404 Accessibility Not Found: Disability and Technology
Nicholas M. Weiner
Illustrations by: Yuchen Wang
Note: For this piece, I alternated between person-first (ex. person with a disability) and identity-first language (ex. disabled person). This is in accordance with the Stanford Disability Language Guide [1].
Imagine living in a world that isn’t built for you. Perhaps the stairs on the way to class are too high, or every door you go through is just a bit too narrow. Unfortunately, this is just a snippet of reality for many people with disabilities: they live in a world that was built specifically for their non-disabled peers. A disability is a condition of the mind or body that makes it difficult to perform essential everyday tasks and interact with the world as it is currently structured [2]. To lessen these difficulties for disabled folks, those who design public-facing facilities need to make sure people with disabilities can use the facilities as easily as those without. The practice of ensuring that people with disabilities have equal access to resources is called accessibility [3].
Note: The US government definition of accessibility allows for segregated products and environments, as opposed to universal design, where all products and environments are built for equal access by disabled and non-disabled people [3, 4]. In practice, effective accessible design is almost always synonymous with universal design [4].
The disabled community often faces difficulty accessing public facilities designed without their needs in mind. People with disabilities make up 15% of the world’s population and 26% of the United States’ populace, meaning that large swaths of the population are unable to access resources that are intended for everyone [5, 6]. For example, if voting takes place in a building without ramps, those who use wheelchairs will have a significantly harder time participating in elections. One of the most promising implementations for accessibility is the development of usability-increasing technologies, which addresses the varied needs of those with disabilities. However, even technologies that increase usability often have barriers. Designers may not acknowledge the diversity of needs when expanding accessibility in the digital sphere. Our society needs to place more emphasis on creating and researching new accessible technologies and making current technologies more accessible to all, regardless of disability status.
An Introduction to Neurodiversity
Think back to when you were in first grade. Your teacher drones on and on about grammar rules and multiplication tables, and you find it difficult to concentrate. The sound of the teacher calling your name interrupts the seemingly endless lesson. When you struggle to respond, they scold you for not paying attention, unaware that you weren't able to think through the question yet, or that a condition, such as dyslexia, may have interfered with your ability to process the class reading. This frustrating situation demonstrates the reality faced by many neurodiverse individuals.
In the fields of neuroscience and cognitive science, patterns of thinking and learning have been sorted into two categories: neurodivergent and neurotypical. The word “neurodivergent” describes people who have neurological conditions, such as autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD), and dyslexia [7]. Conversely, the term “neurotypical” refers to individuals without any sort of neurodevelopmental condition [8]. Therefore, neurodiversity is the spectrum of variations in human brain function, which includes both neurodivergent and neurotypical individuals [7]. The concept of neurodiversity posits that both neurotypical and neurodivergent thinkers fall into this expected variation [7]. Unfortunately, much of society’s physical and social infrastructure is not constructed to accommodate neurodiversity [9].
There are many tasks that neurotypical and non-disabled people trivialize: walking, speaking, absorbing information in a classroom setting, or using their senses to interact with the world, to name a few. Some people struggle with these everyday processes due to disabilities. Disabilities can manifest in a variety of forms: impairments in auditory, cognitive, neurological, physical, speech, or visual systems; they can arise at birth or develop later in life as a result of illness, accident, injury, or old age [2, 10]. There are more than 61 million Americans with disabilities, and over a billion disabled people worldwide; yet, as noted earlier, many public resources do not take this significant demographic into account [5, 6, 9]. To address these common barriers to accessibility, scientists have designed devices called accessible technologies. These technological tools make the lives of people with disabilities substantially easier. For example, people with auditory impairments can use hearing aids to help them interpret sound and speech, while amputees can use prostheses to stand in for limbs. Those with mobility issues can use wheelchairs instead of walking, and non-verbal people have the option to use text-to-speech apps to participate in verbal communication. In fact, you may even use a form of accessible technology yourself; eyeglasses allow many people with minor visual impairments to more easily navigate the world. With this in mind, let’s take a look at some of the new and increasingly advanced forms of accessible technologies that may serve the large community of individuals experiencing difficulty accessing essential public resources.
Fictional People Solving Real-World Problems: Personas, HCI, and UX
Mia is a university student who loves an eclectic mix of podcasts about true crime, history, and comedy. She also happens to be deaf. What can the developers of a podcast app do to support users like Mia? In this case, the developers need to address the inherent difficulty of using an audio-based podcast app as a deaf person. Consequently, they construct a fictional character, Mia, to gain perspective on their product from her imagined point of view. By using Mia’s experience as a guide, the developers are encouraged to implement transcription functionality for their app.
Fictional characters like Mia, who represent users with disabilities, are known as personas. Personas help developers plan for variability in the user base by creating diverse, imagined characters [11]. Without personas, it is easy for designers to generalize their user base. In doing so, designers fail to acknowledge the wide variety of individuals using their product, some of whom may be neurodiverse or living with a disability. Creating personas based on disabled or neurodivergent consumers, such as Mia, allows developers to better conceptualize this variability [12, 11]. When tech designers construct personas to represent users with disabilities, like blind users, deaf and hard-of-hearing users, colorblind users, or users with Parkinson’s disease, their new designs are more likely to be accessible to people from a greater variety of backgrounds [10]. Further, the creation of personas increases developer awareness of disability-related issues, while prompting developers to consider how their technologies can be effectively used by the widest audience [11, 13]. Thus, to design products for users with disabilities, it is essential to first understand how disabled users prefer to interact with their devices.
Human-Computer Interaction (HCI) is the study of how humans interact with computers [14]. The goal of HCI is to create a continuous relationship between human users and computers, allowing computers to become a useful tool and an extension of their user [15]. HCI integrates several fields, such as computer science, cognitive science, linguistics, cultural anthropology, sociology, ergonomics, and visual design [14]. Many neuroscientists view HCI as one of the best approaches to restore independence among people living with extreme paralysis, or “locked-in syndrome,” a rare neurological disability that causes individuals to retain consciousness but lose all motor control, except in their eyes [16, 17]. HCI principles can be used to create technology that allows individuals living with locked-in syndrome to communicate via a computer by using input sensors which track eye movements. Even in instances in which people have disabilities less severe than extreme paralysis, creating a continuous human-computer system gives them the ability to perform tasks they might not be able to do otherwise. For example, people living with Amyotrophic Lateral Sclerosis (ALS) are often affected by dysarthria, a condition that causes the muscles used to produce speech to atrophy or weaken, preventing them from speaking [18]. Thankfully, devices exist that help people with ALS produce speech [18]. Stephen Hawking used this kind of speaking device during the progression of his ALS, allowing him to continue contributing to the scientific community until the end of his life [19]. Still, more research is needed to understand how computer design can provide disabled users the same opportunities as non-disabled ones.
Along with an understanding of HCI and personas, User Experience (UX) research is another essential piece of the design process for accessible technologies. UX is the study of users, how they interact with technology, and what limitations exist that create distance between the user and technology [20]. In short, UX puts the theories of HCI into practice. In order to collect information about how users interact with products, UX researchers conduct experiments to collect and observe physiological and neurological data surrounding participants’ experience with the new technology; the results of such studies signal the effectiveness of the human-computer systems at work [21]. If the physiological responses indicate that a system is causing users stress, for example, UX researchers can brainstorm ways to eliminate this stress while preserving the human-computer system’s benefits. By using this quantitative data in combination with qualitative data from user stories, UX researchers piece together the best ways to improve the users’ encounters with their product [21]. It’s important that UX experts make a conscientious effort to include disabled research participants in their studies. By doing so, these researchers can design and prototype the next generation of accessibility technologies.
Virtual Reality: A Whole World of Accessible Possibilities
What if you were able to experience the whole world while remaining in one place? You could hike through the Amazon Rainforest, score touchdowns as a star Super Bowl quarterback, or even travel to the moon. Through the development of virtual reality (VR) technology, such fantasies are quickly becoming a reality. Unlike a traditional computer interface, VR typically uses headsets and motion sensors to place the user inside a completely immersive, simulated environment [22]. However, VR technologies have more uses than mere recreational fun. With broad applications for treatment and rehabilitation of many forms, VR technologies have the potential to radically deconstruct barriers to access for people with disabilities.
VR technologies are especially promising tools to provide occupational therapy and education to children with ASD. Individuals with ASD often struggle to develop executive functions — a combination of working memory, mental flexibility, and self control — that are essential for daily life [23]. There are two leading methodologies for supporting ASD children through the process of developing executive functions: behavioral therapy and Theory of Mind (ToM) [24]. Behavioral therapy involves a complex process of reinforcement and repetition in different types of environments. One example of behavioral therapy would be a special education program that combines the efforts of several teachers, aides, and the child’s parents. This type of program might have the child alternate between mathematics and writing tasks for many consecutive days to practice the executive functions required for these tasks. Conversely, ToM involves the repetition of simple tasks under more static conditions. For instance, a child might attend occupational and speech therapy for an hour a day, where a single therapist instructs them through multiple short reading and speaking tasks. VR-based therapy for ASD children combines the best of both methods; it creates variable and safe environments for autistic children to experiment, while requiring fewer financial and labor resources than traditional behavioral therapy. ASD children might use educational VR modules that teach the same concepts as the behavioral therapy modules in a preprogrammed environment, allowing children to experiment and learn with minimal supervision [24].
Further, VR-based treatments are especially promising because they are easily customizable. Among individuals with ASD and other cognitive disabilities, there is great variability in cognitive skills, motor skills, and therapeutic and education needs [25]. Since VR design applications such as Unity and Microsoft Hololens are customizable, specialized treatment can be made for users with different types of cognitive disabilities. For instance, treatments that incorporate storytelling are thought to be most effective for young children with ASD [25]. It might be easier to explain money management to young children with ASD by having them think through how to run a lemonade stand, rather than simply giving them mathematical equations to solve. Due to its customizability, it is easy to create VR story-based educational programs for children with ASD. Therefore, given that the American public education system is not always set up to support students with autism, VR technologies are a great potential solution to help support their educational experience.
VR technologies also have great applicability for rehabilitation, as they can help patients recovering from a stroke or a traumatic brain injury (TBI) regain the ability to perform daily functions in a digital environment [26, 27]. VR allows patients with TBI to simulate activities such as moving throughout a virtual kitchen space or village [26]. These types of technologies are empowering and effective rehabilitation tools, since they help people regain lost executive function, such as attention and balance, more quickly than via physical rehabilitation. VR-based treatment has been shown to improve executive functions in patients with TBI; the inability to control the difficulty of tasks and high distractibility of patients can make rehabilitation onerous [26]. VR technologies allow control over task difficulty and distractions, enabling an earlier start in the recovery process [26, 28].
From its applications in deconstructing barriers faced by both neurodivergent and disabled people, to its ability to speed up recovery from neurological conditions, VR is incredibly promising as a new tool for accessibility. However, additional research is needed to determine the best method to mass-produce VR technology and seamlessly integrate it into society. Currently, the main limitations of VR systems are their price and lack of fully developed rehabilitative software. Many disabled people who could benefit from VR-based treatments and rehabilitation are prevented from using it due to its high cost. And, since the size of the user base is limited by the cost of entry, VR apps are not as polished as apps on other platforms. These financial and practical barriers currently inhibit VR from being truly accessible. In the meantime, designers can focus on making an extremely pervasive technology more accessible to users with disabilities: the internet.
Can the “World Wide Web” Live Up to its Name?
Imagine applying for a job, researching for a term paper, or video calling friends without using the internet. What if every time you visited a certain website, key elements of it were broken and unusable? In our modern age, it is almost impossible to opt out of smartphone, computer, and internet use. However, 15% of Americans with disabilities report that they never go online, compared to the 5% of Americans without disabilities [29]. Since more than 25% of the population of the United States identifies as having some form of disability, this amounts to an estimated 12.9 million Americans with disabilities who never go online [6, 29]. The large discrepancy between disabled and non-disabled Americans’ use of the internet suggests a lack of web infrastructure to support internet-users with disabilities. Unsurprisingly, only 2.6% of websites are fully accessible [30]. This alarmingly low percentage indicates that there is not enough awareness or consideration of accessibility needs during the design process. This section will review the attributes that render a website accessible or inaccessible in order to convey the obstacles disabled internet-users experience, as well as the methodologies used to remedy these obstacles.
To accommodate disabled users, software engineers have created programs that offer a variety of ways to engage with the internet. These programs, known as accessibility aids, are tools designed for disabled people to interact with modern devices. For example, blind users can use screen reader applications to narrate the contents of a website as they scroll. Deaf and hard of hearing users can add closed captioning extensions to their internet browsers to compensate for video and audio services that do not come with captions by default. Users with low vision can add extra magnification functionality to their browsers, allowing them to read text they can’t see with default browser configurations. Each of these pieces of technology can be useful to allow users with disabilities to access web pages. However, the most effective way to ensure web page accessibility is for web developers to design their websites with accessibility in mind from the start.
To promote website usability, The World Wide Web Consortium (W3C) sets standards for accessible web pages. The W3C’s Web Content Accessibility Guidelines (WCAG) is a series of design guidelines developed to provide uniform standards for web content accessibility [31]. The WCAG recommend including screen reader support for users who are blind and have low vision, subtitles on video content and transcripts of audio content for users who are deaf or hard of hearing, and the ability to navigate websites exclusively with the keyboard for users with limited mobility. The WCAG also provide layout suggestions that make websites more predictable for neurodivergent users. For example, those with ASD often feel more comfortable with predictable website layouts, because a lack of a cohesive design can cause unnecessary stress [10]. Consistent headings across a website’s pages promote easy navigation, allowing neurodivergent and disabled users to participate while simultaneously creating a better interactive experience for neurotypical users.
When web developers ignore the WCAG and build online spaces without disabiled people in mind, there are often glaring design issues that make technology use impossible. One common mistake that creates barriers for blind internet-users is forgetting to label images with alt text [32]. Alt text is an attribute within image tags in HTML website code that was originally designed to describe images if they were unable to load. Nowadays, alt text is used to allow blind people to interact with images through screen readers. Similarly, another mistake that results in web inaccessibility is using unhelpful alt text that fails to convey an image’s contents or meaning (ex. “Home_page_image_2.jpg”). Web designers may also lock their pages’ font size, which prohibits resizing text for users with low vision. Likewise, users with mobility issues such as those caused by Parkinson’s disease often use the tab key to interact with websites if they are unable to exert enough fine motor control to operate a mouse. If website designers do not take tab functionality into account, users with Parkinson’s disease might be unable to fully traverse the site [32]. Not only do these poor design choices adversely affect accessibility for disabled persons, they also limit navigation and reading options for non-disabled users. Therefore, maintaining accessible practices on websites benefits all users, and should be commonplace in web design.
The Future is Now: Implementing Accessible Technology
By emphasizing the development of accessible technologies to address barriers that disabled people often experience, we can create a more equitable world. Many techniques for implementing accessible technologies already exist. Researchers use concepts from the field of Human-Computer Interaction to design computer systems which compensate for barriers between users and their environment. Through this process, they create personas, fictional characters which serve as a reminder of the diverse user base for whom they are designing. These experts perform market research by reaching out to disabled people to ask their advice on how to improve their product’s accessibility. Non-disabled users also interact with the technical and physical worlds in a variety of ways, so providing equal support to each of these methods is beneficial for all. For example, ramps for wheelchair users also make it easier to move strollers, suitcases, and package deliveries inside a building. Normalizing design that considers a variety of users destigmatizes accommodations for disabilities.
Despite the fact that these accessible techniques exist, the main obstacle to a truly equitable physical and digital world is the lack of awareness about the issues impacting people with disabilities [13]. Even if you, the reader, do not end up programming the next Facebook or designing the user interface for the next Google, you can take some lessons away from this article. When you create any product, whether that be a website for your small business, a menu for a restaurant, or a stairway for a local library, the users of your product will be people with a diverse set of needs. By raising awareness of these issues, and prioritizing access for all people, we can mitigate the difficulties that people with disabilities face and show compassion and inclusion to an otherwise underserved community.
Note: Due to the scarcity of peer reviewed sources discussing the topic of accessibility, some non-peer reviewed sources were used in this article. However, all sources used in this article are reputable, including those produced by standards organizations, research institutions, and government bureaus that are experts in their fields.
Special thanks to the Vassar Disability Coalition (VDC).
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