Book Review: Design Meets Disability

Book | Author | Review

By Gerd Waloszek, SAP User Experience, SAP AG – November 24, 2009 • Original article

This review takes a personal look at Graham Pullin's book Design Meets Disability.



Cover of Design Meets Disability     

Graham Pullin
Design Meets Disability

The MIT Press, 2009
ISBN: 978-0262162555

Usability: Design, Accessibility, Universal Usability



Photo of Graham PullinGraham Pullin is a lecturer in Interactive Media Design at the University of Dundee. He has worked as a senior designer at IDEO, one of the world's leading design consultancies, and at the Bath Institute of Medical Engineering, a prominent rehabilitation engineering center in the United Kingdom. He has received international design awards for design for disability and for mainstream products. (From book cover, adapted)



Preceding Remarks

When the SAP Design Guild Team received a copy of Graham Pullin's book Design Meets Disability for review, we asked two colleagues from SAP's Accessibility team whether they would like to review the book. Interestingly, after taking a closer look at the book, both refused to do so – mostly because they found the book too vague. Their reservations about the book reflect something I have often found: There is a huge gap between UI design practitioners and "real" designers. UI designers think and act more like "engineers." They deal with a well-defined and, in a sense, "virtual" domain, namely computer software, a domain that is subject to technical and other constraints, style guides and guidelines, as well as standards and legal regulations. Designers who teach at art schools or work in design companies think and act more like "artists." They deal with a much broader, often less constrained, and more "physical" domain, ranging from consumer products to provocative art installations in museums or public spaces. Software may be involved in their designs as well, but it plays a different role than it does for UI designers and is rarely the main focus. So, despite of being completely unaware of the book's central themes, we were immediately confronted by one of them. In the end, I had to write the review myself, as so often before. Here it is – and from time to time, I will return to the gap between "real" designers and UI designers who – at least for me – represent the medical engineers that Pullin refers to in his book.

Setting the Stage

Pullin characterizes Design Meets Disability as "a book about how the worlds of design and disability could inspire each other." In a brief intro, he uses leg splints made from plywood and designed by Charles and Ray Eames in the 1940s, which later influenced their famous plywood furniture designs, to illustrate how disability can inspire design and remarks: "This sequence of events challenges the so-called trickle down effect whereby advances in mainstream design are expected to eventually find their way into specialist products for people with disabilities, smaller markets that could not have supported the cost of their development." In his opinion, this example of the "flow in the opposite direction" demonstrates how "the issues around disability catalyze new design thinking and influence a broader design culture in return."

But how can design inspire the world of disability? Pullin observes that disability is addressed differently by different professional cultures and identifies two main approaches, which "exist side-by-side in a healthy tension:" The first one focuses on problem solving respecting constraints; it is used by people with a clinical and engineering background. The second approach, playing around with an open mind, is taken by people with a background in design, "challenging these constraints and exploring further freedom beyond them." Pullin highlights that the Eames' plywood furniture was the result of both approaches: from leg splints as well as from sculptures. On the one hand, Charles and Ray Eames looked for a solution to light-weight leg splints and arrived at plywood as a raw material. Ray Eames, on the other hand, played around with plywood and created sculptures out of spare leg splints, which later inspired their furniture designs. Pullin observed, however, that apart from a few notable exceptions, the two approaches are typically pursued by separate professional fields addressing products – not only, but also – for people with disabilities: "After art college, as a design consultant, I led multidisciplinary teams of designers in creating products for consumer markets. I am struck by how distant those two worlds still are, yet how much more each could be influenced by the other." He concludes: "At the moment, there are significant differences between the cultures found within design and medical engineering – differences in values, methods, and even ultimate goals. These differences tend to keep them apart, as two separate fields." And he also admits that "if the two were brought together to collaborate, these differences would undoubtedly set up real tensions within each team."

In his book, Pullin identifies and addresses seven distinct tensions between the two fields or cultures. I have already mentioned the tension between exploration and problem solving; for a list all of the tensions, see the overview of the book below. Pullin is confident – and this is probably the most important message of his book – that "ultimately these could be harnessed as healthy tensions, the inevitable friction serving as a source of energy to catalyze new directions within each – perhaps even to fuse the communities together." Pullin believes all of the tensions currently show a bias toward problem solving and that all of them could benefit from a healthier balance, that is, from bringing in more design and designers. Therefore, Pullin makes the book itself biased in the opposite direction: He admits that while "the book touches on inclusive design, which brings issues of disabilities into mainstream design," it "spends more time looking in the opposite direction, examining what would be gained by bringing art school design culture to products specifically for disabled people. It argues for more designers to be involved in design for disability." Thus, finally we have arrived at an answer to the second question: bring in more design and designers. Pullin provides support for this argument throughout the book: There he demonstrates, mostly based on examples, what design has to offer, namely new, inspiring and sometimes even provocative methods, open-ended exploration, and open minds that challenge constraints and tacit assumptions.


As already mentioned, the book starts with a short intro that sets the stage for the remainder of the book. The intro is followed by an introduction that reiterates the book's central themes. The main part of the introduction provides a helpful overview of the book, which is made up of two parts: In the first part, "Initial Tensions," Pullin explores different design routes by contrasting tensions between the professional fields mentioned above. In the second part, "Meetings with Designers," he presents real and imagined discourses with designers who address selected disability-related design tasks. Pullin looks at the following tensions:

  • Fashion meets discretion: "Examines the traditional goal of medical design to compensate for disability as discretely as possible" – and contrasts this with"adopting the culture of fashion."
  • Exploring meets problem solving: "Compares the problem solving approach at the heart of medical engineering with more open-ended design exploration."
  • Simple meets universal: "Reconsiders the goals of inclusive design."
  • Identity meets ability: "Challenges the distinction between inclusive design and design for special needs."
  • Provocative meets sensitive: "Introduces the method of critical design that is provoking new thinking about issues as diverse as energy policy and antisocial behavior."
  • Feeling meets testing: "Contrasts the roles of prototyping in design and clinical practice."
  • Expression meets information: Approaches "a frontier of design for disability: the development of communication aids for people with speech and language impairments."

Each chapter briefly introduces the antipodes and then outlines the "tensions" between the two. Based on numerous design examples, Pullin demonstrates possible ways in which the specific tensions can be relaxed. He argues that examples better represent the ideas in the book than writing – and he also includes numerous photos to illustrate the examples. The chapters typically close with a short discussion and an outlook.

While some of the chapter titles may initially sound rather abstract, fashion meets discretion is probably a title and a tension that everyone understands immediately. This chapter poses the question whether prosthetics should be worn discretely or as fashion accessories. Currently, most prosthetics are worn discretely – often they are flesh colored and/or worn where they cannot easily be seen (think, for example, of hearing aids or artificial limbs) –, but it turns out that there are already some exceptions. Glasses, for example, even though they are prosthetics, are worn and treated like fashion accessories today. They are used to accentuate certain characteristic of a face, and many people have a number of them for different – practical as well as fashion-related – purposes. This is in stark contrast to hearing aids, which are hidden in or behind our ears (they are also much more expensive, so that people cannot afford to own several ones; but it might be possible to have different "skins" for them, as is the case for mobile phones or MP3 players).

In the chapters provocative meets sensitive and feeling meets testing, Pullin demonstrates how designers can contribute to the overall design by bringing in different perspectives and new approaches to design, which can complement the traditional clinical trials. "Critical design" has been promoted by Dunne and Raby (see the review of Dunne's book Hertzian Tales). It is a tool to evoke discussions that might otherwise go unnoticed and to uncover unspoken assumptions inherent in the current development and designs for the world of disability. "Experience prototyping" is another approach that is not so much a set of techniques, but rather a "state of mind," allowing designers, clients, and users to experience themselves when interacting with new devices.

In the second part of the book, Pullin either confronts designers with certain design briefs and watches how they approach them (XYZ meets ABC, seven longer discourses), or he imagines how certain designers would approach the same or other design tasks (if XYZ met ABC), based on what he knows of them and their design approach. For example, Pullin speculates how Jonathan Ive from Apple would design hearing aids. The list of design briefs is long and comprises step stools, wipers, wheelchairs, robot arms, prosthetic legs, hearing aids, Braille, watches for visually impaired people, communication aids, memory aids, accessibility signage, and wheelchair capes. Pullin expects designers to engage the design briefs in different ways and to also come up with quite different results – and this is what "design and disability still needs and deserves" – considering the diversity of individuals with disabilities. According to Pullin, "when design meets disability, the diversity of complementary, even contradictory, approaches can enrich each field." All in all, Pullin's focus is clearly on demonstrating how designers can contribute to design for disability, not only with respect to the design itself, but also regarding how they approach design tasks.

In his conclusion, Pullin "returns to the theme of creative tension and the importance of looking beyond traditional views of function." He expresses the hope "that examples as much as principles will soon bring about more mutual influence between disability and design, because design inspires design."

Short Discussion

As already indicated, Pullin proposes a change in the way disability is approached, and his book provides the arguments for this change, mostly in the form of examples. To be more precise, he demands a "change ... from a medical to a social model." To make it clear what such a change involves, Pullin provides compelling examples throughout the book: Disabled people want to express, and some already do so, their identity through their disabilities; see, for example, Pullin's visionary move from eyewear to earwear and legwear. They want to access to the diverse range of products just as non-disabled people do, and do not want to be restricted to uniform, "clinical" devices that lack any beauty (for example, Pullin reports that actress Aimee Mullins posed for photos half-naked wearing carbon fiber running legs. She also owns a number of different leg prostheses, including carved wooden legs, to wear at appropriate occasions). According to Pullin, from such a change "it follows that the role of design needs to change too and the nature of the design teams must change as well." He continues: "Design processes need to become more inclusive in several ways, involving not only disabled people themselves but also a greater diversity of designers. ... Art school design disciplines are as essential to the mix as engineering and human factors." This includes involving young design students and "not just those destined for mainstream commercial success but also the enfant terribles." Pullin urges that "mediocrity must be avoided. In design for special needs, mediocrity (in other words: mainstream, traditional, or no design) can result in people being further stigmatized by the very products that are intended to remove barriers for them, thereby undermining the highest goal of social inclusion." Thus, for Pullin it is mandatory to "keep the design in design for disability." In the light of the current state of affairs, it would probably more appropriate to say: to bring the design into design for disability. Some people with sensitive antennae might sense an impending conflict between user advocates, such as human factors or usability people, and design advocates regarding the role of user-centered design. It would not be for the first time that such a conflict has emerged...

As already mentioned, Pullin intended to counterbalance the current bias towards problem solving in design for disability. Therefore, he himself takes a biased approach in his book and devotes the majority of it to how design and designers can contribute to design for disability, including design directions that do not lead directly to commercial products. Moreover, he clearly wrote his book from a designer's perspective and with a design audience in mind. But this bias may not be helpful when addressing prospective team players from other professional fields since not everyone may be willing to share the "designer's perspective." Perhaps these were also among the reasons why my colleagues were reluctant to review the book. This issue leads me to a general concern that I have regarding the book: Pullin is primarily "preaching to the converted," the designers. I have also found this phenomenon in the usability field: I have read so many articles and listened to so many presentations in which usability people tell their colleagues how important usability is for software design. In his book, Pullin tells the design community how important design is in designing for accessibility. However, will he really reach out to people from other professional fields with his book? I doubt it, but these are exactly the people that he needs to convince!

To conclude, I would like to mention that Pullin's book is easy to read with lots of photos, covering a whole page, sometimes even two. I have read quite a few books from designers that did not include even one figure. Can it be that designers who typically deal with physical objects and who sketch a lot use only words in their books? I am well aware that collecting and preparing images implies a lot of work – this may be at least one of the reasons for the sparse use of images in books. Pullin's book, however, is a notable exception. The photography credits alone cover three and a half pages in small print! Purely out of curiosity, I counted the number of photo pages and arrived at a total of 121 (of little more than 350 pages, meaning that on average a photo can be found on every third page). That is very impressive indeed!


The book's cover tells the readers that in his book, "Graham Pullin shows us how design and disability can inspire each other." In this review, I have touched on both directions, but I have also made it clear, in agreement with Pullin, that the focus, or "bias," of the book is on how designers can contribute to a multidisciplinary cooperation addressing design for disability. But Pullin's goal is not to separate, he promotes collaboration and even dreams of ways to "fuse the communities together." But before any fruitful cooperation can emerge, a number of obstacles, habits, and prejudices must be overcome by all involved parties: Engineers and designers will have to be willing to understand each other's goals, approach, and language. Pullin's book can be seen as a step in this direction and although it is neither the first (as the examples in the book demonstrate) nor the last it is nonetheless an important one. As such, I recommended it to all readers who want to get involved in bringing design and accessibility together, whatever professional background they may have.

UI designers may indeed live in a world that is different from that of other designers. I even spoke of a gap between the two groups at the beginning of my review. But designing for accessibility, or more generally, for universal access, are familiar items on their to-do list. Therefore, I recommend the book to them as well: On the one hand, it can help broaden their perspective with regards to handling disability aids. On the other, it provides plenty of inspiration for their own work. There is definitely more to accessible UI design than implementing text descriptions and keyboard access!

After Word

Whether we conceive prosthetics as fashion articles or as aids for people with disabilities depends to a large extent on cultural traditions. Changing these traditions is a laborious and long-lasting process. For glasses, this change has more or less taken place (only a few children are still picked on because they have to wear glasses) as Pullin shows; for other aids, there is still a long way to go. For example, many people, including myself, are still reluctant to use hearing aids, and we are still a long way away from being able to see them as fashion accessories. False teeth are another example, and one which is not even covered in the book, although it is omnipresent. Here, the prevalent design goal is to make them look as "natural" as possible. I once saw a man in Russia who opened his mouth to reveal that all his teeth were made of gold. I have to admit that I was somewhat shocked. These days, some people implant small precious stones in their teeth, but we will probably never see dentures where each tooth is a different color – this would clash with our traditional notion of how elderly people have to behave and dress. All in all, I do not expect that the public view of prosthetics will change either quickly or soon. Designers may be at the forefront of such changes, but global changes will only result from mass adoption.

Finally, I would like to add that disability is just one facet of a larger theme. Pullin shows that prostheses can even surpass the natural body parts they are meant to replace or support. In science fiction books and films, we find gadgets that augment and extend our senses, limbs, and memory and intellectual abilities. There are already a few cases of people who have had chips implanted in their bodies (see CHI 2002 – Changing the World, Changing Ourselves). At HCI conferences, researchers have proposed glasses that translate street signs from foreign languages into one's native tongue, introduce strangers to us, and offer information about famous buildings. Supporting disabled people, therefore, is just one aspect of the theme of augmenting and extending human abilities. Until the "augmented human" scenario becomes reality (we can already say it is in its early days), we will have to overcome not only technical but also cultural and social barriers. Without doubt, designers will once again be at the forefront of this development and will help shape the "augmented human." (I thought that I had invented this term, only to find out that it dates back to at least the late Sixties and to Doug Engelbart's visions and an ACM conference called "Augmented Human" is already set to take place in 2010.)



Augmented Human

SAP Design Guild


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