Heading levels

The use of headings normally helps to:

  • Indicate the beginning of the main content
  • Indicate the title of a section within the content
  • Distinguish the different navigation sections, such as the main, secondary or footer navigation
  • Indicate images (containing text) with the visual appearance of headings

As these titles indicate the beginning of important sections within the content, it is possible for assistive technology users to access the list of headings by going directly to the desired content via these headings.

This ability to “browse” the content via the headings and to go directly to the content of particular interest speeds up the navigation of these documents significantly.

The most common mistake is to create texts that visually appear as headings. This is why it is primordial to apply heading levels via styles defined in Word.

The use of styles defined in Word makes it possible to directly apply appropriate heading levels. Word offers many default heading levels on the “Home” tab, in the “Styles” group, found on the ribbon.

To make a document accessible, one must use heading levels in the corresponding order defined in the style list: Heading 1, Heading 2, Heading 3.

Heading 1 is more important than Heading 2, and so on.

It is important to follow the heading order correctly: For example, a level 1 Heading cannot be followed by a level 3 Heading.

The suggested heading styles must never be used for formatting purposes only, but to give the document the correct hierarchal order.

You can set your own formatting style if you do not wish to use the default styles provided. (See the chapter on “Styles and Formatting”)

Table of contents and bookmarks

The “Bookmarks” in Acrobat Reader, make it possible to access part of a document rapidly. One must, therefore, make it possible for users to locate the desired content by using bookmarks, for long documents in particular.

A person with a cognitive disability could prefer a hierarchy which enables a rapid overview of the document instead of having to read the entire document and scroll through all the pages. It is also a conventional way of navigating through the document which will be beneficial to all users. These bookmarks can be generated in Microsoft Word.

A table of contents which follows the hierarchal order of the headings used in the document must first be generated in Word. This is why it is important to adopt a clear hierarchy throughout the document by defining the headings for each large part, level 2 headings and then level 3 headings, depending on one’s needs (See Heading levels criteria).

To do this, one must go to the “References” tab found on the ribbon and then to “Table of Contents”. Then choose the desired automatic table (the only difference between the two automatic tables is the heading).

During the export of the document to PDF, check in the export options “Create bookmarks using: Headings”.

If the document contains a glossary or an index; these sections must include headings which will appear in the table of contents (and therefore as bookmarks in the PDF document).


The advantage of Microsoft Word is that it makes it possible to create documents containing several columns directly, which assistive technologies will read in the correct order. To create columns, go to the “Page Layout” tab found on the ribbon then, “Columns” and choose the desired number of columns.


In terms of accessibility, paragraphs do not present any particular problems.

However, it is recommended to:

  • Avoid inserting several line breaks between 2 paragraphs; rather use the Line Spacing options
  • Set these line spacing options for paragraphs properly then update the “Normal” style. This, in particular, makes it possible to always use the same formatting for every paragraph that will be created in the document.

To adjust the line spacing between several paragraphs, one must first select them. Then go to “Home” tab on the ribbon and open the “Paragraph” dialogue box, found in the “Paragraph” group of options.

The dialogue box contains alignment, indentation, spacing and outline level options.

In the “Line and Page Breaks” tab, pagination can be managed (for example, to avoid widow and orphan lines) and formatting exceptions.

For better readability, it is also recommended:

  • To avoid centered text alignment
  • To avoid justified alignment of the text, which would result in the gap between characters being too small

It is also important to highlight all upper case letters to make it easy to read but also for screen readers which will transcribe the words as they are written.

Avoid using text boxes

Word offers a function allowing the creation of “Text boxes”. They are floating objects in the document, which can contain text, images, tables, etc.

However, these floating zones raise serious problems regarding accessibility: When they will be converted to PDF format, the reading order may be entirely erroneous and can even prevent assistive technology users from accessing these zones.

It is therefore recommended to avoid using text boxes; otherwise, the logical reading order of tags in Acrobat Pro will have to be redefined.

Use of lists

Able-body users can recognise lists visually and rapidly estimate the number of elements present in these lists. This is also the case for those using assistive technologies such as screen readers: the beginning and the end of the lists are indicated and the number of elements present in these lists are enumerated.

Assistive technology users can also navigate from one list to another and from one list item to another, via specific keyboard shortcuts.

One of the most common mistakes is the visual reproduction of “lists” (they only possess the appearance of lists). This is in particular the case when dashes “-” or other special characters are used. These “lists” are not recognised by screen readers, as one must make use of the list creation tools offered by Word.

Three list creation tools are found in the “Home” tab on the ribbon, then in the “Paragraph” group:

Bulleted lists, numbered lists and multilevel lists can be created (multilevel bulleted or numbered lists).

However, be careful when using multilevel lists; 2 main choices are suggested:

  • Lists without headings
  • Lists with headings

The lists with headings are visually indicated, with the use of several heading levels: Heading 1, Heading 2, etc.

When exporting to PDF format, “lists with headings” will no longer be recognised as lists but as headings only. Hence, caution should be exercised and the appropriate list creation tools should be used.

Another important note:

Try as much as possible to make the lists fit on one page only; otherwise, the screen readers will consider them as two separate lists (one per page).

Footnotes and Endnotes

Some screen readers such as JAWS offer a function which makes it possible to read the content of footnotes and endnotes out loud.

The screen reader will firstly read the first paragraph, then the corresponding footnote and go back to the logical order of the document by reading the next paragraph.

To create a footnote, go to “References” tab on the ribbon, then click on the “Insert Footnote” button.


For each page, only one footnote or endnote can be added. As a matter of fact, screen readers tend to read all the footnotes or endnotes at the same time, bringing confusion to the logical reading order of the document.