Design for Well-Being
Co-creating a communication system for a person living with Locked-in Syndrome
November 2025 - August 2026
Individual Project · Master Thesis· Industrial Design Engineering
In collaboration with D’Andrea & Evers Design
A participant living with Locked-in Syndrome is fully conscious but can only move his eyes. For my Master's thesis, I spent nine months co-designing with him and his partner to understand what communication, safety and independence actually mean when every response takes real effort. The result is EyeVox: a gaze-based system that lets him call for help, speak, and express himself independently.
Understanding the Context
Locked-in Syndrome can leave a person cognitively present while severely restricting movement and speech, making eye movement one of the few available ways to communicate. Rather than beginning with a predetermined technological solution, I first explored the participant’s everyday environment, existing communication methods and lived experiences. Literature research, contextual observation, interviews and experience mapping helped uncover how communication was closely connected to autonomy, safety, dignity and participation in everyday life.
Experience Mapping
The participant and his partner kept a one-week daily log for me, which I turned into an experience map covering his routines, emotions, pain points and opportunities. The hardest moments consistently traced back to one thing: being alone and unable to ask for help. That single insight shaped my four design priorities — communication, safety, agency and autonomy.
.png)
Defining the Direction
The research findings were synthesised into underlying values and a set of design requirements that translated the participant’s needs into concrete criteria for the design. Communication remained central, closely connected to autonomy, agency and safety. A key insight was the importance of independently calling for help, which shifted the design direction towards supporting both everyday communication and a greater sense of security.
Exploring Design Directions
A broad range of concepts was explored across physical, digital and gaze-based interaction. The ideas were assessed against the design requirements and the participant’s capabilities, with particular attention to independent use, communication and safety. This process gradually narrowed the direction towards a gaze-based system that could combine communication with independent alarming.
From Research to EyeVox
The selected direction built on the participant’s existing eye-based communication method rather than introducing an entirely unfamiliar interaction. His letterboard structure was translated into a digital nine-area gaze system, allowing selections through directional eye movements alone. Different letter groupings, navigation patterns and interface layouts were explored and refined into the final interaction concept.
EyeVox
EyeVox is a gaze-based communication system designed around the participant’s available eye movements. From the home screen, he can independently activate an alarm, access a gaze-controlled letterboard to compose and speak messages, or use editable expressions for recurring communication. The interaction was designed to remain simple, familiar and usable through directional gaze alone.
Use Evaluation & Iteration
EyeVox was evaluated through two use sessions with the participant and a separate session with design engineers at D’Andrea & Evers Design. The first evaluation confirmed that the participant could independently activate the alarm and directly informed refinements to the interface and feedback. The second session tested the improved prototype, while also revealing that the main limitation was the fit between the eye-tracking setup and the participant’s individual eye movement range. Evaluation with design engineers showed that the interaction principle itself was understandable and usable, helping separate interaction-design issues from hardware limitations and identify clear directions for further development.
Takeaways
The participant and his partner saw EyeVox as a real, promising step forward — especially for independent alarming. My biggest takeaway: assistive design isn't just about enabling communication, it's about restoring safety, autonomy and a sense of control. And none of it would have worked without designing closely with the participant and adapting the process to him, not the other way around.
Reflection
This project changed how I understand participation in design. Working with someone for whom every response requires significant effort made me reconsider what meaningful co-design can look like and how design methods should adapt to the person rather than expecting the person to adapt to the process. Beyond the final system, the project showed how lived experience can reveal priorities that technology-centred approaches may overlook. It strengthened my interest in healthcare and well-being design and reinforced the importance of designing not only for usability, but also for agency, dignity and the ability to be heard.