Designing cognitive remediation games for individuals with schizophrenia reveals significant variability in cognitive abilities among participants. User testing demonstrated that traditional difficulty settings are inadequate, as some players excelled while others struggled with fundamental tasks. Effective game design necessitates real-time adaptive systems that adjust to player performance, ensuring those who advance quickly can progress accordingly while offering additional support to those facing challenges. Assumptions about gaming literacy must be reconsidered to accommodate diverse cognitive profiles and prevent disengagement among both high and low-ability users.
During our user testing sessions, I watched one participant solve complex spatial puzzles in under ten seconds while expressing frustration that the game wasn't challenging them enough.
Both users had the same diagnosis. Both were part of our target demographic. But their cognitive strengths and challenges were completely different.
You can't design three difficulty settings and call it accessible. Instead, you need systems that automatically adapt in real time based on user performance.
If someone breezes through the first five levels, the algorithm should immediately jump them ahead. If someone struggles with basic interactions, the system needs to provide more scaffolding without making them feel patronized.
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