This document is for people who make Web content (Web pages) and Web
applications. It gives advice on how to make content usable for people
with learning and cognitive disabilities.
This document has content about:
people with learning and cognitive disabilities,
user needs,
user testing,
design patterns (ways) to make content usable, and
Making websites and applications that are friendly for people with
cognitive impairments affects every part of design and development.
Traditionally accessibility has been most focused on the interface, and
making that usable for people with sensory and physical impairments in
vision, hearing and/or mobility. Some accessibility features will help
people with cognitive impairments, but often the issues are about
context, language, usability, and other more general factors that impact
everyone to some degree.
This document aims to provide guidance on how to make websites and
applications that are friendly for people with cognitive impairments by
providing guidance for your designs, and design process.
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-centred 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)
Applicability across websites
The amount of effort an organization should expend on making a website
friendly for people with cognitive impairments will vary. For
organizations that provide public services, or are national (or
international) private service providers and already conduct
user-research, they should:
Organizations that conduct user research should include people with
learning and cognitive disabilities as part of user research such as
usability-testing. This is particularly important for public service
providers as well as national and international private service
providers.
All organizations, regardless of user research conducted, should
review designs and early stage development with the design objectives
in this document.
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 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.
User Needs
User needs for people with learning and cognitive disabilities (COGA)
are often important for other users. However for COGA groups they often
make the difference between being able to use the site or not be able to
use it at all.
Authentication and Safety
secure website authentication that is easy to use
safe way to interact online.
Context and Distractions
consume content or complete a task without unnecessary
distractions
know the context (where I am, what I just did, or what just
happened)
restore context
when I forget where I am or get distracted
in multimedia. ability to go back to what I just missed, or
reorient myself if I get lost
reminders of important information
turn off distractions by default and be a trivial option in real
time
Entering Data, Error Prevention, & Recovery
help avoiding mistakes, and minimizing the mistakes I might make
know what mistake were made and how to correct a mistake. Do no
cause undue alarm a mistake happens
enough time, and do not lose work
use applications or APIs that remember a lot of my information so
I do not need to enter it again, and to otherwise help me, such as
with spelling.
know where I am in a process, including what I have done and what
my next step is.
able to check my work and go back without losing the work I have
just done
Help and support
more explanations, such as context sensitive help and short tips.
know how to get more information.
easily get human help.
symbols that help me understand content.
contextually-relevant graphs and pictures to supplement text so I
can understand a point without a lot of reading.
speech support, with synchronized highlighting, so I can follow as
I go.
rapid feedback.
highlight section of image, chart, or math, while the section is
read.
more space between letters, words, sentences, and/or lines of
text.
reminders, or I will forget appointments, and when I was meant to
do things
not too many reminders, as I will be distracted.
confident that I can manage my tasks.
Simple and Clear Interface
controls are clear
understand the menu terms so I know where to find things
find the controls that I need
a structure that is easy follow
can easily find content I need
signposts so I can find information I need
Multimedia - understandable structure. Easy to find the content
needed
easily separate what I need, and do not need, and find what I need
know what an advertisement is, or one from a different website
know where to find things on a page
know the design patterns
unambiguous affordances - I know what things are and what they do
Familiar Interface
familiar with the UI, and I know how to work it and what will
happen when I work it
symbols I understand immediately
different types of messages to be consistent in different parts of
the screen
controls to be consistently positioned on the screen
Clear and understandable content and text.
clear language - Understandable use of vocabulary, syntax, and
other aspects of language
clarify implied information and provide unambiguous information
reduction of dependence on understanding math concepts
support for slow readers
understand (familiar) symbols
understand images and multi-media
Navigating the system
find information I need without deciphering a lot of words or
symbols
quickly identify options I need.
simple-to-navigate menu systems
simple-to-navigate voice-menu systems
find a human help
Navigation and GPS
option for simplicity - let me balance complexity and speed
understandable terms, which make sense to users, and do not depend
on knowing left and right, or on number dependence
no automatic rerouting without user consent
understandable symbols
no change of context
no change to orientation
Use Cases / Persona
Any time there is a 'target audience', there will be people with with
learning and cognitive disabilities in that audience. Cognitive
impairments are often invisible in day-to-day life until people
encounter particular challenges. To provide some context and
understanding, eight personas have been created which outline fictional
people with various cognitive impairments and the challenges they face.
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. If web content and applications are
difficult to use, they cannot be accessible for people with cognitive
disabilities. Automated testing for accessibility focuses on more
technical areas of accessibility, and cannot assess ease of use. It is
vital for people with cognitive disabilities that development teams do
not rely solely on automated accessibility testing, but incorporate
Design Patterns as described in the Appendix, and if possible test with
people who have cognitive disabilities.
Finding people to include in usability testing who have different
learning and cognitive disabilities can be relatively easy, 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, 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 beyond the scope of this document to provide a guide to usability
testing and user-research, however, there are many resources available
such as:
Differences from usability testing with the general population
There are some differences when testing for accessibility, and that
includes when testing with people who have cognitive impairments:
Ensure that the participation forms are easy to understand, send
them 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 carer, family member or friend to
attend with them. If your tester has a guardian you should get
informed consent from both the tester and their guardian;
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: A simple mood selector
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.
Some brief guidance on usability testing:
Can your users ( people with learning and cognitive disabilities)
manage each task reasonably easily and fast. You can time the task
taken to complete, and note any parts that where the users are
slowed down or seem to struggle. Also note any errors that they
making including clicking on the wrong thing.
Is completing the task frustrating or upsetting?
You can ask the users how they are feeling before and after the
tasks (or rate their mode such as selecting the smiley which
represents how they feel, such as:
ask them if anything was annoying.
How can you make it better for your users ( people with learning
and cognitive disabilities)
You can analyze the data collected above
ask them how they feel about the system and if anything was
annoying.
If the user if failing blame the designer and not the user. Such
as “ it is so helpful that you are doing this because our
designers are not very good, or are always playing computer games
so they think everyone is good at this stuff” or “you are really
helping us make this useable by real people and not just
engineers” . Stop the process if users are getting distressed
despite this.
As a short overview, usability could be measured based on efficacy,
efficiency and satisfaction. This can be done by measuring or
tracking:
successes and 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?
Note you will need to get informed consent from the tester before
testing. Explain what they will be doing and why it is helping you. If
there are any risks they need to be explained and understood. If your
tester has a guardian you should get informed consent from both the
tester and their guardian. Make sure potential participants are aware
they can withdraw from the testing situation at any time and that
their comments will be anonymised before being used in any report.
(With thanks to Smart4MD for this overview. I SMART4MD is co-financed
by the European Union under an EU Framework Programme for Research and
Innovation – Horizon 2020, with grant agreement number 643399.and the
European commission for this contribution.)
Design Objectives
To help web content providers meet the needs of people with cognitive
and learning disabilities we have identified the following objectives:
Design so that as many users as possible understand the site and
know how to use it. This often involves using things that are clear and familiar to the
user so that they do not have to learn new symbols, terms or design
patterns. Personalization and good use of semantics can help make
the symbols and design as familiar to the user as possible. People
with cognitive disabilities rely upon predictable behavior in
digital content. For example, many websites do not follow the
standard convention for hyperlinks: blue = unvisited; purple =
visited; and underlined. See the
design guide.
Help the user find what they need. Navigating the
system should be easy. See the
design guide for navigation.
Use clear and understandable content This includes
clear text, clear images, speech, and easy to understand video. See
the
design guide for understandable content.
Prevent the user from making mistakes and make it easy to correct
mistakes when they do occur.
A good design and use of scripts will make errors less likely, but
when they do occur the user should know how to correct them, without
having to render other data or start from the beginning. See the
design guide for errors.
Help the user focus and restore context if attention is
lost.
Items like breadcrumbs can help orientate the user and help the user
restore the context when it is lost. (Making breadcrumbs clickable
can also help the user undo mistakes.) See the
design guide for focus.
Minimize the cognitive skills required to use the content and
avoid barriers
that stop people with cognitive disabilities from using content,
such as hard to use security mechanisms. When possible, provide more
accessible options. See the
design guide for barriers.
Provide help and support. Graphics, summaries of
long documents, adding icons to headings and links are all examples
of extra help and support. See the
design guide for support.
Feedback is usable by everyone. If users have
difficulty sending feedback then you will not know if they are able
to use the content or when they are experiencing problems.
Therefore, it is essential that all the feedback mechanisms are
tested by people with cognitive disabilities. See the
design guide for feedback.
Note that most of the design patterns in the guide were originally
created as recommendations for WCAG, the
full list of potential requirements
is available.
Mapping design patterns to user groups
The table of design patterns and user groups maps patterns from the
design guide such as "User safety" and "Task
completion" with the groups of users who benefit, such as those
with "Memory impairments" and "Reduced focus and
context".
This section provides guidance for policy makers on how to use the
design patterns to build a policy. This includes:
Defining the scenarios included in your policy
Looking at the different criteria and deciding if they are important
for the scenarios in your policy
Building a policy that include the important criteria for the
scenarios included in your policy.
Table of design patterns and policy criteria
Number
Name
Testable
Requires user testing
Can be applied to all content
Important for conversational interfaces
Important for IOT
User need level
1
Clear purpose
yes
no
yes
yes
yes
high
2
Support personalization
yes
no
yes
yes
yes
high
3
Support simplification
yes
no
yes
yes
yes
high
4
Familiar design
yes
sometimes
yes
no
yes
high
Example recommendations for policies:
A policy for critical services might include any item with a high or
medium level need
A policy for emergency services might include all items
A policy for legislation for wide adoption for all web sites might
include any item that are testable, does not require human testing
and have a high user need level.
A policy for legislation for content needed in the workplace might
include any item that are testable, and have a high or medium level
user need level.
The following are example scenarios that may be included in a
policy:
Critical services - such as water, health care, phone and internet
services, government services
Emergency services - such as police, fire, etc
Content needed in the workplace, including professional sites
Content that helps autonomy such as apps and interfaces to run home
devices, book a cab, write an email etc.
The following are example user considerations:
Safety
Autonomy and savings in care-giving
Cost associated with people leaving the work place earlier than
necessary.
Other considerations include:
Does this item require user testing to conform, and is this too
expensive for the scope of sites that might be required to comply
See the issue paper on user testing for more information
Appendix - Design Guide
The group is working on a design guide to help make Web Content more
usable for people with cognitive and learning disabilities (COGA).The
guide is divided into objectives. There are also user stories and
testing methodologies for each objective. Just understanding the
objectives and user stories may help make your content more accessible
to some users with cognitive and learning disabilities. Please see the
section on user testing for guidance on how to perform COGA user
testing.
