When Denise Stephens was 24, she was diagnosed with relapsing remitting multiple sclerosis (RRMS), a serious nerve disorder that destroys myelin, which helps electrical signals move rapidly from the brain to the rest of the body. When myelin is destroyed, nerve messages transmit slower and less efficiently. In Stephens' case, RRMS affected her strength, sensation and vision.

Around the time of her diagnosis, Stephens moved into her first home. But she had a series of setbacks, which made living alone extremely challenging. "It was like having to relearn how to do things because my hands weren't working properly,” she recalls. “It was a lot of physiotherapy, trying to learn to write again. It was things that people take for granted like using cutlery.” Stephens was frustrated to see her peers go out clubbing while she was struggling to use a knife and fork to eat dinner. She ended up leaving her job as a forensic toxicologist, since she was unable to carry out the tasks involved due to dexterity difficulties and fatigue.

Stephens was seen by an occupational therapist, who gave her a slew of equipment to help her stay independent, such as a perching stool, cutlery with foam-padded handles, and National Health Service-issue crutches. But there was a problem. "Over time, I became increasingly frustrated because it felt like my home was starting to look more and more like a hospital," she told me. In England, where Stephens resides, state provided equipment has a color palette that is rather bland. "It's a lot of grey, beige, wipe clean plastic and the designs aren't very inspiring. It felt like I had gone from someone who had traditionally been a consumer, having choices to buy what I wanted—to suddenly, 'Oh you have a disability, therefore it doesn't really matter and you have to accept what you're given.'"

Stephens started to think about how to fix the problem. Although she never saw herself as someone who was interested in design, Stephens had enough time at home to contemplate everything around her. (Watching multiple interior design shows on TV didn't hurt either.) As she soon learned, "design is relevant to everybody" and it has the potential to make a difference. Stephens began pondering her personal situation through the lens of a designer. "I started to think about how design could improve my independence... Isn't design the onus of improving things?" However, the problem was beyond bland colors; many of the items the government had given her were barely functional.

Contrary to many non-designer's beliefs, design is not entirely about beauty or aesthetic appeal. "Design is a plan for arranging elements in such a way as best to accomplish a particular purpose," said Charles Eames, the renowned designer of the iconic lounge chair. Steve Jobs put it a different way. “Most people make the mistake of thinking design is what it looks like. People think it’s this veneer—that the designers are handed this box and told, ‘Make it look good!’ That’s not what we think design is. It’s not just what it looks like and feels like. Design is how it works.” Note that the words "beauty," "aesthetic," and "pretty" are nowhere to be found in the quotes above. There are a lot of beautiful things in the world that are poorly designed.

One of Stephens' first ideas was to open a design shop that catered to people with special needs, hoping to provide them with a variety of functional products that suited their specific needs. But she realized there was a bigger problem: "There weren't many great products out there."

Around the time of Stephen's realization, Dominic Campbell, who Stephens has known since college, met the director of Social Innovation Camp, which was about to hold its first event. The camp, which was looking for project ideas, "designs innovation programs for private, public, and social-sector organizations, helping build technical solutions to social challenges," according to its website. With Campbell's encouragement, Stephens submitted her idea, which would cultivate "a community of people who are interested in design to support independent living." She called it Enabled by Design. The idea made its way onto the camp's shortlist, where it was a featured project. Upon arriving at the camp, participants broke into teams, composed of designers, technologists and people with business experience who collaborated on the projects. At the end of the weekend, the camp held a pitching contest, where members from each team presented their project to a set of judges. Enabled by Design was the first ever winner of Social Innovation Camp.

Meanwhile, Stephens' friend Campbell left his local government job in London to start FutureGov, an organization that works with local government on "human-centered design." The problem in government, Campbell told me, is that technology tends to be "ugly, unhelpful and expensive." FutureGov looks at how technology might be better used to solve social problems, in addition to injecting "people and design" back into government, where technology tends to be dehumanizing. Although Campbell was not trained as a designer, he was always interested in design, but didn't have a name for it. During his time in government, Campbell often worked on improving and redesigning systems. Through working with Enabled by Design and other activities, the importance of design and his role in it came into focus.

After Social Innovation Camp, Enabled by Design and FutureGov, which was only a few months old with a handful employees, kept working together. Campbell told me that once FutureGov had a larger staff and more resources, it took Enabled by Design under its wing and "tried to give it a boost." Although Enabled by Design is a separate company, Campbell says that "it's part of the FutureGov family." Since FutureGov has significant connections to local government in England, it can act as a liaison for Enabled by Design and help them further realize their mission.

Denise Stephens of Enabled by Design

In 2013, Denise Stephens' winning project turned five. From the outset, Stephens says that it was important to have an optimistic mindset and to be "solution focused." Enabled by Design, she says, is "showing how we would like the world to be opposed to saying, 'This is rubbish and doesn't work.'"

Since the beginning, one of Enabled by Design's goals that has come to fruition is cultivating a community for sharing the best designs and modifications—known as hacks—for people with disabilities. One of the most rewarding moments, Stephens says, is when community members reach out and share the positive impact Enabled by Design has had on them. "There was a lady from the US who contacted me, and she had a condition that meant her mobility wasn't particularly good, so she would need to use a mobility scooter. But she had two twin little boys, and she wanted to be able to take them to school." However, the route to school wasn't built for scooters, since there wasn't a lot of sidewalk, and the woman felt that she couldn't transport her boys safely. The woman asked if Stephens had any ideas, since visiting multiple scooter stores turned up nothing. "I kind of felt a bit like her," Stephens says, "She was saying there wasn't any other option really." Stephens remembered the carriages that some cyclists use to pull their children while riding. "I got back to her and said, 'I found this product, it's like a little trolley to hold children... it's secure. If you could find a way of attaching that to the back of your mobility scooter I think you will be able to take your little boys to school.'" This is a good example of Enabled by Design in action. Having done this many times before, Stephens knows where to look and what to look for; her expertise and advice are clearly sought after.

Enabled by Design, Stephens says, is "showing how we would like the world to be opposed to saying, 'This is rubbish and doesn't work.'"

But Stephens and the woman still had to find a way to attach the carriage to the scooter. Luckily, the lady's brother-in-law was an engineer who built an attachment to connect the two together. "She emailed me photographs of her mobility scooter with the little trolley attached to the back... and she said that she'd been able to take her little boys to school for the first time on her own, and to the park for the first time." Stephens remains extremely proud of this, saying, "It's a really lovely story in terms of how thinking a little bit, even though there wasn't a product specifically made for that way of [using something], you could actually help somebody." And Stephens isn't the only one. At SXSW this past spring, FutureGov hosted a session that dissected Enabled by Design's mission for the first time overseas, which is where I first came across Campbell, FutureGov and Enabled by Design. The reaction at the event was strong, both among the people with special needs and those without, a testament to demand for Enabled by Design's assistance.

This encounter, where Stephens played an integral role in improving a person's livelihood, highlights a new goal for Enabled by Design. Since its 1500 member community is wide-ranging, from people who depend on assistive products, to people who care for those in assisted living, to family members, friends, designers and engineers. "If we could bring all of those people together, I think that could be a very valuable tool to make a difference." Stephens says that in the future, Enabled by Design might help with introducing and brokering partnerships between designers and users.

Educating designers and consumers alike is also crucial to Enabled by Design's mission. Stephens says this is especially important when bridging the gap between a user and a designer, who often don't have a common language when it comes to design. On a recent collaboration, Stephens was speaking with a designer who was grateful Stephens was "design aware," meaning they were able to communicate productively. Helping others become "design aware" is another goal Enabled by Design hopes to tackle, but it won't be easy. "People who might not have a design background might think of design as making things look pretty. So they won't necessarily think about design being how a product works, how you interact with the product... Because design is more than just how something looks," she says. However, not everyone cares about how a product was designed, as long as it works for them. In the end, Stephens believes, it's about choice—letting people be involved as much as they want to be.

Most people don't realize that many products are unusable for certain people, especially when a product is a cornerstone of everyday life. Why question the design of a fork, when it's done its job since I was a toddler? Few people would regularly ask this question, which is why awareness is a huge part of the effort, especially on the designers' end. A perfect example of the lack of "design for all" awareness is the Dyson Airblade. The recipient of multiple design awards, in addition drying hands more than three times faster than competitors, the Airblade seems to be a design feat. However, for those in a wheelchair, the Airblade is useless, thanks to the orientation of the dryer, which is built for people who are standing. This dichotomy, where a product is both hailed as a major innovation but is a massive failure for some people, plagues modern-day design and underscores the importance of Enabled by Design's mission.

Most people don't realize that many products are unusable for certain people, especially when a product is a cornerstone of everyday life. "Why question the design of a fork, when it's done its job since I was a toddler?"

Stephens' frustration with the lack of inclusive design in the world led her to create the Enabled by Design-athon, which focused on this concept of "design for all." "We felt that we talked a lot on the website about things and it felt like we needed to move to the next stage... [to] bring together people to work on projects that we could make something tangible that people could see and start to discuss." The goal was to design products that were "inclusive," and the event was sponsored by FutureGov, IDEO, Ravensbourne, sugru and the Technology Strategy Board. Although Stephens admits that one size fits all isn't possible—"You can never have truly designed something that meets everyone's needs"—customization is an important and growing option. "The idea of the Design-athon was to look at the area of 'design for all' that could be complimented by new advances in technology, new materials, and new processes, really new ways of working."

A poster for the Enabled by Design-athon.

Luckily, the one-size-fits-all approach for design is becoming less necessary thanks to cheaper and faster ways of customization. The forerunner in the customization movement is 3D printing. "Right now, 3D printing is being treated as a novelty, everyone is obsessed with this technology that can make really complex and unique things," says Jonathan Schwartz, a co-founder of Layer by Layer, a marketplace for designers to sell their 3D designs, and a member of Y Combinator's Summer 2013 class.

But seeing 3D printing as just a novelty ignores what the groundbreaking technology can do. "3D printing can make highly customized, unique and complex objects at no extra cost," Schwartz explains. A dentist's needs are a perfect example. With 3D printing, "a dentist can print out a tray of fifty different crowns for fifty different teeth and that costs no more than printing out a tray of one crown fifty different times," Schwartz told me. This is possible because 3D printing sidesteps traditional and tedious manufacturing processes, which include creating molds, casts and placing large-run orders. 3D printing, however, doesn't require any physical changes during the production process or a serious commitment to scale. (Some will point out that you still have to pay designers, but the cost of a designer is often much less than paying factories for physical production, labor and distribution.)

A Makerbot Replicator 2 3D printer.
Photo By: Creative Tools

At scale, 3D printing also obliterates the traditional distribution chain. As Schwartz points out, traditionally, "If I wanted to make my own iPhone case and sell it, I would have to design it with a CAD file, send it off to China, have a master mold made, they have to produce an inventory that I'm going to guess is 20,000. Then you have to send it back to the US, send it to distributors and wait for customers to walk into the store or go online and find it." With 3D printing, "You can take that source file, and send it to whatever printer, whether it's in your house or down the street" and print it out. "This is going to revolutionize consumer products."

Three dimensional printing is not a new concept. A company called 3D Systems invented the practice in the 1980s, primarily for industrial applications. 3D printing is part of a bigger discipline called additive manufacturing, which means taking basic materials and layering them to build something from scratch. Subtractive manufacturing, conversely, is chipping away at a block of material, which sculptors commonly do. At the time of 3D printing's inception, the practice didn't gain much exposure because 3D Systems patented the majority of their process, which hampered the industry's growth. But in 2007, some of 3D System's patents expired, which allowed more companies to enter the 3D printing market, making printers cheaper and less industrial. This created the 3D printing frenzy that exists today. According to Schwartz, we are at the beginning of the exponential growth curve that all new industries hope to achieve.

3D printing "is going to revolutionize consumer products," Schwartz says. 

As of this writing, there are about 100,000 people in the world with 3D printers. Most personal 3D printers use Fused Deposition Modeling (FDM), which involves a 3D printer with a nozzle, a heated plastic and a platform. The nozzle extrudes the plastic like a hot glue gun would; layers of plastic create the finished product. Today, industrial 3D printers can print with a wide range of materials, including metal and ceramics, which major companies are increasingly adopting. Boeing is manufacturing over 20,000 different parts for their aircrafts with 3D printers, while professional motor sports teams are using 3D printers to create specific and easy-to-replicate parts as well. There are multiple technologies, printers and materials within the industry.

3D printing will impact people with disabilities in two major ways, Schwartz told me. "The first is customization and the second [is with] materials and manufacturing." For the past two hundred years, when someone lost an arm, "the answer was 'let's take a stick with a hook and put it on your arm.'" That's changing now because of prosthetics and robotics, but also because of increased customization. "The same thing's not going to work for a little girl or for a fifty year old war vet or for an eighty year old man," Schwartz says. This ability to customize used to be reserved for people with money, but now with 3D printing, the level of customization that people deserve is more attainable.

One of the more amazing examples of the power of 3D printing is Emma Lavelle, who was born with arthrogryposis multiplex congenita (AMC), a genetic condition that causes joints and muscles to stiffen, which eventually renders them useless. Her arms were inflexible and underdeveloped, which hindered her growth and abilities as a young girl, from drawing to playing. Lavelle's mom attended a conference where she learned about the Wilmington Robotic Exoskeleton (WREX). An early prototype of WREX, created by Tariq Rahman and Whitney Sample of A.I. duPont Hospital for Children in Delaware, used metal bars and resistance bands to enable people with underdeveloped arms to play and eat. However, the prototype was connected to a wheelchair, which helped support some of the system's weight. But since Emma was a toddler at the time and didn't need a wheelchair, the current system didn't work for her.

Emma's mom approached the WREX's creators and asked if they could make a smaller and lighter WREX for her daughter. The two WREX creators realized that 3D printers allowed them to make WREX out of light but sturdy plastic that could easily be replaced. So they created Emma's exoskeleton out of ABS plastic—Acrylonitrile butadiene styrene, a rather strong thermoplastic—and attached it to a plastic vest, which is able to adapt as her needs change. When she grows, they can print new parts as needed. The ease of 3D printing also allows for minimal downtime since fixing or recreating a broken component happens more locally and faster since you no longer need to go to China for the part.

Emma Lavelle with her WREX.
Photo By: Stratasys

The potential for 3D printing is tremendous. "3D printing is hopefully going to create a world of makers," Schwartz says. This trend is promising for the 3D printing movement and for people who have specialized needs, since more people will be able to create and modify highly customized products than ever before. Technology will also advance with more makers in the world. An example of this trend is the exponential growth of blogging software. When blogging first came about, one had to know how to technically setup and maintain a blog. But today, the never-ending amount of software and applications available allow someone to type the words while the software takes care of the technology that puts the user's words onto the web.

Gerant Edwards, an industrial design lead for IDEO, a global design consultancy, who led the 3D printing station during the Enabled by Design-athon, says this is already happening with 3D printing software. "Google Sketchup and a few of these easier programs are trying to approach that, but I've got training in industrial design," whereas most people do not. Edwards says he sees a day when costs of 3D printers drop and most people either own a printer or have access to one through a Kinkos-like store. "If I could tell you when that is I could probably make a lot of money, but it will start to happen," Edwards said.

As bullish as Jon Schwartz is on the possibilities of 3D printing, he says it's still important to control expectations. "Not everyone is going to be interested in design, and to assume that's going to be true is dumb." He added that the media needs to manage the hype surrounding 3D printing as well. "The media tends to take things out of proportion, [saying], 'Today we're printing this and tomorrow we'll be printing full human bodies.' No, that's not going to be happening" he says. And as great as ABS plastic is today, it will still take time for the technology to progress enough so printing from other materials is much cheaper and faster. "Do I think eventually we'll be able to print out a cell phone, absolutely. A pair of shoes? Definitely. Just not tomorrow, not in five years, but maybe in ten years."

Recently, bloggers and technologists have debated whether 3D printers will eventually be as ubiquitous as desktop inkjet printers. Joe Evans, a TechCrunch columnist penned a post called "3D Printers Are Not Like 2D Printers: A Rant." Evans argued that the difference between 2D and 3D printing is the intended use of the finished product. "Because paper, I think you’ll agree, is used almost exclusively as a medium of information... This is true even of photo printers: if it can be digitized, it’s information. Whereas 3D printers generate stuff. And our relationship to stuff is thoroughly, extremely, fundamentally different from our relationship to information." John Hauer, a guest blogger for TechCrunch, responded to Evan's column with his own, titled, "Why 2D Printing Is Like 3D Printing: A Counter Rant." Hauer argued that the infrastructure of 3D printing will soon be that of 2D printing, saying 3D printing will move from speciality shops into the home, just as 2D printing did. He added that the workflows for 3D and 2D printing are generally the same, and the end product isn't that important when comparing the two technologies. Others have remarked that 3D printing and the disruption that will ensue is quite similar to the changes that sewing machines brought about.

"Do I think eventually we'll be able to print out a cell phone, absolutely. A pair of shoes? Definitely. Just not tomorrow, not in five years, but maybe in ten years."

However, not everyone needs a 3D printer to take advantage of one. 3D printing shops are starting to pop up, just as Kinko's did over forty years ago. "If there was a way of matchmaking people with designers, or you could design for yourself and send the file through the 3D printing shop and have the [final product] sent to you" would be a viable option, Denise Stephens of Enabled by Design says, since not everyone, no matter how low the price drops, will be able to afford their own 3D printer. Edwards told me that a new 3D printing shop opened across the street from IDEO's offices in London, called iMakr. "3D printers are no longer just a tool for designers and engineers, it's like your everyday ink jet printer." Edwards explained how 3D printing is creeping into everyday life more and more. "I've used it for example for when my IKEA furniture broke and I modeled and made a new part." But as 3D printers become more prevalent, having access to capable designers will increasingly be more important. "Design is always something that will be needed and we need to encourage people to interact with design and to allow them to customize," Edwards says.

The Enabled by Design-athon involved a variety of participants, from product designers to engineers to visual designers to consumers. Edwards is well-versed in the arena that Enabled by Design is playing in. At IDEO, his job entails "listening to users and translating [their needs] into actual design," in the form of three-dimensional objects, which is exactly what the Design-athon hoped to accomplish. "We thought we could take some everyday problems and get the right concentration of people in the space and try and answer those questions," Edwards said about the Design-athon's inception. Just like traditional design (thinking about the general consumer), assistive design (thinking about those with specific needs) is a mindset, Stephens and Edwards both told me, which takes time to develop.

Teams working during the Design-athon.
Photo By: FutureGov

After two long days, the Enabled by Design-athon crowned two winners. The "People's Choice Award" went to SafeHouse, which uses whisper technology that analyzes sound frequencies to detect if windows or doors are left open, and then alerts the homeowner on a control panel. In the beginning of the Design-athon, people were asked to take pictures of products in their life, especially ones that are challenging for them to use. "One person got their grandparents to take photographs" of their everyday life. "And from the photographs you could see that they lived in a rural location, but they were obviously worried about security," Stephens recalls. Safehouse allowed the homeowner to be confident everything in the house was shut.

The "Judges Choice Award" went to Paul's Kettle, which was built for Paul Carter, who was born without lower arms and legs. Now 32, Carter runs a video production company based in London. When Carter's team asked him to take pictures of products he uses everyday, a particular item stood out. Carter is a big fan of coffee. He currently uses a kettle to make the coffee that mostly allows him to escape burning himself, since he has to hold the kettle differently than most, which means placing the top part of his arm through the handle and tipping it.

So Carter's team set out to create a kettle built specifically for people without limbs and used materials that won't cause users to burn themselves. "We set out to design a kettle that is functional not just for me, but for everybody," Carter told me. "The philosophy around inclusive design is that if [a product] is accessible for a disabled person, it's generally accessible for everybody." To some, Paul's Kettle looks futuristic, but it's highly functional. It allows Carter to put each arm through a hoop, which lets him pour the water without burning himself since the hoops are insulated.

A prototype for Paul's Kettle.

Denise Stephens has known Carter for a long time, and since she was eager to have a range of people involved in the Design-Athon, Carter was a perfect fit. In the beginning of the process, teams participated in various empathy exercises, to help them understand how disabled people might experience the world differently. "I find it really interesting that designers who are interested in working in the area of inclusive design or 'design for all' say that they rarely get the opportunity to meet real people and talk about what they really want," Stephens says, what designers would call "real life briefs." These empathy exercises, paired with having the end user on each team, hoped to sidestep these traditional pitfalls of the design process.

Teams participating in empathy excercises during the Design-athon.
Photo By: Enabled by Design

Carter, whom the award-winning kettle was built for, says that the designers on his team were enthusiastic and really open-minded when it came to finding a solution to his problem. More broadly, he thinks this mindset is possible for the industry to adapt. "No one sets out to design a bad product or to design a product that's inaccessible," he says. "I don't think a non-disabled product designer has ever sat down and thought, 'Oh, I wonder how a person without hands would use this' because it's probably not something that comes [across] their radar." Events like the Enabled by Design-athon are trying to change this.

The Paul's Kettle team, with Carter second from right. 

Edwards of IDEO says that working with Enabled by Design helped amplify this practice, called "designing for extremes." By designing for the extremes, the solution for a person with a disability ends up working perfectly well for the generic population. But as a business decision, Edward admits that it's often hard to justify not designing for the general population. "If a client comes to a big consultancy and wants to make a lot of money, it's quite hard for us to be inclusive." But Edwards says that it's still possible for the designer and the client to say, "OK, if we're designing this, how can we make it inclusive?" As a designer, Edwards believes that designing for the extremes is the most interesting design assignment and the most challenging. Designing a water pump for a child in Africa, and immersing yourself in that culture and learning about their daily challenges is "so much more interesting than a piece of soda packaging that's going to drop out of a vending machine."

During the Design-athon, Edwards was careful to not let 3D printing be an end-all solution or a crutch to sidestep important parts of the design process. On the first day, teams didn't touch the 3D printer, and instead worked with paper and foam to evolve their design, a process Edwards favors. On the second day, teams started working with the 3D printer more, while Edwards helped them mockup very simple designs that could be printed. "We weren't worried about radiuses and perfect scale, we were working on how [the product] interacts." One of the limitations of 3D printers right now is the amount of time it takes to print out an object, varying from under an hour for something the size of an expresso cup to a few hours for something the size of a mug. According to Edwards, the 3D printer produced just under a dozen objects during the Design-athon.

The 3D printer working the Design-athon

Two of them, called the FFFFork and Finger Cactus Set, were built for people with dexterity issues. The FFFFork is a three-dimensional fork, meaning it has spikes on more than one plane. The fork helps people with imprecise motion or insufficient strength pick up their food; it looks like long, sharp blades of grass on a stick. The Finger Cactus Set is a group of 3D printed finger caps outfitted with spikes and serrated edges, which also allows someone with weak dexterity, strength or an inability to hold traditional silverware to better pick up their food, bringing new meaning to "finger food." By getting rid of 85% of the material in a normal fork, which affects the physics needed to pick up a piece of food, the Finger Cactus Set allows a user to put less strength towards eating. The 3D printed models, which Edwards says were "pretty crude," nonetheless "capture the essence of the idea and what you're trying to communicate—that's what the role of prototyping is." 3D printing takes this process to a "slightly higher resolution," he added.

The FFFFork and the Finger Cactus Set, two protypes that were 3D printed at the Design-athon. 
Photo By: Haiyan Zhang

But as 3D printers become more prevalent, having access to capable designers will increasingly be more important. "Design is always something that will be needed and we need to encourage people to interact with design and to allow them to customize,” says Edwards." But the main challenge of that is actually producing the file to be printed." He points out that 3D scanning, which scans something in the real world and converts it into a rough 3D file in CAD, has a lot of promise. 3D scanning also makes a designer's job much easier since they don't have to design the product from scratch on the computer. However, there is a tension, Edwards adds, between making products that are relatively easy to create on the computer and ones that are customized to a user's needs, which often requires more design skill.

Designing a water pump for a child in Africa is "so much more interesting than a piece of soda packaging that's going to drop out of a vending machine."

Although none of the projects from the Design-Athon have gone into production, that might be perfectly okay. With 3D personal printers on the rise, customization is going mainstream. These exciting trends, along with the proliferation of social design organizations and projects following in the footsteps of Enabled by Design and FutureGov, are going to make the world a better place. And a more functional one.