From Function to Meaning: Co-Designing Bodily Extensions with Children with Congenital Upper Limb Difference. A Play-Based Participatory Approach to Identity, Agency, and Prosthetic Meaning Making

Designing bodily extensions for children with Congenital Upper Limb Difference (CULD) requires attention not only to functional interaction but also to identity, agency, and lived social experience. While Universal and inclusive design frameworks provide important foundations for accessibility and participation, general design principles may not fully capture the highly situated, experiential, and imaginative perspectives involved in personalised assistive technologies for children. This paper presents a qualitative Research through Design study exploring a participatory, play-based approach [1,2] to co-designing upper-limb bodily extensions with children and their parents, followed by an exploratory development phase involving engineering collaborators. The study introduces a structured role-play framework positioning children as primary knowledge holders and decision-makers within the design process. Two 2.5-hour workshops were conducted in Katowice and Warsaw, Poland, involving 10 children aged 4-9 and 11 parents. Participants were recruited through the "In Our Hands" Facebook parent-support group for families of children with upper-limb differences. Across workshops conducted in Poland, children engaged in storytelling, drawing, role-play, and hands-on making to explore bodily extensions as part of their lived and imagined worlds. Findings suggest that structured role-play enabled children to integrate emotional, functional, and symbolic dimensions within unified design expressions, framing bodily extensions as identity-related and expressive artefacts rather than purely corrective tools. The approach also supported more reflective parental engagement and, during the subsequent engineering phase, provided collaborators with insights into the affective and social dimensions of children's assistive technology preferences. The study argues that bodily extensions can be understood as meaning-making artefacts that participate in identity construction. It proposes a participatory framework [1,2] that complements inclusive design through structured role-play, narrative framing, and child-led co-creation.