IBM Accessibility Research Accessible Design for an Aging

IBM Accessibility Research Accessible Design for an Aging Population Bo Campbell, IBM Research Susann Keohane, IBM Research 1

IBM Accessibility Research Aging: it’s happening 2

Hi, I am 117 years old IBM Accessibility Research …and I am oldest living person. Violet Brown, Supercentenarian 3

IBM Accessibility Research Global aging populations are steadily growing and increasing their share of the overall demographic Percentage of Population 65 years and older Japan Italy Germany Ireland China Australia Brazil US India Egypt 2017 4

IBM Accessibility Research By 2050, the projected % of the population greater than 60 years old Source: United Nations World Aging 2015 5

IBM Accessibility Research Physical and cognitive effects of Aging Low vision, blindness Mobility impairment, ambulatory decline 6 Eyes at 40 Range of sight declines Muscles at 40 Loss of muscle and gain fat Brain at 70 Cognitive decline accelerates Ears at 60 Hearing loss accelerates Cognitive disability, dementia Deaf, low hearing, associated cognitive disability Source: Time Magazine

IBM Accessibility Research Increasing age increases likelihood of acquiring one or more disabilities Similarities of the needs of the Aging Population and Pw. Ds: Both benefit from accessible public environments Both benefit from protection against discrimination (ageism & ableism) Both need access to assistive technology 7

IBM Accessibility Research Poll Question 1 What worries you most about getting older? • Losing your independence • Acquiring physical disabilities • Loss of memory / Dementia • Outpaced by technology 8

IBM Accessibility Research 2016 Survey on Outthink Aging: Memory Loss 47% of people worry most about losing their memory and suffering from dementia as they get older. Based upon 419 responses IBM Outthink Aging Survey, 2016 9 • Surveys conducted at SXSW 2016, CSUN 2016 and via IBM Accessibility online sites

IBM Accessibility Research “The challenge is converting a world built by and for the young into a world that supports and engages population that live 100 years and beyond. ” Laura Carstensen Director of the Stanford Center on Longevity 10

IBM Accessibility Research Technology is happening 11

IBM Accessibility Research Advances in Technology 12 12

IBM Accessibility Research Poll Question 2 What emerging technology will help manage the aging process the most? • Mobile patient monitoring • Artificial intelligence • Robots / Robotics • Wearables • Smart homes (Io. T) 13

IBM Accessibility Research 2016 Survey on Outthink Aging: Smart Homes & Io. T 1 in 3 people believe that smart homes and the Internet of Things will help manage the aging process the most. Based upon 396 responses IBM Outthink Aging Survey, 2016 14 • Surveys conducted at SXSW 2016, CSUN 2016 and via IBM Accessibility online sites

IBM Accessibility Research “All of these silos sets of data that are continuing to be built… nobody is truly pulling that all together and making it meaningful and actionable and simple” Kari Olson Chief Innovation and Technology Officer, Front Porch Center for Innovation and Wellbeing 15

IBM Accessibility Research Global Standards 16

IBM Accessibility Research Global Accessibility Standards 17

IBM Accessibility Research Web Content Accessibility Guidelines (WCAG) WCAG 2. 0 finalized December 2008 WCAG 2. 1 in-development • First Public Working Draft published Feb 2017 • Timeline • Task Forces developed proposals for: • Users with cognitive or learning disabilities • Users with low vision • Small- and touch-screen mobile devices 18

IBM Accessibility Research Developing Websites for Older People: How Web Content Accessibility Guidelines (WCAG) 2. 0 Applies An extensive literature review identified that existing standards from the W 3 C Web Accessibility Initiative (WAI) address the accessibility needs of older web users. Perceivable information and user interface • Text size • Text style and text layout • Color and contrast • Multimedia • CAPTCHA Operable user interface and navigation • Links • Navigation and location • Mouse • Keyboard use and tabbing • Distractions • Sufficient time 19 Understandable information and user interface • Page organization • Understandable language • Consistent navigation and labeling • Pop-ups and new-windows • Page refresh and updates • Instructions and input assistance • Error prevention and recovery forms

IBM Accessibility Research Developing Websites for Older People (1 of 3) Perceivable information and user interface Text size (1. 4. 4) - Many older people require large text due to declining vision, including text in form fields and other controls. Text style and text layout (1. 4. 8) - Text style and its visual presentation impacts how hard or easy it is for people to read, especially older people with declining vision. Color and contrast (1. 4. 1, 1. 4. 3, 1. 4. 6) - Most older people's color perception changes, and they lose contrast sensitivity. Multimedia (1. 2. 1 - 1. 2. 5, 1. 2. 7 -1. 2. 9, 1. 4. 7) - Because many older people's hearing or vision declines, they often need transcripts, captions, and low background sound. CAPTCHA (1. 1. 1) - Older people with declining eyesight may not be able to discern the characters in a CAPTCHA ( 20

IBM Accessibility Research Developing Websites for Older People (2 of 3) Operable user interface and navigation Links (2. 4. 4, 2. 4. 9, 2. 4. 7) - Many older people need links to be particularly clear and identifiable due to declining vision and cognition. Navigation and location (2. 4. 5, 2. 4. 8, 2. 4. 2) - Many older people need navigation to be particularly clear due to declining cognitive abilities. Mouse (2. 4. 7, 3. 3. 2, 1. 1. 1, 1. 4. 4) - It is difficult for some older people to use a mouse due to declining vision or dexterity. Keyboard use and tabbing (2. 1. 1 -2. 1. 3, 2. 4. 1, 2. 4. 3, 2. 4. 7) - Some older people cannot use a mouse well or at all and instead use a keyboard. Distractions (2. 2. 2, 2. 2. 4, 1. 4. 2) - Some older people are particularly distracted by any movement and sound on web pages. Sufficient time (2. 2. 1 -2. 2. 3) - It takes some older people longer to read text and complete transactions due to declining vision, dexterity, or cognition. 21

IBM Accessibility Research Developing Websites for Older People (3 of 3) Understandable information and user interface Page organization (2. 4. 6, 2. 4. 10, 1. 4. 8) - Many older people are inexperienced web users without advanced browsing habits and therefore read the whole page, so good page organization is important. Understandable language (3. 1. 3 -3. 1. 5) - Many older people find it particularly difficult to understand complex sentences, unusual words, and technical jargon. Consistent navigation and labeling (3. 2. 3, 3. 2. 4) - For people who are new to the web, and older people with some types of cognitive decline, consistent navigation and presentation is particularly important. Pop-ups and new windows (3. 2. 1, 3. 2. 5) -Some older people experiencing cognitive decline can be confused or distracted by pop -ups, new windows, or new tabs. Page refresh and updates (3. 2. 1, 3. 2. 2, 3. 2. 5) - Some older people with declining vision or cognition can miss content that automatically updates or refreshes in a page. Instructions and input assistance (3. 3. 2, 3. 3. 5, 3. 2. 4) - It is difficult for some older people to understand the requirements of forms and transactions. Error prevention and recovery forms (3. 3. 4, 3. 3. 6, 3. 3. 1, 3. 3. 3) - It is difficult for some older people to use forms and complete transactions due to declining cognitive abilities. 22

IBM Accessibility Research International Standards Organization (ISO) ISO/IEC JTC 1 — Information Technology Scope includes: • user interface accessibility • cultural and linguistic adaptability and accessibility • methods and technologies for controlling and navigating within systems, devices and applications in visual, auditory, tactile and other sensorial modalities (such as by voice, vision, movement, gestures) • symbols, functionality and interactions of user interfaces • visual, auditory, tactile and other sensorial input and output devices and methods in ICT environments • user interfaces for mobile devices, hand‐held devices and remote interactions. March - April 2017 23

IBM Accessibility Research “The issue of disability for individuals. . . is not whether but when, not so much which one, but how many and in what combination” Irving Kenneth Zola Toward the Necessary Universalizing of a Disability Policy 24

IBM Accessibility Research Design Guidelines For Aging Demographic 25

IBM Accessibility Research Elders Pose a Unique Design Challenge • Unable to group and generalize elders • Aging is different, gradual and personal • Abilities are different • Techniques of adaptation are unique • Typical guides and heuristics for UX and accessibility may not cover elders 26

IBM Accessibility Research WCAG Isn’t Enough • Decent foundation, but does not define usability and experience • Still very weak on cognitive • Does not talk about alleviating fears or bridging gaps 27

IBM Accessibility Research General Tips • Understand Elders first-hand • Elders have a different context and view of the world • Ethnography, Interviews, Focus Groups • Understand Build on WCAG • Follow heuristics for design for elders • Use design thinking – iterative, user-centered design 28

IBM Accessibility Research “Despite declining health, older people tend to be significantly happier and better at appreciating what they have. ” Ollie Campbell Smashing Magazine 29

IBM Accessibility Research Disabilities to Design For • Cognitive • Hearing • Visual • Physical • Context and Experience 30

IBM Accessibility Research Cognitive • Cognitive decline begins generally sometime in the mid to late 40's • Reduced attention span • Reduced short term memory - lose context / focus • Less generalization - skill transfer between situations – association 31

IBM Accessibility Research Cognitive (cont. ) • Difficult words take longer to recall • Difficult to multitask • More easily overwhelmed - cognitive load • More linear approach 32

IBM Accessibility Research Designing for Cognitive • Very simple architecture (2 child branches max for i. OS) • Simple menu structure • Reduce visual noise and distractions • Make things quick – consider context of limited connection and slow responses • Use descriptive labels for confusing icons 33

IBM Accessibility Research Designing for Cognitive (cont. ) • Flow should be one task at a time • i. OS Human Interface guidelines promote this structure • Progressive Disclosure • Use minimum amount of features to accomplish a specific goal • Use positive reinforcement - promote technical independence • Provide a linear path with visited links 34

IBM Accessibility Research Hearing Disabilities • Hard to filter out background sounds ambient noise • Hard to localize sounds • Hard to understand fast speech • Hard to hear high pitches 35

IBM Accessibility Research Design for Hearing • Caption all media • Provide alternatives to audio content • Allow the user to stop any sounds and do not start any media noises automatically • Do not use sound only as feedback 36

IBM Accessibility Research Vision Difficulties Loss of near vision acuity starting around age 40 PRESBYOPIA 37

IBM Accessibility Research Vision Difficulties (cont. ) • High sensitivity to light and long adjustment period to changes • Reduced color differentiation, especially blues • Difficulty scanning leading to a more linear approach 38

IBM Accessibility Research Designing for Vision Difficulties • Use large icons (44 px +) • Use large fonts at least 16 px or higher and avoid fancy fonts • Allow adjustment of size • Use excellent color contrast • Reduce visual noise • Avoid patterned backgrounds 39

IBM Accessibility Research Physical Difficulties • Reduced fine motor ability • Tremors • Stiffness • Reduced hand-eye coordination • More mistakes, unintentional clicks • Trouble with mobile gestures, pinch, drag, multi-finger 40

IBM Accessibility Research Physical Solutions • Make sure all interactions are keyboard accessible • For mobile, don't use complex gestures or include a single tap method with them • Make clickable items large and clear with labels • Provide obvious feedback for actions

IBM Accessibility Research Physical Solutions • Separate targets like links from each other • Moving items such as pull-down menus should be limited • Don't require pixel perfect pointing 41

IBM Accessibility Research “ 45% of seniors showed behaviors that indicated they were uncomfortable trying new things or hesitant to explore” Nielson Norman Group 43

IBM Accessibility Research The Technology Gap • • 44 Less comfortable with technology Risk averse rather than adventurous (like kids) Afraid to break something Chooses a familiar path over new technique Fear of needing help, embarrassment Assigns blame to self rather than assigning to the technology Reluctant to divulge personal info

IBM Accessibility Research Bridging the Technology Gap • • • 45 Don't make any assumptions about the technology and design Question all design elements in the context of elders Give positive feedback to build confidence Keep things intuitive and clear Understand design metaphors and their origins Provide clear and reassuring error messages

IBM Accessibility Research The end is in sight, but… • Each generation faces similar challenges until technology completely can truly be personalized • We will all face technical literacy issues • We will all have less willingness to learn new skills as we age 46

IBM Accessibility Research “Personalization is the automatic tailoring of sites and messages to the individuals viewing them, so that we can feel that somewhere there's a piece of software that loves us for who we are. ” 47 David Weinberger Senior researcher at the Berkman Klein Center

IBM Accessibility Research Poll Question 3 What design guidelines are shown in this example? • Simple menu structure • Use large icons • Use minimum amount of features • Don't require pixel perfect pointing • All of the above 48