Designing for Peoplewith Cognitive Disabilities:

How Can the UX Community Help?

Yulia Nemchinova

Northrop Grumman Corporation

October 19, 2012

User Focus Conference

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Who Has Cognitive Disabilities

Seven percent in the US have some type of cognitive, mental or emotional impairment (Census 2010)

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Types of Cognitive Disabilities

Learning and language disabilities, including dyslexia

Attention disordersTraumatic brain injuries (TBI)Developmental impairments,

including mental retardation, autism, cerebral palsy, Down Syndrome

Cognitive issues related to aging

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Types of Functional Impact

Executive functionsMemoryAttentionVisual and spatial perceptionLanguage and readingMathematical thinkingEmotional control, expression,

understandingSpeed of reasoningSolving new problemsSolving problems based on experience

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When Users Encounter Obstacles…

Lack of confirmation that their action was correct

Cannot find and review features

Cannot recover from errorsCannot find landmarks Do not have enough time to

complete tasksCannot save their work at any

time…

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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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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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Why Are We So Behind?

Cognitive impairments are often:InvisibleDifficult to diagnoseNot universally definedNot willingly disclosed

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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, PhDConsultant, Payne & Associates, Inc.

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Obstacles in Designing for Cognitive

Complexity of cognitive issuesChallenging to find a universal

approachNo automated validation tools

exist, and it is unlikely a tool could substitute for human evaluation

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Web Accessibility Evaluation Tool

WAVE: a grant project at WebAimIdea: to ‘embed’ programmatic

solutions into a single toolIssue: supporting one disability

contradicted support for another; providing images to help with language disabilities distracted users with attention disorders

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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, PhDExecutive Director WebAIM; National Center on

Disability and Access to Education Center for Persons with Disabilities, Utah State University

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Curb Cut Access

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Support Assistive Technologies

Screen readersPlug-ins such as BrowseAloud by

TextHelp Read&Write by TextHelp VoiceOver for iPhone and

comparative Android applications

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Universal Design

Aiming to assist most usersCan be incorporated into existing

systems without having to design separate version

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Universal Design: Navigation

Consistent navigation and design on every page

Flat navigational architectureFunctioning Back buttonLimited the number of links per

pageStandard behavior for links

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Universal Design: Language & Literacy

Clear and simple textNewspaper style 6-8 reading level with a simple

sentence structureShort pages, paragraphs and

sentencesSingle column of contentAvoid navigational links at the

right, which can be distractive

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Mobile or Slimmed Down Access

Direct access to contentLimited content to processAvailability 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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Usability Testing

Usability studies with cognitively impaired people are extremely rare

User testing is neededThere is no substitution for actual

users with disabilities

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The Future: GPII

Global Public Inclusive Infrastructure (GPII)

Video about GPII: http://gpii.net/node/108

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Thank you!

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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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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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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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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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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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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