Designing Around People

For many blind users, updated software versions or revised websites, apps, and operating systems can create a situation where an interface that may have been accessible is no longer accessible, more difficult to use, or confusing. Websites, apps, and cloud-based software are modified on a frequent basis, and many organizations do not have a formal process in place to ensure that those changes comply with accessibility requirements. A web-based survey was conducted to collect feedback from users who are blind to learn more about the impact that website, software, and mobile app updates can have on accessibility and use. The results of the survey illustrate the negative impact that inaccessible updates and revisions can have on users with disabilities.

Socially marginalised groups experience hostility in daily life, and hostility online adds to psychological pressure. For example, hate speech, typically defined as attacks on an individual or socially marginalised group, may impact access to web content for socially marginalised groups. In addition, rendered invisibility, for example being unable to choose your gender in a web form, may act as a psychological and practical barrier to accessing web content for groups, such as genderqueer, intersex and transgender persons. Research has yet to investigate the intersectionality of web accessibility. Preliminary results from semi-structured interviews with a select group of persons that experience multiple forms of discrimination suggest that marginalized individuals expect to experience oppressive content and consider oppressive content as a part of interacting with the web. In this paper, we examine a variety of oppressive mechanisms, including ableism, racism, and transphobia, and how in combination they relate to accessing and using web content. We argue that by ensuring the accessibility of web content substantively, future researchers and practitioners can promote a more universally accessible web. By taking into consideration experiences of hostility, web developers can better support access to information and communication on the web for everyone.

Assistive technologies (ATs) must improve activities but also participations of impaired users. Thus when designing ATs, especially for children, one should consider the diversity of users and disabilities but also the educational and societal contexts, as well as subjectivities (i.e. personal experience of disability, own motivations, etc.). Co-design is a method that encompasses all those features, but it is not easy to achieve with impaired users, especially when they are children. In the context of a research project on interactive maps for visually impaired people, we first conducted a field study to better describe potential users (visually impaired people, but also parents, teachers, therapists, etc.) and their needs. Building upon this field-study, we developed a set of design cards representing users but also needs, places, goals, etc. We then designed a workshop aiming to improve the knowledge and empathy researchers had about users, ideation step of the design process. We report on how these methods facilitated the creation of inventive scenarios, interactions and prototypes, but also how they helped researchers to think about their own design and research practices.

Mental illness incorporates a spectrum of diseases affecting a globally increasing population. Yet, society is still accepting the institutional concept of allocating the risk associated with mental illness to closed institutions. The allocation of closed institutions as the places of treating and caring for mental illness, prevents architecture as well as the rest of the design community of seeing mental health issues as part of a community integrated design concept. On the contrary, design for mental health could form part of a more active dialogue of incorporating the needs of mentally ill people in the broader discussion of accessibility and its implications. As this is a very big and complex topic, this paper will focus on one aspect of the architectural specifications: the buildings use, and how change of legislation towards more flexibility could affect the whole deinstitutionalization prospects of a context. It also includes a case study of the Hellenic mental health facilities planning legislation and how alterations on the change of use legislation for psychiatric facilities could affect their integration outcome.

This paper examines how products can be redesigned to allow flexibility for changes in a user’s condition to give them control and ownership over their care, while offering viable, cost-effective and sustainable healthcare solutions. By focusing on the case study of the Evolvable Walking Aid Kit, we aim to investigate to what extent a modular system which has been designed to incorporate principles of affordability, evolvability and emotional durability can benefit patients. The Evolvable Walking Aid is a modular kit which can be assembled to form a walking stick, crutches, a walking frame, and variations of these aids depending on the individual’s stage of their condition and fitting their anatomy. A co-design process was adopted across all stages of the project and two distinctive contexts, i.e. developing and developed regions of the world were targeted for design development. Through this case study, the rationale and potential for application of this concept to a broader context of inclusive design is suggested.

Restoring mobility and rehabilitation of gait are high priorities for rehabilitation from neurological conditions. Cueing using metronomic rhythmic sensory stimulation via entrainment has been shown to improve gait, but almost all previous versions of this approach have used auditory or visual cues. In contrast, we have developed and pilot-tested a prototype wearable system for rhythmic cueing based on haptics. Our initial pilot study indicated the same kinds of improvement to gait with haptics as for other cueing modalities, but haptics offer some advantages over audio and visual cues. In particular, haptics are generally more practical for use out of doors, in noisy environments, or when wishing to keep open the ability to converse freely. However, haptics also allow the precisely targeted spatial placement of cues on alternate limbs, offering the ability to manipulate attention and proprioception for therapeutic benefit. We outline the theory behind our approach and report on the iterative design of the system as part of a user-centred design evaluation process involving a wide range of stakeholders.

Colour has little significance for children with visual impairments, yet they use colour in their everyday life. This study explore and develop six tactile symbols to represent colour that were implemented in the learning tools of children with visual impairment. This concept was introduced to two age groups of children with low vision and totally blind by conducting learning sessions with them in their school environment. An evaluation process in terms of speed recognition of the colour symbols on the learning tools was carried out with each age group. This assessment provide an initial analysis on the response of the children to this new concept.

Human beings have figured out numerous means to cope with pain, and virtual reality (VR) technology is a new addition to this inventory. This paper reviews relevant articles published in recent 10 years, with a focus on methods and techniques of VR application. It aims to provide a comprehensive picture of VR technology for pain management, thus aiding researchers who are interested in exploring this field further.

An ageing population, pressure on health, social care capacity and changing social roles and expectations are driving demand for innovative solutions to support independence at home for people living with long term conditions and disabilities. Digital health-technologies have been posited as one potential solution to alleviate pressures placed on existing care services, reducing overall costs and carer burden (Petersson et al. 2011). As a consequence, significant investment into telehealth and telecare has been made. However whilst advances in these technologies are moving apace, a growing body of research has suggested that significant questions still remain regarding the acceptance and ultimately adoption of these devices by end users (May et al. 2011, Greenhalgh et al. 2013).

This paper shares the findings of the initial phase of a two-year qualitative research study identifying end-users attitudes to technology in everyday life and exploring how technology might be most appropriately designed to support personal health care. Utilising a critical artefact methodology the study has focused particularly on exploring the needs of groups of individuals who are currently under-represented in this research arena including individuals from diverse ethnic communities and communities classed as being of high socio-economic need. The research has identified a number of barriers to inclusion and the need for designers to understand the broader physical and cultural contexts where health technologies are used. The paper concludes with a broader discussion of the role design in eliciting understanding and developing responses to the complex challenges facing current healthcare services.

This paper describes the author’s ongoing collaborative work with Alzheimer Scotland that seeks to explore how design thinking and action might best contribute to the design and development of a range of products, services, and systems for people living with dementia. The paper focuses on one of three recently completed collaborative design projects undertaken with Alzheimer Scotland entitled ‘Perfect Day’. The ‘Perfect Day’ project aims to better support dementia care support workers and family members who care for people living with dementia through envisioning how they describe their ‘Perfect Day’. For example, David’s “Perfect Day” is playing a round of golf with his friends whilst Bet’s “Perfect Day” would be spent playing dominoes and poker. Overall, the key aim of this work is to better understand how design can most effectively contribute to the development of a range of products, services and systems for people living with dementia. This work, which has adopted a co-design interventionist approach, has facilitated explorations around a range of novel design contributions aimed at improving product and service innovation in a third sector context. It has also provided excellent first-hand opportunities to work with Alzheimer Scotland staff and relevant bodies, which has helped facilitate the design, development, and evaluation of a number of creative design interventions.

The aim of this study is to collect data about packaging openability from older adults in China, so as to better inform designers. It reports a survey that includes self-reporting via a questionnaire and performance tests. The study sample consists of 37 males and 33 females (from seven different regions across China), ranging from 50 to 80 years old. The study collected dexterity capability data—including the ability to pick up small objects—strength, the ability to interact with typical interfaces and visual ability. The research results will assist in the design of appropriate packaging for older people.

Quantifying the proportion of the population who are unable to use a product is extremely persuasive to deliver inclusively designed solutions to market. This paper presents a new method for assessing artwork that is typically viewed at a hand-held distance, such as mobile phone icons. The assessment is performed by mounting the artwork on a wall, and then simulating reduced visual ability by viewing the artwork from further away than you normally would (i.e. walking backwards). Finally, exclusion is quantified by comparing the artwork being assessed against a vision test chart. This new method is able to capture and justify the sort of minor improvements that can really make a difference for people with age-related long sightedness, in a commercially relevant context.

Technology is developing at an unprecedented rate, but the adoption of it, especially among older population, is relatively slow. While information communication technology (ICT) provides great opportunities to improve older people’s quality of life, it is known that many older people are excluded from ICT. The reason can be at least two fold: 1) the usability barrier of technology, 2) the lack of motivation of the users. This paper focuses on the latter through exploring how and why people adopt ICT products. It reviews theories of technology acceptance, innovation diffusion, and motivation, and proposes a preliminary model to explain the factors and theories influencing the adoption of ICT products.

Time disorientation is common in dementia, and can cause difficulty in knowing what day or time it is, or whether it is day or night. Some time orientation products exist to mitigate this, but the need for a simpler product was highlighted by relatives of people with dementia. The Day Clock was developed to meet this need, displaying only the day of the week and part of the day, by working in consultation with people with dementia, carers and healthcare professionals. Questionnaires and user trials were used to fully understand the product requirements. The design was further developed with a commercial partner and supplied as a market product. The Day Clock was evaluated with 123 people with dementia or memory problems as part of a local memory technology lending library, and the majority of goals set using Goal Attainment Scaling by people with dementia and their carers were met as a result of using the Day Clock. There was good acceptability and evidence of efficacy of the Day Clock, in what was one of the largest formal evaluations to date of assistive technology for people with dementia. Understanding the requirements of people living with dementia and their carers, and carrying out iterative design, has underpinned the development of this product and justifies the final design of the Day Clock which gives the day of the week and part of the day but does not tell the time.

Inclusive design aims to design for the widest range of users. In order to address people’s diverse needs and accommodate their capabilities, it is important to establish users’ database, including anthropometric, capability, psychological and social-cultural data, to support the practice of inclusive design. This paper discusses three emerging tools and methods that have the potential to be adopted for collecting user data: 3D scanners, photography and big data. Pros and cons of these tools are discussed based on literature review.

How can we design objects that are better suited to people with disabilities? Finite Element Analysis is a useful technique for engineering physical objects, but optimal design must be informed by how the human interacts with objects. Our group is attempting to model the control of hand movements in order to create CAD packages that allow object design to be informed by an individual’s sensorimotor control strategies (Prehensile Control Analysis). Prehension, the ability to reach-grasp-and-manipulate objects, is one of the most important human capabilities. Numerous activities of daily living (dressing, feeding, cleaning etc.) rely on dexterity, so it is perhaps unsurprising that impairment of prehension (through illness, injury or ageing decline) is often associated with disability. The kinematics of reach-to-grasp movements show high levels of stereotypicality in neurologically intact adults whilst impairment produces predictable kinematic changes in behaviour. Moreover, kinematics change lawfully as a function of the task and the properties of the object. These facts open up the exciting possibility of modelling prehensile kinematics so that a designer can determine the optimal object properties for an individual with a given impairment. This chapter presents a simple model for characterising an individual’s quality of movement in a given reach-to-grasp movement. Our model is able to capture typical and atypical prehension and is the first step in the development of CAD for handheld objects: a tool that allows design around people.

An important aspect for child and robot interactions in various therapy scenarios is the robot’s ability to convey emotions to the child. Due to the fact that 93% of human communication is non-verbal, these socially interactive robots need to have the ability to mimic non-verbal cues to the child, particularly through the use of facial expressions. In this paper, we discuss the ability for a socially interactive robot to emote emotions through a minimal set of features, i.e. soley through the eyes. In a study with five participants, we evaluate participants ability to recognize emotions based on the Plutchik emotion scale and the universal emotions of happiness, sadness, anger, and fear. Results indicate that participants recognition of an emotion is maximum when the intensity of the emotion is not at the extreme ends of the Plutchik emotion scale.

We present an elaboration and application of a proposed framework highlighting the somatosensory system in our understanding of the design and development of computer interactions for the human body. The Somatosensory system encompasses the entire range of sensations, organisms, and mechanisms relating to the human sense of touch, and this framework is intended to serve as a tool for broadening our understanding of the multidisciplinary aspects that influence all interactions designed for the body. The framework illustrates a preliminary approach to organizing all touch-based systems into four categories of critical parameters that can enable the effective comparison of different technologies and systems applications, and approaches to human somatosensory system interactions (HSI). In this paper, the framework is applied to evaluate and compare four speech-to-touch (ST) systems towards informing the design of a novel system that uses tactile-acoustic devices to improve speech comprehension.

Being the most used rooms in any home, the kitchen has evolved for decades in response to older users’ inclusive interaction. Therefore, understanding how older users engage with kitchens helps designers address inclusion of the elderly by eliminating physical, social and cultural barriers. This study further elaborates previously developed inclusive kitchen design factors (Afacan and Demirkan 2010) by adapting the ‘Design Wheel’ model proposed by Clarkson et al. (2011) with a focus on observations of 40 Turkish older users’ kitchen needs. By creating personas and answering the four fundamental questions of the model (1. What are the needs? 2. How can the needs be met? 3. How well are the needs met? 4. What should we do next?), it aimed to gain more insight into an elderly way of thinking and acting in relation to the inclusive kitchen design. Depending on the findings of task analyses and observation of the participants, three personas are created and the three need categories with a total of 10 kitchen need attributes are listed. A mock-up kitchen environment is also created and tested with reference to these needs.

Housing for older people in Flanders evolves toward small-scale, homelike environments. As population ageing puts pressure on the affordability of this tendency, architects are challenged to design innovative living schemes that offer the advantages of smale-scaleness in an affordable way. Little is known, however, about how people use and experience these schemes. Therefore we analyse how a recently built innovative housing and care facility is experienced by its residents. Analysis of interviews and guided tours suggests that the contemporary architecture is not criticised, but that its materialisation should offer a more homelike atmosphere. The generic layout is experienced as highly confusing and should offer more differentiation. The study confirms the importance of furnishing a place in making it “your own”, and shows how architects can facilitate this. While the design incorporates qualities of small-scale, homelike living schemes for people with dementia, the facility lacks some of the underlying ideals. It is therefore unclear whether the intended benefits for people with dementia are still present in this specific set-up. Together the findings illustrate the importance of follow-up studies since architects might take such an innovative concept as an example without knowing its actual benefits and deficiencies. They also highlight the added value of qualitative case studies for such unique housing and care projects.

Older residential care facilities are increasingly confronted with an incongruity between contemporary visions on dementia care and outdated infrastructure. In this context a case study analyses how the architecture of such a facility hampers or supports the implementation of its dementia care vision. Interviews, participant observation and document analysis offer nuanced insights into the interplay between care vision and architecture. The latter’s limitations include its spatial organisation, lack of high-quality communal areas, authoritarian character and hospital-like atmosphere, while potential lies in using adaptable lighting, homelike materials and furniture, and small spatial interventions. These interventions can be framed within a major renovation in the long term, which would allow to realize far-reaching improvements in the ward. Since many older facilities display similar features, the case study’s approach and outcome can help them in adjusting their outdated infrastructure to increase the autonomy of people with dementia and support their individuality and emancipation.

The significance of inclusive and enriched environment for persons with stroke is strongly emphasized by various international studies. This study aimed to explore how architecture can support or hinder rehabilitation for persons with stroke. The result shows that specific training facilities are only used to a small extent. This point to conclusion that there is an essential need for architecture that promotes rehabilitation at stroke units.

The objective of this research is to study how well Naresuan University Hospital complies with the requirements of seven Universal Design (UD) principles in relation to the requirements and physical restrictions of deaf, blind, mobility impaired and elderly users. To achieve this the requirements and physical obstacles of the facilities within the public zone of the hospital were analysed. The research uses qualitative and quantitative methods to implement a heuristic evaluation method (HEM) along side a scenario access audit which required a participation of a group of people with different types of disabilities, experience the level of accessibility of the service functions in public areas of this hospital. The UD principles investigated were: equitable use; flexibility in use; simple and intuitive use; perceptible information; tolerance for error; low physical effort; size and space for approach use. The results of this research present a specific summary of the observations, which found that significant obstructions occurred in the main communication and circulation spaces. This problem has been classified into two parts consisting of: (1) Obstructions to general service accessibility caused by inappropriate use of space, and (2) insufficient and inappropriate facilities covering all types of disability.

Many assistive technology researchers motivate their blind navigation work based on navigation being difficult due to one’s visual impairment. However, through our extensive navigation-related studies with 46 visually impaired adults we learned that architectural details and environmental designs are primarily what make navigation difficult, not one’s disability. In this paper we expound on the ways that architecture both aids and hinders blind pedestrian navigation. We also propose architectural and environmental changes that would better support navigators and future technologies through accessible and standardized architecture. With this we also make a case for collaborations between technologists and architects (especially those focused on accessible architecture).

Designers and engineers utilize personas and user profiles to give life and substance to user research findings. The pace of development and diffusion of mobile wireless technologies make modeling of consumer profiles ever more critical, especially for people with disabilities, for whom mobile technology can be either empowering or disenfranchising. Fueled by global competition and government policy in the US and elsewhere, inclusive design has become a priority for wireless device manufacturers, software engineers, and service providers. This paper discusses the development and use of personas as a critical tool to help stakeholders (the technology industry, regulators, designers and students) understand the needs and preferences of customers with disabilities, and to raise awareness of the importance of designing for people with disabilities—in short, to visualize inclusion. The paper presents data from the biennial Survey of User Needs, a national survey in the United States conducted by the Rehabilitation Engineering Research Center for Wireless Technologies (Wireless RERC). Data are presented on the assets, actions/activities and attitudes of 4 groups of survey respondents: blind, low vision, deaf and hard of hearing. These data inform the development of a user type for each group. Regular interaction with wireless customers with disabilities has enabled us to “flesh out” these user types to help its industry partners better understand their customers with disabilities.

Cognitive overload can be a serious impediment in the assimilation of information for all types of users. Research has demonstrated the usefulness of adaptive interfaces in reducing cognitive overload by providing an interface that automatically reacts to the end users’ information foraging behavior. In order to understand and compare behaviors and patterns (between sighted and low vision users), it is necessary to understand the information seeking behavior of sighted users for any patterns that may exist as a baseline. These findings can then be compared to data on low vision users in a future study. In this study, eye tracking is used to explore information seeking behavior of visual users. In particular, we compare the gaze patterns of users when using both a traditional interface and complex interface to identify current events of interest. The eye tracking data was analyzed using kernel density statistics and correlation analysis to determine if relationships exist between information seeking behavior, task completion and accuracy. Results show that information seeking behavior tends to be more efficient and accurate when using the traditional interface and that a more complex interface introduces additional cognitive overload.

This paper presents the use of picture scenarios in a narrative form to portray aspects of car use, currently and for the near future. The scenarios are based on user personas and design anthropology. It aims to enable automotive engineers and designers to empathise and understand the experiences of different car users in diverse purposes, places and usage situations. Persona profiles are mapped from the ethnographic interviews that have been conducted with car users from different parts the world. These personas then are used in scripts, which are translated into a sequential visual language that provides insight for the development of Human Machine Interface (HMI) design concepts. Narrative visualisation provides a powerful tool for portraying cultural trends and individual differences, exploring different situations, describing personal reactions and feelings, and evaluating the usability of vehicle functions. This project has shown the value of using visual tools to analyse, compare and explore diverse personas, and cultural attributes based on ethnographic case studies to scenario-based HMI tasks applied to future car designs. Such picture scenarios can help engineers and designers explore driver and passenger behaviours, expectations, emotions and motivations. The realistic visual details of each persona lead to an improved understanding of the user needs such as for visually impaired, people with disabilities, children, parents, seniors, technophobic or technophilic people. A series of iHMI potential design concepts for future cars will emerge for selection and development.