This article is based on Abid Virani and Alwar Pillai’s talk at A11yNYC.
Alwar’s career started as a user experience (UX) designer. She attended the Masters of Inclusive Design program at OCAD University in Toronto. The program helped her learn about her biases as a designer. Some of the decisions she made created a barrier for people with disabilities.
This led to her thesis on designing technology for aging adults who experience mild cognitive impairment. She visited retirement residents to evaluate social applications for adults ages 70 and over to help them keep in touch with friends and family. That work helped her realize that designs focused on able-bodied people and young.
Furthermore, the designs were not intuitive, which confused the older users. When they started Fable, Abid and Alwar’s goal was to help companies practice inclusive product development. That means engaging with the people who have been excluded throughout the entire product development process. They wanted to scale this.
Eight years ago, very few companies considered cognitive accessibility. They also didn’t involve people with disabilities. To change that would require a deep learning curve. Moreover, the engagement needs to create a safe space for participants to compel them to give feedback. Over the past seven years, Fable has surpassed 50,000 hours of engaging people with disabilities.
Fable has built communities and scaled them. They felt it was time to invest in cognitive accessibility.
Including Accessibility in Usability
Abid’s background is in international development. His first attempt at applying inclusive design focused on young people who were underemployed in a small country called Lesotho. He wanted to figure out how to engage those young people in economic planning. Eventually, he was introduced to accessibility and worked with a Web Content Accessibility Guidelines (WCAG) report.
Fable wanted to bring something different from WCAG. They believe WCAG accessibility audits are an important evaluative tool and framework. However, in a two-week sprint cycle with many developers, product managers, designers, and companies trying to build products at a pace to keep up with consumer needs and competition, WCAG will not compel them to prioritize accessibility.
They wanted to find a way to take a usability approach to accessibility. They evaluated the different ways people measure usability and user experience. The System Usability Scale (SUS) developed in the mid-1980s rose to the top of the list as the most widely adopted in UX and human-computer interactions (HCI).
Abid came across this quote. “If there isn’t a relevant questionnaire for your situation, you can devise one,” said John Brooke, the creator of SUS. Abid felt like it was permission to play with the SUS.
One of the questions people respond to on a Likert scale is: “I think that I would need the support of a technical person to be able to use this system.” Fable used the System Usability Scale with members of their community. When they started, the community was heavily focused on folks who rely on screen readers and are blind.
When they posed this to Sam Proulx, Fable’s accessibility evangelist, it was clear that it didn’t apply to Sam, who has been blind since birth. Sam is a wizard behind a computer. This moment helped Abid and Alwar realize many of the SUS questions needed tweaking to be appropriate for those relying on assistive technologies.
They adapted that question into their Accessible Usability Scale (AUS). “I would need the support of another person to use all the features of this website.” Also worth noting is that AUS is licensed under a Creative Commons Attribution 4.0 International License.
While it’s a minor change, remixing the 10 questions created a different questionnaire they could pose to disabled users to measure their usability experience. Since its creation, it has been used more than 11,000 times across three categories of assistive technologies: screen readers, alternative navigation (keyboard and mouse alternatives, switch systems, eye gaze, and voice navigation), and screen magnification.
Usability for Cognitive Accessibility
What about those who don’t depend on assistive technology? This is where they get into cognitive accessibility. They had to think about categorizing cognitive accessibility to make it easy to recruit, get feedback, and act on it.
Why cognitive accessibility now? First, cognitive disability is the most prevalent form of disability in the U.S. The number is growing massively when comparing the data between 1960 and 2060. This is a large user base that needs accommodations that they’re not getting.
Fable believes in a needs-based model. As they enter the cognitive accessibility space, they’ve kicked off Fable’s Cognitive Accessibility Working Group. Like with any new initiative, they practice inclusive design internally.
The working group includes practitioners in the industry, individuals with lived experience with cognitive disability, and invited experts. They intentionally created a group with different, and sometimes conflicting, perspectives.
They also have subject matter experts as guests to live in the space of neurodiversity to ensure they always have different perspectives. They intentionally created a working group where they brought in different perspectives and sometimes conflicting perspectives.
Cognitive Accessibility Working Group
The voluntary working group consists of nine individuals. They assigned them to different task forces. The group’s goal continued the following:
- What is the best way to recruit for the cognitive audience? What would be the categories for recruiting?
- How can they do this and scale? How do you collect insights from people, individuals, who experience cognitive disabilities? How do you collect insights that are easy to digest for product teams to act on?
- How do you collect those insights? What methods should be used to collect those insights?
They set a couple of milestones. They wanted to share guidelines with the larger community to help them think about cognitive accessibility. They also went through the process of updating the AUS to accommodate cognitive accessibility requirements.
The working group looked at a lot of literature and research papers. They looked at the medical model of cognitive disability. This group includes intellectual disabilities, learning disabilities, traumatic brain injuries, dementia and Alzheimer’s, and neurodiversity. There are different ways individuals identify themselves within this group.
They wanted to focus on a needs-based approach, so someone doesn’t need to be medically diagnosed. They wanted to allow people to self-identify based on their needs.
Addressing Cognitive Accessibility Needs
The task force had to start somewhere. They captured the needs in three categories to address the following challenges:
- Memory, recall, and processing information. Reduce the need to remember and simplify navigation paths and multi-step processes.
- Reading and writing. Reduce dense text, complex instructions, or spelling and grammar.
- Attention and focus. Ensure products allow them to focus on their tasks.
It’s worth noting there’s a big overlap between needs related to cognitive disabilities and aging. One of the questions of inclusive design is: Can you solve for one and have that impact benefit a broader audience? Cognitive accessibility is well-positioned to have a broad impact on the user experience for everyone else.
Intersectionality and Cognitive Accessibility
And there’s a curve ball here: the intersectionality of barriers. They recruited roughly 25 participants in the pilot study as part of the cognitive accessibility working group. Out of the individuals in the pilot, 35% identified as using assistive technology (defined as screen reader, screen magnification, and alternative navigation) daily.
An interesting statistic has found that 84% of the pilot participants use assistive technology accessibility settings, different types of cognitive tools, and assistive devices.
Fable learned their definition of assistive technology differed from what is typically understood. AT is often thought to refer to screen readers and screen magnification. The participants referred to system settings as accessibility and some plugins they used as assistive technology.
That made Fable broaden its perspective of assistive technology. Part of investing in the cognitive audience is capturing what people use for support. The intersectionality of technology and needs is an area where the industry needs to be flexible in understanding the different ways people use their technology.
The work expands beyond what those who identify as having a cognitive accessibility need. The overlap includes this notion that there is a reliance on technology and tooling that’s baked into the experience. As a product designer, you don’t get to control whether the users you’re serving also have other things installed that are interacting with your product. In the case of cognitive accessibility, this is more prominent than expected.
Product teams want clear guidelines of what to consider when building an application. But intersectionality requires thinking about other devices, plugins, and tools. For Fable, realizing this was a big moment because they started questioning their internal processes. For example, in looking at their recruitment process, they may discover it has too many steps, which aren’t accessible to those with cognitive accessibility requirements.
Fable plans to release a cognitive version of the Accessible Usability Scale. Inclusive design has the foundational argument that when you pay attention to the unique elements of individuals, you develop processes and systems. These facilitate the effective engagement of those individuals who are viewed as outliers.
The belief is that with the cognitive accessibility audience, they’re going to prove that by prioritizing research with marginalized communities, they’re going to capture many usability issues that are not uncovered with general population research. The hope is that people put cognitive accessibility research as the first thing, before the general population, and act on that feedback first.
Video Highlights
- Introduction
- Accessibility Usability Scale
- Expanding to cognitive accessibility users
- Cognitive accessibility categorization
- Q&A with Abid and Alwar
Watch the Presentation
Bios
Alwar Pillai is the co-Founder and CEO of Fable, a leading accessibility platform powered by people with disabilities. Before founding Fable, Alwar led large-scale accessibility initiatives in both the public and private sectors. From her UX and design experience, Alwar learned that the experiences of people with disabilities need to be central to improving digital accessibility.
Alwar has been celebrated as one of Forbes’ Top 30 Under 30 Social Entrepreneurs, and one of The Globe and Mail’s Top 50 Changemakers. Alwar has an M.Des. in Inclusive Design where she focused on designing social applications for seniors with mild cognitive impairments and is currently leading Fable’s Cognitive Accessibility Working Group.
Abid Virani is the co-Founder and COO at Fable. Informed by experiences spanning the non-profit sector, international development initiatives, and digital product development, Abid is a strong advocate of accessibility and inclusive design. Abid has been celebrated as one of Forbes’ Top 30 Under 30 Social Entrepreneurs and an Emerging Innovator in North America by Ashoka Changemakers.
Photo: CC BY 3.0 US Mapbox Uncharted ERG
