Background about People with Learning and Cognitive Disabilities and the Web

People with cognitive and learning disabilities may not be able to effectively use web content because of the design and content choices of the author. Examples may include:

• People with impaired short term memory may be unable to recall passwords or copy access codes. They may have trouble or be unable to remember new symbols and interface paradigms;
• People with different processing speed capabilities may need additional time to understand the design relationships and volume of information on screen;
• People with language related disabilities may need simple clear language and instructions. Some may rely on supporting graphics and familiar symbols to understand content;
• People with social and/or communication disabilities may need clear literal language and may not understand metaphors or non-literal text and symbols;
• People with dyscalculia may not understand or confuse numerical references such as percentages;
• People who have issues with keeping or regaining focus, may be have difficulty completing a simple task if there are lots of distractions and interruptions. They may need headers and signposts to help them regain the context after their attention has been lost (including in multimedia);
• Many groups will need support to minimize errors and complete their task. They will struggle with complex, multi-stage processes such as filling out forms or entering data correctly or finding the content or feature that they need.

These difficulties may sometimes also be experienced by users in the general population due to environmental or situational barriers, such as when they are trying to use a website when they are distracted. For example, working on a mobile device while in an unfamiliar or noisy situations can demand place addition cognitive load on all users by splitting their attention. However, for users with cognitive and learning disabilities, these difficulties are likely to be persistent and significant, so that they are unable to access content and abandon tasks.

Cognitive and learning disabilities include long-term and short-term and sometimes permanent difficulties relating to cognitive functions, such as:

• perception, memory and attention;
• learning and orientation;
• visual, verbal and numerical thinking.

These are usually hidden difficulties and may be age related. The terminology and definitions used for cognitive disabilities varies between countries and users are less likely to have a formal diagnosis of a disability than individuals with physical and sensory difficulties. Cognitive disabilities may include intellectual impairments affecting comprehension alongside written and spoken expression. People may also experience a co-occurrence of difficulties such as dyspraxia / developmental coordination difficulties and ADHD should also be taken into account.

It should be noted that by addressing barriers to accessibility for users with cognitive and learning disabilities, improvements to digital technologies can be achieved and there is the potential to improve user experience for everyone.

Process

Some aspects of making web content and applications friendly for people with cognitive impairments are best dealt with as part of the overall design process. For most organizations there should be scope included for a user-centered design process.

Key parts of this process for people with cognitive impairments should be:

• Including the needs of users with cognitive impairments in the context of use and requirements;
• Including people with cognitive impairments in research methods such as usability testing.

If people with cognitive impairments are included in the usability testing and their feedback is accounted for, you can be sure that the website will be easier to use for everyone. (See Usability testing, below)

Usability Testing, Focus Groups and Feedback

Usability testing is the best way to know if your content and functionality works for real people with cognitive and learning disabilities.

Usability is important for everyone. However, if someone cannot use the content or design without help because of their disability, then the content is not accessible for them. It is important to change the design so that users with cognitive or learning disabilities can use the content independently.

Including digital accessibility throughout a project, right from the beginning, improves accessibility for all users. Including design patterns which focus on the needs of those with cognitive disabilities, and when possible, usability testing with individuals with cognitive disabilities, helps ensure accessibility for these individuals.

Automated testing for accessibility focuses on more technical areas of accessibility. While important, automated testing cannot assess if people with a cognitive impairment can successfully use the content. It is vital for people with cognitive disabilities that development teams do not rely solely on automated accessibility testing. Development teams should:

• Use the design patterns as described in section 3 when designing interfaces and writing requirements.
• If possible, perform usability tests with people who have cognitive disabilities. Usability testing of wireframes, conceptual drawings of the interface, or template pages can be helpful to identify challenges early in the project.

Sometimes designs and content are usable for some people but not if they have cognitive or learning impairments. Sometimes content is usable by people with one learning disability but not a different one. For example, content with fewer words and more numbers may be perfect for some users with dyslexia or autism spectrum disorder, but inaccessible for people with dyscalculia who struggle with numeric information. It is important that usability testing includes a diverse set of users with different cognitive or learning disabilities, such as people with a memory impairment, attention impairment, language and communication disability and intellectual disability.

Including People with Cognitive and Learning Disabilities.

Persons with disabilities should participate in the design and development process. This also includes research that has something to do with them. They're the experts in what works for them.

This can involve including people with cognitive and learning disabilities in:

• focus groups
• usability tests
• the design and research team. 

Informed Consent

It is important to get a declaration of consent from all participants involved in testing and focus groups before they start. Before they sign up, participants must know and understand the details such as:

• What the project is for.
• What they will be doing and why it is helping you.
• Any risks need to be explained and understood.
• What personal details are collected and how any personal data may be used (note that their comments should be anonymized before being used in any report.)
• They do not have to participate. Participation is always voluntary and they can always stop at any time.

If your tester has a guardian, you should get informed consent from both the tester and their guardian. 

Using an understandable consent form is important. Our design patterns on clear content will help you use clear language and layout. Adding symbols can also help. You can also add comprehension questions to confirm that the terms are understood. You can also adapt the example consent forms from our developer resource page.

Finding People to Include

Finding people to include in usability testing who have different learning and cognitive disabilities can be relatively easy. People sometimes recruit users from an organization or self-help group for people with learning difficulties. Social media groups can be an easy and convenient resource. Alternatively, small developers can achieve a large improvement by asking people who they know, such as friends, colleagues, relatives or neighbors who:

• Are older and struggle to use computers, or have age-related forgetfulness;
• Are at an early stage of dementia
• Have dyslexia and/or dyscalculia or ADHD
• Have a learning or intellectual disability
• People with acquired cognitive issues (for example, due to neurological trauma) who have the same challenges as people with other disabilities such as:
• having difficulty (asking a family member to help) with booking travel booking or hotel booking online
• being unable to use online banking
• coping with content forms and pop-up windows when errors occur

It is helpful to find people with learning and cognitive difficulties who are also in your target group as customers or users.

Our developer resource page references project and resources with information on finding and working with persons with learning and cognitive difficulties as co-researchers or peer researchers. Peer-researchers understand the perspective of people with their disabilities. The researchers and developers work together with peer researchers to find solutions. Peer researchers are also involved in testing the solution with other people with cognitive and learning disabilities. 

If your organization has a more formal process, work with those that help employees or community members get assistive technology or other accommodations. They can put out a call for volunteers to their contacts. This helps individuals self-identify and opt-in to help.

Usability Testing

It is beyond the scope of this document to provide a guide to usability testing and user-research, however, there are useful resources available on our developer resource page. As a short overview, usability could be measured based on efficacy, efficiency and satisfaction. This can be done by measuring or tracking:

• successes in completing tasks while noting any errors to measure efficacy,
• time taken per task to measure efficiency, note that the relative time between tasks is often more useful than absolute numbers and
• user’s mood and comments to measure satisfaction.

At the end of the evaluation you should be able to answer:

• What prevents the user from completing a task?
• What creates confusion? When and why do they misinterpret the interface?
• What produces an error and an incorrect action?
• When does the user get frustrated or upset
• When does the user misunderstand navigation, menus and controls?
• How can these problems be avoided?

Differences from Usability Testing with the General Population

There are some differences when performing usability testing with people who have cognitive impairments:

• Ask ahead of time if they need any support for their needs. This could include a quiet room or frequent breaks.
• Ask what test methods work best for them, such as individual interviews or groups.
• Ensure participation forms are easy to understand.
• Inform the participant that they can request the information in a different format. If they make a request, ensure they receive it with enough time for them to review and ask questions.
• Have a copy of the participation forms at the session, in case questions come up before the session begins.
• Send participation forms to the participant in advance, and allow plenty of time for the participant to ask questions and fill in forms;
• Allow the participant to bring a care giver, family member or friend to attend with them.
• If your tester has a guardian, you should get an assent form from the tester and an informed consent form from their guardian;
• If they bring a guardian or care giver, make sure they are not doing the tasks for them. If they give help, monitor closely what help they give as this may be due to a design fault. 
• Explain the testing method before the test.
• The questions should not be too difficult. 
• It helps to provide easy methods of assessing mood, rather than asking for the participant to verbalize. Try asking them to select a smiley face, such as:Figure 1 A simple mood selector
  
  

  

• Some individuals also have challenges identifying moods from faces. Other options to consider are simple mood selectors and text-based rating scales where an individual can point to their selection. For example, I really like this, it is fine, I really don't like this.
• Check they understand the methods used to collect the data. 
• Ensure the person does not feel like they are at fault for making mistakes. While this is always important during usability testing, this scenario is even more likely for people with cognitive impairments.
• Ask them for their ideas, such as, what features they would like to see, what design they prefer and what support they find most helpful.

Here are some suggestions of what to look for when conducting usability testing with people with learning and cognitive disabilities:

1. Before you start, make sure the research team understands that the testers cannot do anything wrong. Research should never harm the user or make them feel bad.
2. Make sure the participants and researchers know they can leave at any time. No one should feel bad if they leave!
3. Check that the testers understand the task or question. Encourage your testers to “think out loud” 
4. Can your testers manage each task reasonably easily and fast? You can time the task taken to complete, and note any parts where the users slow down or seem to struggle. Also, note any errors that they make including clicking on the wrong item.
5. Is completing the task frustrating or upsetting?
1. You can ask the users how they are feeling before and after the tasks or rate their mood such as selecting the smiley face which represents how they feel.
2. Ask them if anything was annoying.
6. How can you make it better for your users (people with learning and cognitive disabilities)?
7. Ask your users if they have suggestions about what would make the interface easier for them to use. This is often best at the end of the usability test.
8. If the user is struggling, remind them that you are reviewing the system not them and that their insights are really helpful. Thank them for helping. Remind them that it is helpful when they find issues because it helps the team make the product better. Stop the process if users are getting distressed.
9. Analyze the data collected and review the findings with the team. Remember to keep the names of individuals confidential unless they have given permission to have their identity and disability shared.

(With thanks to Smart4MD and Easy Reading for this overview. These projects are co-financed by the European Union under an EU Framework Programme for Research and Innovation – Horizon 2020, with grant agreement number 643399 and 780529 and the European commission for this contribution.)

Alison: An Aging User with Mild Cognitive Impairment

Alison has a medical background, working in rehabilitation of physical injuries, but has recently decided to work part-time to take up more hobbies and be with her grandchildren. She wants to try an online course to learn Chinese, in preparation for a special holiday. Alison considers 63 to be the new 36. However, she has difficulty concentrating and finding the word she wants to say. She often makes typos and has to correct sentences when she re-reads them. She becomes easily frustrated as she finds new technical things, like updated design patterns and applications, to be hard to learn and less intuitive than they used to be. Plus, navigation takes longer than in the past. Unfortunately, this includes learning how to use a new interface and this affects the way she works when swapping between her tablet, phone and computer.

Scenario 1: Learning How to Use New Technologies and Interfaces

Alison recently took an evening course to learn how to use Windows and MS Word ten years ago and used to feel very comfortable with the interface. After she had to renew her computer she finds all the updates mean that most applications now appear very different. She realizes that links and buttons have changed appearance and often finds she does not know what to press. Sometimes she will press a picture or stylized heading that is not a control and so is not sure if the internet was down, the site is broken or she has made a mistake. Sometimes she touches something accidentally and the focus moves to a different page or application. For example, she recently tried to enlarge some small text and activated a link instead of enlarging it! She misses the days when all links were in blue and underlined.

Alison loses self-confidence when things go wrong. For example, selecting an incorrect button or getting an error that she does not understand. She knows to try and press the back button to go back a step, but it does not always work as she thinks it will. She tends to think she cannot cope, so gives up, but with support to adapt the interface to suit her needs she could learn to use the new style.

Her children worked with her to reduce the number of menu items on the application toolbar so she can concentrate on the ones she regularly uses. They helped her change her settings so when searching for items on the web, only a limited number now appear at one time. They also found her a de-cluttering browser extension that takes away many of the advertisements and other items that clutter her social media pages when communicating with her grandchildren.

Scenario 2: Correcting Typos and Writing Fluently

When writing letters and messages on her computer, phone and tablet Alison pauses every so often and checks that what she is writing makes sense. She finds it very annoying having to work so slowly, but by using text-to-speech to read out content she has found she can hear her mistakes more easily than she notices them on the screen. She has also discovered that this process can make reading web pages easier and less tiring. However, she often has to go over instructions several times before completing tasks online. She depends on the fact that forms do not time out or have an option to allow her to extend the time to fill in the edit boxes.

Scenario 3: Coping with Online Banking and Shopping

Alison knows her math skills are not as sharp as they used to be. She is worried about making mistakes that will put her financially at risk and she is not sure she should be using her credit card online. Alison wants to feel safe and supported.

She has found that autocomplete helps filling out forms, but she tends to worry that what has been entered may not be accurate. She has a paper card listing some commonly needed information such as her phone number, address and postcode. She stores secure information in a special folder and she has set up an agreement with the bank to limit spending on her credit card and mobile banking.

Scenario 4: Giving Feedback

Alison would like to give feedback and tell her bank what changes they could make to their website to make it more usable for her and other mature customers. She struggles to find the feedback form and she has to type in a lot of information to send her suggestions. When she types in her phone number without the area code she receives an error. She tries to fix the error and send the suggestion but the send button becomes disabled so she probably needs to correct something else as well. At this point Alison feels they do not want her feedback and gives up. She now uses the site much less often. She also finds it hard to reach a support person on the phone because of the confusing phone menu system, so drives into the bank instead. She is thinking of changing to her daughters bank, so her daughter can help her.

Amy: A Computer Scientist who has Autism

Amy loves her computer science course and now programs in several languages. She has discovered she can visualize the outcome of her coding and is quick to find any errors even if they have not been highlighted. Documentation writing is less fun and she tends to be rather too concise which means some users do not receive enough help using her applications.

Scenario 1: Coping with Poor Layouts and Illogical Navigation

Being able to code your own websites can make you very critical of others! Amy finds that she often feels quite confused by some social media sites that have dynamically changing content with random messages and advertisements. She either avoids these sites or tends to try to personalize them by clearing away the clutter and choosing to hide sections. Navigation that does not follow a simple route across an entire site really annoys her, as she feels this does not help anyone. She also finds that she is missing important information on sites that have too much information on pages or have no clear and logical structure.

Scenario 2: Changing Colour Schemes, Flashing, Blinking and Automatic Playing Videos or Music

When a page loads automatically or animations and videos play automatically cause problems for Amy. Sometimes, the movement can be very distracting and the sounds alarming. She has always found that sudden noises or something happening unintentionally has been a problem. When designing her own applications and websites she makes sure all the controls for animated objects or videos are very visible and do not start until the user has decided they wish to interact or view the object.

Scenario 3: Designs that Make Use of Abstract Imagery and Metaphors

Amy is always concerned about communicating clearly and finds it hard when people ask her to create a design that includes abstract imagery. Images that do not directly represent something make Amy feel uneasy and she tends to ask if there can be some explanatory text in case other users are confused. On the other hand, a figure of speech where someone has written something that is not literal makes her wish that the writer would use easy to read content as it is hard to understand concepts such as, "the wheels of justice turning slowly."

Anna: A Student who has Dyslexia and Poor Eye Hand Coordination

Anna has been a student for the past year. Her Fashion Design course has been challenging but fun. She loves the creative aspect of the diploma and would rather be drawing than writing. She has moderate dyslexia, which affects her ability to read, spell and use numbers. Anna has a poor working memory, especially for numbers and digits. She also has poor auditory discrimination which affects her ability to read quickly.

Anna had several projects to complete as part of her portfolio, but the one that worried her most involved a written assignment where she has to research the topic of Post-war fashions and their impact on today’s designs.

Scenario 1: Logging In

Anna's use of the library catalogue from home failed at the first attempt when she could not remember her password. She kept putting in ‘afib61’ rather than ‘afid16’ and could not see the mistake. The error message on the web page had not helped because it announced that her user name or password were incorrect and she was not sure which one was wrong. Luckily, as she was on her own laptop the browser settings allowed her to save her password and she was able to automatically log in.

Scenario 2: Finding Accessible Content

Having navigated the online library system, Anna eventually found a paper on the subject she wanted, which she could download in pdf format. She was hoping to use her text-to-speech app to read the content aloud but when she tried to highlight the text nothing happened. She discovered the document was actually an image and yet there was no warning this was the case. She could not find an alternative accessible version of the paper. This meant she had to use optical character recognition to virtually scan the paper. It was not totally successful leaving gaps in the information she found and the process took away valuable time from her writing.

Scenario 3: Filling in a Form to Ask for an eJournal Article

Finally, Anna found an ejournal that had another article, but there was a form that had to be completed. Anna duly started the process but realized she did not know the author’s name. She returned to the page where she had found the article to copy and paste the name. Sadly when she returned to the form all that she had filled in was lost. She had hoped to just be able to add the final bit, not have to retype the whole thing again.

(Adapted from MOOCAP Erasmus + Persona CC-BY-4.0 http://gpii.eu/moocap/?page_id=33)

Scenario 4: Overlooking Important Information

Anna is a very slow reader and often sounds out words. She has low auditory processing skills so she cannot speed up her screen reader. Therefore, to manage her busy life she has to try and scan read and skip through the massive amounts of content, emails and newsletter she sees so she can read only the most important parts. Sometimes however, she cannot find important content because it is buried inside lots of other content, or the headers and visual layout of the content does not guide her to where she needs to be.

Anna is always worried that she is missing something important and sometimes she is. For example, her daughters elementary school published a weekly newsletter with interesting stories about activities and important announcements. It contained information that her daughters school was ending early one day, but it was buried under less important information about the school activities. Because it takes her so long to read each word she did not manage to read the whole newsletter and did not know that her daughter was coming home earlier than usual. As a result she was not home in time and her daughter was left waiting outside for over an hour.

Scenario 5: Pressing the Correct Button

Anna has bad eye hand coordination, so precise movements are hard and she often touches the wrong button or digit when typing on her small phone screen. With her low letter recognition this makes typing in codes or text very unreliable. She also confuses left and right so she is often pressing the off button in place of the volume. In most interactions on her phone she makes some form of mistake, such as loading a new video when she intended to expand the screen of the window she was watching. To use an application successfully it needs to have a consistent back or undo function.

Carolyn: A Yoga Teacher who has ADHD

Carolyn found concentrating at school difficult and when she got into college to take a course in business studies life became even more stressful. She knew she could cope with the studies but never seemed to get her work completed on time, found it hard to start a report and even to create a plan for a project. When working with others she always had good ideas but somehow they were never taken up and she became frustrated often failing to keep her feelings in check. Luckily, a tutor suggested she sought help and when a psychologist, mentioned Attention Deficit Hyperactive Disorder (ADHD) Carolyn was relieved to have a reason for some of the planning and organizational difficulties she was having. She learnt that if she could make use of her constantly active brain and body as well as manage her time better, she could turn her hobby into a very successful Yoga business.

Scenario 1: Gathering Key Points from a Heavy Text Based Document or Web Page

Carolyn could not really explain her apparent forgetfulness and not being able to focus or complete tasks, but she knew that if she came across a long document or web page with dense text she had to find the key points. If the web page failed to have a clear structure with a content list, well-spaced and highlighted headings she would be lost and lose concentration. Carolyn also said that if she was using her mobile she found advertisements appearing between chunks of text completely upset her focus and she had to stop reading. However, when there was good use of white space, recognizable icons linking to simple bold text clarifying the important points, Carolyn could target these areas and find out what she needed. A clear summary also provided clarity of understanding and Carolyn could remember much of what she had read.

Scenario 2: The Power to Stop Scrolling Carousels and Banners

When setting up a new website for her business, Carolyn found an attractive template with several different ways of being able to show images of her exercises. However, she could not make the carousel of photographs pause, or a banner with her latest news stop scrolling. This really annoyed her as she found both items stopped her concentrating on the real content on the rest of the site. She thought that if it was upsetting her, what about her intended audience! She had to find a friend to add some code that not only added controls, but also stopped the automatic movement giving her website a calmness that she hoped her yoga teaching achieved.

Scenario 3: Losing Focus when Completing Tasks

Carolyn enjoyed her Yoga teaching, but found that if she was developing some instructional materials for her website, online tools often failed to provide sufficient guidance. Unless there was a clear pathway and a way to return to the place where she was working, she often deleted items by accident or could not make corrections. Saving endless previews with yet more tabs being open in her browser caused anxiety levels to rise. It was not until she found a web app that made each task clear with a submit button, that saved her work in stages, that she was able to cope. Carolyn was able to see sections of her work in the correct order and could then manage the bite size chunks of instruction, rather than have to deal with it all at once. This made it so much easier for her to complete the exercise sheets and she became confident in her use of the application to the extent she was willing to purchase the pro version.

Scenario 4: Learning Information from a Video

Theoretically, Carolyn likes instructional videos, but in practice she can only concentrate well enough to learn for a few minutes at a time. Then she loses her concentration. She will usually lose focus earlier if there is more than a minute of content that she already knows. When this happens, she misses the information that she needs! Carolyn tries hard but she still cannot focus for more than a few minutes on content that she already knows. Sometimes she watches videos at high speed so that they are less boring for her, but she still loses focus within a few minutes. When a video is broken down into segments with clear headings, she can jump to the information she needs to learn, and jump forward over segments that she already knows. When she misses information that she needs she can easily jump to the correct location and focus.

Frank: A Retired Lawyer with Dementia

Frank retired from his law firm in his early 60s when he found he was forgetting important items that needed to be discussed in his complex caseload. He found that he was forgetting material that he had just read, losing and misplacing objects and having trouble planning or organizing events. Frank is a very intelligent man and that has not changed. You will often find him reading an article about the law. However, he finds he cannot learn new things that rely on remembering new information. This can include new words or symbols.

Scenario 1: Managing Dates and Booking Holidays

Frank noticed that he had trouble with online calendars and booking flights and hotels when he was planning his summer holiday. He could not work out the way the dates had to be entered into the form and made mistakes with the month and day. If only there had been a good example or tooltip. He also found that when he was booking a flight, the table that had the various lists of airports automatically entered the initials, which was very confusing when he was checking that everything was correct. Finally, there was the issue of making sure he booked the right number of nights for his hotel stay. He knew his arrival time at the airport was a day later than when he left, but it would have helped to have had a calendar with colour and clear markings for the days in the week not just numbers.

Scenario 2: Coping with Icons that are not Recognizable

Many web pages now have their own graphic icons and ways of indicating actions that need to be completed. Frank was having problems searching for information about a care home that he thought might help him in the future. He could not work out what the various options were when he came to fill out a form for his requirements. There appeared to be a series of small images beside the edit boxes, but the minute he began to write in the form the text explanation disappeared. He wanted the instructions to remain in place above the area where he was writing and for the box to be highlighted when he found he had missed some important sections.

Scenario 3: Support when Using Search Engines

Frank likes to surf the web for anything to do with fishing, his favorite hobby. However, he has found that the sheer number of items that appear when he types in a few words very confusing. Ideally he would like the number of search results to be reduced and perhaps have some way of seeing the items categorized in groups so that he can work out which services he needs. In this case it might also be helpful to have icons appearing when the groups are listed, so that he can see articles about fly fishing in one section and sea fishing in another. Blocks of text with more white space around them would also be helpful so that he is not having to cope with such a mass of text.

Scenario 4: Making a Doctors Appointment

Frank can be independent, but often finds unsuitable designs make him require help. For example, he was trying to make a doctor's appointment. He went to the doctor's website and clicked on “make an appointment”. Then a popup opened asking him for the date. He became distracted by the phone, and when he returned to the screen he was not sure what it was for. So he did not make the appointment. If the popup had had a clear heading he would have been reminded of what he was doing, but without this landmark he was just confused.

Later Frank tried calling to make an appointment. Unfortunately, the voice system was automated and asked him questions like “press 2 to make an appointment” Frank typically cannot remember the digit - especially while he is processing the options. He usually gets lost in these systems or types the wrong digit. Frank is reluctant to ask for help and as a result he is not getting the health care he needs.

Scenario 5: Using the Heating

Frank recently moved to a smaller apartment that is easier to take care of. However, this means he is not used to the ICT interfaces for the heating and television system. He has tried to turn on the heat, but the menu item for selecting heat or air conditioning is labeled "mode" and he cannot remember or learn new terms. Frank cannot use the whole unit because of this one term. This has caused emergencies such as hypothermia. Frank keeps the heating on at the same temperature and will only change it when his helper comes.

The TV also has an ICT interface with a lot of symbols that Frank does not know. His helper put an “on/off” sticker next to the button that he can use, but he cannot change the channel or change the volume.

When his microwave broke he bought a new one with controls that were similar to his old one. Because the controls were familiar, Frank can use the microwave unaided, although he needs help with the TV and heating.

George: A User who Works in a Supermarket and has Down Syndrome

George enjoys his job and lives semi-independently in a small town, where he can easily find his way around. However, George finds it hard to use search engines and navigate around websites because of the need to work with large blocks of text. He has problems using the online systems at work, and needs help to search for suitable videos or music.

Scenario 1: Using Symbols for Communication

George used to use Makaton symbols and gestures when at school, but is able to communicate relatively easily now, although reading and writing remains a challenge. Surfing the web is hard when most interactions require text input, but George likes to watch videos, find images and listen to music as well as playing games online. Friends have set up links with recognizable icons on his tablet and this has made it easy to visit his favorite sites. If recognizable symbols or icons could be used in more situations, George feels he would be able to reach more sites independently. There are search engines designed for children and these often use more images, but tend to be too childish for George’s taste.

Scenario 2: Understanding Netiquette and its Impact on Social Media Sites

George has been told about surfing safely and not giving out personal information. He is very lucky that his family has set up his Facebook and Skype account with various privacy settings. However, George finds the way emojis change or new icons keep appearing on his message systems rather confusing and does not always realize what some of them mean. He has sometimes selected an inappropriate symbol and then receives a rather short message from a friend in return that is upsetting. He finds it hard to explain what might have happened. He knows there have been times when he really can’t choose the right symbol because it is too small and he finds it hard to accurately hit the spot. George is then very worried as he does not know how to unlike or change his symbol choice. Interacting with emojis and other symbols is much easier for him with easy ways to enlarge these features on touch interfaces and to undo errors.

Scenario 3: Controls on Videos and Popup Windows

Using a mouse is not easy for everyone and double clicking can take time to learn. George has worked hard to improve his mouse skills by playing many onscreen games, but he still finds it hard to move accurately enough to skip ads on videos or to track down the close/exit method offered by some popup windows. Once again friends have come to the rescue and enabled an ad blocker extension for his browser, but this does not always capture all the ads or prevent George selecting the submit rather than a cross or exit button on a pop-up. There have been times when George has downloaded malware without any second warning appearing or been unable to reach a site because he cannot find the small cross on a transparent popup window that overlays the main page.

Scenario 4: Finding ways to Read Instructions

George finds it very hard to read instructions unless they use very short and easy to read words. He needs text that has been simplified. The best option for George is when someone has taken the trouble to provide a summary of a paragraph with a well-known symbol,short bullet points and a clear diagram or image of what is required. He finds videos with instructions usually go too quickly and he has to stop them, going back time and time again. Helpful instructions with well broken up sets of phrases using easy to read words can work well and he can go back to them when he has to remember how to do a particular task.

Jonathan: A Therapist with Dyscalculia

Jonathan is a massage therapist with dyscalculia. For Jonathan numbers are a foreign language. He can add simple numbers with his fingers and cope with very basic sums. However, he has particular difficulty with numbers that have a series of zeros and their relationship to each other such as 10, 100, 1000 etc. He finds complex calculations, symbols and mathematical concepts are very problematic.

Scenario 1: Coping with Quantities when Shopping Online

Jonathan struggles with the actual value of products, purchasing the correct quantities, for example when buying food at the supermarket and often orders far too much or too little when using online shopping carts. He has found it is much more helpful to have symbols representing the proportional size of items per price or to have a warning when he has ordered an item that might be very large and therefore costly. He saves shopping lists that have been successful and where the amounts have been correct so that he can re-use the lists on other occasions. His bank has helped by adding restrictions on the amount he can spend whether online or using his mobile phone. This can be annoying, but has stopped him from overdrawing his account.

Scenario 2: Remembering Pin Numbers and Passwords

The use of pin numbers and passwords that insist on including a number has always been an issue and most of the time Jonathan uses a secure password application when online. When it comes to the number on the back of his credit card (Card Verification Code) that is always required at the end of a payment exercise, he has to look it up each time, though autofill has helped with completing the rest of the form. Jonathan made sure that what he originally entered and saved in his browser was correct. Too many times he has had to retrace his steps due to typos and not seeing that the entry was incorrect. When he has to return to the form to make corrections, he finds it essential that the corrections needed are clearly highlighted and the instructions provided are helpful. He also feels that it is important that the data he entered previously has not been lost, as the more often he types in numbers etc. the more likely he is to make mistakes.

Scenario 3: Using Spreadsheets Shared with Colleagues

At work, there are times when Jonathan has to share a spreadsheet with a colleague to ensure that the group’s accounts are in order, suppliers have been correctly invoiced and fees collected. The mass of numbers affects Jonathan’s ability to concentrate on the various areas on the spreadsheet. He has found that it helps to use color coding, increased spacing and larger font sizes in order to pick out the various elements. He uses a tool for recording his hours where he can press start and stop to see how long he has worked without using maths but he is not confident to add hours worked to the spreadsheet himself. He wishes it was integrated into the work spreadsheet. Jonathan will often use the comment feature to add something that he feels his colleague need to check, rather than making the correction to the spreadsheet himself. If the document is saved as a PDF or presented in another format, Jonathan insists that it is easy to use with his text-to-speech program which helps him to check how the numbers need to be said and that he can annotate the contents when using his tablet. This is especially important if he is presenting numbers at a meeting.

Maria: A User who has Memory Loss

Maria is 50 years old, married, and lives with her family in Madrid, Spain. Maria is beginning to lose her memory but still works part-time for a local company.

Scenario 1: Finding Key Information on Dynamic Websites

Maria needs to gather specific types of online information for her job. She often has to run through reports about the company on the company’s website. She is only able to easily read the headlines of web pages. The company’s website looks fancy, has a modern user interface and a lot of dynamic elements that change when you hover the mouse over them. For Maria this site is a total nightmare! She finally finds the link to the data she needs as it appears when she happens to hover over a certain menu item with her mouse. The link is positioned in such a bad place that she did not notice it at first. She has found that it really helps if important interactive items are placed in the usual menu areas on a screen and the icons are clearly defined and easily recognizable.

Scenario 2: Remembering Information Entered During a Previous Step

While ordering business cards (a multi-step process), Maria has difficulty remembering information that she enters into previous screens. On the first step she sees content choices that the process expects her to remember in subsequent screens. Additionally, the prolonged mental stress that she experiences while navigating processes inhibits her brain from producing the cells necessary to form new memories. Processes that require her to remember information from one step to another need to provide her access to any previously provided information that is required to proceed, at the exact point of use that is required, otherwise she will not be able to complete the process.

Scenario 3: Pressing the Correct Button

Maria has bad eye hand coordination, so precise movements are hard and she often touches the wrong button on her small phone screen. This means she often presses the wrong button or digit when typing on her small phone screen. With her low letter recognition this makes typing in codes or text very unreliable. She confuses left and right so she is often pressing the off button in place of the volume. In most interactions on her phone she makes some form of mistake, such as loading a new video when she intended to expand the screen of the window she was watching. To use an application successfully it needs to have a consistent back function.

Sam: A Librarian who had a Stroke and Aphasia

Sam loved his work as a librarian. He had spent his entire life surrounded by books in peaceful places where he could research his love for history. In recent years, he enjoyed using the web to explore how other people around the world saw the history of his own country and the changing views on famous people from the past. Now he was becoming depressed and very frustrated due to a recent stroke. The right side of his body was paralyzed and he had difficulty having conversations with friends and family due to aphasia. To him this meant that some of his words were muddled, his understanding was not always as clear as it had been and worst of all; he could not read as fluently as he had in the past. One handed typing was slow and he found his word finding abilities often failed him.

Scenario 1: Having Well-spaced Text with Words that are Easy to Pick Out

Despite all the difficulties that Sam had with his beloved reading, he was determined to improve and found that if a website had no clutter or background imagery he could read the headings. He also found that if there was adequate spacing and the text was not too complex, he could pick words out and with the help of text-to-speech understand the meaning. He did not like the sound of the synthesized speech, because he found it distracting having always read silently. However, over time, he learnt to enlarge the fonts and if the page had left justified text with uneven right edges, he could find his way about by the different shapes of each paragraph. As he became more confident, he began to use some browser tools and was able to increase the line spacing and change the font style on some of his old favorite online historical documents.

Scenario 2: Using Edit Boxes where the Instructions Disappear

Sam had not expected to have to fill in so many online forms in order to receive benefits due to his disability. They caused immense frustration and feelings of self-doubt due to their lack of clarity. Every time he had to fill in an edit box, the instructions disappeared the minute he began to type and he could not remember what was required. He often had to refresh the page and start again to see the label in the box. Sam spent so long on the task that the page would time out. He had to print it out and get help. This was really upsetting as he wanted to be independent and it often reduced him to tears. This was very unlike him, but as the doctor explained, this was linked to his stroke. He also found it very frustrating when a form required a particular way of formatting information with no example as to how to complete the action. Worse still was when the error was not clearly explained, making correction even harder. Dates, postal codes and phone numbers are a particular nightmare.

Scenario 3: Trying to Activate Elements that have been Mis-recognized

The effects of aphasia with acquired dyslexia can be exhausting and confusing but most worrying for Sam was the sense of getting lost on a web page that he thought he knew. He admitted to being nervous when he could not pick out elements in a page that required an interaction. Sometimes he said he did not dare click on a button in case he did something wrong or was sent to somewhere without warning. Sam found this aspect of his web surfing very alarming, as in the past he had been able to navigate with ease. He discovered that the edges of shapes did not appear as clear as they should have been when people use pale greys and he missed links unless expressly highlighted. If a pop-up window suddenly appeared, there were times when he could not close it to return to the page. Small crosses became a nightmare and Sam stressed that the more things happened on a page, the more confused he became. He mentioned the fact that some sites were easier on his tablet as then it all seemed to flow one way and he could just scroll up and down until he felt happy with a decision.

Scenario 4: Coping with Complex Language

When text was written in the passive voice or in an academic manner with long complex words Sam struggled to sometimes understand their meaning even if they were in context. He also found, if he was required to use the same type of language in a form, that he had to copy the words as he could not always spell them and at times he used the wrong word. When he was able to use an app that enabled the text to be read aloud, he could cope if the language was clear and the sentences were kept short. He liked articles that were written in the active tense so he could understand the main ideas straight away.

Tom: A Traumatic Brain Injury Survivor

Tom was involved in a very serious car crash that left him with some physical, sensory and cognitive disabilities having sustained a brain injury. He has returned to work, but often finds communications strained due to difficulties with memory recollection and visual understanding.

Tom had to learn how to walk, talk, and basically live life all over again. Medical experts informed him that his greatest chances for recovery would take place within the first 2 years after his injury. After that he may continue to recover, but at a much slower, and incremental rate. His friends and family were amazed by how quickly he regained his ability to speak, and perform his daily life functions. They were perplexed, however, by all of the cognitive difficulties he expressed having, despite his clear ability to articulate and communicate. For example, he often cannot recognize images and faces. He gets disorientated in physical spaces and often gets lost in rooms, as well as buildings, larger places, documents and websites.

He has now returned to his old company as a researcher and is back using applications and the Internet throughout his working day.

Scenario 1: Using Speech Recognition to Navigate the Web

Tom has dexterity difficulties so he sometimes uses speech recognition to work through web pages and enter text. He finds this method the least tiring of all the possible input options. Although his speech is slow, he is able to control his computer using speech commands and dictation. It is quite easy to use simple commands to control websites, although there are times when he forgets some of the commands and has to use his cheat sheet. Tom likes the scroll commands that allow him to read slowly down a page without using any other input device and he can often retrace his steps as he has to reread items. However, there can be problems if the forms on the website are not labeled correctly or if buttons do not have clear names. Tom had help personalizing some aspects of form completion, but if an element is inaccessible via the keyboard, he has to use the mouse grid to interact with that part of the site. This is a slow process and can be frustrating as Tom finds he loses concentration.

Scenario 2: Finding the Right Words to Use for Searching

Tom finds there are times when he spells words incorrectly and he appreciates error corrections or a system that accepts mistakes. He also has word finding problems when he is tired and he welcomes search suggestions,as these are ideas that might be related to his search. However, too many results can cause concern and Tom admits he really cannot work his way through very long lists that have not been broken up with headings and categories.

Scenario 3: Being Confident that he Understands the Content

Tom has difficulty understanding content when it is not explicitly clear, and without any ambiguity whatsoever. He takes a notably longer amount of time to read and process information in order to be certain that he is interpreting it correctly. His interpretation of information is almost always correct, but even the slightest bit of ambiguity, or open interpretation creates sticking points that he must read over and over again, and question every which way until he can assure himself with the confidence that he understands it correctly. Examples and clear step-by-step instructions can help him have the confidence to complete his task. Simple, clear memorable graphics or large indicators of steps in a process can increase Tom’s understanding,confidence and orientation in a process.

Scenario 4: Understanding where Information is in a Hierarchical Structure

Tom tries to understand the outline of the page and site, so that he does not get lost in the content. Sometimes he dives into the website but then he does not know where he is in the content or task. Clear and consistent headings in a hierarchical structure are needed for Tom to understand the level of importance of content and a clear site structure lets him orientate himself in the site.

He values simple, clear graphics that relate to the content and break it up. These help him orient as well as understand and remember the content. This also includes the following user needs.: Symbols that emphasize the structure and role of the content or an image that accompanies the main text and makes it memorable.

Scenario 5: Cognitive Overload

Complex presentations of information (images, diagrams, content heavy web pages, etc) overload Tom’s cognitive functioning. This shuts his brain down and prevents him from progressing through processes, navigating, systems, and environments, and understanding the information presented, at both the micro and macro level.

Liberal use of white space can decrease the cognitive load where there is a considerable amount of content on one page.

Objective 1: Help Users Understand What Things are and How to Use Them

User Story: Clear Purpose

As a user with a memory impairment, attention impairment and/or executive function impairment, I need to know the purpose of the content so that I know if I am in the right place, and what I am doing even if I lose focus for a time.

This also includes the following user needs.:

• I know what the website offers, or if I should move on
• I know what features and content are on this page or if I should move on
• I always recognize where I am in the architecture of the website, application or multi-step process, even after I get distracted
• I know the relationship between this page and the site/task, even after I get distracted
• I can easily see the context and purpose of the page
• In videos and multimedia: I know what is going to be in the video, I can jump to the content I need, and I can restore context if I get distracted

Related Personas: Carolyn, Frank, Maria, Tom

User Story: Clear Operation

As a user with a memory impairment and/or executive function impairment, I find it hard to learn new interface design patterns. I need to know what controls are available and how to use them so that the site is usable for me.

This also includes the following user needs.:

• I understand my options and the tasks I can perform and I can identify the controls I can interact with in order to complete actions.
• I know how to use all the controls and the effects of each action.
• I do not try to activate elements that are not controls. Otherwise I just think the site is broken and give up.
• Controls do not move unexpectedly as I am using them.
• I know the consequence of each action, such as sending information, changing settings, changing the context or closing the application.

Related Personas: Alison, Amy, Anna, Frank, George, Sam

Objective 2: Help Users Find What They Need

User Story: Findable

As a user with a memory impairment, weak executive function and/or weak language processing skills, I need to be able to find features and content easily, so that I can find things in a reasonable amount of time.

I can identify important information and critical functions on a page, quickly and easily.

This also includes the following user needs.:

• I can reach important information and the controls I need without scrolling or carrying out other actions. They are not hidden or off screen
• I can easily identify content that I need, and do not need. Information I need to know and important information stands out, or is the first thing I read and does not get lost in the noise of less important information
• I can get to the feature I need using the minimum number of easy steps
• I know the starting point for each specific task, such as applying for a job
• I find the design familiar such that user interface elements such as menus, buttons and design components as well as elements common to many websites such as help and search are where I expect them to be and do not move unexpectedly

Related Personas: Alison, Amy, Anna, Carolyn, Maria, Tom

User Story: Searchable

As a user with a memory impairment, weak executive function and/or weak language processing skills, I need to be able to find features and content easily, so that I can find things in a reasonable amount of time. I can easily search for what I want.

This also includes the following user needs:

• I can find what I have searched for before
• I can easily navigate through the menu structure and organization of the site and page

Related Persona: Tom

User Story: Clear Navigation

As a user with a memory impairment, weak executive function and/or weak language processing skills, I need to be able to find features and content easily, so that I can find things in a reasonable amount of time.

The structure and menu categories make sense to me, so that I find what I am looking for, without looking in the wrong place.

This also includes the following user needs:

• I can easily understand, navigate and browse both the site and page structure
• I can scan the page and understand the priority and structure of the content

Related Personas: Alison, Amy, Frank, Maria, Sam, Tom

Objective 3: Use Clear and Understandable Content

User Story: Clear Language (Written or Audio)

As a user with a language impairment, learning disability and/or a memory impairment, I want the language used to be clear and easy for me to understand so that I can understand the content.

This also includes the following user needs:

• I understand the language used including vocabulary, syntax, tense and other aspects of language
• I can easily distinguish the content from the background distractions
• I need words to include accents, characters and diacritics that are necessary to phonetically read the words. (This is often needed for speech synthesis and phonetic readers in languages like Arabic and Hebrew.)
• I do not want unexplained, implied or ambiguous information because I may misunderstand jokes and metaphors.
• I want an easy to understand, short summary for long pieces of content or an option for an easy to read version.
• I use images, diagrams or video clips to help me understand ideas, more than a lot of words

Related Personas: Carolyn, George, Sam, Tom

User Story: Symbols (pictographic or ideographic that represent concepts)

As a user with complex communication needs that may include a mild language impairment, I want symbols that help me understand the content.

This also includes the following user needs:

• I need symbols to help understand essential content, such as controls and section headings
• I need symbols that I understand and are familiar to me; recognizable, commonly used symbols (or personalizable)
• I need symbols placed above the text to link the meaning of the words with the images.

As a user with a severe language impairment, who has managed to learn a symbol vocabulary, to have symbols on top of each phrase and very simplified language. Of course it is best if I understand the symbols and they are the ones I have learnt (via personalization).

Related Persona: Frank, George

User Story: Media

As a user with weak executive functioning and attention impairments, I want media presented in small chunks of understandable content, so I can understand the main points and not lose focus.

This also includes the following user needs:

• I can easily navigate to what I want, take breaks and easily jump back a step if I do not follow or get distracted, when I am using small segments of multimedia that have navigable text or labels that describes the segment.
• I understand plain language used in the media
• I can use a clear structure to help me navigate and understand different parts of the media
• I can use visual aids and pictures to help me understand the media content

Related Persona: Carolyn

User Story: Visual Presentation

As a user with a language impairment, learning disability and/or an impaired memory, I want a page layout that helps me follow and understand the content without getting overwhelmed.

This also includes the following user needs:

• I can read short boxes or chunks of content or sections easily. These usually have:
  • Clear headings
  • Short paragraphs and sentences with one idea
  • Good use of lists
  • Pictographic symbols next to headings, labels and links
• I can read easily when there is a good use of white space
  • Good use of white space between lines, sentences or phrases
  • Good use of white space between chunks, so that the chunks are clear and the page does not get overwhelming
• I need explanations of implied content, like body gestures and facial expressions seen in images and animations.

Related Personas: Amy, Anna, Carolyn, Frank, George, Sam, Tom

User Story: Math Concepts

As a user who does not understand numerical concepts, I need content to be usable without understanding math concepts.

This also includes the following user needs:

• I want content to be usable without understanding math concepts, such as percentages
  • I do not want math concepts in my content or;
  • the content provides multiple / alternatives like a non-math symbol (there are people who find math easier to understand than words - just not me!)
• I find words easier to understand than digits

Related Personas: Alison, Frank, Jonathan

Objective 4: Help Users Avoid Mistakes or Correct Them

User Story: Assistance and Support

As a user who has difficulty with organization (executive functioning), typing, and putting letters and numbers in the right order, I want an interface that helps me avoid making mistakes, complete forms and other similar tasks successfully.

This also includes the following user needs:

• I want an interface that makes mistakes less likely by helping me avoid mistakes, as well as minimize the mistakes I might make
• I want to enter as little information as possible, so the task is more manageable
• I want an interface to provide only valid options, so I can select the ones I want
• I want long numbers that often have spaces, like credit card numbers, divided into chunks. That way I find it easier to check it.
• I want inputs to accept different formats and not mark them as mistakes
• I want interfaces to use metrics I know, and that are common in my location (such as feet or meters) or I get confused. I do not always know what metric they are talking about or notice the number looks wrong.
• I want to use applications or APIs that help me, such as remembering my information so I do not need to enter it again and have help with my spelling.
• I want clear labels, step-by-step instructions and clear error messages, so I know exactly what to do.
• I want examples that make it easy to understand what I need to do
• I want clear and simple explanations of options or choices to help me know what they mean.
• I want help managing my time, such as letting me know how long a task will take.
• I do not want a session to time out while I try to find the information needed, such as my postal/zip code or social security number.
• I want to save my work as I go or be sure all my work is saved automatically. I do not want to have to start over again, which can create a cycle of reentering my data; this makes me tire easily and more likely to make mistakes.
• I want support to manage the task such as letting me know what information I will need (credit card, full address etc) before I start.

Related Personas: Alison, Anna, Carolyn, Frank, George, Jonathan, Maria, Sam, Tom

User Story: Undo

As a user who often makes mistakes or touches the wrong thing, I want to be able to undo what I just did quickly and easily so that I can manage to use applications and not give up.

This also includes the following user needs:

• I want to be able to check my work and go back without losing the work I have just done.
• If I touch the wrong control, it is important to make it easy for me to go back to where I was in one simple step
• I want predictable back or undo features so I'm exactly where I was previously, before I made a mistake.
• I Understand the consequences of what I do

Related Personas: Alison, Anna, Maria

Objective 5: Help Users to Maintain Focus

User Story: Distractions

As a user with an attention impairment and weak memory, I need to be able to avoid distraction and restore the context after I lose focus and come back to the task, so that I can complete the task I am trying to do.

This also includes the following user needs:

• I do not want distractions from my task.
• If there are distractions, I must be able to easily turn them off

As a user that needs help to stay focused, I need help with knowing where a task starts and finishes to help with switching attention so that I can focus on the task.

This also includes the following user needs:

• I need to know the context, where I am, what I just did, or what just happened to me after I lost focus and then needed to come back to the task.

As a user with poor short-term memory, I need to be able to go back or see information about where I am in a site so I can re-orientate myself.

As a user who gets disoriented, I want to know where I am in a process, including what I have done and what my next step will be.

Related Personas: Amy, Carolyn, Frank, Sam, Tom

Objective 6: Ensure Processes Do Not Rely on Memory

User Story: Previous Steps

As a user with short-term and working memory difficulties, I need access to information I entered during previous steps in a process.

User Story: Accessible Authentication

As a user who has memory impairments and often forgets passwords, and has weak executive function, I need a method of secure website authentication that I can use.

This also includes the following user needs:

• I need to be able to use a site without remembering or transcribing passwords and usernames
• I cannot decipher a lot of words or symbols
• I need the login process to be simple, and not multi-step
• As a symbol user, I need a login process I can use that does not rely on a lot of words
• I need the login process that does not contain puzzles or calculations

Related Personas: Anna, Jonathan

User Story: Voice Menus

As a user who has memory impairments and weak language processing skills, I want to get human help, without going through a complex VoiceXML menu system and complex voice recognition menu system that relies on memory and executive function, so I can set an appointment or find out some information.

This also includes the following user needs:

• If I get stuck I want to be able to find a human by pressing a reserved digit (typically the number 0)
• I need simple-to-navigate voice-menu systems with limited options that make sense to me, so I don’t have to struggle with multiple steps
• I need the option to be said before the number to select, so I do not have to remember the number while processing the words
• As a user with low cognitive processing speed, I want pauses between each option so I can process what was said
• As a slow speaker I want the system to wait for my response
• I want it to be simple, to go back every time I make a mistake, without having to start at the beginning
• I want the best practice for usability to be followed
• As a user who has weak executive function, I need a process to get help to be simple, and not multi-step
• I do not want to waste my energy while I struggle to understand other material, such as special offers or promotions
• As a user with weak language skills I need help identifying the right words to say in a voice menu and the words should be the ones I would use
• As a user who struggles with multiple steps, I need to identify relevant options quickly.

Related Personas: Frank, Maria

Objective 7: Provide Help and Support

User Story: Feedback

As a user who often cannot use a website I want to be able to give feedback easily from every place where I get stuck. This ensures I am not excluded and the site is aware of my needs.

This also includes the following user needs:

• I can give feedback from any point in the process.
• I can give feedback, ask questions and get feedback:
  • In a similar time frame to everyone else
  • Using my preferred communication method (form, email, chat, phone support etc) that are being provided, and it accessible to me
  • I know how to get help or information, such as from context-sensitive help or tooltips
• I know how to get human help and can manage the process easily.

Related Persona: Alison

User Story: Support

As a user who often cannot use a website I sometimes need in-page and inline support so that I am able to use the content.

This also includes the following user needs:

• As a user who struggles with text and words, help and support should include symbols or enable me to personalize using my own
• As a user who struggles with text and words, help and main content should be clearly differentiated so I do not confuse them
• As a user who struggles with text and words, I need contextually-relevant graphs and pictures to supplement text so I can understand a point without a lot of reading. For example, I find graphs much easier to understand than the same information in an article or academic paper
• As a user who struggles with text and words, I need speech support, with synchronized highlighting, so I can follow as I go
• As a user who struggles with web content, I need rapid feedback or visual cues to indicate an event was successfully triggered. For example, I need to know when an email has been sent, otherwise it looks as if it has just disappeared
• I need reminders integrated into my calendar, otherwise I will forget appointments and when I am meant to do things. Sometimes I need reminders to revisit a web site to complete the next task
• As a user with an attention disorder, too many reminders distract me. I need to be able to control when reminders are sent, the frequency and type of reminders.

Related Personas: George, Sam,

User Story: Safety

As a user with sensitivities that can be triggered by content (eg content that is busy, confusing, depressing, loud noise), I need content that I can cope with so that I can be successful.

This also includes the following user needs:

• I need to avoid triggers
• I need to feel safe. I need to feel safe and secure when using a website, especially if providing information or communicating with others.
• I need to avoid and recover from mental fatigue

Related Persona: Tom

User Story: Task Management

This also includes the following user needs:

• Explanations for unusual controls in a form I find easy to use (such as a video or text)
• Support and explanations for any choices. The advantages or disadvantages are clear to me and I understand the effects of the choice I might make. For example, when choosing a cheaper airline ticket you often have to pay for a meal.
• I know how to start a task, and what is involved such as:
  • the steps involved;
  • a time estimate and any time limits;
  • and any materials I may need (such as a credit card number, passport number, questions that authenticate login such as “your mother’s maiden name”).
  • There is support and instructions that I understand to help me organize the time and steps
  • Any limitations are clear to me before I begin
• I can turn off any distractions during a task, and help is available at any point

Related Personas: Frank, Jonathan, Sam, Tom

Objective 8: Support Adaptation and Personalization

User Story: Adapt

As a user with short and medium term memory impairment and weak executive function I need a familiar interface so that I do not need to figure out and remember new interfaces. This may take a few weeks of repetition and I may not manage to learn it all if I have a condition affecting learning new things, such as dementia.

This also includes the following user needs:

• I need (a version of) the interface to be familiar to me, that I recognize and know what will happen
• I need the controls to be consistently positioned on the screen where I expect them to be
• I need content delivered in an easy to understand language or an easy-to-understand mode (like short, understandable, video clips)
• I need to be able to find and select the content format or version of the content that is easiest for me to understand
• I need alternatives to spoken and written language such as icons, symbols or pictures
• I need personalized symbols or pictures that I can recognize immediately, as learning new ones takes a long time
• When I do not know a word I need I need the symbols and pictures that I know and recognize
• I need video and pictures that help me understand the content without so much reading of text
• I need my additional support features from widgets or extensions. For example, I have an extension that helps me correctly enter words, grammar and use punctuation as well as read the page to me.
• I need "easy to use" gestures on a touch screen that do not confuse me (or the possibility of alternative access)
• I need to be able to express my ideas without so many words, such as using speech recognition or pictures (I have a program, where I select a word and it gives me a picture)
• I often need more white space can be added between lines, sentences, phrases and chunks
• I need alternatives for mathematical content, that do not rely on mathematical concepts
• I often need less content without extra options and features as sometimes I cannot function at all when there is too much cognitive overload
• I need to be able to find the extra features when I want them

Related Personas: Alison, Amy, Frank, Jonathan, Sam

User Story: Extensions and API’s

As a user with learning and cognitive impairments, who uses add-ons and extensions as assistive technology, I need my add-ons, API's and extensions to work with the content so that I can use it.

This also includes the following user needs:

• Additional support features from widgets or extensions. For example, I have an extension that helps me correctly enter words, grammar and use punctuation as well as read the page to me
• A password manager
• A toolbar that adds symbols and reformats the page

Related Personas: Alison, Anna, Jonathan, Tom