As designers, we design from a human perspective—a position we cannot change but must critically reflect upon. This workshop addresses this fundamental challenge: the invisible "human norm" in design. While norm-critical approaches have explored norms, the most profound invisible norm is simply our existence as humans. This is particularly significant as we confront environmental crises demanding design beyond human needs. We integrate two complementary approaches: more-than-human design, which challenges the assumption that "human-centeredness" represents a neutral viewpoint, and norm-critical design, which makes invisible norms visible. Our 3-hour workshop engages participants in interactive activities analyzing human norms, shifting perspectives, creating norm-critical prototypes, and sharing reflections. We contribute to design research by offering a novel methodological framework combining these previously separate approaches and providing the crucial first step toward addressing needs beyond humans: making human norms in design visible and subject to critical examination. 

This thesis explores how a norm-critical design approach can support the transformation of norms surrounding child participation in care contexts, with a focus on paediatric and social care. It illustrates how such an approach can generate impact in care contexts if applied in related research and tool development. Since a persistent gap remains between the ambition of increased child participation and its realisation in practice, it poses the questions: How can barriers to child participation in care be understood based on the perspectives of key actors? and How can a norm-critical design approach facilitate a shift in norms related to child participation in care, design, and research contexts? Rooted at the intersection of design, critical theory, and health science, the thesis applies a sociotechnical perspective on participation. It compiles five qualitative studies involving children and young adults, parents, care professionals, nursing students, and nursing teachers. Together, the studies provide practical insights into how design can counteract exclusionary norms and structures in care, design, and research contexts—contexts that are still largely defined by adult-centric and biomedical paradigms. The results underscore the importance of enabling children's voices when shaping the systems meant to support them, and putting the spotlight on norms, situated perspectives, and power positions when designing for participation. The comprehensive understanding includes a theoretical model visualising the role of norm-critical approaches in norm change and suggests four ways for design to facilitate norm transformation. While norm-critical design approaches have previously not been used to address the issue of child participation in care, this thesis shows great potential for such approaches to generate impact in care contexts if applied in related research and tool development. 

This study addresses the knowledge gap concerning whether and how digital support tools can amplify children’s perspectives in care contexts while counteracting adult-centric and healthcare-grounded norms. Acknowledging the influential role and power position of care professionals, this paper explores 11 professionals’ perceptions of how a digital communication tool affected child participation in pediatric and social care meetings. Professionals’ narratives were analysed from a socio-technical perspective using Interpretive Description. We found that the tool’s affordances and materiality were perceived to improve the participation conditions for some children, though not all. In cases where professionals felt the tool helped facilitate participation, they described how conversing through the tool influenced topics, meeting dynamics, and parental involvement. Based on these experiences, professionals identified shortcomings in current approaches and practices, expressed an increased openness toward new tools, and ideated alternative ways of working. We discuss how design, affordances, and materiality were perceived to facilitate immediate participation, and what implications these experiences may have for norm transformation in care contexts over time. The insights can inform designers and care professionals aiming to enhance child participation in care settings. © 2025 Teleman, Isaksson, Nygren, & Svedberg.

Engaging individuals with lived experience in research and design without incorporating critical perspectives on norms in knowledge production may result in tokenism and disempowerment. This scoping review pulls together method contributions from 38 recent health-related studies that involved children or young people in marginalized or vulnerable positions, to assist researchers and designers in methodological decisions and planning. We explore participation levels and norm-critical aspects of the studies and map their rationales for participation, theoretical frameworks, output types, and participatory tools. The analytical framework was based on youth participation models and literature in norm-critical innovation and critical participatory and health-related research. Patterns and variations in participation levels and norm-critical aspects are discussed in relation to the studies’ methodological differences and the ages of participants involved. We illustrate where high levels of both participation and norm-critical aspects were found and what signified these studies. © The Authors

Background: This study aims to fill the existing knowledge gap concerning the potential of support tools to amplify child perspectives and foster a more person-centred approach to children’s care. Digital tools have been posited as advantageous in facilitating children’s participation, and norm-critical design perspectives hold promise in enhancing inclusiveness within such support tools. This involves counteracting adult-centric and biomedical norms. Such perspectives also entail a shift in emphasis from solely addressing individual barriers to critically examining prevailing structures and contextual norms. Methods: Acknowledging the influential role and power position of care professionals, our paper explores 11 professionals’ perceptions of how one digital support tool affected child participation in paediatric and social care meetings. Professionals’ narratives were analysed from a socio-technical perspective. Results: We found that different aspects of the tool’s design and materiality were perceived to improve the participatory conditions for some children but not all. In cases where professionals experienced that the tool facilitated participation, it was described how redistribution of control affected conversation topics, meeting dynamics, and involvement from guardians. Based on these experiences, professionals identified shortcomings in current approaches and practices. They expressed an increased openness toward new tools and proposed ideas for alternative ways of working. Implications: The results strengthen arguments about the importance of offering children different means of participation. We discuss what properties of the tool were perceived to facilitate instant participation, and also what implications such experiences may have for norm transformation in care contexts over time. The insights can help designers and care professionals aiming to nudge participation for children in care contexts.

Background: To enhance person-centered approaches for youths within care contexts, developments must engage individuals with lived experience. There is a risk that the perceived intricacies of engaging vulnerable youths deter researchers from including them. Despite the expanding body of health-related research involving young individuals, the utilization of pathogenic methodologies and traditional research methods risk excluding marginalised youth and preserving biases in knowledge production. Among these youth, some face multiple marginalization and without norm-critical perspectives their involvement could lead to tokenism and disempowerment. Hence, there is a need for inclusive, adaptable research tools. Objective: To assist researchers in making methodological decisions, this study pull together method contributions from recent health-related research and design projects that involved marginalized or vulnerable youth in a range of fields. We explore participation levels and norm-critical aspects and maps the rationales, outcomes, and tools. Methods: An interpretive scoping review was conducted. 508 studies were identified by searching six databases, and 38 were included for analysis. An analytical framework was created based on Hart’s Ladder of Participation and literature in critical participatory and health-related research. Results: The studies represented 18 different disciplines. 11 to 15-year-olds were most likely to be involved. A great variation in tools and materials was observed, where visual material was used in 20 out of 38 studies (of which 13 used Photovoice). Participation levels were not directly related to tool types. Rather, high levels of participation were often found where norm-critical aspects were largely reflected. Studies that developed tools, interventions or services reached lower scores for participation levels and norm-critical aspects compared to studies that aimed for a general understanding of target group perspectives. While many studies stressed their method contribution, few compared or critically reflected on their choice of tools. Furthermore, studies differed in their acknowledgement of participants’ expertise and contributions.

Background: There is a gap between ambitions regarding child participation in care contexts and actual practices, partly due to a lack of supportive tools. Children’s influence is determined by structures, technology, and norms within these sociotechnical settings but there is a knowledge gap on how novel digital tools might counteract excluding norms and empower children to make their voices heard.

Purpose of the Study: Based on interviews with professionals this study aims to understand how digital communication support tools influence norm-transformation related to child participation in care contexts.

Methods: The study had an explorative design with a Constructivist Grounded Theory methodology. Professionals (n=11) in healthcare and social services (7 professions represented) that had tested a digital communication support tool with children in their practice were interviewed about child participation and their experiences of introducing the support tool.

Findings: Data patterns indicate that when the tool was added into the context, dynamics changed. The professionals experienced that the tool both had an influence on the participation of the child and changed their own perspectives on participation and their own role in relation to child participation. The perceived gains for children from using the tool were related to access and autonomy.

Conclusion: The study adds knowledge on how digital communication support tools may influence child participation norms and professional’s perspectives on participation in care contexts.

Background: An increase in the demand for child participation in health care requires tools that enable and empower children to be involved in the co-production of their own care. The development of such tools should involve children, but participatory design and research with children have challenges, in particular, when involving children with disabilities where a low level of participation is the norm. Norm-creative and participatory approaches may bring more effective design solutions for this group. “Personas” is a methodology for increasing user perspectives in design and offers representation when users are absent. However, research on participatory persona generation in this context is limited.

Objective: The objective of this study was to investigate how norm-creative and participatory design approaches can be integrated in a persona generation method to suit children with disabilities in the design of games for health that target this group.

Methods: The method development involved interview transcripts and image-based workshops. Sixteen children with various disabilities participated in persona generation through co-creation of characters and scenarios. The results from the workshops were validated together with 8 children without disabilities, 1 young adult with a disability, and 1 rehabilitation professional. A qualitative thematic design analysis was iterated throughout the process.

In order to develop suitable support for participation in pediatric rehabilitation, it is important to understand what barriers need to be bridged from the perspectives of both children and adults. The aim of this study was to explore barriers to participation in pediatric rehabilitation services, according to children and young people with disabilities, parents to children with disabilities, and professionals. Data was collected in individual interviews (n = 48) and focus groups (n = 8), which were analyzed with qualitative content analysis to extract barriers to participation. Identified barriers include three categories: (1) insufficient access (controlling adults, adult-centered healthcare); (2) insufficient trust (low level of trust in adults, low level of trust in children, low self-confidence in children); and (3) insufficient involvement (norms of non-participation, low level of commitment in children). The participant groups had divergent conceptions of where and how barriers originate, and for what situations child participation is appropriate. Adult-centered healthcare and parental presence were described as barriers by all participant groups. Understanding differences in the perceptions of barriers and their origins is crucial when striving to change norms of non-participation. The findings can inform the development of new support tools and participatory formats in pediatric rehabilitation. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.