A holistic understanding of challenges faced by people with low vision

BACKGROUND: There is lack of understanding of “user experience”; i.e. how people with visual impairments use today’s emerging mainstream technologies along with assistive technologies, which would ultimately lead to less user-friendly designs. OBJECTIVE: The primary aim of this study is to advance knowledge of user needs and concerns about usability of mainstream and assistive technologies. METHODS: The archival research method was used to obtain data via online forum sites. After reviewing six forum sites, this study has found 92 messages that specifically discussed the use of technology, and reviewed the messages by comparing them with ten usability heuristics by Nielsen. RESULTS: The majority of usability problems were associated with flexibility and efficiency of use; help for users to recognize, diagnose, and recover from errors; and help documentation. CONCLUSIONS: It is imperative to focus on improving usability of both assistive and mainstream technologies in use by people with visual impairments.

Chapter 1. Assistive Technologies for Improving Quality of Life Giulio E. Lancioni, Nirbhay N. Singh.- Chapter 2. Assistive Technology for People with Acquired Brain Injury Mandy Rispoli, Wendy Machalicek, Russell Lang.- Chapter 3. Assistive Technology for Postsecondary Students with Disabilities Russell Lang, Sathiyaprakash Ramdoss, Jeff Sigafoos, Vanessa Green, Larah van der Meer, Amy Tostanoski, Allyson Lee, Mark O'Reilly.- Chapter 4. Assistive Technology for People with Communication Disorders Jeff Sigafoos, Ralf W. Schlosser, Giulio E. Lancioni, Mark F. O'Reilly, Vanessa A. Green, Nirbhay N. Singh.- Chapter 5. Assistive Technology for Students with Visual Impairments and Blindness Austin M. Mulloy, Cindy Gevarter, Megan Hopkins, Kevin S. Sutherland, Sathiyaprakash T. Ramdoss.- Chapter 6. Assistive Technology for People with Autism Spectrum Disorders Russell Lang, Sathiyaprakash Ramdoss, Tracy Raulston, Amarie Carnet, Jeff Sigafoos, Robert Didden, Dennis Moore, Sam DiGangi, Mark O'Reilly.- Chapter 7. Assistive Technology for People with Behavior Problems Mark O'Reilly, Giulio E. Lancioni, Jeff Sigafoos, Russell Lang, Olive Healy, Nirbhay N. Singh, Audrey Sorrells, Soyeon Kang, Heather Koch, Laura Rojeski, Cindy Gevarter.- Chapter 8. Assistive Technology For People With Alzheimer's Disease Nirbhay N. Singh, Giulio E. Lancioni, Jeff Sigafoos, Mark O'Reilly, Alan S.W. Winton Chapter 9. Assistive Technology for Individuals with Learning Disabilities Diane P. Bryant, Brian R. Bryant, Min Wook Ok.- Chapter 10. Assistive Technology for People with Severe/Profound Intellectual and Multiple Disabilities Giulio E. Lancioni, Nirbhay N. Singh, Mark F. O'Reilly, Jeff Sigafoos, Doretta Oliva.

Our goal is to educate a broader population about the technological needs and interests of people with vision impairments while encouraging artificial intelligence (AI) researchers to develop new algorithms that can help eliminate accessibility barriers. Towards this goal, we organised the VizWiz Grand Challenge Workshop at the IEEE/CVF Computer Vision and Pattern Recognition conference (CVPR 2022). This workshop's scope included charting and celebrating progress on accessibility-related AI challenges as well as engaging invited speakers and stakeholders to discuss challenges and opportunities related to designing next-generation assistive technologies. A total of 72 teams participated in our three AI challenges and the winners received awards sponsored by Microsoft. The facilitated discussions highlighted insights from ten invited speakers who provided a range of expertise spanning the cutting edge of computer vision research, development of industry products and services for assisting people with vision impairments, and perspectives of people with vision impairments who use visual assistance technologies. Finally, nine teams who submitted extended abstracts about their research related to the AI challenges and assistive technologies for people with visual impairments gave spotlight and poster presentations about their research. Links to the content shared at the event can be found at VizWiz Workshop

Background and Objectives: Social anxiety is a type of disorder in which a person becomes anxious and afraid in social interactions and situations. It is well known that 90% of a person’s social interactions are related to their vision, so blind people definitely have problems in all their social interactions. Methods: Leibovitz’s social anxiety scale is the only tool that is based on social situations. Participants were asked to answer the questions of the data collection tool. Normal subjects were also randomly selected from the normal population who are similar to the patient group in terms of age and gender. The results were analyzed with relevant statistical software. Results: The results show that the average score of social anxiety in the blind group is 43.27 and 44.25 in the sighted group. The average score of avoidance in the blind group is 39.83 and 41.66 in the sighted group. The amount of social anxiety between the blind and the visually impaired group has a significant difference compared to normal people. There is also a significant difference in the comparison between totally blind and mildly impaired people (P=0.027). The amount of avoidance is also different between totally blind and sighted people. There is a significance (P=0.024) and there is a statistical difference between the totally blind and mildly visually impaired (P=0.022). Conclusion: People with normal vision or mild vision loss experience more degrees of social anxiety as well as avoidance than totally blind people.

This chapter provides an overview of studies that have evaluated the use of assistive technology to improve the communication functioning of individuals with specific types of communication disorders. The studies are divided into three groups based on the nature of the presenting communication disorder. The first group concerns studies that targeted individuals with cerebral palsy. The second group concerns studies on using assistive technology for people with other motor speech disorders, such as apraxia, dysarthria, and amyotrophic lateral sclerosis (ALS). The third group consists of studies focused on the use of assistive communication technologies to improve spoken and written language expression in people with aphasia. The final part of this chapter analyzes the overall outcomes of the three groups of studies reviewed, considers the implications of these findings for overall communication and social functioning, and highlights directions for future research.

Abstract: Introduction: Assistive technologies (AT) are products, equipment, devices, resources, methodologies and strategies that can be used in education to promote autonomous learning and academic success for students who have some type of disability. Objective: The objective was to analyze the AT available in medical courses in Brazil to support medical students with hearing and/or visual impairment. Methods: This is a descriptive study that used data from undergraduate medical courses participating in the Higher Education Census coordinated by Anísio Teixeira National Institute of Educational Studies and Research (Instituto Nacional de Estudos e Pesquisas Educacionais Anísio Teixeira, INEP), in 2018. AT for students with hearing and/or visual impairment that were available in medical courses were evaluated considering the characteristics of the institution, such as the type of administration (public versus private), location (capital versus interior) and the year the course started (from the year 2000 versus before year 2000). Results: In 2018, there were 323 active medical courses in Brazil. Most of them (90%) confirmed the offer of at least one type of AT. The discipline of Brazilian Sign Language (LIBRAS, Linguagem Brasileira de Sinais) was the most frequently offered AT (80%) and tactile material was the least offered AT (32%). There was greater comprehensiveness of AT supply for medical students in courses with a private administration, compared to the public ones. The location and the year the course started did not influence the provision of AT in Brazil. The courses showed better AT comprehensiveness to support students with hearing impairment than those with visual impairment. Conclusion: Most medical courses supply AT for people with visual and/or hearing impairments who are medical students, but incompletely. Although the location of the course and the length of time that the course has been active did not influence AT provision, the study revealed inequalities. Medical students with visual and/or hearing impairments have access to assistive technologies especially in courses with private administration, adding more barriers to their financial possibilities, which are already sufficiently affected by the fact that they have to meet the essential needs common to people living with disabilities.

Abstract: Introduction: Assistive technologies (AT) are products, equipment, devices, resources, methodologies and strategies that can be used in education to promote autonomous learning and academic success for students who have some type of disability. Objective: The objective was to analyze the AT available in medical courses in Brazil to support medical students with hearing and/or visual impairment. Methods: This is a descriptive study that used data from undergraduate medical courses participating in the Higher Education Census coordinated by Anísio Teixeira National Institute of Educational Studies and Research (Instituto Nacional de Estudos e Pesquisas Educacionais Anísio Teixeira, INEP), in 2018. AT for students with hearing and/or visual impairment that were available in medical courses were evaluated considering the characteristics of the institution, such as the type of administration (public versus private), location (capital versus interior) and the year the course started (from the year 2000 versus before year 2000). Results: In 2018, there were 323 active medical courses in Brazil. Most of them (90%) confirmed the offer of at least one type of AT. The discipline of Brazilian Sign Language (LIBRAS, Linguagem Brasileira de Sinais) was the most frequently offered AT (80%) and tactile material was the least offered AT (32%). There was greater comprehensiveness of AT supply for medical students in courses with a private administration, compared to the public ones. The location and the year the course started did not influence the provision of AT in Brazil. The courses showed better AT comprehensiveness to support students with hearing impairment than those with visual impairment. Conclusion: Most medical courses supply AT for people with visual and/or hearing impairments who are medical students, but incompletely. Although the location of the course and the length of time that the course has been active did not influence AT provision, the study revealed inequalities. Medical students with visual and/or hearing impairments have access to assistive technologies especially in courses with private administration, adding more barriers to their financial possibilities, which are already sufficiently affected by the fact that they have to meet the essential needs common to people living with disabilities.

Background Assistive Technology (AT) helps individuals with multiple sclerosis (MS) to overcome limitations and enhance their social engagement by providing support in areas that would otherwise be difficult or unachievable. Objective The aim of this study is to determine the level of AT usage among individuals with MS and to address various questions related to the sociological implications of (non)use of AT devices, (un)awareness, and logistical barriers that prevent the full utilization of AT devices in the daily activities. Method 121 participants with previously diagnosed MS (26 AT users, 95 non-users), aged 18–65, were surveyed using a modified The Rapid Assistive Technology Assessment tool (rATA) covering: demographics, needs, supply, financing, satisfaction, and recommendations. Results Totally 21.5% of MS individuals used AT, dominantly mobility devices. Insecurity prevents desirable usage of AT devices. Affordability is a factor relevant for the device ownership. Both MS individuals and society lacked sufficient AT informedness. Conclusion Based on the results and current guidelines, it’s essential to improve policies, supplying, AT device enhancements, and education to fully utilize AT’s potential in people with MS.

SIGNIFICANCESystematic lighting assessments should be part of low vision evaluations. The LuxIQ has gained popularity as an assessment tool, but its reliability has not been examined independently and is necessary for evidence-based vision rehabilitation.PURPOSEBesides magnification, improved lighting levels are a common intervention in reading rehabilitation for individuals with low vision. Determining the appropriate lighting can be a complex and time-consuming task. The LuxIQ is a portable lighting assessment tool that can be used to systematically measure lighting preferences; however, there is little independent evidence to support its reliability in low vision rehabilitation.METHODSOne hundred nine control subjects (age, 18 to 85 years) and 64 individuals with low vision (age, 27 to 99 years) adjusted both the luminance and color temperature parameters on the LuxIQ while viewing a sentence on the MNREAD at their preferred print size for continuous reading. After 30 minutes, they were asked to repeat the same measurements.RESULTSUsing Bland-Altman plots, test-retest variability was calculated using the limits of agreement (LOAs). For illuminance, the LOA width was 2806 lux for control subjects and 2657 lux for visually impaired participants. For color temperature, the LOA width was 2807 K for control subjects and 2364 K for those with a visual impairment. Difference scores were centered near zero, indicating overall accuracy.CONCLUSIONSThe measurement of lighting preference lacks the precision necessary for clinical utility, given that the LOA for luminance ranged more than 2600 lux, with normally sighted and low vision participants. Such variability translates into a range of approximately ±40 or 50 W in an incandescent light bulb, depending on the luminance level, making it clinically difficult to narrow down the options for evidence-based lighting recommendations. Next steps are to examine whether the reading behavior of low vision clients is positively affected by interventions that are based on LuxIQ recommendations.

To evaluate the impact of special software training in computer and smartphone apps as a form of rehabilitation to improve the quality of life of individuals with visual impairment (VI). The study utilized a one-group pretest-posttest design. A total of 50 individuals aged 15 years and older with VI participated in the training, which included special software (NVDA) and mobile app training for 60 hours at the Visual Rehabilitation Center. The Low Vision Quality of Life Questionnaire was administered before the start of training and six months after completion. The questionnaire covered the following domains: (1) mobility, distance vision, and lighting; (2) reading and fine work; (3) social well-being; (4) economic impact; (5) attitude toward life; and (6) activities of daily living. Statistical software STATA 14.0 (Texas, USA) was used for data analysis. Paired t-tests and Wilcoxon signed-rank tests were conducted to compare the mean differences before and after training. Significant improvements were observed in five dimensions, namely mobility, distance vision and lighting, reading and fine work, and attitude toward life, at a highly significant level of 1% probability. The dimensions of social well-being and economic impact showed significant improvement at a 5% level of probability. Visual impairment, whether congenital or acquired later in life, affects independence in all aspects of life. To the best of our knowledge, this is the first study to investigate the impact of special software training on the quality of life of visually impaired individuals. The authors suggest that this form of rehabilitation enhances accessibility to mainstream living, promotes independence, and ultimately improves quality of life. Participants experienced an improved quality of life through increased access to mainstream resources, enhanced ability to navigate and manage daily activities independently, and reduced reliance on multiple low vision aids or assistance from sighted individuals.

People with disabilities, specifically, those that are having a problem associated with sight or hearing, which falls under the categories of blind and deaf, require technological assistance to move freely. The technological area that is concerned with “Obstacle Detection and Feedback System” can be utilised to address the specific issues of dealing with the abovementioned problems. The growing demand for improved obstacle detection methods has pushed major developments in assistive technologies for people with visual impairments. The information needed and interrelationships among important criteria impacting the efficacy of obstacle detection systems are investigated in this work using the Decision-Making Trial and Evaluation Laboratory (DEMATEL) approach. Nine critical criteria, including Safety (SF), Accuracy of Detection (AD), Response Time (RT), Ease of Use (EU), Portability (PT), Battery Life (BL), Environmental Adaptability (EA), Cost (CT) and Durability (DD), are used. Data was collected from 21 expert participants through structured questionnaires, and the influence of each criterion was analysed using a total relation matrix. The most influential criteria identified were SF with a total influence score of 42.07, AD (41.08), RT (41.01) and Ease of EU (40.83). Factors such as BL (37.51) and CT (38.54) were found to be dependent on improvements in primary criteria. This study provides a structured decision-making framework to enhance obstacle detection systems by prioritising safety, real-time response and usability. The findings offer practical insights for developing AI-driven assistive technologies, ensuring improved accessibility, efficiency and integration into smart city environments.

Introduction: Despite the plethora of sensor-based assistive technology solutions, there is still no widespread acceptance and adoption by people who are blind or have low vision (i.e., visually impaired). Many reasons prevent reducing abandonment levels with a prominent one being a lack of focus on the dimension of training, which, from our standpoint, is integral to the acceptance of assistive technologies. To prove the importance of training, we extend and validate a new version of the Unified Theory of Acceptance and Use of Technology (UTAUT) model incorporating training as a factor. Methods: Closed- and open-ended questionnaires were given online and offline to 231 participants with visual impairments after conducting training sessions with an application for outdoor navigation by people with visual impairments developed by our research team. To assess the UTAUT extension exploratory factor analysis, confirmatory factor analysis, and structural equation model were employed to explore the relationships between the factors. A usability and user experience qualitative analysis supplemented the previous. Results: We uncovered that no factor besides performance expectancy (standardized regression weight = 0.264, p < .001) and training (standardized regression weight = 0.538, p < .001) significantly predict behavioral intention. Furthermore, the analysis demonstrated a significant interaction ( p < .007) strengthening the positive relationship between training and behavioral intention (standardized regression weight = 0.142). The qualitative analysis showed an overall positive evaluation highlighting the application's usefulness and dependability. Discussion: An application's adoption increases if individuals who are visually impaired are properly trained and acquainted with the features in real-life scenarios and recognize the application's utility for their daily lives. Implications for Practitioners: Training plays an important role in technology acceptance. It can be leveraged to make solutions more appealing to people who are visually impaired.

Objective: To analyze the causes of blindness and residual vision at the Quanzhou Blind School and provide information to help prevent childhood blindness and low vision. Methods: This was a cross-sectional study of all the students (n=126) at the Quanzhou Blind School. All students received routine ophthalmology examinations. A detailed individual-level questionnaire was administered that addressed the causes of blindness and low vision. Results: Among the 126 students, 66 had low vision, and 60 were blind. The major causes of blindness were retinopathy of prematurity (ROP) (23.3%), corneal degeneration (13.3%), optic nerve atrophy (13.3%), and congenital glaucoma (11.7%). The major causes of low vision were congenital cataract (27.3%), nystagmus (13.7%), optic nerve atrophy (10.6%), and corneal degeneration (9.1%). Conclusions: Congenital or hereditary diseases were the leading causes of vision loss at the Quanzhou Blind School. ROP was the principle cause of blindness. Most low vision cases were due to congenital cataract. Key words: blind school; low vision; pathogeny

Ocular causes of reading impairment following stroke include visual field loss, eye movement impairment and poor central vision. Non ocular causes may include cognitive errors or language impairment. The purpose of this study was to identify all patients referred with suspected visual impairment who had reported reading difficulty to establish the prevalence of ocular and non ocular causes. Prospective, multicentre, observation study with standardised referral and assessment forms across 21 sites. Visual assessment included visual acuity measurement, visual field assessment, ocular alignment, and movement and visual inattention assessment. Multicentre ethical approval and informed patient consent were obtained. A total of 915 patients were recruited, with a mean age of 69·18 years (standard deviation 14·19). Reading difficulties were reported by 177 patients (19·3%), with reading difficulty as the only symptom in 39 patients. Fifteen patients had normal visual assessment but with a diagnosis of expressive or receptive aphasia. Eight patients had alexia. One hundred and nine patients had visual field loss, 85 with eye movement abnormality, 27 with low vision and 39 patients with visual perceptual impairment. Eighty-seven patients had multiple ocular diagnoses with combined visual field, eye movement, low vision or inattention problems. All patients with visual impairment were given targeted treatment and/or advice including prisms, occlusion, refraction, low vision aids and scanning exercises. Patients complaining of reading difficulty were mostly found to have visual impairment relating to low vision, eye movement or visual field loss. A small number were found to have non ocular causes of reading difficulty. Treatment or advice was possible for all patients with visual impairment.

Background Language development in children with visual impairments (i.e., blindness or low vision) has received significant attention, particularly regarding its pragmatic component. Controversy surrounds the development of the structural aspects of language in this population, which are crucial for fostering neurodevelopmental skills. This review aims to assess the existing literature on both structural and pragmatic language abilities in infants and children with visual impairments, considering implications for treatment. Method A systematic literature search adhering to PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines and the PICO (Population, Intervention, Comparator, and Outcome) framework yielded 13 relevant studies (1995–2022) from PubMed, PsycINFO, and Cochrane Library. Data synthesis focused on structural language skill development concerning social interactions, perceptual experience, parallels with Autism Spectrum Disorder, and pragmatic language skills in children with visual impairments aged birth to 12 years. Implications for language intervention were discussed. Results All selected articles ( n = 13) originated from high-income countries, predominantly featuring English-speaking participants. Studies often had small sample sizes and included children with heterogeneous causes and types of visual impairment, ranging from moderate visual impairment to blindness. Various tests and questionnaires assessed structural and pragmatic language skills. According to the American Speech-Language-Hearing Association (ASHA) classification, eight, two, and three articles were classified as having evidence levels IIa, IIb, and III, respectively. Conclusion The role of language is pivotal in the educational development of children with visual impairments, facilitating their understanding of the environment and compensating for the lack of visual experiences. Although studies typically suggest no need for direct intervention targeting structural language components, integrating parent training approaches focused on dyadic interaction characteristics and environmental organization can effectively promote language and communication development.