Design for One: An Empathic
Approach to Design for an Expert User
Henry Lin
Fourth Author
Abstract
School of Interactive Arts and
YetAnotherCo, Inc.
Technology, SFU
123 YetAnother Ave.
We are a team consisting of member of Everyday
Design Studio, from Simon Fraser University. This
paper describes the process of designing a game
controller and mouse with a quadriplegic teenager. We
discuss how our design approach addresses issues that
other approaches may neglect. We suggest that design
for one can be adopted by OT and HCI practitioners in
similar situations or where the traditional methods and
techniques have failed to support patients’
requirements. Further design for one provides an
empathic understanding of user’s circumstances and
certain experiences through peer-to-peer interaction
and collaboration among designer, user, and health
care providers.
250-13450 102 Ave Surrey BC, YetAnothertown, PA 54321 USA
CANADA, V3H 0A3
hwlin@sfu.ca
Leila Aflatoony
School of Interactive Arts and
Technology, SFU
250-13450 102 Ave Surrey BC,
CANADA, V3H 0A3
laflatoo@sfu.ca
Ron Wakkary
School of Interactive Arts and
Technology, SFU
250-13450 102 Ave Surrey BC,
author4@yetanotherco.com
Fifth Author
AuthorCo, Inc.
123 Author Ave.
Authortown, PA 54321 USA
author5@anotherco.com
Sixth Author
AnotherCo, Inc.
123 Another Ave.
Anothertown, PA 54321 USA
author6@anotherco.com
CANADA, V3H 0A3
rwakkary@sfu.ca
Author Keywords
Occupational therapy (OT); assistive technology (AT);
empathy; participatory design (PD)
ACM Classification Keywords
Design, Experimentation, Human Factors, Performance
Introduction
Copyright is held by the author/owner(s).
CHI 2014, April 26-May 1, 2014, Toronto, Canada.
Interaction design and HCI typically do not consider
design for a single person. In contrast, within OT and
AT, designing for a single person is common. Designing
a new product or application is critical particularly in
the healthcare context and for vulnerable and impaired
individuals. According to Scherer, a large percentage of
assistive devices for quadriplegic patients end up
unused [8]. Several factors may cause the device’s
abandonment by users such as device performance,
and change in the ability and preference of users [3].
This requires OT and AT professionals to be constantly
designing and refining devices for a single person. The
unique experience and needs of such users necessitates
great empathy in developing solutions for them.
Figure 1: Initial Exploratory meetings.
Figure 2: Initial design meetings.
Figure 3: Designing with Nick in
GF Strong Rehabilitation Centre.
In HCI literature, empathy is rooted in ethnographic
approaches, and the more recent approaches
investigate the potential of involving an empathic
approach in ergonomics [10], and interactive
technologies [4], and concluded that these areas will
benefit from empathy. Relatedly, Participatory Design
(PD) approaches have gained much attention recently
in healthcare [11] particularly to design an appropriate
product for a patient. In PD end users are involved as
co-designers and treated as experts. However, many
PD techniques and tasks are not directly applicable
while designing with vulnerable individuals, and
required modification and appropriation to be used in
other situations and contexts as practiced with seniors
[7] or with younger patients [1].
In our particular case, the performance requirements in
designing a game controller and mouse for our user
(Nick) are critical and specific. Nick’s movements,
agility, and dexterity cannot be generalized sufficiently
for our needs. In addition, his embodied understanding
of his performance abilities together with his deep
reflection on his body and its relations to the world
makes him an expert co-designer of our design
process. Putting all these together, the uniqueness of
the situation makes designing for Nick a challenge of
gaining the knowledge necessary to empathize with the
situation he faces.
Design Orientation and Goals
This research was conducted in cooperation with
occupational therapists, assistive technology resource
personnel, and our expert user Nick. Our original
motivation in working with Nick was to help him
interact with computational tools to allow him to
communicate through online forums. In addition to this
goal, Nick asked us to design a game controller for him
to play computer games. As we consulted with his OT
and AT specialist, we understood that existing devices
on the market did not offer the flexibility to customize
its design to suit Nick’s unique needs. Our design goals
with this project were, on the practical level, to design
and produce a high fidelity prototype game controller
utilizing an open source electronic prototyping process
[2] and digital fabrication for Nick. and on a research
level, to investigate the design process issues in
designing for one that could provide credible
recommendations to HCI researchers, and how
empathy in design plays a part in resolving them.
Our Expert User
Nick is a seventeen year-old high school student, who
enjoys video games and especially first person-shooter
(FPS) games like Halo™. He is a highly experienced
mountain biker who injured himself in a mountain
biking accident. In our project we involved Nick as an
expert user due to his unique physical abilities and
demands. Nick has some sensory input where he does
not have motor skills and the particulars of his
movements are unique to him. HCI literature qualifies a
user as an expert according to the certain domain
Figure 4: Medium Fidelity
Prototyping.
Figure 6: Laser cutting components.
knowledge the user has [7, 11] or length of time a user
has utilized a technology [6]. We began working with
Nick soon after his accident and continued for
approximately six months that included his initial stay
at the hospital’s spinal cord injury ward and his
extended stay at its rehabilitation centre. All the
ideation and design process was conducted with Nick in
the rehabilitation centre.
and fingers, as well as his positioning in relation to the
computer. Further we collaboratively drew sketches,
brainstormed ideas with Nick, and began to
approximate a directional control pad with buttons and
modifications of an existing mouse. These sketches led
more or less directly to the initial prototyping of a
controller. We took notes and video during these
sessions for future references.
Design Process
Prototyping Process
We employed a research-through-design approach,
which is an iterative process in which a series of
experimental prototypes are designed, built and tested
in a real life setting. Throughout the design process, we
consulted with Nick’s OT and AT specialists on
therapeutic, medical and technological matters. The
prototype was designed in incremental stages to test
each parameter with Nick, and to allow for him to
reflect on and co-direct the design. This allowed us to
fine tune the prototype to match his functional
capabilities as they emerged as a result of the
iterations. After every other prototype, the OT or AT
specialist offered their feedback. The baseline for the
success of the game controller was based on Nick’s
game performance and comfort level with the
controller.
Our initial prototype of the game controler was quickly
built out of foam to discover what changes to make,
since early on mutual learning between designer and
expert user was at its highest. The materials of the
controller changed along with the design as the project
progressed. The final game controller is comprised of a
laser cut multi-element panel, sandwiched between
conductive switches made out of copper tape. The final
design allows Nick to access the most basic button for
any FPS game, and all the buttons are
reprogrammable. The size of the button was made to
best suit his movements in order to maximize his
performance in game.
Initial Exploratory Meetings
Figure 7: Nick playing FPS game
with controller and mouse platform.
Our design process was inspired by observing how
Nick’s OT designed his hand splint, and discusses about
the challenges of creating AT for a quadriplegic patient.
For our first meetings with Nick we set ourselves the
task of identifying specific needs of the project. We
discussed ideas he had about what a possible game
controller that suited him would be like. In addition, we
explored Nick’s movement of his arms, wrists, hands,
Testing the Prototypes
The medium and high fidelity prototypes have gone
through numerous iterations to respond to the limitedprecision movement in Nick’s right hand. The final
products (game controller and mouse) were tested by
Nick, and he responded to them positively when he was
able to play an FPS game on his computer.
Design for One Characteristics
Designing for one is design for commitments and
implications. It is an experienced-centered process in
which a series of experimental prototypes were
designed, built and tested in a real life setting. The
uniqueness of the user’s situation, the involvement of
the user as design expert, and critical design decisions
based on the user’s reflections are three commitments
that we considered throughout the process. Further,
design for one promotes an empathic approach due to
the iterative process of design for a unique individual
according to his reflections. The extensive iterations we
created with our participant allowed for the emergence
of tacit knowledge and new skills that were initially
unknown. The continual iteration of the prototype
achieved a degree of fit with Nick that could not be
achieved through any other approaches, or by
measurents or requirements gathering alone.
Implications and conclusion
Figure 8: Design for One: iterative
personally tailored design cycles.
Design for one techniques (DIY and digital fabrication)
can be an alternative for occupational therapists and
HCI practitioners in situations where the most optimal
fit and granularity of design details is a necessity. Since
every single patient is unique, an occupational therapist
can design custom apparatus, tailored to their
requirements. Design for one is an empathic approach
that involves a user as an expert in every single step of
the design process, and can be adopted where other
qualitative approaches are not able to address the
critical and particular needs of a case. The uniqueness
of the design situation and the benefit of this quality of
fit make designing for one a necessary if not preferable
approach in many instances.
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