"I see it as a wellspring for my positive and upward journey in life.": Understanding Current Practices of Assistive Technology's Customized Modification in China

Due to the significant differences in physical conditions and living environments of people with disabilities, standardized assistive technologies (ATs) often fail to meet their needs. Modified AT, especially DIY (Do It Yourself) ATs, are a popular solution in many high-income countries, but there is a lack of documentation for low- and middle-income areas, especially in China, where the culture of philanthropy is undeveloped. To understand the current situation in this paper, we conducted semi-structured interviews with 10 individuals with disabilities using modified ATs and 10 individuals involved in providing these including family members, standard assistive device manufacturers, and individuals employed for their modification skills, etc. Based on the results of the thematic analysis, we have summarized the general process of modified ATs for people with disabilities in China and the benefits these devices bring. We found that modified ATs not only make the lives of people with disabilities more comfortable and convenient but also bring them confidence, reduce social pressure, and even help them achieve self-realization. Additionally, we summarized the challenges they encountered before, during, and after the modification, including awareness gaps, family resistance, a lack of a business model, and so on. Specifically, we conducted a special case study about the typical business models and challenges currently faced by AT Modification Organizations in China. Our research provides important design foundations and research insights for the future of universal and personalized production of AT.