How WCAG helps people with cognitive impairments
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How WCAG helps people with cognitive impairments
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How WCAG helps people with cognitive impairments
- 1. How WCAG helps people with cognitive impairment Valorie Sundby, Karen Herr, Roberto Perez 35th CSUN Assistive Technology Conference March 13, 2020
- 2. © 2020 Optum, Inc. All rights reserved. Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. 2 Meet the speaker: Karen Herr My Super Power The Force that rises for digital equality. “Don’t underestimate the Force.” Education & Experience IAAP WAS and Section 508 Trusted Tester certifications and a BA in Mathematics. 20 “odd” years of software development, working in all the waterfall and agile team roles and specializing in accessibility the last 10+ years. My Accessibility Journey I “cut my accessibility teeth” working on federal contracts where Section 508 was the law. The importance of accessibility hit home when my father was diagnosed with macular degeneration and needed low-vision aids to surf the web, read his Kindle, and publicly post humiliating Facebook messages to his grandkids. Karen Herr, WAS, TT Principal Digital Accessibility Engineer karen.herr@optum.com
- 3. © 2020 Optum, Inc. All rights reserved. Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. 3 Meet the speaker: Roberto Perez My Super Power Desire for knowledge: I always want to have a beginner's mind. Education & Experience Certified professional in Web accessibility (CPWA). Certified in the use of NVDA and JAWS. Information Technology Engineer from Havana University, Cuba. My Accessibility Journey Thirteen years of combined experience as an accessibility professional and trainer in the use of assistive technology. Fixing accessibility related issues may be difficult but fixing the underlying culture that causes these problems in the first place is the true challenge. Roberto Perez, CPWA Principal Digital Accessibility Engineer roberto.perez@optum.com
- 4. © 2020 Optum, Inc. All rights reserved. Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. 4 Meet the speaker: Valorie Sundby My Super Power Revealer and teacher: I help others find their superpower and learn how to use it. Education & Experience My alphabet soup is a CPWA and PCWA with a BS in MIS. I have been a digital accessibility engineer for over 10 years. My Accessibility Journey Accessibility came naturally through my mother who was a physical therapist who specialized in spinal cord injury. She taught a paraplegic patient to climb stairs in a wheelchair by popping a wheelie and going backward. Fine for a young athletic person but not a maneuver likely for a grandmother with arthritis. Striving for access in the digital world is a good fit for me. Motto: Accessibility is a journey, not a destination. Valorie Sundby, CPWA Principal Digital Accessibility Engineer valorie.sundby@optum.com
- 5. © 2020 Optum, Inc. All rights reserved. Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. 5 Agenda: Celebrate the current benefits WCAG 2.1 does a lot for people with cognitive impairment 1. Cognitive impairment categories 2. What is cognitive load? 3. How does WCAG 2.1 help: • An Assistive Technology (AT) trainer's experience working with people with cognitive impairment • Speech and auditory • Anxiety • Where else does WCAG help?
- 7. © 2020 Optum, Inc. All rights reserved. Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. 7 Cognitive impairment categories Malfunction – something is broken • Learning disability, head injury, c-PTSD Instability – short period impairment • Anxiety, excessive stimulation, physicochemical changes Progressive decline – deterioration over time • Progressive disease (Alzheimer’s), drug use or abuse
- 8. What is cognitive load?
- 9. © 2020 Optum, Inc. All rights reserved. Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. 9 Extrinsic load Sometimes called extraneous load. The effort it takes to perceive the content.
- 10. © 2020 Optum, Inc. All rights reserved. Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. 10 Intrinsic load The effort it takes to understand the information.
- 11. © 2020 Optum, Inc. All rights reserved. Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. 11 Germane load The effort it takes to store the information.
- 12. © 2020 Optum, Inc. All rights reserved. Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. 12 WCAG 2.1 guidelines help cognitive load • Reduces cognitive load • Optimizes the audience’s capability • Allows for use of tools (AT)
- 13. My experience working with people with cognitive impairment Roberto Perez
- 14. © 2020 Optum, Inc. All rights reserved. Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. 14 Adaptable: Impact and how WCAG helps Examples: • Tables - header and data cell relationships − Anything done to define those relationships lightens the load • Page structure − Aids navigation in many ways
- 15. © 2020 Optum, Inc. All rights reserved. Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. 15 Distinguishable: Impact and how WCAG helps • Color contrast – text and non-text • Reflow • Audio control
- 16. © 2020 Optum, Inc. All rights reserved. Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. 16 Input assistance: Impact and how WCAG helps Consider an intake or registration form: • Instructions (date field) • Knowing when errors occur • How to fix • Understanding when it is fixed
- 17. © 2020 Optum, Inc. All rights reserved. Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. 17 Status changes: Impact and how WCAG helps Messages Loading indicator
- 18. Speech and auditory Karen Herr
- 19. © 2020 Optum, Inc. All rights reserved. Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. 19 Speech and auditory (SA) processing impact Four basic skills in auditory processing: 1. Auditory discrimination: song lyrics 2. Figure-to-ground discrimination: screen readers 3. Auditory memory: remembering names – verbal introductions 4. Auditory sequencing: write everything down
- 20. © 2020 Optum, Inc. All rights reserved. Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. 20 SA processing: How WCAG 2.1 helps 1.2 Time-based media – optimizes audience's capability with alternative input format 1.4 Distinguishable – optimizes audience's control of volume and reduces or eliminates background noise 2.2 Enough time – allows users to take their time to process 3.1 Readable – defining the language and language of the parts allows for screen readers to function at their best
- 22. © 2020 Optum, Inc. All rights reserved. Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. 22 Anxiety: Impacts • Often a comorbid impairment • Anxiety disorder can be a primary impairment • Highly variable • Impact changes quickly
- 23. © 2020 Optum, Inc. All rights reserved. Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. 23 Anxiety: How WCAG 2.1 helps 1.2 Time-based media – captions reduce extrinsic load when in a loud environment; transcripts provide an alternate format 1.4 Distinguishable – optimizes audience's control of volume and reduces or eliminates background noise 2.2 Enough time – allows use to take their time to process 3.1 Readable – defining the language and language of the parts allows for screen readers to function at their best
- 24. How else does WCAG help?
- 25. © 2020 Optum, Inc. All rights reserved. Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. 25 3.1.1 Language and 3.1.2 Language of Parts • The correct language impacts screen reader pronunciation and intonation • Incorrect language leads to mispronunciation
- 26. © 2020 Optum, Inc. All rights reserved. Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. 26 1.3.4 Orientation Continuous eye tracking can cause fatigue. Allows audience to adjust orientation to sweet spot. Related success criteria: • 1.4.4 Resize Text • 1.4.10 Reflow • 1.4.12 Text Spacing • 1.4.3 and 1.4.11 Color Contrast
- 27. © 2020 Optum, Inc. All rights reserved. Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. 27 Hand movement impacts cognitive load Success criteria that lighten the load: 1.4.13 Content on Hover or Focus 2.1.4 Character Key Shortcuts 2.5.1 Pointer Gestures 2.5.2 Pointer Cancellation 2.5.4 Motion Actuation 2.5.6 Concurrent Input Mechanisms
- 28. © 2020 Optum, Inc. All rights reserved. Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. 28 Predictability and adaptation: How WCAG 2.1 helps 1.3 Adaptable – WCAG’s "content is programmatically determined" allows innovators of AT to come up with alternative ways to present content 1.4 Distinguishable – lets the audience optimize their experience 3.2 Predictable – consistency reduces cognitive load
- 29. Thank you. Valorie Sundby Roberto Perez Karen Herr
Editor's Notes
- Cognitive impairment types Malfunction – something is broken Learning Disability, head injury, cPTSD (complex PTSD) Instability – short period impairment Anxiety, excessive stimulation, physicochemical changes (Fiz i ko kemical) Progressive decline – deterioration over time Progressive disease (Alzheimer’s), drug use/abuse
- (Valorie) Extrinsic load is the effort it takes to perceive the content Here we are showing an bunch of shapes and words all mixed up. “What is going on here?” , “What is important?”, The brain has to clean out the clutter to figure out what is important. That effort is the extrinsic load. Designers and content creators have the most influence on extrinsic load.
- (Valorie) Intrinsic load is the effort it takes to understand the information The internal nature of this cognitive load makes it difficult to eliminate. What we can do is provide the best formats that allow the consumer along with assistive technology to optimize the load. The cognitive load from a complex task can be reduced by breaking it down into smaller, simpler steps
- (Valorie) Germane Load is the effort it takes to store information Out brain organizes the content puts it into long term memory. We learn all kinds of memory games as children that help our memory. Associating a song, acronym, or image with what we are storing helps us to retrieve it later.
- A person learning the use of a screen reader needs to learn to understand the synthetic speech and develop the ability to create a mental representations based on the auditory information given by the screen reader. That on its own can cause the three types of cognitive load we have been discussing. Let’s imagine the process of interpreting an invoice contained in a data table using a screen reader. When the table meets the requirements in WCAG 1.3.1 Info and relationships, the person using a screen reader will hear the numeric values with their corresponding title in the appropriate order as he or she goes through the table using the keyboard, reducing the extrinsic loads, which will consequently reduce the intrinsic and germane load resulting in an increase level of confidence and satisfaction. When new screen reader users are confronted with the characteristics and structure of modern websites they often ask questions such as: How do I know what is navigation and what is content? Why is that no matter which links I choose the screen reader always seem to read the same content? How can I go directly to the place where the important content begins? When the page structure is conveyed through the use of landmarks and headings and semantic elements are used in a meaningful way, the person using a screen reader is in a better position to understand, discriminate and truly focus on the content instead of fighting with the container.
- (Roberto)
- (Karen) There are four basic skills involved in auditory processing, and kids who have these problems may be weak in one or more of them. Auditory Discrimination: This is the ability to notice and distinguish between distinct and separate sounds. This is crucial in being able tell similar but different words apart, like bat and pat, or seventy and seventeen. A lot of times, kids with auditory processing difficulties might miss information or misunderstand what you say because they mishear words,” says Cortese. “They’re not detecting the subtle differences in sounds.” They may also find it harder to learn to read and to express themselves clearly. When they’re speaking, they may mix up similar sounds because they don’t perceive the difference—say befs instead of best—and drop syllables out of words. Experts call this “syllable attenuation,” and it’s something kids often do when they’re learning languages but these kids continue to do it after most have begun to speak accurately. Kids with processing difficulties also have trouble rhyming, because their brain are not detecting that these are words that sound the same. For a lot of them, Cortese explains, that’s because they’re tuning in only to the beginning of the word, not the end. Figure-to-Ground Discrimination: This is the ability to differentiate important sounds from background noise, to follow verbal instructions or pick out one voice from the auditory clutter. In a classroom, a child who is weak in this figure-to-ground discrimination might have trouble being able to focus on what the teacher is saying rather than other sounds in the classroom. “It’s like a filtering problem,” Cortese adds. “What do I need to attend to? What do I need to filter out?” Auditory Memory: Auditory memory includes the ability to remember things we hear, in both the short-term and the long-term. Children weak in auditory memory have trouble remembering nursery rhymes and song lyrics, learning things through recitation, and remembering information unless it’s written down. Auditory Sequencing: This is the ability to understand and recall the order of sounds. A child with weakness in auditory sequencing will mix up numbers with the same digits in different order (84 and 48) and may switch the sequence of sounds in a word (ephelant instead of elephant). She may also have trouble recalling information presented in lists, and difficulty following instructions in sequence.
- 1.2 Time-based media– providing another format to support what is being heard or in place of listening. This reduces both extrinsic and intrinsic load. 1.4 Distinguishable – controlling volume to an optimal level gives the audience control. This reduces both extrinsic and intrinsic load Reducing or eliminating background noise reduces the extrinsic load 2.2 Enough time – having enough time to process can reduce all cognitive load 3.1 Readable - providing a higher quality experience with screen readers reduces the extrinsic load for someone has comorbid blindness and Speech and Auditory (SA) processing impairments
- (Valorie) Anxiety, with depression, is often a comorbid diagnosis. They are the baggage that comes with a primary impairment. Like barnacles on a boat, they add extra weight and drag. Anxiety disorder can be a primary impairment. General Anxiety disorder or GAD, Panic disorder, and OCD are each distinctive diagnoses that can occur on their own Anxiety disorders can be highly variable and the impact can change quickly. Think of a time when you were relaxed; low heart-rate, reclining. Suddenly a loud bang happens that shakes the room. Your heart instantly starts beating fast, your body physically seizes, eyes dilate, a cold sweat breaks out. That is the amygdala response. Someone with an anxiety disorder is either on-guard for this reaction at any time or can have the reaction to normal occurrences that the rest of us have learned to ignore. Medications, on the other hand, can lessen the amygdala response so that the person reacts at a lower level than is appropriate. A person in the middle of a car wreck may appear eerily calm.
- (Roberto) Mispronounced words take extra time for cognitive processing to “repronounce for understanding”. This creates a cycle of frustration and anxiety. Screen reader can be switched to another language. Causes distraction. Requires a higher level of skill. Possibility that the visitor does not know the language. Assumes a capacity to know which language is being used.
- (Valorie) When a mobile audience is able to shift orientation it allows the audience to find the “sweet spot” for their field of vision. audiences who magnify the text especially benefit from being able to adjust from portrait to landscape mode Changing orientation also allows them to optimize context clues on screen to help reading comprehension Related success criteria that help eye fatigue: 1.4.4 Resize Text 1.4.10 Reflow 1.4.12 Text Spacing 1.4.3 and 1.4.11 Color Contrast Text and Non-text
- (Karen) When complex or even simple physical movement is required, the extrinsic and intrinsic load is increased. For example, as we age, our physical functioning diminishes including fine motor coordination , reflexes, and reaction times. Cognitive load is increased by how the persons responds to these changes This can create anxiety, fatigue, frustration and confusion. Attention is split between the physical movement and the digital content.
- (Karen) 1.3 Adaptable – "content is programmatically determined" allows innovators of AT to come up with alternative ways to present content. Integrated literacy software is widely available to people and helps customize presentation and interaction. 1.4 Distinguishable – lets the audience optimize their experience. This point brings in both guidelines 1.3 and 1.4: Using 2 characteristics (1.3.3 Sensory characteristics and 1.4.1 color alone) provides choices for the audience. Resizing text, adjusting spacing and using real text instead of images of text, allows audiences to optimize the presentation to their best fit 3.2 Predictable – consistent presentation, placement, order and actions means the content is dependable for the audience. This reduces the cognitive load by reducing the need to relearn each time.