Inclusive Design for the Senses: How to Support Users with Vestibular Disabilities

This blog is based on content by Dana Randall from the Level Access thought leadership team.

We know digital accessibility empowers people with visual, auditory, motor, and cognitive disabilities. But have you ever considered how your website, content, or app might impact someone who encounters challenges in all these areas?

You would never intentionally harm a customer or user. However, the way your digital experience affects a user’s senses could cause trouble for customers with sensory or vestibular disorders, or who identify as having a vestibular disability. So, how do you make sure your experience is safe and enjoyable for the widest possible audience? In this blog, we’re offering key considerations for supporting users with vestibular disorders and disabilities.

What is a vestibular disorder?

The vestibular system, located in our inner ear, aids in maintaining balance and spatial awareness by relaying sensory information to the brain for proper body positioning. These sensory inputs come from our:

• Ears: helping detect the movement of the head in space
• Eyes: helping detect quick movements
• Body: helping notify the brain about where various parts of our musculoskeletal system are in space

Vestibular disorders cover a wide spectrum of experiences and can be temporary or permanent. They can range from a person having vertigo (spinning sensations) to feeling unbalanced (like they are on a boat or that the ground is uneven) to spatial disorientation.

Many individuals with vestibular disabilities also have other disabilities or conditions. It is not uncommon for a person who is blind or deaf to have a vestibular disorder, because one or more of the key sensory inputs that control balance is sending bad data or no data to the brain. Individuals who experience vestibular migraines, Meniere’s disease, damage to the vestibular organ, Alzheimer’s, Parkinson’s, or multiple sclerosis (MS) may also identify as having vestibular disabilities.

Due to the various potential causes, the prevalence of vestibular disorders is often underestimated. In the U.S. alone, 35% of adults who are over 40 years of age, or nearly eight million people, have chronic problems with balance and an additional 2.4 million have dizziness alone.

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Common challenges people with vestibular disabilities encounter online

The general public may be pretty familiar by now with the idea of avoiding flashing images to prevent seizures. You may have noticed warnings about the use of flashing effects before a TV show or on your way into a movie theatre. However, these same images can also cause a vestibular episode for many people.

To understand the science behind this, it can be helpful to think of your body like a computer, which has multiple data inputs. Your brain is the processor; your eyes and ears are your hardware. The data that hardware sends is the software. People with vestibular disorders typically encounter challenges in the hardware that result in sending bad data to the brain. The computer expects to receive data that is consistent, but when one packet of data doesn’t coordinate with all the others, the system crashes, causing episodes of dizziness, disorientation, headaches, and other difficulties.

Excessive motion, constant animation, 3D depth effects like parallax, videos that play automatically, animated GIFs, flashing imagery, bold patterns (especially on pages that require scrolling), and sudden or abrupt audio can all trigger a vestibular episode.

How can website and digital experience owners consider people with vestibular disabilities?

1. Choose patterns and colors wisely:
   • Avoid bold and repeating patterns, especially in backgrounds. When a user scrolls through a bold pattern, this can simulate motion and flashing, which is known to trigger vestibular episodes.
   • Be mindful of using highly saturated, bright colors over large areas. Vestibular disorders can be linked with photosensitivity, and since these colors are emitted via a screen, they can cause a similar reaction to that which many of us have to bright lights.
2. Consider the audio experience:
   • Captions are critical. People with vestibular disabilities may be hard of hearing and / or have hypersensitive hearing. Users may need audio captions because they are hard of hearing or choose to intentionally limit their sound exposure (for example, by wearing noise-cancelling headphones or earplugs) due to hypersensitivity.
   • Do not autoplay audio. Whether it’s an autoplay video or background music, sudden sounds can be problematic for users with hypersensitive hearing. The user will likely be startled by this audio, and it can trigger pain, headaches, confusion, and disorientation. Avoiding autoplay also benefits any user who is sensitive to sound and visual stimuli, which can include individuals with autism and other Sensory Processing Disorders (SPD).
3. Approach motion intentionally. Motion isn’t completely off-limits, but when using motion, try to be:
   • Purposeful: Use motion with intention. Make sure all animations help users reach their goals by surfacing connections between states or views, drawing attention to crucial details, or providing feedback.
   • Intuitive: Provide motion that feels familiar and expected. It should mirror traits from the real world like acceleration, gravity, and volume to achieve a natural feel.
   • Seamless: Motion should fit naturally into the experience without creating a distraction. The amount of motion used should be just enough to get the intention across, and no more.

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4. Allow for user control:
   • Giving users the ability to control their experience is a key aspect of accessible design, particularly for individuals with vestibular disabilities. This means enabling them to adjust settings, such as font size and color contrast, to suit their individual needs. It also involves offering alternative options, such as audio descriptions for visual content, or turning off animations to accommodate users’ needs and preferences.
5. Respect the user’s device settings
   • As part of most phones’ and computers’ accessibility settings, users have the option to reduce motion. This applies to their experience with operating systems like iOS and Mac OS, as well as to web pages that are loaded on the device (if these websites have been developed to recognize the relevant user setting).
   • “Reduce motion” settings can stop or reduce the movement of some screen elements, such as:
     1. Screen transitions
     2. Typing autocompletion
     3. Animated full-screen and bubble effects in messenger apps
   • It’s important that CSS ensures that when a user has determined “reduce motion” to be their preferred experience, it is maintained, so they are not hunting for a “stop animation” button somewhere on the page. For more technical support on respecting a user’s device settings, visit this article from the World Wide Web Consortium’s (W3C’s) Web Accessibility Initiative on animation from interactions. You can also check out this suggested technique for meeting the related success criterion in the Web Content Accessibility Guidelines (WCAG).

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Support customer relationships, protect your brand

Your team works hard and invests valuable resources to build a brand customers and users will stick with. But one triggering episode on your site or digital experience could put those hard-earned relationships at risk, negatively impacting your brand and resulting in lost business. In this light, a commitment to accessibility isn’t just a design best practice: it’s a commitment to a better, more successful brand. Keep in mind that design considerations to support users with vestibular disorders also support many other users, including:

• People with sensory processing disorders (SPD)
• People who have chronic migraines
• People who experience seizures
• People with autism
• People with ADHD

Plus, fewer pop-ups, flashes, loud colors, and triggering effects make for a smoother, more enjoyable user experience for anyone.

WCAG includes success criteria that account for many of the considerations above. These include user control and the application of flashing effects. But there are also elements of accessible design for vestibular disabilities that WCAG does not cover, like supportive use of bright colors, and limiting the abrupt use of sound. That’s why education, and working with an expert accessibility partner, is so important.

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Additional resources on design for vestibular disabilities from Dana Randall

• Designing Dizzy: Seeing the world through an accessible design lens
• Designing Dizzy: Digital Displays & Neurological Disorders
• Will Web3, The Metaverse & AR/VR ever be accessible for me?