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We present experiences and insights into participatory design with individuals who have anterograde amnesia and therefore have extreme difficulty storing new memories. We discuss our design of the design process, and present a set of techniques used to support memory during and between design sessions. From this experience, we identify cognitive assumptions of participatory design that break down when working with amnestics. We generalize these ideas into an analytical framework for researchers and practitioners who intend to use participatory design with persons having various kinds of cognitive impairments. We illustrate the framework by analyzing a cognitive deficit unrelated to memory that we encountered, and an unanticipated benefit from what at first appeared to be a liability in working with this design team.