but simply read After making changes, save the document by pressing save on the toolbar.
However, most instructions I find for things with buttons like that do always say "the whatever icon" or "the whatever button".
For example, how to make bulleted lists in Open Office:
If you want to remove bullets from an outline item, click the item, then click the bullet toggle button on the toolbar. Click the button again to attach bullets to a paragraph the previously had no bullets.
They may do this to make sure users know they mean something in the program rather than something on their keyboard.
The alt attribute for the save-button should simply be Save.
Yes, I agree. I require title-tooltips to know what any but the most obvious icon/buttons do in any program (I can't even figure out the most of the SitePoint ones) and they only use action text in those (and the alt text is the same as the tooltip text).
What they are comparing this method to is a common popup/dialogue in WYSIWYGs (including theirs) that you see there (appears out of context of the text after an image is included). What I like is the example of the crappy alt text in the beginning ("I small icon of a red heart you") and the idea that now, a WYSIWYG program starts the user/content manager off with text first, so that user remains in the context of what they are saying.