Visual Design + Accessibility

Introduction to accessibility and inclusive design

Accessibility is a users’ ability to use products or services. In this case, I will discuss digital and web-based products on a hand-held mobile device. Everyone has different abilities and products should be designed with a diverse range of abilities in mind.

Usability refers to making products effective, efficient, and satisfying to use. 

Usability + Design = Accessibility

“Inclusive Design is a methodology, born out of digital environments, that enables and draws on the full range of human diversity. Most importantly, this means including and learning from people with a range of perspectives.” Microsoft’s Inclusive design Manual

Inclusive, or universal design, is about designing for all and ensuring that everyone can find a way to participate and use products, without the need for special adaptation. According to, when designing for all, the following should be considered:

  • accessibility for people with disabilities;
  • access to and quality of hardware, software, and Internet connectivity;
  • computer literacy and skills;
  • economic situation;
  • education;
  • geographic location;
  • culture;
  • age, including older and younger people;
  • and language.

The Web removes barriers to communication and interaction that many people face in the physical world.

Tim Berners-Lee, W3C Director and inventor of the World Wide Web

There are many different types of barriers that people face in the physical world. Visual, auditory, physical, cognitive and speech impairments are some of the many challenges. Some are permanent, some temporary, some from birth and some occur later in life as a result of illness, accident or ageing. Some are situational, with elements such as weather or language creating a barrier. Things as innocuous as noise or multi-tasking also creates a barrier, which everyone can relate to.

People do not wish to be ‘othered’ and with over one billion people worldwide with a disability, and an ageing population, inclusive, universal and accessible design of digital products could be considered a basic human right.

Solve for one, extend to many

Of the 7 Principles of Universal Design, I have chosen to focus on the following two for my project:

Principle 2: Flexibility in Use.

The design accommodates a wide range of individual preferences and abilities. For example, left hand, right hand, both hands or no hand use.

Principle 6: Low Physical Effort.

The design can be used efficiently and comfortably and with a minimum of fatigue. Catering for those with motor or muscular control limitations or weaknesses or paralysis, chronic or temporary pain, missing limbs, injuries, joint disorders such as arthritis and limited sensation.

According to Steven Hoober: 

The user’s focus on the center of the screen is why we use so many list and grid views. … Always place the primary content at the center of the screen…. Place secondary actions along the top and bottom edges.

“The ability to bend the thumb is important because, while the thumb’s free range of movement is in three-dimensional space, touchscreens are flat. Therefore, only a limited portion of the thumb’s range of movement maps onto the phone’s single-axis screen.”

-Steven Hoober

Raynaud Syndrome

“Raynaud syndrome, also known as Raynaud’s phenomenon, is a medical condition in which a spasm of arteries cause episodes of reduced blood flow. Typically, the fingers, and less commonly the toes are involved. Rarely, the nose, ears or lips are affected. The episodes result in the affected part turning white and then blue. Often, numbness or pain occurs. As blood flow returns, the area turns red and burns. The episodes typically last minutes but can last several hours. Episodes are often triggered by cold or emotional stress.” Wikipedia

The two main types are primary Raynaud’s, when the cause is unknown, and secondary Raynaud’s, which occurs as a result of another condition

Primary Raynaud’s

Risk factors : (Mayo Clinic)

  • Age – onset begins age 15-30
  • Gender – More women suffer from it
  • Family history is a risk factor
  • Climate – Cold weather conditions also bring it on
  • Smoking
  • Caffeine

Secondary Raynaud’s

Risk factors : (Mayo Clinic)

  • Associated diseases (scleroderma and lupus)
  • Certain occupations (jobs that cause repetitive trauma, operating tools that vibrate)
  • Exposure to certain substances (smoking, taking medication that effects the blood vessels and exposure to certain chemicals)


  • Blood leaves extremities
  • Fingers go white, then blue
  • Numbness
  • Distress
  • Mild to extreme immobility & dexterity

Raynaud’s attacks, usually triggered by the cold causing a lack of blood flow to the extremities, are often mild and manageable; however being exposed to cold or wet conditions may cause problems.

Prevention is better than cure

It’s easier to stop something happening in the first place than to repair the damage after it has happened.

Desiderius Erasmus

There is no cure, but the following are suggested preventions to avoid and manage attacks:

  • Wear gloves
  • Avoid getting cold/ wet
  • Don’t smoke
  • Avoid caffeine
  • Drink hot drinks
  • Use silver socks/ gloves (Silver which acts as a heat conductor is threaded through the knit – they don’t work, I have them!)
  • Heat the water at home in anticipation
  • Heat the car if you have a smart car

If an attack does occur, the following is suggested by the Mayo Clinic and  Scleroderma & Raynaud’s UK:

  • Reheat slowly
  •  If wet or sweaty from exercise, change immediately
  • Dip your hands and feet into a bowl of warm but not hot water
  • Dry thoroughly

Many people who enjoy outdoor sporting activities or who work in outoor or cold climates may suffer regularly from painful and debilitating Raynaud’s attacks. During high intensity sports such as mountain running, the blood rushes to the core to aid the heart, lungs and muscles in the chest, legs and abdomen. Extremities such as fingers and toes have to fend for themselves.

When cold and wet conditions are also a factor, the onset of Raynaud’s will almost certainly occur.

Potential outdoor risks


Taking the gloves off up a mountain can cause an instant attack and give you painful hands for the rest of the day.


Hard to regulate body temperature with having a hot body core & wearing fewer clothes, but cold extremities and so needing gloves.


Being out in the wet, and often windy conditions generates an even higher wind chill factor and often affects the hands that are gripped to the handlebars.

Sea swimming

In open water this can be tricky and in competitive swimming the lack of gloves can mean that hands are exposed to extremes in temperature.

“User interaction with mobile devices can be negatively affected by a vast number of contextual factors, known as situationally-induced impairments.”

“The ubiquitous nature of mobile devices requires them to be able to accommodate situational impairments in order to reduce the difficulties that people experience during mobile interaction while temporarily impaired.”

– Gonclaves et al. Challenges of Situational Impairments during Interaction with Mobile Devices

With Raynaud’s in mind, and considering the two principles of universal design stated above, I have decided to improve a current Raynaud’s management app, MyRaynauds, available on iPhone.

I aim to improve it’s usability and accessibility for Raynaud’s sufferers, using human centered design principles and by collecting, tracking and learning from individual and personal data, experiences of Raynaud’s and external and environmental factors, which the user will track over time, tailoring a response from the app to prempt and manage the next experience and improve the users life. 

I will use the risk factors of Raynaud’s as an pain points and choose best practices in relation to hand dexterity and motor impairments to solve the user problems.

Research shows that “lower finger temperatures are associated with lower throughput and higher error rate when interacting with the mobile device with two hands and fine motor performance was adversely affected by cold”

– Gonclaves et al. Tapping Task Performance on Smartphones in Cold Temperature

A solution for one group of users could benefit unexpected wider target groups.

– Gonclaves et al. Challenges of Situational Impairments during Interaction with Mobile Devices


Hoober, Steven. Mobile Matters, Designing for every screen. March 6th, 2017:

Zhanna Sarsenbayeva, Niels van Berkel, Chu Luo, Vassilis Kostakos, Jorge Goncalves. Challenges of Situational Impairments during Interaction with Mobile Devices. Brisbane, Queensland, Australia — November 28 – December 01, 2017.

Zhanna Sarsenbayeva, Niels van Berkel, Chu Luo, Vassilis Kostakos, Jorge Goncalves. Tapping Task Performance on Smartphones in Cold Temperature. © The Author 2016. Published by Oxford University Press on behalf of The British Computer Society.

On mobile touch devices people do not scan from the upper left to the lower right as on the desktop. Nor do they touch the screen in the opposite direction—from the lower right to the upper left—because of the limitations of their thumb’s reach. Instead, as Figure 8 shows, they prefer to view and touch the center of the screen. Figure 8 shows touch accuracy for the various parts of a mobile phone’s or tablet’s screen.
People can read content best at the center of the screen and often scroll content to bring the part they’re reading to the middle of the screen if they can. People are better at tapping at the center of the screen, so touch targets there can be smaller—as small as 7 millimeters, while corner target sizes must be about 12 millimeters.


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