Sunday, August 19, 2012

How Do You ... Read?

This is the second installment in my series of posts called "How do you ...?" designed to answer some questions I frequently get about living as someone with a visual impairment. The first post in this series covered how people with visual impairments use computers. Future posts will include how I get around, how I manage diabetes, and how I accomplish everyday things around the house like cooking and cleaning. If you have any ideas or questions that I can cover in future posts, please comment!

Numerous studies have documented that blindness is the most-feared disability, and for a lot of people this relates largely to a fear of helplessness and dependency. For many, reading is a vital part of their lives, whether for work, school, leisure, or everyday activities such as reading mail. The good news is that, like computer access, today people who are blind or visually impaired have greater access to print than ever before in the past. This is largely a result of the huge advances in technology that have occurred over the past 30 or so years.

Fifty years ago, if someone was unable to read standard-sized print and wanted to read, they were limited in their options. The material might be available in an alternate format such as large print, braille, or audio recording. Each of these formats required a labourous transcription of the material by hand or a reading of the entire text onto a special record, each of which took many hours. If the book wasn't available in one of these formats, then a "reader" could read the material aloud to the person with a visual impairment

Fortunately, these days are long gone, although this may be the types of limitations many people who are sighted imagine when they think about blindness and literacy. Today there are still traditional libraries for the blind that provide books in braille and audio formats (the CNIB Library in Canada and the National Library Service for the Blind and Physically Handicapped in the United States, among others). These libraries provide an invaluable service to those with vision loss, but it's impossible for them to keep up with the publication of print materials. Only about 3-5% of print materials are available in one of the alternate formats of braille, audio recording, or electronic text, which means that the selection in these libraries is extremely limited compared to what you would find if you walked into even a moderate-sized public library.

Many people with low vision are able to access print books directly simply by enlarging the print. Some can see well enough to read large print books which are present in many libraries and bookstores, although the print in these books is still often too small for those with low vision to read. Handheld magnifiers can be useful, too, but they only allow a few letters or words to be viewed at a time, are fatiguing to use for long periods, and for many they do not provide enough enlargement. Magnifiers are great for spot reading price tags in stores or menus in restaurants, but for longer reading they are not as good. Devices called video magnifiers (formerly known as closed circuit televisions (CCTVs), before that term came to mean security systems) use a combination of a camera, a light source, and a monitor to enlarge and enhance print material to a greater degree than handheld magnifiers can. Not only can print be magnified, but colour, brightness, and contrast can be adjusted to suit different eye conditions. Video magnifiers come in desktop and portable models, and are probably the most widely-used technology for reading and writing by those with visual impairments. These devices can also be connected to computers in order to share a single monitor and save desk space if desired.

A desktop video magnifier
A portable video magnifier.

These days, however, many people rely not on hardcopy versions of these formats, but rather on electronic formats which can be used with various devices that render output in whatever format is needed. A digital file can be loaded on one device that provides large print, and that same file can also be loaded onto devices that provide speech and/or braille output. This not only means less work, since only one conversion from print to digital format is needed, but it also overcomes a lot of the limitations of hardcopy formats. Large print takes up more room than standard print, and therefore one textbook may equal two or three volumes in large print. Braille is even worse—one print textbook may take up two dozen volumes in braille! With analogue audio recordings, fast-forwarding and rewinding to find the appropriate starting point often takes up more time than listening to the reading once the right place is finally found. A digital format is also great for people who like to use more than one format, perhaps large print in the morning and switching to audio later in the day when their eyes get tired.

There are a variety of ways in which these digital formats are created. Formats such as RTF (Rich Text Format) and HTML are sometimes used. Most libraries for the blind now create books in DAISY (Digital Accessible Information SYstem) format. This format can contain text (which can be rendered in large print or braille on various devices), audio, or both text and audio with markup so that the media are synchronized during reading. Users can set bookmarks and insert notes, jump to headings and page numbers, and generally use the format in the same flexible, non-linear way print books can be used. DAISY can be distributed on CD, memory cards, or online download, and also created by end-users (see information below). Many of the tools mentioned in the previous post in this series (about computers) can be used to read DAISY files. These files can be accessed with screen reading and screen magnification software, through refreshable braille displays and notetakers, and also through dedicated hardware players and via mobile apps for devices such as the iPhone and iPad.

As mentioned earlier, libraries for the blind are only able to create a limited amount of material compared to the vast amount of print books being published. In addition to libraries for the blind, most schools (K-12 and post-secondary) will create books for students who need alternate formats. But what about those who are not in school and want to read something that is not available from a library for the blind?

Many people with visual impairments are able to create their own books by using flatbed or camera-based scanning systems and specialized OCR (Optical Character Recognition) software. This process seems tedious when explained to people who are sighted: a book must be scanned page by page (or, in many cases two pages at a time), and once scanned can be converted to large print, braille, or audio either on the computer itself or transferred in formats such as DAISY to some of the portable devices mentioned above. With a fast scanning system, it might take an hour to scan a 250-page book; this seems like an incredible amount of work to people who can pick up a printed book and read it. But when this means the difference between being limited to 3-5% of available print material versus being able to go to a bookstore or library and read almost any book available, those who use such technologies find them invaluable. A service called Bookshare, available in the United States, takes advantage of users scanning books by enabling them to legally share the material with other print-disabled users through an exemption in the copyright law.

So, you may be wondering, why put in all this extra work of having libraries produce DAISY books and having users scan their own material when Amazon and other companies have over a million e-books available? This could be an entire post of its own, but the short answer is that commercial e-books are, for the most part, not accessible to those of us with visual impairments. So far the iPad is the only accessible e-book reading device (due to its built-in VoiceOver screen reader), and on the iPad, iBooks, Google Play, and Blio are the only accessible e-books. Hopefully over the next few years we will get to a point where all e-books are accessible.

For people with visual impairments, reading and technology are closely tied together. This post has given a broad overview of the ways in which a majority of people are able to read. The formats (large print, braille, audio) have stayed the same over the years, but the influence of technology has had a huge impact on access. In the future, things may be even better. Being able to convert a book from print to braille in a few hours is definitely better than waiting a few months for it to be brailled by hand, but it would be even better if publishers would make their material available directly, so that everyone could have access to material at the same time, regardless of whether they happened to read it in print, large print, braille, or with audio/speech output.

I hope this post has been useful and informative. As usual, feel free to comment, as I appreciate feedback and am always happy to answer questions.