Supporting Social Inclusion with DIY-ATs: Perspectives of Kenyan Caregivers of Children with Cognitive Disabilities
Foad Hamidi, Patrick Mbullo, Michaela Hynie, Melanie Baljko · 2023 · ACM Transactions on Accessible Computing · doi:10.1145/3616378
Summary
This paper examines how DIY assistive technologies (DIY-ATs) can support social inclusion for children with cognitive disabilities in Western Kenya, drawing on interviews with 12 female primary caregivers. The research is part of a multi-year participatory design project (2016-present) conducted in Kisumu, where researchers developed and deployed TalkBox—a Raspberry Pi-based AAC device featuring customizable audio buttons that children can press to trigger pre-recorded messages. The study addresses two research questions: what social, cultural, and technological barriers exist for children with disabilities in Kenya, and what role DIY-ATs can play in overcoming these barriers. Caregivers described pervasive stigma and social exclusion affecting both themselves and their children, rooted in negative cultural beliefs about disability causation (witchcraft, curses, parental sin). They reported being excluded from community events and religious activities, and described how their children face discrimination in schools and public spaces. The researchers conducted semi-structured interviews lasting 30-70 minutes, exploring caregivers' experiences with their children's education, social interactions, and technology use. The TalkBox devices had been deployed in special education classrooms where teachers customized them with locally relevant audio content in Swahili and local languages. The study employs an interdependence framework rather than the traditional independence-focused model of AT evaluation, recognizing that access and inclusion depend on relationships within communities rather than individual capability alone.
Key findings
Caregivers identified significant barriers to social inclusion: widespread stigma leading to social isolation, negative beliefs about disability causation, inadequate government support for special education, and extremely limited availability of assistive technologies for cognitive disabilities (most AT resources in Kenya focus on physical and sensory disabilities). Regarding TalkBox, caregivers observed meaningful positive changes: children demonstrated improved communication skills, showed increased interest in interacting with family members and peers, and generalized their technology skills to other devices like phones and radios. The simple, screenless button interface proved effective—children found it intuitive and the lack of text reduced literacy barriers for both children and some caregivers. Caregivers expressed strong interest in having TalkBox available at home as well as school, wanting to be more involved in their children's technology use. They valued the device's potential for building social connections with community members, not just as a communication tool but as a way to increase their children's visibility and social presence. Cost and durability emerged as practical concerns—caregivers worried about affording repairs and protecting devices from theft. The multi-user nature of TalkBox was particularly valued, as it allowed shared use in classrooms and reduced the prohibitive attitudes toward letting children use expensive technology.
Relevance
This research challenges Western-centric assumptions in AT design and evaluation. The interdependence framework offers accessibility practitioners a different lens: rather than measuring success by individual independence, we should consider how technologies support relationships and community participation. This is relevant for practitioners working in diverse cultural contexts or with populations where family and community support is central to daily life. The findings highlight a critical gap in AT availability for cognitive disabilities globally, particularly in LMICs where resources concentrate on physical and sensory disabilities. For organizations working internationally, this underscores the need for low-cost, locally customizable solutions. The TalkBox approach—simple hardware, no screen, community-customizable content—provides a model for designing accessible technologies that work across varying literacy levels and resource contexts. The study also demonstrates the value of long-term participatory engagement. The multi-year relationship allowed researchers to understand nuanced barriers (like stigma's impact on caregivers, not just children) that shorter studies might miss. For practitioners, this reinforces that meaningful accessibility work requires sustained community partnership, not one-time deployments.
Tags: DIY assistive technology · cognitive disabilities · AAC · social inclusion · low- and middle-income countries · participatory design · caregivers · children