For most of us, the Internet is an important part of our daily lives. It is a source of news, information and entertainment. However, for individuals with cognitive disabilities, especially those with severe cognitive disabilities, the Internet is difficult, if not impossible to use.
According to the US Census Bureau, 14.3 million Americans age 15 and over have a cognitive disability. This includes 1.9 million who have Alzheimer’s disease, senility or dementia, and 3.5 million with a learning disability (US Census Bureau, 2001). This means that improving accessibility of the web to this population is an important problem; however, “those with cognitive disabilities and learning difficulties, appear to have slipped through the cracks to a large extent when it comes to website accessibility” (Hudson, Weakley & Firminger, 2005).
I am an information systems professor that conducts research on how to organize and maintain Web-based content so that it can be used to better meet business and special education needs. I am also the parent of an adult son with Autism that has severe communication impairments. Yet, until
recently, I thought website accessibility meant making your site accessible to individuals with vision impairments. I never considered that individuals with cognitive disabilities like my son could and even should be able to use the Internet.
There are a number of reasons why cognitive accessibility is not taken into account when designing websites. Accessibility for users with cognitive disabilities can be a far greater challenge than for those with other types of disabilities. Cognitive impairments are the least understood of the disability categories (Novak & Paciello, 2002) and the individual need of cognitively disabled users can vary wildly depending on the nature of the disability. This population can have difficulties in any or all of these areas:
- Lingual (text and language)
- Learning and problem solving
- Focus and attention span
- Visual comprehension
Despite the complexity of the problem, there is evidence that this population could use the Internet if appropriate accommodations are made. Researchers working in Spain conducted an experiment which constructed a simplified web that used picture based navigation and content. They found that it was possible to create a web that navigable, “appropriate and understandable” even for those with severe cognitive impairments (Sevilla et. Al. 2007).
That is consistent with what I have found with my own son. If content is presented visually, he can navigate through a multi-level user interface to locate the content he needs. He does this daily on his Dynavox communication device, frequently navigating through 3 or 4 screens to find the icons that will allow him to make the requests he wants to make.
Web accessibility is a complex concept that can be broken down into three areas that need to be addressed when trying to create a cognitively accessible Web system (Loy 1998):
- Computer Accessibility: This area has improved dramatically in the past several years with the availability of relatively low cost touch screen devices.
- Browser Accessibility: Browser features that enable accessibility (screen readers, simplified browsers).
- Web Accessibility: Web pages content and structure.
To this list I would like to add search accessibility, the ability to locate relevant accessible content.
Current State of Cognitive Accessibility
There have been two areas of work that has been done to address cognitive accessibility. The first has been research which has focused on creating specialized browsers that can translate existing content into a more cognitively accessible counterpart using text-to-speech (TTS)
technology, display of in a simplified format, and/or the conversion of Web site text into a symbolic representation.
- WWAAC is the result of a Pan-European effort funded in part by the European Commission. This is an older browser (2004) and does not work in Windows 7, but it is free.
- EdWeb was developed by The School of Informatics, University of Manchester, England. This is also free, and also out of date.
- Communicate: Webwide is a commercial product produced by Widget
Software. It is a subscription-based service designed help any reader who has difficulty accessing the text in standard English language web pages. It does this by converting text to symbols.
- Web Trek is a commercial product produced by AbleLink Technologies. It is a visual web browser
for accessing favorite websites and simplifying access to existing web-based resources used by schools for online learning.
The advantage of the tools above is that they are designed to work with the existing web and make it more accessible. They also include a simplified interface which can make it easier to use the browser and navigate the web. However, for many individuals with cognitive disabilities, even if current websites are translated into symbols or read aloud, the content still not cognitively accessible.
The second area of research has been in the area of website accessibility. That is, what needs to be done on individual websites to make them more cognitively accessible? This has resulted in a set of design considerations that need to be taken into account when creating websites for the cognitively disabled. The National Center for Disability and Access to Education has an excellent article on their site that discusses what needs to be done to make websites more usable and accessible to the cognitively disabled (Mariger 2006). However, the design guidelines published at this site, and numerous other sites, does not seem to have resulted in a large number of websites that have taken them into account.
When I searched for cognitively accessible content or tools I found remarkably few websites with cognitively accessible content. Even sites serving the cognitively disabled population often are not accessible to the cognitively disabled. Clearhelper.org has a list of 20 websites serving individuals and families with cognitive disabilities and rates them on their accessibility. Most do poorly and appear to be designed for parents and caregivers instead of for the cognitively disabled themselves. The only sites I found that were designed for individuals with cognitive disabilities were in the UK. The best site I found was a transition website called Newham Easy Read. Unlike other websites, this site was explicitly designed to provide information of interest to individuals with cognitive disabilities in a format that most could process and understand. It has a mix of consistent navigation and content (picture, audio and video) to explain topics, like safety, to visitors.
The Newham site is an excellent example of what is possible online for individuals with cognitive disabilities. However, it is primarily an informational site and does not include entertainment and other content that could be used by individuals with cognitive disabilities.
Another site that has design and navigation ideally suited to the cognitively disabled population is Zoodles. This web portal was designed for small children. I accessed it using a Firefox plugin which rewrote my browser interface to remove the entire top and bottom browser tools and replace it with the simple tabbed navigation system seen below (the tabs at the top are not part of the website, they are the browser). The web pages themselves obey all of the cognitive accessibility guidelines, complete with bread crumb navigation, picture based navigation, and easy to use arrows to allow you to move forward and backwards in the collection of content. It even has a very nice video mail feature that can be used by the child to send mail to family members that are registered in the system. The primary problem with Zoodels is that it is designed for small children, so the content itself is not necessarily suited young adult and adult cognitively disabled individuals.
Zoodles is a good example of what I think a cognitively accessible web should look like. In my next post I will continue this series, focusing on what we would need to do to get from where we are today, to a more cognitively accessible web that could be used by cognitively disabled individuals, like my son.
Towards a Cognitively Accessible Web Portal
The research on cognitive accessibility and the current tools and websites that are available make it clear that a cognitively accessible web is possible. But it also is clear that we have a long way to go before the internet can truly be accessible to all. Ideally, we should have an accessible tool like Zoodles, built to meet the needs of the more mature cognitively disabled population. Ideally, this site would allow cognitively disabled individuals to access the following types of content:
- Legal information (rights of the disabled)
- Service information
- Public transportation information (schedules, how to get from here to there).
- Information on topics individuals with cognitive disabilities might have difficulty with (e.g. the Newham site had information on how to know if someone is really a friend).
- Health care information (why get a flu shot and where?)
- Content to support communication (an online communication device)
- Content to support independent living
- Entertainment content (games like on Zoodles, plus video from YouTube and music).
- The ability to send accessible email to family and friends
- Possibly social media content
The question is: How can we get from where we are today to something that meets both the near term needs of the population as well as building towards a more widely accessible tomorrow? I have taken the first step toward building the cognitively accessible web portal.
Step 1: Firefox plugin that generates a simplified, Zoodles-like interface
The Zoodles system rewrites the browser interface to simplify it and make it “accessible” to young children. My similar simplified interface could be highly beneficial for the cognitively disabled as well. The current version of the interface has hardcoded tabs to point to specific cognitively accessible web pages. In the future I envision being able to rewrite the tabs to meet the needs of individual users or locations. One advantage to using a browser plugin to rewrite a current browser interface used with the general population is that helps ensure that the browser it self will stay up to date.
Step 2: Directory of Cognitively Accessible Resources
I built a directory of cognitively accessible resources that can be browsed using this simplified browser. I have begun this directory using content that already exists in an format that is accessible to this population (e.g. the info content above points to content from the Newham Easy Read site). Ideally, the directory should grow as people post new content including categories of information that are currently missing from the current site.
I would also like to extend the capabilities of the directory to simplify the interface to other sites with accessible content. For example, the “Videos” tab above currently points to YouTube and Hulu; however, while the videos themselves may be accessible the interface may be too cluttered for a cognitively disabled individual. For these types of sites a mashup, such as Easy YouTube, can be used. In web development, a mashup is a web page or application that uses and combines data, presentation or functionality from two or more sources to create new services. This would allow the portal to pull content, like YouTube videos, from the inaccessible Internet and make them available and searchable via a cognitively accessible interface.
I have started this project, but what I have done to date really is only a first step towards building a web portal that can be used by cognitively disabled individuals like my son. Much of the information that should be available via this type of portal simply is not there. So I would like to ask the web community for help. Do you know of any picture, video or game sites that are suitable for or have content that is accessible to individuals with cognitive disabilities? If so please provide links to those sites in your comments or submit a site you think should be in my mash-up at http://ddweb.developingmindssoftware.com .
I am impatient. A truly accessible web is likely years away but that does not mean that part of the web cannot be accessible to my son today.
- U.S. Census Bureau. (2001). Nearly 1 in 5 Americans has some level of disability. Press release, March 16. Washington: U.S. Census Bureau, Public Information Office
- Hudson, R., Weakley, R. & Firminger, P. (2005). An accessibility frontier: Cognitive disabilities and learning difficulties. Webusability – Accessibility and Usability Services
- Novak, M.E. & Paciello, M.G. (2002). The x-windows accessibility conquest: Developing for people with disabilities. The Paciello Group.
- Loy, B. wt. al. 1998. Surfing the net: The three keys to universal access CSUN 98 papers.
- Javier Sevilla, Gerardo Herrera, Bibiana Mart´Inez, And Francisco Alcantud, “Web Accessibility for Individuals with Cognitive Deficits: A Comparative Study between an Existing Commercial Web and Its Cognitively Accessible Equivalent,” ACM Transactions on Computer-Human Interaction, Vol. 14, No. 3, Article 12, September 2007.
- Heather Mariger “Cognitive Disabilities and the Web: Where Accessibility and Usability Meet?” 2006
- Newham Easy Read
- John Rochford, Cognitive Web Accessibility Assessments: Summary Results By Web Site