Creating a new document or editing an existing document
When creating a new document, there are typically two pathways to accessibility: 

1. Creating an accessible document from within a current PDF file
2. Generating an accessible PDF from another application (such as a word processor)

No matter how they are created, accessible PDF files have the following characteristics:

1. Searchable text (i.e. a PDF not saved as an image)
2. Interactive form fields and defined tab order (enabling users to use the Tab key to navigate within the document)
3. Navigational Aids (enabling users to navigate within the document using their keyboards)
1. Links
2. Bookmarks
3. Hyperlinks
4. Formatted Headings
4. Proper security settings that won’t interfere with a screen reader
5. Alternative Text descriptions for images and charts

Tips for Easy Accessibility

1. When creating a PDF, it is critical to utilize the pre-loaded styles to create headings and paragraph text so that screen readers can navigate easily through the document.  Headings created by using the font and bold buttons will not be recognized as headings by screen readers.
2. The best way to create accessible links is to use the ‘Create Link’ command.  Links must be active in order to be accessible.  Note that automatically detected/created links are not accessible (ensure that the Basic Tools > General Preference >  “Create Links from URLs” is unchecked.  Links must be created one at a time.
3. If you plan to password-protect your documents, in the Permissions section of the Password Security Settings dialogue, verify the box labeled “Enable text access for screen reader devices for the visually impaired” is checked. This is the default setting for Adobe Acrobat 9 and Adobe Reader 9
4. Use the Quick Check accessibility checker to check over your document before using it. 
   
   References
    Adobe Systems Incorporated. (2012). Adobe accessibility training resources. Retrieved from
   http://www.adobe.com/accessibility/products/acrobat/training.html

Scanning an existing document

1. Scanned images are inherently inaccessible because they contain images that represent the text on a page, not actual text.  These documents will appear as completely blank to those using assistive technologies.
2. Documents must be scanned using a scanner that produces a non-image file that contains the qualities listed above.
3. The procedures for creating accessible documents via scanning will be different for each scanner and software.
4. Currently, the Office of Disability Services at Buffalo State recommends the use of  ABBYY FineReader software for scanners as the easiest way to instantly produce accessible PDF files.
5. However, it is possible to create accessible files using Adobe Acrobat Pro.  The Ohio State University has an excellent tutorial on the typical process of scanning, OCR recognition, and editing the document for accessibility.