[Paper Review] "I Choose Assistive Devices That Save My Face" A Study on Perceptions of Accessibility and Assistive Technology Use Conducted in China

Franklin Mingzhe Li, Di Laura Chen+2 more|arXiv (Cornell University)|Jan 22, 2021

Assistive Technology in Communication and Mobility58 references44 citations

TL;DR

This study investigates assistive technology (AT) use, perceptions, and social challenges among 26 people with disabilities in China through semi-structured interviews. It reveals that cultural stigma, infrastructure misuse, and misperceptions—such as the belief that ATs should fix societal inaccessibility—significantly hinder AT adoption. The paper contributes design guidelines emphasizing aesthetic customization, dual manual/electronic design, and social acceptability to improve AT uptake in China’s unique socio-cultural context.

ABSTRACT

Despite the potential benefits of assistive technologies (ATs) for people with various disabilities, only around 7% of Chinese with disabilities have had an opportunity to use ATs. Even for those who have used ATs, the abandonment rate was high. Although China has the world's largest population with disabilities, prior research exploring how ATs are used and perceived, and why ATs are abandoned have been conducted primarily in North America and Europe. In this paper, we present an interview study conducted in China with 26 people with various disabilities to understand their practices, challenges, perceptions, and misperceptions of using ATs. From the study, we learned about factors that influence AT adoption practices (e.g., misuse of accessible infrastructure, issues with replicating existing commercial ATs), challenges using ATs in social interactions (e.g., Chinese stigma), and misperceptions about ATs (e.g., ATs should overcome inaccessible social infrastructures). Informed by the findings, we derive a set of design considerations to bridge the existing gaps in AT design (e.g., manual vs. electronic ATs) and to improve ATs' social acceptability in China.

Motivation & Objective

• To understand the practices, challenges, and perceptions of assistive technology (AT) use among people with disabilities in China.
• To investigate why AT adoption rates remain low (only 7%) despite China’s large disabled population.
• To identify cultural, social, and design-related barriers that contribute to high AT abandonment rates in the Chinese context.
• To derive context-specific design recommendations that improve the social acceptability and functionality of ATs in China.

Proposed method

• Conducted semi-structured interviews with 26 participants across four disability groups: visual, hearing, motor impairments, and cerebral palsy.
• Focused on lived experiences with ATs, social interactions, infrastructure misuse, and personal motivations for AT use or abandonment.
• Analyzed interview data using qualitative thematic analysis to identify recurring patterns in practices, challenges, and misperceptions.
• Contrasted findings with prior North American studies to highlight cultural differences in AT perception and use.
• Derived design considerations based on emergent themes, including customization, dual design modes (manual/electronic), and social integration.
• Explored the role of DIY ATs and emerging fabrication tools (e.g., 3D printing) in enhancing personalization and aesthetic appeal.

Experimental results

Research questions

• RQ1 What are the practices and challenges surrounding assistive technology (AT) use among people with various disabilities in China?
• RQ2 How do cultural stigma and social perceptions influence AT adoption and social interactions in China?
• RQ3 What misperceptions about ATs do people with disabilities hold, and how do these compare to those in North America?
• RQ4 What design factors influence the social acceptability and long-term adoption of ATs in the Chinese context?

Key findings

• Only 7% of people with disabilities in China have ever used assistive technologies, and over 20% of those users abandoned their devices.
• Participants frequently chose or modified ATs to signal retained abilities and avoid stigmatization, often opting for discreet or manually operated devices.
• Social stigma in China manifests through public misuse of accessible infrastructure, use of derogatory terms like 'can fei,' and unwanted assistance.
• A major misperception is that ATs should compensate for inaccessible social environments, rather than being tools for individual empowerment.
• Participants believed that ATs with more functionalities are inherently better, despite practical drawbacks like reduced portability and higher failure rates.
• Designers should support both single-function and multi-function ATs, integrate aesthetics through customization (e.g., 3D printing), and ensure easy software and hardware updates.