Cyndi: Welcome to today's broadcast, cognitive disabilities and the web.What we think we know. This is Cyndi Rowland with the national center on disability and access to education, and I'd like to welcome you today to this wonderful topic.
We've been talking about the impact of cognitive disabilities, and a variety of technologies including the internet as these are the kinds of things that are happening, they're PERVASIVE in higher education today.
With us today we've got two fabulous panelists that are really working to unravel the mess as I think of it, of cognitive disabilities and technologic or web experiences.
Our first panelist, or I should say one of our two panelists, is Dr. Clayton Lewis, and Dr. Lewis is a proper professor of computer science at the university of Colorado boulder and his interest is in human computer action, interaction, excuse me. HCI, human-computer interaction.
Dr. Lewis is also scientist in residence with the Coleman institute for cognitive disabilities there in Colorado. He's a recognized expert in this area, and I can't emphasize that more. In fact, he was recently invited by the access board to come and discuss this very issue with the tie tack group, and for those of you who don't know what tie tack is, that's the telecommunications and electronic and information technology advisory committee, which is part, which is a committee that has been asked to refresh the technical standards for both section 508 and 255 of the telecommunication act. So welcome Clayton.
Clayton: Glad to be here.
Cyndi: Our other panelist is Paul Bohman, and many of you may recognize Paul's name. Paul is also a colleague of mine, Paul works with me at WebAIM for years and years and years. He has now moved on, in part because he's completing a doctoral degree, but in part because he is back east, he's at George mason university right now, where he's the technology coordinator at the Keller institute, and Paul, I know you're teaching accessible web design and a host of other things there.
So hi, Paul.
Paul: Hello. And thanks for the welcome.
Cyndi: Well, let me just start by asking each of you, because I think this is kind of an interesting way to start, what drew you to consider the needs of those with cognitive disabilities as they relate to technology use?
And let me just start, actually, with Clayton, you know, you're coming at it from a computer science software engineering angle. This seems to me to be quite an interesting leap. So how did you end up by making that?
Clayton: Well, it's actually not as big a leap as it might sound. I think as a computer science faculty member. I'm actually one of two people on our computer science faculty whose PHD is in psychology. So I'm kind of a hybrid. The psychology part of it has actually been part of what's drawn me in. But there's no question that the really, kind of instigating event was meeting bill and Claudia Coleman.
Bill and Claudia are the donors behind the Coleman institute with which I've become affiliated. But when they were first getting in touch with the university, they're both people in the high-tech computer field, and so their initial contact came through our college of engineering and our computer science department, and I was lucky enough to be included in some of those meetings. And I don't know if any in the audience have had the pleasure, but bill and Claudia are just tremendously inspiring people who have devoted tremendous resources but also tremendous personal energy to this field of cognitive disabilities. There's no question that that's why I'm here.
Cyndi: And so as a perfect match because it sounds like you already had some of those interests and then you met up basically with a work group that was forming to look at this stuff.
Clayton: Yes.
Cyndi: Fabulous.
Well Paul, how about you? I think I may know how you ended up with some of these interests, but why don't you share them more broadly.
Paul: Sure. Of course one of the reasons that Cyndi's aware of is she encouraged me to look into this area. I was working for WebAIM at the time and I'd been investigating the different aspects of accessibility for other types of disabilities, for visual disabilities, auditory, and so on. But we both recognized that there was a need for more interest and more research in cognitive disabilities, and a little confession, he wasn't particularly excited about doing the research initially, just because it is kind of an ill-defined domain. There isn't a lot of research out there. Of course that's one of the reasons why it needed to be done. The more I got into the literature and into the research that does exist, I realized that it's a really rich area for research, for potential research. I found more research than I expected to find. I think a lot of people in web accessibility assume that there's not much out there, which is still the case, it's still true. But there are pockets of information that are out there in different disciplines, not all of them related to web accessibility. It's hard to cull through them and come up with the ones that are most relevant, but some things are out there, and definitely a lot more needs to be done.
Cyndi: And Paul, you actually hit on the reason that pulled both you and Clayton together, folks from very different backgrounds, but with the thought that if this research exists, and I'm not entirely sure we've got enough of a body of research to move ahead in ways that make sense for us as a field, but if so they're probably just dispersed across lots and lots of different disciplines.
And in fact, this is an opportunity for me to just mention to any of the listeners, we've got some of those resources listed, or linked, I should say, off of the NCDAE web cast page. So you may want to look under the heading "resource," and look at what we have there. If you are aware of any additional resources, especially if they are research-driven, you know, some evidence-based, empirical research that deals with factors of the web that can be altered to make the experiences of individuals with cognitive disabilities better, please send those in. We want that to be a building resource list.
You know, while I'm doing a bit of house keeping, and then I'm just going to jump right into our conversation, I know we've got a lot to say here, I also want to mention to folks that are listening, that you'll have opportunities to ask questions of our panelists, if you go on the NCDAE web cast page there is a place where you can submit a question. So that's the header, submit a question, and it'll take you to a form where it just emails it directly in to us.
So a little bit later in today's broadcast we're going to be taking any questions that may have come in. And I would encourage and invite you to submit things that you're thinking about. Okay, well I'm pretty anxious to get started, and thanks for sharing with people how you got into this, and how you got started. I think for a lot of us it is going to be a long journey. I know this topic holds my fascination. I just wish I could get funding to pursue a more of a program of research in this area.
Okay.
When we talk about cognitive disabilities and the web, that term is so diffuse. In fact I think one of the problems that we have when we're talking about cognitive disabilities is that to a certain extent that's kind of a trash can term. You know, everybody throws everything and its brother into that term. But as the two of you are talking about it today, and as you think about it more globally or more broadly, what are you talking about? Can you help by defining the term for us? And Clayton, I'm just going to start with you and then Paul add in anything else, or if your answer is different. But I think it's important to start with some definitions so that folks know what it is that you both mean when you say cognitive, individual with a cognitive disability. So Clayton, go ahead.
Clayton: Okay, well you mentioned as a garbage term, and there's a sense in which it legitimately is that, and it's important for people to think about it that way, and that may sound a little PARADOXICAL. But one of the things I've learned from colleagues and people that I've gotten in touch with, is that the kind of lay, you know, sort of way the public tends to think about cognitive disabilities is really not a good fit for the reality. So it's possible to identify various specific conditions, and there are a lot of different kinds of them. For example, down's syndrome is a common form of what's called a developmental disability, it's caused by a chromosomal abnormality, and it has a wide range of effects, some of which are cognitive, and people know about that, and sort of think medically, sort of think okay, that's a well-defined condition. But already starting there, one learns that the impact of that condition, even though it seems to be very well-defined medically, the cognitive impact of it is very, very variable. So it would be a big mistake for someone to say, X-has down syndrome I know all about X, it's just not that way.
And then you move into other things which can produce cognitive limitations or cognitive impairments, another big category is brain injury. Well, that can be very diverse. There are many ways that the brain can be injured, and it can have many kinds of impact, including cognitive impact, just to make a little distinction there. You may have a brain injury that affects specifically language function but it may not affect other kinds of things, or you may have a brain injury that affects emotional control which is very difficult, again. You've got effects of aging, you know the one that people think about these days is Alzheimer's disease, which mainly affects memory, but there are other effects of aging that have cognitive impacts.
So you can make a list, and actually I'll quickly run through one, here. This is actually one from a review that was done by Ellen FRANCHEK a few years ago, pull the together a lot of information, specifically looking at telecommunications. But many of the considerations are relative to the web. So you know here's one list, efforts to kind of break down cognitive functions into different categories. Executive functions, that has to do with planning and monitoring, and things like that. Memory, that like these other things has many facets to it.
Attention. So we may not think about this in everyday life, but we're really dependent on our ability to focus our attention in ways that are relevant to tasks that we're trying to perform, and if you have difficulty in doing that it can be a big problem in a number of activities.
Visual and spatial perception. Again, people may not think of the cognitive aspects of that, but if you kind of take a systems point of view of perceiving the visual world, it's kind of a sensation part of that, picking up the light, resolving edges and that kind of thing. But then vision includes a tremendous amount of sort of higher-level processing which is cognitive in character, that can be affected.
Language, again, multi-facetted, mathematical thinking, there are conditions which specifically affect that.
Emotional control, I already mentioned briefly.
Speed of problem solving, flexibility of problem solving.
So back to that kind of garbage concept, it doesn't appear that in our current state of knowledge that we can really analyze these things very clearly, even though we often think that we can.
So cognitive systems is extremely complex, there are many facets that can be affected, by very many different kinds of mechanisms so we're talking about an extremely diverse group of people, here, brought into a category just by saying some one or more of these many aspects of cognitive functioning may be or is impaired in them.
Cyndi: Well and, you know, as we think about what you just said, what I'm struck with is almost kind of a tiered approach, here, that you have whatever the condition is, that lends itself to the cognitive, the garbage term cognitive disability, be it traumatic head injury or downs syndrome as in your example, the next is almost like what's the functional fallout of that condition?
Is it memory? Is it visual processing? Is it, you know, attention? What is the fallout? And then I would also maybe even toss in a third category, which is for any of those functional areas, what's the severity of it? I know that as I've read through some literature, it's one of the other things that I think makes it difficult is that you take something as simple as, you know, reading level. Well, for one person it may be the inability to read above a third grade level. For another it may be illiteracy. So I think that further complicates how it is that folks even look at this population, because it isn't a population, as you said, it's lots of them.
Paul, do you have any different ways that you define this, and how, as you're discussing it today with everyone, is it any different than what Clayton has described?
Paul: I wouldn't say that it's any different. I'll put it in a little bit different terminology, and put a little bit of a different perspective on it. Just listening to the conversation so far, it sounds like we've just defined cognitive disability as something completely undefinable, and unsolvable almost, which is kind of a little bit of a negative slant to put on it.
That doesn't mean that anything that was said was untrue, of course. It's very accurate that it's a very, as I myself said, it's an ill-defined domain. But I think we can begin to bring things together into some general concepts that hopefully people who develop content can start to use. And one of the resources that I put together that's linked from the page, on the web cast page, the link, the second link in my list, this was submitted by Paul Bohman, and then it says functional is at the end.
For those that aren't going there I'll just start to read some of the parts, there. I've begun to organize them into categories not dependent on the clinical diagnosis, I just mentioned there are abnormalities in genetic structure that can lead to cognitive disabilities and so on. From a design standpoint, although those are important, also from a clinical standpoint those are important. From a design point they're actually quite irrelevant. What we need to know as designers or people who develop content is what is the functional disability at the end of the process. And I put together my list here.
Some of them have already been mentioned, there's memory, attention, problem solving, intolerance for change, abstraction, inference, deduction logic, calculation logic, sensory perception, and encoding, text and language processing, task sequencing and completion, and only a few more, orientation and contextual awareness, conceptual organization, cognitive speed, and then the last two are psycho social development and intellectual confidence. And by that last one, I mean is the person's faith in their own abilities to understand things, to solve problems and so on.
Cyndi: So is that more almost like a resilience, if I make some kind of an error, I have enough confidence to persist? Is that what you're thinking?
Paul: Right, it's bringing in the emotional and personality side of things that were mentioned earlier. Now these are my own terms, and people could probably rearrange the list, perhaps consolidate parts of it.
This is my list as it stands now and in the document I say it's a draft because it's a work in progress. But I think it's helpful to have at least a list, whether it's completely accurate or not, a list of some of the broad categories that have been mentioned in the literature, and that are brought up by some of the experts in the cognitive disability field. And even though I list them all without going into much of an explanation at this point, I just wanted to put them out there. And I guess we can probably get into more details later.
Cyndi: Well, I think it's really important, though, for folks that are listening, to understand the, really, the depth, the density of definition, as it were, that we are bringing to this glib phrase "cognitive disability." Because it really is this enormous range that has enormous depth. But with that, I don't want us to get hung up on kind of those definitional characteristics.
I kind of want to spend more of the next 15, 20 minutes or so, getting into the meat of whether or not there is research that would suggest that web developers do certain things with elements of their design. Certainly the national center on disability and access to education, as well as WebAIM, have looked long and hard at the literature. You know there are a few little things that are popping up, but not a lot. What we're seeing, and listeners have been poking around a bit, they're probably seeing the same, which is that there's a lot of folks, and I'll add myself to that list, that have written based on our own opinions of the kinds of things that we suspect would be helping individuals that have some sort of cognitive disability as they get to the web.
So whether that's, you know, golly, I think that the amount of white space on the page probably, you know, helps someone with visual chunking. So I think that ought to be a recommendation. No one to my knowledge is really testing that kind of stuff with different populations of folks with different kinds of cognitive disabilities, or the use of certain fonts, or even things as simple as, well, let's make sure that we are, in fact, pairing icons with text, so that if someone has poor literacy skills, they can benefit from the pictures or the icons.
I know that as I hit a web site that is in another language it's helpful for me as a typical user, but again, I've not seen that anyone is asking those questions in a research context in ways that can truly help and benefit the field.
So let me throw this out to both of you, to find out, and this can just be back and forth and you know offer comments, or ask questions, have either of you been privileged enough to find some research that would help point developers in the field towards doing or not doing any specific thing?
Oh, there's silence.
Clayton: We're just wondering who's going to go first.
Cyndi: Sorry, well Clayton, go for it.
Clayton: Okay. Actually if I can just add a comment after what Paul was saying. So he was concerned about a negative impression, and I wanted to correct that. And actually my trying to complicate the coming any disability story was actually trying to make a positive kind of sociopolitical point which I think is an important one. In our kind of medical and technology kind of world, we're really looking to be able to pigeonhole people. And because we know there are conditions like downs syndrome, we're drawn to those, we think okay there's some well-defined kind of thing, here. And when you work with people, you fined that that kind of pigeonholing is not what you want to do.
So I really endorse Paul's move to say let's not be hung up on what these conditions are from the medical point of view to the degree there are some. Because there are plenty of disabilities for which we have no assignable cause, and let's move to the level as Paul was suggesting, of what are the cognitive functions that are stressed in things like using the web, and let's try to understand as designers how we can modify those impacts, and reduce them.
So I'll also endorse, Cyndi, your lead-in. I haven't found a lot of stuff here. I, and I'm sure others listening, including probably Cyndi and Paul, have been trying to get some research funding in this area, you know, I've got another attempt to do that, we've had a little bit of success actually from Google in getting some attention paid to this, and perhaps we can get more of that. But there are a couple of things that are out there, and actually I think, Cyndi, maybe one of my messages might have gone astray because I think I had some other lengths.
But anyway the two that are up there I'll mention in the resource section under my heading, there. So one is something which isn't directed specifically at, quote, cognitive disabilities, unquote, but looked at in a functional point of view has a lot to say, I think. And that's Jacob Nielsen's alert box column of a couple of years ago, reporting a study of low literacy folks. And conceivably some of the low literacy people that he used might have been people who had some cognitive limitations. Perhaps not. There are a lot of reasons why people's literacy may below. But that's a study which shows the concrete impact on successful task completion supported by web pages.
So can people really do something using the web? Showing the impact of some of the kinds of interventions that people point to in some of the guidelines.
Another thing that's relevant in some arms of argument that one sometimes gets into on these things is that Jacob's study also showed that these same changes actually increase the performance of people that didn't have limited literacy. So sometimes there's a concern, and I think sometimes it's legitimate, that by making a change to support one person's access to something, that perhaps someone else's access is actually interfered with in some way. But Jacob reports the study where it's clearly a win-win.
Cyndi: And of course that coincides with lots of other elements in the accessibility field that, as folks are moving towards things that are a little more universally designed, although they may have come initially from the point of providing an easier way for one type of person to get content, they're pretty much benefiting the typical user, as well.
Clayton: Yes. And something else which I think goes in that direction, the other thing I wanted to point to is some research that I'd certainly encourage people to look at, Richard apple yard and collaborators in Portland, I noticed that this group shows up in Paul's list of references as well. I've given one of the references a small and other authors, including apple yard, a paper at KAI, 2005.
What that group has done is to study the experience of people with cognitive disabilities working with web sites, and to give a very broad brush summary that has stuck with me from that work, you get a pretty good appear approximation, I think, if you say, you know, all the things that everybody has trouble with about the web, people with cognitive disabilities have trouble with only more so.
So to take one example that I recall from the study, we all know that the function of the back button is inconsistent.
Okay, so you know, you find yourself looking at a window and you didn't really realize that it's a new window that was opened, and so the back button doesn't work.
Okay.
Well, you know, some people have enough web experience or whatever to cope pretty well with that. They may curse under their breath, but you know, it doesn't really hold them up. Other people, including some people with cognitive disabilities, and plenty of people who wouldn't carry that label, are going to be really thrown by that.
So something, as I work in this area, that I'm really impressed by, is the kind of convergence of usability and accessibility, cognitive accessibility, where one could say that a lot of issues which we'd recognize as good design practice from a usability point of view, but perhaps not things where, you know, violating these principles is utterly fatal, those become higher stakes issues in the cognitive, in the sphere where you're working with people with cognitive disabilities, because a given level of severity of problems, it's going to have greater impact for them.
Anyway those are two, in one case a study and another case a little body of studies done by that group that I'd point people to.
Cyndi: Just to add in on that, WebAIM did a little work for the Sliver center, not empirically based but pulling together some of our best thinking on this. And one of the things that you mentioned came up in that as well, which is to the extent that the web is starting to actually create conventions, for example, you know, an awful lot of search boxes are starting to appear in the upper right-hand corners of lots of sites.
Where we're seeing some conventions emerging that folks ought to just stick with that for exactly the reason that you've said. As people become familiar with some functionality, either appearing in a certain place, or having a predictable behavior, we need to kind of keep doing that, because that will help folks that have a hard time with thinking of doing things in different ways. So it's interesting that you had mentioned that, as well.
Paul, any other things that you would want to bring up? I know you've been knee deep in this research for a bit of time.
Paul: Yeah, just to address some of the last things that were said, especially Cyndi about your mention of conventions and the use of, well the use of conventions on web sites. I couldn't agree more. I think that's one of the more important things.
I can also hear the rumblings in the background, some people thinking well, you know, conventional design, is that really good design? Is that creative design?
And it brings up the attention of designing for creativity versus designing for the masses, or designing for artistic effect, or designing for people's cognitive disabilities.
These can all be viewed as different purposes, different audiences.
And you know, part of the definition of what conventional is, is going along with the flow, and perhaps there is a little bit of a loss of creativity, and that is one of the things that has to be held in the balance.
We can't just say that everything, all the freedoms that you want to have you can have in the same way if you're trying to accommodate the broadest range of users.
And there is that tension, there.
Part of the reason why the artistic geniuses out there succeed in ways that they do is because they come up with new ideas, and of course people copy them.
And then their new ideas become the convention.
So it's a matter of coming up with the creative ideas that foster conventions that actually work, so it's not really to stifle creativity, but rather, to continue in creativity using conventions where appropriate, and making the adjustments where necessary, just kind of the general commentary on that thought, there.
In terms of some of the other comments that were made, I especially liked the comment that people with cognitive disabilities experience things, experience the difficulties on the web that all of us do, just to a greater extent.
And the list of functional disabilities that I went through a few minutes ago is not specific to people with cognitive disabilities, it's general to all of us.
And that makes cognitive disabilities unique in comparison to some of the other disabilities, because a person can have 100 percent vision or 0 percent vision, but a person who's going to be using the web, is there such a thing as 100 percent cognition?
And if they have 0 percent cognition would they be using the web?
The answer is no.
We all have cognition if we're going to be using the web and it's just different degrees in different areas.
So the trick, then, is to think of cognitive disability access as an issue within the broader usability arena as was mentioned before, which includes all of us.
We all can receive benefit from the different attempts that we try to make to make things accessible to people with cognitive disabilities.
And I'm going into the literature just a little bit, most of the studies that look at cognitive disabilities specifically generally come to that conclusion also, and if you're looking at the by graphical list that I've got there, a few studies that I'll point out that actually have some empirical study behind them, and not just talking about the issue, one that I'll mention is the fifth one- -
Cyndi: Let's see, Paul, which, from your- -
Of the three links that we have- -
Paul: The bibliography link.
Cyndi: Oh, the bibliography of the top link.
Paul: And it's not necessary that you be looking it up. I'll try to describe some of the things.
The fifth one in the list, there, is entitled interaction design, a multi-dimensional approach for learners with autism. And this one looked at mapping the different cognitive, and I guess you could say deficiencies to the different design recommendations for web accessibility, and they came up with their list of recommendations based on their observations of the people that they were studying.
And without going into a whole lot of detail I'll just mention another one, number 25 on the list, and this one's entitled the use and value of illustrations as contextual information for readers of different progress and developmental levels. It's kind of a long title. But what they're basically looking at is the value of illustrations in text content. Do the illustrations help people understand it? Now this is one that I'm bringing up because it is a little bit of an exception.
For the most part, other studies have found that people in general benefit from changes that we could make that would also benefit people with cognitive disabilities. But this one found that illustrations were very beneficial to people with cognitive disabilities, and then the benefit dropped off sharply as the person's, comparing different people with different reading abilities, as a person's reading ability increased, usefulness of the illustrations actually decreased.
Cyndi: Was there any worry that it was actually distracting, or harmful?
Paul:- -
Cyndi: Or maybe they didn't look at that.
Paul: They didn't go into that in great depth. And that would be an interesting thing to study as a follow up. But they bring up the possibility, and more, I think more they're just looking at the benefits decreased as a person's reading level increased. But that would be interesting to find out to what degree there was a distraction, or if there was a harmful effect.
And there were several other studies that looked, well that came to the basic overall conclusion that things needed to be simple. And- -
Cyndi: However we define that, huh?
Paul: However we define that, right.
They did define it in a few different ways and I'm not going to be able to bring these all out just off the tip of my tongue. I have annotations on the bibliography that can help people later as they go through it themselves. But simplicity is often defined as a reduced amount of content, and a reduced number of choices.
And they talk especially- -
I keep saying this phrase, most of the studies.
I have to admit it's been, I took about two months off of diving into this research that's why I'm a little bit rusty on actually have aring the names ready for me, but many of the studies did come to the conclusion, or they looked specifically at navigation issues, and found that fewer choices was better, they found that having smaller amount of content on a page was better overall.
The ones that I looked at didn't compare those sites that they were looking at to the ones with simplistic design. They did not compare the usefulness of those sites between people with cognitive disabilities and people without cognitive disabilities.
Cyndi: Let me ask a quick question, we are using that big, broad, sweeping term. Do you happen to recall--and I realize this is from your memory banks--the sample that they used? Were these individuals that had low literacy skills? Were these individuals that had certain other kind of functional problems or characteristics? Or was it that other mechanism that Clayton brought up, we're going to find ten people with downs syndrome, as if some unifying sample.
Paul: Well one of the sources is number 32 in my list, and they were looking at people with Alzheimer's disease, a form of dementia, so that was one population that was looked at. This is one that I was referring to earlier when I was saying most of the studies, this is one of them they recommend limiting the number of choices and reducing the amount of information. And I've got to scroll through my list.
Off the top of my head I do remember one I probably won't be able to find it quickly, that had a broad range of people with, their categories were more the clinical categories, so Down's syndrome and Alzheimer's and a few others like that. So it didn't look at it from a functional kind of disability standpoint.
Cyndi: Or the conditions.
Paul: And so I think the usefulness of the results to a large degree because as was mentioned before, there was a broad spectrum within each clinical diagnosis, or each category.
They tended in that study to mix their conclusions across all of the people that they studied. They didn't differentiate as much, and it would be nice if I had that number in front of me to point you to in my list but I might be able to come up with it later.
Cyndi: That's okay. Well one of the things that I really like about, and thanks to both of you for pulling some resources together, is I knew, I just had a sense that this is such a huge topic. Frankly, this warrants its own summit or something. There's so much to talk about here, and we have just this one hour to cram a bunch of stuff in.
These resources will enable folks to go and you know poke around at some of them, and again, I would invite people as they're finding things, to send them our way and we will add them to the list so that others are aware of them and can use them. We've got to come together, I think, from very disparate disciplines to figure out what really makes sense to recommend on to developers, or software engineers, whoever it happens to be.
We've got actually quite a number of questions that have come in, so I'm going to--whoops, excuse me for that noise--I'm going to shift gears, here, and we'll take some questions from our listeners right now.
And this is really open for anyone, I'll just ask it.
The first comes from Daniel, and the question, I was wondering what is your opinion regarding eye-catching advertisements on a web page that have little or no importance to the contents of the web page itself? Most users will try to ignore a flashy, colorful banner at the top or side of the page, but someone with cognitive disabilities might spend too much time and effort to understand what this irrelevant and useless ad may mean.
Any comments or thoughts from either of you?
Paul: I'll go ahead and start.
Just a quick thought there, a lot of advertisements are designed very well for cognitive disability access, which is why they're so distracting. They focus the attention of the viewer, and they draw them in. Of course if the page is intended to have some other purpose other than showing a bunch of ads then you've defeated your purpose with the content. So yes, you'd want to avoid that because it does distract the user. At the same time, I think we can learn something from some aspects of advertisement design because they do focus the attention of the user so well.
Cyndi: I agree. Actually, I wonder sometimes if we couldn't do a better job of focusing the attention of the user on the content that we're wanting them to pay attention to. Especially in things like , important things like error recovery mechanisms, or how could we do a much better job in helping to focus the attention of the user?
Any different thought you have, Clayton, on that?
Clayton: Just to add something. And I don't know of studies specifically on this kind of attentional control that is especially with dynamic stuff. There are studies showing that some people in this broad category of cognitive disabilities actually have enhanced ability to perform some kinds of perceptual tasks.
So there are so-called embedded figures tests that some people may have seen where you're looking at a complex network of lines, let's say, and within that there's a shape that's picked out by those lines and your task is to find that. And some studies have shown that there are people in this, again, in this broad category's ability to perform that task appears actually to be better than the ability of typical people. So maybe I've sufficiently emphasized this point, but that, again, underscores the fact that it's just not going to work to try to think of people in terms of these kinds of conditions, and relating Paul's point, we're talking about in some cases functional abilities which are actually enhanced for some people.
So it's a complicated thing but I don't know of work on a specific point. You know the speculation is certainly plausible there would be such ads would be more distracting than for others.
Cyndi: And you've hit it on the head, which is we could talk, we could speculate a lot about very specific conditions, a very individual and specific user. Whether that user's need at that moment in time would at some point become a generalizable recommendation to the field is a whole different story. But this really is a very complicated situation.
Let me read the next question.
And this comes from Jerry Smith, university of Minnesota.
And Jerry asks, how have you addressed content issues for internet users with cognitive interest intellectual disabilities, particularly in the delivery of educational information? Addressing, for example, limitations in abstract thinking and attention span.
Clayton: I'll jump in on that one.
I've been able to work with an organization called the arc link, one of whose projects is the desk dot INFO, and what the desk.INFO is to present information about Medicaid programs that would be of particular interest to people with cognitive disabilities, and what the folks at the desk do is to rewrite the material that comes from state, federal agencies, to make it more comprehensible, and I can't resist the note, again, that the kind of editing that they do is also something that makes anyone who looks at that material feel that it's easier them to get a general sense of what's going on.
Now, in the course of editing the material, the staff at the desk, they're doing a complicated thing. There's nothing simple about it, they have general guidelines that they're following, but one of my interests with colleagues has been, is there any prospect for automating some of this kind of re-presentation of material? It's definitely a tough problem. Because the way it's being done now by people, you know, it's a multi-facetted thing. So it certainly includes changes in content.
So they're sort of more superficial things going on which are important which you can think of as vocabulary control, so trying to avoid the use of complex technical terms unless they're essential, but if you look at the editing process that the desk goes through, what they're also trying to do is really try to gist out the material to make it more concrete and less abstract. But there's not a lot of science behind this. One of the things that's key, and that's another thing that may come up, something that I think is important to stress, they've got one of the people on their editorial team is a self-advocate.
And if there are people who don't know that term, a self-advocate is a person with a disability who acts on behalf of themselves and others who share that situation. So this is a person who's working as an editor who is a person with a cognitive, with some cognitive limitations, but who's very effective in this editorial role of actually finding ways to make things more concrete. This person is extremely gifted in doing that.
So sort of a larger theme, here, is I think that there's an essential human element in a lot of what we're talking about, here, that you know, we might wish that there's some sort of turn-the-crank guidelines that we could employ, but I think a lot of the work we're talking about takes significant intellectual engagement and participation by self-advocates has a big contribution to make there.
So there are people working on this kind of thing. There's not a big science base behind it, but I think one can get some insight into the kind of thing that's helpful.
Cyndi: And you know, you're absolutely right, it's going to take effort. I mean even going back to what Paul had said earlier about simplifying. Well, that's an easy word to toss around, and it's something that takes a lot of engagement from the developers to make happen.
Paul, I'm going to ask you this, to respond to this next question.
This comes in from Cathy HARSTAD in North Dakota. And she asks, can you describe standards or resources that address the cognitive content of web information? For example, she's got down here reading levels and structure, informational organization, et cetera.
Paul: Yeah, of course there are plenty of resources out there that make attempts to give guidelines.
Cyndi: And unfortunately they're not based on any kind of evidence base because we don't really have one yet.
Paul: Right. I mean there's some evidence, and I think people are genuinely taking it, though, from the perspective of common sense, if there is such a thing in these issues, or at least best guesses.
Specifically in the realm of web accessibility there are the web content accessibility guidelines, which version two of that is still in draft form. But they have made an attempt to include cognitive disabilities as a part of that document. In fact early on they made the claim that the document did address cognitive disability issues, along with other types such as visual, auditory, and motor, so on. There was a formal complaint that was filed against that claim, saying that the guidelines really didn't address cognitive disabilities sufficiently, and I think there are arguments both in favor of the complaint and in favor of later responses by the committee.
I think version 2 of the guidelines does address a lot of the aspects of cognitive disability access, at least to some degree. And they also leave out a lot. Part of it, part of the problem is that it's a matter of degree, as has been brought up before. You can do some things to a small degree and satisfy the needs of general users or people with visual auditory disabilities, motor disabilities, but in order to accommodate people with cognitive disabilities you would have to do some of those same things but to a larger degree, to a greater extent.
And there are reasons to think that the version 2 of the web content accessibility guidelines does not do that. One other resource that I can bring up from my list, which I can pull this up, number 81 in my list. This is a document that was, well the title of it is guidelines for developing an AAC-enabled world wide web, and AAC being the augmentive, any other word- -
Cyndi: Alternative.
Paul: Thank you for the save, there.
So they were looking specifically at people with cognitive disabilities that fit that category, as opposed to all kinds of disabilities. And it's a rather lengthy document it gives some examples and illustrations. It's not as technical as the web content accessibility guidelines.
But they give some good ideas, and if you were to compare those two documents side by side I think you'd find that there's a significant amount that's left out of web content accessibility guidelines version 2.
But in their defense, there's quite a bit there.
One specific technique that I'll mention that is also backed up by the literature, and if I'm lucky I'll be able to find it, but the idea that some people with cognitive disabilities benefit from having it read out loud to them. Number 27 in my list mentions this. It talks about computer reading machines for poor readers, and talks about how some people benefit greatly from having the content read out loud to them, as is done- -
Cyndi: So some of those native screen readers that are starting to pop up in just about every new OS would be an example, then, of a way that users could help themselves.
Paul: Right. And well I should say with- -
Let me back up.
With the web content accessibility guidelines, a lot of the emphasis is on making sure things are in a text format. Usually the interpretation is so that this can benefit blind users, those that use screen readers because they can't see the content so they need it read out loud. Studies such as the one I just mentioned talk about the way that this same technology also benefits people with cognitive disabilities. Of course again I'm using that term as if it's everybody. Some users with some kinds of cognitive disabilities.
And so when you address the needs of a person who is blind, as web content accessibility guidelines do, you're also addressing some of the needs of some people with cognitive disabilities. So there's definitely a significant amount that is addressed, but they're afraid, I think, for good reasons, to not go the full distance. They're afraid of some backlash.
Because if you have to simplify your content down to the point where someone who has a lot of memory deficit is able to use it, then you've basically simplified it beyond the point where most people are willing to look at it. And then you get into that tension, again, that I was mentioning before, of the general users versus those with cognitive disabilities. They wanted to try and straddle that and come up with a set of guidelines that was generally applicable, recognizing the fact that they can't accommodate all users.
Cyndi: So it sounds like there may be some emerging standards, we'll see, but they're a little controversial.
And in terms of resources, I really would point our listener back to this initial list. In fact one of the other questions that we have is coming from REUBEN who's wondering if we're going to point to some sites or books or other resources that will be helpful to web designers so they can be getting some good ideas on what it is they should do given the wide variety of cognitive disabilities that we're addressing. And I think I'll answer this one really quickly, I think a good place to start will be in this list.
I happen to know, for example, that some of the WebAIM articles, the cognitive disabilities part 1 and 2, actually does provide some expert opinion on some design elements that you might want to think of incorporating. But I would just want to remind everybody that this is not an area that has received enough study. I don't think anyone is going to find a source that says, you know, "do this for these kinds of people for these reasons, and here's the empirical base for that."
But these are very valuable resources, so I would encourage folks to look at them. I just almost can't believe this, but we are out of time.
I have a pile of questions that guys just can't even believe. This confirms for me that we need some attention in the field on this important issue.
I would, what I'm going to do is I'm going to pull together these questions, and send them out to both Clayton and Paul, and if we get any responses to those I'll go ahead and post them. And I want to thank everybody, and Clayton and Paul, thank you so much for your time.
I'd like to give both of you an opportunity to make any kind of closing comments or thoughts that you have on the future of research, or things that are needed right now. Try to make it brief.
Clayton we'll start with you.
Clayton: Gosh, there's so much to say. I'll just say thank you, and I certainly, I'm sure Paul will as well, make every effort to respond to the further questions, and their other thoughts. I'll try to put in some notes. I hope this is just the start of this discussion with the people who have tuned in.
Cyndi: Yeah, thank you. Paul, any last thoughts?
Paul: I think I've probably said enough in terms of the time that we have here but it is an area that needs more attention, that needs more research. And if this sparked the interest of anybody out there I hope you follow through on that interest.
Cyndi: Definitely.
Well, and I would, again, I'd like to thank everyone here. I know we wanted to get some more questions and we wanted to get to more solutions folks could take away with them. We ran out of time.
I would encourage folks to come back, March 14th we will be having another web cast sponsored by the national center on disability in access to education. We will be doing another in our policy series on accessible electronic education and information.
So please do join us. If you are part of the national center affiliates, you probably subscribe to our free monthly, or I'm sorry, free bi-monthly news letter that reminds folks of these very web casts.
So join, if you'd like, come back and visit again, mark it on your calendars, March 14th, and it's, as we say, same bat-time, same bat-channel. Just go to the web site at this time on the 14th of March, and you'll get to hear another very lively discussion.
Well thanks again to the panelists, and hopefully each of you out there in the field has more questions that you will just pursue on your own, and please do give us information if you cross paths with it.
This is Cyndi Rowland from the national center, and thank you very much. Have a great day.