Co-creating a Conversation Skills Game With Young Adults With Intellectual Disabilities

Start with your focal population's own expertise, not with a blank page. Before writing a single game scenario, we asked young adults with IDD, individually, what games they already loved and why. We heard preferences such as “I like games where you can be creative” and “I don’t like it when there are a lot of rules, and it takes a long time to get into the game.” These answers pointed toward group-based, hands-on play with clear roles and steady pacing, preferences that shaped the game's structure long before anyone drafted a single card.

Let personal experience write the content. Two focus groups turned youth’s stated preferences into substance, walking participants through the stages of a real conversation and asking where things become difficult. One person shared, “As someone who has a stutter, and I have a disability, sometimes it can be hard to talk to people that I don't know.” Another said, “I struggle with getting overstimulated and trying to avoid a meltdown, and I cover my ears because it’s too loud and people think I’m being rude. So maybe a question about what to say to a person who thinks you’re being rude.” Youth repeatedly mentioned direct communication, self-advocacy, and boundary-setting, so we made these the core skills the game teaches. When participants later voted on which stage (starting, maintaining, or ending a conversation) felt hardest, maintaining won by a clear margin—reshaping where the game places emphasis.

Test early, test often, and revise along the way. Four rounds of hands-on testing came next, each resulting in substantive revisions. Accessibility barriers surfaced in early sessions, including dense text, low contrast, and limited support for varying literacy levels. Those findings led directly to larger text, simplified instructions, and guidance to have facilitators read cards aloud instead of relying on players to read for themselves. Later rounds refined the gameplay itself, including a new discussion prompt to ask players why they chose the card they did. One participant reflected that the prompt "made [the game] feel more like a group activity." And participants didn't stop at reacting to what we built. One spontaneously proposed a "wild card" option to write a custom response instead of choosing from the deck—an idea we’re now building into the next version of the game.

Too often in program design or research, involving a population means asking for their reaction to something that’s already been built: a survey at the end or a focus group responding to decisions that have already been made. Technically, that's participation. We prioritized something different and more authentic—a decision perhaps exemplified by our adoption of a participant’s proposal to customize gameplay to meet their own needs and preferences.

The phrase "Nothing About Us Without Us" doesn’t mean soliciting more voices to weigh in after decisions have been made, but rather giving young adults with IDD real authorship over the tools meant to serve them. Our game will be more accessible as a result, but it's also a better game, shaped by ideas no program development and research team would have arrived at on their own.