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Inclusive and Collaborative Exergame for Adults With Intellectual and Developmental Disabilities: Development and
Chiara Piazzalunga1, Samuele Ravazzani1, Alberto Romano2
1Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Lombardy, Italy.
JMIR Serious Games
|July 31, 2026
Summary
This study developed an inclusive exergame, Elemental, co-designed with individuals with intellectual and developmental disabilities (IDDs). Personalized features and tailored support eliminated performance disparities in heterogeneous groups, fostering equitable and enjoyable collaboration.
Area of Science:
- Human-Computer Interaction
- Inclusive Design
- Rehabilitation Technology
Background:
- Individuals with intellectual and developmental disabilities (IDDs) experience challenges in social inclusion due to cognitive and social skill differences.
- Existing video games often fail to provide equitable multiplayer experiences for diverse user groups, particularly those with IDDs.
- Exergames present a potential avenue for promoting inclusion, physical activity, and social engagement, but require accessible design.
Purpose of the Study:
- To co-design and develop an inclusive, collaborative, real-time multiplayer exergame named Elemental.
- To assess the usability, impact of accessibility features, and player satisfaction and enjoyment of the developed exergame.
- To investigate if personalized accommodations can eliminate performance disparities among heterogeneous groups of players with IDDs.
Main Methods:
- The exergame Elemental was co-designed using the CeHRes Roadmap, involving diverse stakeholders including individuals with IDDs.
- Two cooperative minigames, Igloo and Volcano, were developed with customizable facilitation options for sensory, cognitive, and motor needs.
- A two-phase study involved young adults with IDDs using various input devices and personalized accommodations, with data collected on performance, behavior, and satisfaction.
Main Results:
- In initial sessions (Igloo), performance correlated negatively with intellectual disability severity, while reaction time correlated positively.
- In later sessions (Volcano), tailored support (personalized facilitations and optimal devices) eliminated performance disparities in heterogeneous groups.
- Behavioral analysis indicated frequent peer collaboration, and participants reported high usability and satisfaction with the exergame.
Conclusions:
- Elemental, an inherently accessible exergame, was successfully co-designed and demonstrated the effectiveness of inclusive design principles.
- Personalized features and accommodations can effectively eliminate performance disparities, enabling equitable participation for individuals with diverse abilities.
- This approach shifts towards designing digital environments that embrace diversity, transforming activities into inclusive and enjoyable collaborative experiences.
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Intellectual Disability
Intellectual disability (ID) is a neurodevelopmental condition characterized by deficits in intellectual and adaptive functioning that manifest during the developmental period. This condition encompasses challenges in reasoning, memory, problem-solving, and learning, accompanied by impairments in everyday life skills, such as communication, self-care, and social interactions. Intellectual disability affects approximately 1% of the population in the United States, impacting an estimated 5...
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Learning disabilities are cognitive disorders caused by neurological impairments that affect cognitive functions like language and reading, without indicating overall intellectual or developmental challenges. These disabilities differ from global intellectual or developmental disabilities as they are limited to distinct cognitive functions. Common learning disabilities include dysgraphia, dyslexia, and dyscalculia, each of which impacts unique aspects of learning.
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