Ability + Motivation: Understanding Factors that Influence People with Cognitive Disabilities in Regularly Practicing Daily Activities
Varsha Koushik, Shaun Kane · 2023 · Proceedings of the 20th International Web for All Conference (W4A) · doi:10.1145/3587281.3587295
Summary
This paper investigates the factors that influence people with cognitive disabilities in regularly practicing daily activities, focusing on the interplay between ability and motivation. The researchers conducted 90-minute remote participatory design interviews with 13 participants — six adults with cognitive disabilities (intellectual and developmental disabilities, learning disabilities, autism, or ADHD), five caregivers, and two parents — aged 25 to 58. All individuals with cognitive disabilities lived in community homes with staff support or with a parent and received services from organizations supporting adults with cognitive disabilities. Using Mural, an online collaboration tool, participants categorized their daily activities across three dimensions: frequency (routine to never), motivation (like it to don't like it), and difficulty (easy to difficult). The study addresses a gap in existing prompting systems — technologies that provide stepwise guidance for daily tasks — which currently focus on addressing specific accessibility obstacles but lack capabilities to customize support for diverse needs or integrate motivational strategies. With the growing adoption of smart home devices like voice assistants and smart appliances, there are new opportunities to design context-aware prompting systems that support both accessibility and motivational needs without requiring users to switch context to a separate device.
Key findings
The study revealed that both ability and motivation are significant barriers to regular practice, but their relationship is more complex than existing goal-setting theories suggest. Critically, activities with low inherent motivation (like brushing teeth, cleaning, or laundry) often become routines because they are essential for independent living — contradicting behavioral models that predict low-motivation activities won't become habitual. Conversely, high-motivation activities (like art or cooking) may not become routines due to accessibility barriers, lack of staff support, or limited assistive devices. Ability barriers included difficulties tracking progress through multi-step tasks, struggling with proportions and quantities, and challenges understanding timer displays. Caregivers use scaffolded prompting strategies that progress from reminders to verbal prompts to demonstrations to physical assistance, adjusting based on each individual's current abilities. The "anchoring" or "first-then" strategy — linking disliked activities with liked ones — emerged as an effective motivational technique used across the community. Positive reinforcement through social interactions and appreciation was a powerful motivator. The meaning of "difficulty" itself varied significantly: for some it meant inability to do activities independently, while for others it meant discomfort during shared activities with caregivers.
Relevance
This research provides essential design guidance for developers creating assistive technologies for people with cognitive disabilities. The key insight — that motivation and ability interact differently for this population than standard behavioral models predict — means that prompting systems cannot simply rely on making tasks easier or more rewarding. Future smart devices should integrate personalized scaffolds that adapt prompting intensity based on individual ability levels, incorporate motivational features like anchoring and positive reinforcement, and support multi-user roles where caregivers can customize and review prompts. The participatory design methodology offers practical lessons for including people with cognitive disabilities in research: offering both self-design and proxy-design options, adapting methods on the fly for different communication abilities, and using structured choice-based activities. For organizations deploying assistive technology in community living settings, the findings underscore that technology must complement rather than replace the nuanced, relationship-based support that caregivers provide.
Tags: cognitive accessibility · cognitive disabilities · daily living activities · prompting systems · smart home · independent living · participatory design · caregivers