Accessible design for cognitive considerations

May 27, 2020

When we discuss digital accessibility, the conversation often centers around screen readers and color contrast, but it’s important for designers and developers to consider the more nuanced difficulties that “thinking” disabilities and impairments can cause for users. Thinking impairments impact emotions, problem-solving, memory, and other ways we use our brains.

Everyone is cognitively impaired at various times. Cognitive impairments are by far the most common type of disability and can come from congenital conditions from birth, developmental conditions from a young age, traumatic injury, infections, chemical imbalances, and other conditions later in life. They may also be situational considerations attributed to fatigue, anxiety, depression, environmental stimulus, or being new to a situation.

Cognitive disabilities impact the capacity of a person to:

Think
Concentrate
React to emotions
Formulate ideas
Problem solve
Reason
Remember

Here are some common issues people with cognitive impairments encounter when navigating websites and applications and ways you can design more accessible services for each issue.

Limited comprehension

Nearly all people with cognitive disabilities face comprehension issues. Complex ideas, metaphors, and abstract concepts may create difficulties. Yet some people may have high cognitive function in an area, but low function in others. For example, I know someone who has tremendous creative writing abilities but is challenged in social and emotional awareness.

How to help: Narrower columns make reading easier so aim for columns of no more than 80 characters per line. Use percentage widths for text areas and set your margins to “0 auto” via CSS so they adjust proportionately. Keep your sentences short, use bullets, and ensure headings provide useful summaries. If your site uses videos or audio, keep them as short as you can. You should also limit the number of choices available on each screen and provide contextual help features when possible. Consider online aids like Hemingway App or Grammarly for concise composition.

Short-term memory loss

Some people have a hard time remembering things from moment to moment. Their mind interferes with focusing on new information, and they’re unable to absorb it quickly. Extended processes, such as online forms, purchasing, or account creation, may lead to people forgetting what they were doing, and they may be unable to retain information needed from step to step.

How to help: Minimize the effects of short-term memory loss by building websites with predictable navigation and structure across every page. Complicated sites may tire users. Also, consider short-term memory loss when writing and designing help features to get a user through a long process.

Attention deficits

Users with attention deficits may have a hard time focusing on the task at hand. They may find online ads or long loading indicators distracting or get lost in their thoughts. Too many distractions on a web page may cause people with cognitive considerations to miss important information, lose focus, or navigate from the page.

How to help: Reduce distractions and be careful when implementing moving elements such as ads or carousels. Similarly, auto-play audio or videos can cause major distractions. Always allow users to stop and control moving elements.

Low tolerance for cognitive overload

Some people may easily become frustrated, emotionally flooded, overwhelmed, or upset when they sense difficult situations, or if there are too many things in their environment happening at the same time. If they cannot handle the complexity of the moment, they may need to take a break. They need things to be simple and straightforward. Too many choices can cause them to freeze, and they may be emotionally unable to change their state of mind for a period of time.

How to help: Keep your navigation as logical and concise as possible. Ensure your home page is accessible throughout your website or app. This may offer reassurance if people start feeling confused. Ensure the experience is streamlined, and minimize choices. As they may need to take a break, consider if auto-save is appropriate, and anticipate errors to make recovery straightforward.

Limited problem-solving skills

If confronted with a question or problem, some people with cognitive impairments may struggle to solve it or may give up. For example, when a website expects users to type text into a CAPTCHA (an online test to determine if a user is a human), some people may not be able to process what is required. If they enter incorrect info and get an error message, they may not be able to figure out what the issue is or how to solve it.

How to help: Provide contextual help for content, anticipate and minimize errors, and ensure recovery from errors is compassionate.

Difficulty reading

A lot of people have difficulty reading, for a variety of reasons. It may be developmental, a non-native language issue, or from an injury. They may read at a lower level than others their age, and some may not be able to read at all. A number of people with dyslexia have high cognitive function conceptually, but struggle with visual presentation of words. This may result in difficulty spelling or reading. Some people with dyslexia read the “shapes” rather than letters. There are many more people with dyslexia than those who are blind, yet we rarely prioritize experiences for dyslexic users.

How to help: Consider plain language guidelines to develop inclusive content. Use a sans-serif font. The hooks on serif letters may distort shapes. If you must use a serif, reduce letter-spacing slightly. You can also explore typefaces developed specifically for dyslexic users. Use bold for emphasis instead of italics or underlines which can visually distort the text. Offer readability tools, such as a text-to-audio option, to help people access your content in the way they prefer. Ensure your markup activates functionality like iOS Reader Mode.

Don’t think they can “just ask for help”

Often, if you can’t do something on your own, the common response is “just ask for help.” While this seems simple, it’s not an appropriate response to a person with a cognitive disability. They should be able to access the web with the same independence as a person without a disability.

Assuming users can just ask for help means you’re designing an experience that forces them to sacrifice their independence and potentially become vulnerable to sharing personal information, such as medical data. If someone has to ask for help to log into their account, they have to share their credentials with someone else, which leaves them vulnerable to identity theft. If they have to have someone else help to access their medical record or bank account, there’s more personal information shared that they may prefer to keep private. Being able to access your information independently is a civil right and is especially important when the information may be sensitive or private.

If you’re designing a digital experience you should be practicing accessibility beyond compliance and involve users with a wide range of disabilities, including cognitive disabilities, in your usability testing. It may be time-consuming to plan for and recruit participants with disabilities, but the findings will improve the accessibility, and overall user experience, for your digital service.