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Mobile phones have transformed the way we communicate with friends and family, coordinate our daily activities, and organize our lives. For families with children with cognitive disabilities there is widespread hope, though not always fulfilled, that personal technologies---particularly mobile phones---can bring a dramatic increase in their child's level of safety, independence, and social connectedness. However, many individuals with significant cognitive disabilities are unable to use off-the-shelf mobile phones because of a mismatch between their needs and abilities and the technology design at the user interface and functionality level. In this research, I conducted ethnographic studies to first understand the current patterns of use and the adoption process of assistive technology for individuals with cognitive disabilities and their families. I identified barriers to technology adoption including the lack of consideration given to a caregiver network, lack of simplicity, and lack of support in upgrade and replacement of technology. I then combined participatory design and a "technology probe" study with individual families with a young adult with cognitive disabilities to co-design a PDA-based mobile phone that matched the abilities and needs of their child. This study included an eight-week field trial with the phone to evaluate the user interface and functionality. The technology evolved during the field study based on the experiences of use. This research identified requirements for functionality and customization of mobile phones for this population. The importance of emotional and social motivations emerged as an important focus in the design of assistive technology. This method also proved to be an effective way to engage individuals with cognitive disabilities as participants in the design of their own technology.