makes this perceived as unexpected or impolite. upgraded reminder-request conversationally relevant by turning to (d) Multimodal monitoring: Continuous and extensive F and relativizing the reminder-request with the utterance that there multimodal monitoring-processes need to be implemented as a pre- is no urgency in taking exactly this bus (Fig. 5: i must- (.) i condition for the implementation of accurately applied verbal MUST not_this-). It becomes clear that the reminder-request is strategies. These monitoring processes should encompass the perceived and understood by C, but that she still is involved in a monitoring of gaze and head orientation as well as body orientation conversational task (of ensuring to meet R (researcher) in the (e.g. via Eye tracker). Besides these requirements, the system needs following week). After R's reassurement, C and F leave. The a structure to classify the different states of the participant in the negotiation of the reminder underlines C's involvement in the process of reminding after an appointment has been registered (Fig. interaction, the solving of a conversational task first, and so, the 2) to produce meaningful reminders that are timed and autonomous prioritization of tasks in interaction and her autonomy synchronized with the classified state. These strategies need to be in changing an action plan due to contingencies in social adapted to needs and competences of each participant [20]. On this interaction. Even though the task of taking the bus seems clear, account, the system needs to detect different states of the other tasks are more important and the initial action plan has to be participant’s attention to secure contact if necessary. The adjusted to contingencies in social and interactional activities. monitoring of the surroundings (e.g. via Kinect), like the apartment F and C's reminder system appears to be an evolving process with its artefacts and other present people (e.g. via face or voice which is adaptive and flexible enough to be embedded in complex recognition) would be needed, to classify and differentiate social social interactions as well as to react to changing circumstances. interactions. This data can serve as a basis for the system's The analysis shows that it is well-practiced within contingent social classification, to i.e. ‘understand’ different participant states (e.g. interactions to jointly handle complex tasks. attention) in the process of reminding to produce meaningful reminders and to apply suitable strategies. 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