More people are wondering – “How do we design for people with cognitive disabilities?”

When you’re designing sites that sell services and products, especially health-related services and products, this question often comes up. Usually when it’s raised as a requirement, it’s followed by an awkward pause and silence. Those in the room would agree it’s important, as is accessibility in general. But in that pause and silence, you can see steam pouring out of designers’ and usability specialists’ heads, who are wondering, “How do we design for people with disabilities? What does that even entail? Can we handle that? And…what do we mean by cognitive disabilities?”

In our “Designing for Cognitive Disabilities” talk at the Usability Professionals’ Association International 2008 Conference in Baltimore, MD, Whitney Quesenbery, Sarah Swierenga, and I talked about what we’ve learned through the Telecommunications & Electronic and Information Technology Advisory Committee (
TEITAC, aka Section 508 and Section 255 refresh), from Dr. Clayton Lewis of the Coleman Institute, and from Sarah’s research at Michigan State University. The biggest discovery, which is not so shocking when you think about it, is that if you follow usability best practices – use consistency, use plain language, include landmarks, include ways for people to back up and correct mistakes… – you’ll be making great strides in making your site or application accessible by people with cognitive disabilities as well. (see below for our slides – our paper is available in the UPA 2008 proceedings (visit UPAssoc.org for more info))

I fell into the “wheels spinning, steam pouring, awkward silence” category when this topic came up in early conversations. I’ve worked with children and adults who have autism, Asperger Syndrome, Down Syndrome, cerebral palsy, and mental retardation. I have family members who’ve had various cognitive disabilities, including dyslexia, brain injuries, and mental retardation. And I was still at a loss – it’s hard to envision how to accommodate people without stopping to think about what they can do and what they do differently.

So here are some things to consider – these are not at all meant to oversimplify the field of cognitive disabilities – it’s really a complex and amazing topic. These items are meant to help you stop, think, and consider ways to improve on your existing site and product designs and accessibility, and, at the same time, improve usability for all your visitors.

Design Considerations

The following are based on our experiences working with users with various cognitive disabilities, as well as best practices that we’ve gathered from sites like Dyslexia.org, that focus on audiences with different disabilities.

All users

• Apply consistency in labeling, titles, navigation positions, etc. – match labels with the destination page’s heading so users know they clicked the right link.
• Include landmarks, to easily tell where you are
• Provide ways to back up if you make mistakes
• If your site automatically times users out after periods of inactivity, offer timer reset features – this will benefit users who take some additional time to process information or read through material
• Apply plain language guidelines!
• Offer spell check capabilities or suggestions for features like search engines or document generation

Users with dyslexia

Drawn from dyslexia.org

• Provide options to change background, foreground colors – high contrast like black on stark white can be challenging for these users to read. See dyslexia.org for examples. (Aside: my nephew has a much easier time reading things that are printed on green paper – the white paper was too busy for him)
• Use narrow columns, with 60-70 characters – easier to scan and read.
• Left justify content, as opposed to using full justification where left and right sides are even. Full justification creates varying white space that can cause problems.

Resources

• Designing for Cognitive Disabilities [PDF, 1.13 Mb], UPA Presentation by Walser, Quesenbery, and Swierenga
• The Coleman Institute
• Designing for Dyslexics, Accessites.org
• Telecommunications Problems and Design Strategies for People with Cognitive Disabilities, by Francik, Levine, Tremain
• Section 255, Telecommunications Act Accessibility Guidelines, specifically, 1194.31 (i)
• WebAIM, We Still Know Too Little, and We Do Even Less
• ACM CHI 2006 Workshop, Designing Technology for People with Cognitive Impairments