Cognitive and Neurological Disabilities

Introduction

Cognitive, learning and neurological disabilities include neurodiversity, neurological disabilities, mental health, and behavioral disabilities ¹. Cognitive and neurological disabilities don’t necessarily impact someone’s intelligence ¹, though they may impact their ability to express themselves.

There’s more diversity in presentation of cognitive and neurological disabilities than any other category, so the key to designing for this group is allowing them to be flexible. One person may be best served by changing the visual display of text in the system, and another may be best served by using a screen reader to read the content while they follow along on the screen ¹. Many of these methods are shared by people with hearing, physical, speech, or visual disabilities ¹.

Examples of disabilities

Examples include ¹:

• Attention Deficit Hyperactivity Disorder (ADHD)
• Autism Spectrum Disorder
• Dementia
• Down Syndrome
• Dyscalculia and low numeracy
• Dyslexia
• Developmental disabilities
• Perceptual disabilities
• Reading disabilities
• Mental health disabilities including
  • Anxiety
  • Delirium
  • Depression
  • Paranoia
  • Schizophrenia
  • Many others
• Memory impairments
• Migraines
• Multiple Sclerosis
• Seizure Disorders
• Vestibular Disorders

Because cognitive and neurological disabilities result in such a wide range of experiences, it can be incredibly challenging to describe what “people with cognitive and neurological disabilities” experience as a category. However, a few elements tend to trend higher than others. 

• Limited comprehension — difficulty understanding complex ideas, metaphors, or abstract language, slang, or idiomatic expressions ². It’s worth noting that people may have high cognitive functions in one area but not in another ².
• Low tolerance for cognitive overload — becoming easily frustrated or upset in difficult situations, too many stimuli, or complexity ². They need things to be simple and straightforward ².
• Limited problem-solving skills — some (definitely not all) people with cognitive and neurological disabilities may be unable to solve a problem like what to do with a CAPTCHA box when logging in ². They may not even attempt to solve it ².
• Short-term memory loss — some people have a hard time remembering things from one moment to the next². They can’t focus on new information, so it gets lost². Long web process can cause users to forget what they were doing or lose track of information from one step to the next².
• Attention deficit — where people can’t focus on the task at hand, which can also lead to forgetting what they were doing or losing track of information².
• Difficulty reading — this may have many causes with similar results: some people read at a lower level than their peers or can’t read at all².
• Difficulty understanding or using math — like reading disabilities, this may have many causes with similar results: some people solve mathematical problems at lower levels than their peers, or not at all².

Design considerations

Do

• Clearly structure content to make orientation and understanding the big picture easier ¹.
• Make the interface predictable including link targets, functionality, and overall interaction ¹.
• Provide multiple paths through navigation including both browse and search modes ¹.
• Provide clear navigation and page layouts that are easy to understand and use ²
• Use clear and precise “plain language” instructions or explanations.²
• Provide images, graphs, or other illustrations to highlight or reemphasize key content ¹.
• Ensure designs can be adapted using web browser controls or custom stylesheets ¹
• Provide a limited number of choices at every step to cut down on cognitive overload ¹
• Provide help features for when users get stuck ¹
• Ensure predictability across navigation and structure to cut down on cognitive fatigue. Consistently label forms, buttons, and other content parts ¹.
• Limit distractions, including blinking, flickering, flashing, or animated content ¹.

Don’t

• Don’t make navigation and pay layouts complex and hard to use ¹.
• Don’t write complex text that’s difficult to read and understand ¹.
• Don’t write long passages of text without images, graphs or other illustrations ¹.
• Don’t use moving, blinking, or flickering content and/or background audio that cannot be turned off. These things may trigger seizures or other disorders. (That doesn’t mean we can’t use them; it does mean we have to provide easy access to shut them off.) ¹
• Don’t build media that the user can’t shut off ¹.

Don’t build visual page designs that can’t be adapted using custom controls or stylesheets ¹.

Own Words

Your Interactive Makes Me Sick by Eileen Web outlines some of the impacts of animated scrolling and breaking the user’s expectations for scrolling on users with migraines and other vestibular disorders.

Additional resources

• Cognitive Accessibility Guidance in All Supplemental Guidance by the WAI
• Cognitive Accessibility Roadmap and Gap Analysis by the W3C
• Cognitive Accessibility User Research by the W3C