REGISTRO DOI: 10.69849/revistaft/ra10202501081508
Guilherme de Abreu Lessa
Abstract:
This article delves into the critical role of inclusive design in addressing the unique challenges faced by individuals with cognitive disabilities. It highlights how inclusive design transcends the traditional one-size-fits-all approach, focusing on creating user-centered systems that accommodate diverse needs, including those with cognitive impairments such as ADHD, dyslexia, and autism spectrum disorder. The discussion explores key principles of accessibility standards like WCAG, emphasizing participatory design and methodologies to reduce cognitive overload. Furthermore, it examines advanced technologies, including AI and VR/AR, to enhance adaptability and personalization. By presenting case studies, guidelines, and potential pitfalls, the article underscores the importance of empathy-driven innovation and iterative design in fostering equity and usability. This work serves as a comprehensive guide to integrating inclusive practices into design processes, fostering an accessible digital and physical environment for all.
Keywords: Inclusive design, cognitive disabilities, accessibility, user-centered design, WCAG standards, cognitive overload, adaptive technologies, participatory design, artificial intelligence, virtual reality, augmented reality, personalization, empathy-driven innovation.
1. Introduction to Cognitive Disabilities and Inclusive Design
We are at a place in time where a light is being shone on the experiences of marginalized groups in our societies like never before. Members of many of these groups agree it has been a very long time coming and are hopeful things will change for the better in the future. One tragic component of our physical, on-the-ground world events refuses to wave before us: persons with cognitive disabilities are one of those groups. As the general population becomes aware that some of us have to take a different approach for comprehending written and spoken language and making memories for a variety of reasons, the state of the world’s inclusive design will benefit from a solution. Including each of us in conversations, communities, and society on even ground. Inclusive design is flexible, user-focused, and doesn’t follow a “one-size-fits-all” philosophy. Open-mindedness in approach and design and a comprehension of the wide-ranging spectrum of this type of disability’s effects are imperative to moving out of the dark period of negative connotations and social models. Being able to adapt and evolve is key, as is implementing a little bit of common sense to bridge the gap between both a speedy and eager push for immediate change in perception and a reluctance towards a long-standing tradition may seem utterly and deeply rooted. Finding success here requires practitioners to be comfortable with, and almost as sensitive to change as transformative and highly innovative thinkers are. (Willner et al.2020)
1.1. Defining Cognitive Disabilities
Like any chronic impairment, a cognitive disability is a struggle with a basic function that must be accommodated daily, although this level of support may often be invisible. Unlike sensory impairments, cognitive disabilities affect not only perceiving raw information but also thinking and learning, or differently processing new information. These differences might persist with appropriate assistive devices and accommodations. Three common types of cognitive disabilities are Attention-Deficit/Hyperactivity Disorder, Learning Disabilities, and Autism Spectrum Disorder. Impairments often co-occur with these conditions. (Chen et al.2021)(Lin et al.2023)
A cognitive disability is usually diagnosed after a marked difference in functioning is identified. If there is average performance in the face of norms, this is often seen as ‘talent’, ‘gift’, ‘diversity’, or ‘learning style’, rather than impairment. People with long-standing cognitive disabilities struggle to be taken seriously not only in the workplace but also in interaction because of a widespread, normative, deficit-driven medical definition. The social model of disability would better frame cognitive impairments as deficits only in relation to an environment, with implications varying widely by the interaction demands of different environments. We would like to frame cognitive variability as a spectrum from mild to severe, consistent with many medical classifications and first-person discourses. Emphasizing the impairment-function-need relationship, within a design context, one individual’s impairment can also be framed as another person’s difference, and framed as a design problem of universal and inclusive access. Cognitive disabilities may be temporary, permanent, or possibly age-related, and affect different parts of human functioning from day to day or person to person. The combination of human variability suggests this domain-ranging, personal-when-impairing definition. Treatment typically includes ongoing interpersonal, medical, and time-management supports. Successful supports are often tailored for personal disability types or learning styles. Long-time carriers of cognitive disabilities show a wide range of adoption potential, accommodation needs, and often use organized supports as adults. Unlabeled carriers could still be supported by an inclusive frame. (Slade et al., 2020)
1.2. Importance of Inclusive Design
Inclusive design is essential in supporting individuals with cognitive disabilities and other forms of impairment. A paradigm shift has been suggested, from designing for the impairment to designing for the person—and now to designing for everyone. Expanding design scope not only satisfies those with special needs legally, but also morally, by promoting social solidarity. Enforcing inclusion can be seen as promoting integration with others and establishing a sense of equality and justice. Inclusive design should not be approached only as an invaluable ‘add-on’; it should be a ‘strategy’ to design not only special products to serve marginalized groups, but better products for all users. After all, the distinctions between ‘marginalized’ and ‘normal’ are somewhat artificial. One size fits all is not about ‘only one product’ but ‘one product meeting different needs.’ (Basham et al.2020)
Social inclusion is a core benefit of inclusive design. When designing for diverse users, it also increases usability and user satisfaction and enhances interaction. Including users with cognitive disabilities and applying inclusive design strategies in the design and evaluation process make the system easier to use for all users. Being inclusive serves as a final appraisal tool for the world, practices, and technology. Providing a ‘diverse’ view in the design process increases the chance of developing a more desirable and usable system. Enhanced acceptability and usability are thus linked with incorporating designs that cater to a larger psychological makeup of users. Likewise, when systems are tailored and thought out to handle the extreme cases, it inherently increases its market and customer satisfaction.
2. Understanding the Needs of Individuals with Cognitive Disabilities
Before we can really build effective solutions for people with cognitive disabilities, we need true empathy with these users and we need to understand just how diverse this community is. The term “cognitive disability” can refer to something as “simple” as dyslexia or as complex and erratic as cognita. Individuals with cognitive disabilities may have trouble with memory, planning, organization, following specific instructions or complex vocabulary, mathematics, and time management, among other things. They often face unique challenges, such as meeting unfamiliar interfaces, surfing massive flows of information, and not reacting to too many stimuli at the same time. It’s high time for the design of digital platforms to adapt to the needs of users with cognitive disabilities. While some of these designs may seem appropriate and respectful for a certain user, others may seem confusing. This variability emphasizes the importance of understanding the cultural context of the target user and developing user-centered designs based on solid data and observations. Mobile learning interventions aimed at adolescents and young people with cognitive disabilities or without them are a special focus. To make such interventions adaptive, meaningfully engaging, and supportive, it is essential to understand the users’ needs and their contexts. An important part of a user’s context is their personal, social, and cultural environment. This environment has a direct influence on their approach to learning and has to be considered when making learning interventions. Thus, the aim of this study is to detail the needs of users with cognitive disabilities from their own and social perspective, detailing their needs with fine granularity in order to support the development of culturally responsive design that maximally meets the needs of all users across different environments. (Miciak & Fletcher, 2020)
2.1. Common Cognitive Disabilities
Autism: Autistic individuals frequently engage with the world and other people in ways that can be quite distinct from those displayed by neurotypical individuals. They often exhibit tendencies to be less active and more reserved in various social situations, sometimes leading them to avoid situations where maintaining eye contact with others is expected. Their perception of the world around them can be quite different, causing them to comprehend various environments, events, and respond to information in unique and unusual manners. These responses often break away from the standard social norms that many people take for granted, making their interactions and reactions noticeably diverse from what is typically observed in the general population. (Cherry, 2021)
Dyslexia: Dyslexia is a specific learning difficulty that makes learning to read, write, and spell significantly more challenging. Individuals with dyslexia often have average or even above-average intelligence, which can make the learning difficulties seem particularly perplexing. The core issue primarily resides in the individual’s ability to identify and process the individual letters within words, as well as in understanding how to accurately blend those letters together to form the sounds and meanings of the words. This struggle can lead to frustration and a sense of inadequacy in academic settings, even when the person possesses the cognitive capabilities to excel in other areas. (Hadhrami et al.2022)
ADHD: Attention Deficit Hyperactivity Disorder, commonly referred to as ADHD, represents a frequent and prevalent condition that is often identified in children and teenagers, although it can persist and impact individuals throughout their entire lifespan. Those who are diagnosed with ADHD frequently encounter a range of challenges when it comes to maintaining their attention on tasks at hand, and they may experience significant difficulty in remaining sitting still and calm. This can lead to behaviors such as fidgeting and excessive talking in various situations. However, it is essential to clarify that ADHD is not solely characterized by boundless energy, nor is it merely a reflection of laziness or an inability to focus. Individuals with ADHD usually face obstacles that hinder their ability to follow structured routines and concentrate effectively on activities or subjects that do not pique their interest. Consequently, aspects of learning such as reading, writing, and overall concentration abilities can be notably impacted. (Young et al.2020)
Doubly Disadvantaged: Dyslexia can occur alongside other difficulties that can contribute to learning. These disabilities can occur concomitantly with connectivity issues related to a specific reading disorder in dyslexia. Dyslexia also occurs together with a wide range of physical, sensory, and medical illnesses, and it is not uncommon to occur with other learning disorders. Interacting with technology exacerbates the difficulties and limitations experienced by people with this condition. Many consider it a form of neurodiversity. In a scenario of a child with a cognitive disorder, the reader is presented with a child who is unable to master the construction, sound, and meaning of his mother tongue adequately in relation to his age group. (Miciak & Fletcher, 2020)
2.2. Challenges Faced in Accessing Digital Interfaces
2.2. Cognitive Access Challenges
Interfaces suffer from three main barriers for individuals to access inclusive design. First, the structure of these digital systems often requires a user to navigate complex content hierarchies. Not only do these hierarchies demand that an individual follow submenus, but the information is often contained within multiple sublayers of division. Secondly, much of the language used on this platform is vague, or generic. As such, the content is not clear and is interpreted by others as imperceptible or indistinct. This lack of clarity results in others finding the platform confusing and practically impenetrable. Thirdly, access to the site is impaired because the information it contains is bewilderingly excessive. Often, someone will report that all they can see is the same thing repeated over and over again. This barrier is termed information overload. The technology has a networking capacity that allows it to keep reproducing the same information. As such, if a base element is too large, then the final content can be infinitely expanded. (Creed et al.2024)
Systems are not developed with cognitive diversity or disability in mind. Instead, the underlying assumption of how we perceive the world leads to a view that ‘normal’ people must be like us. ‘Normal’ is a synonym for the term ‘common sense’ and as such dictates that the status quo should remain the way it is. The example given is when an individual applied for a driving license; they were told to phone an incident hotline. This was standard bureaucratic practice, failing to understand that a list of informal details could never include a helpline based on a conversation had previously between two old friends. The designers of the form not only dismiss the needs of the individual, but they make other lives more complex by forcing change upon a pluralistic world. This is not merely a case of being unable to appreciate the needs of others; it is about changing social systems to fit their view of what normal is. To understand what challenges cognitive barriers create, we need to encompass the multitude of experiences and practical difficulties individuals face. These experiences fall apart between cost, distress, frustration, and failure. For example, one participant describes how their central energy for today was already gone after checking an invoice that is not correct due to the amount of information assumed of them. Not only do fatigue and frustration impact other areas of their life, but it is also expensive to access the information. This includes the cost of printing additional invoices, the cost of lost time at work, and possible errors due to lack of concentration. Instead of defining barriers, the focus should be on developing services to solve practical or functional problems. In the space of access, it is about making the best use of the system or site. This requires a move to a functional definition of the concept of the user. It is also about challenging a system that uses language that makes the user figure out or interpret what is being said. Screen readers and language constructed in this manner do not mix. Repeated annoyance and tasks of magnitude in accessing content result from the language being almost indignant in nature: ‘You will automatically be redirected.’ Design tasks to alter such language so that it is more user-friendly should be a key area of development in the digitization process. (Schramme2024)(Mackelprang et al., 2021)
3. Guidelines and Methodologies for Inclusive Design
Accessibility guidelines and standards are fundamental in the design of any inclusive product. These are some of the most popular guidelines and tools for evaluating the accessibility of web and mobile applications. Many states around the world and the European Union require that public web pages comply with the accessibility guidelines and that they report on their compliance through structured testing. In addition, some countries require that all web applications comply with accessibility standards. Therefore, implementing guidelines and standards is very important to the design process. Designers should use these guidelines and standards as a source of inspiration for designing accessible products that meet the needs of most people. The main design challenges described in accessible design standards revolve around the usability of various components, such as documents, videos, and forms. Emphasizing this content in the design process will bring products closer to compliance from the beginning. (Stucki et al.2022)
Although there are important regulations despite all disabilities, this study is limited to targeting cognitive disabilities. This means that design access has not been studied in general, but with AI, only for mental disabilities. Accessibility must be practiced to design an inclusive solution that helps guide the user throughout the user-centered design process. This section will present our six guidelines, together with explanations and examples. These guidelines are intended to inform readers on how to design for people with psychological disabilities. Some items in this list may surprise, contradict, or conflict with what people say or do in everyday life. This is because the guidelines we provide are deeply rooted in the everyday life of people with psychological disabilities. In this section, we also refine these recommendations based on practical methodologies that contribute to their application. (Miskowiak et al.2021)
Guidelines are always applicable in the context of all animated recommendations and circumstances. It is of great importance that people working in the media interpret them in different ways. The guidelines are also too general to simply “do”. They need further refinement in the context of your organization and your particular needs. This requires the application of expertise in the field of human-computer interaction and usability. In other words, use the knowledge of your design team and collect customer feedback in order to develop a code of conduct that will allow you to bring people with mental disabilities to your website. To help the process, each of the guidelines is accompanied by a number of illustrations in the accompanying document, showing them at work. (Wies et al., 2021)
3.1. WCAG and Other Accessibility Standards
Web Content Accessibility Guidelines, commonly known as WCAG, represent the leading and essential standards for ensuring website accessibility and promoting inclusive design practices. These guidelines serve a critical role as they not only provide an explicit and clear roadmap towards achieving inclusion but have also been meticulously developed from real-life experiences and proven outcomes in various environments. Striving for compliance with these established standards is considered a best practice within the digital landscape and significantly aids in creating web content that is accessible to the widest possible audience, regardless of the technologies they may be utilizing or the disabilities they might be facing. The guidelines are carefully formulated to be technology-independent, meaning they can be applied universally, and they reference a comprehensive set of specific directives for various media types such as images, sound, video, structural elements, style choices, dynamic content, and forms. There are four foundational principles that underpin the process of designing in ways that are inclusive: perceivable, operable, understandable, and robust. While these principles might seem most directly applicable to users who engage with tiny screens or have motion impairments, they hold equal significance for individuals with cognitive disabilities and those who rely on screen readers to navigate digital content effectively. Embracing these guidelines fosters an environment where everyone can interact with online content unhindered by barriers, and it is a vital step towards achieving true digital inclusivity.
There are several accessibility standards and policies other than WCAG that offer rich insights and good practices supporting inclusive design. Following these is an issue of ethical or legal compliance as much as it is a best practice. However, the development of support for these is also less specific, and their inclusion may be less inclined toward “user-centric” design. It is crucial to remember that “web accessibility is not a final destination,” and a commitment to ongoing, iterative improvement through incorporating user feedback and acknowledging the value of supporting a broader base of everyone is essential. These standards, based on 12 principles, cover areas including language, multimedia, non-text content, accessible design, and coding. WCAG standards compliance and these standards-based approaches serve as benchmarks for how to engage in inclusive design for website content.
3.2. User-Centered Design Approaches
Inclusive design approaches emphasize the importance of engaging with end-users at all stages of the design process. It is only by engaging with users with cognitive disabilities that we can begin to understand design solutions that would be the most beneficial to a wide variety of users. When using a user-centered design approach for inclusive design, it is critical to go beyond a singular user consultation for critical feedback. Participatory design is one common method to conduct inclusive design. This design process involves the active participation of end-users through involvement in the development of the system, making recommendations and usable suggestions based on lived, embodied, and intuitive knowledge. After a solution has been identified by the software designers, end-users meaningfully evaluate and test the tool in a real-world context via usability testing. The received feedback can lead to refinements in the design of the solution based on end-users’ input and enhance the system’s usability. The further benefit is knowledge gained by the designers about how end-users are using the solution. Mission-critical systems require iterative usability testing sessions any time a significant redesign is made. This adaptability to the end-user experience in the design process will improve the usefulness, practicality, and relevance of the solution. However, there are potential drawbacks to this strategy. The end-users involved in the design of the system may not be fully representative of the end-users who could use the tool. For example, in the inclusive design of a solution for students with cognitive disabilities, the children may not have the language or capacity to articulate what they cannot or do not understand in using a product. These potential problems demonstrate the necessity for a holistic approach to understanding users with disabilities. (Schalock et al.2021)
4. Reducing Cognitive Overload in Design
Reducing the cognitive load can help improve comprehension for people with reading and intellectual disabilities. Overwhelming a user with a lot of functional and nonfunctional information can create confusion and disorient the user. A design must balance its functionalities and information widgets to avoid overwhelming users. A good in-between is maintaining a clean, organized website without blank backgrounds but using the remaining area to have the information easy to peruse. Changing a simple webpage layout into one that is even easier to pursue is called “Information Architecture,” which is the art of organizing and labeling content, data, and support systems so that people can easily find what they’re looking for while learning about new things along the way. (Tortora et al.2024)
Creating a clean, uncluttered “Information Architecture” enables teams to identify the key content and tasks when redesigning web content and navigating aids. When done well, users spend more time learning about what they need to learn about, rather than wandering throughout the site in an unorganized and uncontrolled manner. When we simplify the Information Architecture and apply it to our design, this uncluttered look becomes clean and organized. Good Information Architecture and design includes: a balanced mix of text, white space, and images that are easy to look at and to understand; a visual hierarchy that clarifies and emphasizes the relationships between objects on a page in a way that is intuitive and easy to comprehend; cues within the design that guide users and funnel them to specific goals without taking away their ability to make choices.
4.1. Simplifying Information Architecture
4.1. Simplifying Information Architecture. Simplifying information architecture can benefit users with a range of cognitive abilities. Common strategies that can be particularly beneficial to users with cognitive disabilities include organizing content in ways that are easier to navigate, reducing visual elements and cognitive loads, and making the layout of information more logical. Supplying content in clear headings, followed by bullet points that are one or two sentences long, can be particularly beneficial because it breaks up content into small, manageable steps. These steps can be communicated in order of importance, thereby enhancing comprehension for many users. (Tortora et al.2024)
Chunking information in an intuitive and straightforward manner can also be useful for treating anxiety or neurotypical readers who are learning a new language. Providing images to clarify dense passages for individuals who retain information more effectively when it contains visual elements is a good practice. Providing direct information before background information and avoiding providing too much context is particularly useful for users who have difficulty focusing. Similarly, including a sample procedure for connecting a device to a service can help. The five-step procedure can be divided into distinct, clear pages. This suggestion reveals that a person with a cognitive disability may require content to be distilled into simple sequential steps. Further, it suggests contextual as well as navigational approaches to accessing the step.
4.2. Visual Design Considerations
Color, contrast, typography, imagery, and visual hierarchy are just a few of the key elements to consider when using visual design universally. These have implications for cognitive accessibility, especially for users with attention difficulties, visual impairments, brain injuries, or learning disabilities. Maintain consistency across your course and within your nonverbal language to develop familiarity with your users. Emphasize the most important and relevant information using size, color, contrast, placement, and styling. Every single element of your design should play into and support a clear visual hierarchy for that screen. Aesthetic and effective visual design tends to include a fair amount of whitespace between and around elements on the screen. Not only does it make your design look clean, uncluttered, and inviting, but it also helps users differentiate separate areas or topics on the screen and guides users’ eyes to the most important information.
Of course, the balance of whitespace to elements isn’t set in stone and can vary based on the complexity of your content, the size of your screen, the viewing distance, etc. Generally, providing about 50% whitespace on your screens gives your course both a clean, organized feel and gives learners enough clarity to read and understand the content. Where helpful, use icons, images, diagrams, and other visual aids to visually display an idea, process, or relationship. These can often be easier for a user to interpret and can help create a visual context to support deeper learning and understanding. When using visual aids, follow a few basic guidelines. Use them sparingly and where they add value. Ensure that they are clear, self-explanatory, and universally understandable. Ensure that they are high contrast, high quality, and have been vetted for good design principles. Always include a text label if the image may have an accessibility impact for some users. In the next section, we’ll talk about how to design visual aids that work more effectively for learners with cognitive disabilities. In the next section, let’s talk about visual design guidelines, we’ll give you some concrete ways to apply these design principles. (Doherty et al.2020)
5. Improving User Experience for Cognitive Challenges
Improving the user experience for people with cognitive challenges is a very rewarding thing to do. When you install an interactive element that someone engages with in an intuitive, natural, and easy way, you are, in some way, validating their effort. This validates their view of the world and their place in it. The same way it does when something is easy to use. One way of doing this is to make an interactive interface look more familiar. Things like creating a button that looks like an actual button or reel, or a sound effect interacting with a physical property, are good ways to create familiarity in an already well-understood format.
Another important component of interactive design for a person with cognitive challenges is having strong feedback mechanisms. Things such as progress trackers, user notifications, and confirmations can go a long way in creating a good level of engagement. Providing some kind of visual confirmation that an action has occurred reduces errors in the mind of the user and also reduces a level of frustration. This is basically error prevention. Another important part of feedback is an error message. They serve a vital purpose too. They allow users to know how something can be improved and can be a way of providing feedback. Some good examples of intuitively designed elements are illustrated well in mobile device inputs. The on-screen keyboard is a good example of a familiar interface. It offers multiple ways to type text by implementing buttons, voice typing, and multiple input fonts, with good visible error prevention features. An error message will display if a word the user is typing is outside the context of the device dictionary, offering a suggested correction in a drop-down – one swipe to change this or one swipe to ignore. (Schalock et al.2021)
As designers, we should be looking at the happier side of the human experience, empathy, providing enough of a prompt to change behavior in an unobtrusive, elegant way, creating better outcomes for the person using our designs. We all use machines in our daily routines. We have the touchscreen ticket machine, the app that shows things we can’t remember, and even the self-checkout machine at the store. Providing better prompts, helpful hints, and changing the word ‘error’ to something less terrifying is well within our skill set. Empathetic design can be leveraged in the enhancement of other user experiences.
5.1. Interactive Design Elements
Complex-systems theorists understand that challenges are inherent to the system and the navigational elements need to support learning, adaptation, and resilience. Design elements that require interaction have the facility to explain or elaborate on step-by-step decisions or actions for the process or interaction. They are most often used to expand for clarity or to engage with decisions. Interactive elements need to be easily directed, prompted for guidance, and provide simple feedback. If miscommunication may lead to failure, confirm proposed actions or provide a theoretical ability to contemplate alternate actions, for example, undo. It is important that harmonizing interactive and procedural functions in the work of systems is transparent to the user and not overwhelming.
The purpose of a button is for simple choices, such as canceling a pop-up or navigating between pages. A radio button is used to pick one option, such as an agreement. More than one can appear in a set, and they must be part of a group, such as selecting a language. Checkboxes allow more than one option to be selected from the list, such as multiple likes and dislikes. While sliders may be visually interesting, they are not always aligned to cognitive users except in real life, tactile object comparisons. They tend to be preferred by visual/hands-on learners, as sliders are for comparative choices where one option may be better or worse than another through a range of values. Menus reduce long lists of choices, requiring less scanning. The refined categories allow the user to jump to their topic while being visible and easy to return to. There are many rules around the design of a clear, easy-to-use menu that has the potential to hinder or assist. Each hierarchy of the menu is best limited to seven or fewer so the list doesn’t get overwhelming. Users expect and can handle the language of hierarchical menus: ‘main’, ‘sub’, ‘sub-sub’, not descriptive language-only options. To ratify that users don’t misinterpret information within the interaction, feedback mechanisms need to be built into the interactive solution, such as a short pop-up elaboration, once a preview is requested, showing the entire selection effect. Simplicity with detail integrates each of these components as design principles. These principles can be made to reflect design clarity in such a way that it aligns with the online behavior of users to calculate their user experience. (Gavelin et al.2021)
An engaging interactive design shows careful consideration for the sequence and degree of information linked in its elements. Critics have praised a website that makes it easier to design a logo, which was rated on the basis of how simple it is to use. Another platform has a very user-friendly point of sale (PoS) system that stands out as a good example. A company that offers self-service business loans has a very easy application process on its website, and another company was named an innovation leader for a really easy website to use. Processing buying made easy on a mobile app also helps increase the user experience.
5.2. Feedback and Error Handling
Harry Withoutfield calls feedback and error handling a “classic usability issue,” describing that “software tools should provide immediate feedback—dialogue to the user’s action. Errors should be communicated in a constructive manner based on the system’s analyzed error message plan.” Feedback and error handling are especially critical when designing for cognitive disabilities, as without support, users may not have the awareness or resources to identify or resolve an issue that prevents them from participating in a system. (Schalock et al.2021)
Common errors that users might encounter when operating digital devices or tools include, but are not limited to: hardware failures, connectivity issues, user or system settings errors, and workflow errors. By introducing thoughtful design, programmers can offer proactive problem avoidance through intelligent system defaults, alerts, and step-by-step processes. However, when an error does occur, it’s very important that it is clearly communicated and the user is guided to a solution. Proactive systems offer alerts and then suggest a resolution, helping guide the user through the necessary steps. Simple, jargon-free language accompanied by clear diagrams or other visual explanations will be best. By responding to users in this clear manner, they are more likely to trust the system, which can boost confidence. This is especially important when designing for cognitive disabilities, where users may not have the cognition, attention, or background to troubleshoot issues for themselves. This can also be used as an opportunity to give the user a sense of control and help increase their skills.
6. Personalization and Adaptability in Inclusive Design
Within the realm of inclusive design, personalization is aimed at empowering people by creating interfaces and services that adapt to better suit their cognitive needs. Personalization provides the opportunity for product or service adaptation through customizable settings, but also through content and behavior personalization. Customizable settings are part of many digital products and allow users to modify the interface to suit their individual needs. For instance, desktop, mobile, and web design all feature customizable settings to modify font size and color scheme. Some products also allow for customization of content layout.
In web design, customizable settings typically involve only the capability to increase or decrease font size, or sometimes the ability to change color themes or turn off images. In some designs, choices are limited and do not provide comprehensive access to visual adjustments. While exceptions do exist, designs that do facilitate personalized visual display options are rare. Adaptable content is an approach that allows content materials to sense and respond to user cognitive and sensory needs. Such responsiveness provides information in a way that is more accessible and understandable according to user behaviors and preferences instantiated at any given moment, while being agnostic to disability category. By allowing content to be responsive, emphasis shifts to the user’s abilities as they change in real-time, not their permanent states or conditions. In this environment, it is assumed that the user benefits from choices and personalization and can develop a personalized content experience through a process of constructive exploration of the user interface. Over time, through repeated interactions, the user can gain a good sense of her profile. The user interface should have provisions for changing the personalized settings or resetting them back to the original compromise mode at any time. These personalized cognitive interfaces help restore normalcy for people with cognitive impairments and make computing accessible, enjoyable, and assistive for all. We describe several applications and prototypes that have experimentally demonstrated cognitive adaptability. These have employed a cognitive engine, which is able to simulate alteration of real sensory inputs and generate outputs in a user’s preferred reading or interaction formats. The applications have been demonstrated to work with users in blind schools, brain injury victims, co-morbid patients having both visual and motor impairments, and the general public. (Schalock et al.2021)
6.1. Customizable Settings and Preferences
Inclusive design recognizes that people have diverse needs and intentionally plans for people to produce broader, more inclusive solutions. One way to design an inclusive interface is to allow people to adjust it to their needs. This involves removing any barriers while still keeping the interface usable even when customized significantly. For most systems, functionality will change very little, while the look and feel can be altered significantly depending on the person’s needs. This section looks specifically at inclusive design strategies for cognitive disabilities, but relevant considerations are similar for other types of disabilities. Including users in defining what those options are and how they work is critical. (Tortora et al.2024)
For people with cognitive and learning difficulties, customizable settings and preferences that can be saved in a profile help to overcome barriers and create an environment that feels comfortable and familiar. These options make interfaces usable for a far wider range of people. For example: – allowing users to change the font and text size, background colors, and color contrast; – remembering settings so that the user does not have to keep adjusting them when visiting the site or software; – choosing a system that transfers settings when moving between computers or networks. These kinds of systems allow individual tailoring so that the application becomes most comfortable and usable for the specific individual using it. They also enter into the environment of the person; a user is not constantly set back by not being able to change the look of the application when, with another application that they are used to, they may make the changes.
6.2. Dynamic Content Adaptation
An emerging area in inclusive design research is dynamic content adaptation, where content is automatically modified in real-time according to the requirements of a diverse range of users. Technologies driving dynamic content adaptation are powered by techniques such as algorithms and machine learning, enabling adaptability according to user performance, preferences, goals, background, and cognitive resources. It is now possible to adapt text legibility, complexity, terminology, or audio output speed according to user profile and device. As a system agent, the intelligent digital environment can learn from user activity to optimize its features. For another system agent, this content adaptation can include automatic profile loading. (Tortora et al.2024)
Dynamic content adaptation respects the principles of universal design and achieves inclusiveness, as it can deliver optimal content for all users regardless of their cognitive abilities. The presented content will at the same time be specific to an individual profile, a group profile, or a target audience profile. The dynamic interaction of users and cognitively accessible adaptation will make an inclusive activity possible. This is especially true in the field of online games, one of the earliest technologies to implement dynamic adaptability. By constantly adapting the content to the state of users, this approach can eventually revolutionize the accessibility of electronic mainstream cultural products.
The innovation provided by dynamic content adaptations for cognitive disabilities is to no longer adapt to specific deficits, but to support adjustments in cognitive functioning depending on the context, fluctuating states, and interests of users. Of course, implementing an adaptive reading mode that would provide such content is only possible because the technology to execute it exists. Consequently, this system can provide treatment for any cognitive disabilities in case they may prevent individuals from fulfilling tasks. The intelligent video player developed within a project demonstrated the feasibility of dynamically adapting the audio description of video sequences according to the degree of visual impairment of viewers. With respect to cognitive abilities, a methodology was developed and tested to evaluate such adaptivity, concentrating on matching reading speed and syntactic complexity of captions with the comprehension of cartoon story sequels in users with mild mental disabilities.
7. Case Studies and Best Practices
Case studies, examples, and best practices are the synthesis of successful implementations of inclusive design. In Chapter 3, we will outline a review of some successful, foundational, and emergent best practices of inclusive design for people with cognitive disabilities or age-related impairments. These case studies and best practices for inclusive design will illustrate one or more of the theories or concepts outlined in the previous sections; and in many cases, some of them will incorporate all of these theoretical foundations. All of them will illustrate the findings we will be concluding in Section 9, that successful inclusive designs are often those that developed bottom-up and engage people with cognitive disabilities as both collaborators and end users.
Case studies and best practices are also not without their difficulties, and learning from the unfounded practices of the past and the flaws of the present are as valuable as knowing what constitutes a good design. There are many myths, misconceptions, and practices within inclusive design that can be harmful, and through evaluating what should not be included in inclusive design guidelines, we can discover new directions in this matrix of practices. Therefore, some case studies will contain subsections on inclusive design failures or limitations, as well as their successes. A successful design solution that works can only be determined by first identifying those that didn’t work. This also helps us to keep a critical eye on our own best practices, since inclusive design is a continually emergent practice and those best practices we take for granted now are always just a starting point for future investigations.
7.1. Successful Examples of Inclusive Design
Case 1: Inclusive in-car experience Users with cognitive disabilities rarely participate in design discourse. Not only was the design of inclusive interfaces and PaaCT inclusive, it included representatives from the end-user community to work with the project team every step of the way, ensuring that the technology would truly be empowering and useful for their peers. The prototype designs led to tangible improvements in the travel experience for end-users with intellectual disabilities. Three months after the test day, each modification was still in place, and several had facilitated a higher level of transport independence, such as overcoming anxiety caused by route changes and reducing car sickness by being able to have the pre-journey rest they needed. Also, the carers reported increased satisfaction at their child or sibling undertaking ‘real journeys’ to new destinations, e.g., visiting friends or traveling home, not just the routine journey to session places by day. (Schalock et al.2021)
Case 2: Inclusively designed online reading strategies The success of these working memory training strategies is, in part, due to their design. The team was aware that they were trying to support sustained engagement with an online activity that resembles homework or workplace training, and so the serious games needed to be designed as engagingly and in as user-friendly a way as possible. The aim was to achieve the best balance of ease of use and real-world functionality in serious game simulations. To do so, both formative and summative usability testing and participant feedback were sought. Design features that the team found beneficial in informal feedback included the ability to distinguish between features in terms of time resources and mental effort, the use of adaptive pacing and supportive help, and that the game was ‘fun.’ Feedback also indicated that players with WS were more interested in fictional characters than real-life characters. Ongoing development and improvement of this working memory strategy continue in collaboration with those who understand how the tool meets the case notes generated in the chat room. Account is also taken of what session attendees and users are saying. (Schalock et al.2021)
7.2. Lessons Learned from Failed Attempts
It can often be easier to elucidate the challenges in dealing with a topic area by examining what it is not. In this respect, we would like to present two case studies with particular design challenges—often manifest as a design failing. The goal is to learn from these failings to become better at our inclusive design practice. When designing the original prototype of Health and Fitness Lab, we did not sufficiently apply our inclusive design methodologies, resulting in poorer suitability for people with cognitive impairments and disabilities. We discovered, through both layperson and expert evaluations, that people with cognitive impairments and disabilities had difficulties, including comprehension problems and frustration with the system. We held our initial design workshops at a learning center for individuals with cognitive impairments and disabilities. However, we did not maintain a good level of user involvement throughout. After the first session, we failed to involve these people in the redesign of the prototype. Keywords such as ‘learning’ and ‘trust’ are important here because this subject matter is about the methods required to learn. By selecting appropriate materials and an appropriate design, subject matter can be made more accessible—easy to understand—even if the fundamental concepts are difficult. This was not initially successful, and therefore we failed in the desires and demands of inclusive design and these learners. This failure is more about what we did not have rather than what we did. Reflective design. In this paper, we are discussing the cognitive dimensions of inclusive design. To do so, we need to recognize that our understanding is itself emerging. We do not know all we need to know about the cognitive dimensions of inclusive design. We cannot claim yet to be with it. We are, therefore, taking an inclusive design approach to learning. We are considering those we leave out or have not yet involved in the information society when we make our intellectual properties. We are viewing our intellectual efforts as the artifacts needed to involve every member of society in the information society. (Sabatello et al.2020)
8. Future Trends and Technologies in Inclusive Design
Recent decades have seen revolutionary advancements in technology and progress towards innovative software development techniques that enhance accessibility and usability of interfaces for people with disabilities, including those with cognitive limitations. The deployment of specialized user interfaces in the field of assistive technology has the potential to strengthen the autonomous living of these individuals. Future trends in technological innovations can open new opportunities for inclusive design. Such future trends and technologies facilitate customization and empirical assessment of designs, which is seen as a powerful means to support the cognitive abilities of various users with cognitive disabilities. This paper sheds some light on such novel approaches.
Some of the potentially promising future trends and technologies are those that deal with artificial intelligence, machine learning, and user modeling; virtual and augmented reality; advanced mobile computing; and advanced gamification. These are tools that can cater well to features most citizens and designers associate with cognitive disabilities. Research and development of these trends are well underway. For example, in the area of artificial intelligence, recent years have shown considerable interest in adaptive hyper-movies. This innovation takes individual movie users’ personality, style, and mental model into account. In a similar manner, the advent of virtual and augmented reality technology is indicative. Systems exist where users can help each other navigate a location since all users can upload additional relevant information. Previous research started from a specific set of data; designing for a broader community of atypical users from the beginning promises research directions for future developments of inclusive design techniques. The future will see changing needs among these user groups. (Schalock et al.2021)
8.1. Artificial Intelligence and Machine Learning Applications
AI is at the heart of many new applications in the inclusive design space. The ability of AI to adapt and personalize the user experience has enormous potential for designing interfaces that are inclusive to all individuals, regardless of age, abilities, and other fixed and variable factors. In digital contexts, AI-powered algorithms take these concepts a step further by analyzing a significant amount of metadata generated by several users. These technologies then use predictive modeling to identify likely areas or features that may require custom offerings, such as interfaces targeted for users with cognitive disabilities.
While AI technologies have great potential for addressing the area of inclusive design, it is paramount to be aware of the ethical considerations and limitations specific to incorporating this technology into a design application. For instance, AI technology should be used to augment human connection as opposed to replacing human compassion in moving design. Examples of modern AI algorithms and their applications to the inclusive design process include supervised and unsupervised machine learning, deep learning and large data, generative adversarial networks and image-to-image translation, reinforcement, transfer, and meta learning, and others.
8.2. Virtual and Augmented Reality Innovations
Virtual and Augmented Reality Innovations
Immersive technologies, such as virtual reality (VR) and augmented reality (AR), are exciting technological realizations that can be utilized in an inclusive design philosophy. These technologies can create virtual or mixed reality spaces that can be individually tailored to a user’s perception and cognitive needs. A VR world, particularly when presented through a head-mounted display, can shut out the many distractions of the physical built world. AR applications can overlay filtered real-world scenes, supplementing the understanding of digital or actual content. These forms of immersive technology can drive user engagement with content and can grow understanding and awareness. A range of VR and AR tools are available for teaching and experiencing cognitive accessibility. Tools shown at conferences, workshops, and educational sessions often aim to offer a vision of the sensory and cognitive experiences of others. They are limited, though, in that they represent an experience that is fundamentally still alien to the audience, and the instructive nature of the engagement is of necessity overt.
In conclusion, the examined applications demonstrate that user experience enhancement extends beyond the needs of individuals with sensory or cognitive disabilities. Numerous augmented reality (AR) applications facilitate the creation of personalized content that aligns with users’ varying interaction, auditory, visual, and reading capabilities. Likewise, virtual reality (VR) content can adaptively present multiple pathways, allowing users to engage with content at their own level based on their interactions. The incorporation of cognitive profiling techniques further enables adjustments to user-dependent factors, such as difficulty levels, enhancing personalization. For instance, an AR application designed for individuals who are blind can greatly improve their environmental awareness and understanding. Our findings indicate that excessive nonessential information can hinder user comprehension, highlighting the utility of augmenting optics in this context. Additionally, VR applications have the potential to evaluate sustained outcomes over time in rehabilitative therapy settings, which contributes to our understanding of the needs of the broader community experiencing cognitive disabilities. Moreover, these insights pave the way for future research trajectories that capitalize on the advancements achieved thus far. Interested parties can easily investigate the advantages and disadvantages of the approaches discussed, thereby broadening awareness of inclusive design and social inclusion efforts through innovative AR and VR tools. The diverse pathways leading to cognitive accessibility reveal numerous opportunities for integrating additional meta-layers, exemplified by commercial software that leverages unique user behaviors, such as reading instructions aloud, to facilitate task completion and enhance cognitive engagement. This exploration underscores the significant strides being made in creating inclusive user experiences that cater to individual needs and preferences. (Schalock et al.2021)
References:
Willner, P., Rose, J., Stenfert Kroese, B., Murphy, G. H., Langdon, P. E., Clifford, C., … & Cooper, V. (2020). Effect of the COVID‐19 pandemic on the mental health of carers of people with intellectual disabilities. Journal of Applied Research in Intellectual Disabilities, 33(6), 1523-1533. wiley.com
Chen, S., Zhao, S., Dalman, C., Karlsson, H., & Gardner, R. (2021). Association of maternal diabetes with neurodevelopmental disorders: autism spectrum disorders, attention-deficit/hyperactivity disorder and intellectual disability. International journal of epidemiology, 50(2), 459-474. oup.com
Lin, P. Y., Chen, Y. L., Hsiao, R. C., Chen, H. L., & Yen, C. F. (2023). Risks of attention-deficit/hyperactivity disorder, autism spectrum disorder, and intellectual disability in children delivered by caesarean section: a population-based cohort study. Asian Journal of Psychiatry, 80, 103334. [HTML]
Slade, K., Plack, C. J., & Nuttall, H. E. (2020). The effects of age-related hearing loss on the brain and cognitive function. Trends in Neurosciences. cell.com
Basham, J. D., Blackorby, J., & Marino, M. T. (2020). Opportunity in crisis: The role of universal design for learning in educational redesign. Learning Disabilities: A Contemporary Journal, 18(1), 71-91. ed.gov
Miciak, J. & Fletcher, J. M. (2020). The critical role of instructional response for identifying dyslexia and other learning disabilities. Journal of learning disabilities. nih.gov
Cherry, C. (2021). Characteristics of Individuals with Autism Spectrum Disorder: Supporting Increased Eye Contact. liberty.edu
Hadhrami, A. S. A. L., Al-Amrat, M. R., Khasawneh, M. A. S., & Darawsheh, S. R. (2022). Approach to Improve Reading Skill of Students with Dyslexia. Information Sciences Letters, 11(6), 2333-2338. aaru.edu.jo
Young, S., Adamo, N., Ásgeirsdóttir, B. B., Branney, P., Beckett, M., Colley, W., … & Woodhouse, E. (2020). Females with ADHD: An expert consensus statement taking a lifespan approach providing guidance for the identification and treatment of attention-deficit/hyperactivity disorder in girls and women. BMC psychiatry, 20, 1-27. springer.com
Creed, C., Al-Kalbani, M., Theil, A., Sarcar, S., & Williams, I. (2024). Inclusive AR/VR: accessibility barriers for immersive technologies. Universal Access in the Information Society, 23(1), 59-73. [PDF]
Schramme, T. (2024). Capable deliberators: towards inclusion of minority minds in discourse practices. Critical Review of International Social and Political Philosophy, 27(5), 835-858. tandfonline.com
Mackelprang, R. W., Salsgiver, R. O., & Parrey, R. C. (2021). Disability: A diversity model approach in human service practice. [HTML]
Stucki, A. O., Barton-Maclaren, T. S., Bhuller, Y., Henriquez, J. E., Henry, T. R., Hirn, C., … & Clippinger, A. J. (2022). Use of new approach methodologies (NAMs) to meet regulatory requirements for the assessment of industrial chemicals and pesticides for effects on human health. Frontiers in Toxicology, 4, 964553. frontiersin.org
Miskowiak, K. W., Johnsen, S., Sattler, S. M., Nielsen, S., Kunalan, K., Rungby, J., … & Porsberg, C. M. (2021). Cognitive impairments four months after COVID-19 hospital discharge: Pattern, severity and association with illness variables. European Neuropsychopharmacology, 46, 39-48. sciencedirect.com
Wies, B., Landers, C., & Ienca, M. (2021). Digital mental health for young people: a scoping review of ethical promises and challenges. Frontiers in digital health. frontiersin.org
Schalock, R. L., Luckasson, R., & Tassé, M. J. (2021). An overview of intellectual disability: Definition, diagnosis, classification, and systems of supports. American journal on intellectual and developmental disabilities, 126(6), 439-442. researchgate.net
Tortora, C., Di Crosta, A., La Malva, P., Prete, G., Ceccato, I., Mammarella, N., … & Palumbo, R. (2024). Virtual reality and cognitive rehabilitation for older adults with mild cognitive impairment: A systematic review. Ageing Research Reviews, 93, 102146. sciencedirect.com
Doherty, A. J., Atherton, H., Boland, P., Hastings, R., Hives, L., Hood, K., … & Chauhan, U. (2020). Barriers and facilitators to primary health care for people with intellectual disabilities and/or autism: an integrative review. BJGP open, 4(3). bjgpopen.org
Gavelin, H. M., Dong, C., Minkov, R., Bahar-Fuchs, A., Ellis, K. A., Lautenschlager, N. T., … & Lampit, A. (2021). Combined physical and cognitive training for older adults with and without cognitive impairment: A systematic review and network meta-analysis of randomized controlled trials. Ageing research reviews, 66, 101232. medrxiv.org
Sabatello, M., Burke, T. B., McDonald, K. E., & Appelbaum, P. S. (2020). Disability, ethics, and health care in the COVID-19 pandemic. American journal of public health, 110(10), 1523-1527. nih.gov