Designing an App to Help Individuals with Intellectual and Developmental Disabilities to Recognize Abuse
Thomas Howard, Krishna Venkatasubramanian, Jeanine L M Skorinko, Pauline Bosma, John Mullaly, Brian Kelly, Deborah Lloyd, Mary Wishart, Emiton Alves, Nicole Jutras, Mariah Freark, Nancy A. Alterio · 2021 · The 23rd International ACM SIGACCESS Conference on Computers and Accessibility (ASSETS 2021) · doi:10.1145/3441852.3471217
Summary
This paper presents the design of Recognize, a mobile app intended to teach individuals with intellectual and developmental disabilities (I/DD) how to identify and report abuse. The work addresses a critical safety issue: abuse of people with I/DD is at epidemic proportions in the US, yet reporting is severely lacking because individuals often do not know what constitutes abuse or how to report it. The app's content is based on the Awareness and Action (A&A) abuse prevention training curriculum developed by Massachusetts Advocates Standing Strong (MASS), a self-advocacy organization whose training has been shared with over 75 organizations across 46 US states. The research team was deliberately diverse, including three self-advocates with I/DD who are experienced A&A training instructors (design team 1) and four HCI and psychology researchers (design team 2). The co-design process involved design team 2 creating initial design concept vignettes — implemented as interactive HTML/JavaScript prototypes — which design team 1 then evaluated, critiqued, and refined. Six design concepts were explored across two categories: learning (static content, video-based material, skills-development activities, and quiz-based material) and engagement (motivation through a virtual friend character, and grounding activities for emotional self-regulation). Based on the co-design findings, three implementation prototypes were built in Dart/Flutter, each presenting the same lesson on sexual abuse but using different primary learning modalities.
Key findings
The co-design process produced six key recommendations. For learning: static content is necessary for context but insufficient alone; video interaction must be easy to understand (breaking videos into short clips rather than long continuous segments); skill development activities must avoid triggers (emotion identification was rejected as potentially frightening, while body parts identification and money counting were approved); and quizzes should be optional practice tools, not primary learning methods. For engagement: motivational elements must never penalize users (the virtual friend concept of becoming unhappy over time was unanimously rejected — rewards should only accumulate, never diminish); and grounding activities should be user-controlled in duration and availability. A qualitative evaluation with six participants with I/DD who are themselves instructors found that interactive versions (video-based and skills-based) were strongly preferred over static slides. All participants felt the app was viable for self-learning and would recommend it to their students for use every 1-2 days. Participants also identified an unexpected use case: the app could serve as evidence when reporting abuse, helping individuals with I/DD communicate what happened to them and be believed — addressing the systemic problem that their voices are often discounted.
Relevance
This paper demonstrates exemplary inclusive design practice by centering people with I/DD as co-designers and expert evaluators rather than passive research subjects. The co-design methodology — building trust over 1.5 years, including self-advocates giving lectures in researchers' classes and teaching yoga during pandemic meetings — offers a model for genuine participatory research with people with cognitive disabilities. For accessibility practitioners, the design recommendations are broadly applicable to any app targeting users with I/DD: use interactive multimedia rather than static text, never design motivational systems that can punish users, include self-regulation tools for emotionally difficult content, keep quizzes optional, and provide clear corrective feedback. The finding that the app could facilitate abuse reporting — not just education — highlights how technology can empower people with I/DD to advocate for themselves within systems that often dismiss their experiences. The work addresses a neglected intersection of accessibility and safeguarding that has life-and-death implications for a vulnerable population.
Tags: intellectual disability · developmental disability · co-design · abuse prevention · mobile app · self-advocacy · e-learning · empowerment · safeguarding
Standards referenced: IDEA Act · Americans with Disabilities Act