diff --git a/issue-papers/Conversational-Voice-Systems.html b/issue-papers/Conversational-Voice-Systems.html index 56993355..cfa89cfd 100644 --- a/issue-papers/Conversational-Voice-Systems.html +++ b/issue-papers/Conversational-Voice-Systems.html @@ -1,6 +1,6 @@ - Cognitive Accessibility Research Modules - Voice Systems and Conversational Interfaces + <title>Cognitive Accessibility Research Modules — Voice Systems and Conversational Interfaces @@ -132,24 +132,22 @@ designers, content creators, and developers who wish to have a more in-depth understanding of inclusion issues. -

Note that these modules focus on explaining the issues that lead to diverse user needs impacting web accessibility. For this reason, they may sometimes address a broader scope than web accessibility alone.

- -

This document is part of a set of modules that describe accessibility issues for users with various disabilities that impact cognitive accessibility. See cognitive or learning disabilities research modules for other modules.

-

This document is part of a set of related informative publications from the Cognitive and Learning Disabilities Accessibility Task Force (COGA TF), a joint task force of:

+

Note that these modules focus on explaining the issues that lead to diverse user needs impacting web accessibility. For this reason, they may sometimes address a broader scope than web accessibility alone.

+

This document is part of a set of modules that describe accessibility issues for users with various disabilities that impact cognitive accessibility. For other modules, see Cognitive Accessibility Issue Papers.

+

This document is part of a set of related informative publications from the Cognitive and Learning Disabilities Accessibility (COGA) Task Force, a joint task force of the:

-

This is an early draft. The task force intends to add more research and discussion and make editorial changes to comply with our style guide, including for citations. Please share your feedback, including any research we should consider adding to this document.

-

This document is part of a set of modules or papers that describe accessibility issues for users with various disabilities that impact cognitive accessibility. See cognitive or learning disabilities research modules for other modules.

-

This document is part of a set of related informative publications from the Cognitive and Learning Disabilities Accessibility Task Force (COGA TF), a joint task force of:

+

This document is part of a set of modules or papers that describe accessibility issues for users with various disabilities that impact cognitive accessibility. See cognitive or learning disabilities research modules for other modules.

+

This document is part of a set of related informative publications from the Cognitive and Learning Disabilities Accessibility (COGA) Task Force , a joint task force of:

-

To comment, file an issue in the W3C coga GitHub repository . You can also send an email to public-coga-comments@w3.org ( comment archive ). Comments are requested by 15th April 2026. In-progress updates to the document may be viewed in the publicly visible editors' draft .

+

To comment, file an issue in the W3C coga GitHub repository. Create a separate GitHub issue for each topic, rather than commenting on multiple topics in a single issue. It is free to create a GitHub account to file issues. You can also send an email to public-coga-comments@w3.org (mail archive of previous comments). The deadline for comments is 16 February 2026.

+

In-progress updates to the document may be viewed in the publicly visible Editor's Draft.

+

This document was produced by groups operating under the W3C Patent Policy. The group does not expect this document to become a W3C Recommendation. W3C maintains a public list of any patent disclosures (Cognitive and Learning Disabilities Accessibility Task Force), a public list of any patent disclosures (Accessible Platform Architectures Working Group), and a public list of any patent disclosures (Accessibility Guidelines Working Group) made in connection with the deliverables of each group — these pages also include instructions for disclosing a patent. An individual who has actual knowledge of a patent which the individual believes contains Essential Claim(s) must disclose the information in accordance with section 6 of the W3C Patent Policy.

+

This document is governed by the 18 August 2025 W3C Process Document.

Introduction

@@ -213,7 +214,7 @@

Disabilities that may require cognitive accessibility support

Examples of specific disabilities that may require cognitive accessibility support include attention deficit hyperactivity disorder (ADHD), autism spectrum disorder, dyslexia, dyscalculia, mild cognitive impairment (MCI), Down syndrome, aphasia, and others.

-

Cognitive accessibility also supports benefit a broad range of users, including:

+

Cognitive accessibility also benefits a broad range of users, including:

-

It is worth noting that many crucial systems integrate voice systems and conversational interfaces, including emergency notifications, healthcare scheduling, prescription refilling, and more. With this in mind, full accessibility needs to be supported.

-

An example use case of a voice system used in telephone self-service may be as follows:

+

It is worth noting that many crucial systems integrate voice systems and conversational interfaces, such as emergency notifications, healthcare scheduling, and prescription refilling. With this in mind, full accessibility needs to be supported.

+

The following is an example of a use case for a voice system used in telephone self-service:

-

An example use case for a conversational interface may be as follows:

+

The following is an example of a use case for a conversational interface:

Voice systems are often implemented with the W3C VoiceXML 2.0 [[voicexml20]] standard and supporting standards from the Voice Browser Working Group . [[VBWG]]

@@ -254,7 +255,7 @@

Voice systems and conversational interfaces

address a broader scope than web accessibility alone.

-

Challenges for People with Disabilities that Impact Cognitive Accessibility

+

Challenges for people with disabilities that impact cognitive accessibility

Voice systems and conversational interfaces can create a number of cognitive accessibility barriers. These technologies can create challenges due to heavy demands on memory and on the ability to understand and produce speech in real time. In particular, voice systems and VUIs can be inaccessible to people with disabilities that affect:

-

General Concerns

+

General concerns

Voice systems and conversational interfaces depend on the users’ knowledge and abilities. Many groups fall outside the norm in these categories. In these cases, the system often fails.

Training and artificial intelligence (AI): User groups in this module's scope often have different speech patterns, vocabulary, impaired memory, executive function, and cognitive function.

For the system to work well, it must be trained with a set of training content where different abilities and impairments are well represented. This includes long-term impairments such as mild cognitive impairment (MCI), learning disabilities, intellectual disabilities, and mood disorders, as well as temporary disabilities such as stress.

Requirements, user needs, and functional needs: Similarly, when teams use user needs and functional needs in the product lifecycle, they often focus on peers or groups with biases in terms of cognitive abilities. For example, university students are often used for focus groups, but often do not represent cognitive and speech issues associated with aging. It is essential to include user needs from a diverse perspective beyond neurotypical audiences (See User Story and User Needs .)

Testing: It is also essential to test with a wide group of users with diverse cognitive abilities to determine whether the system actually works as intended. Watch for increased levels of frustration, errors, and worsening of the users’ mood.

-

Memory: Recalling and Responding to Prompts

+

Memory: Recalling and responding to prompts

General: The user needs to recall information to successfully interact with the system, such as activating phrases, as well as information presented by the system during the interaction.

Voice Menu Systems: Menus that present several choices at once may pose challenges for users with disabilities related to working memory. Such systems require users to hold multiple pieces of information, such as the number associated with an option, while processing the terms that follow. This is true of systems that require either a voice response or a key press.

Many designers assume that users can remember lists of about seven items. This assumes a typical working memory. People with impaired working memory can hold significantly fewer items simultaneously. As a result, they may not be able to use a system that requires them to compare items or remember numbers while processing words or directions.

@@ -300,32 +301,32 @@

Memory: Recalling and Responding to Prompts

For example, the instruction “to speak to a nurse, press 2” stands by itself and does not require remembering anything before or after. Pausing between “to speak to a nurse” and “press 2” gives users time to decide if they want to speak to a nurse before they are given the rest of the instructions. The order of the instruction is important, and so is the pacing. The goal is to give users time to process the prompt and reduce the need for memory.

Voice User Interfaces: For VUIs, users may be required to remember key phrases (such as activating phrases like “Hey, Google”) in order to operate successfully. Users who have difficulty recalling such phrases due to long-term memory impairments may not be able to operate the system.

-

Executive Function: Deciding When to Respond

+

Executive function: Deciding when to respond

General: If a system response is too slow, a user with disabilities related to executive functioning may not know if their input was received and may press the key or speak again.

Voice Menu Systems: The user needs to be able to decide when to act on a menu choice. If the user does not know how many options will be presented or if the system presents them too slowly, the user may make an incorrect choice based on partial information.

-

Reasoning: Making the Correct Selection

+

Reasoning: Making the correct selection

Voice Menu Systems: The user may need to compare similar options such as "billing," "accounts," and "sales," and decide which one is best suited to accomplish their goal. Without additional context or prior knowledge, the user is likely to select the wrong menu option.

-

Knowledge: Interpreting Responses

+

Knowledge: Interpreting responses

General: If responses produced by a system are not provided in clear and accessible language, the user may have difficulty interpreting them. The user may not understand the response or know if they are using the system correctly.

-

Processing Speed

+

Processing speed

General: Systems that time out may not give users with disabilities that affect processing speed sufficient time to interpret information and formulate a response. Advertisements and additional, unrequested information also increase the amount of processing required.

-

Attention: Making Correct Selections

+

Attention: Making correct selections

Voice Menu Systems: The user needs to focus on the different options and select the correct one. It can be challenging to focus on long or multi-level spoken menus without written counterparts. Advertisements or other unrequested information may also make it harder for users with attention-related disabilities to stay focused on the task they are trying to complete.

-

Language and Auditory Perception: Correctly Interpreting Spoken Information

+

Language and auditory perception: Correctly interpreting spoken information

General: The user needs to interpret the terms and choose the one that most closely matches the user’s goal. This involves speech perception, language understanding, and time limits. The sounds of language need to be heard, interpreted, and understood within a given time.

Users with disabilities related to language and auditory perception may make mistakes in interpretation due to auditory-only input.

-

Speech and Language Production: Responding to Voice and Speech Recognition Systems

+

Speech and language production: Responding to voice and speech recognition systems

We identified three issues to consider that apply to all kinds of voice systems or conversational interfaces:

Timeouts: The user needs to formulate a spoken response to the prompt before the system "times out" and generates another prompt. For example: Users of assistive and augmentative communication devices (AAC) or speech-to-speech technologies may require significant additional time to respond before the system times out.

Spontaneous speech: In directed dialog systems that guide the user through a series of predefined questions and responses, the user only needs to be able to speak a word or short phrase. However, the increasing use of natural language systems means the user may need to describe their issue in their own words. This feature is an advantage for some users because it does not require them to remember menu options. But it can be problematic for users with disabilities that impact their ability to produce spontaneous speech, such as people with aphasia or autistic people for whom stress may impact spoken communication.

Speech recognition: Speech recognition systems might not work well for people whose speech sounds different. Users may not be able to interact with a system that requires verbal input but does not recognize their speech. This affects many groups such as users with MCI or Down syndrome.

-

Mental Health: Interacting with Voice Systems and Conversational Interfaces

+

Mental health: Interacting with voice systems and conversational interfaces

General: Mental health, such as anxiety, may also impact a user’s ability to interact with voice systems or conversational interfaces. High demands on cognitive load, negative experiences with technology, and interruptions can exacerbate anxiety or frustration, and decrease a user’s ability to interact with a system. Note that many people requiring cognitive accessibility supports find their skills are reduced as anxiety and cognitive load increases.

-

User Story and User Needs

+

User story and user needs

This list of user needs is not complete. We are also seeking feedback on the format for presenting user needs.

In the next version, we will cross-reference this section with the user needs in Making Content Usable for People with Cognitive and Learning Disabilities. New user needs that are identified in this research module will be included in the next version of Making Content Usable for People with Cognitive and Learning Disabilities.

As a user who has cognitive accessibility needs, I need to get human help, without going through a complex menu system (VoiceXML [[voicexml30]]) or a complex voice recognition menu system that relies on memory and executive function , so that I can set an appointment or find out some information.

@@ -405,7 +406,7 @@

Related user needs

I need to know what the next steps are and when I am finished. -

Related Personas

+

Related personas

Other numbers can be used for special actions too, but there shouldn’t be too many—too many rules can be confusing and hard to remember. Also, repeating these options too often can be distracting.

Human help should be trained to support users with disabilities. Too often, human help places users back into the system they did not manage.

-

Allow Users To Change Settings

+

Allow users To change settings

Make it easy to set user preferences when available, such as adjusting the settings by using natural language ("Slow down!"). Examples of customization include:

  1. @@ -459,11 +460,11 @@

    Allow Users To Change Settings

    Consider customizable voices, including regional and standard accents, to create familiarity for the user.
-

Simplify Error Recovery

+

Simplify error recovery

Error recovery should be simple and take the user to a human operator. Error response should not end the interaction or lead to a more complex menu. Keypad or telephone-based systems should use a reserved digit to help with error recovery. Example: Setting a default for a human operator as the number 0.

-

Design Prompts to Reduce Cognitive Load

+

Design prompts to reduce cognitive load

Give prompts in ways that reduce the cognitive load. For example, the prompt "press 1 for the help desk," requires the user to remember the digit 1 while interpreting the term “help desk.” This wording is harder to process than the prompt "for the help desk (pause): press 1" or "for the help desk (pause) or for more help (pause): press 1."

-

Remove Unnecessary Words

+

Remove unnecessary words

Avoid additional information such as special offers or extra text that does not support the task directly. For example, the following sentences can cause anxiety or add to the users’ cognitive load:

-

Ensure Voice and Speech Recognition for All Users

+

Ensure voice and speech recognition for all users

Natural language understanding (NLU) or natural language interpretation (NLI) and AI systems allow users to state their requests in their own words, which can help users who have difficulty remembering menu options or mapping the menu options to their goals. However, the following should be taken into account:

  1. diff --git a/issue-papers/Online-Safety-and-Wellbeing.html b/issue-papers/Online-Safety-and-Wellbeing.html index 45888edd..23411ccd 100644 --- a/issue-papers/Online-Safety-and-Wellbeing.html +++ b/issue-papers/Online-Safety-and-Wellbeing.html @@ -101,7 +101,7 @@

    Abstract

    -

    Internet use and apps can create a number of risks for people requiring cognitive accessibility. This module/paper covers safety issues for these users, including cybercrime, mental health, wellbeing, privacy, and more.

    +

    Internet use and apps can create a number of risks for people requiring cognitive accessibility. This module covers safety issues for these users, including cybercrime, mental health, wellbeing, and privacy.

    This module:

    • @@ -127,16 +127,25 @@

      Abstract

      designers, content creators, and developers who wish to have a more in-depth understanding of inclusion issues.
    -

    Note that these modules focus on explaining the issues that lead to diverse user needs impacting web accessibility. For this reason, they may sometimes address a broader scope than web accessibility alone.

    +

    This document is part of a set of modules that describe accessibility issues for users with various disabilities that impact cognitive accessibility. For other modules, see Cognitive Accessibility Issue Papers.

    +

    Note that these modules focus on explaining the issues that lead to diverse user needs impacting web accessibility. For this reason, they may sometimes address a broader scope than web accessibility alone.

    -

    This document is part of a set of related informative publications from the Cognitive and Learning Disabilities Accessibility Task Force (COGA TF), a joint task force of the Accessible Platform Architectures Working Group (APA WG) and the Accessibility Guidelines Working Group (AG WG) of the Web Accessibility Initiative.

    +

    This document is part of a set of related informative publications from the Cognitive and Learning Disabilities Accessibility (COGA) Task Force, a joint task force of the:

    +
    -
    - -

    This section describes the status of this document at the time of its publication. Other documents may supersede this document. A list of current W3C publications and the latest revision of this technical report can be found in the W3C technical reports index at https://www.w3.org/TR/.

    -

    This is an early draft. The Task Force intends to add more research and improved discussion.

    -

    Feedback on any aspect of the document is accepted. For this publication, the Working Groups particularly seek feedback on the following questions:

    +
    +

    Status of This Document

    +

    This section describes the status of this document at the time of its publication. Other documents may supersede this document. A list of current W3C publications and the latest revision of this technical report can be found in the W3C technical reports index at https://www.w3.org/TR/.

    +

    This is an early draft. The COGA Task Force intends to add more research and discussion, and make editorial changes to comply with our style guide, including for citations. Please share your feedback, including any research we should consider adding to this document.

    +

    Feedback on any aspect of the document is welcome. The AG and APA working groups particularly seek feedback on the following questions:

    • Are issues for the included user groups well covered? @@ -181,22 +190,22 @@

      Abstract

      mental health disabilities, and
    • - temporary impairments that affect cognitive function, such as anxiety, illness, effects of medication, treatments such as chemotherapy and others. + temporary impairments that affect cognitive function, such as anxiety, illness, effects of medication, and treatments such as chemotherapy.
    -

    Examples of specific disabilities include attention deficit hyperactivity disorder (ADHD), autism spectrum disorder, dyslexia and dyscalculia, mild cognitive impairment (MCI), Down syndrome, asphasia, and others. +

    Examples of specific disabilities include attention deficit hyperactivity disorder (ADHD), autism spectrum disorder, dyslexia and dyscalculia, mild cognitive impairment (MCI), Down syndrome, and asphasia.


    People with disabilities that require cognitive accessibility support can benefit from using the internet. However, there are risks as all users are at risk of experiencing activities like fraud, terrorism, extortion, harassment and hacking.These activities are collectively referred to as cybercrime [[RM-hökby1]].

    Examples of cybercrime include:

    • - Hackers steal someone’s identity, information or money without the user being aware of what is happening. + hackers stealing someone’s identity, information or money without the user being aware of what is happening,
    • - Con Artists or cheats misleading people into giving them information or sometimes money. + con artists or cheats misleading people into giving them information or sometimes money, and
    • - Sexual predators using the Internet to identify vulnerable people and exploit them, either online or offline. + sexual predators using the internet to identify vulnerable people and exploit them, either online or offline.

    People with cognitive and learning disabilities are at higher risk and may be unable to take the recommended safety precautions.

    @@ -207,16 +216,16 @@

    Abstract

    This module focuses on explaining the issues that lead to diverse userneeds impacting web accessibility. For this reason, it may sometimes address a broader scope than web accessibility alone.

    -

    Safety Issues for People with Cognitive disabilities

    +

    Safety issues for people with cognitive disabilities

    Cybercrime

    Potentially rewriting this section to focus on the issues on development end that lead to risk/vulnerabilities.

    Hackers and Identity Theft

    People with cognitive and learning disabilities may not be able to easily use some of the common security measures used on the Web such as two-factor authentication and complex, unique passwords for each login [[RC-ophoff1]].

    Extra security precautions to increase password strength often make this group more vulnerable to "human error". This can encourage risky behavior such as keeping a list of passwords on a desk that can be viewed by anyone with physical access to the room. Also, when users ask for assistance to complete these security procedures, they can put themselves at high risk of being abused by those they trust to help.

    -

    Con Artists and Deception

    +

    Con artists and deception

    These cyber-criminals use deception to gain trust. This enables them to negatively influence the behavior of vulnerable individuals. People with cognitive and learning disabilities who experience difficulty understanding social cues may fail to accurately identify a potentially harmful situation. Those who have difficulty understanding others may be more trusting and more easily believe false information. Also, people with disabilities affecting reasoning, attention or memory may be similarly vulnerable to these situations, as they may struggle to validate presented information.

    -

    Sexual predators and Physical Safety

    +

    Sexual predators and physical safety

    People with cognitive and learning disabilities may be more at risk of being a victim of a sexual crime. Some potential reasons for this include:

    • @@ -232,17 +241,17 @@

      Sexual predators and Physical Safety

      they are less likely to identify unreasonable requests.
    -

    Data, Algorithms and privacy

    +

    Data, algorithms and privacy

    Personalization

    Personalization is important, especially as a way to avoid conflict when meeting varying user needs. However, there is a significant risk that if poorly implemented, user information and vulnerabilities can be exposed. This puts the most vulnerable users of this population at the greatest risk.

    -

    Algorithms and Privacy

    +

    Algorithms and privacy

    Algorithms are computer programs that try to solve a specific problem or achieve a goal. (Goals are set by the programmers and company they work for). Currently, computer algorithms are increasingly responsible for automated decision-making. These decisions use information from tracking our everyday behaviors online and via apps. This data is often sold to or used by companies, including organizations providing critical services such as employment, health care, and credit.

    This creates multiple problems. Many users know that they are at risk of scams and data misuse, and are therefore afraid of using digital services that they may need. All users in a recent study had concerns about privacy and their data being inappropriately shared [[RM-rotondi1]].

    The misuse of algorithms has the potential to cause financial harm to people with cognitive and learning disabilities and mental health conditions. As an example, a patent could be filed that included an algorithm that could help financial institutions analyze a person's social network and use that data with regard to granting a person's loan application. [[RM-oneil1]]

    People with cognitive and learning disabilities may be vulnerable to risks related to algorithms and big data. This includes errors and biases in the algorithm and problems with privacy [[RC-venkit1]] [[RC-moura1]] [[RM-monteith1]].

    In another use case, Internet of things (IoT) devices are involved more and more in providing medical care. This can include support for mental illness and cognitive support. Massive amounts of data from as many digital activities through devices as possible are collected. This erodes people's knowledge of what is public, as much of this data is done in homes and other private settings. This data is then used to drive decisions such as loans, insurance coverage, and more. Privacy becomes more important for individuals with mental health diagnoses and cognitive disabilities, especially where there is prejudice and stigma [[RM-monteith1]].

    For example, people who are victims of domestic violence may avoid putting their picture online because they do not want to be easily found, but automated programs for job applications may be biased against profiles without a picture.

    -

    Social media and Mental Health

    +

    Social media and mental health

    This section focuses on research from the Mental Health subgroup. More research is needed on social media and cognitive and learning disabilities.

    Prolonged time spent on social media platforms appears to contribute to increased risk for a variety of mental health symptoms and poor wellbeing. This may partly be driven by the detrimental effects of screen time generally on mental health. Research suggests social media usage can cause increased severity of anxiety and depressive symptoms [[RM-hardy1]].

    Recent studies have reported negative effects of social media use on mental health of young people particularly. Negative outcomes include social comparison pressure with others (sometimes called social media envy), rumination, depressive symptoms, anxiety, greater feeling of social isolation after being rejected by others on social media, and body image issues (especially in teens) [[RM-ang1]][[RC-karim1]].

    @@ -256,7 +265,7 @@

    Social media and Mental Health

    It is also worth noting that many of the studies reviewed were scientifically weak. For example, studies often have small samples, effects that are not scientifically significant, or show correlation rather than causality. For example, the correlation between social media use and mental health issues may be that users use social media to help with mental health issues. More robust research is needed in this area in order to develop solutions that enable use with less risk [[RC-odgers1]].

    Longevity of posts

    Further, people have reported (in response to this paper) that they are afraid of other long term consequences of posting online. For example, if they post about their disability (mental health issues), or if their posts are considered inappropriate or imply health issues, then they worry that it can be used against them or to harm them after recovery has started.

    -

    Algorithms, AI (Artificial Intelligence) and Curated Content

    +

    Algorithms, AI (artificial intelligence) and curated content

    Editor’s Note: This section focuses on research from the Mental Health subgroup. More research is needed on AI and curated content and cognitive and learning disability.

    Algorithms and artificial intelligence can make all the above issues worse.

    Artificial intelligence (AI) and cognitive computing can empower algorithms by learning. This includes learning the individual users' behaviors. For example, an algorithm may have a goal to increase the time the user spends on a web site or application. AI could then continuously adapt the algorithm to be more effective for each individual user. In our example they will be learning what makes you more likely to click on a link. Unfortunately, this is often anger, fear, and other negative emotions. This may have two main effects on the mental health of the user:

    @@ -289,7 +298,7 @@

    Poor Representation in Data Sets

    Additionally, as discussed above, many people do not use apps for mental health services and cognitive support due to concerns about how their data is used and whether mental health information will be kept private. Other reasons include the complexity and frustration experienced when these apps are not designed with cognitive learning and emotional disabilities in mind [RM-Lipschitz1]].

    -

    User Story and User Needs

    +

    User story and user needs

    This list of user needs is not complete. We are also seeking feedback on the format for presenting user needs.

    In the next version, we will cross-reference this section with the user needs in Making Content Usable for People with Cognitive and Learning Disabilities. New user needs that are identified in this research module will be included in the next version of Making Content Usable for People with Cognitive and Learning Disabilities.

    @@ -376,8 +385,8 @@

    Ease of personalisation

    -

    Supported decision making

    -

    Supported decision making (SDM) are functions that help people with disabilities make decisions as independently as possible whilst staying safe. This includes choosing helpers to help them make choices. See links including;

    +

    Supported decision-making

    +

    Supported decision-making (SDM) are functions that help people with disabilities make decisions as independently as possible whilst staying safe. This includes choosing helpers to help them make choices. See links including;

    • Supported Decision-making diff --git a/issue-papers/Supported-Decision-Making.html b/issue-papers/Supported-Decision-Making.html index ec01dfb7..42f0e437 100644 --- a/issue-papers/Supported-Decision-Making.html +++ b/issue-papers/Supported-Decision-Making.html @@ -2,7 +2,7 @@ Cognitive Accessibility Research Modules -- Supported Decision-Making Online +— Supported Decision-Making Online @@ -104,7 +104,7 @@

      Supported decision-making (SDM) is a person-centered approach that empowers individuals with disabilities to make their own choices with the help of trusted supporters. Rather than substituting decision-making authority, SDM emphasizes autonomy, dignity, and inclusion in everyday life. This module introduces the principles and practices of SDM, highlighting its legal, ethical, and practical implications. Participants will explore how to implement SDM in ways that respect individual rights and foster independence.

      -

      This module explores:

      +

      This module:

      • identifies the need for supported decision-making online, @@ -134,17 +134,17 @@ designers, content creators, and developers who wish to have a more in-depth understanding of inclusion issues.
      -

      Note that these modules focus on explaining the issues that lead to diverse user needs impacting web accessibility. For this reason, they may sometimes address a broader scope than web accessibility alone.

      - -

      This document is part of a set of related informative publications from the Cognitive and Learning Disabilities Accessibility Task Force (COGA TF), a joint task force of:

      +

      Note that these modules focus on explaining the issues that lead to diverse user needs impacting web accessibility. For this reason, they may sometimes address a broader scope than web accessibility alone.

      +

      This document is part of a set of modules that describe accessibility issues for users with various disabilities that impact cognitive accessibility. For other modules, see Cognitive Accessibility Issue Papers.

      +

      This document is part of a set of related informative publications from the Cognitive and Learning Disabilities Accessibility (COGA) Task Force, a joint task force of the:

      +
    @@ -200,28 +200,24 @@

    Introduction / Summary

    -

    Supported Decision-Making (SDM) is a model that provides human or technological assistance to a person with a disability making a choice. Supported Decision-Making (SDM) allows individuals with disabilities to make choices about their own lives with support from people they choose.

    -

    Features typically include:

    +

    Supported decision-making (SDM) is a model that provides human or technological assistance to a person with a disability making a choice. SDM allows individuals with disabilities to make choices about their own lives with support from people they choose.

    +

    SDM typically includes the following features:

    • - The user remains the decision-maker.
      They are the one making the final choice, not the care giver or a legal guardian. Note that the user may sometimes elect to delegate decision-making in limited circumstances. + The user remains the decision-maker: The person with the disability is the one making the final choice, not the caregiver or a legal guardian. (Note: The user may sometimes elect to delegate decision-making in limited circumstances.)
    • - Helpers and support clarify and explain options, helping weigh risks and benefits, or assisting with communication (for example, through alternative and augmented communication, easy-to-understand content, clear format, etc.). + Helpers and support systems clarify and explain options:: These help weigh risks and benefits, or assist with communication (for example, through alternative and augmented communication, easy-to-understand content, and clear format).
    • - The support is tailored to the user.
      With supported decision-making (SDM) a person should be able to customize the level and type of support they want and stay in control of their decisions. It respects the person's preferences, even if their decisions are unconventional. For example, a person with dyscalculia may choose for unusual financial decisions to go via a support person. They may change the support person at any time.
    + The support is tailored to the user: With SDM a person should be able to customize the level and type of support they want, and to stay in control of their decisions. SDM respects the person's preferences, even if their decisions are unconventional (for example, a person with dyscalculia may choose to have unusual financial decisions made via a support person). The user may change their support person at any time.

    Supported decision-making is often not provided on the internet or apps.

    This module describes the advantages and risks in providing SDM online. It includes suggestions so that supported digital decision-making can safely allow more people to participate in the digital world while maintaining dignity and autonomy.

    There are Technology and digital communication can enable SDM in two main areas:

      -
    1. -Enabling helpers to support online decisions, by sharing the process involved in high risk decisions.
    2. -
    3. - Technology and digital communication can also take some of the role or work involved in supported decision-making. For example, clearly presenting options in a table, and in plain language. - -
    4. +
    5. Enabling helpers to support online decisions, by sharing the process involved in high-risk decisions.
    6. +
    7. Taking some of the role or work involved in supported decision-making (for example, clearly presenting options in a table, and in plain language).

    The examples and strategies in this paper may apply to people who are or are not their own guardians. Having a legal guardian does not mean that a person is not able to or interested in using the internet. However, this module is about how to integrate support, often from a helper, whilst enabling the user to stay in control.

    This module focuses on explaining the issues that lead to diverse user needs impacting web accessibility. For this reason, it may sometimes address a broader scope than web accessibility alone.

    @@ -232,7 +228,7 @@

    Disabilities that may require SDM

    cognitive, developmental, intellectual, learning, and specific learning disabilities,
  2. - language and communication disorders,> + language and communication disorders,
  3. neurodivergence, @@ -247,7 +243,7 @@

    Disabilities that may require SDM

    mental health disabilities, and
  4. - temporary impairments that affect cognitive function, such as anxiety, illness, effects of medication, treatments such as chemotherapy, and others. + temporary impairments that affect cognitive function, such as anxiety, illness, effects of medication, and treatments such as chemotherapy.
  5. Examples of mental health issues include: Bipolar disorder, low impulse control, psychotic disorders and others.

    @@ -270,7 +266,7 @@

    Target Audience

-

Examples of Supported Decision-Making (SDM) Online

+

Examples of supported decision-making (SDM) online

Currently, there are some tools for supported decision-making online.

These include:

    @@ -287,7 +283,7 @@

    Examples of Supported Decision-Making (SDM) Online

    Supportive tools that help organize and support people and the helpers. There can be apps or just a template. This is well-developed in addiction recovery.

Note, that we have not included parental controls, as such tools typically do not support the dignity and autonomy of adult users with disabilities. However, they may be refactored in a way to be useful in the future.

-

Customizable supported design-making is when the level of support can change. (It is usually set by the user.) For example, the user can set a desired level of support. They can set it so the helper has view only permissions and receives notifications about high risk activity.

+

Customizable supported design-making is when the level of support can change. (It is usually set by the user.) For example, the user can set a desired level of support. They can set it so the helper has view only permissions and receives notifications about high-risk activity.

This allows a helper to provide support, but not take control.

More intrusive setting might include:

-

Challenges Faced by People Needing Cognitive Accessibility Support and Mental Health Assistance Face When Making Decisions Online

+

Challenges faced by people needing cognitive accessibility support and mental health assistance when making decisions online

Being online results in many risks to the user that can be reduced via SDM. Some examples of them are:

-

Informed Consent Online

+

Informed consent online

In many cases online the user “agrees” terms or a situation without being able to understand them or being in a mental position to agree. Nonetheless, it can be difficult or impossible to retract. For informed consent or informed assent there is a basic need for the person to understand the information.

Accessibility of digital formats is also important for both informed consent and informed assent as is enabling the use of assistive technology.

-

Spending and Emotional Regulation

-

Cognitive learning and Mental health conditions often impact spending [[RC-M1]]. Further frustration from difficult interfaces can also cause stress and impair decision-making. When under stress, people can become more impulsive. Research on decision-making under stress shows a change towards fast intuitive decision-making over slow logical or analytical process in making decisions. Emotional regulation may also decrease how people act on line, and make their reactions more extreme. [[RC-IG1]]

-

Appropriate Sharing

+

Spending and emotional regulation

+

Cognitive learning and mental health conditions often impact spending [[RC-M1]]. Further frustration from difficult interfaces can also cause stress and impair decision-making. When under stress, people can become more impulsive. Research on decision-making under stress shows a change towards fast intuitive decision-making over slow logical or analytical process in making decisions. Emotional regulation may also decrease how people act on line, and make their reactions more extreme. [[RC-IG1]]

+

Appropriate sharing

Cases have been reported where impairments in decision-making and emotional regulation have caused people to share information about family, friends, room mates etc that is personal in nature and violates the subject's privacy.

-

Longevity of Content and Recovery

+

Longevity of content and recovery

Further, people have reported (in response to this paper) that they are afraid of other long-term consequences of posting online. For example, if they post about mental health issues, or if their posts are considered inappropriate or imply health issues, then that can be used against them or to harm them after recovery has started.

Note that even after the user removes the original post, shared version or saved versions may persist.

Safety

@@ -417,7 +413,7 @@

Informed Consent In SDM Solu
  • May need to re-collect consent when the organization changes the way they work or use the information. (Sometimes this is legally required.)
  • -

    Accessibility of Terms

    +

    Accessibility of terms

    Efforts should be made to ensure that terms are accessible to all. These include:

    -

    Principles for Supported Decision-Making

    +

    Principles for supported decision-making

    Researchers have identified four dimensions for reasoned and responsible design in decision-making:

    1. @@ -550,7 +546,7 @@

      Supported Decision-Making as a Feature

      One of the strengths of SDM is that it can be customized by the user. For example, someone might choose a trusted person, called a “helper”, to support them. The user stays in charge and decides how much access that helper has. Some people may want their helper to give advice only. While others may want their helper to be able to cancel a decision or require approval before continuing.

      By including supported decision-making features, organizations can create safer, more inclusive digital experiences while building greater trust with their customers.

      The following proposed solution aims to allow more users to participate in online activities, support the principles of supported decision whilst making with minimal or no cost to the users dignity or autonomy.

      -

      Cognitive Support

      +

      Cognitive support

      A good design can add cognitive support, and help people understand the options,and make the best decision for them. Making Content Usable for People with Cognitive and Learning Disabilities at https://www.w3.org/TR/coga-usable/ has many design patterns that help. For example:

      Clear presentation helps decision-making.

      Make it easy for the user to see what they hard to know what you are agreeing too - with risks identified and separation of each option:

      @@ -571,7 +567,7 @@

      Cognitive Support

      For example, a user may have an impaired short-term / working memory. They can not remember many items at the same time. A clear layout of options can help someone who has a short-term memory can see all the advantages and disadvantages without having to remember them.

      A good layout can help users see what options are and make a decision.

      This can include using a table or bulleted list, simple language, and good use of color and white space.For example, a clear layout of options can help someone who has a short-term memory can see all the advantages and disadvantages without having to remember them.

      -

      Example 1 - Table showing main points for each option before booking

      +

      Example 1: Table showing main points for each option before booking

      Summary of this hotel option

      @@ -731,7 +727,7 @@

      Summary of this hotel option

      -

      Example 2 - if / then table

      +

      Example 2: If/then table

      Welcome to our companies job applications page

      How to apply @@ -797,7 +793,7 @@

      Example 2 - if / then table

      If you want to work in programming, write to programing@example.com with a resume and sample code that you wrote. If you want to work in design, write to design@example.com with a resume and sample pages.

    2. -

      Confirming Understanding

      +

      Confirming understanding

      Cognitive tests can be added that confirm the user understands what they are agreeing to.

      Note that this is not a simple yes or no option. This involves the user demonstrating understanding the terms.

      Can I leave at any time?

      @@ -812,7 +808,7 @@

      Confirming Understanding

      No - I can not opt out. -

      Finance and Spending

      +

      Finance and spending

      Supported Decision Making allows users to consistently make decisions, despite difficulties with emotion regulation and other cognitive, learning and emotional challenges. For example, increased impulsivity, can make it harder to resist the temptation to spend. Businesses can support decision-making online by offering features like:

      Source: [[RC-YLS1]]

      -

      Legal and Privacy Requirements

      +

      Legal and privacy requirements

      All supported decision-making features must follow privacy and consent laws that apply to the type of services they offer and where they operate. In the U.S., this includes national laws like the Gramm-Leach-Bliley Act (GLBA) [[GLBA]], which says financial institutions must get permission before sharing a person’s private information. Other laws, like the Electronic Fund Transfer Act (EFTA, also known as Regulation E) [[EFTA]], protect people from unauthorized money transfers. Some state laws have additional rules about how and when consent must be given, especially for banking or healthcare features. In many states, businesses are also required to report suspected financial abuse or exploitation.

      Outside the U.S., laws like the European Union’s General Data Protection Regulation (GDPR) [[GDPR]] set strict rules on how personal data is collected, stored, and shared, and require clear, informed consent.

      This document does not provide legal advice, so organizations should check with legal experts to make sure they are meeting all the rules when supporting decision-making.

      -

      Social Media and Algorithm-Driven Content

      +

      Social media and algorithm-driven content

      Social media platforms and algorithm-based content feeds can present serious risks to people with cognitive and learning disabilities, especially when decision-making is affected by emotional regulation, impulsivity, or difficulty understanding consequences. Algorithms often promote engaging content that may not be safe or appropriate. Without the right support, these environments can lead to oversharing, impulsive purchases, extended screen time, or exposure to harmful interactions. See …Safety document ref

      Some of this section might be better in our Safety document. A review is needed to identify how this content can be included or referenced in both documents.

      Supported decision-making that can help people check themselves such as:

      @@ -856,7 +852,7 @@

      Social Media and Algorithm-Driven Content

      Note these features are only suggestions for further research or testing. They may not be effective.

    -

    Supported decision-making in the W3C, public private partnerships, and similar organizations.

    +

    Supported decision-making in the W3C, public private partnerships, and similar organizations

    This section focuses on how the W3C can address SDM, but the same principles and ideas can be adapted to other organizations with similar features such as: