Design for Inclusion & Accessibility

Design for Inclusion and Accessibility - rachel mai.jpg

This week, during a visit with my grandparents, I spoke with my nana about some of her earliest experiences in learning about her hearing impairment. With design in mind, I wanted to better understand how her environment affected her understanding and ability to have better experiences.

A glimpse into impaired hearing

My nana pictured above, holding her great granddaughter

My nana began childhood hard of hearing, but without a proper diagnosis or realization of what it was. At the age of 8, she rode a train with her mother, who was complaining about not being able to sleep due to the sound of the trains. My Nana responded that she was fine so long as she turned to her other ear. It was at that moment her mother realized she needed to see a doctor. They had taken my nana in to an ENT doctor– she had several checks performed, radiation tests (new at the time and an uncomfortable memory for her), removed her tonsils, and still there was uncertain diagnosis or answers to what was causing her hearing loss. She had a constant ringing in her ears, which she later in life found out was tinnitus. It made it challenging for her to carry out normal activities.

She remembers in the third grade sitting in the back of the classroom and having trouble following along. After a teacher’s attention drew toward her, she subsequently sat in the front of the classroom for all of her classes. A moment of clarity happened after she took a lip reading class that allowed her to decipher speech more easily – she found she could follow along quicker. As she progressed in her classes into high school, out of her own ambition she enrolled in summer classes (her school’s most advanced courses) so she wouldn’t lag behind when the school year started. She took every precaution to ensure she would keep pace with her peers.

She met my grandfather and as part of his courting he would sing to her. She would see people embracing their hearts with eyes of endearment as he sang and although she couldn’t hear, she sensed the romantic gesture from her visual cues. They married and my Papa strived to ensure she had the most optimal comfort level and support to live as full as possible, regardless of her impaired hearing. Her face lights up when recollecting her new in-laws purchasing her first hearing aid – it was her first chance at enhancing her hearing through a device. Raising children was a challenge as she could not hear crying at night — she would ask my Papa to nudge her as the babies were crying as her work-around. She made a seemingly tough situation look easy, raising four children with grace.

Reflecting back, I notice some of her challenges for seemingly ordinary instances in life – booking appointments by phone, ordering from a menu in dim-lit restaurants, attending movie theaters (particularly animated movies) and orchestras, adjusting voice projection. The list builds, but through these challenges she finds a proactive way to being extremely organized and planning ahead as much as possible, as she does not indulge in the thought of slowing other people down – so much so that she does not miss a beat, making it difficult for anyone to notice her challenges are present. In design, often times we are designing for the self first, and individual voices might not be loud enough or even present in the room to affect our decision making. My nana is the type to avoid ruffling feathers and prefers to not cause interjections or commotion. Because of this, I see it as my duty as a designer to actively seek and listen to people with challenges, expanding periphery of understanding and sensitivity.

Once products, systems and tools are designed to be accessible and inclusive, people facing existing challenges suddenly have a portal into inclusion with an ability to obtain enriched and meaningful experiences. I admire my nana for being a spearhead in our family for embracing technology.

Nana embraces technology

Apps, Electronics and Mobile technology:

She was the first person I knew with an AOL account, a webcam, Skype, Netflix (mail-delivered DVDs), and a Kindle. She was an early adopter of technology, testing out ways to improve communication and access to the content she enjoyed.

She also installed a CapTel captioned telephone to help read the words we were saying on the phone when we called her home phone. As soon as she could get her hands on an iPhone, she was texting proficiently, and as technology and applications advanced, she adopted FaceTime, joined Facebook, and started playing ‘Words with Friends’ (as a means to not only remind the family of her mastery at Scrabble but to stay in touch with us more seamlessly).

Medical technology:

Since the time of her first hearing aid gifted to her, she continued to wear hearing aids and wanted the next version even if it only helped slightly with hearing tones and sounds.

Much later in life, a surgical opportunity became available for her to be a candidate for a cochlear implant, a surgically implanted neuroprosthetic device that provides a sense of sound to a person with severe to profound sensorineural hearing loss.

She was selected to have the surgery performed and it resulted in gaining a significant level of hearing on one side. It was a rigorous process that involved learning to what it was like to “hear” again through a device. She endured nine months of vertigo, and with her inner ear in chaos, her balance was compromised. She became hyper sensitive to sounds both near and far once she was training with the implant and headaches were frequent. It required serious post-surgery training with dedicated exercises to help her adjust. I recall sitting with her on my living room couch, reading her flash cards and watching her experience hearing a bird outside of our window. Her being able to identify the bird that created corresponding sound was something I’ll never forget. She now has 80% hearing in her right side while wearing her implant. She carries around batteries in her purse and replaces swiftly as they die out. She removes it at night, rendering her completely deaf, but she has progressed at an astounding level in terms of comfort with the device.

Awareness and adjustments

Even with all of the technology-driven support, I knew from an early age I needed and wanted to create adjustments to enable her ability to understand and better enjoy her overall experience – speaking in front of her and enunciating properly, in order for her to read our lips; making calls on her behalf for appointments; turning on sub-titles on the television when she visits; translating if someone has a thick accent or mumbles words; reducing noise level (sensitive with her cochlear implant); avoiding splash zones in pool areas and being mindful of sand on beaches (hearing aids sensitive to water and sand); and giving her cues with voice projection if she sounds too loud against current environment.

These considerations were originally made out of necessity, but grew to be one of my most cherished understandings of design. As a child, you learn to accept reality as is, without much thought. To this extent, growing up with a grandmother unable to hear, I needed to modify situations. It was one of my earliest lessons of empathy and understanding. These two pillars are ones I have come to realize hold material weight in my approach to design. Thinking inclusively to make sure everyone in the room could absorb the same experience at the same time – achieve laughter, witness happiness, receive sad news. It enabled me to embrace differences and challenges in order to help create a better outcome through altering environment.

When pressed with an inability, it’s critical to recognize when something is off, but also see it as an opportunity to improve the current norm.

How can someone’s experience be enhanced? What are the components that create a fulfilling experience? How can we design spaces and environments that feel both beautiful and natural? These questions often lie at the root of any design challenge – to overcome them, the answer could be a simple matter of being aware, going back and truly understanding the user/customer/nana. Those who do not know what it is like to lose or have a sense impaired, should take the time and learn from those who can teach the intricacies and daily experience challenges we could never truly understand on our own.

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