Chapter 15

All Technology Is Assistive: Six Design Rules on Disability

Sara Hendren

In 1941, the United States Navy commissioned the husband-and-wife team of Charles and Ray Eames to design a lightweight splint to get wounded soldiers safely out of the battlefield. Metal splints of the period were not secure enough to hold the leg still, causing unnecessary death from gangrene, shock, blood loss, and so on. The Eameses had been working on techniques to mold and bend plywood, and they came up with a splint design conforming to the body without a lot of extra joints and parts. The wood design became a secure, lightweight, nestable solution, and the Eameses produced more than 150,000 such splints for the Navy. Over the next decade, they would refine their wood-molding process to create both sculpture and functional design pieces, most notably the celebrated Eames chair.

Graham Pullin (2009), in Design Meets Disability, cites this story as an example of a seemingly specialized design problem — improving a battlefield medical aid for wounded soldiers — that inspired a whole aesthetic in modernist furnishings. The chairs launched a thousand imitators and a new ethos of simple, organic lines in household objects. Most people assume that such innovation usually happens in reverse: that a generalized design solution “trickles down” to the narrow confines of adaptive and assistive aids. But, as Pullin points out, the Eames story suggests that disability concerns are in fact an overlooked source of rich aesthetic ideas, with relevance and impact for design far beyond their immediate starting point. More than that, the story demonstrates why everyone should pay more attention to matters of disability.

You might imagine that “disability studies” is just one more category of identity research that has been created primarily for political advocacy, interesting only to those directly affected by issues of accessibility, accommodation, or special rights. But “disabled-ness” is another matter altogether. There are at least two big reasons why disability concerns are everyone’s concerns.

First, any us/them distinction between able-minded/able-bodied and disabled is a false divide. After all, how cultures define, think about, and treat those who currently have marked disabilities is how all their future citizens may be perceived if and when those who are able-bodied become less abled than they are now, whether by age, degeneration, or some sudden or gradual change in physical or mental capacities. All people, over the course of their lives, traffic between times of relative independence and dependence. So the questions cultures ask, the technologies they invent, and how those technologies broadcast a message about their users — weakness and strength, agency and passivity — are critical ones. And they are not just questions for scientists and policy-makers; they are aesthetic questions, too.

Second, in many cultures — and certainly in the United States — a pervasive, near-obsession with averages and statistical norms about bodies and capacities has become a naturalized form of describing both individuals and populations. But this way of measuring people and populations is only a recent development and worth reconsidering. Disability studies scholar Lennard Davis (2002) writes:

Before the nineteenth century in Western culture, the concept of the “ideal” was the regnant paradigm in relation to all bodies, so all bodies were less than ideal. The introduction of the concept of normality, however, created an imperative to be normal, as the eugenics movement proved by enshrining the bell curve (also known as the “normal curve”) as the umbrella under whose demanding peak we should all stand. With the introduction of the bell curve came the notion of “abnormal” bodies. And the rest is history. (Bending over Backwards 39)

The bell curve is the source of all talk about how individuals measure up relative to others. In case you doubt this obsession, I invite you to witness conversations among parents of young children — it is all percentiles, and milestones, and being “ahead of the curve” with respect to each month of a child’s development. Exceptional normal-ness is prized above all else. Measurements reassure anxious caregivers, despite little correlation between them and a lifetime of wellness, healthy relationships, or sustaining work.

Again, Davis reminds us that such standards comprise a recent set of cultural ideas, so unquestioned now that they have a way of “enforcing normalcy.” Of course, as Davis writes, “It is too easy to say, ‘We’re all disabled’” (Bending over Backwards 31). But a challenge remains: to interrupt cultural assumptions in powerful, creative ways — and to alter wider collective thinking about one’s own dependence and independence, and that of others. So how might designers and artists engage these myths about what is normal and make more visible, critical, and expansive technologies?

All technology is assistive technology. What technology are you using that is not assistive? Your smartphone? Your eyeglasses? Headphones? Those three examples alone are assisting you in multiple registers: they are enabling or augmenting a sensory experience, or providing navigational information. They are also allowing you to decide whether to be approachable in public; to check out or in on a conversation or meeting in a number of subtle ways; to identify, by your choice of brand or look, with one cultural group and not another.

Making a persistent, overt distinction about “assistive tech” embodies the second-tier do-gooderism and banality that still dominate design work targeted toward “special needs.” “Assistive technology” implies a separate species of tools designed exclusively for people with a rather narrow set of diagnostic “impairments” — impairments, in other words, that have been culturally designated as needing special attention, as being particularly, grossly abnormal. But are you sure your phone is not a crutch, as it were, for a whole lot of unexamined needs?

Undoing the distinctions between design for disability and design in general yields a couple of benefits: it brings new attention to technologies that are profound in their use and impact on physical and political accessibility. (Advanced replacement limbs,[1] all-terrain wheelchairs,[2] and exoskeletons[3] are evidence of this new attention.) It also brings a productive uncertainty and powerful friction to the task of designing technologies of all kinds. Whether you are designing for an established need or seeking an application for a technical novelty, you might take more time before confidently assigning it to a particular user, or deciding, up front and with confidence, how it will be used. A design might be for practical ends, play, or something you have not yet imagined.

Instead of labeling some technologies and not others as assistive, let us start like this: we are all getting help from the things we make — all kinds of help, all the time, for our many material, social, educational, and political needs. Private needs and public ones. No one is exempt. Then the questions get really interesting: What can a body do (Deleuze 1992)? What needs are you interested in? Who might use which thing for what? Where might the surprises be? How might a familiar thing morph into something else altogether? In the name of good friction, then, I want to suggest some possible dispositions for designers and artists taking a look at ability and disability.

1. Invisibility Is Overrated

The Victoria and Albert Museum’s 2005 exhibition, “Hearwear: The Future of Hearing,” commissioned designers to reconsider the traditional hearing aid, a long neglected prosthesis known for dubious “flesh toned” plastics and metal circuitry. The designers rejected the idea of these devices as objects of shame.

“The Beauty of Inner Space,” a design by Ross Lovegrove, has more in common with jewelry than medical gear. His proposal would have a hearing aid amplify and mute sounds at the user’s discretion — highlighting sounds you want to hear and canceling out others. And the Svara hearing aid, by BreweryLondon, is a proposal to make amplification gestures blend seamlessly with other movements: moving the necklace’s “pendant” up or down, for example, or tucking one’s hair behind the ears.

In other words, one strand of design might be devoted to making the hearing aid as discreet as possible — to hide its function from view. But another round of questions becomes more interesting altogether: What might a hearing aid also do — or do instead — that has not been considered? [4]

2. Rethink the Default Bodily Experience

Researchers at Georgia Tech used a tongue driver — a wireless device that allows those who have high-level spinal cord injuries, and therefore little or no limb movement, to operate computers and their own electric wheelchairs — to reimagine wheelchair navigation for quadriplegic users. Placing wheelchair controls in headsets, say the researchers (Robinson 2012), makes them susceptible to jostling and frequent recalibration. Moving the entire system inside the mouth makes it stable and reliable, and the tongue’s receptors are sensitive enough that the user can move a cursor on a screen and direct a wheelchair. Instead of approximating a hand movement with joystick directionality, the system exploits a built-in sensitivity goldmine, protected from outside elements. And it can be programmed for many complex commands at once. Sometimes heightened functionality is about reconsidering typical adaptations entirely, inverting the expected sensory mechanism. One could easily picture this system in general use for tasks, like gaming, that typically require hand control.

3. Consider Fine Gradations of Qualitative Change

I am as much a fan of exoskeletons and bionic limbs as the next person. But designers must also address far subtler changes for bodies over a lifespan. Some of the most interesting ideas pose ways to “edit” environments that already exist, to accommodate more bodies more of the time. Nichola Trudgen’s “Wanderest” (2009)[5] is just that kind of edit: a perch for pausing on the otherwise relentlessly forward-looking streetscape. As cities consider their usability for aging populations, this kind of accommodation might be as important as newer, “smarter” nursing home environments. Could small structures like “Wanderest” make streets more navigable and independent living more attainable for a longer period?

So many medical technologies for treatment are just that: medicalized. They operate with the assumption that a change in ability is primarily a biological condition, without thought for the broader ways the built environment can expand and shift to welcome multiple kinds of bodies and experiences.

4. Uncouple Medical Technologies from Their Diagnostic Contexts

Temple Grandin (2012) is a research scientist in animal husbandry and a well-known self-advocate for people with autism spectrum conditions. She revolutionized the cattle slaughter process, creating far more humane tools and practices for a huge percentage of slaughterhouses across the United States. She grew up a close observer of cattle on ranches and noticed the common use of a “squeeze chute” — a tight chamber that holds a cow still for inoculation. The deep pressure had a calming effect on the animals.

Watching this technology, Grandin intuited her own need for an adaptive “hugging machine” that would provide her with a proxy for human touch. For someone whose interpersonal interactions were often confusing, this machine delivered a kind of affection and calming influence that Grandin needed but would not get from a typical human relationship. Artist and MIT professor Wendy Jacob (1998) collaborated with Grandin to modify and replicate the hugging machine in the form of “squeeze chairs” — furniture that gives you a hug.

What happens when a tool used for therapeutic reasons also points outward from a diagnostic mode toward something more ambiguous, entering the realm of the poetic? Why should a critical object like the squeeze chair not possess more affect or be more responsive? When an object’s uses and users become less clearly marked, new stories about that object and its users can suddenly emerge.

5. Design for One

Michail Vanis (2017), an interaction designer working with a team of fellow students on “the future of work,” started to think about his grandmother Despina’s retirement from her job as a seamstress — a job she valued for its camaraderie of fellow workers at their sewing machines in a shared physical space. After her retirement, Despina did not need a chair or adaptive machine to sew in her elder years, but she did miss the togetherness of colleagues. So Vanis created “Social Sewing” (2011), a complex of sewing machine avatars that activate when Despina’s now far-flung colleagues are also laboring in their post-work contexts. This project is about productive, radical constraints: it narrows the design question to a single user, but it suggests a much wider frame for thinking about the future of work in all its crucial qualitative senses.

6. Let the Tools You Make Ask Questions, Not Just Solve Problems

The tricky part with popular prosthetic design — bespoke artificial limbs, for example — is an overwhelmingly dominant trend toward making people with atypical bodies “pass” as “normal.” Plenty of well-meaning designers set out to redesign an object so that its wearer will not “appear disabled,” with the presumption that a preconception of “normal” is always desirable.

Yes, of course, some users want discreet tools. But others roundly reject the notion that all bodies should conform to some standardized or performative ideal. This kind of variability and disagreement should also be a productive friction for designers. Once freed from thinking in terms of creating tools for disability, designers can create personal objects that disrupt our notions of dependence and autonomy.

Jennifer Crupi (2017), an artist and metalsmith, makes a kind of gestural jewelry. Her “Power Gesture” (2013) is an assistive device to rehearse one’s self-presentation. It forces its wearer to assume the authoritative position of steepled fingers, held confidently and calmly in front of one’s chest, with fingertips on each hand aligned, pressed together, and spread wide apart. Crupi’s “Guarded Gesture” (2012), a “necklace” of thick silver wire that ends in two curved resting bowls for the wearer’s forearms, externalizes the betrayal of emotions that is so revealing in the crossed-arms stance. These designs express a kind of comedy-with-teeth: Crupi makes a shrewd comment on the sciences of body language and the ways humans say both what they want to express and what they wish to hide.

Questions of utility matter: Does it work efficiently? Is its power maximized? Is it user-friendly? Can it be mass-produced, affordably? But questions outside utilitarian concerns also matter. Whether interrogative design,[6] or critical design (Dunne and Raby 2013), or “design for debate” (Dunne 2008), objects and their stories suggest a para-functionality (Dunne 2005) that renders visible subtler needs and proxies.

Let us hope for objects that raise and suspend questions, and employ them alongside objects designed to solve problems. Then we can have a complex public conversation about needs and desires for interdependence — and about tools that provide assistance to every human body.

Notes

Bibliography