"I just thought it was me": How Smartphones Fail Users with Mild-to-Moderate Dexterity Differences
Molly Bowman, Jerry Robinson, Erin Buehler, Shaun Kane · 2023 · Proceedings of the 25th International ACM SIGACCESS Conference on Computers and Accessibility (ASSETS 2023) · doi:10.1145/3597638.3608396
Summary
This paper examines the smartphone experiences of people with mild-to-moderate dexterity (MMD) challenges — a population largely overlooked by accessibility research that tends to focus on more severe motor disabilities requiring specialized assistive technology like switches. The researchers from Google conducted a two-stage qualitative study with 12 Android and iOS users (ages 31-70) who self-reported reduced dexterity in their hands or fingers. Dexterity challenges stemmed from diverse causes including nerve damage, physical restriction from injury, whole-body tremor, arthritis, stiffness, pain, and fatigue — conditions that varied across axes of congenital versus developed, permanent versus intermittent, and chronic versus transient. Stage One consisted of one-hour in-person lab interviews where participants demonstrated dexterity-related pain points during smartphone use. Stage Two, conducted two weeks later via remote video chat, focused on technology discovery, accessibility language engagement, and socio-emotional factors. Participants also attempted to find and test accessibility settings on their phones during Stage Two. The study used open coding with analysis focusing on physical user characteristics, barriers to accessibility, and user-created adaptations.
Key findings
Four key themes emerged. First, there were large gaps in available and usable accessibility tools for this population — smartphones are physically difficult to hold and manipulate, touch interactions demand stretching and precise movement that users cannot reliably produce, and assistive features (when they exist) are hard to find, understand, and implement. Critical interactions like answering calls (requiring a large swipe-down), unlocking the phone, and pressing hardware buttons were particularly problematic. Second, users were unlikely to seek accessibility features due to complex disability identity — many did not identify as having a disability, engaged in self-blame ("I just thought it was me"), and viewed the word "Accessibility" as meaning tools for people with more severe disabilities, not them. One participant was surprised to discover dexterity-related settings existed, exclaiming in shock upon finding them. Third, contextual and situational factors significantly impacted use — stress, public visibility, and fear of being perceived as vulnerable created a cyclical effect where nervousness worsened dexterity, leading to more errors and more anxiety. Several participants reduced public phone use, and one felt unsafe using her phone in public at all. Fourth, users relied heavily on self-created adaptations including physical repositioning and stabilizing, privacy trade-offs (removing passcodes entirely to avoid the unlock gesture), tech ecosystem workarounds (using earbuds, tablets, or smartwatches), and simply avoiding or substituting tasks they found too difficult or painful.
Relevance
This research has significant implications for smartphone design and the broader accessibility field. The finding that users with MMD challenges blame themselves rather than the technology — internalizing the message that "the phone was correct, and my problems were the burden" — reveals how ableist design assumptions compound the physical barriers these users face. For developers and designers, the study demonstrates that burying accessibility features in settings menus labeled "Accessibility" creates a double barrier: users with mild disabilities do not identify with the label, and even if they find the menu, the features are often insufficient for dexterity needs. The paper argues that this population needs universal design improvements rather than siloed accessibility features — solutions that benefit all users without requiring disability identification. The privacy trade-offs participants made (removing lock screens, avoiding biometrics) highlight how inaccessible design can actively compromise security. The authors suggest phones should proactively detect dexterity patterns and surface relevant features, rather than requiring users to navigate complex settings hierarchies that their dexterity challenges make difficult to use.
Tags: motor disability · dexterity · mobile accessibility · smartphones · touch screen · disability identity · assistive technology abandonment · qualitative research