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 Table of Contents  
GUEST EDITORIAL
Year : 2019  |  Volume : 31  |  Issue : 2  |  Page : 86-91

Assistive technology for students with visual disability: Classification matters


Department of Community Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India

Date of Web Publication27-Aug-2019

Correspondence Address:
Dr. Suraj Singh Senjam
Department of Community Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/kjo.kjo_36_19

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How to cite this article:
Senjam SS. Assistive technology for students with visual disability: Classification matters. Kerala J Ophthalmol 2019;31:86-91

How to cite this URL:
Senjam SS. Assistive technology for students with visual disability: Classification matters. Kerala J Ophthalmol [serial online] 2019 [cited 2019 Sep 20];31:86-91. Available from: http://www.kjophthal.com/text.asp?2019/31/2/86/265497





Disability is a global health concern that affects all people irrespective of age.[1] The International Classification of Functioning, Disability, and Health, WHO (ICF-WHO 2001) defines disability as a term including impairment, activity limitation, and participation restriction. It denotes the negative aspects of the interaction between an individual with a given health problem and that individual's environmental and social factors.[2] Persons with disabilities may have lack of access to health-care services due to various reasons, and lesser opportunities for education and employment, as well as participation in social and cultural events, or to enjoy social protection. Addressing disability needs a multidimensional approach, including the appropriate use of assistive technology (AT).


  Assistive Technology Top


The World Health Organization defines AT as “any piece of equipment, product, or tool, whether it is acquired commercially, modified, or customized, that is used to increase, maintain, or improve the functional capabilities of individuals with disabilities” based on the International Standard Organization.[3] The ICF-WHO later introduced the term “Health Technology” and redefines it into AT and assistive products (AP).[4]

AT includes the AP as well as the system and service provision related to these products.

AP is any form of external product (e.g., low vision aids, large print books, liquid level sensor, and computer software), especially designed and produced, whose primary purpose is to maintain or improve an individual's functioning and independence to facilitate participation in society and to enhance overall well-being. These products are ranged from very simple, low-technology devices such as walking cane to very sophisticated and highly specialized technology, e.g., specialized computer hardware and software.

Following the WHO report on disability published in 2011, the World Health Organization introduced the Global Cooperation on Assistive Technology (GATE) in 2014 to address the substantial gap between the demand and provision of AT for persons with disabilities in all countries. The vision of the GATE initiative is to create a world where everyone in need has high-quality, affordable AP to lead a healthy, productive, and dignified life. Under this global initiative, the WHO published the first list of 50 priority AP list needed by people with disability.[5] This list is for all types of disabilities. These 50 priority AP were selected through an extensive consultative process among users and potential users as well as experts and stakeholders from across the globe. There are sixteen assistive devices in the GATE list, which can be used by people with visual impairment.


  Assistive Technology for Students With Visual Disability: Its Classification Top


Educating students with visual loss poses a great challenge unlike sighted children who can learn easily so many things by observing and imitating. However, education is an indispensable for every citizen, irrespective of health condition or disability. According to The Universal Declaration of Human Rights, Article 26 United Nation, everyone as the right to education and technical& professional education shall be available to all.[6] The important aspect of educating the children with visual disability is to make them literate, self-reliant, and useful individuals to the society. The child with visual impairment needs more time to learn things or in performing basic life activities. They require a guidance and supervision from special educators and trainers or other rehabilitation professionals. The visual impairment to a child necessitates the use of special educational methods or adaption to materials. They need to use special aids and AT to be able to accomplish various educational activities while learning.

AT for visually impaired (low vision) and blind people is based on the use of sight or other senses, e.g., touch or vibration, sound, and smell. For example, braille and embossed print require touch to generate information for visually impaired and blind people. Over the last few years, the development on AT, including technology for people with visual impairment, is significantly improved mainly in industrialized countries. Despite such a rapid development of AT, there is no internationally accepted uniform and holistic classification of AT for visually impaired and blind people, especially for students with visual loss. Special educators, academics, and occupational therapists have tried to classify AT of visual impairment without specific mentioning for students' learning and teaching.[7],[8],[9],[10],[11] Evidence shows that there is no consensus and uniform classification on AT for students with visual impairment.


  Field Observation at Schools for the Blind Top


We visited National Association for the Blind New Delhi to evaluate students' activities at the school. The target group was students in grades nine and ten as they would be better familiar with schools' learning environment. Moreover, we expected that we could receive more information about the various activities of students from higher grades. We also did extensive conversation with teachers or tutors of the National Association for the Blind regarding medium of teaching for writing, reading and various discipline to learn by the students with visual loss. Further, we took expert opinion about various application and usage of assistive technologies while teaching and training to students with visual loss. The National Association for the Blind, Delhi, established in 1979, is a leading nonprofit organization working for visual loss children with special emphasis on education and skill development among students with visual loss. The association is a pioneer in initiating integrated education in Delhi.[12]

A similar consultation with rehabilitation experts about varied applications and role of assistive technologies to younger patients visiting visual rehabilitation clinic of a tertiary eye care hospital in Delhi was also done. As a result of extensive consultation and expert opinion, the assistive technology could be categorized into, first, three domains base on the body sense used [Table 1] and second, eight different domains as long as students' activities and educational purpose are concerned at the schools for the blind [Table 2]. Using same domain for the application of assistive technology in students with visual impairment, the author has published few original articles in peer-review journal.[13],[14] However, there is no standardized classification on AT for students with visual loss documented in the paper or anywhere else as evidence showed.
Table 1: Assistive technology based on the sense being used

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Table 2: Assistive technology based on the activity being undertaken

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Therefore, it is an overarching important to have a classification of AT, which is simple and understandable to laypersons as well as students with visual loss. This paper describes a simplified classification of AT for students with visual loss based on (a) the sense being used and (b) the activity to be undertaken by students at schools for the blind. Such classification would be helpful in implementation as well as application of assistive technologies in schools for the blind.

We explained AT based on the various activities of the students with visual disability in schools for the blind. Considering students' activities in the schools for the blind, it is not only worthy but also a potential applicability for the AT.


  Assistive Technology for Education Top


Preacademic learning

These are technologies that support early learning in children with low vision and blindness. Supporting the learning of young children with visual impairment and blindness can enhance their academic and functional performance at a later stage of their education. The development of visual behaviors, haptic or tactile awareness, fine motor skills and use of the residual vision in playing, and social interaction enable the learning of more sophisticated and complex functional behaviors and skills in subsequent years.[15],[16] Technologies enhancing the sense of touch and haptic awareness are available, for example, simple tactile toys or kits, toys that give off light or produce sound, and embossed print toys [Figure 1].
Figure 1: Tactile toys animal model

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Reading

The act of reading is fundamental to many learning activities for the school students. Literacy is a requisite skill and knowledge for a wide range of work-related, leisure, and other life maintenance activities in today's societies. AT to support reading and learning depend on the student's level of visual functioning and their literacy level as well as the environment and task demands. These technologies help students' academic performance whenever possible in the classroom or later in life. Few examples are large print books, multiple window typoscope, optical magnifiers, DAISY books, braille reading materials, refreshable braille display, and screen readers [Figure 2], [Figure 3], [Figure 4].
Figure 2: Multiple window typoscope

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Figure 3: Optical magnifiers

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Figure 4: DAISY books

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Writing

Students with visual impairment and blindness face a lot of challenges in writing tasks involving typical writing and visual writing, such as ink on paper or type on a computer screen. Students with visual impairment and blindness can experience difficulties in learning the mechanics of writing (e.g., punctuation and spelling), taking notes during classes, and engaging in the various phases of composing (e.g., prewriting, drafting, and editing) due to limitations of their visual acuity, visual field. There are variety of assistive devices used to support students with visual impairment and blindness for writing tasks. Few common devices are braille slate and stylus, Jot a Dot, Perkins Brailler, and braille electronic notetaker [Figure 5] and [Figure 6].
Figure 5: Braille and stylus

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Figure 6: Perkins Brailler

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Mathematics

Majority of mathematics relies on visual instruction, so learning mathematical concepts is a great challenging task for students with visual impairment and blindness. For instance, concepts such as direction, quantification, and shape require substantially more cognitive processing when visualization is not possible. Textual and audio supports, such as braille textbooks and talking calculators, are useful in facilitating student's access to mathematics materials; however, tactile support and haptic technology at times offer advantages in the promotion of concrete mathematical understandings in students with visual impairment and blindness. There are some assistive devices that use in mathematical learning. Few examples are abacus, braille compass, braille ruler or protractor, raised line graph, talking calculator, and tactile geometric kits [Figure 7], [Figure 8], [Figure 9].
Figure 7: Tactile geometric kit

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Figure 8: Braille protractor

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Figure 9: Braille cube

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Science

Similar to math learning, science course is also traditionally depended on visually oriented concepts and information. Although this visual information is not made widely available in a format which can be easily accessed to visually impaired students, there are some devices which can be used for science teaching, for example, tactile maps, tactile diagram set for sciences, tactile anatomy atlas, animal models, plants, or three-dimensional models objects, e.g., DNA twist model. Students can touch and explore it [Figure 10] and [Figure 11].
Figure 10: Tactile human digestive system

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Figure 11: Tactile anatomy kit

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  Orientation and Mobility Top


Orientation and mobility is a building block of students' learning. It is critically important for students with visual disability as they need to learn to move safely and independently throughout school environments with the use of their remaining senses. Students should be taught on how to move around in the classrooms, library, halls, doorways, stairs, kerbs, parks, and refectory. Various mobility devices are long walking cane, children's walking cane, guide cane, symbol cane, and support cane [Figure 12].
Figure 12: Orientation and mobility canes

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  Games and Leisure Top


Many games and toys help children to develop cognitive skills such as recognizing shapes, numbers, textures, and letters. It also promotes the development of social skills such as taking a turn around, interacting with peers, and participating in group activities. It is important to keep in mind that children with visual impairment or blind will need to learn to play toys and games with a sense other than sight. Few games can be played by most blind children with no special skills adaptation, e.g., Simon memory game, Cootie game to develop fine motor, and Hot Potato game for social interaction.

There are numerous adaptation games that will allow blind and visually impaired children to play. The selection of appropriate game is very important. The games should be aimed at the appropriate development of the child and adaptability of the child. Few examples of adaptive games are tactile dice, peg boards, audible balls, large print paly cards, and braille chess [Figure 13] and [Figure 14].
Figure 13: Braille chess

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Figure 14: Large print cards

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  Activities of Daily Living Top


Students with visual disability require a range of assistive technology for their daily living activities. These AT help in improving independence living, enhance their productivity in routine works. Assistive technologies for activities daily living are available. Few examples are liquid level sensor, talking color detector, talking watch or alarm clock, and talking money Identifier [Figure 15] and [Figure 16].
Figure 15: Color detector

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Figure 16: Talking watch

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The accomplishment of educational learning in students with visual challenge depends greatly on the use to AT. Children with visual impairment also have the potential to learn various skills if they are properly guided. Classification of AT for the education of students with visual loss will help in thinking about what AT will assist individual student to their learning. We developed a simple classification based on the activity to be undertaken and the sense to be used.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Bickenbach J. The world report on disability. Disabil Soc 2011;26:655-8.  Back to cited text no. 1
    
2.
World Health Organization. International Classification of Functioning, Disability and Health. Geneva, Switzerland: World Health Organization; 2001.  Back to cited text no. 2
    
3.
International Standard Organization 9999: Assistive products for persons with disability - Classification and terminology 2016. Available from: www.iso.org/standard/60547.html. [Last accessed on 2019 Mar 03].  Back to cited text no. 3
    
4.
World Health Organization. Global Cooperation on Assistive Technology (GATE). Geneva: World Health Organization; 2016.  Back to cited text no. 4
    
5.
World Health Organization. Priority Assistive Products List. Geneva: World Health Organization; 2017.  Back to cited text no. 5
    
6.
United Nations. Universal Declaration of Human Rights. Available from: http://www.un.org/en/universal-declaration-human-rights/. [Last accessed on 2019 Mar 18].  Back to cited text no. 6
    
7.
Marion and Michael. Assistive Technology for Visually Impaired and Blind People, 1st ed. Glasgow, UK. Springer, 2008.  Back to cited text no. 7
    
8.
Tebo L. A Resource Guide to Assistive Technology for Students with Visual Impairment. Diss Grad Bowl Green State Univ. Available from: http://indicators.knowbility.org/docs/resourcebank/TEBO_VI_Resource_Guide.pdf. [Last accessed on 2019 Mar 03].  Back to cited text no. 8
    
9.
Mulloy AM, Gevarter C, Hopkins M, Suntherland KS, Ramados ST. Assistive Technology for Students with Visual Impairments and Blindness; Lancioni GE, Singh NN (eds.), Assistive Technologies for People with Diverse Abilities, Springer, New York 2014.  Back to cited text no. 9
    
10.
Wiazowski J. Assistive Technology for Students who are Blind or have Low Vision, Gierach J. 5th ed. Assess Students' Needs Assist Technology, WATI, Milton 2009; Chap 12: Pp 1-29.  Back to cited text no. 10
    
11.
American Foundation for the Blind. Writing Tools for Visual Readers. Available from: http://www.afb.org/section.aspx?FolderID=2&SectionID=4&TopicID=200&DocumentID=6253. [Last accessed 2019 Jan 23].  Back to cited text no. 11
    
12.
National Association for the Blind. Delhi, India. Available from: http://www.nabdelhi.in/. [Last accessed on 2019 May 20].  Back to cited text no. 12
    
13.
Senjam SS, Foster A, Bascaran C, Vashist P, Gupta V. Assistive technology for students with visual disability in schools for the blind in Delhi. Disabil Rehabil Assist Technol 2019;23:1-7.  Back to cited text no. 13
    
14.
Senjam SS, Allen F, Covadonga Bascaran PV. Awareness, utilization and barriers in accessing assistive technology among the young patients aĴending in low vision rehabilitation clinic of a tertiary eye care centre in Delhi. Indian J Ophthalmol. [In Press].  Back to cited text no. 14
    
15.
Groenendaal F, Van Hof-Van Duin J. Visual deficits and improvements in children after perinatal hypoxia. J Vis Impair Blind 1992;86:215-8.  Back to cited text no. 15
    
16.
Oldham J, Steiner G. Being Legally Blind: Observations for Parents of Visually Impaired Children. Anchorage: Shadow Fusion; 2011.  Back to cited text no. 16
    


    Figures

  [Figure 1], [Figure 2], [Figure 4], [Figure 3], [Figure 5], [Figure 6], [Figure 7], [Figure 8], [Figure 9], [Figure 10], [Figure 11], [Figure 12], [Figure 13], [Figure 14], [Figure 15], [Figure 16]
 
 
    Tables

  [Table 1], [Table 2]



 

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