An Ecosystem of Support: A U.S. State Government-Supported DIY-AT Program for Residents with Disabilities
Erin Higgins, Marie E Sakowicz, Foad Hamidi · 2024 · ASSETS '24: Proceedings of the 26th International ACM SIGACCESS Conference on Computers and Accessibility · doi:10.1145/3663548.3675667
Summary
This paper documents an Action Research study in which the authors collaborated with the Maryland Department of Disabilities (MDOD) to launch and study a state-level Do-It-Yourself Assistive Technology (DIY-AT) program. The program connected people with disabilities who needed customised assistive devices with volunteer makers (primarily university students) who had access to digital fabrication tools like 3D printers. While DIY-AT approaches promise greater customisation and lower cost than commercial assistive technology, previous efforts have revealed barriers: the technical expertise required for digital fabrication, financial costs of equipment, communication challenges between end users and makers, and liability concerns. The Maryland program attempted to address these through a multi-organizational collaboration drawing on complementary strengths — state government provided legitimacy, funding, and access to disability service networks; universities provided maker expertise, equipment, and student volunteers; and disability organisations connected end users. Over the course of the program, 15 assistive devices were created for residents, including adapted utensil holders, one-handed devices, wheelchair accessories, and sensory tools. The researchers conducted interviews and observations with all stakeholder groups — end users, makers, programme coordinators, government officials, and disability service providers — analysing how participants engaged with the programme, their motivations, the relationships that formed, and how the experience shaped their understanding of disability and assistive technology. The study used thematic analysis to develop an ecosystem model describing the interdependent roles and relationships between stakeholders.
Key findings
The ecosystem model identified five key stakeholder roles — end users, makers, connectors (disability service professionals who linked users to the programme), facilitators (programme coordinators), and supporters (government and institutional leaders) — each with distinct motivations and contributions. A central finding was that the programme expanded participants' understanding of both assistive technology and disability. End users moved from viewing AT as expensive, clinical products to recognising that everyday customised solutions could address their needs; makers gained empathy and design skills through direct engagement with disabled end users; and government officials saw DIY-AT as a cost-effective complement to traditional AT provision. Communication between end users and makers was identified as the programme's greatest challenge — differences in technical vocabulary, expectations around iteration and timelines, and the difficulty of articulating needs for custom devices all created friction. The connector role proved essential — disability service professionals who understood both the users' needs and the programme's capabilities served as critical translators and advocates. The programme also revealed tension around liability and quality assurance, as 3D-printed devices lack the regulatory oversight of commercial AT. Participants reported that the programme fostered a sense of agency and community beyond the devices themselves, with several end users becoming advocates for the programme and some makers pursuing careers in assistive technology.
Relevance
This research provides a practical blueprint for scaling DIY-AT programmes through government partnership, addressing a persistent gap between the promise of maker culture for disability and its actual reach. Most DIY-AT initiatives remain small academic projects; the Maryland programme demonstrates how state government involvement can provide the infrastructure, legitimacy, and service network connections needed for broader impact. For accessibility practitioners and disability service organisations, the ecosystem model offers a framework for understanding and designing multi-stakeholder AT programmes, with the connector role being particularly important to replicate. The finding that the programme expanded definitions of AT — from clinical products to customised everyday solutions — has implications for how AT is funded and provided, suggesting that AT provision systems should be more flexible in what they support. The communication challenges documented between end users and makers are relevant to any participatory design context and reinforce the need for skilled intermediaries. The tension around liability and quality assurance for DIY devices is an unresolved but critical issue for the field.
Tags: assistive technology · DIY · digital fabrication · 3D printing · makerspaces · action research · government policy · disability services · ecosystem model