Cognitive Accessibility User Research

Cognitive Accessibility User Research describes the challenges of using web technologies for people with learning disabilities or cognitive disabilities. The research describes challenges in the areas of attention, executive function, knowledge, language, literacy, memory, perception, and reasoning. It is organized by user groups of the following disabilities: Aging-Related Cognitive Decline, Aphasia, Attention Deficit Hyperactivity Disorder, Autism, Intellectual Disability, Dyscalculia, Dyslexia, and Non-Verbal. Additional user groups may be added to future versions. This document provides a basis for subsequent work to identify gaps in current technologies, suggest strategies to improve accessibility for these user groups, and develop guidance and techniques for web authors.

Summary of User Groups and Cognitive Function

Different people with cognitive disabilities may have problems in the following areas:

Memory - Including: Working Memory, Short-Term Memory, Long-Term Memory, Visual Memory, Visuo-spatial Memory, Auditory Memory (memory for sound patterns and others).
Executive Functions - Including: Emotional Control and Self-Monitoring; Planning/Organization and Execution; and Judgment.
Reasoning - Including: Fluid Reasoning (logical reasoning), Mathematical Intelligence, Seriation, Crystallized Intelligence, and Abstraction.
Attention - Including: Selective Attention, and Sustained Attention.
Language - Including: Speech Perception, Auditory Discrimination, Naming Skills, and Morphosyntax.
Understanding Figurative Language - Including: similes, personification, oxymorons, idioms, and puns.
Literacy - Depends upon functions including: Speech Perception, Visual Perception, Phoneme Processing, and Cross-Modal Association (association of sign and concept).
Other Perception - Including: Motor Perception, Psychomotor Perception.
Knowledge - Including: Cultural Knowledge, Jargon (subject matter); Web Jargon and Technology; Metaphors and Idioms; Symbols Knowledge (such as icons); and Mathematical Knowledge.
Behavioral - Including: Understanding Social Cues.

For more information, please see section 5.

It is important to note that people may have limitations in one area and not in other areas. For example, a person with dyslexia may have above-average reasoning, but impaired visual memory and literacy skills. A person with Intellectual Disability may have an above-average visual memory, but impaired judgment.

Cognitive Function Table and Tags
Cognitive Function Category	Cognitive Function Subcategories and Tags	Dyslexia	Aphasia	Non-Verbal	Intellectual Disability	Autism	Dyscalculia	Aging-Related Cognitive Decline	Attention Deficit Disorder (ADD/ ADHD)
Memory	Duration Based Working Memory Short-Term Memory -typically lasts seconds Long-Term Memory - (includes recall and writing - the ability to learn, such as learn a new symbol and use it the next day.) Context Based Episodic Memory(autobiographical – time, self) Semantic Memory (factual) Visual Memory Visuo-Spatial Memory Auditory Memory: memory for sound patterns (um) Procedural Memory Musical Memory Prospective Memory - remembering to do things in the future, such as keep appointments, return a book to the library, or pay bills on time Emotional Memory Awareness based Implicit memory: (non-declarative memory) Explicit Memory: (declarative memory, intentional use of memory) Also memories can be stored and recalled as Associative Memory (MA) Meaningful Memory (MM) Free-recall Memory(M6)	May have impaired: Short-Term Memory Visual Memory Visuo-spatial Memory Auditory Memory Procedural Memory Prospective Memory	Receptive and Expressive Aphasia may result in impaired short term memory which can impact on re-learning language as can the impairment of auditory memory for relearning correct articulation and visual memory that affects reading and writing. Visuo-spatial Memory maybe an issue with the inability to remember how to get to places and recall locations, not helped if procedural memory is also involved where the order of doing things is affected. This is usually automatic but actions may have to be relearnt and there can be involvement of prospective memory that involves being aware of when certain activities have to be performed.	Cognitive impairments may result in impaired short term memory which can impact on learning how to use any symbolic representations of speech such as pictograms and other photographic symbols. This may result in a very reduced number of symbols being used on a daily basis. Lack of Auditory memory affects the ability to gain skills in phonemic awareness that aids literacy skills. Difficulties with visuo-spatial memory impact on the speed withwhich symbols may be found on a communication board or located on a screen and with physical difficulties this can further slow communication. Procedural memory difficulties result in poor automaticity in terms of Language Acquisition through Motor Planning (LAMP) which is one of the ways individuals can speed their AAC output.	Impaired auditory (verbal) short-term memory, and explicit long-term memory. However, visuospatial short-term memory, associative learning, and implicit long-term memory functions are preserved. Short-term auditory memory, which can affect writing to long-term auditory memory. Visual memory is often far-stronger. Difficulty remembering information.	There may be problems with memory, and integration of Episodic Memory (past experience) with present action.	Memory may be affected: Mainly Visuo-Spatial and Procedural Memory for layout, schedules, or sequences; and Prospective Memory for things such as financial planning.	Affected in dementia: Primarily new memories and working memory. Long-term memory becomes affected as dementia progresses. Age related cognitive decline may result in slight forgetfulness.	Working memory may be affected.
Executive Functions	Executive Functions Emotional Control and Self-Monitoring Shift (also called task flexibility) Initiation Planning/Organization and Execution Judgment	Sometimes affected: Planning/Organization	Those with Aphasia may have executive-functional difficulties especially if emotional lability is an issue. Cognitive impairment can affect cause and effect; and therefore planning and organization; as well as execution.		Problems with executive function, including: Difficulty with organizing and planning; difficulty working within time limits; sequences; emotional control and self monitoring; and judgment.	Sometimes affected: problem-solving; time management; planning and organization; emotional control and self monitoring; and inappropriate speech or behavior. Shift can be strongly affected.	Sometimes affected when involving numbers or time such as getting the right bus/train at the right time and on the correct platform.	All Executive Functions are affected in dementia. Sometimes Executive Function is affected in age-related cognitive decline, such as Shift and judgment (less often).	Executive function may be affected.
Reasoning	Fluid Reasoning (logical reasoning). Mathematical Intelligence Seriation - reasoning via seriation including organization. Conservation and Classification Behavioral -(or cognitive) component involving memory, such as long-term autobiographical memory. Crystallized Intelligence (sometimes called comprehension- knowledge) is the ability to use skills, knowledge, and experience. Abstraction	Typically not affected	Where intellectual capacity is affected there may be issues with reasoning, learning and thus remembering plus abstraction.	Where intellectual capacity is affected there may be issues with reasoning, learning and thus remembering plus abstraction.	Typically affected. Slow speed of information processing, such as a 'penny dropping' delay between hearing or reading something, and understanding and responding to it. Difficulty with Seriation, such as sequencing of events; strings of numbers and letters; time.	Typically affected: Behavioral intelligence, and understanding or relating to feelings; Interested in people, but not know how to talk, play, or relate to them; Difficulty dealing with change. Mathematical intelligence is also often affected.	Typically affected: Mathematical Intelligence; Seriation (such as estimating how much food to buy); and Abstraction.	Often affected in dementia including Behavioral. Crystallized Intelligence may be the strongest form of reasoning. Age-related cognitive decline can also lightly affect problem solving and reasoning.	Typically not affected other than planning, time estimates, and short-term recall, which is part of executive function.
Attention	Selective Attention -the ability to attend to some stimuli while disregarding others that are irrelevant to the task at hand. Divided Attention Sustained Attention	Selective Attention may be affected.	Shortened-attention span can occur with Aphasia.	Shortened attention span can occur alongside distractability when other cognitive impairments are present.	Difficulties with sustained attention.	Typically affected.		Affected in dementia.	Affected
Language	Speech Perception Speech Literacy See below for more details.		Aphasia can cause difficulties with word finding, the meanings of words and sentences, grammar and comprehension affecting the ability to communicate.	Young AAC users may have difficulty developing good sentence construction for written language in particular if reading skills are poor		Typically affected.
Speech Perception	Speech Perception depends upon: Auditory Discrimination (Note: not loss of hearing, butidentification and differentiation of sounds, also called general-sound discrimination (u3), Temporal Tracking (uk) Listening Ability (ls) Naming Skills (n) MorphosyntaxThe system of the internal structure of words (morphology) and the way in which words are put together to form phrases and sentences (syntax). Note: There is also related memory, such as working memory, auditory memory - see above. There is also knowledge required (see below), such as: Grammar Metaphors Lexical	Often affected: Auditory Discrimination Temporal tracking Naming skills Morphosyntax related memory	Individuals may have difficulties coping with the sounds that make up speech being unable to interpret their meaning which affects understanding and speech output.	Cognitive impairments can affect speech perception	Problems with morphosyntax. Problems with short-term auditory memory, affecting writing to long term auditory memory weaker-expressive language, and grammatical skills overall delayed language and speech development			Affected in dementia and, to a much-lesser degree, by age-related cognitive decline (temporal tracking).
Understanding Figural Language	Understanding figural language, such as: a simile, onomatopoeia, personification, an oxymoron, a paradox, an allusion, an idiom, and a pun. This is the ability to understand figural language, and does not include knowledge of metaphors.	Not affected	Idioms, metaphors, similes and other representations of language that contain abstract notions can cause issues for those with aphasia.	Idioms, metaphors, similes and other representations of language that contain abstract notions can cause issues for AAC users				Sometimes affected by dementia.
Literacy	Depends upon Speech Perception and visual perception. Also depends upon: Phoneme Processing phonetic coding (PC) Cross-Modal Association (association of sign and concept)	Affected	Aquired dyslexia can be an issue with individuals having to relearn how to read, sound out words and remember how to spell.	Aquired dyslexia can be an issue with individuals having to relearn how to read, sound out words and remember how to spell.	Problems with speech perceptions as above, spelling and grammar. Poor auditory-processing skills.	Typically affected.		Phoneme Processing and Cross-Modal Association are affected in dementia.
Visual Perception (visual recognition)	The visual system automatically groups elements into patterns: Proximity, Similarity, Closure, Symmetry, Common Fate (i.e. common motion), and Continuity. (Gestalt psychology) Functions include: Object Recognition Face Recognition (seems to be a different process from object recognition [Face and object recognition (Alex Huk. (1999) "Object and Face Recognition: Lecture Notes." pp. 5] Visual-Pattern Recognition	All can be affected. May also have visual stress.	Not recognising letters and words impact on reading and even object recognition can be affected.	Not recognising letters and words impact on reading and even object recognition can be affected	Strong visual memory but possible visual-processing difficulties May have visual stress	Visual comprehension is often affected.	Face Recognition, Object Recognition, and Visual-Pattern Recognition	Can be affected in dementia.	Diminished visual processing speeds
Other Perception	Auditory Perception (see Speech Perception above for further classifications), Motor Perception Tactile Perception Smell Perception Psychomotor Perception Kinesthetic Perception (body position, weight, or movement) Olfactory Perception and Sensory Perception	Auditory Perception affected Psychomotor may be affected	Auditory perceptual difficulties affect the relearning of speech and recognition of sounds and words impacting on understanding.	Auditory perceptual difficulties can affect phonemic awareness and any possible speech output	Psychomotor Perception seems affected. Difficulty with finding the way to places or navigating sensitivity to noise and visual stimuli. Impaired ability to screen out background noise / movement. Sensations of mental overload Tendency to "switch off".	Have unusual reactions to sensory-, olfactory-, smell-, tactile-, and auditory-perception sensory integration sensitivity to physical contact sensitivity to loud noises	Psychomotor Perception spatial orientation	Affected in dementia and, to a lesser degree, by age-related cognitive decline (such as Psychomotor Perception -Spatial/Temporal Understanding)	Developmental coordination disorder / motor clumsiness.
Knowledge	Types of knowledge that might be required for use of the Web include: Cultural Knowledge base Language Knowledge including: Lexical (UL) Jargon (subject matter) Web Jargon and technology Web and Technology Usages and Risks Metaphors and idioms Symbols Knowledge (such as icons) Mathematical Knowledge Mechanical Knowledge (MK) Knowledge of behaviors Design-Metaphor Knowledge Design-Functions Knowledge	Typically not affected.	Aphasia does not necessarily impact on intelligence but knowledge will be trapped within the brain if the individual cannot express their thoughts.	An AAC user does not necessarily have intellectual difficulties but knowledge can be trapped within the brain if the individual cannot express their thoughts.	Affected	Partial Knowledge of Behaviors	Mathematical Knowledge And Mechanical Knowledge are affected.	Affected in acquisition of new knowledge. Affected strongly in dementia
Behavioral	Behavioral Abstractions and social – Norms etc Social Cues other Behavioral	Slightly affected: Norms and Social Cues	Behaviour can be affected by lability where there can be unnatural emotions including depression. Tiredness can impact on the ability to cope with day to day activities.	Behaviour can be affected by the inability to communicate with considerable frustration occurring at times. Individuals may also become depressed and irritable, however these individuals can also show amazing resilience and understanding when issues arise.	Affected	Strongly affected (primary symptom)	Not affected	Affected in dementia
Consciousness	Delusions, Hallucinations	Typically not affected.	Consciousness in those who have deep Aphasia with no communication can be difficult to assess.	Consciousness in those who have no communication skillscan be difficult to assess			Not affected	Affected in dementia, such as delusions, and, to a lesser degree, by age-related cognitive decline, such as irritation and withdrawal.

Notes on the Cognitive Function Table:

Terms that will be used for tags are italicized and capitalized. Alternative terms are in brackets. Alternative terms will not be used as tags.
Discussions on the different functions can be found in section 4 below.
Speed: Processing speed affects all functions above. A related concept is fluency.

Research on Cognitive Function

This section aims to provide:

a basis for consistent use of terms within our documents;
a basis / background for making tags that can be used in meta data or functional-accessibility approach
a useful resource

Note: We have taken terms and concepts from across the work we are doing on disability and cognitive function. Where more than one term exists for what seems to be a very similar function, we have chosen one term, but brought others for reference. We have also reviewed the Caroll taxonomy, but it was focused on educational assessment, and psychometric-based models for human intelligence, and was therefore not fully-relevant (for example: knowledge categories). When quoting a Caroll category, we have tried to put the mnemonic after the term such as (RG) or (I).

Here are the cognitive functions that we have identified so far. They are not complete, and not yet in a taxonomy form.

Reasoning and Executive Functions

Executive functions (also known as cognitive control and supervisory-attentional system) is an umbrella term for the management of cognitive processes such as reasoning and problem solving (goal-focused reasoning) as described below. Executive function also includes:

emotional control and self-monitoring
shift ( also called task flexibility)
initiation
planning/organization
execution

Executive function also relies upon or includes: working memory, other memory (short, long), attention, abstraction, associations, as described below.

In making a decision or conclusion, we may use:

Fluid (logical) reasoning;
Attitudes and experience from or guiding Crystallized intelligence;
An Affective component involving a person’s emotions (such as fear) and identity (sense of self).
Behavioral (or cognitive) component involving memory, such as long-term autobiographical memory.

Reasoning

Fluid reasoning is the capacity to think logically and solve problems in novel situations, independent of acquired knowledge [Fluid_and_crystallized_intelligence] Fluid intelligence may involve both the dorsolateral prefrontal cortex and the anterior cingulate cortex.

Types of fluid reasoning are:

Deductive Reasoning (RG) (sometimes called General or Sequential or hypothetico-deductive reasoning). It is the ability to start with stated assertions (rules, premises, or conditions), and engage in one or more steps leading to a solution.
Inductive Reasoning (Induction (I) Reasoning from specific cases or observations to general rules or to broad generalizations. Often requires the ability to combine separate pieces of information in the formation of inferences, rules, hypotheses, or conclusions.
Mathematical Intelligence (also called Quantitative Reasoning (RQ) depends upon ability to inductively (I) and/or deductively (RG) reason with concepts involving mathematical relations and properties.
Piagetian Reasoning (PR): reasoning via seriation (organizing material into an orderly series that facilitates understanding of relationships between events), conservation (awareness that physical quantities do not change in amount when altered in appearance), and classification.

A related idea is Speed of Reasoning (RE): Speed or fluency in performing reasoning tasks [http://www-personal.umich.edu/~itm/688/wk6/CHC%20Definitions.pdf]

Crystallized Intelligence (sometimes called Comprehension Knowledge), is the ability to use skills, knowledge, and experience. It does not equate to memory, but it does rely on accessing information from long-term memory. Crystallized intelligence is one’s lifetime of intellectual achievement, as demonstrated largely through one's vocabulary and general knowledge. [http://en.wikipedia.org/wiki/Fluid_and_crystallized_intelligence</cite> Crystallized Intelligence involves storage and usage of long-term memories, such as by the hippocampus.

We have included the dependent aspects in the sections on memory and language [ http://www-personal.umich.edu/~itm/688/wk6/CHC%20Definitions.pdf]

Attention

Reasoning and executive functions require attention. Types of attention are the following.

Selective attention refers to the ability to attend to some stimuli while disregarding others irrelevant to the task at hand. [http://www.ncbi.nlm.nih.gov/books/NBK3885/]
Divided attention tasks require the processing of two or more sources of information, or the performance of two or more tasks at the same time. (Divided attention has usually been associated with significant age-related declines in performance, particularly when tasks are complex.) [5]. The cost of dividing attention is assessed by comparing performance under dual-task conditions to performance when the tasks are performed separately. [http://www.ncbi.nlm.nih.gov/books/NBK3885/]
Sustained attention refers to the ability to maintain concentration on a task over an extended period. [http://www.ncbi.nlm.nih.gov/books/NBK3885/]

Abstraction

Types of abstraction include:

essentialism
object recognition - Abstraction is part of visual comprehension
face recognition (seems to be separate from object recognition)
facial patterns (such as an angry face)
linguistical abstractions (such as relations between syntax, semantics, and pragmatics.)
quantities
numerical concepts
abstract context of time
spatial orientation, directions, layout of things.
mechanical abstractions
musical abstractions
behavioral and social abstractions –
- norms, etc
- social cues
- other behavioral:

Memory

People talk about types of memories are often talking about different categories of types of memory. Any memory-based events can be described in all these categories. For example: an event may cause a sensory experience to go into long-term memory implicitly. Here are the types we have identified:

durationbased: working, long term, short term, and possibly intermediary
context based: emotional, procedural, sensory (tactile, smell, psychomotor, kinesthetic, olfactory, auditory, visual, visuo-spatial, spatial, musical, and prospective memory.
awareness level: implicit and explicit

Duration Based

Working memory involves mentally manipulating — is the system that actively holds multiple pieces of transitory information in the mind, where they can be manipulated. [1] Baddeley and Hitch feel it is executive and attention control of short-term memory, but others point out that long term memory can also be involved in working memory.
Short-term memory (also called active or primary memory) typically lasts seconds, such as remembering the phone number while you find a pen and write it down. Subtypes are Verbal, Visual, and Spatial. Four different units in short-term memory are probably average. Capacity of short-term memory is often called memory span.
Long-term memory (also called reference memory, long-term storage and retrieval (Glr),TSR, Glm), the ability to store and consolidate new information in memory and later fluently retrieve stored information. Broad retrieval ability (G) is a related idea.

Context Based

Episodic memory (autobiographical – time, self)
Semantic memory (factual)
Visual memory
Visuo-spatial memory
Spatial memory
Musical memory
Auditory memory: Memory for sound patterns (UM)
Procedural memory: Memory for performance of particular types of action such as walking.
Prospective memory: Much of what we have to remember in everyday life involves prospective memory — remembering to do things in the future, such as keep appointments, return a book to the library, or pay bills on time. [http://www.ncbi.nlm.nih.gov/books/NBK3885/]
Emotional memories: can be both declarative- and procedural-memory processes.

Awareness Based

Implicit memory: (Can be called non-declarative memory) is built or used without conscious awareness. In contrast with...
Explicit memory: (Can be called declarative memory) the intentional use of memory such as remembering the time of an appointment or studying for an exam.

Also, memories can be stored and recalled as Associative Memory (AM), Meaningful memory(MM), Free-recall memory (M6),

Language

Speak, write, read, or understand speech and/or language.

Spoken Languages

The basic skills for spoken languages seem to be speech perception. Speech perception is when sounds of language are heard, interpreted, and understood. This depends upon:

Auditory Discrimination (Note: not loss of hearing, but identification and differentiation of sounds, also called General sound discrimination (U3)
Temporal Tracking (UK)
Listening Ability (LS)
Naming skills (N)
Related memory such as Working Memory, auditory memory - (Memory for sound patterns)
Morphosyntax: The system of the internal structure of words (morphology) and the way in which words are put together to form phrases and sentences (syntax).
Understanding figural language, including a simile (a comparison of two things, such as “His cheeks were like roses”; a metaphor; onomatopoeia (a word designed to be an imitation of a sound such as “Bark! Bark!”); personification (attribution of a personal nature to inanimate objects); an oxymoron (opposite or contradictory terms are used together for emphasis, such as “organized chaos”); a paradox;a hyperbole (an extreme exaggeration, such as “I was so upset I nearly died”); allusion; or idiom, such as "You should keep your eye out for him"); and puns.

Spoken language also requires an ability to produce voice

Sign Language

Sign language, without spoken language, probably requires a slightly-different set of skills, such as:

Visual Recognition Skills
Non-vocal Naming - Association of sign and concept
Phoneme Processing and Phonetic coding (PC)
Related memory, such as Working Memory, Visual memory, Memory for patterns
Morphosyntax: The system of the internal structure of words (morphology) and the way in which words are put together to form phrases and sentences (syntax).
Understanding figural language.

Literacy

Beyond basic language, literacy typically requires:

Visual Recognition (see below)
Visual memory (not affected in Intellectual Disability)
Phoneme Processing and Phonetic coding (PC)
Cross-modal Association of sign and concept

Note that many people with dyslexia achieve literacy without many of these functions, or with impaired functioning.

Perception

Visual Recognition (Also called visual perception)

The visual system automatically groups elements into patterns: Proximity, Similarity, Closure, Symmetry, Common Fate (i.e., common motion), and Continuity (Gestalt psychology).

Functions include:

object recognition
face recognition (seems to be a different process from object recognition [Face and object recognition ((Alex Huk. (1999) "Object and Face Recognition: Lecture Notes." pp. 5]
Pattern Recognition

Other Perception

Auditory perception (see Speech perception above for further classifications), Motor, Tactile, Psychomotor, Kinesthetic (body position, weight, or movement), Olfactory and sensory perception.

Speed

Processing speed affect all functions above. See Caroll. A related concept is fluency

Knowledge

Types of knowledge that might be required for use of Web content include:

knowledge of culture
base Language knowledge, including:
lexical (UL)
jargon (subject matter)
Web jargon and technology
Web and technology usages and risks
metaphors and idioms
icons and symbols
mathematical knowledge
mechanical Knowledge (MK)
knowledge of behaviors
design metaphor – look
design functions

Not (Yet) Fully Addressed:

consciousness
identity
emotions (such as fear), moods, and motivations
libido and sexual function
creative thought
personality
judgment and self-monitoring
initiative
inhibition

Note that these are in our mandate. For example: Dementia with Lewy bodies affects the cerebrum, where small round lumps of proteins build up and can cause fluctuations of consciousness, as well as hallucinations, delusions (firmly held beliefs in things that are not real), and false ideas (such as with paranoia).

Areas of the Brain

This section summaries functions of different areas of the brain. See http://www.md-health.com/Parts-Of-The-Brain-And-Function.html and http://www.enchantedlearning.com/subjects/anatomy/brain/Structure.shtml.

Frontal Lobe

reasoning and problem solving
initiative, inhibition, and behavior
abstractions
attention
creative thought
some emotion
reflection
judgment
coordination of movements
generalized and mass movements
skilled movements and some motor skills
libido (sexual urges)

Occipital Lobe

vision
Broca's Area controls facial neurons as well as understanding of speech and language.

Parietal Lobe

tactile sensation
appreciation of form through touch (stereognosis)
response to internal stimuli (proprioception)
sensory combination and comprehension
some language and reading functions
some visual functions

Temporal Lobe

some hearing
memory, including auditory memories and visual memories
music
some behavior and emotions, such as fear
sense of identity
Wernicke's Area- This portion of the temporal lobe is formed around the auditory cortex. Formulate or understand speech.

Limbic System

The limbic system contains glands, which help relay emotions.

Amygdala: The amygdala helps the body respond to emotions, memories and fear.
Hippocampus: Used for explicit memory, specifically converting temporary memories into permanent memories, which can be stored within the brain. The hippocampus also helps people analyze and remember spatial relationships, enabling accurate movements.
Hypothalamus: mood, thirst, hunger, and temperature.
Thalamus: attention span, sensing pain, and tracking of sensations the body is feeling.

Corpus Callosum

communication between the left and the right sides of the brain

Cerebellum

balance and posture
cardiac, respiratory, and vasomotor centers

Brain Stem

Motor and sensory pathway to body and face
Vital centers: cardiac, respiratory, vasomotor

Pituitary Gland

hormonal body processes
physical maturation
growth (height and form)
sexual maturation
sexual functioning

Sources on Cognitive Functions

1. Educational taxonomies, such as Carol for Cyristalised resing, includes:

Language Development
Lexical Knowledge (VL)
Listening Ability(LS)
General (verbal) Information (K0)
Range of general stored knowledge (primarily verbal)
Information about Culture (K2)
Range of stored general cultural knowledge (e.g., music, art)
Communication Ability (CM)
Oral Production and Fluency (OP)
Grammatical Sensitivity (MY)
Morphology and sentences (syntax)
Foreign Language Proficiency (KL)
Foreign Language Aptitude (LA)

2. Inappropriate behavior is common with Frontotemporal dementia - impaired social interaction.

Affected in: Alzheimer’s disease, Aphasias, Advanced age, dyslexia, emotional disabilities such as Schizophrenia and PTSD

4. Expressive aphasia left inferior frontal cortex. These people are described with having severe syntactical deficits, which means they have extreme difficulty in forming sentences correctly. Hessler, Dorte; Jonkers, Bastiaanse (December 2010). "The influence of phonetic dimensions on aphasic speech perception". Clinical Linguistics and Phonetics. 12 24: 980–996.

5. Receptive aphasia - left temproparietal lobe. People with Receptive Aphasic mostly suffer from lexical-semantic difficulties, but also have difficulties in comprehension tasks. The effect of receptive aphasia on understanding is much more severe. Hessler, Dorte; Jonkers, Bastiaanse (December 2010). "The influence of phonetic dimensions on aphasic speech perception". Clinical Linguistics and Phonetics. 12 24: 980–996.

Anarthria: Loss of the motor ability that enables speech. Complete loss of the ability to vocalize words as a result of an injury to the part of the brain responsible for controlling the larynx.

Aphonia: The inability to produce voice.

Alalia: A delay in the development or use of the mechanisms that produce speech.

Dyslalia: Difficulties in talking due to structural defects in speech organs.

Developmental verbal dyspraxia: Motor speech disorder involving impairments in the motor control of speech production.

6. Carol tends to have abilites as the main category with memory and sensitivity, such as tactile sensitivity (other than psychomotor abilities, which have subcategories of static strength (P3), multi-limb coordination (P6), finger dexterity (P2), manual dexterity (P1), arm-hand steadiness (P7), sontrol precision (P8), aiming (A1), gross-body equilibrium (P4)

7. Carol brings Processing speed (Gs), such as cognitive processing speed (Gs), broad-cognitive speediness (Gs), perceptual speed (P), rate-of-test-taking (R9), number facility (N), speed of reasoning (RE), reading speed (RS), writing speed (WS), reaction and decision Speed (Gt), correct decision speed (CDS), processing speed, (RT) decision speed (such as simple-reaction time) (R1), choice reaction time (R2), semantic processing speed (R4), mental-comparison speed (R7), inspection time (IT)

8. Carol brings Ideational Fluency (FI), Associational Fluency (FA), Expressional Fluency (FE), Word Fluency (FW), Figural Fluency (FF), Figural Flexibility (FX), Sensitivity to Problems (SP), Originality/Creativity Fluency (FO), Learning Abilities (L1), Naming Facility (N)

Potential for Inclusion

Proposed Directions

The aim of the Cognitive and Learning Disabilities Accessibility Task Force (COGA) is to improve Web accessibility for people with cognitive and learning disabilities.

This is a background-research document. However, it may be worth concluding with an overview of what could be done for accessibility for people with cognitive and learning disabilities. It is intended to help us (COGA) identify what needs to be done to get there.

Note that some of the ideas below may be out of scope for our mandate and role as a W3C task force.

What is Needed

The pieces of what needs to happen next (described in the text below)

Techniques for Everyone

A substantial amount of techniques are helpful for over 90% of people with cognitive disabilities. These techniques need to be gathered in one place.

For example, most people with any cognitive disability may be disturbed when form data is lost when a session times out. Almost all user groups may need help or need to double check data entered into a form. Timing out so they need to start again may make a form unusable.

See sample technique format to help us gather techniques as we come across them, so that they do not get forgotten or are hard to find later when we are finished the gap analysis.

Techniques for User Groups

We also need to document techniques good for some user groups and not for others (depends upon cognitive function and localization). For example, text under symbols may be useful for many people with dementia, but unhelpful for many people with severe language disabilities.

In a localization example using left-hand-side text, alignment is helpful for English sites, but right-hand-side text alignment is helpful for sites in Arabic or Hebrew.

See sample page structure and more examples.

Grouping Techniques

Once we have a comprehensive set of techniques, we may want to group techniques into “enhancements”. For example, we may make a group of techniques as “simple text” enhancements for easier reference.

We may also want to identify how different enhancements benefit people with different limitations of cognitive functions.

To achieve this, we may need to label groups of cognitive functions, so that we can simplify linking enhancements to cognitive functions. See an initial page of cognitive function.

Once we have a set of enhancements, we can enable standards, such as EARL, to identify which documents support which enhancements. Other supported standards and systems include ISO, GPII including subprojects Prosperity4All and Cloud4all, and possibly FLUID.

Once we have a comprehensive set of techniques, we can also explore what is needed to make a website adaptable to different groups of users. We may be able to identify semantics that enable adaptation for specific learning and cognitive disabilities; and to conflicting needs of different users.

This could include:

adaptive text: This would enable text to become simpler or more literal or adapt to the user needs.
adaptive components: There are many ways to make the same widget. Because different web sites implement the same functions differently, the user needs to learn how to interact and use them with specific-page widgets. Adaptive components would enable the user to use one interface, which they know how to use, across many different sites.
adaptive pages: This would enable changing or adapting the page layout, cutting out extra features or confusing aspects of the page. This would add semantics to enable adaptive interfaces and AT. This would enable adaptive interfaces to allow users to use complex interfaces via an independent and familiar interface tailored to their scenarios and strengths. As this interface is designed for the user/user group, all features are familiar, and the same buttons and metaphors will be used across all conformant applications.
adaptive media
adaptive forms and billing: This may result in suggestions to ARIA 2.0 and PF for additional semantics to enable AT to provide techniques.

(See more information about making adaptable content for people with cognitive disabilities)

This may result in suggestions to PF group for the ARIA 2.0 specification.

Special Projects

There may be other accommodations needed that are outside the handshaking approach or adaptable pages.

Accessible -menu systems for people with cognitive disabilities: This will look at what measures or techniques could make phone menu systems usable by for people with cognitive disabilities, such as enabling people to reach an operator. (Relevant specification: voice Ml)
Interoperable AAC symbols AND
Lexicon and symbols that support low literacy.
Labels for cognitive function: See an early draft.

Also see more ideas.

Introduction

Importance of This Document

Assumptions

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