From Dyad to Triad: Eliciting XAI Requirements in Stroke Rehabilitation

Abstract

Eliciting explainable AI (XAI) requirements from stroke survivors presents a methodological challenge with direct implications for the design of trustworthy brain-computer interfaces for rehabilitation. How can patients and caregivers articulate preferences about algorithmic transparency when they lack conceptual frameworks for explainability, and when standard elicitation approaches are structurally inadequate for users with acquired communication disorders? We present a video-based scaffolding protocol for XAI requirements elicitation, developed and piloted in a rehabilitation context. In a formative study with three stroke survivors (two with moderate-to-severe aphasia) and three caregivers, facilitators employed four scaffolding approaches alongside the videos: 1) analogical bridging mapping AI states to familiar systems, 2) projective personas depersonalising sensitive topics, 3) binary forcing reducing cognitive load, and 4) extended response time. These approaches successfully surfaced heterogeneous, sometimes conflicting XAI needs across participants. Reflexive analysis additionally revealed three systematic facilitation biases, namely, normative bias, hypothesis confirmation bias, and presence effect, where scaffolding inadvertently shaped responses. We present these as protocol risk guidelines for practitioners. Together, the protocol and guidelines constitute a reusable methodological contribution for eliciting patient-facing XAI requirements in rehabilitation, arguing that such elicitation is a necessary prerequisite for trustworthy human-machine systems design, not an optional preliminary.