An Introductory Guide to Understanding Cognitive Disabilities
“For most people, technology makes things easier. But for people with disabilities, technology makes things possible” – Mary Pat Radabaugh
By Glenda Sims and Jennie Delisi
Accessibility helps more than just people who are blind. There are five disability types that are commonly considered in digital accessibility: seeing, hearing, speaking, moving and thinking. For this article, “thinking” includes disabilities that impact emotions, problem-solving, memory and other ways we use our brain.
Why is digital accessibility so important? Imagine if you could not use your smartphone, TV or computer by yourself. According to a 2018 Nielsen study, “American adults spend over 11 hours per day listening to, watching, reading or generally interacting with [digital] media.” Technology is not just for play. We use technology every day to be successful at work, at school, and in our lives.
In this post, we focus on how to make technologies accessible to people with cognitive disabilities, a type of disability that is often overlooked.
Cognitive Disabilities and Skills
To make technology accessible for people with cognitive disabilities, we need to have a broad understanding of these types of disabilities. A disability is a condition that limits a major life activity. Communicating, learning and working are examples of major life activities. Some types of cognitive disabilities are aphasia, autism, attention deficit, dyslexia, dyscalculia, intellectual and memory loss.
|Example||Has Significant Difficulty|
|Aphasia||Speaking (finding words), writing or understanding language|
|Autism||May have difficulty understanding some communications or social interactions|
|Attention-Deficit/Hyperactivity Disorder||Focusing and Keeping Attention|
|Dyslexia||Recognizing letters and words|
|Dyscalculia||Recognizing numbers and symbols|
|Intellectual||“intellectual functioning (such as learning, problem-solving, judgment) and/or adaptive functioning (activities of daily life such as communication and independent living)” – American Psychiatric Association|
|Memory Loss||Difficult time remembering past events, new events, or both|
These types of cognitive disabilities are just the beginning, there are many more types of cognitive disabilities.
Some webmasters, software designers and developers may not have ever interacted or observed a person with a cognitive disability. However, webmasters, designers, and developers love to solve problems. Below are simple to understand descriptions of the problems people with cognitive disabilities encounter. Let’s talk about words and phrases you can use to describe problems or barriers you may find:
- Attention – ability to focus and keep focused on the current task
- Processing Speed – the rate at which the brain handles information
- Short-Term Memory – the ability to retain information for short periods of time
- Long-Term Memory – the ability to store and recall information for later use
- Logic & Reasoning – the ability to reason, prioritize and plan
- Language Processing – the ability to recognize letters and words and the ability to understand written or spoken language
- Math Processing – the ability to recognize numbers and symbols and the ability to understand and calculate simple math
The first three skills (attention, processing speed, and short-term memory) are part of automatic processing. The last four skills (long-term memory, logic and reasoning, language processing and math processing) are part of higher thinking. The diagram below shows how information is input into our brain, flows through automatic processing, can tap into higher thinking, and results in output (a decision).
Figure 2: Thinking Flow Diagram: Input to automatic processing group (attention, processing speed, short-term memory), leading to higher thinking group. The higher thinking skills each interact with a decision cog: long-term memory, logic and reasoning, language processing, math processing. The decision cog leads to output.
Let’s try out an example using the Thinking Flow Diagram above. Here is a sample task: buy the ebook you need. Imagine you are shopping online for an ebook you need for work or school. Your computer has a fingerprint reader. You log on to your favorite online bookshop using your fingerprint. You find the book you need.
Here are the cognitive skills you applied:
- Automatic Processing
- Attention – you kept your attention on the task for buying this book (even if you get interrupted by a phone call or a text message).
- Processing Speed – luckily, this site does not have any time limits, so you were able to take all the time you needed to read the information on the site.
- Short-Term Memory – this site was relatively short, so you didn’t have to remember what was at the beginning of the page by the time you reach the bottom of the page.
- Higher Thinking
- Logic & Reasoning – you considered all the different book formats.
- Language Processing – you recognized the letters and words on the page and were able to read the information about this book and find the button to buy the book. Or, to process this text, you needed it to be read out loud to you by your assistive technology.
- Math Processing – you recognized the numbers that represent the price of the book and calculated if you can afford it based on how much money you have.
- You made the choice to press the “Buy Now” button (which you have set up so it will automatically charge to your credit card).
Besides the potential accessibility blockers listed above, there are other types of accessibility blockers that people with cognitive disabilities could encounter that people might not be aware of. For example, some people with reading disabilities use assistive technologies to read what is written on the page aloud. If content, such as an image, is not properly made accessible to a screen reader, this could also be inaccessible to a person with a cognitive disability.
Additional Accessibility Blockers for Cognitive Disabilities
Oftentimes, if you cannot do something on your own, the common response is “just ask for help.” However, this is not an appropriate response to a person with a cognitive disability, as they should be able to access the web with the same independence as a person without a disability.
Sometimes people with cognitive disabilities just need information presented in a different way. Let’s review how that could apply to if someone learns best from videos. Here are a few examples of accessibility blockers in a video that could exist for a person with a cognitive disability.
- Difficult words – The words and examples in the video script might be too difficult.
- Complicated directions – The video may not break things down so the steps are easy to follow. Do you ever get lost when the directions are too complicated?
- No captions – Many people use the captions, including some people with cognitive disabilities. If the captions are not there, some people may not be able to follow along. They may not remember the information as well. Or they may not learn the new vocabulary.
- Not able to turn captions off – For other people the captions can be distracting. If you are unable to turn off the captions, they may have difficulty focusing on your content.
- Can’t play video – And what if you can’t control the video player using your way of interacting with a computer (such as your voice)? You may not be able to use the video at all.
Being able to access your information independently is a civil right. This is very important when the information about you is personal and something you want to keep private. Let’s look at how these barriers can impact another common situation, such as accessibility medical test results.
Potential accessibility blockers could be:
- The website does not work with your assistive technology.
- You cannot remember your login and password and then you have trouble resetting it because the steps are not easy to follow.
- Once you open the results, they are in a PDF that doesn’t work with your assistive technology.
In both the examples listed above, it’s important to note all the different use cases and scenarios that developers and designers should consider when designing websites or user flows.
Assistive Technology (Software/Hardware)
There are many solutions to help people with disabilities access content online. Assistive technologies can help people with disabilities:
- Type or speak to their computer to help them write emails
- Search the internet
- Post to Facebook
- Keep records
- Make documents
For cognitive disabilities, there are also assistive technologies that can:
- Remember passwords
- Help a person organize their thoughts before writing a letter
- Keep track of where they are in a project
Is There Existing Web Accessibility Legislation?
Many people around the world want the web to be accessible to all people. This includes people with disabilities. A group of people at the W3C created a rule called the Web Content Accessibility Guidelines (WCAG). This rule explains how to make the web work better for people with disabilities. Some countries have made this rule required for governments to follow. Examples are the United States, Canada, and Europe.
Do these rules apply to people with cognitive disabilities?
The existing accessibility rules are good, but there is room for improvement. The Cognitive Accessibility Task Force at the W3C has been working on making the web more accessible for people with cognitive disabilities. The nickname for this group is COGA (COGnitive Accessibility). This group is led by Lisa Seeman at the W3C.
Members of this group research types of cognitive disabilities as well as specific user needs. They identify where user needs are not being met and are writing a guide for “Making Content Usable for People with Cognitive and Learning Disabilities.”
Here is an example of three types of user needs for people with cognitive disabilities:
- Easy to Use and Secure Authentication
- I.e. “I need a secure way to log in that is easy enough for me to use.”
- No Distractions
- I.e. “I need to be able to read content or complete a task without distractions.”
- Prevent Errors
- I.e. “I need help avoiding mistakes, and minimizing mistakes I might make.”
As you look at these user needs, you may be thinking, everyone will benefit from these improvements. Correct! But for a person with a cognitive disability, these user needs are crucial for them to equally access content online.
This task force and their research includes people with all types of cognitive disabilities. Examples of just a few of the types of disabilities that have been included are:
- Learning: Dyslexia, Dyscalculia, Attention Deficit Hyperactivity Disorder
- Age-related: Alzheimer’s, dementia, memory
- Intellectual: Down Syndrome
- Accidental: traumatic brain injury
- Mental health: anxiety, depression, Post-traumatic stress disorder (PTSD)
Here are some ways you or people you know could help address the issues of accessibility:
- When you find a digital accessibility barrier, tell someone. Send an email, make a phone call, or complete a “contact us form.” You can:
- Tell them a quick story about the barrier. Be specific.
- Include the website address, document title, and location, or software name.
- Use one or two sentences to describe what happened.
- Thank them for reviewing this issue.
- Tell them to contact you to learn more.
- Ask for the name of the person you should talk to about the problem.
- Tell them a quick story about the barrier. Be specific.
- Find other people you can work with to learn more, teach others, and plan ways to improve digital accessibility.
- Check out the Web Accessibility Perspectives videos!
- In your advocacy groups, start talking about digital accessibility.
- Spend even a small amount of time per month learning about assistive technology and digital accessibility.
- Help the Cognitive Accessibility Task Force (COGA TF) at the W3C.
- Suggest ways the web could be easier for people with cognitive disabilities
- Review learning materials
- Send feedback
You can be a part of the solution! Know how digital accessibility helps you and those you care about. Tell someone. The digital community must be inclusive, so all our voices can be heard.