The document discusses designing user experiences for people with cognitive disabilities. It notes that 7% of the US population has some type of cognitive impairment. It outlines common types of cognitive disabilities like learning disabilities, attention disorders, traumatic brain injuries, and those related to aging. The document discusses challenges people with cognitive disabilities face when using technology, like difficulty finding features, recovering from errors, saving work. It also reviews the state of accessibility research, which has focused less on cognitive disabilities. The document proposes approaches like universal design, assistive technologies, and usability testing to help make technologies more accessible and usable for those with cognitive impairments.

1. Designing for People
with Cognitive Disabilities:
How Can the UX Community
Help?
Yulia Nemchinova
Northrop Grumman Corporation
October 19, 2012
User Focus Conference

2. Who Has Cognitive Disabilities
 Seven percent in the US have some
type of cognitive, mental or emotional
impairment (Census 2010)
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3. Types of Cognitive Disabilities
 Learning and language disabilities,
including dyslexia
 Attention disorders
 Traumatic brain injuries (TBI)
 Developmental impairments, including
mental retardation, autism, cerebral
palsy, Down Syndrome
 Cognitive issues related to aging
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4. Types of Functional Impact
 Executive functions
 Memory
 Attention
 Visual and spatial perception
 Language and reading
 Mathematical thinking
 Emotional control, expression,
understanding
 Speed of reasoning
 Solving new problems
 Solving problems based on experience
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5. When Users Encounter
Obstacles…
 Lack of confirmation that their
action was correct
 Cannot find and review features
 Cannot recover from errors
 Cannot find landmarks
 Do not have enough time to
complete tasks
 Cannot save their work at any
time…
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6. When Users Encounter
Obstacles…
 It is a work around for most
users
 It is a real showstopper for many
users with cognitive impairments
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7. The Accessibility Research
Landscape
 Blindness remains the priority for
accessibility researchers
 Lack of research on the usability
engineering methods suitable for users
with cognitive disabilities
 Limited representation of cognitive
impairments within the accessibility
community
 Very little testing has been conducted
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8. Why Are We So Behind?
Cognitive impairments are often:
 Invisible
 Difficult to diagnose
 Not universally defined
 Not willingly disclosed
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9. Needs Assessment
“When it comes to needs assessment
more often than not people with
disabilities prefer not to disclose it or they
don‟t know what their disability is.”
Nancie Payne, PhD
Consultant, Payne & Associates, Inc.
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10. Obstacles in Designing for
Cognitive
 Complexity of cognitive issues
 Challenging to find a universal
approach
 No automated validation tools exist,
and it is unlikely a tool could substitute
for human evaluation
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11. Web Accessibility Evaluation Tool
 WAVE: a grant project at WebAim
 Idea: to „embed‟ programmatic
solutions into a single tool
 Issue: supporting one disability
contradicted support for another;
providing images to help with language
disabilities distracted users with
attention disorders
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12. WAVE Project
We no longer think that the best solution for
users with cognitive disabilities is to put
issues of cognitive load and web
accessibility into the hands of web
developers. While they have an important
role in helping, the need to HIGHLY
individualize to the unique user is too great
to be practical.
Cyndi Rowland, PhD
Executive Director WebAIM; National Center on
Disability and Access to Education Center for
Persons with Disabilities, Utah State University
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13. Curb Cut Access
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14. Support Assistive Technologies
 Screen readers
 Plug-ins such as BrowseAloud by
TextHelp
 Read&Write by TextHelp
 VoiceOver for iPhone and comparative
Android applications
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15. Universal Design
 Aiming to assist most users
 Can be incorporated into existing
systems without having to design
separate version
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16. Universal Design: Navigation
 Consistent navigation and design on
every page
 Flat navigational architecture
 Functioning Back button
 Limited the number of links per page
 Standard behavior for links
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17. Universal Design: Language &
Literacy
 Clear and simple text
 Newspaper style
 6-8 reading level with a simple
sentence structure
 Short pages, paragraphs and
sentences
 Single column of content
 Avoid navigational links at the right,
which can be distractive
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18. Mobile or Slimmed Down Access
 Direct access to content
 Limited content to process
 Availability on multiple electronic
devices
Clayton Lewis, PhD
Professor of Computer Science, Scientist in
Residence, Coleman Institute for Cognitive
Disabilities, University of Colorado
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19. Usability Testing
 Usability studies with cognitively
impaired people are extremely rare
 User testing is needed
 There is no substitution for actual
users with disabilities
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20. The Future: GPII
 Global Public Inclusive Infrastructure
(GPII)
 Video about GPII:
http://gpii.net/node/108
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21. Thank you!
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22. References:
Bergel, M., Chadwick-Dias, A., & Tullis, T. (2005). Leveraging Universal Design
in a Financial Services Company. Accessibility and Computing, 82.
Bodine, C., & Lewis, C. (2004). Rehabilitation Engineering Research Center
(RERC) for the Advancement of Cognitive Technologies. Accessibility and
Computing, 80.
Cole, E. (2011). Lessons Learned and Challenges Discovered in Developing
Cognitive Technology for Individuals with Brain Injury. Proceeding of CHI 2011.
Czaja, S. J., Gregor, P., & Hanson, V. L. (2009). Introduction to the special
issue on aging and information technology. ACM Trans. Access. Comput, 4.
Fernando, S., Elliman, T., Money, A., & Lines, L. (2009). Age Related Cognitive
Impairments and Diffusion of Assistive Web-Base Technologies. Universal
Access in HCI, Part I, HCII 2009 (pp. 353-360). Springer-Verlag Berlin
Heidelberg.
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23. References (contd.):
Francik, E., Levine, S., Tremain, S., Roberts, E., & Bayha, B. (1999).
Telecommunications Problems and Design Strategies for People with Cognitive
Disabilities. Annotated Bibliography and Research Recommendations, World
Institute on Disability.
Gordon, W. A., & Nash, J. (2005). The Interface Between Cognitive
Impairments and Access to Information Technology.
Gregor, P., & Dickinson, A. (2006). Cognitive difficulties and access to
information systems – an interaction design perspective.
Hagood, K., Moore, T., Pierre, T., Messamer, P., Ramsberger, G., & Lewis, C.
(2010). Naming Practice for People with Aphasia in a Mobile Web Application:
Early User Experience. ASSETS: ACM Conference on Assistive Technologies,
273-274.
Hanson, V. L. (2009). Cognition, Age, and Web Browsing. Universal Access in
HCI, Part I, HCII 2009, (pp. 245-250). Springer-Verlag Berlin Heidelberg.
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24. References (contd.):
Jansche, M., Feng, L., & Huenerfauth, M. (2010). Reading Difficulty in Adults
with Intellectual Disabilities: Analysis with a Hierarchical Latent Trait Model.
ASSETS’10,. Orlando, Florida, USA.
Judson, A., & Nicolle, C. (2004). Internet accessibility for people who use
augmentative and alternative communication. Conference Proceedings --
International Society for Augmentative & Alternative Communication, 181-186.
Keates, S., Kozloski, J., & Varker, P. (2009). Cognitive Impairments, HCI and
Daily Living. Universal Access in HCI, Part I, HCII 2009 (pp. 366-374).
Springer-Verlag Berlin Heidelberg.
Lepistö, A., & Ovaska, S. (2004). Usability evaluation involving participants with
cognitive disabilities. NordiCHI '04. Tampere, Finland.
Lewis, C. Cognitive and Learning Impairments.
Lewis, C. (2008). Cognitive Disabilities. In The Universal Access Handbook.
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25. References (contd.):
Lewis, C. (2006, May-June). HCI and Cognitive Disabilities. Interactions , pp.
14-15.
Lewis, C. HCI for People with Cognitive Disabilities.
Lewis, C. (2006). Simplicity in cognitive assistive technology: a framework and
agenda for research. Univ Access Inf Soc (pp. 351-361). Springer-Verlag.
Moffatt, K., & Davies, R. (2004). The Aphasia Project: Designing technology for
and with individuals who have aphasia. Accessibility and Computing, 80, pp.
11-17.
Poncelas, A., & Murphy, G. (2007). Accessible Information for People with
Intellectual Disabilities: Do Symbols Really Help? Journal of Applied Research
in Intellectual Disabilities. 20, pp. 466-474. BILD Publications.
Poulson, D., & Nicolle, C. (2004). Making the Internet accessible for people
with cognitive and communication Impairments. Universal Access in the
Information Society, 3(1), 48-56.
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26. References (contd.):
Redish, J. (., & Chisnell, D. (2004). Designing Web Sites for Older Adults: A
Review of Recent Literature. AARP.
Rowland, C. (2010). Accessibility: The Need for Champions and Awareness in
Higher Education. Educause Review, 45(6), 12.
Rowland, C. (2010). Transforming the Institution. Educause Review, 45(6), 14.
Savidis, A., & Stephanidis, C. (2004). Developing Inclusive e-Learning and e-
Entertainment to Effectively Accommodate Learning Difficulties., (pp. 42-54).
Solheim, I. (2009). Adaptive User Interfaces: Benefit or Impediment for Lower-
Literacy Users? Universal Access in HCI, Part II, HCII 2009 (pp. 758-765).
Springer-Verlag Berlin Heidelberg.
Summers, K., & Summers, M. (2005). Reading and Navigational Strategies of
Web Users with Lower Literacy Skills. Proceedings of the American Society for
Information Science and Technology, 42.
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27. References (contd.):
Vigouroux, N., Rumeau, P., Vella, F., & Vellas, B. (2009). Studying Point-Select-
Drag Interaction Techniques for Older People with Cognitive Impairment.
Universal Access in HCI, Part I, HCII 2009 (pp. 422-428). Springer-Verlag
Berlin Heidelberg.
Walser, K., Quesenbery, W., & Swierenga, S. (2008). Designing for Cognitive
Disabilities. UPA 2008 – The Many Faces of User Experience. Baltimore,
Maryland, USA.
WebAIM. (n.d.). Cognitive and Learning Disabilities Literature Review.
Retrieved from WebAIM Web Accessibility in Mind:
http://webaim.org/projects/steppingstones/litreviewsummary
WebAIM. (n.d.). Steppingstones Project on Web Accessibility and Cognitive
Disabilities in Education. Retrieved from WebAIM Web Accessibility in Mind:
http://webaim.org/projects/steppingstones/steppingstones
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