Adaptive Design Ass'n: MAKE Magazine meets the AMA

Ed. Note: Boing Boing's current guestblogger Clay Shirky is the author of Here Comes Everybody: The Power of Organizing Without Organizations. He teaches at the Interactive Telecommunications Program at NYU, where he works on the overlap of social and technological networks.

The Adaptive Design Association is an NYC non-profit that "works to ensure that children with disabilities get the customized equipment they need to participate fully in home, school, and community life." Lofty goal, but pricey, no? After all, regular equipment for disabilities is already expensive; how can customized equipment be in the reach of anyone but the rich? By constructing it out of cardboard.

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The beauty of the Adaptive Design folks is that cardboard engineering lets them create work that is custom, playful, and cheap, and improves the quality of social life and autonomy, rather than just defending against medical harm. Pictured above is a before and after picture of a chair made for a child who can't sit on her own; she was in 3rd grade and it was the first time she could join her classmates in the cafeteria and sit properly.

Below is Hannah; Adaptive Design has created over two dozen pieces of equipment for her over a few years, because rapid prototyping with cardboard lets them move from a design regime of one-size-fits-all to one-size-fits-one, even for growing kids. And of course all of this is R&D for patterns that can be further adapted for other children.

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They run training and workshops to help others adopt this kind of form-fit/rapid design/personal need approach to adaptive technology. They're also operating well outside the traditional reimbursement economy of the health care system, so they live on grants and donations--they're listed on, and run the whole thing on just $42K in administrative expenses a year.

Says my ITP colleague Marianne Petit, who first showed me this stuff "I know these items are so intensely low tech that you can't believe they don't exist or no one has created them, but, they don't exist. And in the case of most of the kids they work with, their needs are so completely individual there is no way for something to be pre-made - hence the fantastic-ness of working with cardboard."

Adaptive Design | Adaptive Design catalog | Adaptive Design on JustGive


  1. Funny how in the end artisans superiority is still needed/appreciated. Albeit on “disabled folks”

    Reminds me of Douglas Bader´s story.

  2. This is great, I love it in every way.
    I missed my calling, I loved making things out of cardboard and tape, I still remember the Christmas all I wanted was a stack of cardboard and a roll of tape.

  3. Often, from the disabled child’s perspective, the “special” chair is reviled; it’s another reminder of cripplehood.

    I speak from personal experience.

  4. Dewexdewex @4, that comes with the territory of adaptive design, obviously, but since there’s no way around it — tools always remind us of their uses — ADA’s answer is to make the tools seem special on more than just the ‘Special Ed’ axis.

  5. This is obviously great stuff, but as someone who works in the field of accessible technology, I’m of 2 minds about it. The need is huge, with millions of kids with disabilities forced to do without essential furniture and low-tech accommodations. That’s not tolerable, and anything that alleviates the situation is valuable.

    However, there *is* a small business sector in this field. You can say that their products cost too much, but you can also say that the cost of customizing and marketing in such a niche are enormous. All too often, once the volunteers have gone home there’s no one left to provide the follow-up support, or build the next chair the kid needs to grow into. It’s an unsolvable riddle, really, that’s based as much in the underfunding of all kinds of “special” services as it is in the nature of the tricky interface between for-profit and non-profit.

    What can we do to provide sustainable support for these efforts?

  6. Mimsong @6, you hit the nail right on the head there. Follow up, education/training, ongoing support – that’s all pretty much in the realm of fantasy for way too many people right now.

    I think these ADA folks are really on to something here, in terms of rapid prototyping and extremely low costs. Their example for Hannah – over two dozen solutions – is great, but it’s still not ideal in one respect: their services aren’t free.

    One family’s cheap is another family’s expensive. At (from their catalog) $350 to $700 per solution, this stuff is an order of magnitude cheaper than anything the medical system can offer, but still prohibitively expensive for many people. Which brings up a very serious dilemma.

    Running a non-profit off of donations and grants alone is incredibly difficult, and it’s nigh impossible to expand your services to more than a handful of clients without Serious Cash. Taking money from the government and insurance systems would bring in money, but the bureaucracy, accreditation process, oversight, reporting, billing, etc. would negate the flexibility that the ADA is founded on. As soon as they grow big enough to serve more people…. they can’t serve anyone.

    So crap, I’ve just been a huge downer and I don’t have a solution to offer. My folks founded and ran a similar non-profit for years, and never charged a dime for their services – but they were never giving out stuff, and they spent 99.9% of their time fundraising instead of serving more people.

    What the ADA is doing here is wonderful, inspiring, and indispensable – now we just have to figure out how to make it free. Is there any spare doe-eyed Web 2.0 optimism to spare, Boingers?

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