Cognitive accessibility is the future of
UX design and research

For too long, cognitive accessibility has been an afterthought in digital product development. While companies have made strides in designing for mobility, vision, and hearing disabilities, cognitive disabilities—affecting memory, attention, learning, and problem-solving—remain widely misunderstood and underserved. This is despite the fact that cognitive disability is the most prevalent form of disability, affecting nearly 19% of the global population.

At Fable, we believe that digital products should work for everyone. Historically, cognitive accessibility hasn’t been a core part of how companies test and build their products. We can’t build truly inclusive experiences without including people with disabilities in the research process — including individuals with cognitive accessibility needs. Fable is on the forefront of developing the tools and methods to make this possible.

There are several demographic pressures that make now the right time to consider cognitive accessibility throughout the product development process. Perhaps most significant among them is the overlap in the needs of people with cognitive disabilities and the needs of an aging population, in particular, challenges with memory, attention, and navigating modern digital interfaces.

Alwar Pillai
Co-founder and CEO at Fable

The aging global population will thrust cognitive needs front and centre in the coming years

  • A universal reality of the aging process is a slow-down of many cognitive processes. As the population ages, the prevalence of cognitive disabilities is expected to increase dramatically.
  • Approximately two thirds of seniors experience some level of cognitive impairment around age 70.
  • As this population segment expands, companies will need to build for these more complex user needs.

Organizations can ensure they are capturing the needs of both groups by incorporating people with cognitive disabilities into their user research practices.

This is why we’re making cognitive accessibility a priority. We’re expanding our tester community to formally recognize and engage individuals with cognitive disabilities. We’re investing in new methods to capture their experiences. And we’re working closely with companies to help them understand how cognitive accessibility fits into their broader accessibility and usability strategies.

At Fable, our mission is to empower people with disabilities to fully participate in, contribute to and ultimately shape society. For the past five years we have been pushing the envelope and advancing the ability of product teams to practice inclusive product development — with novel methods to engage quickly and easily with users with disabilities. Cognitive accessibility is the next big leap forward and we’re excited to lead the charge.

What we’re learning

We need to move beyond medical definitions to focus on functional needs and lived experiences. A cognitive diagnosis may be helpful for a medical professional, but for a product researcher or designer, the needs of the individual are what’s truly relevant. Our goal is to shape the industry and release a framework for the practice of cognitive accessibility, an approach centred on individual needs rather than a medical model of disability diagnosis.

In that vein, in 2024, Fable launched the Cognitive Accessibility Working Group, bringing together leading experts in the field dedicated to defining standards and methods for incorporating individuals with cognitive accessibility needs throughout the product development life cycle. We’re collaborating with practitioners, thought leaders, and clinical research firms to improve digital experiences for people with cognitive accessibility needs.

The group’s work has been organized into four task forces:

  • 1

    Participants: Develop methods to recruit and organize research participants

  • 2

    Methods: Conduct literature and industry review and recommend best practices on research methods

  • 3

    Research: Design and run a pilot task-based evaluative study

  • 4

    Authoring: Document findings, gather feedback, and prepare materials for publication

The pilot research is complete and the group is now in the in the fourth phase, focused on authoring a publication to share the research findings. These findings are critical to the design of Fable’s initial cognitive accessibility offering on Fable Engage. The full details will be released soon, but we’re excited to share a few highlights in advance:

Reliance on tech and tools

In our pilot group, 35% of participants reported using assistive technology daily, and the vast majority — 84% — leverage either assistive technology (screen reader, screen magnification etc), accessibility settings (captions, larger fonts etc.), tools (reminders apps etc.) or assistive devices (hearing aids). This intersectionality reinforces the need for a holistic understanding of users in product research and design.

Usability challenges

Fable’s Community often uncovers compatibility issues between digital products and assistive technology. The pilot group had more significant usability challenges. This means that conducting research with a cognitive accessibility group may uncover more usability insights than engaging with the general population. By engaging users with the most complex set of needs we inherently capture the needs of a broader audience.

Tailored research methods

We need to adapt existing research methods and create new ones to better engage people with cognitive disabilities. Commonly used research methods, such as the “Think Out Load” protocol, do not work well for all members of this group. Adaptations like shortened sessions, researcher scripts and participant guides are critical to make task interpretation and feedback easier and to keep cognitive load to a minimum. Soon, Fable will be releasing a guide to make it easier for all researchers and product teams to run engagements successfully.

Fable Engage to include cognitive accessibility research

The next phase is to expand Fable Engage to include cognitive accessibility research participants. Beta access to cognitive accessibility will be unlocked for select customers on March 31, 2025.

Simultaneously, we will be taking several steps to share our learnings and to push the research field forward. Just as with our release of the Accessible Usability Scale, our goal is to provide tools and resources that empower all practitioners. We will be publishing a case study from our Cognitive Accessibility Working Group’s pilot findings and updating the AUS and Fable’s usability benchmarks to better reflect cognitive accessibility needs.

We are thrilled to be entering this new phase of Fable’s customer offering. Cognitive accessibility is a massive opportunity for organizations globally. With Fable, customers will be able to expand market reach, improve customer experience, and ensure legal compliance by incorporating feedback from users across the disability spectrum, including those with cognitive needs. We’re proud to support organizations taking a step in this direction, no matter where they are on their accessibility journey. The future of user research starts now.

A business advantage, not a compliance checkbox

Accessibility is still often treated as a compliance check rather than a core design principle. That’s unfortunate, because inclusive design can actually be a competitive advantage. There are plenty of examples where designing for the margins led to the development of remarkable products that are good for everyone.

A woman holds a smartphone in front of her face and speaks into it.

Text-to-speech technology was originally designed for people with visual impairments. Today, it powers audiobooks, virtual assistants, and hands-free computing.

Screenshot of a video playing with subtitles on Netflix. The subtitles show the text "it's once in a lifetime". The red Netflix logo is overlaid on top of the video.

Netflix subtitles were originally created for Deaf and hard-of-hearing viewers. Now 80% of global Netflix users turn on captions monthly.

Nike Go Fly Ease shoe in white. The shoe hinges in the middle, into two parts: The front part which is around two-thirds of its entire length and the rear third which is made up of the heel. When the shoe is bent in two, the bed where the foot sits rises above the rest of the trainer. It looks like the shoe’s inner is coming out of the shoe entirely. this is where the foot can be inserted easily.

Nike’s Go FlyEase Step-In-And-Go shoes were designed for people with limited mobility seeking ease of entry. The design ended up appealing to other people who need a fast way to get shoes on and off—like parents and athletes.

Nike also happens to be the highest-earning brand in the sports industry.

The high cost of ignoring accessibility

In order to tap into the business benefits of inclusive design we need a shift in thinking. People with disabilities represent the largest untapped market segment in the world with incredible spending power that surpasses the GDP of entire nations. 1.3 billion people worldwide have disabilities, representing a $13 trillion market when combined with their friends and family.

6 person icons. One is pink and 5 are black.

1 in 6 people in the United States have a disability.

A black pie chart with 16 per cent of it highlighted in pink. In the centre of the pie chart it says 16 per cent.

1.3 billion people in the world have a disability.

People with disabilities and their families possess $13 trillion in spending power.

Disabilities aren’t always permanent. They can be temporary, like someone who has to navigate digital experiences with a broken arm for a few weeks. They can also be situational, like struggling to hear the conversation in a crowded bar or another environment with excessive background noise.

So, while a portion of our population experiences permanent disability, all of us rely on and benefit from accessibility accommodations.

The Persona Spectrum. Diagram shows examples of permanent, temporary, and situational disabilities.

Microsoft’s Accessibility Persona Spectrum (Microsoft Inclusive Design)

Finally, it’s important to remember that people aren’t always born with disabilities. Many are acquired through injury, disease, or simply aging. And our global population is aging, with United Nations (UN) data projecting the population of people aged 65 and older will grow to 1.7 billion by 2054.

Unlike the Boomers of today, this group will consist of digital natives who have high standards for their product experiences and no qualms about taking their spending power elsewhere if any experience falls short.

In fact, this dynamic is already playing out:

  • 71% of users with disabilities abandon inaccessible websites, resulting in billions in lost revenue (Forbes)

  • UK retailers lose £17 billion per year due to inaccessible e-commerce experiences (AbilityNet)

  • U.S. e-commerce brands lose up to $6.9 billion annually to more accessible competitors (Bureau of Internet Accessibility)