The User-Initiated Design Phenomenon in Stroke Survivors: Adapting Inaccessible Environments

Friday, November 1, 2013
First author:
Sarmiento M.
Adapting the Environment II

1 Facultad de Artes, Departamento de Diseno Industrial, Universidad Nacional de Colombia, Bogota, Colombia

2 Disability Studies, Disability and Human Development, University of Illinois, Chicago, USA

3 Joint Doctoral Program in Disability Studies & Doctoral Program in Rehabilitation Sciences, College of Applied Health Sciences, Departments of Occupational Therapy & Disability and Human Development, University of Illinois, Chicago, USA

All authors:

Martha P. Sarmiento1,2, Joy Hammel

Empowerment & Environment
Choice, Design and Participation


Design is a basic human activity; everyone who advances actions to change an existing situation into a desired one engages in design. The act of designing thus posits a discussion about the active involvement of “users” in the design process and responds to and integrates user-initiated design. User-initiated design is a phenomenon that many disabled people enact while negotiating their less-than-accessible environments every day but this experience has been neglected from research in the field of design. Given this lack of attention the study explores designs people with disabilities, particularly people who have had a stroke, generate in their home environment and factors supporting them in taking an active role in designing this key living environment.


The study used a comparative case study design to explore user-initiated design in a group of people with disabilities as they strategize to adapt their home environments following a stroke. In addition a participatory approach was used to involve participants in the research process and in generating implications for changing how designers and rehabilitation professionals look at design of everyday living environments and how they could engage disabled people more actively in this process.


User-initiated design seems to play an important role in the process of adaptation and ongoing interaction with the environment after the stroke. Their engagement as active agents in the innovation of accessible living environments can increase their sense of competence and enable social participation.


Innovative users with stroke actively shape and personalize their environment through user initiated design processes.  Their experience and inputs in this process is silent but innovative.