Going Beyond the I With CI: an Interview-based Design Space

Paper Title

Going Beyond the I With CI: an Interview-based Design Space

Publication Info

• Topic area: Human-Computer Interaction (HCI) for cochlear implant (CI) users in mainstream social contexts.
• Keywords: Cochlear implants, deaf and hard-of-hearing, inclusive design, accessibility, social interaction, shared responsibility, proxemics, seamfulness, mutual awareness, social translucence.

Background and Problem

• Problem / challenge: Current HCI research for CI users focuses primarily on functional accessibility, such as speech understanding, but neglects broader social, emotional, and relational aspects of interaction barriers in mainstream settings. Interaction challenges remain largely invisible to hearing peers, leading to misunderstandings, stigma, and asymmetrical effort in communication.
• Significance: Addressing these barriers is critical for enabling CI users’ full social participation, reducing fatigue, and fostering emotional well-being. Inclusive design must move beyond medicalized perspectives to support shared responsibility and relational dynamics in social interactions.
• Motivation and related work: Prior work has explored assistive technologies for speech recognition, captioning, and sensory substitution but has rarely targeted environmental adaptation or interaction-level dynamics. Calls for interventions that promote awareness among hearing peers and reduce the burden on CI users have emerged only recently, leaving significant gaps in mainstream, face-to-face social contexts.

Solution

• Proposed approach: A design-focused thematic analysis of interviews with CI users to identify interaction-level challenges and generate intermediate-level design knowledge. The study connects empirical insights to HCI concepts such as seamfulness, proxemics, and social translucence to propose actionable design principles.
• Novelty:
  1. Introduces intermediate-level design knowledge to broaden the solution space for CI users’ social interactions.
  2. Highlights shared responsibility between CI users and hearing partners, moving beyond individual-focused designs.
  3. Links empirical findings to established HCI concepts, offering a structured lens for inclusive design.
  4. Proposes six concrete design principles and nudging strategies to scaffold mutual awareness, adaptive behavior, and balanced disclosure.
• Procedure and key techniques:
  • Conducted semi-structured and go-along interviews with 14 CI users aged 17–34 in Germany and the Netherlands.
  • Used reflexive thematic analysis with abductive reasoning to identify four key themes: invisible hearing demands, misunderstandings, coping strategies, and emotional costs.
  • Mapped findings to HCI concepts to generate design principles and actionable guidelines.

Results

• Concrete findings:
  • CI users face invisible and shifting hearing demands, leading to fatigue and effort that hearing peers often fail to notice.
  • Misunderstandings arise from communication breakdowns, misattributions, and social withdrawal, amplifying stigma and relational strain.
  • CI users employ strategies like positioning, environmental control, and self-advocacy, but these often come at emotional and cognitive costs.
  • Hearing partners rarely share the burden of communication, highlighting the need for designs that foster mutual awareness and shared responsibility.
• Advantage over baselines: Expands HCI discourse by addressing relational and emotional dimensions of accessibility, moving beyond functional access to support nuanced dynamics of interaction.
• Experiments / evaluation: Analysis based on qualitative interviews with 14 CI users; findings linked to HCI concepts such as grounding, seamfulness, and proxemics to inform design directions.
• Limitations and future work:
  • Limited sample diversity (age, nationality, CI-specific experiences); future studies should include broader demographics.
  • Hearing partners’ perspectives were not directly captured; mixed-group studies are needed to refine shared responsibility approaches.
  • Analytical scope relied on a single researcher; multi-perspective analysis could enhance interpretive depth.

Summary

This study addresses interaction-level challenges faced by CI users in mainstream social contexts, proposing design principles that emphasize shared responsibility and mutual awareness between CI users and hearing peers. By linking empirical insights to HCI concepts like seamfulness and proxemics, the work expands the design space for inclusive technologies that support social interaction beyond functional accessibility. Findings highlight opportunities for context-sensitive interventions that reduce communication asymmetries, foster empathy, and preserve CI users’ agency. The proposed guidelines have broader applicability to other DHH populations, contributing to inclusive and disability-focused HCI.