Identifying Crucial Objects in Blind and Low-Vision Individuals' Navigation

We investigate whether tactile charts support comprehension and learning of complex visualizations for blind and low-vision (BLV) individuals and contribute four tactile chart designs and an interview study. Visualizations are powerful tools for conveying data, yet BLV individuals typically can rely only on assistive technologies-primarily alternative texts-to access this information. Prior research shows the importance of mental models of chart types for interpreting these descriptions, yet BLV individuals have no means to build such a mental model based on images of visualizations. Tactile charts show promise to fill this gap in supporting the process of building mental models. Yet studies on tactile data representations mostly focus on simple chart types, and it is unclear whether they are also appropriate for more complex charts as would be found in scientific publications. Working with two BLV researchers, we designed 3D-printed tactile template charts with exploration instructions for four advanced chart types: UpSet plots, violin plots, clustered heatmaps, and faceted line charts. We then conducted an interview study with 12 BLV participants comparing whether using our tactile templates improves mental models and understanding of charts and whether this understanding translates to novel datasets experienced through alt texts. Thematic analysis shows that tactile models support chart type understanding and are the preferred learning method by BLV individuals. We also report participants' opinions on tactile chart design and their role in BLV education.

With the advancements in mobile health (mHealth) technologies, sighted individuals can benefit from mobile apps and wearable devices to more easily manage their physical activity (PA) and wellness data through intuitive touch gestures and effective data visualizations. However, for blind and low-vision (BLV) individuals, these conventional interaction methods are often challenging, not only limiting their ability to use these technologies but also potentially diminishing their motivation to adopt them to support health-promoting behaviors. We aimed to develop a health monitoring application called Personalized and Conversational Health Agent (PCHA) that supports BLV individuals with self-monitoring and management of their PA and wellness data (e.g., step count, exercise duration, calories burned, heart rate). Drawing on social cognitive theory and insights from prior needs assessment research, five key design goals were established to guide the development of the app's core features and functionalities. PCHA leverages a large language model (LLM) to enable a conversational health agent that can be installed on iPhone and Apple Watch devices. This conversational interface is designed to ensure accessibility and inclusivity, offering PA management tools through a voice user interface (VUI) that minimizes the navigation challenges often associated with traditional touchscreen-based systems. To ensure evidence-based PA guidance, a thorough review of scientific literature and published PA guidelines was conducted. Finally, two blind accessibility experts conducted the accessibility testing. Accessible user interface (UI) designs, featuring high color contrast, large buttons, and a simple layout, were created using Figma. The main features and functionalities include: (I) a voice health interview to assess users' basic health information; (II) PA recommendations to guide users toward achieving their PA goals; (III) a chat feature enabling human-like conversations with the app; (IV) a PA scheduling and reminder feature with haptic feedback on the Apple Watch; and (V) an in-exercise mode that provides audible updates on heart rate, PA duration, and walking speed. The app's mobile accessibility was found to be satisfactory. A follow-up study involving BLV research participants will be conducted to improve the app's accessibility and usability, and to update its features and functionalities. More research is needed to fully harness the potential of LLMs in the new mHealth system to motivate PA behaviors for BLV populations. To deliver truly personalized PA feedback for BLV individuals, mHealth app developer should incorporate PA and wellness data specific to the BLV population, along with their unique personal and contextual factors that influence PA behaviors.

Objectives: The aim of the study was to investigate caries experience in correlation with self-reported oral health-related habits in a sample of blind and low-vision individuals in Croatia. Methods: The study is a part of the research in the “Project for Oral Health Promotion in Blind and Visually Impaired Persons” conducted at the Zagreb University School of Dental Medicine from 2014 to 2018. The final sample consisted of 85 adults: 42 females and 43 males; 50 blind and 35 low-vision individuals, age range 18–98. The assessment included dental examination and a questionnaire. Results: The median DMFT (Decayed, Missing, and Filled Teeth) index score was 17.0 (IQR = 12.5–22.0), with no significant difference between sexes or between blind and low-vision individuals. The occurrence of untreated caries was low (median D-component = 1.0), while the median F-component was 6.0. There was a significant increase in M-component and DMFT in older age groups. The number of untreated caries (D-component) was significantly correlated with consummation of soft drinks and smoking. Total DMFT did not correlate with frequency of tooth brushing, time since last dental visit, smoking, or level of education. Conclusions: This study revealed high caries experience among blind and visually impaired individuals that did not correlate with factors that normally influence oral health. Similar results were found in the control group, reflecting a 30-year post-war period without organized preventive care. The low number of decayed teeth reflects the availability of public dental care in Croatia; however, preventive care should be provided for both this vulnerable group and the general population.

Blind and low-vision individuals often have severely reduced mobility, affecting their quality of life and associated socioeconomic cost. Despite numerous efforts and great technological progress, the only used primary mobility aids are still white canes and seeing-eye dogs. Furthermore, there is a permeating tendency in the field to ignore knowledge of both mobility and the target group, as well as constantly design new metrics and tests that makes comparisons between solutions markedly more difficult. The Desire of Use model is introduced in an effort to promote a more holistic approach; it should be generalizable for any activity by any user, but is here applied on mobility of blind and low-vision individuals by a proposal and integration of parameters. An embodiment of the model is presented and with it we show why popular mobility metrics of today are insufficient to guide design; what tasks and metrics that should provide better understanding; as well as which fundamental properties determine them and are critical to discuss. Desire of Use has been introduced as a tool and a theoretical framework, and a realization has been proposed. Desire of Use offers both a structured perspective of pertinent design challenges facing a given solution, as well as a platform from which to compare test results and properties of existing solutions; in for example the field of electronic travel aids it should prove valuable for designing and evaluating new tests and devices.

Loss of visual function reduces the accessibility of the environment. A person's ability to move around is closely related to their skills in wayfinding, i.e. finding clues and mental mapping. Individuals with visual impairment use non-visual sensory aspects, such as tactile clues, to form a cognitive map of the structure of the environment. Navigating new and complex environments can cause confusion, anxiety and take longer. Environmental interventions through tactile-based media conditioned into signage design are still scarce, therefore this study aims to try to identify the different roles of three design conditions namely; Rised lines (RL), Texture (TX) and Elevated Graphics (EG) on the wayfinding performance of blind individuals through a navigation task. Data collection involved an experiment with the participation of totally blind and low vision individuals in a simulated environment with three design conditions: raised lines, textures and raised graphics. The experimental process used spatial tasks including; navigation tasks. Measurements on the navigation task used questionnaires and duration scores. This experiment used repeated measure procedures on the three tactile design conditions, as well as a randomized sequence of conditions. The data obtained was analyzed through statistics using repeated measure ANOVA test to test the effect and difference of intervention of three tactile sensor-based signage designs. The findings showed that there was no significant difference in the navigation experience, but there was a significant difference in the navigation task duration score. The Rised Lines (RL) condition showed good performance especially in the aspect of duration score. This research has concluded that, tactile-based signage design has a significant role to help blind individuals understand the environment. This signage design is expected to be a medium for blind individuals, especially special education students in practicing Orientation & Mobility skills properly.

The title of [1] contains a typo. "Desire of Use: A Hierarchical Decomposition of Activities and Its Application on Mobility of Blind and Low-Vision Individuals" is the correct title.

A group co-design was held in March 2021 with six blind and low-vision individuals (BLIs) from the United States. Participants were asked to discuss problems related to travel during the COVID-19 pandemic and make recommendations for possible solutions. Two probes (prototypes) of a non-visual neighborhood travel map and a non-visual COVID-19 choropleth map (a map using colors or sounds over each state to represent different values) of COVID-19 state data were shown to participants for inspiration. The participants expressed that COVID-19 had significantly increased their apprehension and discomfort associated with activities such as venturing outside, traveling, engaging with strangers, communicating, adapting to changes in familiar environments, and wearing masks. Participants gravitated towards the need for information the probes provided, and made a number of observations and recommendations for improvement. They wanted more detailed geo-referenced COVID-19 data (including by county), information related to voting, a mobile app, and more detailed building information, such as doors on the travel map.

A crosswalk entrance is on the boundary of a roadway and is a dangerous area for visually impaired persons. Tactile walking surface indicators (TWSIs) are installed on the road to support independent travel for blind and low-vision individuals. We developed an LED block equipped with projections to strengthen support at the crosswalk entrance. Blind individuals can sense thiss block through the soles of their shoes. Results indicated that the LED block equipped with projections to locate travel direction effectively supports crossing. The effectiveness of this block is determined using measurement and questionnaire results.

"Tell Me What That Is": Examining Blind and Low Vision Individuals’ Reviews on Assistive Smartphone Applications

Individuals who are blind or low-vision face multiple barriers to quality health care, including insufficient training for health care providers and staff. Limited research has examined provider and staff skills and knowledge gaps, attitudinal barriers, or relevant training needs specific to caring for blind or low-vision patients. In this qualitative study, we sought to understand, from the perspective of blind or low-vision individuals, what needs to be known and improved to better care for this population. We conducted four structured focus groups with 22 blind or low-vision individuals. Questions assessed general health care impressions, positive and negative health care experiences, and recommendations for training providers. Reflexive thematic analysis was conducted, which identified three overlapping, training-focused themes: 1) disability etiquette and communication, 2) understanding barriers to care, and 3) dismantling ableist stereotypes and misconceptions. The need for health care provider and staff empathy and compassion is emphasized as a central, core theme shared by each of the training-focused themes. Our findings confirm and expand previous calls for improved education regarding the health care needs for patients who are blind or low vision. Most significantly, we draw from recent literature in health professions education to propose training interventions targeted to the training needs identified via thematic analysis. We advocate for educational design and implementation that is community-engaged and centers the patient who is blind or low vision as the educator.

Integrating different senses to reduce sensory uncertainty and increase perceptual precision can have an important compensatory function for individuals with visual impairment and blindness. However, how visual impairment and blindness impact the development of optimal multisensory integration in the remaining senses is currently unknown. Here we first examined how audio-haptic integration develops and changes across the life span in 92 sighted (blindfolded) individuals between 7 and 70years of age. We used a child-friendly task in which participants had to discriminate different object sizes by touching them and/or listening to them. We assessed whether audio-haptic performance resulted in a reduction of perceptual uncertainty compared to auditory-only and haptic-only performance as predicted by maximum-likelihood estimation model. We then compared how this ability develops in 28 children and adults with different levels of visual experience, focussing on low-vision individuals and blind individuals that lost their sight at different ages during development. Our results show that in sighted individuals, adult-like audio-haptic integration develops around 13-15years of age, and remains stable until late adulthood. While early-blind individuals, even at the youngest ages, integrate audio-haptic information in an optimal fashion, late-blind individuals do not. Optimal integration in low-vision individuals follows a similar developmental trajectory as that of sighted individuals. These findings demonstrate that visual experience is not necessary for optimal audio-haptic integration to emerge, but that consistency of sensory information across development is key for the functional outcome of optimal multisensory integration.

Blindness and low vision have severe effects on individuals' quality of life and socioeconomic cost; a main contributor of which is a prevalent and acutely decreased mobility level. To alleviate this, numerous technological solutions have been proposed in the last 70 years; however, none has become widespread. In this paper, we introduce the vision-to-audio, super-scale sensory substitution/supplementation device Audomni; we address the field-encompassing issues of ill-motivated and overabundant test methodologies and metrics; and we utilize our proposed Desire of Use model to evaluate proposed pilot user tests, their results, and Audomni itself. Audomni holds a spatial resolution of 80 x 60 pixels at ~1.2° angular resolution and close to real-time temporal resolution, outdoor-viable technology, and several novel differentiation methods. The tests indicated that Audomni has a low learning curve, and several key mobility subtasks were accomplished; however, the tests would benefit from higher real-life motivation and data collection affordability. Audomni shows promise to be a viable mobility device - with some addressable issues. Employing Desire of Use to design future tests should provide both high real-life motivation and relevance to them. As far as we know, Audomni features the greatest information conveyance rate in the field, yet seems to offer comprehensible and fairly intuitive sonification; this work is also the first to utilize Desire of Use as a tool to evaluate user tests, a device, and to lay out an overarching project aim.

Presents corrections to references in the above name paper.

Virtual reality (VR) technologies have garnered substantial attention and adoption across various fields, including workspaces and education. People with disabilities, who already face lower employment rates and fewer full-time opportunities, may be further disadvantaged. Addressing this, recent advancements have focused on making VR inclusive, particularly for individuals with visual impairments. With the rapid development of artificial intelligence (AI) technology, it has also become possible to integrate AI technologies into VR systems to enhance accessibility for individuals with visual impairments. Despite growing interest, there is a gap in comprehensive literature focusing on AI’s role in enabling blind and low vision individuals to experience VR. This review aims to fill that void by providing an overview of current research, discussing benefits and challenges, and identifying future opportunities. By synthesizing existing research, this study contributes insights for researchers, developers, and practitioners working in the field of accessibility and assistive technology.

For decades, researchers have investigated and developed technologies that support independent navigation for people who are blind. This has led to systems that primarily aid in detecting routes, landmarks, and building features. However, there has been relatively little inquiry regarding how technologies might support navigation around and in the presence of other people. What visual information, if any, do blind navigators wish they had about people on their path? To address this question, we surveyed 58 blind and low vision individuals and interviewed 10 blind individuals. We discovered our participants were interested in using visual information about others to increase their physical safety. For example, they wanted to know if a passerby was holding a weapon, if a presumed official had a proper uniform or badge, and how to describe visual aspects of a criminal to law enforcement. This paper presents one of the only reports documenting accessibility challenges related to physical safety posed by others, including how future assistive tools can empower individuals with disabilities to more actively increase their sense of safety. We call this emerging area Personal Safety Management and contribute a set of four broad subareas that deserve further exploration by researchers and designers working within the blind and broader disabilities communities.