Technologies for inclusive employment: beyond the prosthetic fix–social transformation axis

ABSTRACT

Technologies are often expected to enhance inclusive employment for people living with a disability. Following conventional dichotomies, policy actors generally consider technologies to either provide a prosthetic fix to ‘able’ people with disabilities, or become instruments for social transformation. In three pilot projects within a national initiative for enhancing inclusive employment through technologies, we empirically explore the potential of such conceptually opposed approaches for realising inclusive employment in practice.

Reporting on a transdisciplinary ‘learning evaluation’, we combine semi-structured interviews with participant observation and transformation-oriented methods from Reflexive Monitoring in Action, involving a myriad of stakeholders. We introduce the notion of scripts to explore how we as researchers become part of the de- and re-inscription of technologies for inclusive employment. We find that regardless of an initial prosthetic- or transformative approach, technology can support a transformation toward inclusive employment through the work and effort of the actors involved.

Points of interest

• Whether the initial approach to inclusion through technology is to ‘fix’ disability or ‘transform’ work practices, the concerted effort of the people involved can generate transformative potential

• For technology to attain this transformative potential it is imperative that the sociocultural environment is shaped accordingly

• To understand the dynamics that work for transformation, it is critical that technology is seen in practice, in specific situations

• To understand how disability is made through technology we recommend deconstructing the ‘scripts’, that is the user-assumptions and roles, embedded in the technology

• To support that technologies contribute to inclusive employment, a method is needed that supports reflexivity and involves people from various backgrounds actively participating

Keywords:

• Inclusive employment
• technology-in-practice
• actor-network theory
• co-construction of technology and inclusion
• learning evaluation

Rethinking the possible roles of technology in achieving inclusive employment

In many parts of the world, people with disabilities encounter low levels of employment (Friedman 2020; Ebuenyi et al. 2019; Kiesel, Dezelar, and Lightfoot 2019). In Western Europe, for example, only half of all people with disabilities have a job (Waltz 2018). People with disabilities face barriers, disadvantages and discrimination when trying to find employment and remain employed (Kuznetsova and Yalcin 2017; WHO 2015). Having a paid job is an important part of participating in society; it can be seen as a sign of social participation and provides people with financial security, a sense of identity, a sense of belonging and a meaning in life (Trezzini et al. 2021; Hogan et al. 2012; Nota et al. 2014; Galer 2012). Various scholars have pointed to the opportunities that technological innovations can introduce for improving the participation of people with disabilities in the job market (Roulstone 2016; Syurina et al. 2017). Technology could provide people with disabilities with the means to participate more actively in society, become more independent and live improved and generally happier lives (Manzoor et al. 2018; Dewsbury, Taylor, and Edge 2002). Some authors point out that technology could ‘revolutionize our lives’ by breaking down barriers and expanding access for people with disabilities’ (Foley and Ferri 2012, 1).

The increased attention for the possibilities of using technology for social change can also be seen in the policy area, where disability policy increasingly incorporates technological innovation (Goggin et al. 2019). In Europe, this increased attention can be found in the European Commission’s (2019) digital inclusion strategy. In the Dutch setting, the rise in popularity has led to the establishment of various consortia, including the coalition for inclusion and technology (in Dutch, Coalitie voor Technologie en Inclusie) and the knowledge alliance for inclusion and technology (in Dutch, Kennisalliantie Inclusie en Technologie) (CTI 2020; KIT 2020).These coalitions set up various experiments to try and improve work participation for people with disabilities in the Dutch setting. Three of these experiments form the basis of this study. These initiatives make up a small part of a much wider transition towards more inclusive workplaces, technologies and policies for people with disabilities. But however hopeful these steps are, a transition towards inclusion usually does not follow a straightforward or linear path, and the relationship between technology and disability should be seen as complex and unruly from both the technology side and the disability side (Rip 2018; Roulstone 2016, 15).

Technological advancements can potentially increase access to work for people with disabilities but at the same time reproduce the idea that disability is something that needs ‘fixing’. This is visible in the medical model perspective, where disability is seen as a deviation from a supposed normal or able state (Oliver 1990). Technology, in the medical model, is mobilised to compensate this deviation. This compensatory logic can be seen in examples such as prosthetic arms, exoskeletons, reading glasses and hearing aids (Goggin, Newell, and Newell 2003; Roulstone 1998). In compensating for an implied deviation, the technology and its designers seek to ‘normalize’ disability (Goggin, Newell, and Newell 2003, 149). Moser (2006) describes the risks of this approach as follows; ‘notwithstanding their generative and transformative power, technologies working within an order of the normal are implicated in the (re)production of the asymmetries that they and it seek to undo.’ In this article we call technologies that approach inclusion with this normalizing logic; ‘prosthetic technology’. We define prosthetic technology as an approach to inclusive technology. One where technology compensates for a disability, ‘assisting’ people with disabilities to approximate an imposed ableist norm.

The social model seems to offer a solution by conceptualizing disability as a social construct. From this perspective, people with impairments are disabled by society; they are excluded from participating fully because they are seen as being disabled on the basis of their impairment (Oliver 1996). Following this reasoning, when disability is socially constructed in a society, the role of inclusive technology in countering this social construction involves becoming an instrument for societal change or transformation. In this article we call technologies that are designed to contribute to a shared commitment to transforming society towards becoming more inclusive; ‘transformative technology’. We specify this shared commitment and intended transformation as trying to improve inclusion of people with disabilities in the workplace. Note that the commitment is shared, which resonates with the logic of the social model and its focus on the environment as a dis/abling factor. The social model has also attracted some critiques, an important one being that it fails to account for personal experience and the impact of impairment on one’s own body (Galis 2011, 828). Moreover, authors have pointed to the importance of taking the ambivalent nature of technology into account when thinking about its promises (Shelley-Egan 2010).

The theoretical debate about the medical and social models poses an apparent choice between the two and acts as a distraction from addressing questions regarding how inclusive employment can be achieved. In this article, we use these models to study the approach technologies take to inclusion. We deliberately make no claims about actual transformation. Instead we use these perspectives as a way of showing how approaches to inclusive technology and transformation relate. We see the theoretical debate and apparent division between medical and social as what Deleuze (1991, 17) calls a ‘badly posed problem’, an arbitrary grouping of items on a scale while these actually differ in kind. The debate on cochlear implants is an exemplary case in point: where cochlear implants were often considered as either a tool for deaf people to access the hearing world or an assault on deaf culture and the deaf community altogether (Snell 2015). Similarly, technologies are often approached as combining elements of ‘fixing’ disability and contributing to societal transformation, thus forming what we call ‘hybrid technologies’, in the sense that they combine these two opposed elements. This understanding of technologies as hybrid, still means they are defined in terms of the ends of the scale.

As an antidote to the dichotomous theoretical medical–social debate, with ‘hybrid technologies’ as positioned ‘in the middle’, authors such as Galis (2011) have called for a shift of focus to how disability is ordered through practices and interactions. When we make this shift, we subdue the ways in which technology can create ‘unexpected and under-critiqued forms of social exclusion for people with disabilities’ (Foley and Ferri 2012, 192). Moreover, we acknowledge and account for the wide diversity of disabilities, lived experiences, cultures and contexts (Goodley et al. 2019). Doing so fits with a recent statement which asserts that we are all able and change in different ways (De Schauwer et al. 2020, 1). Acknowledging and accounting for these factors is in line with the thinking of Moser (2006, 377), who considers being disabled as something that one becomes within sociotechnical assemblages. She points out that disability is enacted and ordered in specific ways and that different assemblages make disability in different ways. This perspective offers a way of looking at how people are enabled and disabled differently, how the disabled body is made and how technologies can produce, or perform, different forms of disability. This raises the question: how are people made disabled and, in particular, what role do technologies and other material assemblages play in enabling and disabling interactions? Moser (2006, 389) suggests that ‘if we want technologies to become enabling also for disabled people then we will need to recognize not that disabled and abled is a dichotomy between two unities, but that people are abled and disabled in many different ways and in many different situations’. By following this line of thinking, we hope to go ‘beyond dangerous polarizations such as medical model versus social model to achieve a complex, multi-factorial account of disability’ (Shakespeare 2013, 1).

By doing so, our work resonates with an argument by Timmermans and Berg (2003, 101), who point out that dominant models of technological determinism and social essentialism are unsatisfactory in accounting for the complex relation between technology and society; technological determinism overestimates the power that technology, that aims for social change, has and social essentialism underestimates the role technology plays, seeing it as purely socially situated. In this article we similarly aim to move beyond the social essentialism and technological determinism polarizations by following the approach of studying technology-in-practice (Timmermans and Berg 2003). The technology-in-practice perspective considers technology as embedded in relations with groups, practices and other devices and can be seen as a way of doing away with the straightjacket of determinism or essentialism. Instead it offers a way to ‘investigate how “material” and “social” intertwine in complex ways’ (Hadders 2009, 573). In this article we thus take inspiration from technology-in-practice and contribute to their move beyond critique and towards experimental action (Timmermans and Berg 2003).

From deconstructing scripts to experiments in re-scripting

We specify the technology-in-practice approach by building on notions from actor-network theory where human and non-human actors interact with and influence one another, forming networks. Both human and non-human actors have agency and influence the way disability is ‘done’ in the specific setting (Akrich and Latour 1992; Sayes 2014). By analysing these interactions in the network, we do away with the previously described contrast between social essentialism and technological determinism. In doing so we hope to answer a call for more work on ‘understanding the fluid and variable roles of technology in action’ (Jensen and Gad 2009, 293). To make sense of the interactions and the work the actors do while at the same time providing an opening for learning from technology-in-practice, we specifically draw on the notion of technological ‘scripts’. Madeleine Akrich (1992) defines scripts as the outcome of the work through which designers:

‘define actors with specific tastes, competences, motives, aspirations, political prejudices, and the rest, and they assume that morality, technology, science, and economy will evolve in particular ways. A large part of the work of innovators is that of ‘inscribing’ this vision of (or prediction about) the world in the technical content of the new object. I will call the end product of this work a script’. (Akrich 1992, 208)

Scripts help us understand how objects can have ideas inscribed into them and how this can lead to them enabling or constraining relations between actors. Defining scripts as the outcome of the work done can account not only for the inherent values of the designers that are scripted into the object but also for the interactions that occur. This leads to a framework of action that is created by the human and non-human actors and defines the playing field. When you analyse the scripts of a technical object, you are de-scripting it, which involves the opposite movement to scripting it (see Box 1).

By adopting scripts, we deal with two important critiques of the dominant version of actor-network theory. The first is that it does not give enough attention to continuity and what repeatedly comes into being. Actor-network theory has an inherent resistance to structure and hierarchy, which can result in difficulties when accounting for changes over time and on different levels (Callon 1986). The de-scripting process can help here by teasing out which parts of the assembly are continuous and return. Second, actor-network theory has been said to under-represent vulnerable and excluded groups in its analysis (Galis and Lee 2014; Genus and Coles 2008; Star 1990). When following the actors and interactions in a network, there is a chance that only the most visible, or powerful, actors are followed (Star 1990). Here, scripts can help show the less visible actors by clarifying their re-inscriptions. This still leaves a third critique unaddressed: actor-network theory approaches are criticized for producing detailed empirical accounts, while providing limited actionable contributions to improving the practices studied (Cresswell, Worth, and Sheikh 2010). To address this criticism, we engage in this study in the active re-scripting of technologies for inclusion. In doing so, we follow insights from emerging work in Science and Technology Studies on Making & Doing (Downey and Zuiderent-Jerak 2021), including intervention-oriented research and reflexive monitoring in action (Zuiderent-Jerak 2015; Van Mierlo et al. 2010). Through such methods we experiment with re-scripting technologies for inclusive employment, involving people with disabilities, colleagues in the workplace, technology developers, policymakers and other relevant stakeholders. Together we attempt to shape how inclusion is being done and can be done in the specific setting, while the combination of action and participation maintains a specific focus on how people with disabilities can help shape the project (Balcazar et al. 2006).

To summarize, the moves we make in an attempt to honour the complexities of using technology for inclusion are as follows: first, we move beyond the medical and social model dichotomy to see disability as something that is ordered in specific ways through different configurations of non-human and human actors interacting. Second, we take insights from technology-in-practice and actor-network theory to study how different approaches to inclusive technologies take shape in specific empirical settings. Third, we adopt the notion of scripts to tackle some of the important critiques of actor-network theory and to help analyse how disability is made through the use of technology in a specific situation. Fourth, we recognize that we not only need to study local orderings, but also need to think about how we can improve the opportunity for inclusive employment. To do this we use insights from transdisciplinary- and intervention-based research methods which we will describe further in the research process section (Zuiderent-Jerak 2015). Thus, we link disability and technology theories and conceptualizations with an empirical focus on action, participation and contributing to change. This strong connection between conceptualizations and empirics is important for a thorough understanding of the role of technology in promoting inclusion (Gad and Ribes 2014). By making this connection, we hope to distil lessons and provide pointers on how technologies can contribute to achieving inclusive employment while redefining in the process what such inclusive employment precisely entails.

Reflection by doing: Participating in developing technologies for inclusive employment

Using insights from intervention-oriented research, we created a space where people from the workplace, policymakers, researchers and other relevant stakeholders could learn together and try to make a change together (Bradbury 2015; Baum, MacDougall, and Smith 2006). We opted for an embedded multiple-case study design (Gray 2004) (see Box 2 for participants and planning of observations and interviews). To make our analysis more robust, we compared three cases (Yin 2013, 156): the implementation of the Laevo exoskeleton, SpeakSee and the Ebb app (see Box 3). These cases were purposively sampled from a project funded by the Employee Insurance Agency of the Netherlands in which multiple pilots were conducted to try to improve work participation for people with disabilities. We sampled on the basis of diversity in technologies, disabilities and perspectives on disability that seemed to be inscribed. All pilots were experimental one-year projects. All respondents gave their written informed consent; they were all given a pseudonym and are referenced as such in the text.

We held semi-structured ethnographic interviews and reflection sessions with the people from the workplace, the end-users, their colleagues, the technology-developers, the policymakers and the funders of the project. The end-users did not have previous experience with the specific technologies used. Extra efforts were made to plan the interviews as to minimally interfere with daily work practice and keep the burden on energy levels of participants to a minimum. We also did participant observations and document analysis. Documents included promotion material by the pilots, the original grant applications, the websites of the technologies and workplaces, annual reports and progress reports by the pilots. The interviews were conducted using a topic list based on concepts identified during an unstructured review of the literature on disability and technology. To increase validity, the topic list was discussed and refined with other researchers.

To make the necessary adjustments along the way and to provide opportunities for generative learning, we set up a learning evaluation based on insights from reflexive monitoring in action and theory of change (Van Mierlo et al. 2010). We conducted outcome-mapping sessions with supervisors, project coordinators, management and technology-developers. In outcome mapping, participants map out their pathways to an impact and the specific steps that are needed to reach this impact (Earl, Carden, and Smutylo 2001). We asked participants to reason backwards from the desired impacts to outcomes and then to concrete actions. We then asked them to identify possible boundary partners, which are persons, groups or organizations which interact with the pilot directly and are capable of making an impact. They can form a bridge between the outcome of the project and the impacts they envision, in this case inclusive employment of people with disabilities.

All interviews and outcome-mapping sessions were recorded and then summarized. Important overarching themes were identified manually. A constant comparison method was used to look for important patterns, codes and concepts. To increase internal validity, the case studies were pattern matched and then compared. Coding was done inductively and data was triangulated with the findings from the document analysis and the field notes from the participant observation. The field notes were taken during each meeting with the pilots. The field notes were discussed directly after each meeting. After coding, the codes were grouped into a network of groups and evaluated again. All data was analysed using Atlas.ti version 7.10.5.

Inclusive technologies: Prosthetic fixes, social transformations and hybrid forms?

Re-inscripting the Laevo Exoskeleton: From prosthetic to transformative

We visit a local assembly plant, where people with and without disabilities produce various domestic climate systems such as ventilation systems, boilers and solar panels. The production line consists of around 12 stations, each performing mostly precise production work and packaging tasks. A large part of the work includes standing slightly bent forward or rotated, both significant risk factors for low back pain (Taylor et al. 2014). This production line forms the backdrop for the introduction of the Laevo Exoskeleton: a wearable piece of technology which mechanically supports the hips and trunk, reducing strain on its users’ back muscles and spine. The exoskeleton was designed for an array of workplaces, but not specifically for people with cognitive or mental disabilities. In this setting, the exoskeleton is used by Suzanne, one of the female employees working on the sheltered employment production line of the plant.

We sit in the company’s canteen at the table closest to the factory floor entrance and Suzanne talks about her experience with the exoskeleton. First, we talk about the ways in which the technology supports her back. She has a history of low back pain and states that wearing the technology has helped relieve her pain: ‘I do not fall asleep on my couch anymore when I come home, I feel healthier, have more energy and less pain.’ This is in line with the script the designers envisioned. However, she follows this statement with a very candid description of her turbulent personal life: she described to us that she was diagnosed with borderline at age 19, that she had a difficult home situation and has experienced trauma. She points out that her colleagues needed some time to get used to her wearing the technology and that she was asked a lot of questions. At that point, the factory doors open and the canteen fills with employees commencing their break. We decide to end the interview but not before she shows me how the skeleton works. She puts it on, causing quite a few quizzical looks among the other employees. She does not seem to mind, and says, ‘You are quite an attraction wearing this.’

At the other side of the canteen, John, one of Suzanne’s colleagues, is being interviewed. He is the foreman of the production line and has a cognitive disability. He also has low back pain but is adamant that he will not wear the skeleton because people will comment: ‘They will see me coming, you know, I am a little broad myself and then you are also wearing an exoskeleton. They will say “that man is crazy!”’ When prompted, he explains that he has worked hard to find a job where he is accepted, that is, where he is seen as normal. And now that he has finally found that job, he does not want to emphasize his differences. The possibility of being stigmatized again seems very real to him. Here, the introduction of the technology causes John to take a stance on what an inclusive workplace should look like. He then talks about how proud he is of his daughter, who also works at the factory. He describes her as being slightly overweight and explains that she has learned not to be bothered by the looks she gets or by what people say. But he remains determined that he will not wear the exoskeleton and adds jokingly that his non-disabled supervisor should wear the technology first, to set a good example.

Suzanne’s situation, that is, the fact that she has cognitive disabilities, differs from the original script of the exoskeleton. By wearing the technology, she is taking part in re-inscribing what the target audience of the technology can be. Her colleagues needing time to adjust can be seen as their own re-inscription process. The introduction of the technology forced them to think about and maybe even re-evaluate in some way their ideas about technology and disability. John’s ideas about what the technology could be are very different, emphasizing the risk of stigma and the exoskeleton as a highlighter of differences. The reactions of Suzanne and John can be seen as re-inscriptions of what the exoskeleton should do. The idea is that the exoskeleton is worn during working hours and is visible, that a user mostly works standing up and slightly bent forward, and that the work is physically demanding. The original script also anticipates that the user has low back pain or is at risk of having it. Here it is also important to note what was not taken into account in the script: the fact that users and their colleagues would have to get used to working with the technology or sometimes would not even want to wear the technology despite the possible advantages. Suzanne wears the skeleton with pride and embraces its visibility, while John is afraid that he would be stigmatized for wearing it because his impairments would be highlighted with a visible piece of technology. Both actors actively re-inscribe how disability is done in the workplace: the technology becomes a prosthetic tool that relieves pain or a tool that causes stigma and further cements the disabled status of its user.

The workplace itself also changes through these re-inscriptions. In Suzanne’s case, the workplace is a reasonably inclusive place with little risk of the technology causing any stigma, while for John it is a place where wearing a visible aid could cause someone to be excluded. The exoskeleton was designed with the former kind of workplace in mind and the aim was for it to be a literal extension of its user: a prosthetic, that is, a fix for possible impairments that extends its user’s capabilities. But the technology was not designed for the latter kind of workplace, so the re-inscription opens up possibilities for transformation by suggesting that John, who is suffering from low back pain, should also start wearing the exoskeleton. John’s reaction and the discussions that followed it were a first step in talking about disability and the possibility of stigma in the workplace. By taking a stance and voicing his fear of stigma, the employee’s re-inscription started a discussion on inclusion and with it a slow move towards change, or transformation.

This change was further supported by the role of the relevant account managers. In an outcome-mapping session with the account managers of the pilot, we ask them about the outcomes and the impacts they envision for the pilot. On the basis of the visit and the interviews, the managers state that one of the outcomes they envision is that John will wear the exoskeleton, greatly reducing his back pain. This concrete outcome is then used to think through the steps they will have to take to eventually get John to start wearing the technology. They use these steps to work on normalizing technology use in the workplace, which they hope will eventually lead to a higher level of wellbeing for the people in the workplace. When we ask the account managers about this again at a closing interview, they tell us that the focus on softer outcomes allowed them to experiment within the pilot. Their CEO also played a role in enabling this because he defined success as gaining insight into what works and what does not when it comes to inclusive technology. Both the account managers and the CEO played important roles as boundary partners, translating the outcomes of the pilot into impacts. By thinking through what the exoskeleton can and should be in the workplace, the managers re-inscribed their ideas about an inclusive workplace into it. By conceptualizing the impact as having an effect in the form of softer outcomes first, this re-inscription opened up possibilities for a workplace and environment focused on transformation and inclusivity instead of profit and productivity.

The Ebb app as a re-inscription tool: Moving from being a transformative technology to achieving transformation

We are attending a brainstorming session at a sheltered employment company. The goal of the session is to think about the possibilities that will be provided via a new app that will be piloted in the workplace. The app consists of different, easily adjustable, categories that can be used to save images and photos. The stock categories include topics such as ideas, important people, what helps at times of stress, talents and dreams. The idea is that the user builds their own archive of images and photos that reflect who they are. The archive can then be used as a conversation starter and a way of communicating more effectively through visuals. The app is aimed at people who have difficulties communicating or whose verbal skills are not strong. Attending the brainstorm is a group of 15 employees comprising the CEO, job coaches, supervisors, development coaches, managers, project coordinators, counsellors and foremen and forewomen. The group has worked with a prototype of the Ebb app for a few weeks and today the group members are sharing their insights with the creators of the app, who will use the feedback to create a new version of the app specifically for the workplace. In this session, the creators actively ask the stakeholders to contribute to their vision of what the technology could be.

The creators of the app, a disability studies researcher and a software developer, clearly scripted their own transformative ideals into the app. When introducing the session, the researcher talks passionately about the app being developed specifically for users with a disability and the possibilities for expression and agency the app offers. The words she uses echo the disability studies discourse, which focuses on the empowerment, participation and holistic inclusion of people with disabilities, and point to the app being developed as a transformative technology. The software developer supports this focus on empowering people with disabilities. However, he will be the person making adjustments to the app and he seems to temper the expectations of the participants when it comes to adding features. He reminisces about the old days, when software developers determined what an app would look like, instead of having brainstorming sessions. When we ask the researcher during an informal chat what she hopes to achieve through the app, she says she not only wants to improve inclusion but also to change the mindset of the professionals who work with people with disabilities. She later adds in a short conversation that she foresees struggles in trying to get the project team on board with this change in mindset.

These transformative scripts lead to difficulties in the first brainstorming session: the professionals mention productivity, measurement and oversight instead of empowerment and see particular possibilities in the calendar function. One attendee enthusiastically mentions the possibility of employees clocking in via the app. Another describes a situation in which an employee who is ill can send a photo to their supervisor to initiate their sick leave but also to prove that they do actually look ill. These are all examples of the re-inscription of the original idea of the app. By allowing people to participate in brainstorming, the developers invited this rethinking of what the app should be. In later visits, we also see a strong reaction to the transformative idea of the app; the project members and coaches do not really see a fit with the workplace or how the app can raise productivity, and they doubt if they can persuade their colleagues that this is the case. These re-inscriptions by the stakeholders highlight the stark contrast with the initial transformative scripts where the transformation was placed in a central position. Here the sociocultural environment in which the app will be implemented does not seem to be ready for the change in mindset and work practices the app envisions. Delays and setbacks in the development of the app further strengthen the stakeholders’ reservations. Questions about the suitability of the app for the specific workplace are asked at the kick-off of a version of the app. The developers give a presentation, and when it is over, one of the employees asks how he will be able to use the app, referring to one of the regulations of the workplace: ‘You cannot use your phone in the workplace’.

However, the story of the Ebb app does not end in a failed attempt at transforming inclusiveness through technology. The creators persist in emphasizing the importance of empowerment and use the resistance to this as a rallying point for change. They actively re-inscript the technology so that it should give agency to people with disabilities and create more inclusion and emphasize that it is not a tool to boost production or oversight. One of these re-inscriptions follows from a talk with the CEO of the company about the problems the creators have had in implementing the app. The CEO recognizes these issues as a wider organizational problem and mentions a company culture that was inherited after an earlier merger, which is not always kind to innovation, change or inclusive employment. She has already started trying to change this culture and sees the role the app could play in this process as central. She sees transformative capabilities in the app and agrees with the creators of the app that the app can be used as a catalyst for rebalancing production and coaching in the workplace. The company will do this by using the app in upcoming training and coaching activities and will try to make it an integral part of the change process. The creators and the CEO re-inscript the initial reactions of the employees and the technology then becomes a starting point for transforming the workplace so that it becomes more inclusive.

Re-inscripting the sociocultural environment through SpeakSee: Moving from a hybrid to a transformative environment

We are at a monthly meeting of the quality of information team of the Dutch national police. Attending are team members and their supervisor. One of the members, Aryana, has been hard of hearing since birth, and to help her communicate, a speech-to-text interpreter is present. Aryana is employed directly by the police rather than via an employment agency. She has been relying on lip reading and interpreters to communicate. The meeting consists of part ordinary meeting and part technology introduction. The technology that is being introduced is SpeakSee, a combination of microphones and an app that transcribes speech to text in real time. The aim of SpeakSee is to allow people who are deaf or hard of hearing to effectively participate in all sorts of conversations, from telephone conversations to meetings to casual office conversations. To introduce the technology, the developer of SpeakSee is also present. This session differs from the brainstorming session in relation to the Ebb app because this meeting is more about how people use technology in the workplace and their possible re-inscriptions concerning how they want to use this particular technology and their ideas about the scripting of the technology.

Both parents of the developer of SpeakSee are deaf. He designed SpeakSee with the wishes of his father in mind, which are that the technology should be as inconspicuous as possible. SpeakSee has this non-invasiveness inscripted into it: the less attention it attracts, the better, and in its wake the less attention the disability attracts, the better. The second important element for the designer was the look and feel of it: it should have a plug-and-play design and be user-friendly. These values are also inscripted into the technology, in the slick look and manageable size of the microphones, in the easy-to-understand docking station and power options, and in the bright colours of the speech bubbles used in the app. The third important element to note is the prosthetic logic. Similar to the exoskeleton, SpeakSee functions as a prosthetic technology: it is an extension of its user. SpeakSee was developed and designed in close consultation with people with disabilities in the form of the developer’s parents. Because of this, SpeakSee already has transformative sensibilities inscribed into it. This hybrid of the prosthetic and the transformative produced interesting dynamics in the first experiment with SpeakSee.

Implementing the technology uncovered different intentions for its use. When asked, Aryana explains that her goals for the technology are to enable her to be included in social conversations, to be able to understand jokes, to hear what people say they did on their holidays and to hear and join in general conversations around the coffee machine. She explains that she often feels excluded in the workplace. When asked what would help her to feel more included, she stresses the importance of people talking at a steady pace, ensuring that their facial expressions are clearly visible and having a clear pause between sentences. Her colleagues sometimes take the time to consider her needs but sometimes forget or fail to include her in conversations. Therefore, she sees a role for the technology in diminishing the instances when she feels excluded. In contrast, her hearing colleagues have completely different ideas about what the technology should do. The interpreter and the employee who is hard of hearing at the meeting both agree that even during this session, immediately after SpeakSee was introduced, hearing colleagues spoke at an increased pace, with fewer pauses and therefore less room for double-checking meaning when compared to other, earlier meetings they have attended. When Aryana talks about this change in behaviour in an interview, she says that she sees their attitude as indicating that they will ‘just let the technology take care of it’. In this example, the fact that the script of SpeakSee was to be as invisible as possible caused a reaction among Aryana’s colleagues, who had less attention for her specific needs. Ironically, this resulted in the technology leading to more exclusion instead of more inclusion.

For SpeakSee to be fully effective for the person who is hard of hearing, speakers must pick up, wear and turn on the microphone. This means that colleagues have the last say on when they will use the microphone and therefore when they will be heard. Being able to decide what is heard and what is not increases the possibility of exclusion for the person who is hard of hearing. The supervisor at the meeting played an important role in countering this exclusion by actively re-inscripting what the technology should do. Having hired Aryana himself, he was enthusiastic about trying to meet her needs. He had learned a bit of sign language and integrated this into standard discussions during meetings, taking time for one-on-one conversations to reflect on communication challenges and reminding colleagues of the importance of taking a disability into account. In the meeting, the supervisor was vitally important to re-inscripting the original script to form a new one where disability remains clearly visible to everyone. He did this by encouraging employees to speak slowly and clearly and to pause and check that listeners had understood them.

After this first test, the technology was used for two months in the workplace. Some of the queries the colleagues anticipated, such as how long the transcript would be stored for and whether the person who used the app would see everything that was spoken, proved to be easily resolved through agreements. The supervisor again proved key during these two months of use. He actively pursued the necessary adjustments to the work culture and made agreements about when SpeakSee was to be used (all the time), how to communicate (the same as without SpeakSee, by taking your time and double-checking) and to leave enough breaks in conversation (allowing for the employee who is hard of hearing to take notes and ask for clarification). Also, side discussions were kept to a minimum, when possible a short debrief was planned for after each meeting and facial expressions were visible, thus allowing for lip reading to be used in tandem with the technology. These agreements formed part of the active re-inscription of the technology. Through this re-inscription, the chances of a more inclusive workplace through technology were increased. By playing an active role in the emergence of these new rules, the supervisor served as a guide for re-scripting what the technology should be. If others do this, SpeakSee will become much more than a prosthetic technology fix; it will become a rallying point for transforming workplace interactions.

Moving beyond the prosthetic–transformative axis

The aim of this study was to explore the possibilities that technologies can offer for inclusive employment of people with disabilities. In the three cases, we can see three different ways in which the introduction of technology provided an interpretation of what disability means in a specific setting. In the case of the exoskeleton, the initial prosthetic scripts of a visible technology fix for people with disabilities were re-inscripted and took on a more transformative function, opening up a discussion on stigmatization, normalization and inclusion. Then, through multiple experiments, these re-inscriptions were used as a rallying point for shaping inclusion in different workplaces, increasing the transformative capacities of the technology. In the case of the Ebb app, the technology was scripted to be transformative but the clear scripting of these transformative values led to initial resistance in the workplace. Some of the stakeholders seemed more interested in boosting production and increasing oversight. In response to this reaction, the developers re-inscripted the technology to stay close to the original script, which improved the prospects of the app improving inclusion and changing local mindsets. In the case of SpeakSee, the technology was also somewhat prosthetic but it already had some transformative sensibilities inscripted into it through the experiential knowledge of the parents of the developer. However, the inconspicuous and plug-and-play design choices initially led to more exclusion. To counter this, the technology was re-inscribed and new rules and conventions where established. Through these re-inscriptions, SpeakSee moved towards becoming more transformative.

These empirical examples show that, regardless of their initial approach to inclusive technology, the technologies move beyond their prosthetic- and transformative elements. This could potentially be read as classifying all pilots as a ‘hybrid’, following the dichotomous definition of hybrid as a mixture of two opposed elements. However, the risk of stigma in the exoskeleton pilot, the Ebb app being seen as an oversight device by some and Speaksee initially leading to exclusion, indicate that this hybridity involves more than a basic mixture of elements. By navigating the boundaries between positions, a hybrid can rather be seen to act as a signifier of sorts (Haraway 1991, 2). As Prins (1995, 360) puts it; ‘a hybrid creature shows the arbitrariness and constructed nature of what is considered the norm(al)’. Wilkie (2010, 14) suggests that the main value of extending this notion of a hybrid to the design of technologies, is that this helps in highlighting that in designing; ‘people and technology are mutually reconfigured with new identities and new capacities’.

Even though these examples show how initial approaches evolve into hybrids which can then signify a supposed normal, they also demonstrate the risks involved in this endeavour. In our case stigma, the risk of increased surveillance and exclusion reveal the treacherous nature of developing technologies for inclusive employment. When introducing technology to a situation, results are often surprising; ‘technology exceeds and surprises those who were involved in its production; each technology transforms those who draw upon it in ways which are unanticipated by both designers and users’ (Berg 1998). Haraway (1991, 197–201) uses the figure of a trickster to describe this nature, one where technologies react in unexpected ways to circumstances and where we can only ‘strike up non-innocent conversations’ with the situation at hand. We argue that the experimental approach presented here can be seen as an example of how such conversations can be had. The non-innocence resonates with the politics of technology, where technology is emergent and often results in unforeseen new configurations of humans and technology. Exactly in these configurations, the possibility lies to make a change to certain practices, to reconfigure them through ‘doing politics’ (Berg 1998).

In the pilots presented, possible risks were used as a starting point for discussion. In a joint effort the different actors assembled around the shared goal of inclusion. Various actors aimed at re-inscripting the technology to fit with their idea of inclusivity in the workplace; in SpeakSee, new rules and a new social etiquette were established, the exoskeleton-related talks about inclusivity gave way to more openness towards people with disabilities, and in the case study on the Ebb app, the app became an integral part of the company’s vision for social change. This process took time, and the actors and their beliefs and ideas about technology and disability and their values connected to them needed to be ordered to accommodate the possibility of transformation (Galis 2011). The importance of shaping the sociocultural environment echoes the thoughts of Foley and Ferri (2012, 199), who call for an understanding of human–technology relations that has the social, historical and cultural context in mind instead of designing technology around impairment. De-scripting technology can be a useful way of making this shaping, and the transformative capacities that arise from it, explicit. It also can be used as a starting point for action if it is combined with a reflexive monitoring-based research approach. This combination adds reflexivity, which can help highlight the shared commitment to inclusion in the pilots and help foster an experimental approach. The literature noted in this article points out that people, things, places and feelings can all produce ability or disability (Gauci 2021). Our research does not contradict this but does find that the role of human re-inscriptions is essential for contributing to inclusive employment.

The positioning of the project and the role the researchers played in de-scripting the technologies were also key. Because the research was commissioned by a policy actor (Employee Insurance Agency of the Netherlands) and it consisted of having room to experiment, the researchers themselves could act as boundary partners. Furthermore, the participatory set-up of the research and the emphasis on learning through reflexive monitoring in action gave us the tools to not only observe but also intervene, change and re-inscript. The focus on reflecting together with participants also helps mitigate the risk of putting too much focus on our own perspective (Jensen and Lauritsen 2005). and ensure that a truly mutual learning, although currently understudied, becomes a central element of transitions (Beers et al. 2019). By conceptualizing technology as technology in practice and disability as something that is made and by having the support of scripts when looking at what is repeatedly being made, we were thus able to open up learning possibilities.

As we looked at how the approach to inclusive employment and technology changes over the course of the pilot, we bypassed the risk of posing technology as a determinism/essentialism binary and disability as a medical/social binary (Gad and Ribes 2014; Hadders 2009). It is important to note here that these conceptualizations should not be seen as a magical third way that solves the binary problem. Instead, we follow Wyatt (2008, 176) and take seriously ‘efforts to stabilize and extend the messy and heterogeneous collections of individuals, groups, artefacts, rules, and knowledges that make up our sociotechnical world’. She points out that only by continuing to take these efforts seriously will we understand why they succeed in making a change. The combination of being able to conceptualize the technology–disability relation with a keen eye for science and technology insights and at the same time attach this knowledge to practices of changing or ‘doing inclusion’ proved fruitful.

Even though our research offers some valuable insights, it does have its limitations. The most important two limitations pertained the participation of people with disabilities; we had to find a balance between burdening daily work practice and studying the workplace and work in detail. The study could possibly have benefitted from more visits to the workplace and observations of the work done. Because we did not want to burden people in the workplace too much. We also considered the fact that our research does not have a direct tangible effect on the workplace, instead the change is more subtle and in some cases long term. A second important limitation is an extension of this balancing act; it was especially difficult to include people with cognitive disabilities in the study. We think it essential that this last limitation gets the attention it deserves and is handled with care, hence we decided to describe this limitation more in-depth elsewhere (Grijseels, Zuiderent-Jerak, and Regeer, forthcoming).

The aim of this study was to explore the possibilities that technologies can offer for transformation that leads to more inclusive employment of people with disabilities. We hope that we have provided pointers on how technologies can contribute to employment while redefining in the process what an inclusive workplace looks like. We found that technology can become a rallying point for creating situated solutions as well as the transformation of the sociocultural environment. Our findings suggest that de-scripting and looking at re-inscriptions can be a useful way to bypass dichotomous understandings of the technology–disability relation. A thorough conceptualization of this relation that is geared towards action and change contributes further to making this process useful. This results in moving beyond the prosthetic/transformative and social essentialism/technological determinism axes without completely disregarding them. Such intervention-oriented research practices should by no means be positioned in opposition to, nor as an appreciation of, theoretical studies of the relation between technology and inclusion; they can form an experimental extension in the search for inclusive technologies.

Disclosure statement

No potential conflict of interest was reported by the authors.

Box 1.

Central terms for the use of scripts:

• script: what is written into an artefact, what the actors do to one another and how they interact. The act of inscribing the scripts is called inscription.

• de-scription: laying bare the inherent scripts in an object. The person who analyses undertakes the opposite movement to that which is undertaken in inscription

• re-inscription: inscription but as a feedback mechanism, that is, a wilful inscription

Adapted from Fallan (2008, 64).

Box 2.

Planning observations, interviews and participants.

Table

Planning
Exoskeleton	Ebb app	Speaksee
Day visit where we observed the technology in the workplace, organized outcome mapping sessions, collected initial learning questions and conducted interviews	Day visit where we observed a brainstorm session where multiple stakeholders gave feedback on an early version of the app, organized outcome mapping sessions, collected initial learning questions and conducted interviews	Day visit where we observed the technology during a work meeting and conducted interviews
Visit to the workplace together with members of the coalition for inclusion and technology	User testing day where the technology was tested by users together with their coaches, conducted interviews	Session with supervisor and technology developer, conducted interviews, organized outcome mapping sessions, collected initial learning questions
Additional interviews via video conferencing	Additional interviews via telephone	Additional interviews via telephone and video conferencing

Table

Participants
Pilot	Role participant	Number
Exoskeleton	End-user	1
	Direct colleague	1
	Account manager	2
	CEO	1
Ebb app	End-user	8
	Manager	1
	Technology developer	1
	Researcher/founder	1
	Project team member	2
	CEO	1
Speaksee	End-user	1
	Direct colleague	1
	Supervisor	1
	Technology developer	1

Box 3.

Summary of the basic characteristics of the three pilots.

Laevo exoskeleton

The Laevo Exoskeleton is a wearable piece of assistive technology which mechanically supports the hips and trunk of its user. It is aimed at people who do physically demanding work and who already have low back pain or who will use the technology as a preventative measure. The idea is that the support greatly reduces strain on its users’ back muscles and spine. This exoskeleton is specifically designed for people who lift and who work in a forward-bended posture.

The exoskeleton was introduced at an assembly plant producing various domestic climate-related systems such as ventilation systems, boilers and solar panels. People with regular jobs work on the factory’s production lines but there is also a production line which serves as a sheltered employment unit. People who work here are seconded via a sheltered employment company which also serves as an employment agency for people with a disability.

Ebb app

The Ebb app is an image database with different, adjustable, categories that can be used to save images, photos and stories. It is a digital technology aimed at people who have difficulties communicating or whose verbal skills are not strong. The idea is that the user builds their own archive of images and photos that reflect who they are. The archive can then be used as a conversation starter and a way of communicating more effectively through visuals. By using the app, users can have autonomy and discuss what has previously been left unsaid. The stock categories include topics such as ideas, important people, what helps at times of stress, talents and dreams.

The Ebb app was introduced by a sheltered employment company. The company offers a range of jobs to people with mental and/or cognitive disabilities, such as working with packaging or food, working in a warehouse, in postal services and in sewing jobs. The app will be used by the employees of a company working in these types of departments.

SpeakSee

SpeakSee is an advanced technology using combination of microphones and an app that transcribes speech to text in real time. Individual speakers can be distinguished via the colour coding of their speech. The aim of SpeakSee is to allow people who are deaf or hard of hearing to effectively participate in all sorts of conversations, from telephone conversations to meetings to casual office conversations.

SpeakSee has been introduced for the quality of information team of the Dutch national police. The team consists of four members, who share an office, and their supervisor. One team member has been hard of hearing since birth and has been using a combination of lip reading and an interpreter to communicate effectively. she is employed directly by the police rather than via an employment agency.

Additional information

Funding

This work was supported by the Employee Insurance Agency (Netherlands) and the Ministry of Social Affairs and Employment (Netherlands) under Grant (number K1806).