A chunk of my job involves making sure that the things we design for the web are accessible. I spent a few years helping GOV.UK services take form — when your digital service has to work for literally almost everybody, you take accessibility seriously.
One of the more overlooked aspects of accessible design for the web is cognitive difficulties. Ironically, this is a woolly concept for many: do we mean people with brain injuries? With Alzheimer’s disease, or mild cognitive impairment in old age? What about people with autism?
Yes, all of those. But cognitive difficulties also arise circumstantially, such as when people are tired: new parents; shift workers; those with chronic fatigue; people who just came in on the red-eye. Or stressed: carers; parents of kids going through difficult phases; the recently bereaved; those struggling to make ends meet; recent immigrants.
Or, recently, me.
It gets a bit much, all those “I never knew X was a problem until Y happened and now I am a champion for justice” blog posts. But roll your eyes all you want — lived experience of a thing is often the only way to fully grasp it.
I got the ’flu. How utterly mundane.
It wasn’t even bad ’flu —you know, the kind with hallucinations and alternating sweats and chills. It was just fever and coughing and nose-blowing and headaches, and that horrible listlessness that comes from suddenly having time to do things, but no appetite to do them. I spent a few days on the sofa, staring vaguely at the internet.
Presumably because my brain was cooking itself, everything that had to do with language or complex cognition was suddenly, unexpectedly hard. Trying to type messages on my phone was a nightmare: typos all over the place; lots of deleting and trying again. Reading and writing in Norwegian, things I now largely take for granted, were suddenly unnecessarily difficult. Checking Slack messages, I was so far gone that when a colleague said “Monday and Tuesday” and I replied “but what about Tuesday?”, I didn’t even understand that this was a non-sequiteur (I meant Wednesday).
I thought I was better. I had a day working at home, reading and typing at a relaxed pace. I tried to keep up with Slack messages. I love Slack (like, to the point of irrationality), and it’s useful as hell, especially when you’re working remotely. But I was just completely overwhelmed by the bombardment of @-replies and @channel and @here. Was it really all necessary? I wrote a short and not un-cranky note to my colleagues. The note took me nearly two hours to compose. Not that it felt like two hours; the passing of time was something I noticed had altered for me. Time just disappeared into a cognitive fog full of backspaces and reformulations and realising I’d been staring into space for who knows how long.
And then I went back to work, or rather to a day of expert interviews at a client’s. Normally I like to be the one who takes notes during interviews: I’m a fast typist, and it means we end up with a searchable transcript. But I could not do it. My fingers just stumbled over each other. Could not keep up. I couldn’t hear that well, either; my ears were still a bit blocked.
In between interviews, I explained that I was struggling. My colleague sweetly offered to take notes instead. So I just sat and listened, thinking I would try to come up with good questions. But I couldn’t follow a conversation, at least not the way people speak when they are talking in detail about that thing they do all day. The interviewee would start a sentence, and already by the second or third clause, I could not tell you what they had said in the first one. Or before that. My body still knew how to make “I’m listening” noises and postures, but it was just an empty machine.
Observer-me thought this was pretty interesting. I come from a background in cognitive science, so what was happening looked to me like reduced working memory and problems with executive functions. In other words, exactly the kinds of things you see when people are tired, highly stressed, or in certain states of illness or disease.
But subjective-me was having a whole different experience, and it sucked. Subjective-me grasped, in a way that objective, scientist-me only ever understood intellectually, that this is what people mean when they talk about cognitive difficulties. The inability to hold the thread of a detailed conversation. The lack of extra bandwidth for things like tact and precision. The time fog. The sensation of being overwhelmed by input that isn’t yours to control. The poor fine motor coordination, and not hearing well. I felt like an ailing 80-year-old.
Saying Tuesday when you mean Wednesday is probably not a disaster, most of the time. But wow, how easy it would have been to make such a substitution error while using an online government service. (I was supposed to be submitting a tax return while all this was going on. Once I realised how fallible and fragile my cognitive processes had become, I didn’t dare). How very easy it would be to get into quite serious difficulties because you gave the wrong answer — ‘submitted false information’, as the state might view it —and didn’t even realise.
Imagine struggling just to hold onto the conversation while someone tries to tell you what you need to do to keep qualifying for state benefits. Or while a medical professional is explaining how to care for your ill child or elderly relative. Imagine needing to talk to law enforcement, or immigration officials, or the tax people. Even people whose brains are working fine struggle to process information in unfamiliar domains, so what chance does someone with cognitive difficulties have?
Writing this post, I’m still not quite well. It’s taken you four minutes to read, but it took me four hours to write, in a quiet room, with breaks. But I’m lucky: this will go away in a couple of days. Lots of people are stuck with it for long periods —some permanently.
So be kind. Design, online and off, for people who, usually through no fault of their own, cannot engage with complexity. Use shorter, familiar words, and shorter sentences. Give users as few choices as possible, presented one by one. If there is a way to engineer things such that users don’t have to enter a lot of information themselves, choose that. Do the hard work to make it simple.
And don’t think that it can’t happen to you.
Cognitive difficulties: an overlooked aspect of accessible design was originally published in UX Collective on Medium, where people are continuing the conversation by highlighting and responding to this story.