How You Might Be Excluding Up to Half Your Users

A surprising number of people are low-literacy. What that means and how you can design for it.

Photo: JGI/Jamie Grill/Getty Images

It’s very important to consider your content from your user’s perspective. Is it written so that your target audience will understand and relate to it?
— Kristina Halvorson

In her book Content Strategy for the Web, Kristina Halvorson reminds us to always consider our target audience when writing content. Who that audience is will, of course, depend on your particular website or product and its goals. But if your target audience includes the general public, you may want to consider that nearly half of them may have low literacy skills.

That’s right: Half.

Don’t believe me? I don’t blame you. It’s a shocking number. If you’re still unconvinced, just check out the results of the National Adult Literacy Survey (NALS), which found that 21–23% of U.S. adults had “highly deficient” literacy skills, while another 25–28% had “very limited” literacy skills. Both groups are defined as having “low literacy.” The Organization for Economic Co-Operation and Development found similar levels of low literacy in North America, Australia, and most of Europe.

What is low literacy?

The National Literacy Act of 1991 defines literacy as “the ability to read, write and speak English; compute and solve problems at levels of proficiency necessary to function on the job and in society; to achieve one’s goals; and to develop one’s knowledge and potential.” The basic skills needed for literacy include things like recognizing words fluently, understanding the structure of sentences and how they relate to each other, drawing appropriate inferences, applying information, and solving quantitative problems.

A person with low literacy skills will have a harder time doing things like filling out a job application, interpreting a bus schedule, or understanding when or how to take medications.

Despite how characteristics of low literacy may manifest themselves, they do not indicate a lack of intelligence; they indicate a lack of skills.

Low literacy does not mean illiteracy. But it used to. As recently as 1979, the U.S. Census Bureau defined “illiterate” as anyone who hadn’t finished the fifth grade. In the 1800s you only had to be able to sign your name in order to be considered literate. We now view literacy as something that exists in gradations, not as something you either have or don’t have.

Who are these people?

There are many misconceptions about low literacy, what it means and whom it affects. While you might assume that only those who didn’t finish high school or who speak English as a second language have low literacy skills, you’d be wrong. And although it’s true that minority groups are disproportionately affected by low literacy, according to an earlier NALS survey, most of those with low literacy skills in the United States are white and native-born. Completing high school doesn’t get you out of the woods either: A person’s literacy skills tend to be three to five grade levels lower than the last school year completed. The U.S. Department of Health and Human Services found that older adults tend to be much more likely to have low literacy skills, with nearly 35% of people ages 60–65 considered not functionally literate.

Despite how characteristics of low literacy may manifest themselves, they do not indicate a lack of intelligence; they indicate a lack of skills. Underdeveloped reading skills have less to do with IQ and more to do with economic factors like having to drop out of school to work to support a family. Reading, writing, and comprehension skills may be underdeveloped in people who are low-literate (or “low-lit”), but the capability to develop those skills is usually present. Think of it this way: I may not be the best typist, what with my 20-word-per-minute rate, but that doesn’t necessarily mean there’s anything wrong with me, or that I’m dumb. It just means I haven’t developed that skill.

Think you can tell who has low literacy skills by simply looking at or talking to them? You might not be as successful as you’d expect. Practitioners in the medical profession frequently deal with patients who have low literacy skills. Yet when physicians at one women’s health clinic were asked to identify which of their patients were very low-lit (defined in this study as reading below a third-grade level) they only did so successfully 20% of the time.

It’s difficult to tell when someone has low literacy skills for two main reasons:

1. They’ve developed coping mechanisms that hide their condition.
2. They don’t think of themselves as being poor readers.

In one study, two-thirds of those who admitted having reading difficulties had never told their spouse; 19% had never told anyone. Because of the stigma associated with underdeveloped reading skills, most people won’t reveal them. Instead they’ll come up with strategies to avoid reading, like saying they’ve left their glasses at home or that they usually leave the work of filling out forms to a family member.

Surprisingly, poor readers tend to view their own reading skills as adequate. In the National Adult Literacy Survey, 66–75% of adults in the very lowest skill level described themselves as being able to read or write English “well” or “very well.” Of those in the next lowest skill level, 93–97% described themselves this way.

What are the reading strategies of adults with low literacy skills?

There’s a lot of stuff going on in your brain when you read. First you have to recognize the words in front of you by associating the printed word with the spoken word it represents, a process called decoding. Beginning readers start by recognizing letters. More proficient readers can move past letter-by-letter reading to recognizing individual words. The second part of the process is comprehension — interpreting the meaning of all those sentences and paragraphs.

People with low literacy skills have difficulty understanding what they read because they’re spending so much effort on decoding — word and letter recognition — that they have few cognitive resources left to interpret meaning. They may read every word put in front of them, but because they don’t have much left to attend to comprehension, they take little meaning from what they read.

When you observe someone who has low literacy skills reading, you’ll likely see some of the following behaviors:

• Reading one word at a time: Observe an eye-tracking test and you’ll see that most people fixate on one word out of every three or four. But low-lit readers may fixate on every single word. By spending all their cognitive resources on word recognition, low-lit readers may have little left over to interpret what they’ve read.
• Taking things literally: Being able to apply what you’ve read to your situation is one of the key literacy skill sets. Low-lit readers don’t do this very well, particularly with abstract concepts based on written text. They tend to think in concrete terms. Because they take things so literally, they may not realize that stories or examples used in written text are meant to illustrate a point or actually apply to them.
• Avoiding reading altogether: Low-lit readers will judge whether it’s even worth their time to attempt to read. They may skip difficult words or entire chunks of text and miss the information they were looking for in the first place.
• Satisficing: A combination of the words “satisfy” and “suffice,” this refers to the tendency of low-lit readers to stop reading as soon as they’ve found the first plausible answer to what they were looking for, even if it isn’t the best answer or even the correct answer.
• Retaining little: People with low literacy skills may not be able to store as much information in their short-term memory. Adults with adequate literacy skills can store around seven independent chunks of information at a time in short-term memory. The number for poor readers may be closer to five or fewer. That becomes a problem when you include lots of information (more than five to seven chunks) and expect readers to remember it. When our working memory is full but more stuff is coming our way, our brains don’t just discard some of what’s in there, it all gets dumped. So it’s not a good idea to include lots of information in text and hope that some of it will stick; it probably won’t.

How to accommodate those with low literacy skills

You might be feeling like there is little you can do to accommodate poor readers. But take heart, content creators! There are ways to present information that make it easier (if not exactly easy) for low-literate adults to understand and use it.

• Make it easy to read: Writing text at an appropriate reading level can give the reader a better chance of understanding and being able to use the information. Plain language guidelines like using common words and shorter sentences will help.
• Make it look easy to read: Designing a simple layout with lots of white space, type that is large enough to be easily read, and headings that provide visual cues about the content will make the interface less intimidating.
• Include only what’s important: Given the amount of effort required by low-lit readers to decode text, much less interpret and apply it, you should only include information they need to know, not what’s nice to know. Focus first on actions the user should take, not the theory behind why they should be taken.
• Be consistent: Using synonyms (for example, alternating between using “dairy” and “milk” at different points in text to describe dietary restrictions for a medication) requires additional cognitive resources. What is often obvious to skilled readers — like using two different words to mean the same thing — requires more work for poor readers to decipher.
• Provide feedback: Let users know there are a certain number of steps to achieve a desired result and where they are in the process; in other words, provide a light at the end of the tunnel. Provide validation whenever possible. Otherwise, low-lit users may opt out.

Why bother?

I’ve heard people question why it’s the writer’s or designer’s responsibility to accommodate people with underdeveloped reading skills. “Shouldn’t we expect people to attain a basic level of literacy? Why is it my job to do all the hard work for them?”

Crafting information so that it meets the needs of your audience is hard. No doubt about it. Audiences can be inconvenient and unwieldy. They’re rarely homogenous. They probably don’t know what you know. If they did, they wouldn’t need you to fill in that gap, would they? Writing to accommodate people with low literacy skills may feel like introducing a new set of requirements, but it isn’t really — because there has always been a large part of the population with low literacy skills. Those results from the NALS? They don’t really change much from decade to decade. People with low literacy skills have always been part of your audience. They’ve always needed information to be presented clearly, plainly, and simply so they can succeed in understanding and using it. You probably just didn’t know it. But now you do.

Accommodating low-literate adults does not come at the expense of more adept readers.

Another common question is “Won’t dumbing down the content make it unpleasant for everyone else?” First, let’s get one thing straight: You’re not “dumbing down” anything, you’re simplifying it. Second, accommodating low-literate adults does not come at the expense of more adept readers. In fact, crafting your content to accommodate this audience has the added benefit of making information easier for everyone to read, understand, and use. Everybody appreciates clarity. So I say the answer to this is a resounding “no.” (For a quantitative comparison of task success, time-on-task, and satisfaction for low- vs. average-lit participants using a site designed for low-lit users, read Jakob Nielsen’s Alertbox article on low literacy, in the reading list below.)

My final reason for recommending that you take low-lit readers into account when creating content is completely self-serving: One day that may be you.

We’re all low-lit (at times)

Ever screw up a recipe because you were rushing to finish before the guests arrived and mistook “t” for “T”? Ever been confused while in a foreign country trying to figure out how to use public transportation to get to the Flughafen (airport)? Then you’ve experienced some of the same situations and exhibited some of the same behaviors as people with low literacy skills. When people are tired, under stress, or just plain busy, they may have fewer cognitive resources to bring to the task at hand. And that has an effect on word recognition, inference, problem solving, all the skills you use for reading and understanding.

Let me tell you a story from my own experience: When my son was four years old, he had his tonsils removed. About a week later, the surgery site started bleeding badly. I called the doctor’s office to ask what to do and was told to take my son to the emergency room at St. Christopher’s Hospital in Philadelphia, where the doctor would meet us and take my son in for surgery.

In my panic, I forgot to ask the administrator for the hospital’s address. So I looked it up on Google, wrote down the first result for “St. Christopher’s Hospital for Children …”, got in the car, entered it into the GPS, and started driving.

When I arrived at that address half an hour later, there was no hospital. The address I had written down was for the St. Christopher’s Hospital for Children Foundation in West Philadelphia. The hospital, my intended destination, was nearly 45 minutes away in North Philadelphia. (Fortunately I was close to another hospital. They stabilized him, then sent us via ambulance to the other hospital and the awaiting surgeon.)

This is classic satisficing behavior: picking the first plausible answer without confirming that it’s the correct or best answer. I don’t have low literacy skills, but that afternoon, because of the high-stress situation, I behaved like I did.

It’s tempting to think that audiences are coming to our content with the basic skills needed to comprehend and interpret it. That may simply not be the case. Part of considering your content from your user’s perspective is understanding what reading skills the user brings to the equation and writing to accommodate them.

For more information

There are so many resources out there about low literacy and how to design and write for it. Some great places to start:

• Teaching Patients with Low Literacy Skills by Ceci and Len Doak. If you read nothing else about low literacy, you must read this.
• Clear & Simple: Developing Effective Print Materials for Low-Literate Readers published by the National Institutes of Health
• Caroline Jarrett’s Design to Read site
• Kathryn Summers’ research on Reading and Navigational Strategies of Web Users with Lower Literacy Skills and Designing Web-based Forms for Users with Low Literacy Skills
• Recruiting Users with Low Literacy Skills by Angela Colter
• Lower-Literacy Users: Writing for a Broad Consumer Audience by Jakob Nielsen
• Adult Literacy in America: A first look at the findings of the National Adult Literacy Survey (PDF)
• Literacy in the Information Age: Final Report of the International Adult Literacy Survey (PDF)
• Unweaving the Web: An Exploratory Study of Low-Literate Adults’ Navigation Skills on the World Wide Web (PDF)
• The Association of Health Literacy with Cervical Cancer Prevention Knowledge and Health Behaviors in a Multiethnic Cohort of Women
• Shame and Health Literacy: The Unspoken Connection