We conducted a purposeful review of literature in the fields of rehabilitation, education, health literacy, community advocacy, and communication technology to identify design features that may optimize the accessibility of self-reports for people with developmental disabilities.
Based on this review, we proposed specific features that can be used to optimize the content, layout, and administration procedures of self-reports.
Please contact us if you would like more information about all of the proposed features.
The meaning conveyed in each item.
11 features, including:
Context: Item specifies specific interactions, locations, or activities within which the action or task is intended.
Example: “Introduce myself to a new coworker.”
Personal reference language: Item uses first or second person language.
Example: “Look up my doctor’s phone number.”
The arrangement of words, images, and response options.
14 features, including:
Visual integration of items with rating scale: The item and rating scale are visually close to each other.
Example: Wash my hands  Hard  Easy
White space: Reduce visual/perceptual demands.
- 1 inch margins, 1/2 inch between items
- at least 35% white space
9 features, including:
Teaching: Respondents review example items or complete practice items.
Example: It is hard for Maria to remember her PIN number. She picked “hard.”
Validate respondent: Respondents are assured the PRO is about their perspectives, perceptions, or feelings.
Example: “I want to know what you think. There are no right or wrong answers.”
Outcomes of Cognitive Accessibility
- Increased access to healthcare decision-making
- “Nothing about us without us.”
- Improves response consistency
- Increased usability results in more valid responses
Responsive to policy
- Enacts the vision of the Affordable Healthcare Act for people with I/DD
- Address under representation of people with I/DD in healthcare evaluation