This Wiki page is edited by participants of the Cognitive and Learning Disabilities Accessibility Task Force. It does not necessarily represent consensus and it may have incorrect information or information that is not supported by other Task Force participants, WAI, or W3C. It may also have some very useful information.

Gap Analysis/aphasia

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Note: This page is out of date. This page has been ported to the github version. If you have edits for this page please send them to the list or to Michael and Lisa.


To do: Write a short overview of the group to give readers a sense of context

Some useful links

Cognitive functions

Identify cognitive functions affected by aphasia

Aphasia is a communication disorder that impairs an individual's abilities to speak, write, read or understand speech, or a combination of these abilities. Aphasia is caused by brain damage due to stroke, injury, brain tumors or infections and can be mild to severe.


Symptoms of Aphasia

Inability to read, naming problems (finding the right word to refer to something), mis-articulated words, grammatical errors in speech, difficulty with numerical calculations, slow and effortful speech, inability to compose written language or inability to understand speech.

Their challenges

How symptoms result in challenges for people with aphasia

Language abilities affected by aphasia

Aphasia can affect any aspect of language -- reading, writing, speaking or listening, or combinations of these abilities. However, difficulty in reading is probably the symptom that most impacts use of the web, because most websites do not make heavy demands on the other language-related skills. Minimal writing, such as form-filling, is common on websites, but extensive writing, such as a product review or blog comment, is usually optional. Speaking is rarely required for interacting with a conventional website. It may be used in websites that support real-time human-human communication, but then a human is present who can make an extra effort to understand someone who doesn't speak fluently. Speaking, however, is often required in telephone voice applications. Using the keypad as an alternative to voice may also be difficult for some people with aphasia. Listening is required for websites where audio or video material is presented. Closed-captioning is not necessarily an option because many people with aphasia are unable to read. Many people with aphasia have some degree of hemiplegia, associated with the brain injury that affected their language. This means that using a mouse or keyboard can be difficult, so typing is not necessarily available as an alternative. In addition to difficulty reading text, some people with aphasia find certain websites confusing, for example, if there's too much material.

Variability of symptoms of aphasia

Another aspect of aphasia that impacts web accessibility is that the symptoms of aphasia vary considerably from person to person, and even in the same person from day to day. For example, some people with aphasia find that reading text for 15 or 20 minutes is ok, then the "brain shuts down". However, for some people reading is unaffected. Some people with aphasia can speak fairly well, but some don't talk at all. Specific aspects of reading might be differentially affected, for example, numbers, or people's names.

Some persona with use case that address key challenges

To do: Add persona and scenario

To do: Add table of ICT Steps and challenges.

Step Challenge

How they use the web and ICT to include: Email, apps, voice systems, IM

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Task Description
People with aphasia use the web to shop, get information, communicate with others, and be entertained. These tasks involve the language abilities affected by aphasia (listening, speaking, reading and writing), although to different extents. Tasks like shopping, getting information and being entertained typically heavily involve reading, with some writing required for form-filling. Communicating with others via email or social networking requires both reading and writing. People with aphasia who have difficulties with spoken language may find it hard to understand the audio tracks of videos. Speaking is very rarely required for interacting with a traditional website, so speaking difficulties are unlikely to impact web usage by people with aphasia. Telephone voice applications, on the other hand, are likely to be very difficult to use for people whose speech is affected.

How people with cognitive disabilities use optimized content and special pages

To do: Add examples with descriptions of features

Characteristics of content optimized for this group

Impairments in reading ability affect many aspects of web usage. We can separate reading tasks into reading multiple paragraphs of informative text and reading captions on form items. Paragraphs of informative text can be made easier to read through general techniques that improve readability, such as simpler language, well-structured layout and organization, use of white space, and typography that enhances legibility. Form filling also requires reading, but in a different way. The purpose of reading the caption on a form is to understand what the user has to do to provide the correct information for the form. Form captions need to be simple and clear. The user should be able to hear as well as see the caption on a form as needed, even repeating the audio several times if necessary. Well-designed icons can also supplement text and audio captions. The user should also be able to hear their own input, since some people with aphasia can write but not read.

Specific technologies (reference section below and how they use it differently)

Text to speech

Summary Existing research and guidelines

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Extent to which current needs are met

   To do: Review challenges and describe where needs are met. Identify gaps 

Potentials and possibilities

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Although estimating the prevalence of aphasia is difficult, especially in the developing world, aphasia is estimated to affect about 0.4 percent of the population. "This year 130,000 people in the UK will have a stroke. One-third of those who survive will have aphasia. Surprisingly, there are currently about 250,000 people with aphasia in the UK alone." - from

References to research.

 To do: Add section