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Introduction to Cognitive Disabilities

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People with cognitive disabilities have specific access needs that affect:

  • how they process information
  • how they focus on something
  • how they remember or recall information
  • how they interact with other people

These needs affect many everyday activities at home, in the workplace, in digital environments, at school, or in public. These needs are often permanent, but may be temporary or situational. There are many simple methods you can use to support people with cognitive disabilities.

Overview

Section titled “Overview”

Cognitive disabilities affect how people think, process information, or make plans. These disabilities are usually permanent, but may be temporary or situational. People with these disabilities have specific access needs in the physical world, digital spaces, and in programs and services. These needs vary, but include:

  • How people focus, make plans, or remember information
  • How people avoid distractions or shift their focus
  • Ways of thinking of or assessing future events or social cues
  • Ways of expressing information or understanding information, especially when interacting with others

Common needs for people with cognitive disabilities include:

  • Limited attention and concentration
  • Limited executive function
  • Limited memory and memory loss
  • Limited social skills

Further information on these needs is available on useable.

Common cognitive disabilities include, but are not limited to:

  • ADHD
  • Autism
  • Brain injury
  • Dementia
  • Epilepsy
  • Intellectual disability, including Down syndrome
  • Multiple sclerosis
  • Stroke
  • Tourette syndrome

Many people with cognitive disabilities also have learning disabilities. You can learn more from Introduction to Learning Disabilities (Ta11y).

Cognitive access needs

Section titled “Cognitive access needs”

People with cognitive disabilities benefit from different accessibility methods in physical and digital environments. Different processes and methods also can help people with these disabilities. Techniques to meet these needs are highlighted below and in various articles found throughout Ta11y.

Limited attention and concentration

Section titled “Limited attention and concentration”

People with this access need may:

  • have difficulty focusing or concentrating on a task, object, or interaction
  • have difficulty shifting their focus or concentration from one thing to another
  • need help keeping their focus on something
  • need help avoiding distractions

People with limited attention and concentration often benefit from:

  • written prompts and tools that help them focus or concentrate on a task
  • simpler layouts, processes, and spaces that have fewer potential distractions
  • reduced sensory input - for example, rooms with adjustable lighting
  • multiple ways to achieve a task - for example, by email or phone
  • more time to achieve a task

Common disabilities associated with this access need include, but are not limited to:

  • Anxiety disorder
  • Attention deficit / hyperactivity disorder (AD/HD)
  • Autism
  • Depression
  • Head injury
  • Mental health conditions
  • Obsessive compulsive disorder (OCD)
  • Tourette syndrome

Limited executive function

Section titled “Limited executive function”

People with limited executive function may have difficulty with:

  • planning ahead
  • thinking of future events
  • perceiving or managing time
  • organizing objects, ideas, or tasks

People with this access need often benefit from:

  • written or picture supports and directions
  • simple layouts, spaces, or tools that reduce the complexity of tasks
  • prompts or reminders for steps - for example, when completing a form
  • human help in navigating information

Common disabilities associated with this access need include, but are not limited to:

  • Autism
  • Dementia, including Alzheimer’s disease
  • Epilepsy
  • Intellectual disabilities like Down syndrome
  • Multiple sclerosis
  • Stroke
  • Traumatic brain injury
  • Tourette syndrome

Limited memory and memory loss

Section titled “Limited memory and memory loss”

People with limited memory or memory loss may:

  • have trouble remembering or keeping recent information
  • have trouble remembering or keeping information from the past
  • not be able to recall information in response to a question or request
  • not be able to remember information accurately

People with this access need benefit from:

  • written information that is easy to find
  • simpler processes that do not rely on recalling information
  • automatic ways to store and retrieve information, such as autocomplete
  • explicit guidance on tasks, directions, and locations
  • social interactions that do not rely on remembering information - for example, with name tags in large settings with many people
  • human help with achieving tasks

Common disabilities associated with this access need include, but are not limited to:

  • Attention deficit / hyperactivity disorder (AD/HD)
  • Brain injury
  • COVID-19 and Long COVID
  • Dementia, including Alzheimer’s disease
  • Depression
  • Fibromyalgia
  • Seizure disorder
  • Sleep disorder

Limited social skills

Section titled “Limited social skills”

People with limited social skills may:

  • have trouble managing their emotions or responses to other people
  • have difficulty understanding social cues
  • have difficulty expressing their emotions, thoughts, or ideas
  • process social cues more slowly or in a different way from others
  • act in ways that are not typical in their social context

This access need differs significantly between cultures and contexts. For example, a social cue in one country may not exist elsewhere. Similarly, someone may have more difficulty expressing themselves at work or school than at home.

People with this access need often benefit from:

  • flexibility in social spaces in how people may express themselves or interact with others
  • human help in interacting with other people
  • written, picture, or physical prompts that provide information
  • “social scripts” that help them navigate an interaction

Common disabilities associated with this access need include, but are not limited to:

  • Autism
  • Brain injury
  • Dementia, including Alzheimer’s disease
  • Intellectual disabilities such as Down syndrome
  • Obsessive-compulsive disorder
  • Substance use disorder
  • Tourette syndrome

Accessibility Impacts

Section titled “Accessibility Impacts”

People with cognitive disabilities face many different barriers when environments are not accessible. These barriers often happen when people have to:

  • rely on specific ways of paying attention or maintaining focus
  • need to plan ahead, remember information, or recall things without help
  • interact with other people in certain ways - which are often unclear

The nature of these barriers vary. They depend on where the person is, the specific task or environment, and a person’s needs. Here are a few examples of accessibility impacts for people with cognitive disabilities:

  • Digital barriers: an autistic person may not be able to apply for a business permit if they have to do so on a website with many distractions. This problem may also occur if the information on what they need to provide is unclear.
  • Usability barriers: a person with an intellectual disability may not be able to buy a train ticket if the kiosk interface has a complicated layout. The problem may be more intense if the help directions are complicated to read.
  • Social barriers: A person with ADHD may have trouble meeting expectations at work if their workplace does not communicate social norms clearly.

These barriers impact inclusion of people with cognitive disabilities. Inaccessible spaces and environments lead to the social and economic exclusion of people with these needs. Many people are unable to access opportunities or needed support. Sometimes, an inaccessible environment can even be a safety risk.

Supporting Methods

Section titled “Supporting Methods”

Different methods can support people with cognitive disabilities. These methods vary widely. These methods may change depending on local culture, context, and the physical or digital space. Many people with cognitive disabilities have different needs, too.

Certain common methods help many people. These include:

  • Simpler layouts and organization
    • Consider how digital content is organized. You can learn more in Visual organization (Ta11y).
    • Review the layout of your documents. You can learn more in Content organization (Ta11y).
    • Try to make your physical space layout as simple as possible. You can learn more in Common-Use Areas (Ta11y).
  • Reduced sensory input or information - for example, avoiding bright lights or many colors
  • Providing written or verbal prompts and clear directions
    • Prompts can help people concentrate or focus, or remember and recall information. You can learn more about writing clear prompts in Writing Accessible Content (Ta11y).
    • Plain language (Ta11y) directions help many people achieve tasks. Consider including pictures or images too, as these help many people with cognitive disabilities.
  • Flexibility in how tasks are done
    • Where possible, do not time tasks.
    • Offer different ways to do a task or communicate information - for example, through an online form or by email. You can also offer flexibility in how much time, where, or how a person can do something.
    • On online content, allow people to use autofill or other tools that help with remembering or providing information.
  • Providing support for meeting social norms
    • Try to be socially flexible whenever possible. This will vary depending on your cultural context.
    • Explain any social norms or expectations in your organization clearly.
    • Be flexible in how you interact with others.
  • Offering human help whenever possible

Examples

Section titled “Examples”

Gisli has ADHD and Tourette syndrome, and is in a vocational training program to become a welder. He can sometimes become distracted, which can be dangerous in a welding studio, especially when he is worried about controlling one of his tics - arching his back, which can be difficult when welding. He benefits from low-distraction environments. In the studio, he benefits from a simpler layout, facing away from distractions, a plainer space that only focuses on his equipment, and signs that remind him to focus on the work.

Signy is an autistic woman living with a traumatic brain injury. She often needs support when making plans or achieving tasks that involve planning. Today, she is making a list for her groceries. She finds it is easiest to make this list at home, away from distractions. She has a list on her phone of things she needs to check on her grocery list, and a past example pinned on her refrigerator that she can copy off of. Sometimes, if she is having someone over, she will call her friend and neighbor Gudny for help. Gudny’s number is saved in her phone and is pinned on the refrigerator too. She writes “make sure you have everything before you leave the store” on her list to help her not forget key items.

Hrani has early-stage dementia. He also has multiple chemical sensitivity, and several common cleaning chemicals can give him “brain fog” that makes it more difficult for him to navigate a space. He is at the grocery store. He finds it easy to navigate the store, which has a simple layout and signs with text and images showing him what is in each aisle. He brings a grocery list - similar to Signy’s - that has a list that prompts him to get each item. If he enters the store right after it is cleaned, he may need to step outside - but there are signs that can help him find the exit, even if he is disoriented. Sometimes, he may need help finding a product. The store staff are friendly and kind, and he does not mind asking for help.

Elin is a UX/UI designer with obsessive-compulsive disorder and ADHD. She sometimes has a compulsion to phrase things in a specific way, and often speaks at length, about a lot of information. Elin lives in a country where most people tend to be more terse in their statements. In online meetings, her colleagues are relaxed, and allow Elin to speak in her own style. They help Elin with nodding and visual cues that help Elin focus. The timer on the meeting also helps Elin keep track of how long she has been speaking. When taking notes, Elin’s colleague Gudny translates Elin’s comments into plain language, and will check with Elin if these were transcribed correctly.

Section titled “Related Articles and Podcasts”

Many of these articles are forthcoming.

  • Balancing Different Access Needs (Ta11y)
  • Check Reading Level (Ta11y)
  • Consistent Design Patterns (Ta11y)
  • Content Organization (Ta11y)
  • Disability Inclusive Language (Ta11y)
  • Indoor In-Person Events (Ta11y)
  • Indoor Wayfinding (Ta11y)
  • Introduction to Learning Disabilities (Ta11y)
  • Introduction to Pedagogy and Access (Ta11y)
  • Introduction to Writing Accessible Content (Ta11y)
  • Providing Help (Ta11y)
  • Use Plain Language (Ta11y)
  • Visual Organization (Ta11y)
  • Accessibility in Practice: All in Dublin

References

Section titled “References”