Multidisciplinary Perspectives on Designing Accessible Systems for Users with Multiple Impairments: Grand Challenges and Opportunities for Future Research
Arthur Theil, Chris Creed, Mohammed Shaqura, Nasrine Olson, Raymond John Holt, Sayan Sarcar, Stuart Murray · 2022 · Proceedings of the 24th International ACM SIGACCESS Conference on Computers and Accessibility (ASSETS 22) · doi:10.1145/3517428.3550405
Summary
This workshop paper from ASSETS 2022 challenges a fundamental assumption in accessibility research: that designing for one impairment category at a time is sufficient. The authors argue that this single-impairment approach, while practical and widespread, oversimplifies disability and fails to serve the large population of people who live with multiple concurrent impairments. Drawing on UK survey data showing that nearly 75% of people with disabilities in England live with more than one type of long-term impairment, the paper makes a compelling case that current assistive technologies are inadequate for users with complex, overlapping needs. The workshop brought together researchers and practitioners from disability studies, medical humanities, engineering, education, social work, and human-computer interaction to explore this gap across three sub-domains: theory, technology, and users. On the theoretical side, the authors question whether established frameworks like Universal Design and Ability-based Design adequately address multidimensional user needs, or whether new frameworks are required. On the technology front, they examine how interaction modalities such as gaze, haptics, audio-visual, and multisensory approaches can be adapted for users who may not be able to compensate one ability with another. On the user side, they ask whether current participatory design and evaluation methods are truly inclusive of people with multiple impairments, many of whom report feeling excluded from both disability communities and mainstream technology design processes.
Key findings
The paper presents several striking findings from existing research. Over 51% of people living with three or more impairments reported that current assistive technologies do not adequately address their needs. In the US, at least 122,559 students with profound or multiple impairments require special educational accommodations annually. People with deafblindness, for example, find that technologies designed for either visual or hearing impairments alone do not effectively serve them. The authors highlight that people with multiple impairments often feel rejected by single-impairment disability communities for being "different," creating social isolation that compounds technological exclusion. A review of ASSETS conference contributions over the years reveals that the majority of technical work still relies on rigid impairment categories and rarely includes users with more than one impairment in empirical studies. The paper identifies six key research questions spanning theory, technology, and user involvement that the accessibility community must address to move beyond single-impairment design paradigms.
Relevance
This paper is essential reading for anyone involved in accessibility work because it exposes a critical blind spot in how the field conceptualizes and designs for disability. For practitioners, the takeaway is clear: accessibility solutions designed for one impairment category may actively fail users with multiple impairments, who represent the majority of disabled people. This has direct implications for web accessibility, where WCAG guidelines and testing approaches tend to address individual impairment types in isolation. Organizations conducting user testing should ensure their participant pools include people with multiple impairments. The multidisciplinary approach advocated here — bringing together disability studies, engineering, medical humanities, and lived experience — offers a model for more holistic accessibility practice.
Tags: multiple impairments · assistive technology · disability studies · multidisciplinary design · inclusive design · participatory design · deafblindness · complex disabilities
Standards referenced: Universal Design · Ability-based Design