Cognitive Impairment
Summary
A cognitive impairment is a person’s reduced ability to perform cognitive functions, such as understanding verbal or written language, solving mathematical problems, matching patterns, or making choices.
A cognitive impairment tends to mean that a person has more difficulty performing tasks that require thought than someone who does not have a cognitive impairment. Cognitive impairments manifest themselves in a multitude of ways.
Processing Verbal Language
This person does not necessarily have an audio impairment, but still has a reduced ability to process spoken or verbal language. This means that the person can hear you speaking perfectly, but what you say makes no sense.
Accommodations
- Some people with a reduced ability to process verbal language can process written language. Provide captioning as you would for someone with an audio impairment.
- Some people with a reduced ability to process verbal language cannot process written language, either. Provide alternative means of communication, such as gestures, diagrams or other pictures, to facilitate understanding.
Processing Written Language
This person does not necessarily have a visual impairment, but still has a reduced ability to process written language. This means that the person can see the written words, but the words as written do not make sense. This is not equivalent to a lack of education resulting in illiteracy.
Accommodations
- Some people with a reduced ability to process written language can process verbal language. Provide audio output as you would for someone with a visual impairment.
- Some people with a reduced ability to process written language cannot process verbal language, either. Provide alternative means of communication, such as gestures, diagrams, or other pictures, to facilitate understanding.
Problem Solving
This person has trouble solving problems, such as mathematical problems, logic problems, and puzzles. The person may be able to understand the content of the problem, but is unable to reach an answer to it. The person may be able to read "two plus two", but not be able to reach the answer: "four".
Accommodations
- Some people with a reduced ability to solve particular types of problems are able to solve other types of problems. For situations such as human identification (e.g., Captcha), provide alternative types of problems the person may solve.
Attention Span
This person has trouble concentrating on a single task long enough to complete it. This can also be a result of short-term memory loss. When this is combined with a reduced ability to process written language, lengthy sentences and paragraphs become huge obstacles to understanding written content.
- Keep sentences and paragraphs short. Use whitespace to clearly separate text into smaller blocks. Avoid complex sentence structures. Make paragraphs scannable.
- Break tasks down into small, manageable pieces. This depends on the sort of task being performed, but the person should not have to refer to a single instruction multiple times.
Short-term Memory Loss
This person has trouble remembering events in the immediate past. If the person needs to retain information from one part of a task to the next, the information must be readily visible, not requiring the person to look it up somewhere else.
Accommodations
- Keep sentences and paragraphs short. Use whitespace to clearly separate text into smaller blocks. Avoid complex sentence structures. Make paragraphs scannable.
- Break tasks down into small, manageable pieces. This depends on the sort of task being performed, but the person should not have to refer to a single instruction multiple times.
- If the person needs to refer to information from one step to another, give the person a place to write that information down and use proximity to associate it when it is needed in the future.
Performing Complex Tasks
This person has trouble performing tasks that involve more than a set amount of atomic tasks. The person knows how to perform certain tasks, but is unable to perform several of them in sequence to perform a more complex task without proper support. The person can follow a checklist if each task on the checklist is atomic for that person, i.e., the person can independently perform each task on the checklist without support.
Accommodations
- Break down instructions so that they are atomic for a novice.
- Provide a definition for each piece of terminology.
- Avoid jargon. If it is necessary to use jargon for the sake of simplicity, make sure it is clearly defined and consistently used.
Decision Making
This person has trouble making decisions which involve more than a certain number of choices. The person is able to identify the different choices available, but once the number of choices exceeds this person’s limit, the person’s ability to make a choice is incapacitated. The person may be unable to make any choices or the person may be limited to making a selection from no more than three items.
Accommodations
- Provide reasonable defaults where applicable.
- Avoid lots of options for a single choice.
- If possible, break complex choices down into multiple, simpler choices.
- Avoid allowing the person to make invalid choices or choice combinations.
Fuzzy Logic
This person has trouble dealing with anything other than absolutes. The person is able to identify the extremes, “yes” and "no", “black” and "white", “love” and "hate", but has trouble with anything in between. It can be difficult for the person to make meaningful decisions based on scale, such as “1 to 10” and "very unsatisfactory to very satisfactory". The person can have trouble with the ambiguity of “may” and “maybe” or choosing items such as “favorite book” or "favorite movie".
Accommodations
- Avoid ambiguity where possible. Clearly explain any necessary ambiguity.
- Include absolute, time-independent, unambiguous options for security questions, such as, “What high school did you graduate from?” or, “What was your maternal grandmother’s maiden name?” These questions could be ambiguous (thus problematic) if they are not phrased specifically enough. “What high school did you attend?” can be ambiguous becase some people have attended multiple high schools. “What was your grandmother’s maiden name?” can be ambiguous because most people have at least two grandmothers.
Remember
Disabilities are not mutually exclusive. Someone with a cognitive impairment may also have audio, mobility, and visual impairments.