Clear by Design

Intro

When people talk about accessible design, most immediately think of wheelchair ramps in the physical world and screen readers in the digital world. Both are important–but there’s one group that’s far too rarely discussed: people with cognitive impairments. Yet they are the largest group of all among those who rely on accessibility. And at the same time, they are the most neglected when it comes to research and design.

For a paper I wrote for the “Society and Digital Media” seminar at IU, I focused specifically on this topic. What I discovered was sometimes surprising, sometimes frustrating–but ultimately, above all, motivating. Because the good news is already hidden in the bad: Improving in this area makes the web better for everyone.

First off: Who Are We Actually Talking About?

“Cognitive impairments” sounds abstract. Basically, it refers to difficulties in receiving, processing, or retaining information – and that can have many causes. It can be permanent, as in the case of a learning disability, an intellectual disability, or ADHD. It can be temporary, as with a severe cold, exhaustion, or intense stress. And it can also be situational – for example, when someone is not a native speaker or is distracted by a loud, distracting environment.

Ultimately, this means that in one way or another, we’ll all be affected at some point.

To give a sense of the scale: In Germany, around 16% of the population lives with recognized cognitive impairments. On top of that comes an ageing society – and with it an increasing number of people affected by dementia. The question of how digital products work for these people is therefore not a niche issue. It is socially relevant. And it is becoming more relevant.

What Research Says –
and What It Doesn’t Yet Know

The most important findings can be divided into five areas that play a role in the design of digital offerings.

1. Language: Short, Clear, Understandable

Language barriers are the most common hurdle. Around 12% of the German population has limited reading proficiency. (Of course, this applies not only to this 12%: understandable language is never a disadvantage.)

Two concepts have become established here: Plain Language and Simple Language. Plain Language follows a strict set of rules and is intended for people with severe cognitive impairments – short sentences, simple words, no metaphors, and a clear structure. Easy-to-read language even sets guidelines for design. Simple language is much less standardized and is intended for people who find more complex texts difficult (or who simply aren’t experts in the subject).

What studies show: Easy-to-read texts demonstrably reduce reading time, lower the number of follow-up questions, and are perceived positively. So it works. The effort is worth it.

A small aside (for all the German writers) that surprised me while writing: Gender-inclusive language poses a real accessibility problem. Special characters like * or : can be disruptive and are pronounced strangely by screen readers – thus creating a barrier for people with cognitive impairments. There’s no simple answer to how this could be solved. But it’s a good reason to keep this context in mind when writing.

2. Content: Less, Clearer, with Context

People with cognitive impairments often have difficulty filling in missing context on their own. If a text simply starts in the middle of a complex topic – without any context, without “What is this actually about?” – the barrier is immediately high.

What helps: a clear focus on content, short texts even when using simplified language, introductory contextual information, and a balanced emotional tone. (Yes, that sounds strange – but studies show that the mix of positive and negative content also makes a difference. Bad news alone exacerbates feelings of being overwhelmed.)

An honest assessment: Some content cannot be made fully accessible. Highly complex legal or medical texts, for example, cannot be simplified to their full depth without losing important information. That’s no reason to give up – but it could be an argument for creating parallel, simpler versions.

3. Navigation and Usability: Reducing the Mental Load

People who have trouble remembering things also struggle with poorly structured websites. Navigation that looks different with every click, lengthy processes without guidance, and time limits that leave no room for error – all of these factors cause stress and lead to mistakes.

What really helps:

• Consistent navigation – always structured the same way, always in the same place
• Breadcrumbs and step indicators (e.g., “Step 2 of 5”) – so it’s clear where you are
• Large, clearly labeled buttons – get rid of small and, above all, overly generic link text
• Error prevention and correction – autocorrect, flexible input formats, immediate feedback
• No password stress – Touch ID and similar alternatives significantly reduce the cognitive load

4. Design: Clarity Beats Creativity

This is perhaps where there is the greatest overlap with what is generally considered “good design.” Visual hierarchy, good contrast, sans-serif fonts, distraction-free layouts – these aren’t special requests; they’re the basics of the craft.

Particularly valuable: images and icons that convey real content – not decoration, but explanation. The key here: one image, one piece of information. Too much at once, and the explanatory effect backfires.

Multimodal approaches also help enormously: captions, audio alternatives, voice assistants. What was intended for people with visual and hearing impairments also helps here. The principle behind this is called the Curb Cut Effect – curb cuts were built for wheelchair users and are used by everyone today.

5. Code and Implementation: Accessibility Starts in the Backend

That sounds technical – and it is. But the point is important: Accessible design ultimately fails if the underlying code isn’t right. Semantically correct HTML, clean structures, and tested compatibility with assistive technologies – these are the foundations on which everything else rests.

And then there’s the methodological approach: rapid prototyping with real users. People with cognitive impairments often cannot articulate their needs in interviews – but you can observe what works and what doesn’t. This is a bit more involved than a standard usability test. It’s still worth it.

The Honest Assessment

Complete accessibility for all people with all types of cognitive impairments – that is not achievable. That sounds harsh, but it’s important to understand. The target group is too diverse, the needs too varied, some content too complex. That’s not a failure – it’s reality.

What follows from this: Accessibility is not a state you reach once and then check off the list. It is a process. And the most important question is not “Have we met all the requirements?” but “For whom will things improve if we make this change?”

Furthermore: There is still far too little research in this area. Especially regarding visual explanatory elements – that is, how exactly images, icons, and graphics can support cognitive accessibility – there is a lack of empirical foundations. Please consider this an invitation to anyone interested in exploring this topic.

What I’m Taking Away – And What You Can Take Away

The four words that sum up how digital products should be designed – aand my seminar paper in a nutshell – are: short, clear, consistent, error-tolerant.

These four principles don’t just make digital offerings more accessible to people with cognitive impairments. They make them better – for everyone. For someone using the website on their phone while on the bus. For someone who is tired. For someone visiting this site for the first time. For someone who doesn’t speak the language perfectly.

I believe accessibility isn’t an extra feature. It’s good design.

And once you start thinking that way, your approach to products changes. Not as a checklist to be ticked off. But as a mindset: Who am I excluding right now – and what can I do about it?

The answers are often simpler than you think. You just have to start asking. And, as always: progress before perfection.