Nearly everyone on the planet will be at least temporarily, minimally disabled at some point in their lives. It may be a broken bone or a major illness. And if you live long enough, you will experience age-related impairments such as limitations of sight, hearing, dexterity, and mobility. Those who are born with severe medical conditions, however, have to accept their disabilities and live with them every day. In Design Meets Disability, Graham Pullin looks at design for disability through the principles that drive design in the able world. By doing so, Pullin helped me realize that most of us who work on accessibility have been thinking about this all wrong.
So much of design for disability has been about basic engineering and problem solving, making it possible to overcome certain limitations. For example, the creation of accessible voting systems was a watershed moment for people with varied disabilities. Since about 2004 disabled persons who are able to access a polling place can independently cast their vote. This is no small thing. I've witnessed people with disabilities shed tears of joy and relief as they recount their experiences of voting independently for the first time. However, voting is still extremely difficult if you have disabilities. Most existing voting systems were retrofitted rather than designed for accessibility. There's nothing elegant about them. They're slow. They're awkward. They're different from the voting systems that non-disabled voters use.
If you don't have a disability, it is easy to look at designing for limitations as accommodating exceptions. But for people who have impairments, limitations, or disabilities, working around them or through them is a way of life.
Pullin, a medical engineer by training, works on projects to embed assistance in everyday objects, such as a "speaking chair" to help people who can't verbally communicate. In Design Meets Disability, he gives us an inspiring book about disability that talks to the art school-trained designer. The book has two parts. In the first, he contemplates what it would be like if designers rather than engineers designed hearing aids, limb prostheses, and wheelchairs. Or rather, what it would be like if an interdisciplinary team of designers and engineers developed designs for disabilities that took into account context and experience.
To frame the discussion, Pullin looks at the tension between sets of design principles. From the opening pages, the tension between discretion and fashion is introduced as a short and welcome history lesson on the design and engineering of medical devices. The classic approach has been to try to make the disability invisible, a thing that has never been done particularly well. The materials aren't right, the assumptions aren't right, and the technology isn't good enough. But what if design could be used to destigmatize disability, as in the case of eyeglasses?
Pullin also contemplates the tension between universal design and simplicity. Making a device that will work for nearly everyone often means adding complexity by layering on affordances for differently abled people. Not only is there a visual layer, but also a tactile layer and an auditory layer, which is a direct conflict with the principle of simplicity in design: taking things away until only what is needed is present. Pullin closes this topic by giving examples of designs that did strip away nearly every feature that might be considered helpful to universal design, but in doing so actually delivered the best possible experience for the widest audience.
In his discussion of ability and identity, Pullin presents the World Health Organization's definitions of disability, which are broad and assertive. WHO states every person will experience disability at some point, recognizing, as Pullin says, "disability as a complex interaction between the features of a person's body and the features of the environment and society in which the person lives." Adding context to the picture of disability stretches the design possibilities and removes limitations, disabilities, and handicaps from the medical realm and inserts them into the everyday lives of us all. The discussion no longer centers on a binary classification of disabled versus able.
As a researcher and evaluator more so than a designer, I identified most strongly with the tension between testing (or clinical trials) and feeling. In a discussion about prototyping beyond the object to get at fitness of use, Pullin discusses experience prototypingengagement, experience, and emotionas it relates to the first prototypes of digital cameras. It was curious to me that those designers seemed to think of a prototype as something to show rather than something to interact with.
In the world of user interface design, we've been working with interactive prototypes for a long time. However, Pullin implies designers might not see the importance of testing, especially in very formative stages of design. I found it fascinating that his audience might not have thought about getting people to try designs, and I'm pleased to see the idea of testing design for disability included in this book. Pullin does the idea justice in his description of testing prototypes using the "Wizard of Oz" methodan evaluation technique commonly used in technology user interface design.
One of the most helpful accounts in the book highlights design testing for people who have dementia. Researchers found that testing early, rough prototypes was disorienting and disturbing to people with dementia. Instead Pullin recommends first doing this testing with the people who care for those with dementia. Only after the prototype can look, feel, and behave realistically, then is it the time to do necessary testing with people with dementia.
Pullin goes on to briefly explain the differences between formative and summative testing, concluding that testing in the home over time is the best way to learn of a design's flaws and successes. Intriguingly, he rarely uses the word "usability," except to describe an attribute of a design. I liked that.
In the second half of the book, he imagines what would happen if high-profile designers took on specific design challenges in designing for disabilities. Though he has spoken with many of the designers he writes about, this section of the book is more of a museum. If Pullin could curate a show of all the great designers and their works, this would be the catalog for the show. It is compelling, but to me, ultimately dissatisfying because the imagined designs are never made, only contemplated, talked about, or storyboarded. (I found the few storyboards included to be some of the most engaging artifacts in the bookpotential examples for design students to examine and perhaps emulate.)
What is instructional and useful, though disconnected from the first part of the book, is how Pullin gives us glimpses of how different designers approach design. We get a peek at where they start, how they think, and what their processes are. Though the process may not be open to introspection by an individual designer, looking across the chapters, we can see a wide range of philosophies and approaches in use.
Overall this is a beautiful and thoughtful book full of ideas and aspirations that lives in a world between textbook and coffee-table book. The purpose of this book is to help designers remember, as Pullin says:
"In the context of an environment or society that takes little or no account of impairment, people's activities can be limited and their social participation restricted. People are therefore disabled by the society they live in, not directly by their impairment."
It's a call to action against an old way of thinking, in which design for disability is solving a medical engineering problem rather than meeting a cultural, societal challenge. As Jared Spool has said, "Too often, we choose a design because it's doable, not because it's the best we could do." I'd love to see what Pullin could do with voting systems.
Dana Chisnell has helped hundreds of people learn how to make better design decisions by giving them the skills they need to gain knowledge about usersespecially voters and older adults. She is an independent researcher and consultant who founded UsabilityWorks. Chisnell has observed hundreds of study participants for dozens of clients to learn about design issues in software, hardware, websites, online services, games, and ballots. She has helped companies like Yahoo!, Intuit, AARP, Wells Fargo, E*TRADE, Sun Microsystems, and RLG (now OCLC) perform usability tests and other user research to inform and improve the designs of their products and services. Chisnell is a fellow of the Society for Technical Communication and a longtime member of the Usability Professional's Association and ACM's SIGCHI, IEEE, and AIGA She's the co-author, with Jeff Rubin, of Handbook of Usability Testing, second edition (Wiley, 2008).
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