• Molly, a 14-year-old girl with cerebral palsy, uses a single switch to click links on Web pages for a research project at school.
• Simon, a 73-year-old man with a severe hearing loss, reads captions that accompany online greeting cards from his grandchildren.
• Chris, a 23-year-old man with dyslexia, uses a screen reader that moves from left to right across a Web page and speaks text using a synthesized voice.
• Jane, a 40-year-old woman who experienced a traumatic brain injury, has a visual impairment and has her Web browser set to enlarge text.

Individuals with communication disorders may have motor, language, hearing, and/or visual impairments that inhibit their ability to access many of the over 4 billion Web pages currently online. The Americans with Disabilities Act raised awareness about the need for accessibility in public places and mandated change. As a new kind of public "place," Web pages also require accommodations for individuals with a variety of needs and skills.

The W3C (World Wide Web Consortium) is a non-profit international group in which member organizations, a full-time staff, and the public work together to develop standards to make Web pages available to anyone using Internet technologies now and in the future. Within their broader mission the W3C has a Web accessibility initiative (WAI) that contains a set of Web content accessibility guidelines to assist creators of Web pages in developing sites with features that enable individuals with disabilities to access Web content (see sidebar online on accessibility icons).

Principles of Accessibility

The W3C's WAI has three different priority checkpoints to give a "grade" to the extent a site accommodates people with various disabilities. Meeting priority one requirements grants a single A rating. Meeting all three of the priorities gives a Web page the highest rating, or AAA. The following three important guidelines from the W3C are relevant to individuals with communication disorders:

• Multimedia. The Web features images, movies, music, and more. Just as with closed-captioning on TV, individuals with hearing loss need alternative text for audio signals in multimedia. For some individuals (such as those with attention deficit hyperactivity disorder), it may be necessary to turn off images on a page and instead focus on the text only. Conversely, strategic presentation of images may assist individuals with cognitive disabilities in accessing a site.
• Layout. Individuals with visual impairments or reading difficulties may use screen readers to speak written text aloud. Setting up Web page information and tables linearly provides the user with comprehensible sequencing. Meaningful titles preceding all tables also inform the user what a table is about before deciding to scan through all the entries.
• Cascading style sheets (CSS) are sets of rules attached to a Web page that can make layout and format more accessible by providing instructions for font size, color, and spacing. A designer or user can set up their own rule sheet and apply it to any page using CSS. ASHA's Web site is using CSS for most page layout and design details now.
• Navigation. Individuals with limited mobility may use an alternative mouse or single switch that basically functions as the "tab" key. Pages with forms (e.g., name, address, etc.) need to have boxes that can be "tabbed" to in a logical order and without excessive branching menu options.

What You Can Do

Here are some different options you and your clients have to ensure accessibility.

• Check out the WAI's 10 quick steps to accessibility from W3C (see references).
• Contact the person in charge of your company's Web site and ask if they know about these initiatives.
• Contact administrators of sites that are not accessible to your clients. Report accessibility concerns to either the webmaster listed or the sponsoring agency of the site.
• Encourage clients to maximize use of accessibility features of Web browsers (see sidebar on accessibility features of Web browsers for options).
• If you design a Web site, check its accessibility and make changes to ensure everyone can visit your site.

As with changing physical structures, realizing "virtual accessibility" requires changes in policy and practice. Raising awareness is the first step.