A review of principles in design and usability testing of tactile technology for individuals with visual impairments

Accessibility of drug databases and resources with assistive technology

Purpose Globally, approximately 285 million people have visual impairments, with over 39 million people having full blindness. Beginning in the late nineteenth century, assistive devices such as service dogs, braille reading devices, and white canes have aided those with visual impairments. From the immense development of technology over the past two decades, traditional assistive devices have been supplemented with more technologically innovative assistive technologies. Despite this technological growth, many people with visual impairments have chosen to forgo the use of assistive technologies and continue to use traditional assistive devices instead. Materials and Methods We have devised a series of surveys and questionnaires to study the views of those with visual impairments towards assistive technologies. Our survey was given to 568 visually impaired people in Taiwan both in person and electronically; the data was cross-referenced with the demographic information of the surveyors to find the disparities in user-preferences amongst different levels of visual impairment, age, household income, and other demographic factors. Results Results drawn from the data concluded that while there was a large variation in whether or not participants used assistive technology, those that did indicated that assistive technologies were purchased to help them live life more independently. Conclusions While assistive technology provides a beacon of hope for the visually impaired to live more independent lives, the data indicated that many visually impaired people were not aware of the new assistive technologies and devices that have been entering the market; furthermore, many visually impaired people are of lower income, and therefore cannot afford the technology. Implications for rehabilitation Determining differences between congenital and acquired visual impairments, and comparing how the two types of visually impaired users have preferences over the assistive technology and devices that they utilise. Experience of life without visual impairment disincentivizes visually impaired people from purchasing new assistive technologies, whereas the appeal of an independent lifestyle incentivizes it. The visually impaired tend to purchase assistive technologies to operate rehabilitation more effectively, and the use of assistive technology and assistive devices, respectively, encourage future participation in rehabilitation. Marketability and cost of assistive technologies are the largest deterrents from visually impaired users from buying new technologies.

Purpose There are about 2.2 billion people with visual impairment all over the world. In order to improve the quality of life for visually impaired people, various devices have been developed that support the users to make them capable of performing everyday work. There have been considerable advancements in the development of assistive devices over the last few decades. This work aims to review the research work of past decade to explore the technologies used in the assistive devices for the mobility of the people with visual impairment. It focuses on range sensors based (RSB) solutions and to present a comprehensive comparison for researchers to improve the quality of the assistive devices. Methods In order to improve life quality of about 2.2 billion people with visual impairment in the world, various assistive devices have been developed. This work aims to review the research work of past decade to explore the technologies used in the assistive devices for the mobility of the people with visual impairment. It focuses on RSB solutions and their comparison. Results Various devices developed or the people with visual impairment, in last decade are described along with their workings. Authors also introduced, their own, newly developed assistive device for the people with visual impairment. The feedback from the people with visual impairment, about assistive technology, is also included in the paper. Conclusions This study will benefit researchers developing assistive devices to help for the mobility of the people with visual impairment. Through user feedback and evaluation of the assistive devices, the authors have come to the conclusion that performance, weight and cost of the assistive devices are always important considerations to make the assistive devices more popular among their users. Implication for rehabilitation Although assistive device cannot rehabilitate a visually impaired person, range sensor-based assistive device may have following implications: •Use of assistive device is growing, and performance, weight and cost of assistive devices are always important considerations so that proposed technology solution should widely be accepted and adopted by the visually impaired people. •The adaptability and acceptability of an assistive device by the visually impaired people must be considered during design phase. •Proposed assistive technological solutions should meet all the needed functions. •Performance of these devices should be assessed in application context so that these devices may help the visually impaired to perform their tasks independently. •At the end, a new light weight and low-cost device developed by authors, is also given, that could be used to assist the visually impaired people to move independently.

Advances in deep learning and computer vision have revolutionized object detection, enabling real-time and accurate object recognition. These object detection technologies can potentially transform accessibility solutions, especially for individuals with visual impairments. This study aims to enhance accessibility and environment-effective interaction for individuals with visual disabilities by detecting and naming objects in real-world environments. This study examines and optimizes the potential of a set of developed deep learning models, including YOLOv8L, YOLO11x, and Faster region-based convolutional neural network (R-CNN) with seven backbone models for multi-class object detection to enhance object recognition and provide auditory feedback; these models aim to bridge the gap between the visually impaired and their surroundings. In addition, we attempt to propose a system that translates detections into audible descriptions, empowering individuals to navigate and interact with the world independently by integrating object detection with text-to-speech (TTS) technology. The models leverage Arabic-translated PASCAL VOC 2007 and 2012 datasets, with performance evaluated through precision, recall, and mean average precision (mAP). The results revealed that YOLO11x achieves the highest mAP of 0.86, followed by YOLOv8L with an mAP of 0.83. Faster R-CNN with EfficientNet-B3, HRNet-w32, and MobileNetV3-Large showed the highest accuracy among other backbones with 79%, 78%, and 75%, respectively. The study proves the efficacy of deep learning models in accessibility applications as assistive technologies for individuals with visual impairments and highlights opportunities for future development.

The digital platform’s usability is crucial for users but is often overlooked for those with visual impairments. The study aims to review and analyze the usability of platforms for users with visual impairments. The study is a Systematic Literature Review (SLR) that adapts the preferred reporting items for Systematic Reviews and Meta-Analysis (PRISMA) model to review 49 out of 137 publications from 2019 to 2023 indexed in Scopus. Key themes emerging from the analysis include accessibility, navigation, daily activities, screen division layout, and audio guidance. The success of platform implementation is evaluated using the System Usability Scale (SUS), Think Aloud, and Heuristic Evaluation. Building upon the exploration of 49 findings and categorization, a subsequent search is conducted for similar studies that can reinforce the strength of the arguments presented in the 49 studies. The analysis in the study is examined through research questions to provide a comprehensive and in-depth insight into the use of technology to enhance the quality of daily life for users with visual impairment. In addition to evaluating the success of platform implementation and popular evaluation methods, the systematic literature review explores the evolution of assistive technologies over the reviewed period and identifies emerging trends. The study delves into the ethical considerations surrounding developing and implementing technologies catering to individuals with visual impairments. The research aims to contribute not only to the usability aspects but also to the responsible and inclusive advancement of technology for users with visual impairments. In conclusion, this systematic literature review provides a comprehensive overview of the current state of usability in platforms designed for individuals with visual impairments. The findings of this study contribute valuable insights for designers, developers, and policymakers to enhance the inclusivity of platforms for users with visual impairments. Recommendations based on the identified themes aim to guide future research and development, fostering continuous improvement in usability and user experience for this often-neglected user demographic.

The development of Artificial Intelligence (AI) has been widely applied as an assistive technology for individuals with visual impairment (VI), providing various assistive technologies such as object recognition and obstacle detection. The accurate and powerful systems can be triggered through voice commands and thus significantly enhance the life experiences of users with VI. However, most assistive technologies simply accept a clear and exact command as input, ignoring the cognition and memory problems in blind people. If the users forget some parts of the full command (e.g., name of a target object, available system actions), it will be difficult for them to utilize the assistive technologies. To fill the research gap, our study presents an interactive system which integrates a Large Language Model (LLM) with focused self-attention (FSA) mechanisms to assistive technologies, facilitating the voice control for VI users. A virtual reality-based experimental study (N=12) was conducted to simulate a real-world application scenario to compare the direct voice command control with the proposed LLM-FSA approach. The results demonstrated significant improvements in convenience, intuitiveness, and efficiency when using the LLM-FSA method. This research provides insights into the integration of domain-specific LLMs into assistive technologies, contributing to more accessible solutions for visually impaired individuals.

Purpose of the article This study explored the role of assistive technology devices in facilitating the participation and learning of students with visual impairment in higher education institutions in Tanzania. Materials and methods Twenty-one respondents were purposively involved in an open-ended questionnaire survey and semi-structured interview, seventeen of whom were students with visual impairment and four were transcribers. Data were analysed using descriptive and thematic analysis. Results and conclusions The study found that students with visual impairment were well-acquainted with the meaning of assistive technology. However, their knowledge was limited to the assistive technology devices available at their institution. Most of the students with visual impairment emerged as dependent users of assistive technology devices, who depend on the support of either sighted students or a more skilled person. The study further established that the institution under review has only a few basic assistive technology devices, at the disposal of students. The study also established the benefits of assistive technology for students with visual impairment as giving them greater access to educational materials and widening their employment prospects. Based on these findings the study recommends that higher education institutions provide adequate and sustainable funding for assistive technology to ensure that students with visual impairment benefit from the education they get. Furthermore, students with visual impairment need encouragement to make use of the modern assistive technology devices available and learn how to use them to ease their sense of exclusion and dependence on sighted students. Implications for rehabilitation The accessibility of assistive technology for persons with disabilities is a human right just as access to medical or other health services, and education. People with disability including those with visual impairment need utmost support for them to acquire and access AT to enhance their participation in learning and contribution to societal development without unnecessary inhibitions. Students with visual impairments (VI) require a variety of learning support mechanisms to cater for their learning and mobility needs to be productive in society. Stakeholders should develop strategies that focus on supporting and meeting the learning needs of students with VI. These interventions may include assessing the nature of the learning disability and environmental modifications to enhance the learning performance of such students as well as ensuring both the availability and accessibility of AT devices and products for students with VI. Inclusion of assistive technology in the national disability policy can serve as a guide for supporting students with learning difficulties including those with VI on a sustainable basis and within the national framework. When included in the policy, education stakeholders and people with VI can have grounds to fight for and defend their rights enshrined in both the constitution, legal instruments, and policy documents.

Visually impaired individuals face significant challenges in navigating unfamiliar environments due to their inability to detect nearby obstacles. To address this issue, we propose a Smart Stick, an affordable and effective assistive mobility device aimed at enhancing the independence and safety of blind users. The device utilizes ultrasonic sensors to continuously monitor the path ahead, and upon detecting obstacles, it activates a vibration motor to provide haptic feedback, allowing the user to take appropriate precautions. In addition to aiding navigation, the Smart Stick is equipped with an SOS emergency button a crucial feature for speech-impaired users. When pressed, it triggers a speaker feedback as an “Emergency help” audio message, allowing users to signal distress and seek help in critical situations. The core of the system is an Arduino Uno microcontroller that processes sensor data and coordinates the vibration and audio outputs in real time. The device is lightweight, power-efficient, and ergonomically designed for user comfort and long-term battery usage. By integrating tactile and auditory feedback along with an emergency communication feature, the Smart Stick significantly improves mobility, safety, and quality of life for users with visual, hearing and speech impairments. Keywords: Arduino Uno, Ultrasonic Sensors, Vibration Motor, Assistive Device, Obstacle Detection, Mobility Aid, Visually Impaired, Smart Stick.

The article discusses the CMOS implementation of a multipath differential OTA with two flipped voltage followers, focusing on enhancing gain, bandwidth, and addressing the needs of modern analog and mixed-signal applications. By utilizing two flipped voltage followers as variable current sources, the design enables class A-B operation and adaptive biasing for various driver units. The structure includes multiple input-to-output paths as dynamic current boosters, enhancing slewing rate performance. The study evaluates the amplifier's performance in terms of gain and bandwidth, implementing the proposed method using 50nm and 75nm CMOS technologies, and developing the work in the Tanner EDA tool. Additionally, the research explores advancements in assistive technology for individuals with visual impairments, proposing a CMOS implementation of a multiple-path full-differential OTA with two flip-type voltage level followers (FVF) cells. The effectiveness of this design is investigated in both 75nm and 50nm CMOS technologies, showcasing improvements in transconductance and operational characteristics. These results offer a promising direction for the development of assistive devices, contributing to efforts to create inclusive and accessible technological solutions for individuals facing challenges in visual navigation.

Interacting with mobile applications can often be challenging for people with visual impairments due to the poor usability of some mobile applications. The goal of this paper is to provide an overview of the developments on usability of mobile applications for people with visual impairments based on recent advances in research and application development. This overview is important to guide decision-making for researchers and provide a synthesis of available evidence and indicate in which direction it is worthwhile to prompt further research. We performed a systematic literature review on the usability of mobile applications for people with visual impairments. A deep analysis following the Preferred Reporting Items for SLRs and Meta-Analyses (PRISMA) guidelines was performed to produce a set of relevant papers in the field. We first identified 932 papers published within the last six years. After screening the papers and employing a snowballing technique, we identified 60 studies that were then classified into seven themes: accessibility, daily activities, assistive devices, navigation, screen division layout, and audio guidance. The studies were then analyzed to answer the proposed research questions in order to illustrate the different trends, themes, and evaluation results of various mobile applications developed in the last six years. Using this overview as a foundation, future directions for research in the field of usability for the visually impaired (UVI) are highlighted.

Vision impairment is a common disability that poses significant challenges to individuals' ability to perform activities essential for independent living, including activities of daily living (ADL) and instrumental activities of daily living (IADL). Despite extensive research, the extent and nature of these associations remain unclear, particularly across varying levels and types of vision impairment. This meta-analysis aims to estimate associations between vision impairment and difficulties with ADL and IADL. We conducted a systematic review of relevant literature from the inception of the databases to February 2024, using electronic database searches, including PubMed, MEDLINE (Ovid), EMBASE, Cochrane CENTRAL, and CDSR. The articles were screened for title and abstract and then for the full-text reports by two independent reviewers and study quality was appraised. Meta-analyses were performed using random effects models to calculate the pooled effect size, expressed as odds ratio (OR) with corresponding 95% confidence interval (CI) of each outcome. Forty-six studies involving 210,960 participants were included. A positive large correlation between vision impairment and difficulties with ADL (Correlation coefficient [r] = 0.55, 95% CI 0.37-0.68, p = 0.001) and IADL (r = 0.60, 95% CI 0.49-0.69, p = 0.001) was shown. We also found that vision impairment was associated with difficulties in ADL (OR = 1.77, 95% CI 1.56-2.01, p < 0.0001) and IADL (OR = 1.96, 95% CI 1.68-2.30, p < 0.0001). Subgroup analysis revealed that moderate to severe impairment resulted in difficulties in ADL (OR = 1.78, 95% CI 1.43-2.21, p = 0.02) and IADL (OR = 1.86, 95% CI 1.57-2.20, p = 0.0003). Further, there was a significant association between mild to moderate vision impairment and difficulties in IADL (OR = 1.38, 95% CI 1.23-1.55, p < 0.0001). Greater impact was observed in individuals with near vision impairment compared to those with distance vision impairment. Near vision impairment was significantly associated with higher difficulties in ADL (OR = 1.77, 95% CI 1.57-2.01, p < 0.0001) and IADL (OR = 1.79, 95% CI 1.32-2.42, p < 0.0001). In contrast, distance vision impairment showed lower but still significant associations with IADL (OR = 1.19, 95% CI 1.05-1.34, p = 0.005) and a nonsignificant association with ADL (OR = 1.12, 95% CI 0.90-1.40, p = 0.30). Meta-regression analysis indicated that for every one-year increase in age, ADL performance decreased by an average of 0.0147 units (p < 0.001), while IADL performance declined at a slower rate of 0.0047 units/year (p = 0.031). The present systematic review and meta-analysis using several statistical methods indicates that vision impairment including near vision impairment, is associated with difficulties in ADL and IADL. Thus, vision impairment remains an urgent and increasingly important public health priority. These findings highlight the need for targeted measures to raise public health awareness to provide rehabilitation and eye care examination strategies to reduce the risk of developing disabilities in adults and the elderly who have vision impairment.

Introduction: Children with optic nerve hypoplasia (ONH) frequently have co-occurring developmental disorders, and children with both visual impairments and autism spectrum disorder (ASD) have complex educational needs. Research Question: Do the individualized education programs (IEPs) of children with visual impairment and ASD comport with national educational guidelines? Methods: Participants were 13 children enrolled in a larger longitudinal study of ONH. Children were assessed for ASD, verbal intellectual functioning, and level of visual impairment. An IEP coding manual was developed by the authors and used to compare the IEP goals, services, and accommodations to national guidelines for the education of children with visual impairment and children with ASD. Results: Key findings indicated that needs in the domains of academics, assistive technology, and orientation and mobility were addressed, but other crucial areas of development such as social skills, social-emotional and behavioral needs, and skills for independent living were commonly overlooked. Discussion: It is recommended that IEP teams pay greater attention to the complex range of needs of children with visual impairments and that national guidelines for the education of children with visual impairment and ASD be incorporated into federal special education law. Implications for Practitioners: National guidelines for the educational needs of children with visual impairments and with ASD provide important guidance for IEP teams when developing goals, services, and supports, and efforts should be made to ensure educators and parents are aware of them. Children who have both visual impairments and ASD have complex educational needs that are often not fully addressed in IEPs. In particular, social-emotional, behavioral, and developmental needs may be overlooked by IEP teams, and consistent inclusion of school psychologists or other mental health professionals on IEP teams may lead to greater attention to these areas of need.

BackgroundGlobally, 39 million people are blind, and an additional 246 million experience moderate to severe visual impairment (WHO, 2021). These impairments severely affect navigation, safety, and daily—task performance. Studies show that 70% of individuals with visual impairments face falls annually, and many report challenges with spatial awareness and cognitive load. Adaptive design offers solutions that utilize sensory input, spatial predictability, and barrier-free layouts to address these challenges. This study explores accessible interior design principles to empower visually impaired individuals with greater independence and comfort in their homes. This study investigates the principles of adaptive design in creating safe, independent, and comfortable living spaces for individuals with visual impairments, a condition affecting over 285 million people worldwide, according to the World Health Organization (WHO). The research emphasizes barrier-free environments with unobstructed pathways, tactile and auditory cues, and consistent spatial arrangements to enhance accessibility. By integrating sensory elements like contrasting textures, lighting, and acoustic treatments, the project aims to foster spatial awareness, safety, and autonomy. Engaging visually impaired residents in the design process ensured tailored solutions that empower independence and well-being. The findings highlight the transformative potential of inclusive design in enriching the daily lives of those with visual challenges.MethodsThe research involved case studies, user interviews, and participatory design workshops with visually impaired individuals aged between 18 and 75. Key challenges included trip hazards, inconsistent layouts, and sensory overload. Design strategies such as tactile navigation systems, acoustic enhancements, and optimized lighting layouts were tested. Tactile navigation systems use textured flooring, Braille signage, and raised pathways to aid visually impaired individuals. Acoustic enhancements include sound cues, echolocation-friendly materials, and noise reduction techniques to improve spatial awareness. Optimized lighting layouts feature uniform illumination, glare reduction, and adaptive lighting to enhance visibility. These strategies are implemented through tactile paving, contrasting textures, natural sound sources, sound-absorbing panels, motion-activated LEDs, and diffused lighting. Together, they create an accessible environment that enhances safety, independence, and ease of navigation for visually impaired individuals, ensuring a more intuitive and user-friendly spatial experience. Over 80% of participants highlighted the need for tactile and auditory cues to aid navigation. Feedback loops ensured practical and effective outcomes.ResultsImplementing adaptive design features resulted in a 40% reduction in reported falls and a 25% decrease in cognitive fatigue during navigation. Textured handrails, non-glare materials, and consistent furniture placement improved confidence in navigation for 90% of participants. Enhanced lighting solutions, such as natural and task lighting, were appreciated by 75% of users, while acoustic treatments improved spatial awareness for 65%.ConclusionsAdaptive design demonstrates immense potential in transforming residential spaces for visually impaired individuals. By integrating multi-sensory elements and prioritizing user-centric approaches, these designs foster independence, dignity, and improved quality of life. The findings highlight that inclusive design strategies can address challenges faced by over 1.3 billion people globally with some form of visual or functional impairment, underscoring the need for wider adoption.

Children with visual and motor disabilities constitute a distinct group with a unique set of educational needs. Such children are often grouped with the broader population of children with multiple disabilities and visual impairments (that is, those who are blind or have low vision) (Erin, 2000; McLinden, 1997). The chief characteristic of children with multiple disabilities and visual impairments is the interactive element of the disabilities and their combined impact on development. Other researchers support the belief that in multiple disabilities, there is no primary or secondary disability; instead, there is a combination of conditions that operate in a synergetic way (Hogg & Sebba, 1986). In particular, children with multisensory impairments (such as visual impairment combined with motor disabilities) face difficulties in obtaining sufficient information from their environment to learn independently, and in turn to use such information effectively to function independently (Taylor & Preece, 2010). The number of case studies or projects regarding this population is very limited, and most of them refer to assessment rather than intervention (Erin, 2000; Parker & Pogrund, 2009). The present study highlights the framework and discusses the results of an action research project that aimed to develop the keyboarding skills of a student with multiple disabilities and visual impairment via adaptive technology (the main research aim). MATERIALS AND METHODS The principles of action research (O'Hanlon, 1996) strengthened the argument about choosing action research as the best methodology for the purpose of the present project. According to Kemmis and McTaggart (1988), there is a group of four fundamental aspects in action research: planning, acting, observing, and reflecting. These aspects were present in the project presented here and converged to the improvement of the writing skills of a student with multiple disabilities and visual impairment. Participants The action research project concerned a 12year-old girl (Cathy, the name has been changed) with severe visual impairment (central visual acuities [less than or equal to] 3/60) and motor disabilities (left hemiplegia), who attended the fifth grade in a general educational setting. Because of left hemiplegia, Cathy's left side was affected in such a way that she had little use of her left hand, and she also had a limp. She had poor balance, and, according to her medical records, apart from blindness and motor difficulties, she had no other additional disabilities. Instead, she spoke three languages (Greek, Italian, and Albanian) and had good social skills, interacting with others effectively. The persons included in this project constituted two Groups: (a) the Action Group, which comprised a special education teacher and an expert in adaptive and assistive technology, who was also a visually impaired person, and (b) the Validation Group, which comprised specialists in research methodology and the special education field. Preliminary activities The preliminary stages of the project included meetings between the members of both groups and initial observations regarding the problems Cathy was facing in school. The reflections on the preliminary stages showed that Cathy was not using a brailler because of her left hemiplegia, and as a result she did not know braille at all. [FIGURE 1 OMITTED] In addition, Cathy was using a computer with specialized software (speech output) with a standard English computer keyboard (QWERTY); however, her writing fluency while typing was very slow (one or two words per minute). Also, when she realized she had made a spelling error, instead of deleting the error, she preferred to delete the whole word and write the word from the beginning. Cathy's fine motor skills in her right hand seemed well developed, and she knew by heart the keys on a standard keyboard of Greek letters. …

There has been a rapid growth in the literature on the design and evaluation of assistive technologies for people with visual impairments; yet, there is a lack of a comprehensive analysis of the existing literature on the classification of immediate-, short-, medium-, and long-term psychosocial impact of assistive technologies on the quality of life of people with visual impairments. This protocol outlines the methodology for a scoping review aimed at identifying and synthesizing the existing literature on the psychosocial impact of assistive technologies on the quality of life of people with visual impairments. The review will include primary research studies published in English between 2019 and 2024 that focus on the psychosocial outcomes of assistive technologies for people with visual impairments. Eligible studies will involve participants with visual impairments, of all ages and across various settings, examining psychological (eg, emotional well-being and self-esteem) and social outcomes (eg, social participation and support). Searches will be conducted across 7 electronic research databases: CINAHL (EBSCO), PsycINFO (EBSCO), ACM Digital Library, IEEE Xplore, Scopus, Web of Science, and Google Scholar (first 100 records). Studies will undergo screening and selection based on predefined eligibility criteria, with data extraction focusing on publication details, study design, population characteristics, type of assistive technology, and psychosocial impacts. Results will be summarized using descriptive statistics, charts, and narrative synthesis. The database search, conducted in July 2024, identified 1145 records, which will be screened and analyzed in subsequent stages of the review process. This protocol outlines the planned approach for identifying, categorizing, and synthesizing evidence. The study findings are anticipated to be finalized and submitted for publication in a peer-reviewed journal by February 2025. This study will synthesize the recent body of work on the psychosocial impact of assistive technologies for people with visual impairments and recommendations for researchers and designers interested in this research area. Open Science Framework 10.17605/OSF.IO/SK7N8; https://osf.io/4gc5t. DERR1-10.2196/65056.