Cognitive barriers and assistive technology

Why it matters

Cognitive accessibility is both the most prevalent and the least uniformly addressed domain in web accessibility. Most WCAG criteria were originally developed with sensory and motor disabilities in mind; cognitive barriers are subtler and more varied. The BoK’s approach is function-based — addressing what a person cannot do, rather than what diagnosis they carry. (BoK p. 24)

Web and ICT barriers

The BoK identifies the following as the most common cognitive barriers in digital environments: (BoK p. 24)

• Information overload: too much content on a single screen, excessive choices, or text without visual hierarchy overwhelms processing capacity.
• Lack of structure: no clear headings, unpredictable navigation, and inconsistent layouts force users to re-learn the interface constantly.
• Complex language: long sentences, jargon, passive voice, and abstract concepts are barriers for users with intellectual disability, low literacy, or language disorders.
• Session time-outs: forms or applications that expire require users to restart — particularly harmful for users who need more time.
• Irreversible actions without confirmation: users with impulsivity or attention difficulties may make accidental selections.
• Distracting content: autoplay media, animations, and pop-ups divert attention from the main task.
• Multi-step processes without progress indication: users with memory impairments cannot track where they are without persistent cues. (BoK p. 25)

The function-based approach

The BoK emphasizes that cognitive AT should be matched to functional limitations, not diagnoses. Different diagnoses can produce the same functional barrier (difficulty reading, difficulty maintaining attention, difficulty following a sequence), and the same AT can serve multiple conditions. (BoK p. 24)

This parallels the functional solutions model from Domain 1A: what can the person not do, and what tool or design change addresses that specific limitation?

Design solutions

Plain language

Plain language uses short sentences, common vocabulary, active voice, and logical structure to help all users understand content quickly. It is particularly important for users with intellectual disability, cognitive fatigue, low literacy, or aphasia. (BoK p. 25)

Plain language is a design decision, not an AT product — it is an accessibility improvement built into the content itself.

Easy-to-read

Easy-to-read (ETR) is a more intensive format than plain language, using very simple vocabulary, short sentences, and supporting images or pictograms. It targets users with intellectual disability or severe cognitive impairments and is recognized in European accessibility standards. (BoK p. 25)

Wayfinding systems

Physical and digital wayfinding systems guide people through complex environments using consistent landmarks, color coding, icons, and clear signage. For users with cognitive impairments, poor wayfinding in hospitals, transit systems, or government buildings is a significant access barrier. (BoK p. 26)

Online, this corresponds to breadcrumb navigation, consistent menus, site maps, and search functionality.

Assistive technology

• Text-to-speech reads content aloud for users who cannot decode text fluently.
• Symbol-based software supplements text with pictographic support (Widget, Boardmaker) for users with intellectual disability or AAC needs.
• Prompting apps use step-by-step reminders and task sequence guidance for users with memory or executive function difficulties — common supports for people with intellectual disability, acquired brain injury, or dementia.
• Word prediction reduces composition effort for users with dysgraphia or slow typing.
• Reading guides on-screen (screen rulers, colored overlays via software) reduce visual distraction and help users track their position in text. (BoK p. 26)

Real-world example

A hospital patient portal requires completing 12 insurance verification questions in 8 minutes, using medical jargon throughout. A patient recovering from a brain injury — with intact intelligence but reduced processing speed — cannot finish in time and loses all entered data. Plain language, a progress indicator, an extended session time, and a save function each independently reduce barriers — and together they transform the experience without removing any required content.