Investigating modern-day Talaria: Mobile phones and the mobility-impaired in Singapore.

Journal of Computer-Mediated Communication

Investigating Modern-Day Talaria: Mobile Phonesand the Mobility-Impaired in Singapore∗

Arul Chib

Wee Kim Wee School of Communication and Information, Nanyang Technological University, 31 Nanyang Link,WKWSCI Building, #03-08, Singapore 637718

Qiaolei Jiang

Department of Journalism and Communication, Dalian University of Technology, No. 2 Linggong Road,Ganjingzi District, Dalian City, Liaoning Province, China 116024

Revisiting the medical and social models of disability, this study adopted the integrated biopsychoso-cial approach to examine experiences of 25 mobility-impaired respondents in Singapore with usingmobile phones. We found that mobile phones provided respondents a greater degree of mobility, asense of control, and opportunities to escape the stigma of disability, thus challenging the boundariesbetween the able-bodied and the disabled. Mobile phone appropriation allowed the management ofpersonal identities and social networks, leading to a sense of empowerment. However, mobile phoneusage might act as a double-edged sword for disabled people, creating mobile dependencies and aspatial narrowing of social connections. Theoretical and practical implications are discussed.

Key words: disability, identity, ICT, mobile phone, mobility, social support, social network.

doi:10.1111/jcc4.12070

Introduction

The talaria, winged sandals made of imperishable gold, according to legend, promised flight to theirwearer, the Greek god Hermes. This study ostensibly investigates the much-heralded premise that mobilephone technologies, as a special case of information and communication technologies (ICTs), promisealleviation, mitigation, normalization, and empowerment of the disabled condition. However, investiga-tion of this modern-day phenomenon requires an unraveling of myth, opinion, and fact, as determinedby the experiences of the subject—the disabled individual.

Such an investigation then requires a historical grounding in the domain of disability research, assituated in the debates concerning the medical and social models, finding integration in the biopsychoso-cial model. We adopt the integrated biopsychosocial approach to disability as a point of departure toseeking the role of the experiential for technology usage by the disabled. In examining the physiological,psychological, and social outcomes of mobile phone usage by the mobility-impaired, we necessarilyadopt a critical stance as a counterpoint to both the distinctly techno-optimistic stance adopted bysome in a broader effort at inclusion (Buland & Dahl, 2000; Holanda & Dall’Antonia, 2006; Mann et al.,

∗Accepted by previous editor Maria Bakardjieva

Journal of Computer-Mediated Communication (2014) © 2014 International Communication Association 1

2004) based on the medical model, as well as the call-to-action of particular sociocultural approaches(Areheart, 2008; Oliver, 1996; Shakespeare, 2006) based on the social model. This stance is not unsympa-thetic to work aimed at sociopolitical stakeholders that examines cultural, policy, economic, or technicalfactors; rather, we emphasize the agency afforded the disabled by their appropriation of mobile phonetechnology.

Grounded in the British tradition1, we distinguish between ‘impairment,’ a physical condition, and‘disability,’ a social construct (Albrecht, Seelman, & Bury, 2001); further, noting the composite and con-tinuum that these constructs represent, rather than the binary. In particular, the argument build uponcritique of the social model (Shakespeare & Watson, 2001), in terms of the need for multiple identityconstruction and a contextual examination of particular conditions of impairment and disability fromboth medical and social perspectives.

History of disability studies

From ‘normalization’ of the body to disability as a ‘social construct’In the 1970s, disability studies witnessed a seminal shift from the hitherto prevalent medical model tothe social model, shifting the onus of responsibility from the disabled person to society, with disabilitycharacterized as social oppression rather than a bodily impairment (Shakespeare & Watson, 2001).

The medical model of disability postulates impairment as a condition of a deficient, sick, or abnor-mal body, whose responsibility to fix lies with the individual (WHO, 2011). The (bio)medical model haslargely been discredited for reductionism (Engel, 1977), being criticized for distilling disability down toa purely biological (dis)function, i.e., deviance from normal physiological functioning. This argument,when extended, acts as an excuse for policy disengagement by placing the responsibility of resolutionupon the ‘impaired’ individual (Goggin & Newell, 2003), with intervention focusing on the ‘normaliza-tion’ of bodily defects.

The social model arose out of dissatisfaction with the limited positivist approach of the medicalmodel, and is currently the most widely accepted theoretical approach by scholars of disability. Dis-abled people, often stigmatized by the able-bodied, are perceived as deviant and assigned with discred-iting personal qualities and stereotypical behaviors (Oliver, 1990; Söderström, 2009), according themsecond-class citizenship status. The social model advocates a relational perspective, regarding disabilityas social construction. Accordingly, it is not the bodily impairment, but rather barriers in interpersonalrelationships and social encounters that make disabled persons so (Gustavsson, Sandvin, Traustadòttir,& Tøssebro, 2005; Shakespeare, 2006).

By regarding disability as social oppression, the social model took an active political stance. Theresponsibility of transformation, as postulated by the social model, lies primarily external to theindividual. The social model thus advocates a rights-based approach (Barnes, 1991; Finkelstein, 1980,1981; Oliver, 1990, 1996), with the disabled demanding reconfiguration of systems designed for theable-bodied. There is certainly value in reconfiguring health and social systems to the needs of thedisabled. However, social hand-outs deprive the disabled person of agency and autonomy; therefore weargue for a multidimensional approach, with a particular emphasis on the psychology of the disabled.Adaptation of the body and the social environment, as argued by the medical and social modelsrespectively, is then supplemented by a thinking, sensitive, and agentic individual.

Towards an integrative biopsychosocial modelThe biopsychosocial model emerged in reaction to the medical model’s limitations, proposing addi-tional social and psychological factors; the latter encompassing cognitions, emotions, and behaviors.

2 Journal of Computer-Mediated Communication (2014) © 2014 International Communication Association

The medical model was criticized for the mechanistic and reductionist approach that failed to accountfor the range of individual and social factors within which humans operate. Engel (1977) argued thathumans are not just biological determinations but operate in a complex social milieu. He proposed thebiopsychosocial model that regards disability as a complex product of the dynamic interaction betweenphysical and psychological variables, which together were set against a background of socioenvironmen-tal (context and relational) influences (Bernard & Krupat, 1994; Dunstan & Covic, 2006).

While the approach of the medical model has since been replaced in the disability discourse prin-cipally by the social model, we select the biopsychosocial model as it captures impairment as a realisticexperience for many of the disabled. Scholars consider the social model outdated due to the notice-able absence of the experience of impairment, going on to call for multidimensional perspectives on theexperiences of disabled people (Hughes & Paterson, 1997; Shakespeare & Watson, 2001). The revision-ist approach to the social model is further advocated by scholars dis-satisfied with merely catalogingexperience, instead calling for ethnographic methods that translate into technological design solutions(Dewsbury, Clarke, Randall, Rouncefield, & Sommerville, 2004).

According to the biopsychosocial model, the individual is able to self-determine whether he/she isindeed disabled, the extent of the impairment, whether intervention is required, and the form of suchassistance, rather than the decision determined by doctors, academics, corporations, or policymakers.We note that such an approach certainly does not absolve these key stakeholders from their responsi-bilities of providing aid or de-stigmatizing disability, a sociopolitical agenda sometimes leveled at thebiopsychosocial approach (Biderman, Yeheskel, & Herman, 2005; Epstein & Borrell-Carrio, 2005).

From a systems perspective, one can categorize prior approaches to disability as subindividual, themedical approach focusing on the impaired body, or supraindividual, the social approach focusing onthe societal framing of the disabled. We aim to fill the particular research gap by elaborating on an indi-vidual’s motivations, emotions, and behaviors in response to his/her own bio-physiological condition ofimpairment, on one hand, and to the social network of relations, on the other, thus bridging the levels,currently theorized as distinct and oppositional dichotomies.

Technology introduction can then be viewed from the perspective of adoption and appropriationbased on the personal experiences of the disabled person, as the emphasis of the investigation shiftsfrom the binary viewpoint of either techno-determinism based on impairment or social constructionism(Thoreau, 2006). We are thus able to examine ‘how’ technology is being used by the individual concerned,with implications for personal identity, social relations, and psychological empowerment.

Mobile Phones and the Biopsychosocial Model of DisabilityThe underrepresentation of the disabled as active users of assistive technologies has been repeatedlydecried (Cole, Nolan, Seko, Mancuso, & Ospina, 2011; Shakespeare, 2005; van Dijk & Hacker, 2003).Current digital divide studies have a tendency either to ignore disability as a separate category for anal-ysis, or to assume that it can be conflated with other potentially disadvantaged categories, and muchof the literature is relatively uncritical in its enthusiasm for ICTs to alleviate social exclusion (Adam& Kreps, 2009; Cole et al., 2011). Scholars indicate that the engagement of the disabled is rarely men-tioned, or is addressed and then elided in such research areas as new media (Goggin & Newell, 2003;White, 2006). When addressed, we find that certain groups of the disabled with particular conditionshave attained equality of ICT access (Dobransky & Hargittai, 2006). More broadly, there is evidence ofwell-being (Chen & Wellman, 2005), social support (Finn, 1999), and emotional support (Seymour &Lupton, 2004).

Although past ICT research has partially included the voices of disabled people (e.g., Harris, 2010;Mitra, 2001; Söderström, 2009; Thoreau, 2006), few studies have investigated in-depth the diversity of


the everyday experience and the social interaction produced by mobile phones. Research on disabledpeople’s social uses and psychological impacts of mobile phones is yet emergent, a noticeably deficientsituation, particularly as the diffusion curve of mobiles approaches saturation in the developed world.

BiopsychosocialThe medical paradigm, the bio of the biopsychosocial model, would regard technology adoption by thedisabled as aiding the ‘normalization’ of bodily defects. The (bio)medical approach is focused on theovercoming of physical impairments by technology substitution, most notably when mobile phones arecompared to limbs (Lin & Lim, 2010), permitting users to be actively involved in everyday activities. Theideology of liberation from the impaired body proposes that disabled people can carry out an indepen-dent life with a mobile phone (Abascal & Civit, 2000), with the device portrayed as an assistant to carryout hitherto unattainable functions (Bertini & Kimani, 2003).

Mobile phones, viewed from this distinctly techno-optimistic stance, reveal a frontier of novel pos-sibilities in terms of information gathering, social communication, employment attainment, and guidesagainst, and access to help in cases of hazards. Paradoxically, the medical paradigm, thus stated, stripsthe disabled individual of agency, placing the onus of the transformation firmly on the technology. Fur-ther, some disabled consumers lack the ability and information necessary to access, select, and use thedevices and services routinely used by the able-bodied, as a consequence shying away from technologyadoption (Baker & Bellordre, 2003; Bertini & Kimani, 2003).

BiopsychosocialThe social paradigm, the social of the biopsychosocial model, suggests that people with disabilitiesare perceived as different, and therefore are at risk of being marginalized in everyday interactions(Söderström, 2009). This places the disabled in a disadvantaged position, requiring special attentionfrom society (Golledge, 1993; Hahn, 1986). Viewed from the social constructionist perspective, normsguide technological design and service provision from the perspective of the able-bodied.

Mobile phones provide the disabled with valuable possibilities for personal development andempowerment, by helping maintain strong ties and strengthen social support, while also manifest asdeveloping capacity for independence and self-determination (Moser, 2006). The disabled use commu-nication with social ties to enhance their feelings of inclusion, warding off depression and mental healthissues (Honey, Emerson, & Llewellyn, 2009). Through daily encounters, strong social ties have a greatinfluence, providing emotional support on a regular basis (Wortman & Conway, 1985).

We acknowledge recent critical work (e.g., Cole et al., 2011, Goggin, 2009; Goggin & Newell, 2007,Söderström, 2009) in arguing for a more nuanced double-edged approach (French, 1993; Oliver, 1990).This research considers the potential of mobile phones to create social dependencies, and exacerbateexisting power differentials in society. Certain mobile services that monitor the health status or the loca-tion of disabled users for security may incur invasion of their capacity of taking decisions (Abascal &Civit, 2000). Other scholars have commented on the negative potential of ICTs to reproduce and evenreinforce boundaries between the able-bodied and the disabled (Cole et al., 2011; Hughes & Paterson,1997; Moser, 2006).

There are risks associated with the potential substitution of direct communication by mobiletelephony. Prior research suggests that mobile telephony helps create more frequent, longer, moremultimodal, and more extensive ties, yet simultaneously decreases the geographical range of socialties, potentially due to the expenditure required of time, energy and resources (Palackal et al., 2011;Schroeder, 2010; Sooryamoorthy, Miller, & Shrum, 2008). Further, intense bonding through mobilecommunication can lead to tele-cocoons (Habuchi, 2005) or monadic clusters (Gergen, 2008), which


can be associated with social privatism and have negative consequences for involvement in broaderspheres of public life (Campbell & Kwak, 2010; Granovetter, 1973).

A high density of communication with a closed circle of ties predicts a deepening of establishedrelationships rather than the formation of new ties (Ling, 2008). These observations from the mobilephones literature are particularly problematic as research on disabled people’s communication behaviorindicates confined choices of social ties (Skär, 2003; Söderström, 2009). The social ties of the disabled arequite isolated; confined to their local settings, the disabled lack multiplicity in social networks (Aitchison,2003; Skär, 2003).

BiopsychosocialThe psychological experience, the psycho of the biopsychosocial model, provided by mobile phone usagehas been considered transformational for the disabled. At the psychological level, the technology, notdissimilar to mainstream mobile phone research (Katz, 2006; Ling & Donner, 2009), has led to funda-mental changes in the daily lives of the disabled. Usage is treated not merely as an adoption process, butas a process of appropriation, being configured to the needs of the disabled and their care-givers.

Shakespeare (2002) argues that disabled people have the right to construct their own identity asindividuals, resisting the terminologies of the medical model (impaired) or the social model (disabled).Earlier studies have found that online interactions allow disabled users to hide physical impairments andemphasize their qualities as ‘normal’ people (Dobransky & Hargittai, 2006; Söderström, 2009). Unlikeface-to-face interaction, where impairment or the stigma of disability (Goffman, 1963) might preventthe disabled from venturing into the world freely, mobile communication removes disability from theforefront of interaction until it is relevant or desirable to reveal it (Bowker & Tuffin, 2003).

Mobile communication allows the disabled reconstruction of their identities in a positive mannerin the face of challenges to their sense of adequacy (Ravaud, Madiot, & Ville, 1992). This action may beseen as resisting discourses that position people with disabilities as somehow ‘abnormal,’ and perpetuatetheir dependency and passivity (Wehmeyer & Shalock, 2001).

While recognizing the empowering potential of mobile communication for marginalized users (Elias& Lemish, 2009; Mehra, Merkel, & Bishop, 2004), some scholars suggest that such mediated interactionmay reinforce the standard assumption of normality based on a nondisabled identity (Bowker & Tuffin,2002; Cole et al., 2011). There is thus the possibility of developing a mobile dependency culture impedingpersonal growth and social integration (Shih, Chen, Chiang, & Shih, 2012).

Our research adopts the biopsychosocial model of disability to critically interrogate the mobile com-munication experience of the disabled, focusing on specific physiological, sociological, and psychologi-cal dimensions, and their interrelationships.

Methodology

We conducted an in-depth qualitative investigation on the diversity of the mobile communication expe-rience amongst the disabled, specifically the mobility-impaired. We acknowledge that research on dis-ability and ICT usage is specific to the type of impairment under investigation (for example mobility,visual, hearing impairment), and thus lacks generalizability for others (Cole et al., 2011; Dobransky &Hargittai, 2006). Previous research has been criticized for collapsing differing types of impairments intoa single homogeneous category (Cole et al., 2011; Shakespeare, 2005, 2002), leading to a potential over-statement of claims. Thus, we choose a nuanced categorization based on a specific condition, focusingon the experiences of the mobility-impaired with mobile phones (Abascal & Civit, 2000).

The site of our research was Singapore, a digitally savvy city-state with mobile subscriptions reaching1,436 per 1,000 inhabitants (DOSS, 2012) and a leader in smartphone penetration (ITU, 2012). Due to


pressure from the activist agenda to establish a legislative and policy framework concerning disability,the Singapore government recently ratified the 2006 United Nations Convention on the Rights of Personswith Disabilities, scheduled to be implemented in 2013. The law is designed from the perspective of thesocial model, with an emphasis on equality and justice in education, employment, etc.

The biopsychosocial model, at the level of praxis, is characterized by attentiveness to the subjec-tive experiences of the disabled (Borrel-Carrio, Suchman, & Epstein, 2004). Such an orientation resultsin a patient-centered approach with a deep inquiry into narratives of experience (Biderman, Yeheskel,& Herman, 2005). A purposeful sample of 25 mobility-impaired Singaporeans participated voluntar-ily in the IRB-approved ethnographic study. All respondents owned mobile phones, with 12 possessingsmartphones. The sample consisted of 16 males and nine females, aged 19-65 years, of whom ten wereunemployed, and three were wheelchair-bound.

Respondents were recruited through the Society for the Physically Disabled (SPD) and the Singa-pore Cheshire Home (SCH), where the interviews primarily occurred, or at the respondent’s residence.Data was gathered in English, with Malay and Chinese utilized when necessary for clarification. Theethnographic approach, while involving in-depth interviews and observations, included the researchers’presence in the daily lives of the respondents.

The interviews focused on the respondents’ experiences with mobile phones in everyday life.Respondents elaborated upon their history and frequency of mobile phone usage, time spent, favoritefeatures, underlying motivations and barriers encountered, and the attitudes and meanings associatedwith these activities. In addition, a series of open-ended questions elaborated upon key aspects of therespondents’ lives, such as employment, health, social life, and emergencies faced. The interviews wereaudio-recorded and transcribed verbatim, with English translations provided when required. The par-ticular idiosyncrasies of Singlish are presented in quotations to retain the original intent, with bracketsinserted only for reasons of clarification or explanation to improve meaning, not as a grammaticalfunction.

Findings

Mobile phones, viewed from the theoretical frame of the biopsychosocial model, exhibit both benefitsand constraints for the disabled in physiological, sociological, and psychological terms. Each dimensionof the biopsychosocial model is further elaborated upon with specific quotations from respondents toilluminate the argumentation.

Physiological: Substituting the condition of impairment, with effortThe disabled used mobile phones as an empowering technology to substitute for the condition of impair-ment. However, the lack of ease of handling a technology designed for the able-bodied led to numerousphysical challenges.

Viewing technology as a ‘normalizing’ agent, mobile phones certainly helped respondents, muchlike the able-bodied, counteract temporal and spatial constraints while conducting daily activities (Ling& Campbell, 2009). The ‘access anytime, anywhere’ capabilities of mobile phones (Perry, O’Hara, Sellen,Brown, & Harper, 2001, p. 325) helped respondents contact others, or obtain information, more easilyand efficiently.

When I use the normal wheelchair, I moved very slowly like a tortoise. So that’s why I need to get amobile phone, so that it’s easy for me to call or message.

Normalization from a physiological perspective is presented as a bodily metaphor by the disabled.With the device literally in the ‘palm of your hand,’ mobile phones allowed the mobility-impaired to take


control of their personal needs, accompanied by feelings of security. With considerable loss of personalautonomy in daily tasks, the mobility-impaired got an opportunity to be mobile.

Having the phone in your hand, you can actually reach out to anybody at any time. If you’re anable-bodied person you can actually walk over to a phone. But being disabled, the mobile probablyhelps because you have it in the palm of your hand.

The (bio)medical stance necessitates comparative approaches, whether in terms of the disabled ver-sus the able body, or normal versus special environments or lifestyles. One respondent argued for hergreater need for mobiles than the able-bodied due to the unpredictability of frequently encounteredemergencies. On a daily basis, the mobile phone enhanced her feelings of safety, manifesting in a will-ingness to venture outdoors unaccompanied.

Seen from a physiological perspective, usage of mobile phones can be framed in terms of personaldeficiencies arising out of the condition of impairment. Viewed positively from an operational perspec-tive, mobile phones were described as ‘lighter’ and ‘easier to bring around’. However, due to varyingconditions of impairment, respondents had different complaints regarding specific mobile phone fea-tures, such as bulky weight, awkward design (hard to press buttons), and absent ease-of-use (numerouscommands required); for example, one respondent claimed that, “To send one SMS, I have to click sevento eight times just to send it out.”

When we have nerve damage, we can’t control [our movements]. So either we press too hard or toosoft; it can’t move.

The centrality of mobile telephony as a tool of empowerment can be captured in the notion thatsometimes the absence of the device is as important as the presence. Mobile phones alert care-giversto whether their wards are in need or danger. For example, trapped in a partially flooded room withthe mobile phone beyond reach, a respondent received help because he failed to answer incoming calls,stating that, “When my family members call, if I don’t answer, they will know that I have a problem.”

Social: Instantly accessible influential ties, and isolationismDisabled respondents found social oppression prevalent, both in personal interactions as well as inthe encounters with a physical infrastructure designed for the able-bodied. Mobile phones providedrelief from the former by allowing constant access to strong social ties, and a way to escape the con-straints of the latter by permitting calls for aid. Conversely, the mobile technology hindered the disabledfrom developing new relationships, reinforced conditions of social isolation, and potentially led to socialdependencies.

Due to public misunderstanding of their impairments, respondents shared a deep sense of helpless-ness and expressed intense feelings of disorientation in their social interactions.

[During] face-to-face [interaction], they [able-bodied] are kind of shy in front of me. I’m the one whodoes the talking. I’ll be like ‘Why? I look like alien or what?’ Maybe they are afraid and don’t knowhow to handle a person like me.

A social perspective suggests that the disabled lack adequate opportunities to be productive and eco-nomically self-reliant participants in society. Ten respondents were unable to sustain a full-time job, withthe balance engaged in low-wage jobs requiring basic skills. Meanwhile, the restricted mobility of respon-dents reduced their potential for working overtime, often a key requirement of low-wage employment.In effect, the responsibility for inadequate economic resources was squarely placed on the shoulders of


the disabled. This lack of economic independence translated into restrained mobile usage, mainly voicecalling and texting. Mobile Internet usage was limited to usage of maps and chat messaging.

Based on my budget, I will surely use SMS. If emergency, then I will have to call. If you were callingout, it’s not like you are calling out for fun. It’s expensive.

I always control [mobile phone usage]. I use it for people calling in to me, not to call out. Because I’mnot working, I try not to spend over the limit.

The respondents perceived the public telecommunication infrastructure to be designed for theable-bodied, placing the disabled at a disadvantage. Public payphones, often challenging to locate, werefrequently placed at an inadequate height for wheelchair-users. Mobility-impaired respondents hadto spend a lot of time and effort to ‘hunt for’ public pay-phones, which then usually only allowed amaximum of three minutes’ talk.

When you get a call from the central phone at home, people have to look for you. By the time I reachedthe phone, five minutes would have passed. Without having a mobile phone I have to get to a publicphone which is not as accessible.

When respondents did use mobile phones, they faced sociocultural disapprobation, sometimesbeing stereotyped as ‘charity cases,’ placing restrictive social norms on their behavior. Although disabledrespondents needed user-friendly functions, such as Bluetooth or touchscreens, they felt uncomfortableusing ‘fancy’ smartphones and accessories publicly.

There was a time when not everyone had a [smart-] hand-phone. We [the disabled] were the onlyones. I had to hide my hand-phone when I’m outside so that people wouldn’t say ‘we donated to peoplelike them and they have a nicer phone than ours’. In an organization like this, people see us like we aresupposed to be poor. So when they see us with a hand-phone and an earpiece like that, they are like ‘hey!’

The mobile, by allowing control of social interaction, acted as a tool to combat the social oppressionfelt. The feeling of being a social misfit was palpable, with the mobile phone offering some alleviation tothe social estrangement felt by the mobility-impaired.

When I feel down or scared that something will happen to me I call my friend and then he will try toencourage and console me.

Although it’s just a simple message, they will still message me ‘Good Morning’. It makes me feel thatpeople around care… so I don’t feel left out … I’m still being treated as a normal person.

The social model advocates a rights-based approach (Barnes, 1991; Finkelstein, 1980, 1981; Oliver,1990, 1996), with the disabled demanding reconfiguration of systems designed for the able-bodied.Failing adequate response, help is demanded as a right. The ubiquity of mobile phone systems bothprovided security and allowed for aid required in emergencies, proving useful to a respondent “when Ihave urgent needs. When the transport doesn’t turn up, I don’t need to go to the [public pay-] phone.”

With a mobile phone, I can contact [doctors] on my own. Without a mobile phone, I have to look for thenurses [physically]. And by the time they called the hospital, I don’t know what’s going to happen to me.

Respondents recalled extreme situations in which the mobile technology had been critical. Themobile phone performed the role of a ‘buddy guard’ in such real-life situations. In an instance, awheelchair user entered a door only to encounter insurmountable steps. Retreat proved impossible as


the door-handle was uni-directional, designed for the able-bodied, not taking into account a situationwherein steps might prove an obstacle.

When they [able-bodied] went through the door, we followed. We [the disabled] found ourselvesfacing the stairways. We turned back and we saw that the door had closed. [It only opened from theother side.] So I’m basically stuck and don’t know what to do… I had no choice [but to] phonecustomer service.

The desire for social connectivity was found to be a primary motivator for using mobile phones, asone respondent stated, “My contacts are all in the mobile phone.” Respondents frequently used mobilephones to maintain and strengthen social connections, particularly close ties with family members andfriends; according to a respondent, “Because of mobile phone, I get to keep in touch with others and ourfriendship is stronger.”

It was evident that, as a consequence of mediated communication, physical attachment was no longernecessary for the maintenance of strong social ties. Respondents admitted a preference for face-to-faceinteractions with friends and family members, yet had less expectation of such interactions. As theemphasis shifted to relationship maintenance, mediated communication seemed to serve the purpose ofsocial support, with one respondent stating that, “Just a press of a number you feel good… you don’t evenexpect them to come here, you feel that these words are good enough.”

On occasion strong ties offered much more than emotional support, such as in the case of an emer-gency. The mobile phone provided access to a core group of care-givers, who counter-acted the marginal-ization encountered by the disabled from mainstream society in critical situations of need.

There was one occasion when my tire got punctured and I was stranded. In public, people would justpass by you. They know but they don’t care. Without the phone, I can’t imagine what I would havedone. I called my friend and he came down, changed the tire for me.

Some respondents expended an extraordinary amount of effort on maintaining their social ties byphone calls or text messages, claiming feelings of being incomplete if the mobile phone was “silent allday long”. The majority had communication solely with close ties, which translated into the diminishingof other social networks, particularly limiting their ability to create new relationships. According to onerespondent, “Contacting people… that’s the important thing for people like us because it is very hard tomake friends.”

While this hesitancy in broaching new relationships may partly be due to the social discriminationencountered, the reliance on mobile communication may yet further distance the disabled from richersocial interactions. For the disabled who suffer physical isolation, the likelihood of social dependencyon the mobile phone is a real concern, with one respondent stating that, “One day when I really don’thave a message from someone it will feel very strange.”

Without the mobile phone] I will be a bit tense as I won’t be able to contact anyone. If anythinghappened, I’m all by myself.

We recognize that the affordances, benefits, and potentials that mobile phones offer the disabledare increasingly embedded in daily experiences, such that the question now is not whether such usageis seen as assistive, dependent, or addictive, but really how the process may be better understood, andpotentially managed.

When I don’t have the mobile phone, it’s kind of weird. It’s already part of my life. … I meanwhatever it is, I have to have that phone. Otherwise, if I go out… in case of emergency, I would not beable to do anything about it.


Psychological: Mediated identity as an escape, and a dependencyMobile phones allowed the disabled to create mediated identities as a way of normalization, and asembodiment of the agency afforded by technology. However, these astute communication practicespotentially led to social and psychological dependencies, with perpetuation and internalization of thestigma of abnormality respectively.

Respondents actively managed their personal identities via mobile phones. Without the need forphysical cues, the mobility-impaired engaged in mediated communication to manage impressions in thesame manner as the able-bodied (Beard, 2004). From a psychological perspective, respondents revealeda deep sense of inferiority versus the abled-bodied. As a result, the chance to be ‘ordinary’ was relished,and seen as a response to the fear of being stigmatized.

We always have to create a facade of ourselves, an image to show the world. … I think many [of thedisabled] prefer to hide behind the facade. Because they are afraid. They have every right to be afraid.

The lack of visual attributes provided an opportunity to escape the stigma of disability by reconstruct-ing a mediated image of their own choice. According to a respondent, “They [mobile phone callers] don’tknow who I am. [They] only know the person talking to them”.

Mobility-impaired respondents repeatedly faced circumstances involving discrimination, as elabo-rated upon earlier, such as when seeking employment. Using mobile phones, identities were not merelyoriented towards the ‘normal’, but respondents actively pursued strategies particular to the requirements,such as the need to acquire a professional identity on, or for obtaining, the job. Such identity managementaddressed the sense of inadequacy arising from the impaired body, but psychologically perpetuated themyth of the ‘abnormal’ and the marginalized status of the disabled individual.

If in person you go straight to the boss, he will immediately see that you are disabled and will straightaway think, ‘No!’. But on the [mobile] phone it is easier; I can talk to the boss and tell him what I amgood at. The boss will listen whether you are disabled or not. After he is impressed, you can just tellhim, ‘By the way, I’m on a wheel chair’.

Beyond managing perceptions, the masking of physical impairment in mobile communication whilecreating a professional identity helped respondents develop confidence. This subterfuge diverted respon-dents from the more challenging task of managing the disabled identity.

On the phone, I think people don’t see you as a disabled [person]. So I think it helps me overcome thefirst barrier. I can express myself better over the phone. When they meet me they are meeting me basedon my role and what I’m doing. Not because of who I am. So I will not feel intimidated when I meetthe person face-to-face and I’m confident of my status. … I think the mobile helps an individual to bemore socially active, it also gives you more control over what you want.

Consistent with previous studies, the mobility-impaired used technology to challenge the boundarybetween ‘abled’ and ‘disabled’, and enact agency beyond their marginalization (Cole et al., 2011). Agencywas especially important due to the fact that the respondents’ confidence and self-esteem had been dam-aged by offensive face-to-face interactions. When reflecting on the significance of “being ordinary” withthe aid of mobile phones, one respondent said:

We’ll never get out of our comfort zone, if we don’t have the hand-phone. Sometimes we just have tonot be afraid. We just have to talk right. … It gives you better skills, better qualities, and mostimportantly, greater confidence.


While mobile communication provided opportunities to hide impairments, it made respondentsoverly aware of their differences in face-to-face interactions. After all, the mask of mobile communicationdoes eventually fade, to be replaced by the reality of face-to-face communication.

Of course through the [mobile] phone they know me… although they don’t know my situation, thereis still some communication. So they are quite comfortable with it. Now all of a sudden they see me inreal life, it’s like two different things in their mind.

Discussion

The digital divide has been a complex and dynamic phenomenon under academic scrutiny. Althoughmodern communication technologies are widely believed to hold the power to bridge and even undo dis-ability, until now there has not been enough analysis to seriously scrutinize the role of the mobile phoneas a panacea for disabled people, particularly among specific disability groups and within particularsocio-cultural contexts (Moser, 2006). To bolster the growing legitimacy of the field (Goggin & Newell,2004; Meekosha, 2004), this study investigated mobility-impaired people’s use and perception of mobilephones in Singapore, by adopting the integrated biopsychosocial approach. In this section, we discussboth empowerment narratives and concerns about technological dependency, whilst suggesting theo-retical and methodological avenues for further research. Finally, we advocate greater multi-dimensionalapproaches for communication technology studies.

Mobile phones enhance considerable swathes of daily life, counter-acting barriers that place themobility-impaired at major material and social disadvantages typical of disability, thus challenging theboundaries between being ‘able-bodied’ and ‘disabled’. Respondents’ reasons for using mobile phoneswere consistent with existing research—substitution of impairment with a greater degree of mobility,sense of control in social interactions, and opportunities to escape the stigma of impairment by thereconstruction of a mediated image. This study demonstrates that due to the unique characteristics ofmobile phones, such as mobility, accessibility and convenience, the disabled were better able to cope withmobility impairments. Further, the mobile phone served as a socializing agent in mobility-impairedpeople’s adjustment to society in an efficient and questionably cost-effective way. Mobile phones thusproved a valuable tool for social, cultural and emotional support, especially for personal well-being andempowerment. Furthermore, mediated communication via mobile phones allowed the disabled to man-age personal identities in a manner that mitigated the physiological disadvantages of impairment.

Despite these narratives of empowerment, we argue emphatically for a critical perspective on tech-nology use by the disabled, in contrast to the dominant techno-deterministic and social constructionistparadigms advanced. There are real risks associated with the adoption, adaptation, and appropriationof mobile technologies by the disabled, not merely as mobile phone addiction. While the physiologi-cal challenges of technology design for the disabled has been addressed (Dewsbury, Clarke, Randall,Rouncefield, & Sommerville, 2004), there are concerns around the social and psychological dependen-cies engendered by mobile phone usage. We note that while the preceding sections were categorizedindividually into physiological, social, and psychological dimensions as a heuristic tool, the succeedingdiscussion acknowledges their inter-relationships, and alludes to the complexity involved in addressingthe issues.

For the disabled population, mobile communication as an assistive technology has been referred toas more a necessity than a convenience (Baker & Bellordre, 2003). Mobile phones, unlike other assistivetechnologies, are widely accessible, and do not inherently embody dependency that marks out the dis-abled (Söderström & Ytterhus, 2010). Further, the ubiquity of mobile phones makes them more sociallyacceptable as symbols of identity. One branch of research on technology usage by the disabled focuses


on the physiological challenges concerning impairment-related technical difficulties (Abascal & Civit,2000; Goggin & Newell, 2007). A related stream suggests that socio-cultural barriers in terms of eco-nomic discrimination appears more formidable. Advocates point to the fact that the disabled tend toearn less than the general population due to fewer employment opportunities, making mobile sub-scriptions prohibitively expensive (Baker & Bellordre, 2003; Dobransky & Hargittai, 2006). Logicallyextended, the argument concludes that telecommunications policy should make mobile phones, espe-cially smart-phones and associated services, more affordable to the disabled, either via subsidies ordonations (Baker & Moon, 2008; Sourbati, 2009).

Based on the results of our research, we caution against the indiscriminate optimism inherent insuch advocacy. Application of the biopsychosocial model suggests that management of personal identi-ties and social networks are not without their attendant risks. There are inherent tensions that juxtaposethe empowerment sought from mobile phones with concomitant dependencies that accentuate the con-dition of disability. Identity management using mobile phones may reinforce the standard assumptionof normality based on adopting the identity of a non-disabled person. It is possible that the disabledbecome overly sensitive of differences in face-to-face interactions, making them increasingly dependenton mobile phones, thus internalizing social stigma. Moreover, such mediated interaction may lead to theestablishment of false expectations, leading to future misunderstandings.

Mobility-impaired individuals use mobile phones both for instrumental (e.g. job-seeking) and affec-tive (e.g. contact with relatives and close friends) purposes. The present study confirms earlier researchon disabled people’s confined choices of social ties (Aitchison, 2003; Skär, 2003; Söderström, 2009). Thequality of social ties found resembles prior theorization about strong ties, which consist primarily offamily members, relatives, and friends, with considerable reciprocal services, trust and commitmentspent in the relationships (Granovetter, 1973). While mobile phones provided a valuable tool for socialsupport, especially emotional support for personal well-being, the mobility impaired emphasized com-munication with strong ties. The high density of communication within a closed network of strong tiesmay eliminate possibilities of network expansion to new ties. Simultaneously, an overreliance on mobilephone usage for relationship maintenance purposes can lead to both emotional dependencies and a spa-tial narrowing of social connections to confined choices. We encourage greater critical investigations ofthe role of technology in creating unintended social and psychological consequences that exacerbate theexisting predicament of the disabled.

This study contributes empirical data to the emerging body of research on ICTs for disabled pop-ulations (e.g. Finn, 1999; Houlihan et al., 2003; Seymour & Lupton, 2004; Söderström, 2009). Froma theoretical perspective, the emphasis on the biopsychosocial model is strategic. Despite a plethoraof studies on social cognitive paradigms (Bandura, 1976), the communications field rarely utilizes thebiopsychosocial model, beyond limited application in health communication (Ratzan, Payne, & Bishop,1996). The study of emergent technology from the perspective of physiology finds rare mention in recenttheorizing in the mobile communications field. We encourage the use of theories of the body to supple-ment the established emphasis on psychosocial processes.

The theoretical integration of the biological with psychosocial approaches to disability has beendecried as unlikely within the modernist tradition (McLaren, 1998), and described as unrealistic andunnecessary within the postmodernist one (Shakespeare, 2002). The biopsychosocial model is well estab-lished in the psychiatric field (Tavakoli, 2009), and has received support from investigations in neurolog-ical research (Garland & Howard, 2009). Whether the integration of a physiological perspective, beyondthe limited applicability towards marginalized populations such as the disabled and the unhealthy, ispossible from a communication technology perspective remains to be seen. Nonetheless, redirectingthe frame towards a biopsychosocial approach would attract a new generation of scholars interested inthe integrated theoretical approach, but would also make the discipline relevant to influential external


stakeholders. Reframing the debate around technology and disability as both a sociopsychological andphysiological phenomenon provides an avenue to attract hitherto resources in the form of research influ-ence, funding avenues, and peer recognition.

It is important to categorically state that selection of the biopsychosocial model includes a publicadvocacy stance in addition to advancing an explanatory theoretical model. The objective of theorizingthus includes a need to continue drawing attention and resources made available by the government,medical system, charities, or of other concerned organizations. Further, acknowledging the limita-tions of the biopsychosocial model in terms of the lack of an empirically verifiable model (Epstein& Borrell-Ciarrio, 2005), we argue for deeper examination of the phenomenon with related maturetheories from within the communications field.

Increasingly, interdisciplinary teams in healthcare and policymaking bodies include soci-ologists, urban planners, and others unrelated strictly to the medical profession; for example,patient-communication courses have been established at universities (Epstein & Borrell-Ciarrio,2005). It is time for communication researchers to be included in the debate. Further, such an episte-mological stance would provide proof against claims of the biopsychosocial model being merely ‘anemotive case for more humanity and less technology in medicine’ (McLaren, 1998, p. 89).

Acknowledgements

The authors wish to thank the Society for the Physically Disabled (SPD) and the Singapore CheshireHome (SCH) for aiding in the fieldwork. The study was supported by a grant from the Wee Kim WeeSchool of Communication and Information, Nanyang Technological University, Singapore.

Note

1 See Barnes (1999) for a critique of American scholarship, pointing out the lack of recognition of theextensive tradition of disability research in the UK, and Shakespeare and Watson (2001), in relationto this significant distinction.

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About the Authors

Arul Chib ([email protected]) is Associate Professor at Nanyang Technological University. He wonthe 2011 Prosper.NET-Scopus Award for the use of ICTs for sustainable development, and recentlyreleased a co-edited volume, ‘Linking Research to Practice: Strengthening ICT for Development ResearchCapacity in Asia’.Address: 31 Nanyang Link, WKWSCI Building, #03-08, Singapore 637718.

Qiaolei Jiang ([email protected]) is Associate Professor in the Department of Journalism andCommunication at Dalian University of Technology. Her research areas include the uses and implica-tions of information and communication technologies, public health, globalization, popular culture, andcultural/creative industry.Address: No. 2 Linggong Road, Ganjingzi District, Dalian City, Liaoning Province, China, 116024.Angela, Rasyida, Yi Ting, and Tasneem were undergraduate students at Nanyang Technological Univer-sity, when the study was conducted.


Investigating modern-day Talaria: Mobile phones and the mobility-impaired in Singapore.

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