Just as a sentence has proper structure, so does a paragraph or web page. The elements that help create this structure in a Word file or on the web are:
Titles are very important for those using screen readers, and most especially in eLearning. Be sure your pages have unit or module designations as well as description so students can tell the difference between module 1 content, module 2 content, etc. If you only use Introduction, Content, Assignments, Summary, etc., students will have no idea to which module these pertain to without going into each file.
Screen readers identify the headings on a page as a way to orient the user to the page structure and content. Think of Headings as you would outline enumeration:
This important cognitive aid is lost if you create headings using bold and increasing the font size. A screen reader only changes it's tone when encountering bold text. It cannot determine order or structure.
Screen readers will change in tone and volume when encountering bold or italics (emphasis) text. These are auditory cues for the visually impaired to pay particular attention to these words. However, they do not give order or structure information or cues.
Lists should always be created using the list feature in Word or in the HTML editor. NEVER use tabs, or type I., A., 1., etc, as the screen reader will not see this as a list and read the characters as part of the sentence. Ordered lists, using letters, numbers or a combination of both, tell the reader that there is a sequence to the items listed. An unordered list, which uses bullets, tells the reader that the items have no special order or sequence.
The example above for Headings also shows a nested list of six levels. Except for headings, a best practice is to limit nested lists to two levels (at most three levels):