{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,12]],"date-time":"2026-07-12T11:23:38Z","timestamp":1783855418214,"version":"3.55.0"},"reference-count":51,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T00:00:00Z","timestamp":1762992000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Computers"],"abstract":"<jats:p>Providing equitable, high-quality education to all children, including those with intellectual disabilities (ID), remains a critical global challenge. Traditional learning environments often fail to address the unique cognitive needs of children with mild and moderate ID. In response, this study explores the potential of tablet-based game applications to enhance educational outcomes through an interactive, engaging, and accessible digital platform. The proposed solution, GrowMore, is a tablet-based educational game specifically designed for children aged 8 to 12 with mild intellectual disabilities. The application integrates adaptive learning strategies, vibrant visuals, and interactive feedback mechanisms to foster improvements in object recognition, color identification, and counting skills. Additionally, the system supports cognitive rehabilitation by enhancing attention, working memory, and problem-solving abilities, which caregivers reported transferring to daily functional tasks. The system\u2019s usability was rigorously evaluated using quality standards, focusing on effectiveness, efficiency, and user satisfaction. Experimental results demonstrate that approximately 88% of participants were able to correctly identify learning elements after engaging with the application, with notable improvements in attention span and learning retention. Informal interviews with parents further validated the positive cognitive, behavioral, and rehabilitative impact of the application. These findings underscore the value of digital game-based learning tools in special education and highlight the need for continued development of inclusive educational technologies.<\/jats:p>","DOI":"10.3390\/computers14110495","type":"journal-article","created":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T12:57:13Z","timestamp":1763038633000},"page":"495","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["GrowMore: Adaptive Tablet-Based Intervention for Education and Cognitive Rehabilitation in Children with Mild-to-Moderate Intellectual Disabilities"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7983-2189","authenticated-orcid":false,"family":"Abdullah","sequence":"first","affiliation":[{"name":"Centro de Investigaci\u00f3n en Computaci\u00f3n (CIC), Instituto Polit\u00e9cnico Nacional (IPN), Mexico City 07320, Mexico"},{"name":"Department of Computer Science, Bahria University, Lahore 54000, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-5490-102X","authenticated-orcid":false,"given":"Nida","family":"Hafeez","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n en Computaci\u00f3n (CIC), Instituto Polit\u00e9cnico Nacional (IPN), Mexico City 07320, Mexico"},{"name":"Department of Computer Science, Bahria University, Lahore 54000, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-1192-7914","authenticated-orcid":false,"given":"Kinza","family":"Sardar","sequence":"additional","affiliation":[{"name":"Department of Software Engineering, University of Management and Technology, Lahore 54770, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9575-3157","authenticated-orcid":false,"given":"Fatima","family":"Uroosa","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n en Computaci\u00f3n (CIC), Instituto Polit\u00e9cnico Nacional (IPN), Mexico City 07320, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-6154-1893","authenticated-orcid":false,"given":"Zulaikha","family":"Fatima","sequence":"additional","affiliation":[{"name":"Faculty of Allied Health Sciences, Superior University, Lahore Campus, Lahore 54000, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4454-8791","authenticated-orcid":false,"given":"Rolando","family":"Quintero T\u00e9llez","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n en Computaci\u00f3n (CIC), Instituto Polit\u00e9cnico Nacional (IPN), Mexico City 07320, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8308-8882","authenticated-orcid":false,"given":"Jos\u00e9 Luis Oropeza","family":"Rodr\u00edguez","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n en Computaci\u00f3n (CIC), Instituto Polit\u00e9cnico Nacional (IPN), Mexico City 07320, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e246","DOI":"10.1016\/j.pedn.2024.12.020","article-title":"The effect of cognitive behavioral interventions applied to children with anxiety disorders on their anxiety level: A meta-analysis study","volume":"80","author":"Alemdar","year":"2025","journal-title":"J. Pediatr. Nurs."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Achtypi, A., and Papoudi, D. (2024). An online survey of educators\u2019 views regarding iPad practices for enhancing the social communication and emotional regulation of pupils with autism in special and mainstream schools. Int. J. Dev. Disabil., 1\u201311.","DOI":"10.1080\/20473869.2024.2421062"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1145\/3709144","article-title":"Social Media Apps: A Paradigm for Examining Usability of Mobile Apps for Working-Age Adults with Mild-Moderate Cognitive Disabilities","volume":"18","author":"Huang","year":"2025","journal-title":"ACM Trans. Access. Comput."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"973","DOI":"10.1111\/jir.13064","article-title":"Hey Google! Intelligent personal assistants and well-being in the context of disability during COVID-19","volume":"67","author":"Vacaru","year":"2023","journal-title":"J. Intellect. Disabil. Res."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1044\/2021_PERSP-20-00220","article-title":"Everyone deserves AAC: Preliminary study of the experiences of speaking autistic adults who use augmentative and alternative communication","volume":"6","author":"Donaldson","year":"2021","journal-title":"Perspect. ASHA Spec. Interest Groups"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1675","DOI":"10.9728\/dcs.2025.26.6.1675","article-title":"A Review of International Trends in Mobile App-Based Social Skills Interventions for Students with Autism Spectrum Disorder","volume":"26","author":"Park","year":"2025","journal-title":"J. Digit. Contents Soc."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Sant\u00f3rum, M., Carri\u00f3n-Toro, M., Morales-Mart\u00ednez, D., Maldonado-Garc\u00e9s, V., Araujo, E., and Acosta-Vargas, P. (2023). An accessible serious game-based platform for process learning of people with intellectual disabilities. Appl. Sci., 13.","DOI":"10.3390\/app13137748"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"936","DOI":"10.1186\/s13063-022-06875-9","article-title":"The effectiveness of a tablet-based video game that stimulates cognitive, emotional, and social skills in developing academic skills among preschoolers: Study protocol for a randomized controlled trial","volume":"23","author":"Gaete","year":"2022","journal-title":"Trials"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e59053","DOI":"10.2196\/59053","article-title":"Use of serious games in interventions of executive functions in neurodiverse children: Systematic review","volume":"12","year":"2024","journal-title":"JMIR Serious Games"},{"key":"ref_10","unstructured":"Zhang, Z., Sun, Z., Zhang, Z., Peng, Z., Zhao, Y., Wang, Z., Luo, Z., Zuo, R., and He, X. (2025). \u201cI Can See Forever!\u201d: Evaluating Real-time VideoLLMs for Assisting Individuals with Visual Impairments. arXiv."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Gill, C.S., Dailey, S.F., Karl, S.L., and Minton, C.A.B. (2025). Learning Companion for Counselors About DSM-5-TR\u00ae, John Wiley & Sons.","DOI":"10.1002\/9781394346684"},{"key":"ref_12","first-page":"1407","article-title":"Study to Evaluate Role of Digital Technology and Mobile Applications in Agoraphobic Patient Lifestyle","volume":"32","author":"Abdullah","year":"2025","journal-title":"J. Popul. Ther. Clin. Pharmacol."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Lima, D.T., Medeiros, A.M., Paulino, R.d.C.R., and Seruffo, M.C.R. (2025). Generative AI as a Usability Evaluator: Hype or Help?. Proceedings of the IFIP Conference on Human\u2013Computer Interaction, Springer.","DOI":"10.1007\/978-3-032-05008-3_46"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"914","DOI":"10.1556\/2006.2025.00016","article-title":"Activating perceived social support combined with diluting loneliness: Effects of the personal resources energized intervention program (PREIP) on problematic smartphone use among adolescents","volume":"14","author":"Hu","year":"2025","journal-title":"J. Behav. Addict."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Escriche-Escuder, A., De-Torres, I., Rold\u00e1n-Jim\u00e9nez, C., Mart\u00edn-Mart\u00edn, J., Muro-Culebras, A., Gonz\u00e1lez-S\u00e1nchez, M., Ruiz-Mu\u00f1oz, M., Mayoral-Cleries, F., Bir\u00f3, A., and Tang, W. (2020). Assessment of the quality of mobile applications (apps) for management of low back pain using the mobile app rating scale (MARS). Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17249209"},{"key":"ref_16","first-page":"429","article-title":"Blockchain in healthcare: Investigating the applications of blockchain technology in securing electronic health records. A bibliometric review","volume":"53","author":"Kumar","year":"2024","journal-title":"Cuest. Fisioter."},{"key":"ref_17","first-page":"749","article-title":"Aprendizaje autom\u00e1tico para predicci\u00f3n de anemia en ni\u00f1os menores de 5 a\u00f1os mediante el an\u00e1lisis de su estado de nutrici\u00f3n usando miner\u00eda de datos","volume":"27","year":"2023","journal-title":"Comput. Sist."},{"key":"ref_18","first-page":"1017","article-title":"Survey of Mobile Cloud Computing Security and Privacy Issues in Healthcare","volume":"28","author":"Nabawy","year":"2024","journal-title":"Comput. Sist."},{"key":"ref_19","first-page":"2369","article-title":"Prescriptive analytics-based methodologies for healthcare data: A systematic literature review","volume":"28","year":"2024","journal-title":"Comput. Sist."},{"key":"ref_20","first-page":"1617","article-title":"Integration of Agile Approaches with Quantum High-Performance Computing in Healthcare System Designs","volume":"29","author":"Hafeez","year":"2025","journal-title":"Comput. Sist."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e2025174","DOI":"10.22521\/edupij.2025.15.174","article-title":"Enhancing Communication Skills in Students with Autism: A UAE Case Study on iPad-Based Interventions","volume":"15","author":"Alzyoudi","year":"2025","journal-title":"Educ. Process. Int. J."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1352\/2326-6988-13.1.13","article-title":"How Do I Get to the Student Union? Developing Independent Navigation Skills in Students With an Intellectual or Developmental Disability","volume":"13","author":"Mitchell","year":"2025","journal-title":"Inclusion"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1352\/1944-7558-126.6.439","article-title":"An overview of intellectual disability: Definition, diagnosis, classification, and systems of supports","volume":"126","author":"Schalock","year":"2021","journal-title":"Am. J. Intellect. Dev. Disabil."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Fuentes, C., G\u00f3mez, S., De Stasio, S., and Berenguer, C. (2025). Augmented reality and learning-cognitive outcomes in autism spectrum disorder: A systematic review. Children, 12.","DOI":"10.3390\/children12040493"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1815","DOI":"10.1080\/17483107.2025.2481425","article-title":"Communication challenges and use of communication apps among individuals with cerebral palsy","volume":"20","author":"Chang","year":"2025","journal-title":"Disabil. Rehabil. Assist. Technol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"11251","DOI":"10.1007\/s10639-024-13243-4","article-title":"A multi-dimensional scaffolding-based virtual reality educational board game design framework for service skills training","volume":"30","author":"Lin","year":"2025","journal-title":"Educ. Inf. Technol."},{"key":"ref_27","unstructured":"Leichert, J., Koke, M., Wrede, B., and Richter, B. (2025). Virtual agent tutors in sheltered workshops: A feasibility study on attention training for individuals with intellectual disabilities. arXiv."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1111\/1467-8578.70005","article-title":"Augmented reality\u2019s potential for addressing writing challenges in students with learning disabilities","volume":"52","author":"Selvam","year":"2025","journal-title":"Br. J. Spec. Educ."},{"key":"ref_29","first-page":"107","article-title":"Digital Divide and Equity in Education: Bridging Gaps to Ensure Inclusive Learning","volume":"1","author":"Memon","year":"2025","journal-title":"J. Digit. Educ. Soc. Sustain."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Sung, I.Y., Yuk, J.S., Jang, D.H., Yun, G., Kim, C., and Ko, E.J. (2021). The Effect of the \u2018Touch Screen-Based Cognitive Training\u2019 for Children with Severe Cognitive Impairment in Special Education. Children, 8.","DOI":"10.3390\/children8121205"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"e13190","DOI":"10.2196\/13190","article-title":"Development and evaluation of intelligent serious games for children with learning difficulties: Observational study","volume":"8","author":"Flogie","year":"2020","journal-title":"JMIR Serious Games"},{"key":"ref_32","first-page":"281","article-title":"Virtual reality among individuals with intellectual and\/or developmental disabilities","volume":"56","author":"Oakes","year":"2022","journal-title":"Ther. Recreat. J."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1007\/s10209-019-00655-0","article-title":"Usability investigation of an educational mobile application for individuals with intellectual disabilities","volume":"19","author":"Yeni","year":"2020","journal-title":"Univers. Access Inf. Soc."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"00469580251349665","DOI":"10.1177\/00469580251349665","article-title":"Requirements of innovative technologies to promote physical activity among senior citizens: A systematic literature review","volume":"62","author":"Napetschnig","year":"2025","journal-title":"INQUIRY: J. Health Care Organ. Provision Financ."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"e60602","DOI":"10.2196\/60602","article-title":"Mobile-and Web-Based Interventions for Promoting Healthy Diets, Preventing Obesity, and Improving Health Behaviors in Children and Adolescents: Systematic Review of Randomized Controlled Trials","volume":"27","author":"Talens","year":"2025","journal-title":"J. Med. Internet Res."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1177\/02557614231196972","article-title":"Seeking alternatives in music education: The effects of mobile technologies on students\u2019 achievement in basic music theory","volume":"43","author":"Uludag","year":"2025","journal-title":"Int. J. Music. Educ."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Kurosu, M. (2016). New ISO Standards for Usability, Usability Reports and Usability Measures. Human-Computer Interaction. Theory, Design, Development and Practice, Springer. Lecture Notes in Computer Science.","DOI":"10.1007\/978-3-319-39510-4"},{"key":"ref_38","first-page":"1","article-title":"Rubrics Development for Pre-service Preschool Educators\u2019 Instructional Activity Design","volume":"38","author":"Chang","year":"2025","journal-title":"J. Educ. Pract. Res."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Paraskevopoulou-Kollia, E.A., Michalakopoulos, C.A., Zygouris, N.C., and Bagos, P.G. (2025). Computational Thinking in Primary and Pre-School Children: A Systematic Review of the Literature. Educ. Sci., 15.","DOI":"10.3390\/educsci15080985"},{"key":"ref_40","unstructured":"Batanero, C., Garc\u00eda L\u00f3pez, E., Garc\u00eda Cabot, A., and Piedra Pullaguari, N.O. (2025, October 08). ISO\/IEC 24751 Standard: Access for All. Available online: https:\/\/api.semanticscholar.org\/CorpusID:61224861."},{"key":"ref_41","unstructured":"S\u00e1nchez, D., Ibarra, J., Flores, B., and L\u00f3pez, G. (2012, January 25\u201327). Adoption of the ISO 9241-210:2010 Standard in the Construction of Computer-Based Interactive Systems. Proceedings of the International Conference on Research and Innovation in Software Engineering (CONISOFT), Guadalajara, Mexico."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1023\/A:1022193728205","article-title":"Cognitive Architecture and Instructional Design","volume":"10","author":"Sweller","year":"1998","journal-title":"Educ. Psychol. Rev."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"e25908","DOI":"10.2196\/25908","article-title":"Consumers\u2019 preferences for purchasing mHealth apps: Discrete choice experiment","volume":"11","author":"Xie","year":"2023","journal-title":"JMIR mHealth uHealth"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"822","DOI":"10.1093\/geroni\/igad104.2653","article-title":"Initial findings on the benefits of the Tovertafel: Reducing behaviors in persons with dementia","volume":"7","author":"Steiner","year":"2023","journal-title":"Innov. Aging"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1186\/s12984-025-01551-w","article-title":"Clinical validation of an individualized auto-adaptative serious game for combined cognitive and upper limb motor robotic rehabilitation after stroke","volume":"22","author":"Doumas","year":"2025","journal-title":"J. Neuroeng. Rehabil."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1080\/23279095.2022.2162900","article-title":"Computerized working memory training for adults with ADHD in a psychiatric outpatient context\u2014A feasibility trial","volume":"32","author":"Berglund","year":"2025","journal-title":"Appl. Neuropsychol. Adult"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"e42712","DOI":"10.1016\/j.heliyon.2025.e42712","article-title":"Serious games to support emotional regulation strategies in educational intervention programs with children and adolescents. Systematic review and meta-analysis","volume":"11","year":"2025","journal-title":"Heliyon"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"106257","DOI":"10.1016\/j.jecp.2025.106257","article-title":"Game-based cognitive training and its impact on executive functions and math performance: A randomized controlled trial","volume":"256","author":"Roazzi","year":"2025","journal-title":"J. Exp. Child Psychol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1145\/3596251","article-title":"Eggly: Designing mobile augmented reality neurofeedback training games for children with autism spectrum disorder","volume":"Volume 7","author":"Lyu","year":"2023","journal-title":"Proceedings of the ACM on Interactive, Mobile, Wearable and Ubiquitous Technologies"},{"key":"ref_50","first-page":"215","article-title":"A Smart Collaborative Educational Game with Learning Analytics to Support English Vocabulary Teaching","volume":"6","author":"Tlili","year":"2021","journal-title":"Int. J. Interact. Mob. Technol. (IJIMAI)"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"100216","DOI":"10.1016\/j.tine.2023.100216","article-title":"Board game-based intervention to improve executive functions and academic skills in rural schools: A randomized controlled trial","volume":"33","author":"Ayesa","year":"2023","journal-title":"Trends Neurosci. 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