“Writing Government Information for People with Disabilities”

Perfect.

Are you gonna do an intro?

Yeah, I'm gonna get us warmed up here. Good. Hi, everyone! Welcome to another installation of the New York City accessibility Meetup, a11ynyc.

We've been around for a few years now, and I'm Cameron Cundiff, I'm one of the organizers. Also, my other organizers are Shawn Lauriat and Thomas Logan, who are not here today, but who are remoting in via the live stream, which some of you will be familiar with. On the other side of the camera. So I wanted to start by thanking a couple of people.

I wanted to thank thoughtbot, which is where we are right now. They're a design consultancy based with offices with New York, Boston, and London. They've been very gracious to host us here for a while now, so thank you. Also to SSB BART Group, who has been gracious with sponsoring for a very good time now, and we really appreciate their support.

Finally, we have a couple of regular supporters. Joly MacFie is with the Internet Society, New York chapter, and is leading up their accessibility group in New York. And Mirabai Knight works with White Coat Captioning, and she's providing the captions tonight that you'll see in the live feed and here in the room. Let's see.

I wanna make sure I'm not missing anyone. Yeah. So everyone who's joining in remotely -- welcome. Finally, I think I'll just introduce to you Jonathan Katz.

He's here from the New York City Department of Business? Small Business Services. And he's gonna talk with us about his experience and share some tips on writing content for people with cognitive disabilities in a government context. So without further ado, thank you, Jonathan.

Let's all give him a warm welcome. (applause)

Thanks. I always freak out a little bit with microphones, so forgive me. So hi to everyone here. Glad it's a little smaller here.

Also, hello to everyone on the live stream. I know that there are a number of you. I'm Jonathan Katz. I'm a content and operations manager at the New York City Department of Small Business Services.

Like many people who come to these Meetups and watch the recordings, I make internet. And a lot of what I've been thinking about over the past two years now is writing with cognitive disability in mind. What do I do? So I do a whole lot of things at my job.

I ensure ADA compliance and section 508 compliance, which is why I come to these Meetups. I manage operations for NYC.gov/business, I help out with design, I conduct surveys, I do metrics, but a lot of what I do is I write content. And I come originally from an academic background. I wanted to get a PhD in immigration studies, focusing on South Africa, and that's a very different kind of writing forum, when you need to write about laws that people need to understand, because otherwise, they'll get find or they'll set their business on fire, or they'll let a dangerous animal loose on the streets.

Those are all things that we cover on our site. And those are all things that you cannot use the advanced language of academic theory to describe. And that's how I got into sort of ideas about: How do we make content for various folks, including people with cognitive disabilities? And that's a really big part of my job.

It's also personal for me. I'm on the autism spectrum, and I have non-verbal learning disorder. Which is the form of autism I have. And I also have post-traumatic stress disorder.

So it's something that really... Hits home for me. And it's something that I've also brought in both to my job and then into also writing for Jewish magazines. My food blog.

And Jewish media in general. And so I think we should then go just straight into it. About writing for cognitive disability. Which is oftentimes a very overlooked form of disability.

Partly because it is not usually visible. And partly because in many ways, society is just so structured against people with certain cognitive disabilities that we don't even necessarily think of it at all. A cognitive disability is generally described as some sort of condition or trait that means that the person who has it has more difficulty or more awkwardness, if you will, with one or more types of mental tasks. This can be thought.

This can be language. This can be information processing. This can be sensory processing. This can be literacy.

This can be all sorts of things that involve the brain and processing information and processing the information around you. It's a very broad concept. The disabled world says that it can encompass all sorts of things. Sometimes they're very mild -- in ableist terms, of course -- disabilities, such as dyslexia, or other small learning disabilities.

Some of them are intellectual disabilities that can affect a wide range of life, such as Down syndrome, and many come about later in life or through medical incidents, such as brain injuries or medical aftereffects of hypoxia -- that's not having enough oxygen -- or dementia, Alzheimer's disease, Parkinson's disease. And many of them start at birth, but many of them occur at any age. And generally speaking, it's about 2% to 3% of the US population.

In some places, it's higher. In some places, it's lower. And then once you start counting in projections of how many people will have a cognitive disability at some point in their life, especially because of age-related diseases, it gets much higher. So here are some types of cognitive disability.

I put up a few of them. There's some cognitive disabilities that manifest themselves in lower intelligence. And there are a variety of rude words that often begin with R that describe -- rude words. Not lewd words.

That describe these cognitive disabilities. Some of them are more complex. Down syndrome usually -- not only includes disabilities relating to low intelligence, but also encompasses certain aspects that we would consider physical disability. There's a big question over whether or not autism spectrum is a cognitive disability.

But most professionals and most people with autism that I've met -- myself included -- would argue yes, because it does impact sensory processing and social skills, and oftentimes other things as well. There are also, quote-unquote, "smaller" cognitive disabilities. Dyslexia, which is of course a cognitive disability that affects the ability to read, and then the lesser known, but probably just as prevalent dyscalculalia, which affects the understanding of numbers. There are a whole other category of things -- coordination disorders.

And you have age-related diseases like Alzheimer's, and then what's not on this list is also cognitive disabilities that come about after brain injury, which is particularly common in developed countries, because of the rate of car accidents that we have here. And that is oftentimes one of the largest causes for cognitive disability between the ages of 18 and 70. And that is something that is very often overlooked. It's also important to say what is not cognitive disability.

And this is something that we really have to thank a movement for about 40 years of people saying that people with cognitive disabilities have the right to live independent, happy lives, with whatever support they need. And to achieve their dreams, as they interpret them, in a world as they interpret it. Cognitive disabilities don't necessarily make you less capable, be it less capable of living or of doing things. There are a lot of very achieved people who have cognitive disabilities.

Actors, athletes, and so on and so forth. But even then, whatever you do or don't do -- it doesn't make you less worthy of services, rights, or personal safety and security. And that is also a major concern. Particularly because many people who do have their rights affected, say, in the workplace, or in the medical system, are people with cognitive disabilities who still have less recourse to action and less access to information on what they can do.

It's also not something that makes someone less-than or something that makes them less of a person. And I think this is something that we really struggle with a lot in progressive communities, is this -- we measure so many things based on intelligence or based on being cognitively able, but we ignore what we then say about the people with cognitive disabilities and their communities. As I've said, it's also not something that can't happen to you.

Because anyone can develop a cognitive disability at any time. Be it from, God forbid, an accident, or maybe more happily, reaching a very old age and developing an age-related disease that causes changes in a brain. And this is not something that should push someone outside a community. If you're interested in this, I would recommend looking at the Autistic Self-Advocacy Network.

An awesome thing about how cognitive disability was not considered normal after the 19th century, and the Down Syndrome Information Alliance. That has a lot of great information that is really great to read. And the most important thing to remember is: People with cognitive disabilities are people. And we should also produce information that they can use and read.

And make good of. So... One thing -- there are a number of problems, when people with cognitive disabilities often find with web information and with written information. The most common is that the language is too complex.

Many people with cognitive disabilities have processing issues around language or cannot process language in the same way as, quote-unquote, "normal" people, or may or may not have received as much education or may or may not have as much ability with literacy. They might not necessarily be able to read as well. Another problem is that the formatting is bad and it's made in a way that can not be understood. That is also something that makes it very frustrating for users, because it's in a way that might seem intuitive to whoever designed it, but is particularly difficult for someone with a cognitive disability.

Sometimes it's also a matter of methods of communication. Many people with cognitive disabilities cannot communicate in a certain way. And this particularly affects reading and writing. So if it's something that requires a lot of reading, some people with cognitive disabilities might not be able to necessarily understand that.

Pictorial explanation might be better. In other cases, some people with cognitive disabilities can't really understand pictures, and so text might be better. So the general assumption is that information for people with cognitive disabilities -- and for everyone -- should be perceivable, understandable, well formatted, and widely communicable. This means it can be understood, seen as information that's useful, seen as information that's organized in a way that can be understood, and something that can be explained across a wide variety of levels.

Of course, there are challenges with this. The biggest one is no two people with cognitive disabilities are the same. Someone who is, say, someone with Asperger's syndrome, who is very much more linguistically attuned then, say, pictorially attuned, will have very different needs than someone who, say, has a cognitive disability that affects intelligence and is not functionally literate. In addition, sometimes with making sure that people can understand the language we produce, we worry about: Are we going to provide accurate information?

Are we going to provide the shades of meaning that we want? Are we going to provide the meaning that we need to provide? Are we going to say the things that we need to say? One really huge issue is that a lot of things that are specifically intended for people with cognitive disabilities, particularly for people with Down syndrome and who are autistic tend to be very paternalistic.

Talking down. Or tend to be just not particularly respectful of that person. And oftentimes, readers will just switch off. Just because somebody has a cognitive disability doesn't mean they want to be talked down to.

This is something we've particularly seen in, say, books in schools. There are also linguistic and cultural differences. People with cognitive disabilities come from different cultures. Not just in the way that cognitive disability is addressed, but also in the way that language is used, in the way that colors are used, in the way that words are used, in the way that simple sentences are ordered.

For example, somebody with a cognitive disability from Turkey will probably look for words at the end of the sentence, because in Turkey, things that are important are usually placed at the end of the sentence by the verb. Whereas someone who speaks English might be more attuned to words at the beginning of the sentence, because that's where we tend to do that in English and some other languages. Another issue is volume. If it's a lot of information, many people with cognitive disabilities don't necessarily have the ability to process all of that at once.

And that is something that is also a challenge. How do you get the amount of information that you want to get across, if it's the information that you actually need to get across -- across? And finally, the biggest challenge -- normal people are really not particularly attuned towards the fact that cognitive disability is something that should be addressed. There's this idea -- oh, they're too stupid to do anything.

Oh, they don't necessarily have the ability. Or oh, why should I do that? It's not like they will understand anyway. Well, did you try?

Is a really big question. And I think that is something that really hits on a lot of the challenges that also people who are not -- who do not have cognitive disabilities -- don't necessarily think of people who do. And don't necessarily think of how to make things accessible. So what can we do to make information that is usable, respectful, and of high quality?

Information that people with cognitive disabilities -- and everyone else -- can use? And make good use of? And use to do whatever they want to do? If they decide they want to do it, after reading the information?

So I'm now going to walk through several techniques and ideas that apply partly to web writing, and partly also to just general information production. This also applies to pamphlets, books, business cards -- you name it, it can probably go on there. Whoops. So the first one is: Keep it simple and keep it direct.

Why? Well, on a broad level, simple and direct language is most widely understood. For example, if I was saying a recipe, I would not say: Place the hydrogen dioxide into the metal container and place it over a fire made of natural gas. I would say...

Put water in a pot and put it on to boil. And this is something that initially sounds very intuitive, but is oftentimes -- as soon as you actually start writing -- completely thrown out. I was recently editing for one of my colleagues a guide to commercial leases. And this is supposed to be a simplified guide.

And instead of saying "you need", or "do this", it was like -- please remember that it is important not to commit funds before... Whereas you can just say... Don't buy... Don't purchase...

Don't spend money... Before X, Y, Z. This goes to the second point. Use words for meaning, and don't really use them for sound.

I think we all are guilty of using words that we think look really good on a page. And also, I know that there are even people with cognitive disabilities who have done this. But this can make things really inaccessible. You know, this is, again, the case of saying: It is important to remember not to commit funds.

Also, be direct. A lot of people with cognitive disabilities don't necessarily understand common idioms. So instead of saying "throw the baby out with the bathwater", say "get rid of the thing that you want". And a lot of people with cognitive disabilities also have limited vocabularies.

This is particularly true for people who have cognitive disabilities that affect intelligence. But also for people with age-related diseases, who lose the ability to use language as part of the condition. So if you're writing something for a medicine that... I don't know...

Treats stomachaches, and a lot of the people who are using it are elders, and don't necessarily have all of the language that they used to still with them... It would be important to use as simple language as possible. If you're producing content in another language, you also need to know what is simple language in that language. Because things are very, very different from language to language, and if you're working with translations, that is something that is important to remember.

That what that limited language is -- is also going to affect it. So, for example, in Turkish, the passive tense is used far more extensively. It's actually used in commands. So, for example, the words for "do not smoke" -- it's not "do not smoke".

It's cigarettes are not smoked. And that is something that someone with a cognitive disability, with limited language, in Turkey, will probably learn. Whereas someone might not necessarily learn the passive tense in English. And this is something that's important to keep in mind for translations, particularly because oftentimes, with cognitive disabilities that develop later in life, it also intersects with a need for access in different languages.

So, for example, someone who... This is something that we're seeing a lot now in the City. Is that we have a lot of Russian speakers. Who came to the United States later in life.

And now who are aging, and who are -- as part of dementia or Alzheimer's or Parkinson's -- forgetting the English that they learned. But they're also forgetting the more educated Russian that they may have learned in school or university. So many of the Russian translations for very important things are often too complicated for them to understand. Even though they need to understand them in Russian, because the Russian is simply too complicated.

And in this case, simple and direct Russian would probably help a lot more. So one example that I saw is in Cape Town, where I just was visiting my family. There's been a drought, and they've been distributing these really great water pamphlets. Explaining to people how to find leaks.

Everyone right now in Cape Town is very limited in how much water they can use by the city government, and they've been really producing a lot of information. Everything in Cape Town is produced in three languages. English, Afrikaans, and Xhosa. And they produce everything in about -- what in the United States would be equivalent to a grade 4 reading level.

I have the three cards in English, Afrikaans, and Xhosa up right now. And do note that some of the words might seem a little advanced, if you're reading it. And I'm gonna give a description for each image here. Each image is a clockwise diagram, surrounding a water faucet with one drop coming out.

The first one is for all three -- is water faucet, with one drop coming out, with an X over the drop. The second one is a water meter reading with an 8-digit number. The third one has a clock on it. And the fourth one has a telephone.

They're in English, Afrikaans, and Xhosa. And I'll just read aloud to English. It says: Keep on saving water. Quick reference card for water leaks.

Check your taps, check your meter reading, wait a short period, ten minutes, and take another reading. Make sure no one flushes the tap or the toilet. If there's a difference in the reading, you have a leak. You need a plumber to find and fix the leak.

And in the center, it says: How do you check if you have a water leak? This is written in very simple English. Which is very good, because also many of the people in South Africa only have third or fourth grade educations. But also for people with cognitive disabilities, this is very good, because it says: What you need to do, directly.

It doesn't use idiomatic language. Which is a particular temptation here, because in South Africa, there are a lot of idioms around water. It doesn't dance around the bush. It doesn't say: If you have accidental hydrological drainage.

It just says: Keep on saving water. And it uses a very intuitive organizational structure of how do you actually check that you have a leak. The Afrikaans is also very simple. I don't speak Xhosa, but I've been told that the Xhosa is a second grade reading level from a native speaker.

And this is an example of, you know, simple and direct and culturally attuned. The second thing is really: Format it well. And I think we've talked a lot about formatting in past Meetups. There was a Meetup a number of months ago, talking about how we organize PDF documents.

And this really got me thinking about this. Large blocks of text, lots of text, and nested lists are really hard for many people to follow. But especially people with cognitive disabilities who may already be frustrated with reading the text in the first place. And particularly if it's a nested list, a nested list that has lots of different headers and lots of different things to follow -- it'll just maybe be ignored or maybe be a source of great difficulty.

This is something we see a lot in city documents, where people will have a list like this, of bullet points, and then underneath will be more bullet points. And then -- oh my! What do you think they're gonna put underneath some of those bullet points? Bullet points.

And besides being oftentimes frighteningly ugly, it's also really hard to read. In addition, alongside these, like, long texts is that many people with cognitive disabilities have a history of being teased or shamed or bullied about their reading or lack of reading skills. And then become scared of reading lengthy texts, because they think they can't do it. And then will just ignore them.

So besides the fact that many of them will not be able to read a long passage, people with cognitive disabilities will often avoid long passages. So if you have all of this times three in one paragraph, then many people will pick this up and be like... I can't read this. Oh, no.

Goodbye. Another thing is that if there's especially important information, like, for example, do not put this gas tank by a flame... That should be really legible. And that should stand out.

That should not be buried in a paragraph. I was editing for another person in the agency a piece of content about what to do in case of an emergency. And the thing about -- if you have a flood, you really need to call 911 -- was hidden somewhere in the second paragraph, in a nested list. That's just not good formatting generally, but particularly for someone with a cognitive disability, that can be very frustrating to find or not be found at all.

Alongside these rules, everything else about good practice and formatting applies. Use color contrast that works for text. Don't have grey text on white backgrounds. Don't use too many colors.

That can be very overwhelming for many people. And use headings so that people can find where they actually are. I would also say that something else is that many people with cognitive disabilities tend to react very badly to certain very bright colors. No one really knows why this is.

But there is an increased documentation that yellow is a color to be avoided. So here's an example that I get to see a lot. On the website that I do most of my writing for, we have this thing called a description page. It's a piece of content that explains a license, regulation, a permit, or a process.

This is one page about state needs for how you get this thing called an apostele, which is a stamp that says this document is real, or for language translations that are certified. The title of the page is language translation and apostele information, for those of you who cannot see the slide. The format we've done for description pages is that they oftentimes have four tabs. One is called about.

The other ones, which are not visible on this example -- not every page has them -- is apply. Before you apply, apply, after you apply, and operating and renewing. And before you apply is in apply. Sorry about that.

And then oftentimes we'll have headers. So this one -- I formatted it to have it with translation and interpretation, authentications and aposteles, and documents from abroad. Underneath, there's a section that's not visible here, called additional resources, where people can go and find links. This is something where -- if someone is only looking for a link, they can go and do it, and it's not in bright colors.

It's simple white and black. There used to be some blue on there. And yeah. And I was not there for the design, but my boss, who's here, was.

So this is something that helps. The next one. Fonts matter. Many people with cognitive disabilities have difficulty with fonts.

We often think of this in terms of dyslexia. People who have dyslexia oftentimes have trouble reading certain fonts. Particularly fonts with serifs. So if you're familiar with Times New Roman, that's that little hook at the end of many letters.

That is a serif, and that is something that can really change the way a letter is perceived. It can be seen as another letter or as a blob or as two letters or three letters. So you want to use fonts without serifs. With distinct letters.

So you want to try to use a font that doesn't have things like R, N, and M looking too similar or capital I and L looking exactly the same. This font does have them different. It's called Trebuchet MS. You want to have the letters a consistent size and you want to have them spaced out so that people can actually read them.

For people with dyslexia, this is particularly important, so that letters can be seen as distinguished. And then it's not a struggle to read. Types of fonts tend to be better for many cognitive disabilities than those that imitate handwriting. Those that imitate handwriting tend to be harder to read for many people with dyslexia, although some do say the opposite.

But then for some other people with cognitive disabilities, it can also be harder to read handwritten fonts, since the letter shapes will vary more widely, and for many people with cognitive disabilities, reading different types of writing can already be somewhat challenging. You also want to watch out for similar letters. A and O are often swapped by people with dyslexia. R, N, and M are often swapped by people with dyslexia.

And I'm pretty sure by people who don't have dyslexia. T and F and capital I and lowercase l. Make sure that fonts are of a readable size and color. One thing with many people with cognitive disabilities -- it's also that reading attainment might be such that they won't be able to necessarily read something that's in very fine print, and then with things around processing colors, it can also be very overwhelming if there's, say, two or three different text colors going on at the same time.

So, for example, food packaging can be very overwhelming for many people with certain cognitive disabilities. Because it's just... There are too many things going on at once. And then everything shuts down.

Something that's really helpful here is that there are many fonts that were specifically designed for people with cognitive disabilities in mind. There's one called ReadSpace and ReadRegular, based in the Netherlands, that's now used by some Dutch publishers, specifically designed for people with dyslexia. There are a couple of other dyslexia-specific fonts. There are also fonts, the names of which I don't remember, that were designed for folks with various low intelligence cognitive disabilities.

And then there are also fonts that are accidentally really good, like Trebuchet MS, or something that you might be familiar with -- the fonts from the London Underground. This is Johnston. This is the Johnston 100 version. It was originally designed in the '30s, when cognitive disability definitely wasn't on the radar, but it turns out to have been one of the most useful fonts for accessibility for people with dyslexia and also for books and other writing for people with Down syndrome, other low intelligence cognitive disabilities, dementia, you name it.

Pictured we have the placard for Johnston with the lowercase alphabet, the iconic Mind the Gap, and the iconic G. And then on the right, you have it in all capital letters at the Baker Street Tube Station in London. There's also a mural of someone smoking a pipe. This font has been used pretty extensively.

Now, with fonts, I've been requested by someone on the live stream to talk about this. Comic Sans is actually not a good choice. There's a common assumption in the cognitive disability community, made more popular by a blog post on a feminist site called the Establishment, that hating Comic Sans is ableist, because some people with dyslexia find it easier to read than any other font. I am personally not against Comic Sans, aesthetically.

Please don't throw me out the window. But Comic Sans is not that accessible for even many people with dyslexia. Many people find it too bold, and the O and A are so similar that people have trouble distinguishing. In addition, many people find it condescending, and get the feeling that they're being condescended to when the information is being written in Comic Sans.

One thing that's happening now in the UK is that many warning signs are written in Comic Sans. So you'll have: Warning, danger of death, in many electrical substations, on a yellow background with Comic Sans, and while the intent is to make it more accessible and more friendly, what it also means is that many people have to come very close to the electrical substation to read: Warning. Danger of Death. And are also offput by the ghastly shade of yellow, which maybe is a good thing, because you don't want to get electrocuted.

Generally speaking, some of the fonts that are better for people with dyslexia include this one, Trebuchet MS, Calibri, Century Gothic, although it has an O/A distinction problem, and Highway Gothic, which you will be familiar with, because it is on Highway signs. Now, I said you should be simple and direct, but you should also try to say things in more than one way. People communicate in different ways. Just as some people use phones, email, some people use messenger pigeon, some people with cognitive disabilities prefer pictures and some prefer words.

So if you can have both in a process, it helps people understand what's going on. Particularly for people who might not necessarily be as literate. And again, another thing that's really helpful is if you have a summary at the beginning or the end of a particularly lengthy document, that can really help. Something that I've been seeing a lot in sort of just like...

When you get medicine now... Is the government warnings will come with a summary of like -- what's the highest risk thing with this medicine? And then if you're interested in the 0.001% chance that it makes you go to the bathroom funny, that's somewhere in the fine print. But what's actually important and the too long; didn't read is -- it's up there.

And if you use pictures as summaries, some people, if they're rush-reading, it's pretty good for everyone. So a couple of years ago -- and I'll describe this poster for the folks on the live stream who can't see the poster. In a moment. A couple of years ago, the New York City Department of Health was distributing these posters in 15 different languages.

One of which was Yiddish. So my friend sent this to me, because they did a very, very specific Jewish thing in one of the boxes. Which I was really impressed by. I don't speak Yiddish, but it explained: How to wash the hands.

Unfortunately, it is yellow. And it's meant for children about four or five. But what's really good about this is that it's both in words and also in pictures that very clearly explain how you're supposed to wash your hands. Clearly.

So it says -- what I've been told is wash the hands in Yiddish, and then it has nine boxes of someone rinsing their hands, soaping their hands, lathering their hands, rinsing the lather off their hands, drying each hand, and then they've added three more for the common religious Jewish practice of washing your hands ritually, after certain bodily activities. So they have water coming out of a cup, drying your hands again, making sure that people don't just do the ritual hand wash, but also wash with soap.

And then on number nine, they have a paper towel, and on the paper towel, they've written in Hebrew the prayer that you say after you go to the bathroom. So it's culturally attuned, but it also explains, for people who may not necessarily deal with words that well, or may not necessarily be able to put words into action, what their supposed to imitate. Something I've also seen, that I wasn't able to get a copy of, digitized in time, was their organizations that are making visual guides to Jewish rituals.

Some of them were inspired by posters like this. And this communicates both in words and in picture. And makes it really accessible. Okay.

This is where your English teacher is wrong. Repeat, repeat, repeat, repeat, repeat. There is no shame in repetition. There's no shame in sounding like a broken record.

There's no shame in saying the same word over and over and over again. Because people understand. If there was a fire, you would not say -- fire! Conflagration!

Burning! Brand! I would say fire, fire, fire! And this is something we can take from buildings burning down all the way to how we write things.

This is something how in a lot of communications we're like -- we don't like repetition. It looks ugly. But at the same time, with each turn of phrase, it becomes harder to understand. And with people with cognitive disabilities, the ability to understand that different things might actually be the same thing might be limited.

So if you use the same word over and over again, it helps people understand what they need to know and it also puts it all into context for someone. And repetition is also important, because many people with cognitive disabilities oftentimes don't have access to the same education as normal people. So even if the linguistic abilities are what we would call normal, the educational attainment might be much lower because of the abysmal state of education for people with cognitive disabilities in this country.

It's really bad. People with cognitive disabilities of the same language ability as a quote-unquote "normal" person oftentimes will have a reading level half of the normal person, who has the same... Everything else. Even if this person is capable of reaching that same reading level.

Just as a note, this is also a particularly English-centric problem. In many other languages, it is much more acceptable to repeat words over and over again. We also tend to use a lot more different words in English than in other languages. But one thing here is that the...

UK government has also now been saying that you should try to repeat words. So when you apply for a UK visa, it doesn't say like on certain other countries' sites like this one, different words for visa. Apply for a UK visa. You can apply for a visa to join a family member in the UK, work, or study.

Check for what kind of visa you'll need and what kind of documents. Also check if you need to get a tuberculosis test. So it says visa, visa, visa. Not visa, permission to stay, leave to stay.

People with cognitive disabilities travel too. This is one that is also challenging for many folks without cognitive disabilities, even for many people with cognitive disabilities whose intelligence is not affected. It's speaking as an equal. Many things for people with cognitive disabilities are often addressed in a condescending way.

It's like looking down and like... You can get help to... Or... You can do it in your own special way, even though you can't do it in the normal way.

And even if someone with a cognitive disability might have lower intelligence, they can still pick up on condescension. They feel offended. It's frustrating. It's rude.

And one of the biggest things that's come out of journalism and research on this state and how it interacts with people with cognitive disabilities is that they feel condescended to all the time. Particularly in institutions. But also just even in everything that is produced with a cognitive disability audience in mind. So you should try to communicate as an equal, whatever that means.

Realizing that that can mean many different things for many different cognitive disabilities. My tip is to try to think of it through someone else's eyes, which can be... Or someone else's ears or someone else's head space or someone else's feeling... Because that is a particularly great way to think of it.

But there's also another thing -- is just sort of think about: How do you want to be addressed? And then do the other language tweaking from your experience to a more broad experience. And even with that, it's also important to remember that someone with a cognitive disability will still be someone who wants to be independent and do their own things. So I'm going to -- there might be just one moment where the captions are not available.

Or not visible. I'm just going to show you guys something on the next screen. So one thing that I've been really excited about... Is that there are now cookbooks intended for people with various cognitive disabilities.

That don't say... Oh, get someone to help you with this. Because you can't cook on your own. But, rather, we're going to cook.

You're going to cook. And we're going to explain it in the way that you think of it. So this book, which came out ten years ago, is a cookbook that explains recipes in pictures for people who cannot read. Not just for people who are illiterate because they were not educated, but for people who cannot read because of their cognitive disability.

And it was intended mostly for people on the autism spectrum or people with Down syndrome who are moving out of their parents' houses or other family houses, or institutions, to live on their own. Or to live in an assisted facility where they can still cook. And it explains, picture by picture, from washing hands all the way down to washing the dishes, how to cook various things. There's another one.

One sec. That just came... Oh. There's another one that just came out.

Let's Cook Healthy Meals for Independent Living. Actually came out a number of years ago. And this was written by people who have family members with Down syndrome, and how they wrote recipes to teach their kids or siblings with Down syndrome how to cook. Which is really great.

And now not only are the family members cooking, but this cookbook is now being used by many people with Down syndrome across the country. And it also uses very simple language, but not condescending language, walking people through the process of making things. There are also -- this has become a bit of a cottage genre, and there are now dozens of cookbooks out in various languages that are intended for people with cognitive disabilities, not from the point of view of get your friend or your mother or father to help you with this, but rather -- let's cook this.

This is what you need. This is what you do. And we're going to communicate it on your level, because you want to do this too, and you will do this too, and you will eat a meal, and you will be happy. And these cookbooks are actually really good cookbooks.

And part of the lesson from this is: Know your readers. Because different cognitive disabilities result in different needs. Someone who is on the autism spectrum may have very high linguistic capacities. Many people on the autism spectrum learn 10 to 15 languages, which is amazing.

But might not necessarily be able to understand certain social rules or be able to handle certain color combinations. Meanwhile, someone who has Down syndrome might not necessarily be able to understand certain very complicated language, but can handle lots of different colors, and may actually prefer lots of different colors. So it really depends on audience. And a lot of these roles are just broad.

Don't be condescending, and still format well, no matter how complicated your thing is. Sometimes you will need to use very specialized language for law or medicine, or business analysis. And sometimes you will need to be sure that you use very direct and simple language. If you're writing something that's health and safety, or if you're writing a recipe, you'll want to use much simpler language than, say, if you're writing about tax law for insurance companies in Nevada.

So it's really knowing your audience and having done that research in advance. But while still keeping in mind that lots of cognitive disabilities mean lots of different things. Dyslexia is something that has to be thought about at any level of language, for example, whereas health and safety information really covers everything. And needs to be written in simple language.

So here's an example. I'm not gonna read it aloud, but this is from How You Take the Bar Exam in New York. It's a professional licensure document. And it uses very, very complicated language.

Because that is how law is written in this country. But it is still formatted in a way where someone who may have a visual processing cognitive disability or dyslexia can still find where they actually need to read. So if you are looking for stuff about New York Law Course, you can just go right to header 4 and skip over the first few things. This is part of a 28-page document, so I just screenshotted it.

But it's still something where they know the audience. And I think something to remember through all of this: It's not just for people with cognitive disabilities. Because you also benefit. So here's a screenshot of Oxford.

So I did my masters degree at the University of Oxford, and this is a lot of people. Some of whom have cognitive disabilities. Most of whom don't. Who are supposed to be the smartest people in the world, who can understand any sort of language.

And so on and so forth. People every year get large numbers of points docked off their masters thesis, because they cannot understand the printing directions, which are very complicated, and theses need to be bound in a certain way, printed in a certain way, printed in a certain font, come with a plastic cover on a specific side, and a different plastic cover on the other side, and they need to be submitted at a certain place in a certain type of envelope.

This alone is too complicated, and has been roundly critiqued. But the directions for this were not just, like, a paragraph saying you need this, this, this, this, this. But for many masters students, they received something that was two pages in length, and I personally somehow managed to, you know, get it all in. But I know a lot of people who wrote brilliant theses, but who were not given the grades that they deserved, because they didn't submit it right.

Something else that I found out this afternoon is that the World Bank is also now trying to get its writers to use simpler language, because the journalists who are supposed to be covering it cannot understand the reports they're supposed to be writing to the public. So these are mostly people without cognitive disabilities. Although there are a lot of people with dyslexia or on the autism spectrum at Oxford and I'm sure in the World Bank.

And they still would benefit from the rules here. So in the last three, four minutes, I just want to go through a couple of tools that you can use. And for those of you on the live stream, if you open a second window, you can take a peek at these. One is grade level checkers.

We try to aim in New York City government for a grade 6 reading level. Health and safety information -- we really try not to go past grade 4. Sometimes some things will be grade 7 or grade 8, and I'm trying to get some agencies to cut things down from grade 12. There are these things called the Kinkaide Tests, and you can get one at readable.io.

It will tell you what the reading level is. The Hemingway App is also really great, because it not only tells you what the grade level is, but also makes sure you're using direct language. So, for example, instead of saying "it is important that", say "you need". There's this thing in the '60s and '70s, called Simple English, that was developed by Voice of America to make sure that all of the propaganda telling people that capitalism was great was easily understood by people learning English.

It is a specifically delineated limited vocabulary, and it is now widely used in English teaching. There's a Wikipedia on Simple English and language textbooks do it too, but it's also great it can be used for simple language for people with cognitive disabilities. So something that really helps is: Look through a Simple English dictionary, if you can access one, and see: Is the word there? If it's not there, you probably shouldn't use it.

You can also just use image searches to find educational photos for things that explain to people how to do something. And something I've really liked doing is: Look through kids' picture books. Because we use them to teach people, and it's also different ways of conveying information. And it's oftentimes -- they're often written in very equal level ways that are not condescending, so there's actually a lot to learn from them.

And use pictures. Remember the alt text. And then just ask people around you: Do you understand this? What do you think?

So here's my contact information. Jonathan P Katz at Gmail.com. You can follow me on Twitter at Jonathanpkatz, although that's mostly things that I cook. So yeah.

Questions? Sveta? Okay. We're going to have Sveta's question read aloud by me?

I can read it aloud. I'll get nearer so that Mirabai can hear me. I have a comment and some questions. Agreed with writing for people with cognitive disabilities.

Plain language is not meant to dumb down. It also helps regular people understand information, especially if they're tired or stressed or in a rush. For example, I may understand advanced English, but when reading some legalese, I feel overwhelmed with too much legal jargon, and especially in fine print and in all caps. So simplifying legal information helps me better understand legal information.

I've actually heard of lawyers advocating for plain language when writing legal documents, because many people without any cognitive disabilities are intimidated enough with complicated legal lingo.

Yes. Yes, yes, yes, yes.

I find it interesting about bulleted lists, because according to User Experience, they're easier to follow than a full text paragraph. How to handle bulleted lists? And what do you mean by English language having rules not to repeat words? Can you elaborate more on this?

Okay. I'll answer the second question first. Because... The first question will take me a little longer to answer.

For the second question, it's: English speaking countries, culturally, have a thing about repeating words. It's taught in the educational systems that if you repeat words, it makes you a bad writer. Which is not true. It makes you a writer that's not adhering to a certain cultural idea of English.

This is something that started off in the UK in the 19th century and spread to the US, Australia, New Zealand. Not as much South Africa. But in the big English-speaking countries, it's been taught for about 150 years now that you should avoid repeating words. So that's a cultural thing, more.

And it's across the English-speaking world. To a much bigger extend than other languages. I know, for example, that in my native language, which is Hebrew, it's much more common to repeat words. Not just because Hebrew has only been spoken for about 120 years as a first language, recently, but also because it's taught that it's actually fine to repeat words, especially -- and especially because if you use really fancy words in Israel, it's kind of seen as a no-no.

So the first question, with bulleted lists -- I think bulleted lists are fine when used well. And not when it's like so long that the purpose is defeated, in that the list is, like, this long. I'm holding up my hands very wide. And then also not to have bulleted lists within bulleted lists.

Because those are not only difficult to read, but they also sort of defeat the purpose of the bulleted list, often, in the first place. So a bulleted list of eight points -- I'm with you. It's really great to read those. A bulleted list of 88 points...

With 10 nested lists in there, and maybe one might have a list within that nest... That's not okay. And I haven't quite seen it to that extent, but I've definitely seen 20-plus bullet points with nested lists under half of them, which just makes it really unreadable. And as an aside, makes it incredibly frustrating when you're doing a screen reader test.

Cool. Yes?

I'm just curious where the, like, levels that you spoke about -- like, you said NYC tries to aim for a 6th grade level. I'm curious about where that comes from. Is that different based on the audience or the content?

It's different based on country. And there are national educational standards for reading. But they used... For a general assumption of what is a 6th grade reading level -- partly also from teacher colleges and teacher training.

But of course each country teaches different vocabulary or has vocabulary that's more commonly in use. So, for example, property measurements in South Africa are measured in earths, which is used only in legalese here, but it will be used in front page newspaper in South Africa. So it definitely differs according to country. But there definitely seems to be a national idea in the US and Canada of what a normal person in 6th grade will read, which is oftentimes roughly the reading level that someone with certain types of cognitive disability might attain as an adult.

Because of educational access and linguistic abilities and all that jazz.

A couple questions from Thomas on the live stream. Make sure... Okay. So Mirabai, you can hear me.

I wanted to... This mic is on. Good. The first question is: What font sizes does your agency use for materials?

Generally size 12 or size 14.

Generally size 12 or size 14. And the second question is: Any tips on how to set up a glossary or definition list for complex terms?

I think it really depends on the documents. On our website, nyc.gov/business, we have a glossary page. That people are now increasingly using. That explains many common city terms.

For many documents, what I've seen are... Indexes that have simple definitions of terms. Footnotes, which I'm not as much of a fan of, because it makes for disturbing formatting, for many people. Or even just writing it right into the text, what you mean by a term.

The first time that you use it. And then indicate the term somehow with bold text, for example. This is done a lot in textbooks. And it's also done a lot when you're applying for licenses.

It's like... You will need this thing. This thing does that. That is this thing.

I had a comment and a question. There's a font called (inaudible) that was designed for people with dyslexia that might be useful for some people. I also had a question similar to the bulleted list question. When you said, like, not to present too much information at once, do you have any guidelines for how much is too much information to have?

Like, one webpage... Is it better to break it up into different pages that are more digestible?

It really depends on the information. I would say 3 to 6 points is a nice sweet spot for bullet points, unless it's literally a list of items, in which -- then it can go longer. It also really depends... But it's really context-specific.

And I think it's really also a feel thing. I would say that with separate pages or separate sections, it's generally when it starts to feel like two big things at once, or when it's like something that's complicated enough where you might want to explain it in its own section -- it comes there. And that's just a lot coming in from editing. The easiest thing to do is don't throw the kitchen sink into the section.

Don't put everything in one go. That makes for a really awkward reading, and also becomes really frustrating. Yeah?

I really liked the point about the grade reading level, using the 6th grade reading level for all my outbound communication. The confusion, where there is a dilemma, is when the nature of the content is more technical, more legal, or more scientific in nature. While you cannot simplify it, but there is a certain way you can probably simplify the terminologies or the language -- how do you do that? Like, if you have to simplify a scientific or technical document, how would you do that?

I think it starts with, again, knowing your audience. It sounds like you have a very specific audience in mind already here. I think firstly... Like, huh?

Sorry about that.

Explain to Mirabai what's going on.

The screen just went off? And the screen just went on.

MIRABAI: Okay? Everything okay?

Yeah, we're okay. So... I would say start off with the easy. Which is: Make sure that it's formatted well and that the fonts are readable.

And then from there, what's being done at the World Bank now, which has a lot of very complicated econ terminology -- economics terminology -- is they'll say things like: Don't have run-on sentences. If you are saying two points in a sentence, do it in two sentences and don't say: We are going to achieve X, Y, Z goal, and we're going to achieve A, B, C goal! Just say we're going to achieve X, Y, Z goal, period.

We're going to achieve A, B, C goal. Period. And then try not to string lots of technical terms together. I see this happen with business analysts a lot.

Is they'll say things like... Oh my gosh. I'm forgetting. But this, this, this, and that are concatenated terminologically together.

You can maybe get away with terminologically. You can't get away with concatenated. You should say "put together". But try not to string together lots of technical words or science words or profession-specific words.

It's important to have them put apart. And that's also something that's being discussed a lot in academia right now. People with cognitive disabilities also become professors, and it's frustrating for everyone, but especially for professors with cognitive disabilities when you have an academic paper that is all theoretical terms. The New York Times used to have a bad writing contest, and they could have also done it as the inaccessible writing contest.

I think the winning sentence one year had 94 words, but only one verb. Any other questions? In the back?

Two parts. First part: Have you found that there are any technology tools that are useful for you or for writers to use in the web world, to understand cognitive accessibility or to assist them in making things accessible to people with cognitive disabilities? And two, how do you find political buy-in for making things accessible for cognitive disability? What tools do you use for that?

I'll address the first one first. One of the apps I showed, two of them -- readable.io and Hemingway App -- will actually analyze a text and tell you the grade reading level, with the idea of grade 6 or grade 4 being important for certain information, rewriting it actually in that tool and seeing what comes up is really helpful. I also watched a lot of YouTube videos by people with cognitive disabilities talking about how they approach the world, just to get an idea of what sort of language are they using and what sort of language should I start using to speak in that same way?

Something else that's really also useful -- and it doesn't even necessarily have to be someone with cognitive disabilities talking specifically about the cognitive disability, but talking about what they actually do every day. Because people with cognitive disabilities have complicated lives like the rest of us. I have a specific hobby that may be too embarrassing to talk about here, but there are a lot of people on the autism spectrum who have somewhat limited vocabularies that are also into this hobby, and it's been interesting for me in the past few years, working in accessibility during the day and reading their forum posts at night and sort of looking at the language that they're using and how they use it, and how the language is very, very simple, but also gets the points across, and then taking that language and thinking about it at work.

So instead of saying: Get started... Start. Political buy-in. So political buy-in is complicated, because it's not quite as clearcut a left-wing or right-wing issue, as are many other things.

A lot of the initial efforts to include people with cognitive disabilities in a community were not started by liberals or progressive people. They were started by evangelical Christians. And many of the most inaccessible spaces I've seen and many of the most inaccessible spaces according to many folks with much more experiences are spaces on the left. Bernie Sanders, for example, got completely ripped apart by many people with cognitive disabilities for having very inaccessible speeches, and so did Hillary.

And even when I was volunteering for Hillary, I definitely found that some of the materials were too complicated. And some of it's just taking time and saying -- you know, people with cognitive disabilities vote too. And then some of it is speaking with the different political aims. So, for example, although after this election, I'm not so sure how this applies -- previously with a lot of cognitive disabilities, you could use very religious talk, if you were able to do that, to get certain buy-in.

Talking about children of God, or everyone created in the divine image -- really can get you a lot of buy-in from evangelical Christians or, from my experience, orthodox Jews. And then on the left, also talking in specific left wing terms. You know, I think including people with cognitive disabilities is a very progressive thing, and even a very left wing thing. And many left wing spaces especially, many Marxist and Communist spaces, are not necessarily accessible and use very highfalutin language.

And this is the perfect application of from each according to his own, to each according to his need -- that's also a very accessible thing. But it depends on context. Even though I'm a pretty left-wing guy, I have to say the right-wing, before about three years ago, was way better. But with the advent of...

Coming back of a lot of eugenics and with the advent of a certain head of state... It's really kind of been scaled back, and we're kind of... Gone back to saying like... Oh, this is actually important.

Whereas, say, during the Bush era, and I can't believe I'm saying this... W was actually really good about including people with cognitive disabilities, because he got it explained to him from a religious perspective. I think really the political buy-in just depends so much on where you're getting it. In Israel and South Africa, which are places I've spent a lot of time, it's in the...

In Israel, it's very much a thing where it's like... Oh, these are also Jews. These are also children of God. These are also created in God's image.

We should include people with cognitive disabilities. In South Africa, it's: We did not fight for people with cognitive disabilities to still be excluded from our society. I don't know what it's like in other countries. Any other questions?

Well, thank you very much! It was a small live audience! But I know that there are a lot of people watching, and I know tomorrow morning there are gonna be a lot of other people watching in other places, so thank you! (applause) Okay.

I'm going to disconnect now.

Mirabai, I'm gonna... Keep talking for a second. So if you would keep this laptop running... We have a space.

We should be out of here by 9:00. So if you want to hang out for a bit longer, you're welcome to. There are drinks in the back, and... There are drinks in the back.

So help yourself. And I also wanted to just reiterate our thanks. I'm gonna speak in Sign Language. Thank you, SSB BART, and thank you, Thoughtbot.

Thank you, Mirabai and Joly, and thank you, Jonathan Katz, for speaking tonight. Thanks to you all too. (applause)

We'll be closing the captions now.