20 years of the Loughborough user centered assistive technology design process: has it made a difference?

ABSTRACT An estimated 518 students were taught the Loughborough User Centered Assistive Technology design process, LUCAT, since 2000. Graduates were contacted via a professional networking website to take part in a survey with four being interviewed. The purpose of the survey was to find out if: 1) Did they still use any parts of the process; and 2) Where they had applied them. The respondents ranged from returning placement undergraduates to senior managers in research and development within major companies. From the 105 respondents 23% stated they used parts of the LUCAT process every working day, a further 25% once a week and 27% once a month. The elements of the process used were predominantly semi-structured interviews, concept generation, codesign, design presentation and feedback. Respondents highlighted the benefits of using this process including gaining insights from users, being time efficient, saving money, developing a relationship with end users and making a difference to the lives of people with disability. It was suggested some industries had still not incorporated a User Centered Design approach within New Product Development. The use of the process was shown to be useful beyond AT product design into most areas of design activity.


Introduction
In 2000, a User-Centered Design process was reported that had been used to demonstrate a cost-effective, bottom-up approach to the research, design development and validation of Assistive Technology (AT) products .The design process, later to be named the Loughborough User Centered Assistive Technology (LUCAT) design process was applied and refined over a twenty-year period and used to train Industrial Designers and Design Ergonomists, Ergonomists and Design Engineers.Over 500 UK and International undergraduate and postgraduate students were taught and applied the process during this period.

Objective
The objective of this communication is to reflect on the impact of the LUCAT process taught over the last 20 years on professional practice.A number of questions relating to the application and efficacy of the LUCAT process were defined: (1) Is it still used by graduates in Industry and wider professional practice?(2) What is the frequency of use? (3) Which elements were considered most useful?(4) What benefits have graduates found in applying the LUCAT process?(5) How could the LUCAT process be improved?
The LUCAT process was originally developed by one of the authors in 1998 based on their, at that time, twelve years' experience of designing Assistive Technology (AT) products for Charities in the United Kingdom (UK) and knowledge of existing Ergonomics and Human Factors based User-Centered research and design methods.
Assistive (technology) products and services were and still are a large market.The World Health Organization state that one billion people need assistive products and two billion are expected to need at least one assistive product by 2030 (UNITAID, 2013).They go on to highlight that availability of assistive products are still an unmet need (World Health Organization, 2016).The challenge of this market is the level of specialist need and customization required to fully address a given product within a sector.Based on the thirty-plus years of experience of the author as a designer and researcher, this level of fragmentation of sectors is no different to that found in any other targeted market.This suggests the LUCAT process, although developed to support new product development (NPD) in a specific market, would be useful to designers in any market sector.
The market challenges were originally aligned with sections of the LUCAT process (see Table 1).
The LUCAT process provided an ethically appropriate time-compressed series of information gathering and decisionmaking activities to get from no knowledge about a target user and market sector to a design solution that may be tested more comprehensively.This matched the need to minimize investment risk and cost-effectively accelerate elicitation of requirements, need, and aspirations from target market users.
Recent review articles by one of the authors highlighted that choice of research and design methods used within AT product development was still limited to a fraction of the available methods to apply, around 10 from the 200 plus available.(Torrens, 2018) Similarly, a review of the communication formats used by AT product design developers showed only a quarter of the 41 available were used (Torrens, 2017, pp. -262-276).This further supports the suggestion that the LUCAT process is still relevant.
An intentional byproduct of the user-centered approach involving participatory design was to give the end users of these products "a voice" and direct influence over the specification and design realization of an assistive product.
In later studies where the LUCAT process was applied, undergraduate students worked with pupils in special education schools to define need and realize concept products.Teachers and assistants highlighted the confidence given to the pupils to openly discuss their needs and aspirations; and, how to best articulate what they needed and wanted from their assistive products (Torrens & Fray, 2020, pp. 56-63;Torrens & Newton, 2013, pp. 58-71;Torrens, 2012, pp. 182-205;Torrens, 2011).
A further biproduct of this approach was the ability of young undergraduate students to gain empathy and affinity with individuals "who were not them."There has been criticism of designers designing for specific socio-economic profiles (Newell et al., 2011, pp. 235-243).In more recent years the use of empathic modeling has been seen a negative light by some disability rights campaigners and commentators.(Bennett & Rosner, 2019;Hamraie, 2016) Used in isolation to predict someone's ability to do a task or preferences, it is a poor reflection of reality.This method can be a useful tool when used to dispel assumptions about the ease with which a person with disability can complete daily living activities as well as generate debate about the emotions, challenges, and values of a person with disability before designing a survey, interview, or observation.When used alongside the involvement of a champion user (a representative of a target market) and other stakeholders it can accelerate a common understanding between designer/researcher and user of terminology, key performance indicators, values, and cultural context.
Methods were added during the 20-year period of the LUCAT development, including social camouflage (Torrens et al., 2018) and cultural blindness (Asghar et al., 2019).All methods have been collated into an open access resource Usability-NET (Usability-NET 2022).
At the time of inception of the LUCAT process and training module a participatory approach to obtaining user requirements and the term codesign (collaborative design with participants and stakeholders) was a relatively new concept, for example, the journal Codesign was not published until 2005.HCI/ICT programmes at the time led the way in the evolution of Assistive Technology training (Mitchell et al., 2020;WC3, 2020).Whiteney et al. provide a concise overview of the progression of "Design for All." Understanding the physical and emotional challenges to mobility, communication, appearance, and confidence of an AT product user.3 Ice-breaker with participants and stakeholder (physical and social context) Gaining a common language/terminology and context of environment as well as building trust between user and designer before participatory design begins.4 Semi-structured Interview design (with prompts) Practicing the development of research questions (based on evidence from literature review), based on Human Factors conventions for elicitation of user requirements.5 Interview (participants and stakeholders) Practicing conventional Human Factors and marketing approach, but with additional understanding of communication format and language requirements/flexibility in application.
Practicing elicitation of user requirements.Importantly, inter-personal skills and 'learning to listen.' 6 Concept generation (sketching, modelling) Practicing the interpretation and expansion of options from user requirements obtained, with an emphasis on choice of communication formats and language.7 Co-design (sketching, role play with participants and stakeholders) Practicing inter-personal skills and using a range of communication formats appropriate for participants to enable them to apply a rapid iterative cycle of ideation, making choices and reflecting on why they were made to generate further refinements to user requirements and design solutions in a short time duration.8 Design development AT one-off and batch production approach (REMAP GB) Practicing the application of value analysis, standardisation, and modularity as well as use of original equipment manufactured components/off-the-shelf-parts to reduce cost and increase choice for customisation.9 Design presentation and feedback (Presentation techniques, Competition judging) Practice interpersonal skills and using a range of communication formats suitable for the viewing audience.(Whitney et al., 2011, pp. 163-170) There are now many high-quality training programmes across the world that offer similar insights and understanding of the Assistive product innovation eco-system and associated principles and processes.For example, Inclusive Design, OCAD, Canada, Disability, Design and Innovation, UCL, UK, and Assistive product-related programmes listed on the RENSA resources website.(RESNA, 2022) It is important to understand the contextual difference between the terms Assistive Technology and Inclusive or Universal design when considering the LUCAT process.The principles of Inclusive/Universal design ideals are to deliver a design that enables the maximum number of people to be able to use it, to which designers and engineers strive when developing a new product or service.This may be considered a top-down approach.Assistive Technology being focused on a bottom-up approach to delivering functional need for an individual to maintain a mainstream level of daily living activity.The reality is that commercial products and services are targeted to a section of a population (mainstream or otherwise) and rarely cater for everyone.The LUCAT process was developed to enable practitioners to work within the two approaches.
The aim of this study was to find out if any of the LUCAT process elements were still in use within commercial practice; and gain insights into why those trained in the process still used them.

Method
The survey and interviews followed generic ethics protocols for this format of inquiry and guidelines for compliance with the General Data Protection Regulation (GDPR).Ethical approval was obtained according to the protocols followed for research by Loughborough University staff (Loughborough University, 2022).
To answer the five research questions defined earlier in the text, a questionnaire was used to gain both qualitative and quantitative feedback on the application of the LUCAT process in Industry.A sample of four respondents also gave a thirtyminute semi-structured interview.The protocol for the questionnaire and interview were developed for the earlier surveys of the LUCAT process.(Torrens & Newton, 2013, pp. 58-71;Torrens, 2000, pp. 15-30) The online survey and subsequent interviews were conducted over a six-month period.
The sample population was drawn from those students who had been directly trained in the LUCAT process.Based on academic record archives an estimated 518 students had been trained in the LUCAT process in the UK and through international summer schools.There was no way to contact summer school students, which reduced the available sample population to approximately 467 graduates.From this cohort, the most costeffective way to contact alumni was considered to be the professional network LinkedIn (2022).A sample of eight graduates were also asked to take part in a short interview.A purposive sampling method was used to identify a sample of four male and four female graduates at different stages of their professional practice: 1) an undergraduate returning from placement, 2) a recent graduate with less than 2 years' experience, 3) graduate with over six years' experience, and 4) graduate with over ten years' experience.
Through existing contacts and name search on the LinkedIn website 342 graduates were contacted and asked to complete an online survey hosted by Online Surveys (Online surveys, 2022).As their former tutor, one of the authors introduced themselves and the purpose of the contact.A participant information summary was given in the e-mail, including purpose, anonymity, estimated time to do the survey and what would be done with the completed information.The survey was kept to nine questions (five quantitative and four qualitative) to minimize the time required to complete the survey to around 10 min.This had been tested as a pilot study with a small sample of three participants to check timings.The interview timing was piloted with two participants prior to the interview.
The online survey had a full explanation of the aim and objectives of the study and associated implications for the participants.The survey did not ask for any identification or contact details, but did ask for age range, gender, and current workrelated activities.This was to provide context for the answers given, as a recent graduate may have a different viewpoint to an experienced practicing designer.The questions asked in the survey were aligned with the research questions already stated.There were seven questions in total, but question 3 had two subsections to capture more detail about the respondent's current role and job title.The question of gender only had two options as each participant had indicated their gender through their LinkedIn profile and so "other" was not required.In question 3, a selection of generic socio-economic titles were chosen, again within the context of some prior knowledge of the possible answers due to first contact via LinkedIn.If a respondent selected "other" they had an opportunity to state their current role.To gain further detail, of type of work, Question 3b asked for their job title.This provided a further insight into the areas of work into which graduates had developed and give further context to later responses about the LUCAT process.Question 4 was to provide the frequency of application of the LUCAT design process, with Question 5 providing insights into which elements of the process were used.
Questions 6 and 7 provided qualitative feedback about the benefits of the LUCAT process and how it may be improved.Table 2 has a full list of the questions.
The survey was post-processed through a simple tally of quantitative results (Questions 1, 2, 3, 4 and 5) and thematic analysis of Questions 3a, 3b, 6 and 7. Thematic analysis followed a conventional protocol of initial review to gain themes and grouping of text within themes (Braun & Clarke 2006, p. 77;Hsieh & Shannon 2005, p. 1277).To avoid bias within the qualitative analysis process, a second operator reviewed the questions independently of the first.The two outcomes were compared and discrepancies in allocation discussed, and allocation agreed.Data sheets for the survey, subsequent sample interviews and post-processing were made available via an institutional repository (Torrens, 2022).
To gain further insights into the efficacy (effectiveness and cost-effectiveness), of the LUCAT process four interviews were completed with a sample of the respondents.A semi-structured interview protocol was followed, as defined by Allison et al.
(2016) Creswell (Creswell, 2009), Bryman (2016, pp. 399-503), and Torrens and Newton (2013, p. 60).Sentence removed The interview structure and questions were limited four topics to fit to an estimated 30 minutes, to avoid participant fatigue when answering questions.Question sequence was: 1) Participants were asked to review the LUCAT process and how they used it within their current work.2) They were then asked about how valuable they thought the elements were to them and their work.3) They were also asked if the application of the LUCAT process had had an impact on their career.4) They were also asked about any improvements they could suggest to the process.Additional discussion and ad hoc questions were asked within each question if the participant wished to expand on their explanation or an associated topic.
Microsoft Teams was used for two of the interviews, with the transcript downloaded for post-processing.Two videos were recorded on a Smart phone, with the videos downloaded and the "transcribe" function within Microsoft Word was used to generate a transcript.A content and thematic analysis of the four transcripts was completed to highlight similarities and differences in comments.

Results
From the 342 contacted via LinkedIn, 105 graduates replied.The respondents ranged from recent graduates to senior managers in research and development within major companies.Although not directly recorded through the survey, contacting the graduates via the professional network website LinkedIn highlighted the diversity of work in different parts of the world that the graduates were now involved.Around 20% of the respondents were working overseas, for example, the United States of America, Norway, the Netherlands, and Malaysia.The background datasets for this survey are available (Torrens, 2022).
There was a bias toward male designers in the 25-35 and 36-45 age groups of respondents.A more equal number of female and male respondents can be seen in the 2-24 year old group.
Not all respondents provided a job title, which is why there are less respondents shown in Figure 1.The job titles/roles were collated through an iterative cycle of content then thematic analysis.The themes were focused on professional practice titles, such as Industrial designer (ID) or Human Factors Based on your experience, are there any improvements that could be made to the LUCAT design process or its elements?
Figure 1.Content analysis of job title by age group from responses given by 89 graduate designers and ergonomists.
specialist.ID practitioners included other specialists, such as inclusive designer or kitchen designer.The majority of the older two groups, 25-35 and 36-45 year old, had indicated their position as senior managers, with conventional industrial design-related roles.The 20-24-year-old group were more evenly distributed across other sectors including service and User Experience/User Interaction (UX/UI) design.
The frequency of use of LUCAT process elements by the respondents, shown in Figure 2, highlights the frequent use of a user-centered approach.Seventy-five respondents using the process elements more than once a month and 23 using them daily.
Figure 3 indicates the most popular elements of the process were concept generation, design presentation and feedback, interview, semi-structured interview, and codesign.The thematic analysis of benefits of the LUCAT process were taken through the same iterative cycle of collation as that for the job titles.Figure 4 shows the two most prioritized benefits were defining user requirements and effective decision-making.Raising awareness with other professionals in new product development teams, including legal requirements, making a difference to people's lives, being easy to understand as a process, giving users a voice, end user ownership, as well as helping get a job were all featured.
Figure 5 shows the main improvement suggested was additional techniques to the process, such as online interview and questionnaire, observational ethnography, more awareness and discussion of stakeholders, impact of social media on perception of disability and people with disability, implications for digital design, UX and UI, rapid prototyping.
Four male designers and ergonomists were interviewed.Whilst female graduate designers and ergonomists were approached, they were not available during the period available to complete the interviews.Additional female graduates were approached to take part in the study, but none were available or responded during the six-month period of data collection.
Participant 1 was the Associate Design Director in a bluechip electronics company with thirteen years' experience of industrial design and human factors with the same company and associated consultancy.From their interview key comments were: A user-centered approach to design is a core aspect of any project I lead.Elicitation of user requirements and codesign are critical to new product development.Teams within other parts of the business don't use this approach and hardly ever contact users.Much of the LUCAT process as described is used within our new product development process.
Participant 2 was a Senior Design Engineer with a major manufacturer and supplier of assistive technology products.He had eight years' experience in a range of companies as an industrial designer and design engineer.Key comments included: The training I had enabled me to get my current and previous job (assistive technology related).I still use the LUCAT process with other healthcare professionals in the team to deliver commercially viable products.
Participant 3 was a graduate of just over a year, but who had already won six student design and young innovator awards.Key comments were: The LUCAT process was very influential in a second-year project of my programme through which I've won two awards to-date, which is fantastic.The project and product (outcome) had the LUCAT process at the core, talking with the users, arranging to do codesign with the users and actually understanding the users (needs) throughout the process.
Participant 4 was (at the time of the interview) returning to their final year of study following a placement as a human factor's assistant consultant with a major civil engineering company.Key comments included: I was part of the Company's consultancy element which dealt with people management.I had the opportunity to work on five major and eleven projects in total.They were client focused projects.One of the projects was a building optimization for the future.I knew within the first week of the brief that the elements of the LUCAT process were applicable to the project.Going forward some of the elements were adapted for use within the project.The research element (literature review), personas (champion users) and an understanding of each one of the capabilities associated with those disabilities.Going forward, I applied that to a large civil engineering transport infrastructure project, the same principles were applied.For example, the journey of passengers.I pushed for central organization funding to apply a research aspect for checking the personas I had generated from my understanding of people's disability, which was to talk with individual stakeholders and representatives of the personas to prove that they were accurate.I also organized who would attend stakeholder engagement sessions, where a codesign activity would take place.The range of applications were drawn from the training provided (LUCAT process).In the training we were given how we would approach talking with people who had a range of disabilities.Just prior to the first presentation of the stakeholders for the Company project I flagged up the range of people and their capability to take in the presentation and we ended up quickly changing it.People greatly appreciated being involved at such an early stage of the project.Often in industry the design is agreed, (before checking with stakeholders), which costs a fortune to redesign.Not having an early codesign intervention, especially for an infrastructure project, would be detrimental.Some of the things I stated as important, (stakeholder engagement, checking personas with champion users), were being considered even though I'd only been with the company a short time.

Discussion
The implications for assistive product development are reviewed in more detail in the following section.This includes: a discussion of the profiles of the sample population, highlighting how it has changed in terms of equality, diversity, and inclusion; the frequency of methods used; priority order of methods beneficial to professional practice; potential improvements to the LUCAT process; and, awareness within industry of an inclusive approach to new product development.
The range of working locations of the graduates who responded indicated the international nature of all forms of design.Working within different societies and cultures require the application of methods to quickly gain an understanding of a market sector in order to provide and communicate a new product or service.
From a professional progression viewpoint, the descriptive statistics of graduates and employment show a more equal balance of male and female designers are now being generated through a university system.The bias in the two older groups reflected the perception of Industrial design and Engineering design being a "male" profession in the early part of this Century.The authors were also aware of students who had registered disabilities on the programmes during this period but did not take the module.Whilst these students already have had experience of living with disability, they were unlikely to have access to all the useful knowledge within this field to design for others living with a different disability.Tacit knowledge from the authors suggests many graduates who were trained in the LUCAT process did go on into the third sector (charity) to work, with a number working for manufacturers of assistive products.When discussing frequency of use and benefits of the LUCAT process later in this section, a large proportion of the graduates from the sample indicated their general practice was more inclusive due to the training in the process.Ethnicity was not highlighted in the results, as it was not considered a useful metric for the focus of this topic.However, future studies may wish to explore equal opportunities, equality, diversity, and inclusion shown through a survey of design student populations.Following graduate pathways into professional practice may also be informative for educators to better understand future needs for assistive product and service design in the future.The next section reflects on the frequency and importance of LUCAT process applications.
From the 105 respondents 23% stated they used parts of the AUTHOR process every working day, a further 25% once a week and 27% once a month.The elements of the process used were predominantly semi-structured interviews, concept generation, codesign, design presentation, and feedback.These two figures emphasize the application of conventional Industrial Design (ID) methods, but with a focus on obtaining information and validation of design interventions (user requirements and design concepts).Based on the collective experience of the authors, the quality of insights gained through these methods is directly related to the quality of design outcomes produced.Understanding of individual needs, aspirations, the physical, and cultural environment within which assistive products are used are critical to providing an optimum and novel design solution.
Learning the skill to listen without immediate response is a challenging one for design practitioners whose training is focused on the generation/ideation of solutions quickly from limited information.This becomes even more critical when channels of communication are reduced and dialogue is protracted and difficult to interpret due to disability, as highlighted in the introduction.
Elements of the LUCAT process provided a vehicle for an evidence-based model of ID and the methods for eliciting needs (requirements) and aspirations as well as a method for rapidly checking and modifying options to match those requirements.Separately, these methods are well-documented in academic references and applied in practice.However, the benefit of the given time sequence and combination of methods presented in the LUCAT template, as a way of timecompressing design decision-making, are not defined elsewhere in the literature reviewed.The frequency of application leads on to the discussion of benefits of the LUCAT process as highlighted by respondents.
The respondents highlighted in Figure 3. the benefits of using the process to effectively gain insights from users, and that it was time efficient, saved money, and helped in developing relationships with end users and clients as well as making a difference to the lives of people with disability.
The interviews with a sample of the respondents supported the survey findings.Participant 3 highlighted that the AUTHOR "bottom-up research" approach was effective in producing award-winning designs for students with little time or funding to undertake large-scale market reviews.This view was also supported by the senior manager in a large company, Participant 1.The use of a champion user, expanding to a small group, before investing in a larger survey has been documented as a cost-effective way to minimize risk within a new product development, through designing out what people do not want at an early stage.Individuals are good at expressing opinions about what they do not like.A bottom-up approach uses these opinions to quickly focus on the areas that are important to end users and stakeholders.This leads to the suggested improvements for the LUCAT process.
The suggested improvements to the AUTHOR process were focused on additional methods, which were predominantly an expansion of the core methods that acknowledged the wider implications of stakeholders, and the advent of a digital age of the internet and internet of things.Additive manufacturing was also highlighted, which may enhance the flexibility for, and viability of, customized interface design built on to standardized modular parts.Other suggestions were additional time spent on the core methods to enable them to be used more effectively.It has been highlighted in the introduction that using top-down market research evidence from larger surveys combined with semiotic analysis of the culture and society within which an assistive product is used can provide a more complete and holistic understanding of user and stakeholder requirements to avoid product abandonment.The links between methods and benefits for the assistive product manufacturers and service providers has been highlighted, but a lack of awareness within industry of the benefits of an inclusive participatory approach has also been defined.
Participant 4 and Participant 1 highlighted the need to raise awareness in industry and with other professions of not just the benefit of a user-centered approach, but of available design methods in general.The lack of awareness of what is design and associated methods, such as user-centered design, within Industry has been highlighted by Johnson et al. (2019).Although a different industry sector, similar issues of lack of understanding or appreciation of the benefits a user-centered design approach could bring appear to be highlighted.
The study has highlighted important points to consider as an educator, researcher, or practitioner in the field of assistive product design.However, there were limitations to the study.The purposive sampling approach was necessary but did increase the likelihood of positive bias toward the questions being answered.It is unclear if the lack of female graduates being interviewed about the application of the LUCAT process affected the outcomes of the study.Other than timing, there did not appear to be an issue with female graduates responding.A number of female graduates had agreed to be interviewed but could not then make the appointments.The constraints of time and resource on the researchers resulted in a limited number of set days being available to set up and record the interviews.

Conclusion
The LUCAT process was taught as part of the Universal Design module between October 1997 and June 2019.In that time design research had progress significantly to bring theory to underpin practice.The survey and interviews provide evidence of the usefulness and impact the LUCAT process has had on graduates; their employability, recognition of the quality of design outcome through winning awards; the costeffectiveness of a "bottom-up research" approach and that the sequence of methods in the template are still effective now in this very different time.Effective "time compression" for this form of market research and concept development has also been highlighted.This is supported with previous articles, including the original article in 2000.
The outcomes of the survey suggest the new profession of UX/UI design has embraced many of the user centered methods of conventional ID and Human Factors and is now developing new inclusive approaches that are appropriate for a digitally driven market, not just within Assistive products.This matches with the origins of both "Design for All" and Inclusive/Universal design principles originating from within HCI and ICT; digital environments.
The LUCAT process has been demonstrated to provide Assistive product business, and the designers they employ, with a cost-effective least risk investment approach to giving users, consumers, and stakeholders a chance to say what they want and aspire to have, whilst ensuring an effective first phase outcome that is commercially viable and successful.The previous two articles reflecting on the efficacy (effectiveness and cost-effectiveness), of the LUCAT process from 2000 and 2013 appear to support the comments from graduates in this study relating to providing users and stakeholders with a 'voice' and a level of empowerment.However, the limitations of this study suggest the outcomes related to acceptance within industry require additional investigation.Using this survey format with graduates of other long-running AT programmes would be a move toward validating some of the inferences from this study.
Further research is required to integrate the available new and emerging UX/UI methods with business process, and more conventional new product design methods, to support inclusive sustainable assistive product enterprises.The authors would welcome collaboration on a cross-institution survey of graduates and debate on how best to bridge the gap between a good concept and a successful product or service in these challenging times.

Figure 2 .
Figure 2. Frequency of use of LUCAT process by 105 graduates and ergonomists in industry.

Figure 3 .
Figure 3. LUCAT design process elements used based on multi choice answers from 105 graduates and ergonomists in industry.

Figure 4 .
Figure 4. Thematic analysis of the benefits of the LUCAT process based on written responses from 105 graduate designers and ergonomists.

Figure 5 .
Figure 5. Thematic analysis of suggested improvements to the LUCAT process based on written responses from 105 graduate designers and ergonomists.

Table 1 .
Outline LUCAT process and challenges addressed using this approach.