Title: Inclusion Of Cognitive Disabilities in the Web Accessibility Movement

Author Lisa Seeman, GlobalFormats.com, ablefish.com

Keywords : Cognitive Disabilities, Web Accessibility Initiative, WAI, WCAG,

Approximate word counts: 2,000


This paper explores the attitude and accomplishments towards including Cognitive Disabilities within the Web Accessibility movement. It then suggests practical steps that could be taken to increase the usefulness of Web Accessibility for the Cognitively Disabled. These steps include 1. Increasing the number of practical techniques developed to aid web authors produce material which is more accessible to people with Cognitive Disabilities, and 2. Adjusting the definition of minimal accessibility.


"Disabled persons have the right to respect for their human dignity. Disabled persons, whatever the origin, nature and seriousness of their handicaps and disabilities, have the same fundamental right to enjoy a decent life, as normal and full as possible." (United Nations Declaration on the Rights of Disabled Persons, 1976.)

People with Cognitive Disabilities are legally disabled, and as such are accommodated for within the Web Accessibility Initiative. However WCAG checkpoints pertaining to Cognitive Disabilities are lacking in practical techniques, i.e. they tend to the general, treating all Cognitive Disabilities as cases of low literacy and/or low intelligence.

Section 1: About Cognitive Disabilities

Cognitive impairments incorporate a wide variation of Memory, Perception, Problem-solving, and Conceptualizing. They are attributable to a condition such as mental retardation, cerebral palsy, epilepsy, neurological impairment, autism or traumatic brain injury.

Cognitive impairments are often localized. Where some cognitive functions are impaired, others function at normal or even above normal levels. In other words, people with cognitive impairments can be of average or above average intelligence. Cognitive Disabilities can also be developed with the aging process.

Developmental disabilities are defined as severe, chronic disabilities attributable to mental and/or physical impairment. These manifest themselves before 22 years and are likely to continue indefinitely. They result in substantial limitations in three or more areas such as: self-care, receptive and expressive language, learning, mobility, self-direction, capacity for independent living, and economic self-sufficiency. (source: AHRC 2002) There are nearly four million Americans with developmental disabilities. (source: US Administration on Developmental Disabilities)

Pervasive Developmental Disorders (PDDÆs) include Asperger Syndrome, Rett Syndrome, Williams Syndrome, and autistic disorders. They affect, to a differing degrees, an individualÆs ability to communicate, understand language, play and relate to others. Individuals with PDD vary widely in their intelligence, abilities, and behavior.

An individual is considered to have mental retardation if his/her IQ test result is below 70, and he/she has significant limitations in two or more adaptive areas, such as communication skills, home living ability, social skills, self-direction, functional academics. (source: AAMR, 1992).

There are an estimated 6.8 million people with mental retardation in the United States alone. (source: Batshaw, 1997). Mental retardation affects 100 times as many people as blindness. (source: AAHR 1994)

Section 2: Should Web Authors Accommodate the Cognitively Disabled?

It is the position of this paper that if someone who could understand web content is unable to, because of the design choices of the web author, then that web content is inaccessible, even if it can be used by all types of physically disabled persons. There exist arguments that the web author may exclude designing for the Cognitively Disabled. Typical arguments include: 1) the Cognitively Disabled are not within a site's target audience, and 2) designing for the Cognitively Disabled presents an undue burden on the content provider. The first argument, that web authors can guarantee the abilities of his/her target audience is always weak, but is particularly lacking in this case. The symptoms of the Cognitive Disabilities are often not obvious, and can frequently be developed as a consequence of the aging process. More importantly, cognitive impairments do not guarantee an overall low intelligence. Technical or educational sites, whose target audiences have a prerequisite of intelligence, should not assume that the cognitively impaired would be excluded from their target audience. The second argument of undue burden, is perhaps a stronger case. The argument is that it is not practical - either it is too difficult or too expensive to present information in a way that is accessible to the cognitively disabiled. Policy makers often provide an exemption for the case of undue burden. However all accessibility techniques are difficult until one understands their implementation and is familiarized with them. The same holds true for comprehension-oriented techniques. With practice and familiarization accessibility techniques for the Cognitively Disabled should no longer present an undue burden.

Section 3: Web Accessibility and Quality of Life

The inclusion of techniques to aid the cognitively impaired, within the overall web accessibility, substantially improves the quality of life of many disabled people. Judy Brewer Brewer in "How People with Disabilities Use the Web" (http://www.w3.org/WAI/EO/Drafts/PWD-Use-Web/Overview.html) cites how accessible websites can help people with Cognitive Disabilities advance their careers and increase their educational options. The electronic form of the Internet, provides an excellent opportunity to include and allow people with all disabilities to participate in most aspects of society. In the case of the Cognitively Disabled, this presents people with the opportunity to participate, without continuously being subjected to the stigmas that plague these conditions. The web accessibility movement could also play a significant role in enabling the Cognitively Disabled to live independently.

Section 4: WAI and WCAG Accomplishments

One of the main areas of activity of the W3C is the Web Accessibility Initiative (The WAI). The WAI is involved in creating guidelines for browsers, authoring tools, and content creation (WCAG).

Web Accessibility guidelines contain general principals on how to make web content accessible to people with disabilities. Each guideline is supported by multiple checkpoints that specify what steps need be done to fulfill a guideline. Each checkpoint is associated with multiple technology specific techniques that illustrate how the checkpoint can be met.

WCAG 1 already promotes the following checkpoints that benefit the Cognitively Disabled. They include:

All these guidelines are useful for a wide range of disabilities. There is a lack, however, of specific checkpoints or techniques that could increase accessibility for specific cognitive impairments.

Section 5: Work Required

To help WCAGÆs and the Web Accessibility movement's commitment to adequately include Cognitive Disabilities, the following steps are recommended:

Section 6: Examples of Possible Authoring Techniques

There are two types of authoring techniques that could be incorporated into WCAG 2 to help promote Web Accessibility for the Cognitively Disabled.

6.1 Developing authoring techniques for specific Cognitive Disabilities

Most checkpoints in WCAG 1 that are geared to Cognitive Disabilities tend to be general aids to comprehension. This paper supports the efforts to develop authoring techniques for WCAG 2 to help specific Cognitive Disabilities.

For example, Semantic Pragmatic Disorder (SP) is a communications disorder that impairs the possessing of information that is non-literal and has no visual reference. People with SP are likely to take colloquialisms, metaphors or sarcasm at their literal meaning. Hence they are often unable to understand or are confused by content, because of the semantic choices of the author.

As the web and authoring becomes more informal and "user friendly", this problem is accentuated and spreads even to manual and instructional information. However, the W3C's Ruby Technology offers an excellent potential solution: Non-literal text could be marked up in ruby and a literal translation attribute added to provide a literal alternative. The semantic web could be used to track literal translation attributes. (This technique was suggested by Charles McCarthy-Neville of the WAI).

For example, see the following code snippet:

<p>The Prime minister wants to 
    <rb>have his cake and eat it too</rb> 
    <!-- the metaphorical expression --> 
    <rt class="http://wordnet.org/literally">get the benefit of seeming inflexible
      now, but be able to change his mind again later</rt> 
    <!-- the rt element can be rendered alongside, or instead of, the rb content,
      according to the styling --> 
 in this instance.

People with SP could then easily choose literal alternative renderings and consistently view the information in the semantic format that they need.

6.2 Developing specific techniques to help Cognitive Disabilities in general

WCAG checkpoints that support aiding the Cognitively Disabled lack practical techniques that will ensure the fulfillment of the checkpoint. However, these techniques are in use and are well known by many disability organizations. For example, authors could use products such as MindManager or Ygnius to ensure that their content is logical, that headings are unique and meaningful on their own, that there is one idea per paragraph, to provide a document summary map, and to map the document section to those described in the summary.

structuring a document
caption: MindMap structuring of a document: Flow between document structure and conceptual ideas is well illustrated

Section 7: Examples of Possible User Agent Techniques

User agents could be encouraged to provide renderings and presentations that can help aid comprehension. User agents could provide renderings of xml and xhtml content which mimic tools that are used by the learning disabled to help them understand the relationship and structure of a document without the restrictions of slow reading and literary skills (like MindManager and Ygnius). Alternately XSLT rendering could be provided.

For more severe Cognitive Disabilities, simple instructions could be converted or translated into signs using techniques similar to films produced by cognitivedesigns.com. Cognitivedesigns.com claim that programs stems from research finding that non-verbal children, previously unable to understand spoken language or communicate, could begin to do so after signs, spoken words and their related objects or events were simultaneously presented to them. Signs are adapted from the American Sign Language (ASL) for the deaf. At the same time, the inclusion of appropriate spoken words on the aural rendering makes possible a transfer of meaning from sign to spoken word.

Section 8: Barriers to Including Cognitive Disabilities

It is probably useful to recognize that creating authoring techniques alone will not guarantee that Cognitive Disabilities have an equal standing in Web Accessibility. Attitudes and emphasis also have a significant role to play in the inclusion or exclusion of Cognitive Disabilities.

Section 8.1: Myths about Cognitive Disabilities

Many authors are reluctant to incorporate accessibility for the Cognitively Disabled. Typical reasons given include: 1) These disability groups are not considered within their target audience, and 2) it is felt that including the Cognitively Disabled would present undue burden. As mentioned above (section 2) these arguments are rarely valid. Education and outreach could be directed at changing these attitudes.

Section 8.2: Attitude toward Web Accessibility

Misunderstanding of Web Accessibility has led to a "Text Only" approach towards implementing accessibility, where Web Authors produce allegedly accessible sites by reducing their content to simple text. This practice may remove illustrative marterial, thus reducing the accessibility of the site for the Cognitively Disabled.

Section 8.3: WCAG prioritization

In an attempt to refute the argument that Web Accessibility is overly hard to achieve, WCAG produced a prioritization system to help promote accessibility in a minimal, easily verifiable form. As such, it gave industry and legislators the option to choose Single A compliance and minimal accessibility.The creation of minimal accessibility compliance however, promoted information being available but not necessarily understandable. As a result, checkpoints geared for people with Cognitive Disabilities were presented as lower priority. This had the not surprising outcome that a minimal amount of sites, attempting to address accessibility, have considered implementing checkpoints that are geared to the Cognitively Disabled.

Section 9: Conclusion

It is acknowledged that much has been done to include the Cognitively Disabled within the web accessibility movement. But more techniques need to be incorporated within WCAG. This would ensure a web author, by following the WCAG, can guarantee that those who could understand web content, will be able to do so.

"The power of the Web is in its universality. Access by everyone regardless of disability is an essential aspect."
-- Tim Berners-Lee, W3C Director and founder of the World Wide Web


WCAG team, especially: Anne Pemberton, Charles McCarthy Neville, Rob Pedlow, Graham Oliver


AHRC New York at http://www.ahrcnyc.org/ DSM-IV (American Psychiatric Association, 1994),

AHRC New York City http://www.ahrcnyc.org/index.htm FAQ's Sheet (2002)

American Association on Mental Retardation. (1992).

Mental Retardation: Definition, Classification, and Systems of Supports, 9th Edition. Washington, DC. Alexander, D. (1998).

Prevention of Mental Retardation: Four Decades of Research. Mental Retardation and Developmental Disabilities Research Reviews. 4: 50-58 Batshaw, M. (1997).

The Arc. (1982). The Prevalence of Mental Retardation.

US Administration on Developmental Disabilities, see http://www.acf.dhhs.gov/programs/add/Factsheet.htm, -January 25, 2002