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Bigger than the EAR BOX: A Theory-Grounded Review of XR Accessibility Research for Deaf and Hard of Hearing Communities
Shuxu Huffman, Michaela Okosi, Jose Merino, Tifanie Bouchara, Abraham Glasser, Christian Vogler, Raja Kushalnagar
TL;DR
XR accessibility research involving DHH communities has been studied less for its underlying assumptions than for its technologies. This paper develops a theory-grounded framework and applies it to 53 ACM studies, finding frequent communication support within hearing-default environments alongside limited attention to DHH diversity.
Problem
Prior work leaves the assumptions shaping XR accessibility research involving DHH communities insufficiently examined.
Method
The authors combine Disability Studies, Deaf Studies, and DeafSpace into four analytical dimensions and apply them to 53 ACM-published XR studies.
Results
Translation dominated the corpus at 60.4% (32/53), while 9.4% (5/53) explicitly described hearing researchers’ positionality and connections with DHH communities.
Takeaways & Limitations
The review identifies directions for moving beyond deficit-oriented framings, redistributing accessibility labor, and using XR space to support Deaf-centered interaction.
Takeaways & Limitations
The corpus is limited to selected ACM venues and is better suited to Deaf-centered communication research than work involving DHH users who do not primarily use sign language or identify with Deaf culture.
Abstract
from arXiv · showhide
Extended Reality (XR) technologies have received growing attention in accessibility research involving Deaf and Hard of Hearing (DHH) communities. Yet less attention has been given to the assumptions shaping this work. We present a theory-grounded review of XR research involving DHH users. Drawing on Disability Studies, Deaf Studies, and DeafSpace, we develop a theoretical framework with four analytical dimensions: orientation toward access, distribution of responsibility, conceptualization of DHH communities, and spatial and perceptual assumptions. We apply this framework to 53 XR studies involving DHH users, identified through a search and screening of ACM publications from 2015 to 2025. Our analysis shows that XR accessibility is frequently framed as supporting communication within hearing-default environments, while overlooking the diversity of DHH communities. We identify directions for redistributing accessibility labor and reconfiguring space, and offer our framework as a tool for future XR research involving DHH communities.
1 Introduction
This paper examines how XR research involving DHH communities conceptualizes access, users, and space. It combines Disability Studies, Deaf Studies, and DeafSpace to review 53 ACM papers and identify recurring assumptions and directions for Deaf-centered accessibility.
- Motivation: The review asks whether communication-centered accessibility patterns recur or change in XR, where immersive interaction makes spatial organization especially consequential.Prior DHH accessibility research often centers real-time captioning and signing avatars.
- Approach: The authors combine Disability Studies, Deaf Studies, and DeafSpace to analyze how XR research defines access and engages DHH communities.The review covers 53 ACM-published XR papers involving DHH populations from 2015 to 2025.
- Contributions: The paper contributes a theory-grounded framework, a structured analysis of 53 papers, and directions for moving beyond deficit framings and redistributing accessibility labor.It also proposes using XR’s spatial affordances to support Deaf-centered interaction.
- Terminology: DHH is used as an umbrella for heterogeneous groups whose relationships to hearing status, language, technology, and community membership are not interchangeable.The category includes Deaf signers, hard of hearing individuals, late-deafened adults, and primarily spoken-language users.
2 Related Work
Prior reviews describe which DHH accessibility topics receive attention, while critical reviews examine the assumptions shaping accessibility research. This paper extends those approaches to XR research involving DHH communities through a theory-grounded framework.
- Descriptive Reviews: Earlier accessibility reviews documented field-level trends, but left open how XR research understands access, users, and interaction.They identified topics and populations receiving attention while also revealing under-examined questions about conceptualization.
- Critical Reviews: Critical reviews have shown that accessibility research can reproduce deficit-oriented, ableist, or exclusionary assumptions about populations and technology.Examples include aging research framing aging as a problem to manage and robot-interaction studies excluding autistic perspectives.
- Critical Reviews: Theory-grounded and critical approaches have informed design guidance and analyses of captioning and virtual-reality accessibility.These approaches combine interdisciplinary perspectives to interrogate how accessibility is conceptualized.
- Research Gap: Such approaches had not been systematically applied to XR research involving DHH communities before this review.The paper addresses this gap by combining Disability Studies, Deaf Studies, and DeafSpace.
3 Theoretical Framework
The framework combines Disability Studies, Deaf Studies, and DeafSpace to examine access as relational, DHH communities as heterogeneous, and XR as spatially organized. It directs attention to responsibility, communication, identity, perception, and interaction.
- Framework Overview: The framework derives four analytical dimensions: orientation toward access, distribution of responsibility, conceptualization of DHH communities, and spatial and perceptual assumptions.These dimensions guide the interpretive review of XR research involving DHH communities.
- Disability Studies: Disability Studies treats access as socially and relationally produced through environments, technologies, institutional arrangements, design decisions, and power relations.This perspective rejects locating disability solely in impaired bodies or treating access as a technical add-on.
- Deaf Studies: Deaf Studies frames DHH users through overlapping dimensions of communication, identity, culture, language, and embodied experience rather than hearing loss alone.It treats sign languages as full natural languages and extends access to linguistic rights and culturally grounded interaction.
- DeafSpace: DeafSpace treats space as structuring attention and communication through visual awareness, gaze, movement, proximity, and spatial orientation.Its principles extend to XR, where camera placement, avatar positioning, visual hierarchy, and interaction flow organize fields of view and attention.
- Distribution of Responsibility: The framework examines whether access-related labor such as setup, calibration, interpretation, and coordination falls mainly on DHH users or is distributed across systems and institutions.It also considers whether communication needs are supported during research participation through sign-language communication, interpreters, or other arrangements.
4 Methods
The review builds an ACM-centered corpus of XR research involving DHH users, then analyzes it deductively using theory-derived dimensions and a structured coding scheme. Screening covered multiple publication formats and produced an initial corpus of 206 papers.
- Review Design: The literature review first constructs a corpus of XR research involving DHH users and then conducts a structured analysis using four theoretical dimensions.The two-stage process separates corpus construction from interpretive analysis.
- Corpus Construction: The search covered peer-reviewed ACM Digital Library publications from January 2010 to January 2026 involving XR technologies and DHH users.The ACM boundary was chosen to provide a coherent, high-density HCI, accessibility, and interactive-computing corpus.
- Corpus Construction: The search combined DHH-related terms such as “deaf,” “hard of hearing,” and “sign language” with XR terms including virtual reality, augmented reality, and smart glasses.The review also included early-stage publication formats such as demos, posters, and short papers.
- Screening: Three authors independently screened the initial corpus, with each paper reviewed by at least two authors and disagreements reconciled through discussion.Eligibility required XR involvement and engagement with DHH users or Deaf-related communication practices.
1. Orientation toward Access
The section records classifications related to who bears responsibility for access, including system-supported and socially situated support.
- Access responsibility is classified across user-borne, system-supported, and socially situated forms.
2. Distribution of Responsibility
The section concerns how DHH communities are conceptualized, including sensory-impairment and cultural or linguistic framings.
- DHH communities are considered through sensory-impairment and cultural or linguistic framings.
4. Spatial and Perceptual Assumptions
The review uses a deductive, theory-informed analysis of a final 53-paper corpus, with four pre-established dimensions guiding structured reading and team synthesis. Coding calibration produced substantial inter-rater agreement, while the authors’ positionality includes primarily DHH researchers and one hearing collaborator.
- Corpus construction: The final corpus contains 53 papers after excluding studies that did not substantially involve XR or DHH users and duplicate project publications.
- Analytical approach: Four theory-derived analytical dimensions guided structured reading of how access, responsibility, DHH communities, and space were conceptualized.
- Coding calibration: Three authors independently coded four papers, refined category interpretations, and achieved a Krippendorff’s Alpha of 0.795, indicating substantial agreement.
- Team synthesis: Weekly meetings and iterative collective review were used to resolve disagreements, align interpretations, and synthesize corpus-wide patterns.
- Researcher positionality: The team is primarily composed of DHH researchers, with one hearing collaborator and communication primarily through ASL and written English.
5 Results
Across 53 XR studies, translation dominates accessibility framing, while studies often center hearing-default communication, underreport researcher positionality and accommodations, and treat DHH communities as homogeneous. Other studies recognize variation in preferences, but methodological assumptions can disrupt everyday access strategies.
- 5.1.1 Access Framing: 60.4% (32/53) of papers used translation, compared with 17.0% (9/53) sensory substitution and 22.6% (12/53) spatial reconfiguration.
- 5.1.1 Access Framing: XR systems often facilitate communication for hearing non-signing interlocutors rather than reciprocal interaction for DHH users.
- 5.1.3 Research Practices: Only 22.6% (12/53) of papers explicitly reported researcher identity, sign-language fluency, or relationships with DHH communities.
- 5.1.3 Research Practices: 9.4% (5/53) of papers explicitly described hearing researchers’ positionality and connections with DHH communities.
- 5.2 Responsibility Allocation: Accessibility commonly requires DHH users to adopt extra tools, monitor translated information, or manage breakdowns in hearing-majority environments.
- 5.2.2 Methodological Practices: Among 39 studies reporting DHH user studies, 35.9% (14/39) reported communication accommodations such as interpreters or CART.
- 5.3 Conceptualization of DHH Communities: DHH users were often treated as homogeneous, with studies assuming uniform hearing, reading, captioning, or sign-language needs.
- 5.3 Conceptualization of DHH Communities: Other studies found that sound-awareness preferences vary across DHH users and may serve only a subset of the community.
6 Discussion
The discussion argues that XR accessibility often centers communication within hearing-default environments, while a theory-grounded approach supports more diverse DHH communities, shared access labor, and spatial reconfiguration.
- 6.1 Communication Equity: Beyond Communication Access: The review suggests that framing deafness as a communication deficit narrows XR accessibility toward communication mediation and hearing-default interaction.This framing can position XR as repairing communication with hearing systems rather than supporting broader interaction on DHH communities’ own terms.
- 6.1 Communication Equity: Beyond Communication Access: DHH communities should be treated as linguistically and culturally diverse, with access needs varying by language, hearing status, technologies, partners, and task context.The discussion calls for configurable access ecologies rather than a single default DHH-user profile.
- 6.2 Access as Shared Responsibility: Accessibility labor is often assigned disproportionately to DHH users, including configuring systems, monitoring information streams, and managing communication breakdowns.The paper connects this distribution of labor to assumptions about who is expected to adapt.
- 6.2 Access as Shared Responsibility: The authors propose distributing access responsibilities across users, institutions, infrastructures, designers, and broader communication ecosystems, while recognizing resistance from hearing participants.Examples include live sign-language narration and accessibility design in public exhibits, but shared responsibility may require additional effort from hearing interlocutors.
- 6.3 (Re)Imagining Access through Deaf Possibilities: XR can support DeafSpace-inspired interaction by dynamically restructuring space, attention, gaze, and interaction flow rather than merely overlaying communication aids.Because XR is a space-building technology, it can reconfigure interaction spaces beyond the fixed constraints of physical architecture.
- 6.4 Limitations: The framework redirects XR accessibility toward supporting different ways of being, but its interpretations emphasize American Deaf cultural perspectives and signed, visually oriented communication.The authors also bound their review to selected ACM venues, so findings describe patterns within that corpus rather than the entire XR field.
7 Conclusion
The paper develops a theory-grounded framework from Disability Studies, Deaf Studies, and DeafSpace, using four dimensions to analyze 53 ACM XR studies involving DHH communities.
- The framework combines Disability Studies, Deaf Studies, and DeafSpace into four analytical dimensions for examining XR research involving DHH communities.
- Applied to 53 ACM-published XR studies, the framework identifies recurring patterns in how access, users, and interaction are framed and practiced.
AI Use Statement
Generative AI supported keyword extraction for part of the dataset, while the research team retained responsibility for coding, analysis, interpretation, and writing.
- Generative AI supported keyword extraction from a portion of the dataset but did not generate codes or themes.
- The research team made and validated coding decisions through calibration, cross-review, and consensus.
- The authors retained responsibility for the analysis, interpretation, and manuscript writing.