That is because he is an art director for marketing. Art directors prefer to sketch physically or/and digitally from scratch. It is a stressful job, but you have to LOVE it with passion. He created a visual concept like you saw his Alexa sketches. What he does is a storyboard. Web developers or engineers design/code his storyboard and turn it into the webpages you see online.Alexa is not deaf friendly, not sure why it was mentioned in the video?!