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Series: Designing accessible resources for people with disabilities and Deaf people

Creating Accessible 
E-Documents

Tip Sheet No. 3

July 2017

It is estimated that up to 4 percent of 
the U.S. population (12.5 million people) 
relies on some sort of assistive technology 
to access electronic documents and 
web pages.

Assistive technology includes: 

› screen-reading or text-to-speech 
software; 

› refreshable braille displays; and 

› screen magnifiers. 

The effectiveness of these assistive 
technologies depends on the accessibility 
of electronic documents. People view 
electronic documents (e-documents) on 
websites, through e-mail, or on a CD/
USB drive. Unless you make e-documents 
accessible to people with disabilities, they 
will find them difficult, if not impossible to 
access, read, and navigate. 

Accessible e-documents work in 
partnership with assistive technology 
to ensure people with disabilities have 
easy, effective, and equal access to 

Assistive technology

Screen readers are software 
programs that allow blind or visually 
impaired users to read the text that is 
displayed on the computer screen with 
a speech synthesizer or braille display.

A refreshable braille display 
or braille terminal is an electro-
mechanical device for displaying 
braille characters, usually by means 
of round-tipped pins raised through 
holes in a flat surface. Blind computer 
users who cannot use a monitor 
can use a braille terminal to read 
text output.

A screen magnifier is software 
that interfaces with a computer’s 
graphical output to present enlarged 
screen content. By enlarging part 
(or all) of a screen, people with visual 
impairments can better see words 
and images.



Creating Accessible E-Documents

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information. When you make your 
documents accessible, you also make 
them more portable. This means that 
they work better across all web browsers, 
computer systems, and types of devices 
(cellphones and handheld computers, 
printers, braille devices, etc.).

Elements of an accessible 
e-document

Styles, structure, and tags 

Screen readers rely on a document’s 
organization/hierarchy created 
when using styles to navigate the 
document. A style is a set of formatting 
characteristics applied to paragraphs, 
tables, characters, or lists. For example, 
in Microsoft Word if the style ribbon is 
not visible on your top toolbar, you can 
make the style ribbon visible by going 
to the File menu, choosing Options and 
then selecting Customize Ribbon in the 
popup box. There will be two columns 
of commands: the left side contains the 
options available, the right side shows 
those commands that are currently 
displayed on the top ribbon of Microsoft 
Office. Make sure that the style command 
is checked and moved to the right side.

The use of bold/underline/font 
size for headings and titles does not 
create structure; they are merely visual 
techniques used by, and for the benefit 
of, seeing readers. Using styles, on the 
other hand, actually creates a relational 
structure (hierarchy) on a document by 
assigning outline levels. For example, 
applying “title” style to a heading will 
ensure that it is read before a heading 
marked as subtitle. Use heading levels in 
descending order of importance to help 
users navigate the document and find 
information. 

Heading and paragraph styles, as 
well as a table of contents, make it easier 
for all readers to follow your document. 
These elements are especially important 
for people who rely on visual cues (such as 
section headings) to navigate and follow 
along in the document. They also allow 
people using screen readers to navigate 
the e-document in the intended order. 

Layout and reading order 

Screen readers present content to the 
user one item at a time. The progression 
through the document from beginning to 
end is like an automated telephone menu 
system that does not reveal all of the 
options at once. Users progress through it 
in a step-wise manner.

Reading order refers to how a screen 
reader goes through the document. 

Document tag structures should 
adhere to a logical order that is the same 



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as the order of the document implied from 
the visual layout. When the reading order 
is correct, people who are blind, low-
vision, or who have learning disabilities 
will be able to read the document in the 
same order as those without disabilities. 

Set the language 

Most word processing software offers 
the option to choose the language of the 
document you are creating. Setting the 
language of the document is imperative 
to ensure that assistive technology knows 
what language to speak. Depending on 
the software you are using, the option 
to set the language could be in various 
places. For example, in Microsoft Word, 
go to File, choose Options, and then 
select Language in the pop-up box to 
set the document’s language. Note: this 
process may vary depending on your 
operating system, as well as the version of 
Office and the software you are using. 

Graphics and images

Screen Reader software converts text to 
speech, but it cannot convert graphics/
images to text. You can add text to a 
graphic in the form of “Alternate text” 
or “Alt-text.” Alt-text is a description of 
the image or object that allows people 
using screen readers to understand the 
content of the graphic. Add Alt-text to 
any graphics, images, charts, or tables 
in your document. 

Alt-text should succinctly convey 
in words the same information that the 
graphic communicates. For example, in 
Microsoft Office programs, to add Alt-
text, right click on the graphic and select 
Format, click on Layout and Properties, 
and pick the Alt-text option. There are 
two boxes, one marked “Title” and the 
other marked “Description.” Type your 
Alt-text into the description box. Note: This 
process may vary depending on your 
operating system, as well as the version of 
Office and the word-processing program 
you are using. 

Tables

When using tables, create clear column 
headings that provide context and assist 
with navigation. For example in Microsoft 
Word, you can do this by selecting the 
row in the table that contains the column 
headings and opening Table Properties 
(you can do this by right-clicking on the 
table or under your Table tab). Go to 
the Row tab in the pop-up box and put a 
check mark in the box that says “Repeat 
as header row at the top of each page.” 



Creating Accessible E-Documents

Note: This process may vary depending 
on your operating system, as well as the 
version of Office and the word-processing 
program you are using.

Avoid using nested tables and merged 
or split cells inside of tables, because 
they make it difficult for a screen reader 
to navigate. 

To test and simplify the table structure:

1. Select the first cell of the table.

2. Press the tab key repeatedly to make 
sure that the focus moves across the 
row and then down to the first cell of 
the next row.

Charts and graphs 

Charts and graphs are not accessible 
to screen readers. You can make them 
accessible by adding a short caption 
that describes their content and also 
adding an alternative presentation of 
the findings. For example, if you have 
a chart on high school students with 
disabilities in your document, caption 
the chart with something like: 
“Pie chart students with disabilities 1.”

Pie chart students with disabilities 1

n Freshmen

n Sophomores

n Juniors

n Seniors

Then add an alternate presentation of the 
findings. You can do this by including a 
table of the data: 

Class

Percentage of students
with disabilities

Freshmen

30%

Sophomores

25%

Juniors

15%

Seniors

20%





Another way to provide the information 
for screen-reader users is to add Alt-text 
to the pie chart. That Alt-text should say 

Pie chart students with disabilities

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something like: “This pie chart shows 
that 30% of freshman students have 
disabilities, 25% of sophomore students 
have disabilities, 15% of junior students 
have disabilities, and 20% of senior 
students have disabilities.”

Lists

Instead of manually inserting bullets, 
numbers, or asterisks, use the List tool. 
As with headers, this tool enables screen 
readers to process list items more 
efficiently. Numbered lists with multiple 
levels should use a different numbering 
scheme on each level. 

Hyperlink text

Hyperlink text should provide a clear 
description of the link destination, 
rather than only providing the URL or 
saying “Click here.” 

ScreenTip text (which appears 
when your cursor hovers over a hyperlink) 
can be used in a way similar to Alt-text 
by providing additional detail about 
the hyperlink. 

Forms

Organize forms in a logical manner. To 
make it easier for the user, provide them 
with instructions for completing the form 
and which items are required. Using the 
Form Controls listed under the Developer 
tab will ensure that they have the correct 
labels and that they are readable by 
assistive technology.

Beyond word processing

Spreadsheet software

› Include labels for the x- and y-axis on 
charts and graphs.

› Label columns and rows to provide 
context and assist navigation of the 
table’s contents. 

› Use descriptions in addition to color 
and highlighting to ensure that people 
who cannot perceive color are still 
able to understand the information 
provided. 

› Avoid using blank cells, rows, or 
columns for formatting; these can 
mislead someone using a screen reader 
into thinking that there is nothing more 
in the table.

› Give all sheet tabs unique names.

Presentation software

› The correct use of slide layouts is 
key to ensuring that your content is 
accessible because the layout contains 
the structures a screen reader requires.

› Presentation-development software 
offers a variety of templates. Within 



Creating Accessible E-Documents

each template, you can choose a 
slide layout that meets your needs. 
Each layout will have a placeholder 
in which you can type text or insert 
visuals. Typing or adding items to these 
placeholders ensures that readers see 
the items in the order you intend. Screen 
readers recognize and read only items 
added correctly to a slide placeholder. 

E-mail

› Write e-mails in plain text, rich text, 
or HTML.

› Plain text is the recommended format 
for people using screen readers and 
other assistive technology. The font, 
font size, color, and contrast are set as 
preferences in the e-mail client. Users 
then get e-mails displayed the way 
they want.

› Choose a brief, engaging subject line. 

› Use clear, descriptive attachment file 
names (capitalize each letter of a 
filename to prevent a screen reader 
from reading the file name as a 
single word).

› Include text in the e-mail that indicates 
that a file is attached or that there are 
voting buttons.

› Avoid elements such as blinking text or 
animated images.

› Keep the design or look of your e-mail 
simple and easy to scan.

Portable Document Format (PDF)

› Tag a PDF to make it accessible. 
Tags provide the structured, textual 
representation of the PDF content 
that screen readers can access. 
A few examples of tags include: 

– Heading level 1 <H1>

– Table of contents <TOC>

– Paragraph <P>

› Tagging adds a layer of information 
called “semantics” to a PDF document. 
“Semantics” in the PDF context refers 
to the purpose of each block of text as 
established by its tag. For example, 
headings (<H1>, <H2>, etc.) are used 
for text that organizes other text 
contained in paragraph (<P>) tags. 

Types of email formatting

HTML (HyperText Markup Language) 
e-mail is formatted like a web page, 
using colors, graphics, table columns, 
and links.

Plain text e-mail is an e-mail that only 
includes text. 

Rich text (RT) e-mails support text 
formatting, such as bold, italics, and 
underlining, as well as different fonts, 
font sizes, and colored text.



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› When you save, for example, a 
Word document as a PDF, the Office 
application you are using identifies 
and labels the semantics you are using 
and adds them to the file. You have 
the option to include those structured 
tags in your PDF. A pop-up box will 
appear when you click on Save, and 
you should click the box next to the 
text “Document structure tags for 
accessibility.”

Viewers

When you offer e-documents, provide 
links to the available free viewers 
(such as PDF viewers). Users can then 
view the document without having the 
program on their computers. Free viewers 
are available for word processing, 
spreadsheet, and presentation software. 

Conclusion

This document offers ways to make 
electronic documents both visually 
appealing and disability-friendly. 
These tips not only benefit readers with 
a range of disabilities but also older 
people, those in trauma, and those for 
whom English is a second language. 



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Additional resources

Disability Access Services, CA Department 
of Rehabilitation, “Seven Steps 
to Creating an Accessible PowerPoint 
Slideshow” 

https://perma.cc/C5HY-GSNN

Create Accessible Electronic 
Documents 

https://perma.cc/WHY4-TW3M

Section 508: Making Electronic 
Documents Accessible: PDF 

https://perma.cc/B8CA-5ZXN

Section 508: Making Electronic 
Documents Accessible: Microsoft Excel

https://perma.cc/6A5M-VC9C 

Section 508: Making Electronic 
Documents Accessible: Microsoft Word

https://perma.cc/9HXK-8HMF 

Web Accessibility in Mind, “Designing 
for Screen Reader Compatibility” 

https://perma.cc/37KQ-8L4E

How to Make Your PowerPoint 2010 
Presentations 508-Compliant 

https://perma.cc/JJY4-V4JX

For more information

The Center on Victimization and Safety 
(CVS) at the Vera Institute of Justice works 
with communities around the country to 
fashion services that reach, appeal to, and 
benefit all victims. CVS’s work focuses on 
communities of people who are at elevated 
risk of harm but often marginalized from 
victim services and the criminal justice 
system. We combine research, technical 
assistance, and the training to equip 
policymakers and practitioners with the 
information, skills, and resources needed 
to effectively serve all victims. To learn 
more about CVS, contact cvs@vera.org. 

This project was supported by Grant 
No. 2014-TA-AX-K002 awarded by the U.S. 
Department of Justice (DOJ), Office 
on Violence Against Women (OVW). 
The opinions, findings, conclusions, 
and recommendations expressed in this 
publication are those of the authors(s) 
and do not necessarily reflect the views 
of DOJ, OVW.