A Systematic Review of Technical Accuracy versus Social Utility in Assistive Technologies

This systematic review synthesizes evidence from 29 peer-reviewed studies published between 2008 and 2025 to evaluate the real-world effectiveness of assistive technologies for the Deaf and Hard-of-Hearing (DHH) community. Although recent advances in artificial intelligence, computer vision, and wearable sensing have produced recognition accuracies exceeding 90% under controlled laboratory conditions, substantial challenges remain in practical deployment. Using a tripartite effectiveness framework, the review found that only one technology was Currently Effective for real-world use, whereas 25 studies were classified as Effective with Further Development because of their dependence on controlled environments. The analysis also identified a significant communication imbalance: most technologies support one-way translation, while only three studies proposed truly bidirectional systems. Furthermore, limited participation of native Deaf signers in the design process often reduced usability and cultural acceptance. These findings highlight the need for user-centered, participatory design, long-term real-world evaluation, and bidirectional communication technologies to achieve meaningful accessibility and social inclusion.