Accessibility Statement for AAP Publications

June 16, 2025

AAP Publications is committed to providing a website that is accessible to the widest possible audience, regardless of technology or ability. We are actively working to increase the accessibility and usability of our website while adhering to available standards and guidelines. Alternative text and extended descriptions are not reviewed for consistency with AAP policy.

The European Accessibility Act (EAA) aims to improve the accessibility of products and services for people with disabilities. This EU directive mandates that e-books, along with e-readers, reading software, and e-commerce platforms, must be accessible to people with disabilities. The EAA aims to ensure equal access to digital content and services for all citizens, including those with disabilities. 

The EAA requires certain features for e-book content, including

• Text-to-speech functionality.
• Customization of font size and spacing between letters, lines, and paragraphs.
• Discoverability through accessibility metadata.
• E-book files and digital rights management do not interfere with assistive technology.
• Flexibility and choice in presentation of the content.

The American Academy of Pediatrics (AAP) is committed to the creation of content that meets modern accessibility expectations by applying best practices to target Level AA conformance to Web Content Accessibility Guidelines (WCAG) 2.2 standards of the World Wide Web Consortium (W3C) Web Accessibility Initiative (WAI). Accessibility compliance is tested using industry-standard WCAG 2.2 validation software.

AAP Publications is conformant with WCAG 2.1 Level AA. The EAA highlights the importance of meeting and maintaining that goal. Download our Voluntary Product Accessibility Template (VPAT).

• Our platform host is committed to updating their tools to increase visibility into areas where adjustments may be needed for accessibility compliance. They provide actionable insights on how to enhance accessibility and offer support for alt text, long descriptions, transcripts, tables, lists, and math tagging. Our site is designed for sufficient color contrast and uses clear and legible fonts and clearly defined links. Additional platform upgrades for EAA compliance include: improved keyboard navigation for search pages, maintained keyboard focus after page refresh, addition of ARIA (Accessible Rich Internet Applications) labels to buttons, and improved labeling for asterisk and dagger author note symbols (* and †).

Accessibility Widget

AAP Publications makes the UserWay Web Accessibility Widget available at the lower left of your screen. The widget is powered by a dedicated accessibility server and does not collect any personal information. The software allows AAP Publications to improve its compliance with WCAG 2.1.

The widget helps address specific EAA requirements including

• Making digital content perceivable and operable for users with disabilities
• Ensuring our websites are compatible with assistive technologies
• Providing alternative formats for information

The widget includes various settings for user-managed adjustments on our websites, including

• Screen reader for text-to-speech functionality
• Customization of font size and ability to adjust spacing between letters, lines, and paragraphs
• A variety of additional settings allowing users flexibility and choice in presentation of the content, with contrast adjuster, dyslexia-friendly fonts, color saturation, and text size

Summary of AAP Books Accessibility Compliance

As the EAA deadline approaches, here is an overview of our current compliance status, ongoing improvements, and future goals.

1. Structured Text and Navigation

All AAP eBooks are created within a structured and standardized schema known as BITS. This is an XML format developed by the National Information Standards Organization (NISO). Well-structured XML is human and machine readable, ensuring that our products and services can be perceived, operated, and understood by persons with disabilities. This also ensures a proper heading hierarchy (H1, H2, etc) for screen reader navigation and logical reading order for assistive technologies. Book content uses subheadings, bullet points, and numbered lists to guide readers through the book without overwhelming them. The AAP Publications site has a responsive design and adapts to different screen sizes.

The XML includes metadata such as alt text for images, which allows better discoverability through accessibility metadata.

The UserWay accessibility widget can also assist users with screen reader navigation and additional keyboard navigation.

2. Color Contrast and Management

• The UserWay accessibility widget helps users adjust color contrast (applies to XML-based e-books).

• AAP eBooks are created with sufficient contrast between text and background colors, especially for those with low vision or color blindness. Color is not used as the sole method of conveying content or distinguishing visual elements.
• Line spacing (leading) is set close to 1.5 to enhance readability and character spacing (kerning) is set to avoid visual distractions and improve legibility.

3. Alt Text and Extended Descriptions

The AAP Books site currently hosts 12 backlist titles that include alternate-text (alt-text) and/or extended descriptions. Alt-text is descriptive text that replaces an image if it cannot be displayed, and provides a text alternative for visually impaired users who use screen readers. Extended descriptions are provided for complex visuals (graphs, diagrams, algorithms). New content published after June 28, 2025 will include alt text for images to comply with EAA.