Guide to Cognitive Disabilities
Cognitive disability is a nebulous term that describes a person who has more than average difficulty with mental tasks. There may be overlapping in defining a developmental and cognitive disability. The terms are broad labels that do not indicate the level of ability or skills. Cognitive disabilities are the most common disability type. Most cognitive disabilities are physiology and biology-based.
The connection between mental processes and biology is most apparent in traumatic brain injury cases and genetic disorders. More subtle cognitive disabilities are rooted in chemistry or brain structure. People with serious cognitive disabilities require assistance with almost every aspect of their daily lives. Those with minor disabilities may function adequately to the extent the disability is not diagnosed.
Some web content is too complicated in nature to be fully accessible to users who have profound cognitive disabilities. Designers and developers have techniques that make content accessible to a broad range of users.
Functional vs. Clinical Classifications
Cognitive disabilities are classified as clinical or functional. Clinical diagnoses include dementia, traumatic brain injury, Down syndrome, and autism. Less severe conditions are learning disabilities, such as problems with math, referred to as dyscalculia and difficulty reading, referred to as dyslexia, and attention deficit disorder.
Functional disability classification is useful for web accessibility. From a medical treatment perspective, clinical diagnoses are more useful for proper medical care. The focus of functional classification is the user’s challenges and abilities without regard to behavioral or medical causes.
One clinical diagnosis can reveal multiple functional disabilities. Someone with memory deficits may have difficulty with problem-solving or attention. Functional cognitive disability categories include:
- Math comprehension
- Reading, verbal, and linguistic comprehension
- Visual comprehension
Knowing people are autistic is meaningful to designers only if they know the barriers people with autism may face with web content. Conversely, when developers know people have difficulty with math comprehension they have a meaningful context. Developers need to understand and consider the range of abilities of users.
For individuals who find it hard to stay focused on tasks, distractions like spontaneous dialog overlay, jiggling coins, toast popups, and animating carousels make completing tasks difficult or impossible. Such movements also impair usability for neurotypical users.
Some individuals with Attention Deficit Hyperactivity Disorder have learning difficulties. It is often due to distractability rather than being able to process information. Individuals with ADHD can be inattentive, easily distracted, impulsive, and less able to stick to tasks long-term.
Some are very productive and highly creative in short spurts with enthusiasm and an abundance of energy. Avoid things that distract the main functionality and content from helping users focus on what is essential. Use exceptional web design with the use of simple presentation, white space, and color contrast.
Math expressions may be complicated for users who have cognitive disabilities to understand. You should not avoid mathematics entirely. For people comfortable thinking mathematically and reading equations, math concepts are best explained using equations. Explaining math conceptually is often helpful with or without formulas. It helps readers understand the reasoning behind the math.
Some people with cognitive disabilities have difficulty with either working memory, short-term memory, or long-term memory. They may have trouble with two or three of them. Some users have trouble remembering how they accessed content.
If multiple errors are displayed, the user may not remember them or forget the error message before addressing it. Maintaining consistent presentation and design minimizes memory requirements.
People with cognitive disabilities have trouble solving problems that arise. Low resilience causes frustration and leads users to abandon a website or task. CAPTCHA puzzles are an example that requires a high level of cognitive function, links that take users to unexpected content, and technically worded error messages.
Reading, Verbal, and Linguistic Comprehension
Individuals who have intellectual disabilities such as difficulty understanding text have problems ranging from minor challenges to the inability to read any text. Website developers may not fully accommodate the range from non-readers to geniuses, but they can attempt to write clearly and simply as feasible.
They should take the primary audience into account. That includes those who have difficulty with some content. Approximately 15 to 20 percent of the population has some kind of text or language comprehension difficulty. Many prominent high achievers, such as Whoopi Goldberg, Richard Branson, and Emma Watson, are among them.
People who have difficulty processing visual information have a problem opposite of those with verbal and reading processing difficulties. They may recognize a website page contains objects but cannot identify them. While they see a photograph, they may not realize it is a representation of a person. A talking and moving person in a video is easier to process and identify for these users mentally. Multimedia and narrated videos are more helpful than a static image of someone.
Making Technology Accessible to All Users
Accessibility helps more than those who are blind. Thinking, moving, hearing, seeing, and speaking are five disability types to consider for digital accessibility. Thinking includes disabilities impacting how the brain is used, such as memory, problem-solving, and emotions.
To understand the need for digital accessibility, imagine not using your computer, TV, or smartphone by yourself. A 2018 Nielsen study reported that American adults spend more than 11 hours reading, watching, listening, or interacting with digital media. They use technology at school, work, and play.
A broad understanding of cognitive disabilities is needed for making technology accessible to all users. The typical response when someone cannot do something is, ‘Ask for help.’ That response is inappropriate to people with cognitive disabilities. They should access a website with independence equivalent to someone without a disability. It is a civil right to be able to access information independently.
Sometimes a person with a cognitive disability needs information presented differently. That is important when information about the users is private or something they want to be kept confidential. Potential blockers include:
- A website not working with assistive technology
- Not remembering a password or login and having trouble resetting it due to steps that are not easy to follow
- A PDF does not work with assistive technology
Disability Technological Solutions
Assistive Software or Hardware for People With Cognitive Disabilities
Assistive technologies help those with disabilities keep records, make documents, post to social media, search the internet, and type or speak to a computer to help write emails. For people with cognitive disabilities, assistive technology can help with the organization of thoughts needed to write a letter, track where students are in projects, and remember passwords.
Content Accessibility Guidelines (WCAG) were created by the World Wide Consortium (W3C) that explains how to make the internet better for a person with disabilities. The existing rules are helpful. There is room for improvement.
Children with a learning disability, intellectual disability, and mental retardation have user needs crucial to having equal access to online content. Those with cognitive disabilities’ needs include easy use and authentication security, error prevention, and no distractions. Everyone benefits from all of these improvements. The types of mental disabilities being researched include:
- Accidental: traumatic brain injury
- Age-related: memory, dementia, Alzheimer’s
- Intellectual disability: Down Syndrome
- Learning disabilities: Attention Deficit Hyperactivity Disorder
- Mental health: PTSD, depression, anxiety
How to Help Those with Cognitive Disabilities With Communication Skills
Ways people can help address accessibility issues include:
- Sending an email
- Making a phone call
- Completing a Contact Us form when a digital accessibility barrier is found
Include the software name, location, document title, or website address. Describe the problem in one or two sentences. Thank them for reviewing the issue, and give them your contact information to learn more.
Not all disabilities result in decreased intellectual functioning. Sometimes a person will use the term when referring to a component that affects cognitive functioning. There are many people with a cognitive disability that are not limited in their intellectual functioning.
When accommodations are needed, they should be implemented respectfully. Programmatic and physical capacities are determined on an individual basis. Some benefit from the information presented in a simple, concrete, concise, and straightforward manner and can assist with adaptive behavior.
When necessary, repeat information with a different communication approach or other wording. Allow time for the contents of an article to be fully understood. Avoid jargon and clichés whenever possible. If necessary, analyze activities for a child and sequentially present tasks in small steps.
Use simple photographs or pictures to identify directions, tasks, rooms, and people when appropriate. Think creatively about ways to make jobs easier for a person. Non-readers, for example, may benefit from color-coded files. Using watches that have talking alarms and timers and tape recording instructions are other options.
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The ADA prohibits any private businesses that provide goods or services to the public, referred to as “public accommodations,” from discriminating against those with disabilities. Federal courts have ruled that the ADA includes websites in the definition of public accommodation. As such, websites must offer auxiliary aids and services to low-vision, hearing-impaired, and physically disabled persons, in the same way a business facility must offer wheelchair ramps, braille signage, and sign language interpreters, among other forms of assistance.
All websites must be properly coded for use by electronic screen readers that read aloud to sight-impaired users the visual elements of a webpage. Additionally, all live and pre-recorded audio content must have synchronous captioning for hearing-impaired users.
Websites must accommodate hundreds of keyboard combinations, such as Ctrl + P to print, that people with disabilities depend on to navigate the Internet.
Federal lawsuits filed in 2017 increased 225% over 2016; this percentage would be significantly higher if it included litigation filed in state courts against thousandsof businesses. Retail businesses have been hit hardest, followed by hotels, restaurants, colleges, hospitals, casinos, and banks. But any business that maintains a website, regardless of its size or industry, is vulnerable.
Big box retailer Target Corp. was ordered to pay $6 million – plus $3.7 million more in legal costs – to settle a landmark class action suit brought by the National Federation of the Blind. Other recent defendants in these cases have included McDonald’s, Carnival Cruise Lines, Netflix, Harvard University, Foot Locker, and the National Basketball Association (NBA). Along with these large companies, thousands of small businesses have been subject to ADA web litigation.
Defendants in ADA lawsuits typically pay plaintiff's legal fees, plus their own web acccessibility auditing and remediation costs. In all, the average cost can range from tens of thousands of dollars and above six figures. Furthermore, if the remediation is incomplete, copycat suits and serial filers can follow, meaning double or triple the outlay. There are also high intangible costs for a business, such as added stress, time and human capital, as well as reputational damage.