Accessibility of digital services needs to be improved, in particular for users with cognitive and learning disabilities. Our focus is on digital design patterns that have the potential to increase comprehension for users with low cognitive and reading skills by combining short and simple text with effective design. We conducted a case study with 43 easy-to-read (ETR) users and 12 university students in a control group in which users select a theater play, find a date, and order tickets. In a participatory design process with four co-researchers and a User Experience (UX) expert, we created test material with high ecological validity. Subsequent testing collected quantitative and qualitative data to provide a clear picture of the context of use, the differences in success of the three variants, and the challenges of a multi-step ordering process. Our contributions are an enhanced participatory design process involving UX experts, insights into ETR users' context of use, and proposals for cogni-tively accessible design patterns for ticket selection, appointments, and an exemplary simplified ordering process that can be applied to similar digital services. * First author This work is licensed under a Creative Commons Attribution 4.0 International License. CHI '26,

As designers and researchers, it is our duty to ensure information accessibility for all, irrespective of cognitive abilities. Currently, Easy-to-Read (ETR) is commonly used to simplify text for individuals with cognitive impairments. Although design aspects of text comprehensibility have recently gained attention, digital design patterns remain relatively unexplored. Our understanding of how ETR users interact with digital media, and how to design specifically for their needs, is still limited. Our study involved observing 20 German ETR users engaging with a digital PDF and a website designed in a participatory process. We collected data on their access to digital media, personal use and workarounds, and their interaction with digital design patterns. Tasks on the smartphone were completed mostly successfully, while only 50% could navigate a digital PDF. In both cases, visual cues played a significant role. Our findings contribute recommendations for beneficial digital design patterns and future research.