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Purpose. To characterize the needs for visual improvement of new-visit patients with low vision. Methods. This cross-sectional study collected detailed information of patients presented at low-vision center of the Eye Hospital of Wenzhou Medical University between January 2015 and January 2017. A questionnaire interview, including demographic information and needs for visual improvement, was conducted before ophthalmology examinations. Results. The main need for visual improvement was engagement in hobbies (68.9%), followed by reading (20.9%), engaging in occupation (20.1%), and watching TV or movies (17.1%). Less than 10% of patients mentioned the demand of using public transportation (5.8%), doing housework (3.7%), writing (1.9%), walking on irregular surfaces (1.5%), driving (1.1%), and others (2.4%). Women were significantly associated with a concern for performing hobbies (OR 1.45, 95% CI 1.0–2.0) but associated with lower odds of reading (OR 0.46, 95% CI 0.3–0.7). Older subjects were more willing to choose hobbies (OR 1.35 (per 10-year increase), 95% CI 1.3–1.4), reading (OR 1.11 (per 10-year increase), 95% CI 1.0–1.2), watching TV or movies (OR 1.4 (per 10-year increase), 95% CI 1.3–1.6), and housework (OR 1.21 (per 10-year increase), 95% CI 1.0–1.5) than younger individuals. In comparison with younger participants, older individuals were less likely to choose occupation (OR 0.53 (per 10-year increase), 95% CI 0.5–0.6). No significant association was found between visual acuity and needs for visual improvement. Conclusion. Hobbies, reading, engaging in occupation, and watching TV were the most common needs for visual rehabilitation in patients with visual impairment. Gender and age showed a modest influence on the choice of different needs. [ABSTRACT FROM AUTHOR]

Statement of context: A new grip part for the long cane used by visually impaired children was developed and the effect of this grip, using the muscle activity of the upper limbs, investigated. Critical reflection on practice: When using a long cane with this newly designed grip, the upper limb manipulating the cane showed less muscle activity than when using the conventional grip part. Implications for practice: Since long canes with the new grips require less muscle activity in their operation, they are popular, making it possible to encourage their use from the lower grade of elementary school. [ABSTRACT FROM AUTHOR]

Introduction: The aim of this study is to describe the barriers and facilitators to accessing low vision rehabilitation services in Massachusetts, USA, and determine differences between communities with and without existing low vision rehabilitation services for older adults with visual impairment. Method: A sample of older adults with visual impairment (n = 64) from both communities participated in the study. Barriers and facilitators to accessing the services were explored through focus groups and prioritized during one-on-one interviews, which allowed for comparison between communities. Results: Twelve themes were identified: (a) bureaucracy and funding (public policy); (b) public awareness and stigma (community); (c) services available, knowledge of providers, care coordination, transportation (organizational); (d) people and lack of awareness of family/friends (interpersonal); and (e) income, health status, knowledge, self-advocacy, and time (individual). Conclusion: This study provides insights into the perceived barriers and facilitators of accessing low vision rehabilitation services for older adults with vision impairment living in Massachusetts, USA. Key findings indicate the need for improved awareness of these services at the provider and consumer level, coordinated care, increased education on the efficacy of occupational therapy low vision rehabilitation services, client-centered care provided when the client is ready to accept services, and service provision that addresses sociodemographic factors. [ABSTRACT FROM AUTHOR]

Introduction: The objective was to describe the occupational performance in basic and instrumental daily activities of persons living in the community who have received comprehensive interdisciplinary low vision rehabilitation services. Method: The Mesure de l'impact de la déficience visuelle dans les activités quotidiennes (a measure of the impact of visual impairment in daily activities) was administered at home to 102 individuals who participated in a comprehensive low vision rehabilitation program. Performance in 16 near-vision activities was measured with the person's aids and strategies; nine more global tasks were questionnaire-based. Handicap scores were obtained by multiplying performance × importance ratings. Results: Average performance was satisfactory or very satisfactory for 21/25 items, even if 92% of the participants had a moderate or severe visual impairment. A severe or total handicap was present in at least one activity for 79% of the subjects. The most handicapping activities required visual searches of finely printed information on a complex or visually crowded document, or shopping and mobility. Conclusion: People with low vision who took part in a comprehensive rehabilitation program generally face no or slight handicap situations in their basic and instrumental daily activities. However, major handicap situations may remain in some important activities. [ABSTRACT FROM AUTHOR]

Background: Symptoms of visual motion sensitivity (VMS) secondary to traumatic brain injury (TBI) have previously been reported to improve with binasal occlusion (BNO). In previous literature, BNO has improved ambulation and gait in those with VMS. The aim of this case series was to demonstrate how BNO improves symptoms of VMS during ambulation in a military population with history of TBI. Methods: Three patients with a history of TBI and suspected VMS underwent a neurooptometric examination, including BNO applied to spectacles during ambulation in a clinical setting. Gait was subjectively evaluated by the examiner, and symptoms of VMS were assessed by the patient. Results: Subjective improvement in gait and symptoms of VMS were appreciated in three TBI patients with VMS. Two subjects also demonstrated improved versional function with BNO. All three subjects were subsequently prescribed BNO and neuro-optometric vision rehabilitation. One subject was lost to follow-up, and two subjects reported improved visual function with BNO several months after its initial application. Conclusion: BNO is an effective tool for treating VMS symptoms secondary to TBI. The effect of neuro-optometric vision rehabilitation in conjunction with BNO for VMS is yet to be determined. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to determine the impact of OrCam on vision-related quality of life of patients with legal blindness and end-stage glaucoma. OrCam is a device comprised of a camera and earpiece attached to the user's eyeglass that translates written text to speech. Methods: In this prospective, observational study, a total of 27 participants were recruited and tested. All participants were legally blind. Participants were provided with the OrCam device during the study period and trained how to operate it. National Eye Institute Visual Functioning Questionnaire-25 (NEI-VFQ-25) and other questionnaires were given to participants at the baseline visit and at the end of the 4-week study for comparison. Additional questions were surveyed weekly during the study to monitor progress. Results: At the final visit after 1 month, most participants, 74.1% (n = 20/27), reported an increase in their overall quality of life. Participants were highly satisfied with the device; 88.9% (n = 24/27) reported being "very satisfied" or "satisfied" with the device. The NEI-VFQ-25 near vision subscale score improved from 29.9 to 37.2 (p =.045). Discussion: OrCam allowed participants with legal blindness to read independently when in controlled settings, subsequently improving their quality of life. However, users had more difficulty using the device when the location of text was not readily apparent (e.g., street signs, billboards), and users with some degree of vision had an easier time aligning the device with the text. Implications for practitioners: This device may offer participants with visual impairments the opportunity to read independently. [ABSTRACT FROM AUTHOR]

Introduction: The purpose of this study was to survey the faculty of personnel preparation programs that train orientation and mobility (O&M) specialists in the identification of accommodations, teaching techniques, and resources needed to teach students who are visually impaired (i.e., those who are blind or have low vision) and who are enrolled in blindfold and simulation cane courses (hereafter, cane courses). Cane courses are used to teach the techniques of independent cane travel, and they require total visual occlusion using blindfolds as well as simulated low vision using goggles that depict different visual acuities and field losses. Methods: This study surveyed personnel preparation programs training O&M specialists with an online questionnaire with open-ended items to identify the program's required accommodations, teaching techniques, and resources needed to teach visually impaired students who are enrolled in cane courses. The survey was e-mailed to 22 universities in North America, which have personnel preparation programs for O&M specialists and asked for responses from individuals who teach cane courses. Descriptive statistics were used to analyze the survey data. Results: Results showed that the format of the cane courses was varied, a variety of accommodations and teaching strategies were used, and the universities' office of disabled students generally did not know how to accommodate these courses. Discussion: A need exists for a student who is visually impaired to be an experienced traveler and to be knowledgeable about what accommodations and strategies he or she will use when they need to teach a fellow student during a cane course. Visually impaired students must be able to monitor the safety of their peers as well as the changing dynamics of the environment in which they are working. Implication for practitioners: To effectively teach visually impaired students who are enrolled in cane courses, university faculty teaching these courses could request prospective visually impaired students to provide documentation regarding their travel skills prior to acceptance into a personnel preparation program in O&M. In addition, students with visual impairments need to discuss with their universities' office of disabled students and legal counsel what reasonable accommodations are relevant for visually impaired students enrolled in the cane courses and what accommodations they believe the universities are committed to providing these students. [ABSTRACT FROM AUTHOR]

Lack of access to visual cues can cause challenges and sometimes make social interaction difficult for many visually impaired persons in face-to-face situations. The loss of vision, therefore, demands adjustments––not only for the individual's adaptation with sight loss for independent living but also for communication. While recognizing that older adults with vision impairment face challenges when communicating with others due to inability to perceive visual cues, this study examines the challenges and opportunities presented to them when using a computer to communicate with others. The study employed a case study approach, conducting semi-structured interviews with 20 visually impaired older adults aged 60–87 years. Findings suggest that the lack of visual cues in text-based computer-mediated communications (CMCs) supported their daily social communication. The paper discussed how, within online communication, people with vision impairment compensate for sight loss through CMC. Implications of findings for broader issues that may steer the use of Information communication technologies among visually impaired older people are discussed. This paper adds novel understanding to the field of CMC, in highlighting the need for more attentive rehabilitation than the need for circumventing face-to-face interaction. [ABSTRACT FROM AUTHOR]

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With increased life expectancy at birth and especially the rising incidence of age-related macular degeneration, low vision (re)habilitation is becoming more important today. Important factors to consider when presenting rehabilitation and treatment options to patients presenting to low vision centers include the diagnosis of the underlying disease, the patient's age, their existing visual functions (especially distance and near visual acuity), whether visual loss is central or peripheral, whether their disease is progressive or not, the patient's education level, and their expectations from us. Low vision patients must be guided to the right centers at the appropriate age, with appropriate indications, and with realistic expectations, and the rehabilitation process must be carried out as a multidisciplinary collaboration. [ABSTRACT FROM AUTHOR]

Purpose: This study investigates the social capital implications of vision loss among working-age adults in Nigeria. The study explores the challenges of acquiring and maintaining social relationships post-vision loss, and investigates the extent to which visual rehabilitation services support social goals. Method: A qualitative study using a phenomenological approach was undertaken. Eight adults (18–59 years) were recruited from disability service organizations in Nigeria. Telephone interviews were recorded and transcribed, and thematic content analysis was used to analyze the data gathered in this study. Results: Three broad themes were developed from participants' accounts of their experiences: (1) changes to relationships with friends and others; (2) finding strength in family relationships; and (3) rehabilitation and the confidence to interact. The findings indicate that the relationship between participants and their family members improved post vision impairment, enhancing bonding social capital. However, participants experienced reduced bridging and linking social capital due to diminished or broken relationships with managers, coworkers, friends, and others in the community. Conclusions: As social connectedness and relationships are highly valued in Nigeria's diverse society, we suggest that adults with visual impairment would significantly benefit from visual rehabilitation services placing greater emphasis on addressing the social goals of participants. Visual impairment in working-age adults can strengthen family relationships (homogenous groups), creating bonding capital that is associated with access to important resources including emotional and moral support, and some financial and material resources. Visual impairment can negatively impact relationships with managers, coworkers, and others in the community (heterogeneous groups), resulting in diminished bridging and linking capital. Visual impairment can reduce access to resources such as an income, social status, and reduces participation in the wider community. Visual Rehabilitation Services could significantly benefit participants by placing greater emphasis on social goals, such as building and maintaining social networks, particularly with diverse (heterogeneous groups), which are valued in Nigeria's diverse cultural climate. [ABSTRACT FROM AUTHOR]

The authors convey their concerns about student portfolios in orientation and mobility (O&M) literature. Topics covered include the definition of student portfolios, the lack of standardized O&M assessments to measure and document progress for children with multiple disabilities, and a screenshot of an electronic portfolio developed with Google Slides software by technology company Google LLC.

This study aims to provide an overview of visually impaired cyclists' difficulties with independent cycling in the Netherlands. Normally sighted cyclists (n = 109) and visually impaired cyclists (n = 197) and former cyclists (n = 22) completed an online questionnaire on potential cycling difficulties related to visual function, bicycle control, and contextual factors. The former cyclists were asked to what extent these difficulties were crucial for them to stop cycling. Overall, the visually impaired cyclists reported having most difficulties with light–dark transitions, crossing intersections without traffic lights, and other traffic participants' bad visibility. The former cyclists' determinants to stop cycling were similar to the difficulties reported by those who still cycle. The nature and the origination of the visual function limitations may induce specific difficulties in cycling. However, the ability to cycle does not depend on the visual functions alone, but also on the ability to compensate sufficiently for the visual function limitations. In conclusion, using minimal vision requirements for cycling unnecessarily excludes many visually impaired people from independent cycling. Mobility trainers are recommended to give cycling training and advice based on a practical test of the client's individual ability to compensate for the visual limitations. [ABSTRACT FROM AUTHOR]

Children with a visual impairment are less active than their sighted peers. Yet, they are born with the potential to match their sighted peers' motor skill competency and levels of physical fitness. Environmental barriers are one of the main causes of inequities. This article provides insight on these issues, drawing upon a physical activity intervention called 'First Steps', a British Blind Sport initiative that aimed to get more children with a visual impairment more active. Physical activity packs were delivered to 53 children, aged 5–15 years, with a visual impairment. Of these participants, 62% had additional impairments or medical conditions. A mixed-methods approach was used to gather participants' experiences of physical activity prior to receiving this pack and canvas opinion on how the pack changed their activity levels. The findings revealed inequitable experiences of physical activity. The First Steps pack made considerable progress in developing children's physical activity levels. Participants' motor skills, social interactions, and confidence improved. Organisations working with this population might look to adopt a similar concept. Recommendations for those wishing to do so are provided. [ABSTRACT FROM AUTHOR]

CHARGE syndrome is a rare genetic disorder that arises during early fetal development and affects multiple organ systems. The acronym "CHARGE" comes from some of the more common features: coloboma, heart defects, atresia of the choanae (i.e., blocked nasal cavity), retardation of growth and development, genital underdevelopment, and ear abnormalities. Individual factors contribute to motor skill delays in children with CHARGE syndrome, including hypotonia (i.e., muscle weakness), balance problems, and vision loss. This article will examine the use of a constraints model (Newell, 1984) to develop and improve motor skills, by modifying the task and environment. [ABSTRACT FROM AUTHOR]

Purpose: People with low vision have difficulty reading. There is a scarcity of reports on whether the use of a portable electronic magnifier (PEM) versus a smartphone magnification app is more efficacious for reading tasks. The purpose of this study was to evaluate reading rates for both a PEM and a smartphone app, as well as to have subjects comment on their preferences between the two devices. Methods: Adults attending a low vision clinic were recruited to participate. The study included a pre-study survey, device training, and a reading assessment and concluded with a post-study survey. The reading assessment was a three-minute reading task done with a PEM and a smartphone magnification app. Results: Fourteen subjects completed the study. Reading rates were found to be higher with the portable electronic magnifier as compared to the magnification app, with a P value of 0.04. Seventy-nine percent of subjects preferred reading with the PEM overall, but 57% of subjects favored the magnification app for short reading tasks. Subjects were found to use their smartphones frequently for a variety of different tasks. Conclusion: Reading rates were faster with a PEM, which was preferred by most subjects. Reading with a magnification app on a smartphone is a good alternative for short reading tasks. The majority of subjects responded that their smartphones were helpful to accomplish their activities of daily living, and they were reliant on their smartphones. [ABSTRACT FROM AUTHOR]

This paper will present a process approach to the treatment of vision dysfunctions with the use of lenses and vision therapy. The process approach views vision dysfunctions as syndromes, potentially impacting cognition, posture, balance, movement, speech-auditory, emotions, and feelings. Performance lenses can be prescribed for most daily activities. A set of office vision therapy activities is performed in free or real space, most often slowly, relying on feedback to create change. This process requires the trainer to plant questions for the patient to consider rather than informing them of what they should be seeing. Diaphragmatic breathing, "hanging onto space," and good posture are fundamental to each activity. Balance and movement are emphasized throughout the program. [ABSTRACT FROM AUTHOR]

Evergreen was a World War I (WWI) adult, inpatient vocational rehabilitation facility for war-blind soldiers, sailors, and marines in the United States. Although Evergreen shared similarities with European war-blind rehabilitation organizations, it was novel in its philosophy and approach. It was also unlike any civilian blind rehabilitation program of its day. Although there are no comprehensive records known to us of how many troops became blind or sustained vision loss during WWI, studying published reports of the veterans served by Evergreen provides some insight into this population. As the United States' only blind rehabilitation facility for adults, Evergreen achieved several firsts, including having a national scope, being racially integrated (at least to some degree), and innovating a residential family training program. A role model of its day, it is now largely a footnote in the history of blind rehabilitation. We argue that the story of Evergreen contains lessons that should be remembered. [ABSTRACT FROM AUTHOR]

Background: The antiepileptic drug vigabatrin is associated with characteristic visual field loss (VAVFL) and thinning of the peripapillary retinal nerve fibre layer (PPRNFL); however, the relationship is equivocal.Objective: The aim of this study was to determine the function-structure relationship associated with long-term exposure to vigabatrin, thereby improving the risk/benefit analysis of the drug.Methods: A cross-sectional observational design identified 40 adults who had received long-term vigabatrin for refractory seizures, who had no evidence of co-existing retino-geniculo-cortical visual pathway abnormality, and who had undergone a standardized protocol of perimetry and of optical coherence tomography (OCT) of the PPRNFL. Vigabatrin toxicity was defined as the presence of VAVFL. The function-structure relationship for the superior and inferior retinal quadrants was evaluated by two established models applicable to other optic neuropathies.Results: The function-structure relationship for each model was consistent with an optic neuropathy. PPRNFL thinning, expressed in micrometres, asymptoted at an equivalent visual field loss of worse than approximately - 10.0 dB, thereby preventing assessment of more substantial thinning. Transformation of the outcomes to retinal ganglion cell soma and axon estimates, respectively, resulted in a linear relationship.Conclusions: Functional and structural abnormality is strongly related in individuals with vigabatrin toxicity and no evidence of visual pathway comorbidity, thereby implicating retinal ganglion cell dysfunction. OCT affords a limited measurement range compared with perimetry: severity cannot be directly assessed when the PPRNFL quadrant thickness is less than approximately 65 µm, depending on the tomographer. This limitation can be overcome by transformation of thickness to remaining axons, an outcome requiring input from perimetry. [ABSTRACT FROM AUTHOR]

The emerging discipline of fencing for the blind and visually impaired is a distinct practice that calls for the unconventional employment of perceptual affordances and bodily doings. This paper explores the meaning of ability and agency in narratives of blind and visually impaired fencers' lived experiences. By focusing on narratives of risk taking, active handling, and creativity, we have identified three specific ways in which fencers experience their being-in-the-world. Our findings suggest that instead of rehabilitating to the norm, fencing contributes to rehab/ituation: conceptualising the rearrangement of one's body schema according to personal affordances. This concept, which is present in the notion of rehab/ituation as opposed to rehabilitation, makes possible a more creative and inclusive way of being in the world. Our respondents' stories of intelligence in the flesh, know-how and ability, are stories of fitting - whereas disorientations and disruptions represent a sort of misfitting between the body and an environment. [ABSTRACT FROM AUTHOR]

The article examines the practice paper, "Scope of Practice in O&M," approved by the Association for Education and Rehabilitation of the Blind and Visually Impaired (AER) Orientation & Mobility (O&M) Division in 2018. Topics discussed include the development and revisions of the practice paper, the need to address the requirements of the Individuals with Disabilities Education Act (IDEA) and the Rehabilitation Act of 1973, and future considerations for the paper.

Like other sub-Saharan African nations, Nigeria has a relatively high proportion of adults with acquired vision loss. This study investigates the impacts of becoming blind in adulthood and how the use of blind rehabilitation services addresses functional needs, supports activities of daily living, and enhances participation in educational, vocational, and community activities. Adopting a qualitative and interpretative approach, we conducted in-depth interviews with eight adult users of blind rehabilitation services. Three broad themes were identified: (1) psycho-emotional responses to vision loss; (2) impacts on participation in education, employment, and community; and (3) positive impact of blind rehabilitation services. Findings are discussed in the context of the international literature, and suggestions that may enhance the blind rehabilitation services are made. [ABSTRACT FROM AUTHOR]

We examined individual, socioeconomic, disability, service, and state-level factors predicting vocational rehabilitation (VR) closure earnings exceeding substantial gainful activity for Social Security Disability Insurance (DI) beneficiaries in VR who were blind or visually impaired (BVI). We used 2011 RSA-911 (Rehabilitation Services Administration) data from 3,505 individuals exiting VR. Using multilevel modeling, we found positive relationships for beneficiaries who were male, younger, African American; held higher education levels; were without additional disabilities; had higher earnings and DI benefits at application; received services related to job placement and on-the-job supports; did not receive “work basics” (job-readiness) training; received training/support services in rehabilitation technology and other supports; and resided in states with lower unemployment rates. Interactions with VR agency structure revealed compensatory effects—negative relationships for being female and for being older were overcome by receiving services in a blind (rather than combined) agency. We concluded that prior work experience of a DI-beneficiary consumer contributes substantially to high earnings likely to lead to benefits termination due to work for the BVI consumer exiting VR and may serve to level race/ethnicity differences in outcome. Policy recommendations include retaining separate VR agencies for BVI consumers and strongly encouraging work experiences for consumers in VR. [ABSTRACT FROM AUTHOR]

A wide range of portable and wearable electronic travel aids have been developed to enable visually impaired people to move around public spaces without a sighted guide. However, few of them have gone beyond the prototype stage and the long cane and guide dog are still the main mobility aids. Despite the importance of evaluation to determine, for instance, effective functioning and end-user satisfaction, a standard approach has not yet been developed for mobility aids. The paper reports the evaluation of a low-cost electronic long cane, developed by the authors and colleagues in Brazil. It used a two-part methodology involving an experimental investigation of performance of the electronic long cane and a questionnaire to explore user satisfaction. The results of the experiments and questionnaire demonstrated both the cane’s usefulness and the need for modifications to improve its functioning. This work is also important for the development of methodologies for effective evaluation, as this is the first evaluation of a mobility device developed and carried out in Brazil. In addition, it is one of only a small number of evaluations in real locations with real obstacles. Finally, a series of recommendations for evaluating mobility devices is presented. What this paper adds? A standard approach to evaluating electronic travel for visually impaired people has not yet been developed and the most appropriate approach may depend on the objectives of the evaluation. Existing approaches generally use participants with no previous experience of using the device being evaluated and is carried out indoors with artificial obstacles. The training or device familiarisation period usually provided might be insufficient for participants to obtain optimal device performance or an effective comparison to be made of different devices. The approach to evaluating an electronic long cane reported in this paper has three main advantages over previous methods. The participants were experienced users of the electronic long cane who had been using it to support their daily mobility for at least a month. The evaluation was carried out in two different real urban environments with real obstacles. This has the advantages of being close to real-life cane use and participants being able to make informed comments and suggestions for improvements as a result of their experience. A questionnaire included questions on user satisfaction with and evaluation of a number of different cane features based on their experiences of cane use over a period. The work is also significant as the first detailed mobility device evaluation carried out in Brazil and in the presentation of a series of recommendations divided into themes for effective evaluation of mobility devices. [ABSTRACT FROM AUTHOR]

Introduction: Technological advances have introduced three-dimensional (3-D) printing as an option for creating tactile maps for people with visual impairments (that is, those who are blind or have low vision), diversifying the types of map products that are available. At the same time, it presents a challenge to map makers to implement designs across multiple production methods. We evaluated map symbols to determine their discriminability across three different materials: microcapsule paper, 3-D printer plastic, and embossed paper. Methods: In a single session lasting less than 90 minutes, participants completed a matching task and provided informal feedback regarding their preferences. We measured speed and accuracy to establish discriminability of map symbols on each of the materials. Eighteen participants were recruited from a referred sample among attendees at the American Council of the Blind annual convention in 2013. Results: Response times were significantly different across the three materials (p < 0.001). Without sacrificing accuracy, response times were faster for the 3-D printed graphics than for either the microcapsule paper (p < 0.001) or the embossed paper (p < 0.001). User preference was divided across the three materials. Some people disliked the "sharp" corners of the 3-D printed symbols, while others preferred their "crisp" edges. Discussion: Our results demonstrate faster discriminability of a set of tactile symbols produced on a 3-D printer compared to those same symbols printed on microcapsule paper, the material for which the symbols were originally designed. Participant feedback reflected preferences both in favor of and against reading symbols produced on the 3-D printer. Implications for practitioners: This article discusses the functional equivalence of tactile symbols produced across multiple production technologies. It addresses two considerations when using 3-D printing to make tactile maps: preparing digital files for printing and the printing work flow. Digital files ready for printing on each of the three materials are available for download (Brittell, Lobben, & Lawrence 2016). [ABSTRACT FROM AUTHOR]

Introduction: This study presents and evaluates the use of a method using local cues to indicate perspective in tactile diagrams as compared to the current use of visual perspective methods. Methods: Perspective for an object using local cues is represented with standard visual perspective lines but with the thickness of the lines varying as a function of depth away from the viewer. Performance of visually impaired study participants (that is, those who are blind or have low vision), using the new method and the standard visual perspective method, were compared as functions of: onset of vision loss of a participant, perspective method used, repetition, and object and perspective of an object presented. Results: For the main task, the method used-Wald χ² (1, 585) 7.147, p = 0.008 - and the method-repetition interaction-Wald χ²(1, 585) = 4.272, p = 0.039 - had significant effects. Participants performed better with our new method and there was a significant improvement for (only) this method between repetitions. Discussion: The findings demonstrate that our new method improved the performance of users for tasks involving perspective on diagrams over the standard visual perspective method. The data also indicates that with more repetition, improvement could become even greater than observed during this study. Implications for practitioners: Perspective frequently plays a critical role in aiding the understanding of questions in mathematics and science. Adding local cues to a standard perspective diagram shows promise in improving users' ability to interpret objects. [ABSTRACT FROM AUTHOR]

Introduction: Rehabilitation can improve visual outcomes for adults with acquired homonymous visual field loss. It is unclear, however, whether rehabilitation improves visual outcomes for children because previous training schedules have been tiresome, uninteresting, and have failed to keep them engaged. In this study, we assessed whether children and young people with homonymous visual field loss would adhere to six weeks of unsupervised compensatory training using a specialized video game. Methods: Participants aged between 7 and 25 years with homonymous visual field loss completed tabletop assessments of visual search across four site visits. Two baseline assessments separated by four weeks evaluated spontaneous improvements before training began. Participants were then given a copy of the video game to use unsupervised at home for six weeks. Two follow-up assessments separated by four weeks were then conducted to evaluate immediate and acutely maintained effects of training. Results: Fifteen candidates met the inclusion-exclusion criteria, nine participated, and eight completed the study. Participants completed an average of 5.6 hours of unsupervised training over the six weeks. Improvements on in-game metrics plateaued during week three of training. The time taken to find objects during tabletop activities improved by an average of 24%-95% CI (2%, 46%)-after training. scussion: The findings demonstrate that children and young people with homonymous visual field loss will engage with gamified compensatory training, and it can improve visual outcomes with less of a time commitment than has been required of adults participating in non-gamified training in previous studies. Appropriately powered, randomized controlled trials are required to evaluate the validity and generalizability of observed training effects. Implications for practitioners: Rehabilitation specialists can use specialist video games and gamification technique to engage children and young people with homonymous visual field loss in long-term unsupervised training schedules. [ABSTRACT FROM AUTHOR]

Introduction: The purpose of this study was to gain information from parents in the United States about their children with albinism. The article focuses on information and services related to medical care and low vision care. Methods: An online questionnaire was used to collect data, and parents had opportunities to submit additional information. One hundred ninetytwo families, representing 223 children with albinism from 40 U.S. states, completed surveys. Results: A snapshot of the data indicates that for 8.6 out of 10 families, there were no known relatives with the condition; 55.8% of the children had visual acuities that met the criteria for legal blindness in the United States; and 48% of the children using optical devices had received clinical low vision evaluations by optometrists or ophthalmologists who specialized in low vision. Implications for practitioners: The data gathered suggest recommendations for medical service providers, including clinical low vision specialists who perform evaluations for improving the functional use of vision. [ABSTRACT FROM AUTHOR]

This study examines the meaning of adaptive snow skiing for individuals with significant visual impairment, and explores how hardiness manifests in the contexts in which participants live and recreate. Seidman's (2013) iterative three-part interviewing method was employed with five adults (three female, two male) from an adaptive cross-country skiing program in the northeast. Findings suggested three major themes. Participants (a) found meaning in being with others and having opportunities to develop relationships with other individuals who had significant visual impairment; (b) valued the freedom of being in the outdoors, the freedom of movement, and the independence that skiing provided; and (c) placed importance on the equality they experienced in their ski experiences and acknowledged the significance of others' recognition of this equality. Participants' hardiness was expressed similarly throughout their early lives and skiing experiences, suggesting that hardiness may be developed early on in life and is likely enhanced through recreation experiences. Implications for ways in which community-based therapeutic recreation (TR) programs can respond to the needs of individuals with significant visual impairment are discussed. [ABSTRACT FROM AUTHOR]

Background While a fair amount of research has investigated the impact of sensory impairments on the mental health of young older adults (65–79 years of age), only a few studies have focused on the associations of sensory impairments with mental health outcomes in the oldest-old (80 years and older). To close this gap, this study examined the separate and combined effects of self-reported vision and hearing impairment for depressive symptoms in a sample of oldest-old individuals, controlling for other mental health risks (e.g., functional disability, health interference, and loneliness). Methods Centenarians and near-centenarians (N = 119; average age = 99) were recruited from the community and geriatric healthcare organizations. In-person interviews were conducted at participants’ place of residence. Results Vision impairment and its interaction with hearing impairment as well as functional disability, health interference with desired activities, and loneliness were significant predictors of depressive symptoms in hierarchical regression analyses. Hearing impairment alone was not associated with depressive symptoms, but follow-up analyses clarifying the interaction effect showed that individuals with poor vision had the highest levels of depressive symptoms, if they had a concurrent hearing impairment. Thus, a concurrent presence of poor vision and poor hearing resulted in an increased vulnerability for depressive symptoms. Conclusions Given that a majority of oldest-old has sensory impairments which can result in mental health issues, it is important to facilitate this population’s access to vision and audiological treatment and rehabilitation. [ABSTRACT FROM AUTHOR]

The article discusses the concept of echoidentification that aims to teach people with visual impairments to get the most back from sound. The distinctions between active echolocation and passive echolocation are discussed. The review of literature shows proof that people of various visual acuities can learn echoidentification. Some strategies are provided that may be useful to instructors interested in teaching higher-level echoidentification skills.

The article explores promising practices for promoting emergent literacy skills in toddlers with visual impairments. It is said that children with visual impairments are at risk for differences in early oral language, listening skills, and concept development. A focus on emergent literacy development and shared storybook reading are said to be critical interventions for toddlers with visual impairments. The significance of dialogic reading to preschoolers with language delays is discussed.

Introduction: The objective of this study was to determine the prevalence of Charles Bonnet syndrome in a population of patients seen in a vision rehabilitation clinic and to gain deeper insight into the content of visual hallucinations that are experienced. Methods: This investigation was a retrospective review of medical record vision rehabilitation evaluations from 100 adult patients who were seen consecutively in a vision rehabilitation clinic. Data collected included age, gender, eye condition, current medications, other medical diagnoses, current living situation, and responses to questions about Charles Bonnet syndrome symptomatology. Results: Eight participants were excluded from analysis due to diagnosis of cognitive impairment or a current anticholinergic medication. A total of 25.0% (n = 23) of eligible patients with visual impairments reported visual hallucinations that met the definition of Charles Bonnet syndrome. Images of people (35%) were the most common hallucinations reported by participants, followed by images of animals (26%). Discussion: The occurrence of this syndrome in our study is near the mid-range of estimated prevalence in the professional literature. Implications for practitioners: Individuals with this syndrome are hesitant to disclose that they are experiencing hallucinations for fear of being seen as having dementia or psychosis. An important concept for vision professionals, especially those offering visual rehabilitation, is integrating screening for Charles Bonnet syndrome into their care planning. Demonstrating that the syndrome is not a rare occurrence helps raise awareness of it in people with vision loss, thus explaining it as not so unusual and facilitating a discussion between patients and professionals that will reduce the apprehension that many individuals with visual impairments have that these hallucinations are a sign of more concerning conditions. [ABSTRACT FROM AUTHOR]

Introduction: Recent U.S. legislation supports vocational rehabilitation efforts to maximize employment and community integration of persons with disabilities by providing job retention and career advancement services. The study presented here investigated employed persons with visual disabilities who applied for vocational rehabilitation services. Methods: The sample included 4,499 competitively employed vocational rehabilitation applicants from the FY2015 RSA-911 report. Logistic regression was used to identify consumer characteristics and vocational rehabilitation services associated with losing competitive employment. Results: Employed applicants tended to receive assessment, counseling and guidance, diagnosis and treatment, and rehabilitation technology. Characteristics that put employed applicants at increased risk of losing their jobs included being female, having a secondary disability, working fewer hours, having less education, or having a previous unsuccessful vocational rehabilitation employment outcome. There was a significant interaction between vocational rehabilitation case length and age: those served for longer periods were more likely to lose employment, particularly older consumers. Consumers who received short-term on-the-job support, diagnosis and treatment of impairments, or rehabilitation technology services were more likely to retain competitive employment. Discussion: When developing rehabilitation plans for employed applicants, counselors may identify and attempt to provide services to address factors that put consumers at an increased risk of losing employment. Part-time employment at application is one risk factor that requires increased attention. Implications for practitioners: Prompt service delivery is an important factor in facilitating job retention. Increased efforts to maintain consumer contact and motivation may influence the likelihood of job retention among employed applicants. [ABSTRACT FROM AUTHOR]

OBJECTIVE. We describe the development and content validation of the revised Self-Report Assessment of Functional Visual Performance (R--SRAFVP). METHOD. The content validation process consisted of three stages: (1) three occupational therapy experts in low vision rehabilitation revised items on the 38-item SRAFVP via written feedback and semistructured interview, (2) eight occupational therapy low vision experts evaluated items for relevance and provided feedback on the rating scale, and (3) five adults with low vision provided feedback on item clarity via cognitive interviewing. RESULTS. In Stage 1 review, 21 items were added, totaling 59 items. In Stage 2 evaluation, 9 items were eliminated, resulting in the 50-item R--SRAFVP with a 4-point scale. The scale content validity index of the R--SRAFVP was .9. Stage 3 cognitive interviewing provided no substantive changes in content. CONCLUSION. R--SRAFVP content was relevant to evaluate the ability of adults with low vision to complete vision-dependent daily tasks and was understandable by these participants. [ABSTRACT FROM AUTHOR]

OBJECTIVE. Our objective was to validate the construct of the Revised Self-Report Assessment of Functional Visual Performance (R--SRAFVP) for older adults with low vision resulting from age-related eye disease. METHOD. The 50-item draft of the R--SRAFVP was administered to 87 older adults with low vision. Construct validation included principal-components analysis and the known-groups method. RESULTS. Principal-components analysis revealed nine components (comprising 33 items): Personal Care, Oral Care, Meal/Laundry Preparation, Financial Management, Telephone Usage, Personal Preference Activities, Reading, Writing, and Functional Mobility. Cronbach's a ranged from .72 to .84 for individual components and was .92 overall. Known-groups comparisons showed that participants with moderate to profound acuity loss or contrast sensitivity deficits reported significantly greater difficulty completing tasks on the R--SRAFVP than those with milder acuity loss or normal contrast sensitivity. CONCLUSION. The 33-item R--SRAFVP demonstrates adequate evidence of reliability and validity to evaluate the ability of older adults with low vision to complete vision-dependent activities of daily living. [ABSTRACT FROM AUTHOR]

A convenience sample (n = 35) of Teachers of Students with Visual Impairments (TVIs) and Rehabilitation Specialists completed a survey about their instructional techniques and perspectives on the relationship between braille and technology. While 62.5% of TVIs and Rehabilitation Specialists working with children, adolescents, or adults use technology in braille instruction, only 26.3% of those working with seniors use technology when teaching these clients. Rehabilitation Specialists felt significantly less knowledgeable about technologies than TVIs and used technology less frequently. TVIs felt more strongly that technology increased learner motivation and that the use of technology improved learning outcomes. These results suggest that the level of technological knowledge and instructor beliefs in the benefits such technologies provide may impact the decision to incorporate technology within braille instruction. Additional study is required to assess the validity of the motivational and learning benefits of various technologies within braille training programs. [ABSTRACT FROM AUTHOR]

Purpose: To explore the feasibility and preliminary effectiveness of Problem-Solving Treatment for Primary Care (PST-PC) delivered by low-vision rehabilitation (LVR) practitioners to adult clients with depressive symptoms. Design/Method: A single-group pre/postintervention study. Eighteen adult LVR clients with depressive symptoms (Patient Health Questionnaire-9 [PHQ-9] score of =5) received 6-8 weekly telephone sessions of PST-PC delivered by expertly trained practitioners (n = 14). Feasibility was determined via participating client and practitioner recruitment and intervention retention rates. Depressive symptoms (PHQ-9), health-related quality of life (HRQoL; Assessment of QoL Instrument-7D), and confidence in one's ability to cope using problem-solving strategies (Coping Self-Efficacy Scale) were assessed using pre/posttelephone assessments. Results: Participating client recruitment and retention rates were 71% and 40%, respectively. Seventy percent of practitioners completed supervised training in PST-PC and demonstrated satisfactory levels of fidelity and competency. Postintervention, we observed a 53% improvement in depressive symptoms (p < .001), a 23% improvement in HRQoL (p = .001), and an 18% improvement in participants' confidence to use problem-focused coping strategies (p = .001). Conclusions: Telephone-PST-PC delivered by a trained LVR practitioner may be an effective intervention for clients of LVR services who exhibit depressive symptoms. A randomized controlled trial is now needed to confirm these preliminary findings and establish longer-term effectiveness. [ABSTRACT FROM AUTHOR]

Purpose: Nature of being accessible to all categories of users is one of the primary factors for enabling the wider reach of the resources published through World Wide Web. The accessibility of websites has been analyzed through W3C guidelines with the help of various tools. This paper presents a multi-tool accessibility assessment of government department websites belonging to the Indian state of Jammu and Kashmir. A comparative analysis of six accessibility tools is also presented with 14 different parameters. Materials and methods: The accessibility analysis tools used in this study for analysis are aChecker, Cynthia Says, Tenon, wave, Mauve, and Hera. These tools provide us the results of selected websites accessibility status on Web Content Accessibility Guidelines (WCAG) 1.0 and 2.0. Results: It was found that there are variations in accessibility analysis results when using different accessibility metrics to measure the accessibility of websites. In addition to this, we have identified the guidelines which have frequently been violated. It was observed that there is a need for incorporating the accessibility component features among the selected websites. This paper presents a set of suggestions to improve the accessibility status of these sites so that the information and services provided by these sites shall reach a wider spectrum of audience without any barrier. Implications for rehabilitation: The following points indicates that this case study of JKGAD websites comes under Rehabilitation focused on Visually Impaired users. Due to the universal nature of web, it should be accessible to all according to WCAG guidelines framed by World Wide Web Consortium. In this paper we have identified multiple accessibility barriers for persons with visual impairment while browsing the Jammu and Kashmir Government websites. Multi-tool analysis has been done to pin-point the potential barriers for persons with visually Impaired. Usability analysis has been performed to check whether these websites are suitable for persons with visual impairment. We provide some valuable suggestions which can be followed by developers and designers to minimize these potential accessibility barriers.Based on aforementioned key points, this article helps the persons with disability especially Visually Impaired Users to access the web resources better with the implementation of identified suggestions. [ABSTRACT FROM AUTHOR]

The purpose of this study was to investigate agencies' response to and their perceived impact of two specific changes associated with the Workforce Innovation and Opportunity Act (WIOA): 15% budget allocation for pre-employment transition services (pre-ETS) and elimination of the homemaker closure. Representatives from combined and separate agencies serving consumers with blindness and low vision in all 50 states and the District of Columbia participated in a telephone survey to provide information about the agency's response to these changes. Separate agencies were more likely to experience a challenge with the pre-ETS requirement, but were less likely to be impacted by the elimination of homemaker as a closure status. A concern for all agencies was the yet-to-be-determined impact on services to consumers over age 21. [ABSTRACT FROM AUTHOR]