Augmentative and Alternative Communication, December 2010 VOL. 26 (4), pp.

226–229

BOOK REVIEW

Design Meets Disability{

BY GRAHAM PULLIN

Reviewed by JEFF HIGGINBOTHAM*

INTRODUCTION REVIEW

The notion of design has been part of Augmentative The organization of this book reveals the careful
and Alternative Communication (AAC) since its hand of a designer, in terms of the way informa-
inception. The field has produced a wide variety of tion is presented to the reader. Using the meta-
graphic representation systems designed to pro- phors of meeting and tension, Pullin seeks to
mote vocabulary learning and AAC device access. engage the reader in a dialogue about the relative
Interfaces have been designed to enhance dynamic values of AT engineering and commercial design.
page navigation and facilitate access to informa- In the first part of the book, six attributes of
tion. Devices have been produced in a variety of medical rehabilitation engineering are paired with
shapes and sizes, addressing a number of consumer six attributes of commercial design (see Table 1).
needs and preferences. With the advent of technol- The qualities and resulting ‘‘tensions’’ between
ogies such as the iPhone and iPad, applications are each pair are explored in terms of a ‘‘meeting’’ or
now appearing to take advantage of these new and dialog between them. These pairings are presented
attractive types of hardware. Looking at AAC in the upcoming section. Within the six sections,
design over the years, one wonders: Upon what Pullin develops his thesis that the inclusion of
bases are these design decisions made? Are there – designers and good design principles in AT devel-
or should there be – a set of design principles opment could significantly enhance the evolution of
guiding AAC development? When and how are the AT and the value of these products to their
users of AAC technologies involved in the design of consumers. In the second section of the book,
the communication technologies that they use for Pullin lends the sensibilities of several of the top
life’s interactions? commercial designers as to how they would
Graham Pullin’s book, Design meets Disability approach the development of particular AT pro-
(2009) reveals the ways in which design has been ducts: if Paul Smith (fashion designer) ‘‘met’’
employed in Assistive Technology (AT) and the hearing aids, if Jasper Morrison (furniture de-
historic role of designers and consumers in the AT signer) met wheelchairs, if Durrell Bishop (interac-
design process. Pullin’s thesis is that the historic tion designer) met communication devices. By
functional focus of AT frequently comes at the using the metaphor of a meeting, Pullin seeks to
expense of many other design values, particularly draw the reader into conversations between de-
those which embrace culture and self image. He signers and AT devices and to explore the ways that
advocates for a greater role for the commercial a designer’s sensibilities could enhance, extend, and
designer with respect to design values in AT otherwise re-purpose these devices. Throughout the
development and the inclusion of device users text, Pullin provides the reader with numerous
throughout the manufacturing process. historical portrayals, accounts of consumer experi-

{
Design Meets Disability by Graham Pullin is published by MIT Press, Cambridge, MA, 361 pp.
*Corresponding author. Jeff Higginbotham, PhD, Department of Communicative Disorders and Sciences, University at Buffalo,
Buffalo, New York, USA. Tel: þ1 716 829 5542. E-mail: cdsjeff@buffalo.edu

ISSN 0743-4618 print/ISSN 1477-3848 online Ó 2010 International Society for Augmentative and Alternative Communication
DOI: 10.3109/07434618.2010.532926
 REVIEW: DESIGN MEETS DISABILITY 227

TABLE 1 Meetings. behave in new situations, how their perception

Design AT/medical engineering
of and identification with AT may change as a
result of non-functional design changes, and how
Fashion Meets Discretion AT may be re-purposed by their users as it
Exploring Meets Solving becomes more embraced by its user base.
Simple Meets Universal
Identity Meets Ability
Provocative Meets Sensitive
Feeling Meets Testing SIMPLICITY IN DESIGN
Expression Meets Information
For the more limited, if adequate, is always
preferable. (Aristotle)
ences, and gorgeous photographs. Like a good
designer, Pullin knows how to engage and inform One of the most common design values in AT is
an audience through narrative and visuals. the notion of universal design, that is, objects are
designed to be used by a wide variety of people
with differing abilities. In AAC devices, universal
AESTHETICS AND IDENTITY design may apply to the varieties of input
methods and interfaces available on a single piece
In the chapter, ‘‘Fashion meets Discretion,’’ of technology. In his argument for simplicity,
Pullin describes the evolution of eye wear in Pullin makes the distinction between a platform
contemporary culture, noting that ‘‘eyeware’’ is (like a DynaVox VTM1 or a PRC Echo2) and an
perhaps the most advanced AT in terms of its appliance (like a Lightwriter3 or aDynaWrite1).
social acceptability and design. Unlike many AT He notes that platforms are the ‘‘swiss army
products, glasses are fashionable, worn without knives of technology’’: multi-featured, user-alter-
stigma, and are now a means for expressing able, unstable, and frequently updated. In con-
cultural and personal identity; in fact, the under- trast, appliances tend to be of a single integrated
lying functional value of glasses is almost invisible design, characterized by a restraint on specifica-
to many consumers. The design trajectory of tion, narrow in scope and of a limited complexity,
eyeware marks a progressive attentional shift and less likely to crash. In the AAC field, Toby
from the functional to the aesthetic, and from a Churchill’s Lightwriter provides a good example
medicalized model (i.e., restorative) to a social of an appliance-like technology that provides an
model (image) of prescription. He also shows that easy-to-use, straightforward communication
the design development of ‘‘earware’’ (hearing device for individuals with relatively good direct-
aids) and ‘‘legware’’ (prosthetics) may be similar selection capabilities. Pullin suggests that appli-
to that of eyeware, because both of these ATs are ances tend to be more cognitively and culturally
beginning to include a sense of visual aesthetics inclusive, in that the simplicity of their design may
and personal identity in their design. Such a trend make them easier to understand and use. In the
may be a part of the evolution of every AT. AAC field this comparison is complicated by that
fact that, in order to make systems simple and
straightforward, AAC devices must frequently
DESIGNER AND AT provide a set of underlying features and capabil-
ities in order to meet the multitude of changes
In the chapter ‘‘Exploring Meets Solving,’’ Pullin faced by the individual over time and circum-
begins a discussion on the importance of includ- stance. The comparison becomes more appropri-
ing designers in AT development, by contrasting ate as the AAC industry begins to address specific
the solution-based design stance taken by en- segments of its consumer base (e.g., individuals
gineers and AT specialists (e.g., Step 1: Problem with ALS, aphasia, or autism) by designing
specification, Step 2: Solution generation) versus technologies to meet their AAC needs.
a more playful exploratory approach taken by
designers and artists. The notion, ‘‘solutions are
usable, not just pretty’’ (p. 43) reflects the
EXPRESSION
perspectives of many AT developers; that serious
problems should be met with no-nonsense solu- Technology today is the campfire around
tion-based approaches. The author counters which we tell our stories. (Laurie Anderson,
this functional zeitgeist by pointing out that p.167)
playful, exploratory, and sometimes provocative
approaches to design serve serious purposes by In the chapter, ‘‘Expression Meets Information,’’
examining how users and their technologies Pullin highlights AAC when bringing up issues of
228 J. HIGGINBOTHAM

AT personalization and user-centered design. He throughout the development cycle and recognize
correctly identifies that the major goal in AAC the value of exploring designs for more than just
and many other communication technologies is to their functional outcomes. He advocates for a
achieve unambiguous communication, in which ‘‘resonant design’’ approach, one that addresses
the information conveyed is unimpeded by the the needs of people with or without a particular
technology used. But this information theory- disability who find themselves in circumstances
inspired goal has come at the expense of many that call for the use of a particular technology.
other aspects of expression, including conveying Resonant design is not a compromise, but a
emotion and communicating personal and cultur- fundamental inspiration (p, 93). In the AAC
al identity and attitude. For example, although world, it may involve looking at making main-
the newest synthetic voices provide high intellig- stream technologies adaptable to persons with
ibility and a generically pleasant voice, they differing needs (e.g., using the iPad for emailing),
cannot be acoustically individualized or used for as well as designing dedicated AAC technologies
effective face-to-face expressive goals; thus, users for an explicit user base in order to accomplish
have great difficulty making them part of their specific real-world tasks (e.g., the development of
‘‘personality.’’ Quoting Laurie Anderson, an Visual and Contextual Scenes for persons with
avant-garde musician and performance artist, chronic aphasia; Buekelman, Ball, & Fager, 2008).
Pullin points out that the paralinguistic qualities Pullin strongly advocates for the inclusion of
of speech produce the individuating expressive AAC users as participants throughout the entire
‘‘voice’’ with which we identify and affiliate as design process, and particularly during the early
human beings. Thus, while progress has been phases. As an interaction designer, he is well aware
made in producing more intelligible and natural of the tendency for designers to design for them
sounding voices, they lack many of the persona- selves or according to their simplified perceptions
lized and expressive characteristics so critical for of the needs of AAC users. To design for a user
interpersonal communication. group whose lived experience differs from that of
the designer and engineer, active participation by
individuals representing that group is required.
INVITING IN THE OUTSIDERS

Pullin contends that the overarching medical/ CONCLUSION

functional orientation of AT risks defining (and,
thus, stereotyping) people by their disability by Pullin’s book is not a how-to guide. Other texts
providing technologies that are not responsive to may provide a better basis in understanding
individuality in terms of ‘‘diversity of culture, interaction design (e.g., Cooper, Reimann, &
tastes, temperament, wealth, education values, Cronin, 2007; Moggridge, 2007). The text is more
attitudes and priorities’’ (p. 89). This schism of a design manifesto, providing an overall
between AT and mainstream design is also compelling framework for understanding the role
perpetuated in the definitions developed by of commercial design in AT. Design Meets
professional societies and organizations. For Disability may be compared to Donald Norman’s
instance, Pullin points out that the World Health (1988) Psychology of Everyday Things, which
Organization makes a clear distinction between showed how research in cognitive psychology
AT and mainstream products, with the former can inform commercial design. Similarly, Design
defined as ‘‘specially designed equipment, pro- Meets Disability explains how commercial design
ducts and technologies that assist people in their principles can be used to make more personally
daily living’’; and the latter defined as ‘‘general identifiable and valuable assistive technologies.
products and technology . . . not adapted or As important as Norman’s book was to technol-
specifically designed’’ (p. 92). Pullin argues that ogy design, Design Meets Disability could have a
these differences in goals, attitudes, and defini- similar impact within the AT field.
tions perpetuate an unproductive distinction Pullin’s book and design philosophy have a lot
between technology genres that keeps mainstream to offer AAC research and development. For
design attributes from influencing AT product example, the AAC public’s attraction to the
development. If identity is inseparable from the iPhone and iPad appears to be based not only
objects that we use, what types of images does AT on cost and function but also on visual attrac-
provide for any person if the principles of design tiveness and identification with other users of this
focus primarily on function? ‘‘cool’’ technology. As the generic informational
To rectify this problem and mend the rift, goals of AAC are being met, it may be time for
Pullin recommends that the AT development manufacturers to refocus their attention on
process should include designers and users making more personalized systems, based on
 REVIEW: DESIGN MEETS DISABILITY 229

demonstrated priorities of AAC’s user base.

References
Design Meets Disability may be the book to
provide us with that roadmap. Beukelman, D., Ball, L., & Fager, S. (2008). An AAC
Personnel Framework: Adults with acquired complex
communication needs. Augmentative and Alternative
Notes Communication, 24, 255–267.
Cooper, A., Reimann, R., & Cronin, D. (2007). About face
1 DynavoxVTM and DynaWrite are products of Dynavox 3: The essentials of interaction design. Hoboken, NJ:
Technologies, Pittsburg, PA. Wiley.
2 The PRC Echo2 is a product of the Prentke Romich Moggridge, B. (2007). Designing interactions. Cambridge,
Company, headquartered in Wooster, OH. MA: MIT Press.
3 LightWriter is a registered trademark of Toby Churchill, Norman, D. (1988). The psychology of everyday things. New
Ltd. Cambridge, England, distributed in the USA by Zygo York, NY: Basic Books.
Industries, Inc., PO Box 1008, Portland, OR 97027-1008, Pullin, G. (2009). Design meets disability. Cambridge, MA:
USA. MIT Press.
Copyright of AAC: Augmentative & Alternative Communication is the property of Taylor & Francis Ltd and its
content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's
express written permission. However, users may print, download, or email articles for individual use.