As mixed-ability collaboration has become increasingly focal within accessibility research, managing varied, and sometimes conflicting, access needs has become a key consideration in designing for access. When an accessibility feature or practice benefits some people while constraining others, how should designers navigate these trade-offs? This paper responds to this question by analyzing how a mixed-ability nonprofit worked to make communication accessible to its members as it grew from a small blind-focused athletic group to a larger cross-disability organization. Based on a six-month study that combines interviews and field observations, we show that working with conflicting access needs is not just a technical ‘problem’ but a generative process that sparks reflection on technical constraints and preferences, diverse roles and communication norms, and organizational demands. We therefore argue for rethinking “conflicts” in access as key sites for revealing power structures and creating opportunities for accountability and repair.

Vision-Language Models (VLMs) are increasingly used by blind and low-vision (BLV) people to identify and understand products in their everyday lives, such as food, personal care items, and household goods. Despite their prevalence, we lack an empirical understanding of how common image quality issues—such as blur, misframing, and rotation—affect the accuracy of VLM-generated captions and whether the resulting captions meet BLV people’s information needs. Based on a survey of 86 BLV participants, we develop an annotated dataset of 1,859 product images from BLV people to systematically evaluate how image quality issues affect VLM-generated captions. While the best VLM achieves 98% accuracy on images with no quality issues, accuracy drops to 75% overall when quality issues are present, worsening considerably as issues compound. We discuss the need for model evaluations that center on disabled people’s experiences throughout the process and offer concrete recommendations for HCI and ML researchers to make VLMs more reliable for BLV people.

Information systems, such as electronic health records (EHRs) and case note software, increasingly support direct service providers (DSPs) in social service administration. Previous scholarship examined how these digital interventions enhance care but also create unintended consequences for DSPs and their clients. Despite broad interest in how DSPs and other frontline social service workers utilize information technology, few studies examine how they avoid digital tools, particularly when documentation stakes are high for both clients and DSPs. We report findings from interviews with 16 DSPs, who remain keenly aware that the information they document may become visible to others now and in the future. To protect themselves and their clients, they develop practices to resist recording data in digital records such as EHRs. We offer a typology of resistant data practices and design considerations grounded in the experiences and understanding of power within the roles of DSPs.

Artificial Intelligence (AI) is often framed as a transformative approach for improving accessibility, with major technology companies investing considerable resources into AI applications targeting disabled users. This investment in AI for accessibility has many benefits but remains relatively unquestioned. Through a critical discourse analysis of 126 public-facing blog posts and news articles by leading U.S.-based AI companies, our analysis reveals the ways in which technology companies render different modes of disabled participation, bestow agency upon AI as a competent and capable actor, reinforce their role in shaping AI futures, and legitimize the development of AI for accessibility. By examining tech companies’ AI visions alongside Critical Disability Studies scholarship, we discuss concerns with framing AI as a means to “solve” disability-related challenges while sidestepping deeper structural questions about equity, agency, and responsibility.

While sign language translation systems promise to enhance deaf people’s access to information and communication, they have been met with strong skepticism from deaf communities due to risks of misrepresenting and oversimplifying the richness of signed communication in technologies. This article provides empirical evidence of the complexity of translation work involved in deaf communication through interviews with 13 deaf Chinese content creators who actively produce and share sign language content on video sharing platforms with both deaf and hearing audiences. By studying this unique group of content creators, our findings highlight the nuances of sign language translation, showing how deaf creators create content with multilingualism and multiculturalism in mind, support meaning making across languages and cultures, and navigate politics involved in their translation work. Grounded in these deaf-led translation practices, we draw on the sociolinguistic concept of (trans)languaging to re-conceptualize and reimagine the design of sign language translation systems.

Technologies to support dementia caregivers are often oriented around key milestones and transitions in the caregiving journey, which may not align with how family caregivers conceptualize and adapt to the everyday realities of care. In this study, we present findings from semi-structured interviews with 15 family caregivers of people with dementia to understand how they perceive their caregiving journeys over time. We find that caregivers live in a constant state of flux, characterized by ongoing, unpredictable, and multidimensional changes and fluctuating care demands throughout their journey. Our findings identify three ways caregivers respond to this constant state of flux: navigating through interdependent, multidimensional changes; iteratively adjusting and abandoning tools and supports; and developing an anticipatory mindset oriented toward future disruptions. We contribute to CSCW and HCI by showing how ongoing, unpredictable fluctuations constitute dementia caregiving and use this orientation as a way of thinking about designing technologies for dementia care.

Real-time collaboration tools (e.g., videoconferencing or project management) are central to modern work but often pose significant accessibility challenges for blind and low vision (BLV) people.While these tools can support both in-person and remote collaboration, barriers to usability and access can hinder full workforce participation.Prior research has explored accessibility issues with specific tools, but broader insights into how BLV people use and experience mainstream collaboration platforms remain limited.We conducted an online survey with 155 BLV users, evaluating the ease of using 30 widely used collaboration tools.Findings show that Zoom is rated as the easiest tool to use, however, project management and whiteboarding tools are rated relatively difficult to use.Over half of the respondents reported that accessibility barriers negatively impact their collaboration, job performance, and career growth.We discuss the compounding effects of inaccessible collaborative tools and offer design recommendations for more inclusive digital workspaces.

Attention-Deficit/Hyperactivity Disorder (ADHD) affects millions of individuals worldwide, significantly impacting their academic, social, and professional lives.ADHD students in higher education have faced difficulties with time management, organization, focus, and emotional regulation, which impact their academic performance.Through an analysis of discussions within a Reddit community for ADHD university students, we found that accommodations and general study strategies are often inadequate for them.Instead, they develop and share collaborative, community-based strategies to support their academic success, which include (1) participating in diverse forms of co-presence or body doubling for accountability and focus while studying; (2) engaging in active collaborative support with social partners to manage emotions and distractions, and (3) leveraging community-based support for remembering deadlines, staying accountable, and fostering a sense of belonging.We conclude with a discussion of these strategies with respect to literature on co-presence and design considerations for future assistive technologies and accommodations for ADHD students.

Many technology companies aim to improve access and inclusion not only by making their products accessible but also by bringing people with disabilities into the tech workforce. We know less about how accessibility is experienced and negotiated by disabled workers within these organizations. Through interviews with 20 BLV workers across various tech companies, we uncover a persistent misalignment between organizational attempts at accessibility and the current realities of these employees. We introduce the concept of the accessibility paradox, which we define as the inherent tension between the productivity- and profit-driven nature of tech companies and their desire to hire and retain disabled workers. Focusing on the experiences of BLV workers, we show how the accessibility paradox manifests in their everyday workplace interactions, including digital infrastructure, accommodations processes and policies, ability assumptions, and competing priorities. We offer recommendations for future research and practice to understand and improve workplace accessibility and inclusion.

With remote work becoming a prevalent practice, the use of videoconferencing tools has significantly increased. While the accessibility of these tools in remote work has been studied previously, there is a lack of understanding of how professionals with disabilities conduct meetings using them and what accessibility means in this context. To fill this gap, we investigated the experience and accessibility practices of 18 blind and low vision (BLV) meeting facilitators who regularly use videoconferencing tools. Our findings reveal that BLV professionals undertake several steps to facilitate meetings effectively, including preparing materials in advance, ensuring the security of the meetings, maintaining awareness of attendees’ activity, coordinating with co-hosts to overcome accessibility obstacles, maintaining professionalism, and advocating for accessible meeting practices and technology. We discuss how our findings reveal barriers to career advancement for BLV professionals, help understand the interdependent activity of meeting facilitators and co-hosts, and provide recommendations for making videoconferencing more accessible.

Exchange of peer-to-peer support in online Q&A communities plays an instrumental role in helping people learn and use complex software tools. While prior work has documented how disabled people support each other in finding accessible practices and workarounds in different contexts, research on understanding their participation in dedicated online Q&A communities has been limited. Through the analysis of 180 conversation threads consisting of 1140 posts in an online text-based Q&A community of blind and low-vision audio producers, we reveal various strategies members in this community use to formulate their queries and provide effective solutions regarding screen reader based navigation of complex graphical user interfaces. We reflect upon our findings to discuss the complexities blind and low-vision software users face in developing a shared understanding during collaborative troubleshooting through textual conversations and reimagine how online Q&A platforms could enhance peer-to-peer instructional support among screen reader users.

The maker movement has garnered significant attention as democratizing design; yet, recent work has called attention to the challenges disabled people encounter in making. Although researchers have built systems to improve accessibility of maker technologies, limited studies have centered disabled people’s engagement in traditional forms of making like fiber arts. We examine the practice of fabric pattern design among a community of blind weavers who create hand-woven products with sighted instructors. Grounded in seventeen interviews with blind weavers and sighted instructors, we built Simphony, an audio-tactile system that aims to support blind weavers in creating and perceiving patterns. Findings from eight design exploration sessions at the community studio reveal how blind weavers used Simphony to learn the process of pattern design and generate patterns with sighted instructors. We reflect on collaborative understanding of pattern design among blind and sighted individuals and discuss opportunities for integrating technological augmentations into traditional craftwork.

Older adults are increasingly acting as caregivers, given population aging and pervasive caregiver shortages. Meanwhile, gig-economy-based carework platforms have also become popular. As older adults are one of the fastest-growing groups of informal caregivers and technology users in the past decade, we conducted an online survey among older adults residing in the US (N = 193) about how they use these platforms to manage their caregiving tasks. We identified factors related to their frequency of using caregiving help and their intention to continue using caregiving help via carework platforms. We also reported how and why older adults use these platforms, their main concerns and needs related to these platforms, and their most significant positive and negative experiences. Our findings contribute to a foundational understanding of how older caregivers use carework platforms and how such platforms could be better designed to suit the needs and wants of older caregivers.

Audio production is a skilled practice that requires mastery in highly complex software and hardware tools. Blind audio producers face a steep learning curve where they must learn multiple inaccessible audio production tools in conjunction with workarounds for screen reader support. Learning audio production is made even more challenging due to a scarcity of educational resources geared towards blind people. Grounded in formative interviews and observations with seven blind audio production instructors, we developed Tutoria11y, an extension for GarageBand to support blind audio producers in creating accessible, interactive tutorials that screen reader users can follow to receive step-by-step guidance and confirmation of their actions. Findings from design exploration sessions with five blind instructors highlight how Tutoria11y can support tutorial creation and augment tutorial playback for blind audio producers. We discuss how we can rethink technology’s role as a means to amplify, rather than replace, the knowledge of disabled experts.

In today's society, the relationship between younger and older generations is increasingly characterized by tension and conflict, with each generation holding deep-seated biases and stereotypes against each other. Fostering meaningful communication among generations is one way to avoid age segregation and dismantle associated biases. This paper presents a case analysis of an age-integrated online community (r/AskOldPeople) with an in-depth analysis of the most popular types of questions as well as the types of discussions within this community. Using content analysis of the top 999 posts, we describe the exchanges between different generations in this community, with people sharing experiences and perspectives, seeking advice, reminiscing about the past, and engaging in community building. Using thematic analysis of the same corpus, we also identified four themes characterizing the types of discussions prompted by the questions. We find that younger and older generations use the community to learn about experiences of the past, co-navigate psychosocial challenges across the lifespan, understand and commiserate about aging, and collectively make sense of crises and changes in the pandemic era. We discuss the meanings behind the themes and how r/AskOldPeople, as an age-integrated online community, supports intergenerational communication.

Emerging social media platforms and online marketplaces introduce new ways for individuals to sell and distribute handmade or custom items. This new landscape of online tools has the potential to provide work opportunities for people who are excluded from traditional workplaces due to inaccessible environments and work expectations. The present study involves an analysis of the work practices of 44 disabled creators who sell and promote their goods via online marketplaces. Through an analysis of publicly available content on Etsy and social media platforms, complemented with semi-structured interviews with a subset of creators, we report on the ways disabled sellers create, share and provide support through their practices. Our analysis reveals that creators move their work to an online space seeking more accessible ways to earn income, yet find themselves navigating access barriers that are enacted through platform norms, reward structures and algorithms. We discuss how online marketplaces present unique opportunities and challenges to participation for people with disabilities.

Collaborative writing is an integral part of academic and professional work. Although some prior research has focused on accessibility in collaborative writing, we know little about how visually impaired writers work in real-time with sighted collaborators or how online editing tools could better support their work. Grounded in formative interviews and observations with eight screen reader users, we built Co11ab, a Google Docs extension that provides configurable audio cues to facilitate understanding who is editing (or edited) what and where in a shared document. Results from a design exploration with fifteen screen reader users, including three naturalistic sessions of use with sighted colleagues, reveal how screen reader users understand various auditory representations and use them to coordinate real-time collaborative writing. We revisit what collaboration awareness means for screen reader users and discuss design considerations for future systems.

People living with dementia as well as dementia caregivers are finding new ways to provide and receive support online. The emerging use of social media platforms-such as TikTok, Clubhouse, and Facebook-by people with dementia and dementia caregivers enables new forms of sharing about stigmatized, poorly understood, and often under-discussed experiences. Building on prior work focused on formal support groups, we report findings from an interview study of how people living with dementia and dementia caregivers provide and receive social support through emerging online spaces and communities. Our analysis reveals that both groups cultivate new online spaces for sharing about the experience of dementia while also navigating tensions surrounding public disclosure of lived experiences, advocacy, education, and the ability to protect and keep private elements of life experiences. We discuss how these groups cultivate online spaces across platforms and contribute to ongoing ethical debates about consent in online communities. We conclude with questions that guide future work on emerging online spaces for supporting people living with dementia and caregivers of people living with dementia.

Writing is the currency of academia. Although technology-mediated writing has been studied extensively in CSCW, we know little about how writing practices unfold with disabled people, such as dyslexic writers whose neurodivergence shapes how they process language. Our qualitative analysis reveals how dyslexic professionals simultaneously identify how editing tools break down on academic language; develop workarounds that re-appropriate other tools as language sources; cultivate ad-hoc collaborations to compensate for technology's limitations; and navigate culturally ingrained ableist expectations for writing. We discuss how dyslexic writers' experiences with shouldering invisible work to participate in academic writing processes indicates that current tools and services do not support their needs. We then draw on our findings to inform design opportunities to make writing processes more accessible through changes to writing tools, institutional services, and peer review practices.

Collaborative writing tools have been used widely in professional and academic organizations for many years. Yet, there has not been much work to improve screen reader access in mainstream collaborative writing tools. This severely affects the way people with vision impairments collaborate in ability-diverse teams. As a step toward addressing this issue, the present article aims at improving screen reader representation of collaborative features such as comments and track changes (i.e., suggested edits). Building on our formative interviews with 20 academics and professionals with vision impairments, we developed auditory representations that indicate comments and edits using non-speech audio (e.g., earcons, tone overlay), multiple text-to-speech voices, and contextual presentation techniques. We then performed a systematic evaluation study with 48 screen reader users that indicated that non-speech audio, changing voices, and contextual presentation can potentially improve writers’ collaboration awareness. We discuss implications of these results for the design of accessible collaborative systems.

Self-management research in HCI has addressed a variety of conditions. Yet, this literature has largely focused on neurotypical populations and chronic conditions that can be managed, leaving open questions of what self-management might look like for populations with progressive cognitive impairment. Grounded in interviews with seventeen technology savvy people with mild to moderate dementia, our analysis reveals their use of technological and social resources as part of the work of self-management. We detail how participants design self-management systems to enable desired futures, function well in their social world, and maintain control. Our discussion broadens the notion of self-management to include future-oriented, sociotechnical, self-determinate design. We advocate for expanding the way technologists, designers, and HCI scholars view people with mild to moderate dementia to recognize them as inventive creators and capable actors in self-management.

There is a growing need to design augmentative and alternative communication (AAC) devices that focus on supporting quality of life goals, such as increased social participation in leisurely activities. Yet, designing AAC applications that support leisurely activities is difficult, as the activity might require novel and specific language in a timely manner. Through observations and contextual interviews with people with aphasia, their social partners, and speech-language therapists, we characterize the important but challenging nature of supporting one specific leisure activity: meal ordering in restaurants. Based on our observational and interview data, we design and explore three prototype AAC systems to support people with aphasia in ordering meals in restaurants. Each prototype integrates a different AI technology, contributing insights into how AI may enhance AAC usage and design. The study opens up questions of designing accessible restaurant experiences for neurodivergent people and the role of AI in AAC devices more broadly.

Working from home has become a mainstream work practice in many organizations during the COVID-19 pandemic. While remote work has received much scholarly and public attention over the years, we still know little about how people with disabilities engage in remote work from their homes and what access means in this context. To understand and rethink accessibility in remote work, the present paper studies work-from-home practices of neurodivergent professionals who have Autism Spectrum Disorder, Attention Deficit Hyperactivity Disorder, learning disabilities (e.g., dyslexia) and psychosocial disabilities (e.g., anxiety, depression). We report on interviews with 36 US-based neurodivergent professionals who have been working from home during the pandemic. Our findings reveal that while working from home, neurodivergent professionals create accessible physical and digital workspaces, negotiate accessible communication practices, and reconcile tensions between productivity and wellbeing. Our analysis reconsiders what access means in remote work for neurodivergent professionals and offers practical insights for inclusive work practices and accessibility improvements in remote collaboration tools.

The advent of digital audio workstations and other digital audio tools has brought a critical shift in the audio industry by empowering amateur and professional audio content creators with the necessary means to produce high quality audio content. Yet, we know little about the accessibility of widely used audio production tools for people with vision impairments. Through interviews with 18 audio professionals and hobbyists with vision impairments, we find that accessible audio production involves: piecing together accessible and efficient workflows through a combination of mainstream and custom tools; achieving professional competency through a steep learning curve in which domain knowledge and accessibility are inseparable; and facilitating learning and creating access by engaging in online communities of visually impaired audio enthusiasts. We discuss the deep entanglement between accessibility and professional competency and conclude with design considerations to inform future development of accessible audio production tools.

The rise of maker communities and fabrication tools creates new opportunities for participation in design work. With this has come an interest in increasing the accessibility of making for people with disabilities, which has mainly emphasized independence and empowerment through the creation of more accessible fabrication tools. To understand and rethink the notion of accessible making, we analyze the context and practices of a particular site of making: the communal weaving studio within an assisted living facility for people with vision impairments. Our analysis helps reconsider the material and social processes that constitute accessible making, including the ways makers attend to interactive material properties, negotiate co-creative embodied work, and value the labor of making. We discuss future directions for design and research on accessible making while highlighting tensions around assistance, collaboration, and how disabled labor is valued.

For individuals with mental illness, social media platforms are considered spaces for sharing and connection. However, not all expressions of mental illness are treated equally on these platforms. Different aggregates of human and technical control are used to report and ban content, accounts, and communities. Through two years of digital ethnography, including online observation and interviews, with people with eating disorders, we examine the experience of content moderation. We use a constructivist grounded theory approach to analysis that shows how practices of moderation across different platforms have particular consequences for members of marginalized groups, who are pressured to conform and compelled to resist. Above all, we argue that platform moderation is enmeshed with wider processes of conformity to specific versions of mental illness. Practices of moderation reassert certain bodies and experiences as 'normal' and valued, while rejecting others. At the same time, navigating and resisting these normative pressures further inscribes the marginal status of certain individuals. We discuss changes to the ways that platforms handle content related to eating disorders by drawing on the concept of multiplicity to inform design.

Haptic feedback displays are an emerging technology that have the potential to enhance how children and their parents interact with and learn about science concepts. Yet, we know little about how to design haptic feedback applications for science learning or how children and their parents make use of these interactive features. This paper presents the design and evaluation of TCircuit, an application for a variable friction touch-screen display (i.e., Tanvas Tablet) that enables parent-child dyads to feel electric current flowing through a circuit diagram by touching the display. We describe results from a formative design study with 10 parent-child dyads that reveal which texture patterns and mappings are most appropriate for representing the concept of electrical current through haptic feedback. We also report results of a comparative study with 40 parent-child dyads in a museum setting. Our analysis shows that dyads in the haptic condition performed slightly better when predicting their answers to learning tasks. However, we found that haptic feedback introduced new complexities for how dyads perceived and discussed the exhibit content. We discuss the potential for haptic feedback displays to support science learning, particularly in collaborative settings, and design considerations for future systems.

Children are known to be curious and persistent questionaskers. The pervasiveness of voice interfaces represents an opportunity for children who are not yet fluent readers to independently search the Internet by asking questions through conversational agents such as Amazon Alexa, Apple's Siri, and the Google Assistant. Through a two-week, in-home deployment study involving 18 families (children aged 5-6 and their parents), we report on which questions children choose to ask the conversational agent, the answers the agent provided, challenges in use, and their perceptions of the technology. Based on our analysis, we identify several considerations for the design of voice-based conversational agents that aim to support young children's question-asking behavior and subsequent development.

Despite historical precedence and modern prevalence, mental illness and associated disorders are frequently aligned with notions of deviance and, by association, abnormality. The view that mental illness deviates from an implicit social norm permeates the CHI community, impacting how scholars approach research in this space. In this paper, we challenge community and societal norms aligning mental illness with deviance. We combine semi-structured interviews with digital ethnography of public Instagram accounts to examine how Instagram users express mental illness. Drawing on small stories research, we find that individuals situate mental illness within their everyday lives and negotiate their tellings of experience due to the influence of various social control structures. We discuss implications for incorporating 'the everyday' into the design of technological solutions for marginalized communities and the ways in which researchers and designers may inadvertently perpetuate and instantiate stigma related to mental illness.

Community-based approaches to participatory design, such as the design workshop, promise to engage underserved populations in collaborative dialog and provide a platform for promoting the views of communities who are not typically given a space to engage in design. Yet, we know little about how design workshops as a research site can engage underserved individuals (i.e., due to class, race, or age status) or address personal concerns (e.g., health). As a way of exploring these issues, we conducted a series of five design workshops with low-income African-American older adults to understand their health experiences. Our findings reveal three insights associated with the design workshop and the topic of health: comfort with community versus personal health; the sociocultural configuration of interaction; and empowerment in the context of systematic inequality of opportunity. We discuss the importance of understanding the situated nature of design workshops, particularly when engaging underserved groups in the topic of health, and the potential of the design workshop as a mechanism for activism.

Recent studies have identified various forms of bias in language-based models, raising concerns about the risk of propagating social biases against certain groups based on sociodemographic factors (e.g., gender, race, geography). In this study, we analyze the treatment of age-related terms across 15 sentiment analysis models and 10 widely-used GloVe word embeddings and attempt to alleviate bias through a method of processing model training data. Our results show significant age bias is encoded in the outputs of many sentiment analysis algorithms and word embeddings, and we can alleviate this bias by manipulating training data.

While parents of young children regularly make decisions about sharing content about their child or family online, we know less about how they create, produce, and share video-based content of children with stigmatizing experiences. Through an analysis of publicly available content on YouTube, supplemented with semi-structured interviews, we report on the ways in which parents of children with developmental disabilities produce, share, and interact with others through videos of their children's experiences. Our analysis finds that parents disclose child information on YouTube to build authenticity, connect with others, advocate for social change, and justify monetization and child involvement. We discuss tensions between parents' practices and the ethical complexities of sharing and studying parent-generated content featuring children with disabilities.

Collaborative writing tools have become ubiquitous in today's world and are used widely in many professional organizations and academic settings. Yet, we know little about how ability-diverse teams, such as those involving people with and without vision impairments, make use of collaborative writing tools. We report on interviews with 20 academics and professionals who are blind or visually impaired and perform collaborative writing with sighted colleagues. Our findings reveal that people with vision impairments perform collaborative writing activities through four interconnected processes, which include learning an ecosystem of (in)accessible tools, adapting to complexities of collaborative features, balancing the cost and benefit of accessibility, and navigating power dynamics within organizations. We discuss how our analysis contributes to theories of accessibility in collaboration and offers practical insights for future collaborative system design.

Participatory Design (PD) is envisioned as an approach to democratizing innovation in the design process by shifting the power dynamics between researcher and participant. Recent scholarship in HCI and design has analyzed the ways collaborative design engagements, such as PD situated in the design workshop can amplify voices and empower underserved populations. Yet, we argue that PD as instantiated in the design workshop is very much an affluent and privileged activity that often neglects the challenges associated with envisioning equitable design solutions among underserved populations. Based on two series of community-based PD workshops with underserved populations in the U.S., we highlight key areas of tension and considerations for a more equitable PD approach: historical context of the research environment, community access, perceptions of materials and activities, and unintentional harm in collecting full accounts of personal narratives. By reflecting on these tensions as a call-to-action, we hope to deconstruct the privilege of the PD workshop within HCI and re-center the focus of design on individuals who are historically underserved.

Computational approaches to text analysis are useful in understanding aspects of online interaction, such as opinions and subjectivity in text. Yet, recent studies have identified various forms of bias in language-based models, raising concerns about the risk of propagating social biases against certain groups based on sociodemographic factors (e.g., gender, race, geography). In this study, we contribute a systematic examination of the application of language models to study discourse on aging. We analyze the treatment of age-related terms across 15 sentiment analysis models and 10 widely-used GloVe word embeddings and attempt to alleviate bias through a method of processing model training data. Our results demonstrate that significant age bias is encoded in the outputs of many sentiment analysis algorithms and word embeddings. We discuss the models' characteristics in relation to output bias and how these models might be best incorporated into research.

There is a growing emphasis on designing with people with diverse health experiences rather than designing for them. Yet, collaborative design becomes difficult when working with individuals with health conditions (e.g., stroke, cancer, abuse, depression) that affect their ability or willingness to engage alongside researchers and verbally express themselves. The present paper analyzes how the clinical practice of art therapy engages these individuals in co-creative, visual expression of ideas, thoughts, and experiences. Drawing on interviews with 22 art therapists and over two years of field work in a clinical setting, we detail how art therapists view making as expression for people with complex communication needs. Under this view, we argue that art therapy practice can inspire collaborative design engagements by understanding materials as language, creating space for expression, and sustaining expressions in a broader context. We discuss practical and ethical implications for design work involving individuals with complex communication needs.

In CSCW and HCI, work examining expression of mental health and illness on social media frequently aims to classify content, quantify visual trends, and predict user states. This approach to analysis is a form of the coded gaze, a type of algorithmic 'way of seeing' coined with respect to artificial intelligence techniques. The coded gaze classifies content through researcher- and machine-labeled categories, relying on a series of theoretical assumptions that influence how values pertaining to mental health and illness become inscribed in data. In this paper, we build upon this research to support alternative methods of data interpretation. We join manual collection of Instagram posts with semi-structured interviews and digital ethnography over six months to understand how Instagram users express their experiences with mental health and illness. We argue that individuals negotiate claims to mental health and illness through visibility and signaling, the boundaries between mental health and illness are porous and blurred, and reposting and remix are a form of participation. We discuss practical and ethical implications for studying the expression of mental health and illness online.

Although accessibility in academic and professional workplaces is a well-known issue, understanding how teams with different abilities communicate and coordinate in technology-rich workspaces is less well understood. When hearing people collaborate around computers, they rely on the ability to simultaneously see and hear as they start a shared document, talk to each other while editing, and gesture towards the screen. This interaction norm breaks down for teams of people with different sensory abilities, such as Deaf and hearing collaborators, who rely on visual communication. Through interviews and observations, we analyze how Deaf-hearing teams collaborate on a variety of naturalistic tasks. Our findings reveal that Deaf-hearing teams create accessibility through their moment-to-moment co-located interaction and emerging team practices over time. We conclude with a discussion of how studying co-located Deaf-hearing interaction extends our understanding of accessibility in mixed-ability teams and provides new insights for groupware systems.

Augmentative and Alternative Communication (AAC) devices help people with speech-language impairments due to aphasia express themselves more independently and fluently. However, current AACs are still limited in that they must be pre-programmed with common words or phrases prior to use. When people with aphasia encounter unexpected and unplanned situations or contexts, they may have difficulty using their AAC device to generate the desired speech. We present the design of an AAC application that uses image recognition technology to give people with aphasia just in time access to words. Our design automatically carries out an extensive retrieval of words associated with a captured image. The relevance, accuracy and usefulness of each word can then be verified independently by the user through an intensive retrieval of images associated with each word.

Traumatic Brain Injury (TBI) can affect all aspects of an individual's life, including physical ability, communication, and mental health, and present chronic health conditions that persist throughout the lifespan. Although prior work documents a decrease in social interaction following brain injury, little is known about how individuals with TBI engage in social behavior during their recovery, how others in their lives participate, and how these interactions occur in both online and offline contexts. We examine these issues through an interview study involving individuals with TBI, as well as caregivers and social contacts of individuals with TBI. Our analysis identifies the concept of social re-emergence, a non-linear process of developing a new social identity that involves withdrawing from social life, developing goals for social participation, disclosing health information for social support and acceptance, and attaining social independence.

Sharing online is an important way in which people across the lifespan express themselves, maintain relationships, and connect with others. Yet, people with dementia are often not supported in engaging to the full extent of their abilities, particularly in their interaction with online technology. This paper presents a design case study that examines what it means to design for agency in online sharing involving individuals with dementia. Our work is situated in the context of art therapy for adults with dementia. We present the design and exploration of Moments, a system that allows individuals to share through artwork by manipulating their physical environment. We discuss how designing for agency calls attention to the ways in which the material workspace, including the tools we introduce, and the surrounding social context participate in the creation of agency.

Designing new technologies with and for individuals with dementia is a growing topic of interest within HCI. Yet, predominant societal views contribute to the positioning of individuals with dementia as deficient and declining, and treat technology as filling a gap left by impairment. We present the perspective of critical dementia as a way of reflecting on these views in the context of recent epistemological shifts in HCI. In addition to articulating how HCI can leverage the perspective of critical dementia, we present a case analysis of technology design in art therapy involving people with dementia aimed at challenging conventional narratives. This paper calls attention to and helps solidify an agenda for how the CHI community approaches dementia, design, and technology.

Ageism is a pervasive, and often invisible, form of discrimination. Though it can affect people of all ages, older adults in particular face age-related stereotypes and bias in their everyday lives. In this paper, we describe the ways in which older bloggers articulate a collective narrative on ageism as it appears in their lives, develop a community with anti-ageist interests, and discuss strategies to navigate and change societal views and institutions. Bloggers criticize stereotypical notions that focus exclusively on losses that occur with age and advocate a view that takes into account the complexity and positive aspects of older adulthood. This paper contributes a unique case of online collective action among older adults while drawing on their online discourse as a way of understanding what ageism means for CSCW.

Although many older adults are active online, certain age-related disabilities, such as late-life vision impairment, make sustaining online participation difficult. Motivated by the need for accessible online spaces for people experiencing vision impairment in older adulthood, we developed xPress, a voice-based online blogging community. Through a 10-week deployment with seven older adults with acquired vision loss, we analyze how this type of online community enables connecting with peers, sharing experiences, and offering social support in new ways. The design of xPress also highlights the importance of human voice in accessible social platforms and reveals expectations around community participation. We discuss designing for age and disability through the lens of intersectionality and offer design considerations for similar voice-based online communities.

Cognitive impairment is sometimes viewed as a deficit limiting an individual's ability to participate fully in society. Art therapy, in contrast, is a context in which older adults with cognitive impairments (e.g., dementia, aphasia) are positioned as capable, competent, and engaged through the act of creating and sharing artwork. We draw on the concept of the "Third Hand," a practice in art therapy in which the therapist attunes to and enables the desires of the client during interaction. We use this concept to understand how to empower creative work and sharing among older adults with cognitive impairments. We introduce an interactive frame prototype to explore new opportunities for sharing and supporting interaction between these older adults and their therapist. We conclude with a discussion of what designing for the Third Hand means to HCI, including how this metaphor provides a model of empathy and empowerment in design for this population.

Robots are seen as a potential solution to the perceived needs of the aging population. Thus far, research has primarily focused on robotics for the functional and emotional support of older adults. Robotic pets have been developed primarily for the older adult who is perceived as lonely and isolated, and fears have consequently arisen that robots will replace human caregivers and deceive older adults into developing relationships with them. Missing is the perspective of older adults on the ethics of and potential uses for robotic companion pets. In this study, we conducted focus groups with 41 older adults. We discuss concepts raised by focus group participants such as giving into the fiction of the robotic pet, the social role of the robot, and the role of reciprocity in building a relationship with a robotic pet. We present resulting considerations for new directions for robotic pet design for older adults.

Older adults and people with vision impairments are increasingly using phones to receive audio-based information and want to publish content online but must use complex audio recording/editing tools that often rely on inaccessible graphical interfaces. This poster describes the design of an accessible audio-based interface for post-processing audio content created by visually impaired seniors. We conducted a diary study with five older adults with vision impairments to understand how to design a system that would allow them to edit content they record using an audio-only interface. Our findings can help inform the development of accessible audio-editing interfaces for people with vision impairments more broadly.

Diversifying participation in crowd work can benefit the worker and requester. Increasing numbers of older adults are online, but little is known about their awareness of or how they engage in mainstream crowd work. Through an online survey with 505 seniors, we found that most have never heard of crowd work but would be motivated to complete tasks by earning money or working on interesting or stimulating tasks. We follow up results from the survey with interviews and observations of 14 older adults completing crowd work tasks. While our survey data suggests that financial incentives are encouraging, in-depth interviews reveal that a combination of personal and social incentives may be stronger drivers of participation, but only if older adults can overcome accessibility issues and understand the purpose of crowd work. This paper contributes insights into how crowdsourcing sites could better engage seniors and other users.

While the majority of older adults are now active online, they are often perceived as passive consumers of online information rather than active creators of content. As a counter to this view, we examine the practices of older adult bloggers (N=20) through in-depth interviews. We study this group of older adults as a unique case of content creation and sharing. We find that the practice of creating and sharing through blogging meets several important psychological and social needs for older adults. Specifically, blogging supports the development of identity in older adulthood; fosters self-expression that supports older adults' values; provides meaningful engagement during retirement; and enables a sense of community and social interaction that is important for wellbeing in late-life. We argue for a focus on designing for late-life development and detail opportunities for online systems to better support the dynamic experience of growing older through online content creation and sharing.

With much of the population now online, the field of HCI faces new and pressing issues of how to help people sustain online activity throughout their lives, including through periods of disability. The onset of cognitive impairment later in life affects whether and how individuals are able to stay connected online and manage their digital information. While caregivers play a critical role in the offline lives of adults with cognitive impairments, less is known about how they support and enable online interaction. Using a constructivist grounded theory approach, data from focus groups with caregivers of adults with cognitive impairments reveal four forms of cooperative work caregivers perform in the context of supporting online activity. We find that staying active online is a way of empowering and engaging adults with cognitive impairments, yet this introduces new forms of risk, surrogacy, and cooperative technology use to the already demanding work of caregiving.

Older adults are most often considered consumers of online information, but recent work highlights the importance of engaging older adults in content generation and online sharing. One context in which older adults generate and share content is art therapy for individuals with dementia. Our analysis draws on Altman's notion of privacy and territorial regions to understand what sharing means for this vulnerable population. This theoretical framing reveals the ways in which privacy is cooperatively negotiated, which is in contrast to the individualistic view of existing sharing systems; how older adults derive benefits from sharing depending on interaction with their audience; and how sharing fluctuates between a focus on the process of therapy versus the product depending on privacy needs. Our analysis contributes an understanding of the complex nature of sharing for vulnerable populations and offers design considerations for systems that support this practice.

This paper explores the integration of tactile feedback into children's electronic books (e-books) through variable friction surface haptics enabled by the TPaD Tablet technology. Through a user study with 10 pairs of children and their parents, we examine how children and parents conceive of and add haptics to a popular e-book. We report conceptual and practical differences in the ways in which children of various ages (3-8 years old) and adults envision haptic feedback within an e-book and conclude with a discussion of design considerations for creating haptic e-books.

The increasing pervasiveness of voice input systems in consumer devices (e.g., Apple's iOS Siri) creates the potential for young children to use features and access content that previously required the ability to read and write. However, whether and how young children use voice input systems and associated voice agents on mainstream devices has not been studied in detail. This paper reports preliminary findings from an online survey with parents about children's use of voice input systems and a content analysis of YouTube videos depicting child interaction with one popular voice input system. Our results reveal three primary ways in which children use voice input systems: exploration, to understand and relate to the voice agent and for fun; information seeking, related to fact-finding questions and information about their surrounding environment; and functional, as a means of operating the device. While our results are preliminary, they highlight a variety of opportunities and challenges voice input systems present for children and parents.

With the ubiquity of wearable computing, an important and emerging challenge is to understand how to design wearable information displays for non-visual, non-auditory interaction. This is particularly relevant to the design of accessible technologies for people with vision impairments. Working towards this aim, we developed a smartwatch prototype that uses variable friction surface haptics to test initial design concepts. Through interviews and iterative prototyping with seven blind users, we identified three key use cases for a haptic smartwatch as well as embodied conceptual models for presenting haptic information. We found that a physical clock face, compass, and numerical keypad are productive representations for presenting information haptically, and these models build on existing tactile and spatial understandings of our target user group.

The TPad Tablet combines an Android tablet with a variable friction haptic touch-screen and offers many novel interaction possibilities. For example, unique textures may be associated with different user interface elements, such as text boxes and buttons. This paper presents an Android AccessibilityService that was created to give operating system-wide (OS) access to haptic effects. Prior to this work, the haptic feedback of the TPad could be controlled only from within specific applications. With the new implementation, all applications and primary user interfaces (e.g. home screen) will have access to the TPad. Rather than focus on specific elements or applications, we seek to provide a high fidelity haptic experience that elevates the TPad's accessibility to the standard of Talkback and Voiceover, Android's and Apple's accessibility programs respectively. The code for the application is available on our website.

Online technologies are promising for helping older adults maintain social connectedness, particularly with younger people, yet many older adults resist or participate minimally in the mainstream technologies used by younger members of their social network. We present results from an interview study involving 22 older adults (age 71-92) to understand communication preferences and values related to social media. Seniors articulate many concerns with online social media, including the time required for legitimate participation, the loss of deeper communication, content irrelevance, and privacy. Additionally, older adults engage in social practices that could be supported by online social technologies, but they rarely use such tools. The theme of material social communications emerges from our data, and we examine this in context of online social media. We conclude with design considerations for the development of social media for older adults, and as part of this we describe the notion of bridging technologies as a framework for intergenerational communication design.

This paper explores the use of variable friction surface haptics enabled by the TPad Tablet to support affective communication between pairs of users. We introduce three haptic applications for the TPad Tablet (text messaging, image sharing, and virtual touch) and evaluate the applications with 24 users, including intimate couples and strangers. Participants used haptics to communicate literal texture, denote action within a scene, convey emotional information, highlight content, express and engage in physical playfulness, and to provide one's partner with an experience or sensation. We conclude that users readily associate haptics with emotional expression and that the intimacy of touch in the contexts we study is best suited for communications with close social partners.

This paper explores the use of a guessability study to examine child-defined gestures with Kinect. Applying a Wizard-of-Oz approach, gestures were elicited from six children (age 3--8) through a series of 22 task stimuli including object manipulation, navigation-based tasks, and spatial interaction. Gestures were video recorded, transcribed, and coded by three researchers employing an inductive, qualitative method of analysis. Five themes emerged from the data: (1) the influence of 2D touchscreens on children's interactions in 3D, (2) the role of contextual cues in designing a stimuli set, (3) individual preferences for dominant styles of interaction, (4) different approaches children employ to simulate the same object path, and (5) and allocentric versus egocentric approaches for manipulating objects on screen. While we did not achieve strong consensus among all of the gestures produced by children in our study, our results provide a basis for further refinement of the stimulus set and methodology used for future work examining child-defined gestures for whole-body interfaces.

Documentation of development is a critical aspect of the work of early childhood education teachers. Through field observations and interviews, we detail the process and tools used in documenting development for children age three months to five-years-old at one school. Teachers use paper forms and printed photos to record and analyze observations of development. The evolving final product is a paper portfolio of development. This practice relies heavily on the teacher's ability to objectively observe children in situ, create a record of the activity, and make salient the link between evidence and developmental milestones. We describe current paper and photo documentation practices in light of an online record keeping system that will be introduced at this school within the next year. The present analysis contributes to a growing literature on the role of paper and digital media in documentation.

Photographs are powerful and pervasive media that facilitate communication and support reminiscence. Adding audio narrations to traditional paper photographs combines the familiarity of paper photos with the nuanced richness of voice. We enable creation of and interaction with audio-enhanced paper photographs through custom software deployed on a digital pen. This paper reports on use of a paper-digital photo album by an older adult (Ethel, age 105), her extended family, and nursing staff over a five-month field deployment. The interactive photo album was found to be easy to use and accessible, effectively engaged Ethel's and family members' interest, and provided a focal point for communication and social interaction. Family and caregivers report improvements in Ethel's social interaction. We discuss the properties of our audio-enhanced paper approach that make it a promising medium for engaging older adults and distill general design considerations for paper-digital photo albums.

Hybrid paper-digital interfaces are a promising approach for supporting language activities. The familiarity of pen and paper makes it a particularly attractive media for many user groups, including young children. Digital pens enhance interaction with traditional paper content by playing and recording audio and recognizing handwriting and gestures. Currently, generating custom interactive paper documents involves some programming, limiting its use by many user groups (e.g., educators and families) who might especially benefit from application of hybrid paper-digital interfaces in their practices. To address this need, we developed an end-user Toolkit for Authoring Pen and Paper Language Activities (TAP & PLAY). This paper describes the iterative development of the toolkit, its accessibility for novice non-technical users, and use in three different contexts for early language learning. We demonstrate and document the system's usability, generality, and utility for people who want to create and tailor their own custom interactive paper-based language activities.

After a stroke or brain injury, it may be more difficult to understand language and communicate with others. Speech-language therapy may help an individual regain language and cope with changes in their communication abilities. Our research examines the process of speech-language therapy with an emphasis on the practices of therapists working with adults with aphasia and apraxia of speech. This paper presents findings from field work undertaken to inform the design of a mixed paper-digital interface prototype using multimodal digital pens. We describe and analyze therapists' initial reactions to the system and present two case studies of use by older adults undergoing speech-language therapy. We discuss the utility of multimodal paper-digital interfaces to assist therapy and describe our vision of a system to help therapists independently create custom interactive paper materials for their clients.

This paper examines accessibility issues of surface computing with older adults and explores the appeal of surface computing for health care support. We present results from a study involving 20 older adults (age 60 to 88) performing gesture-based interactions on a multitouch surface. Older adults were able to successfully perform all actions on the surface computer, but some gestures that required two fingers (resize) and fine motor movement (rotate) were problematic. Ratings for ease of use and ease of performing each action as well as time required to figure out an action were similar to that of younger adults. Older adults reported that the surface computer was less intimidating, less frustrating, and less overwhelming than a traditional computer. The idea of using a surface computer for health care support was well-received by participants. We conclude with a discussion of design issues involving surface computing for older adults and use of this technology for health care.

In this paper we compare the affordances of presenting educational material on a tabletop display with presenting the same material using traditional paper handouts. Ten pairs of undergraduate students used digital or paper materials to prepare for exams during four one-hour study sessions over the course of a term. Students studying with the tabletop display solved problems on their own before resorting to answer keys and repeated activities more often than students studying with paper documents. We summarize study activities and discuss the benefits and drawbacks of each medium.

This paper describes the design and evaluation of Shared Speech Interface (SSI), an application for an interactive multitouch tabletop display designed to facilitate medical conversations between a deaf patient and a hearing, non-signing physician. We employ a participatory design process involving members of the deaf community as well as medical and communication experts. We report results from an evaluation that compares conversation when facilitated by: (1) a digital table, (2) a human sign language interpreter, and (3) both a digital table and an interpreter. Our research reveals that tabletop displays have valuable properties for facilitating discussion between deaf and hearing individuals as well as enhancing privacy and independence. The contributions of this work include initial guidelines for cooperative group work technology for users with varying hearing abilities, discussion of benefits of participatory design with the deaf community, and lessons about using dictated speech on shared displays.

This paper presents a design case study of SIDES: Shared Interfaces to Develop Effective Social Skills. SIDES is a tool designed to help adolescents with Asperger's Syndrome practice effective group work skills using a four-player cooperative computer game that runs on tabletop technology. We present the design process and evaluation of SIDES conducted over six months with a middle school social group therapy class. Our findings indicate that cooperative tabletop computer games are a motivating and supportive tool for facilitating effective group work among our target population and reveal several design lessons to inform the development of similar systems.