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Creating Accessible PDF files using MS Word 2010 (Windows)

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This document is available in alternate formats upon request. Please contact the Accessibility Hub Coordinator.

Why make documents accessible?

Making accessible documents ensures that they usable by the widest range of users, but also ensures your document is easier to edit and navigate. It is important to make these changes to Word documents to accommodate a variety of disabilities. For example, many people with visual disabilities use screen readers which read aloud information on the screen such as text or image descriptions provided through alternative text (Alt Text).

If you plan, format, and structure your document correctly in the beginning, it will ensure the file is not only accessible but can also be converted into a variety of different alternate formats (e.g. PDF or braille) while retaining its accessibility features.


What are Accessible PDF files?

Usually, accessible PDF files are “tagged” documents. Tags are hidden accessible elements that provide structure for screen readers.

PDF files are usually created from applications such as Microsoft Word or PowerPoint but there are many more. Creating accessible PDF files depends on the accessibility of the original document like the use of headings, alt text for images and colour contrast etc. for example. Please view tutorials for Creating Accessible Word Documents for Word, or Mac, Creating Accessible PowerPoint Presentations Word, or Mac for more information.

Although you can create PDF files using several programs, it is best practice to use Adobe Acrobat Professional in conjuncture to evaluate, repair, and enhance the accessibility of existing PDF files.

Best Practice When Using Word 2010

Update: creating a PDF through "Save As >> PDF" of a .docx file in Word 2013 seems fine.

Even though MS Word 2010 has the ability to create tagged PDF natively (i.e. “File”, “Save as”, “PDF”), it was found during accessibility testing that the resulting structure and reading order of PDF file created from a .docx file was very poor. The method used to create the best results using Microsoft Word or PowerPoint files:

  1. Create an accessible document with headings, alternate text, etc. Please view other tutorials in the Accessibility Hub for detailed information on achieving this.
  2. Save the document in an older format (e.g. MS Word .doc) File >> Save as >> Word 97-2003 Document.
  3. Install Adobe Acrobat Professional available at the Queen’s Computer Store for departments, faculty, staff, and students. When Adobe Acrobat Professional is installed, it will also install an add-in called PDFMaker into MS Office.

Using MS Word 2010 and Adobe add-in PDFMaker

First, follow the three steps as described above. To create a tagged PDF, in MS Word, select “Preferences” from the Acrobat ribbon and ensure that “Enable Accessibility and Reflow with tagged Adobe PDF” is checked.

screenshot setting PDF preferences from the Acrobat ribbon

screenshot: Enable Accessibility and Reflow with tagged Adobe PDF is checked

With the “Preferences” window still open, select the “Bookmarks” tab, and ensure “Convert Word Headings to Bookmarks” is checked.

screenshot: Converting Word Headings to Bookmarks

To save your MS Word document as a PDF file

There are two methods to convert your MS Word document (.doc) to a PDF file. The first is to select “File” from the ribbon, then “Save as Adobe PDF”.

screenshot: Save as Adobe PDF from File in the ribbon

The second method is to select “Create PDF” from the “Acrobat” ribbon.

screenshot: creating adobe pdf from acrobat ribbon

Using Adobe Acrobat Professional

Now that you have a saved PDF file, you need to ensure the tagging and reading order allow for proper accessibility. As previously mentioned, Adobe Acrobat Professional is used to evaluate, repair, and enhance the accessibility of existing PDF files. The software is available at the Queen’s Computer Store for departments, faculty, staff, and students.


One step of checking the accessibility of the document is to view the tags. When a PDF is tagged properly, the logical structure of the file can be read by a screen reader or other assistive technology in an appropriate manner. This can lead to better reading and navigation while using these assistive technologies. The “Tags pane” can be opened by selecting “View”, then “Show/Hide”, then “Navigation Panes”, then “Tags”.

screenshot: opening the tags pane in Acrobat Pro

Within the Tags pane, you may view, reorder, rename, modify, delete, and create tags.

screenshot: the tags pane

By selecting each tag in the list, the corresponding content in the document will be highlighted (if not, check “Highlight Content” from the “Options” menu screenshot: options menu to highlight tagged content )

Add tags to an untagged document

Tags may be added to an untagged document, choose “Tools” from the right-hand menu, then select “Accessibility”, then “Add Tags to Document”.

TouchUp Reading Order

With this tool, the user can add and edit PDF tags and view the reading order of elements on the page. It is important to note that this method should not take the place of using the “Tags pane”. Certain tags, such as lists, are only available in the Tags pane.

To use the tool, select “Tools” from the right-hand menu, then “Accessibility”, then “TouchUp Reading Order”.

You will notice a couple of things. First, all the content of your document will be enclosed by various numbered boxes. These boxes represent a tag and the number corresponds with the tag number in the “Order” pane (more information in the next section). Secondly, the “TouchUp Reading Order” window will also open.

screenshot: touch-up reading order window

The window has groups of buttons so you can edit and add tags to any numbered block of text in your document or selected text/objects of your choice.

Order Pane

The Order pane allows you to change the reading order of the content on the page so it matches the visual reading order. To open the Order pane, select “View”, then “Show/Hide”, then “Navigation Panes”, then “Order”.

screenshot: how to show the order pane

The “Order pane” divides the document into pages and every element is ordered into the reading order. This makes changing the tags and reading order much easier by simply drag-and-drop the elements into the desired order.

screenshot of the order pane

Checking Accessibility

Adobe Acrobat Professional X can run an “Accessibility Full Check”. This can be a good tool to ensure that nothing was overlooked. Run the full check by, selecting “Tools” in the right-hand column, then “Advanced”, then “Accessibility”, then “Full Check”. This action opens another window. On the bottom right-hand side select “Start Checking”. This will generate a report of accessibility errors and tell you how to fix them.

Action Wizard

The Create Accessible PDFs” Action Wizard in Acrobat X is a tool to ensure that you don't miss any steps while making your document accessible. To run the wizard, select the “Tools” in the right-hand column, then “Action Wizard”, then “Create Accessible PDFs”.

Read Out Loud

Read Out Loud is a built-in voice synthesizer that is available in Adobe Reader and Acrobat that reads the content of a PDF document out loud to you. You can get a good idea of what screen reader users encounter.

External Resources

WebAim – PDF Accessibility

Penn State Accessibility - PDF Issues, Recommendations and Links