Accessibility Research and Users with Multiple Disabilities or Complex Needs
Arthur Theil, Craig Anderton, Chris Creed, Nasrine Olson, Raymond John Holt, Sayan Sarcar · 2023 · Proceedings of the 25th International ACM SIGACCESS Conference on Computers and Accessibility (ASSETS 2023) · doi:10.1145/3597638.3615651
Summary
This workshop paper argues that accessibility research has historically oversimplified disability by focusing on single categories of impairment, and calls for a fundamental shift toward inclusive research that addresses the needs of people living with multiple disabilities or complex needs. The authors cite a literature survey of 836 papers published at ASSETS and CHI from 1994 to 2019 that found only 7% focused on multiple communities and just 1% focused on users with multiple disabilities. This is starkly out of proportion with reality: a 2016 UK survey found that nearly 75% of people with disabilities live with more than one type of long-term impairment, and over 20% live with at least three. The paper proposes the 2nd International Workshop on this topic, building on a successful inaugural edition at ASSETS 2022 where researchers identified shared challenges including lack of terminology standards, limited research methods and tools for collecting data with these participants, and insufficient funding. The workshop brings together researchers from human-computer interaction, disability studies, engineering, and other disciplines to share perspectives on designing accessible systems that consider multidimensional user needs.
Key findings
The paper identifies several critical problems with current accessibility research paradigms. People with deafblindness report that assistive technologies designed for "visual" or "hearing" impairments do not effectively address their needs, and neurodivergent individuals with combinations of sensorimotor and cognitive impairments face similar gaps. Over half (51%) of people with three or more impairments do not believe current assistive technologies adequately address their needs. Interaction techniques that have been explored for single impairments — such as gaze-based, audio-visual, haptic, or multisensory approaches — are not always easily adaptable for users who may have challenges across multiple abilities simultaneously. The US Department of Education provides accommodations for at least 122,559 students with profound or multiple impairments annually. The authors argue that framing disability as discrete categories is a decontextualization that fails to match lived experience, and that many individuals with multiple disabilities feel rejected by communities organized around single disability categories.
Relevance
This paper highlights a significant blind spot in accessibility practice and research. For practitioners building accessible technologies, the implication is clear: designing for one impairment at a time may inadvertently exclude the majority of disabled users, who experience multiple intersecting access needs. The 75% statistic — that three-quarters of disabled people in England have more than one impairment — should fundamentally reshape how we approach accessibility testing and design. Organizations should consider how their accessibility solutions perform for users with combinations of impairments (e.g., someone who is both visually impaired and has limited motor control, or someone with both hearing loss and cognitive disabilities). The workshop also raises important methodological questions: how do we conduct research with participants who have complex communication needs, and how do we develop assistive technologies that are flexible enough to accommodate diverse and intersecting access requirements? The call for multidisciplinary collaboration — bringing together HCI, disability studies, engineering, and lived experience — offers a path forward.
Tags: multiple disabilities · complex needs · assistive technology · research methodology · inclusive design · deafblindness · participatory design · disability studies