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When to Augment Print With Braille For The Student With Low Vision?

Editor's Note: Editor's Note: Karen Nagel is an Instructor/Consultant in the Skills Training and Resource Centre (STAR), at the W. Ross Macdonald School in Brantford, Ontario.

'Teaching this student braille and having him use a white cane will make him different and dependent.'

The above statement was written by an ophthalmologist in response to the recommendation given by one of our resource services staff that a student with low vision be taught the use of braille in addition to the use of print for reading.

Teaching braille to students with low vision is a topic which brings about varied opinions. Many professionals and parents believe that braille should not be taught to students with any useful, residual vision. This article is an opportunity to explain the reasoning and determining factors in not ascribing to this theory.

Literacy, by definition, is the ability to read and write and to read your own writing. Since the 1950's, the literacy rates among individuals with vision impairments have decreased. This is due to a variety of reasons including technology which may be mistakenly viewed as a substitute for reading and the negative attitude which the need for braille may induce in certain individuals.

As educators, our mandate is to provide our students with the opportunity of developing literacy and to provide this opportunity in the most exciting, appropriate and easiest way so they can experience success and, 'the joy of reading.'

When you are successful in an activity, you tend to repeat it. Therefore, the more you read, the better you become. The more accomplished you are as a reader, the more information you gain and the better prepared you are to become a contributing member of society.

Educators have 3 crucial goals in mind when viewing the instruction of reading:

  1. To motivate the student's desire to experience 'the joy of reading.' 2. To provide the student with the opportunity to access the gift of literacy. 3. To design an environment of success for the student.

The decision to augment the medium of print with the medium of braille must be given an individualized approach for each student. We, as a multi disciplinary team, must observe 'the whole child' academically, socially and emotionally at a functional visual level.

The following factors must be given careful consideration before a decision can be formed.

  1. Eye Condition :

How does the vision loss manifest itself in this individual? - Is the central vision still intact? - Is there distortion, or double vision? - What is the field of vision? - Is the vision impairment a perceptual difficulty or a physical one? - What is the prognosis of this eye condition? If the prognosis is unknown or that vision could decrease it may be wise to have the student begin braille so that a visual as well as a tactual image of the Braille formation is developed. - What is the functional vision? Eg. If the student has severe nystagmus, print letters may not stay in place for efficient reading but tactile letters would.

Bottom Line: How does the eye condition affect reading?

  1. Learning Style:

Which senses is the student using to gain the information he/she needs? - How is the student using these senses? - Which sense is used primary, which one is used as the reinforcer?

  1. Reading Stage:

The stamina for reading print and its comprehension must include the following considerations:

A. Working distance from the page:

The greater the distance between the eye and the page, the easier it is for the student to maintain focus for an extended period of time. If this is not possible, visual fatigue may occur. Although it may be recommended that the student take breaks, no one else in the classroom is and they are once again in danger of falling behind in their studies.

B. Portability of reading skills:

The ability to read your own handwriting with or without an optical aid is a portable skill. If the student is unable to do this, they are not only considered illiterate by definition, and they are not on equal footing with their peers for note taking, public speaking etc.

C. Reading rates and accuracy:

If a student is unable to read more than 70 print words per minute he/she will not only fall behind peers in a classroom setting by the time they reach Grade 2, he/she will not be eligible for many entry level jobs which require at least a reading rate of 75 to 80 words per minute. An average braille reader can read 110 to 150 words per minute.

D. Visual Fatigue:

How long can the student read visually without experiencing vision fatigue and frustration. Headaches, sore or itchy eyes, etc. are not conducive elements in promoting a desire or love for reading.

How may this visual fatigue affect their life as a whole? Are they too tired to enjoy their evening activities with family and friends which would affect quality of life? Do teachers, peers and family members understand that visual fatigue can fluctuate on a daily, hourly or minute basis? If not, this may influence their interaction or reaction to a student's behavior. Many students have been labeled lazy, or non-compliant when in reality visual fatigue is the cause.

E. Reading Comprehension:

Reading has to flow like language for comprehension to be good. The larger the print, the fewer words there are on a page which would affect context and the fluidity of reading. Close Circuit Televisions (CCTVs) are wonderful pieces of equipment but they require a skill that must be developed and not everyone has the ability.

F. Department Levels:

There are changes in print size, the volume of print on a page, and spacing change between the primary, junior and intermediate grade levels. There are fewer pictures, smaller print and a larger volume of print, and a decrease in spacing which could lead to more intensive and frequent visual fatigue. This, in turn, may cause the student to fall behind his/her peers once again which could affect self-esteem and social interaction.

  1. Motivation and Attitude towards Reading:

This consideration includes the motivation and attitude of not only the student but the parents and school.

  • Does everyone understand the eye condition and how it is manifested? - Has an acceptance level been reached? - Are optical aids seen as hindrances or blessings? - Is braille seen as a positive, unique method of reading or as a negative, inferior method to print? - What part does literacy play in the family unit? - What is the student's purpose or need for reading - for information, for recreation, or for life skill activities? - What is the attitude towards reading? - Has the student experienced success, failure or frustration in reading thus far?

All avenues to reading must be considered and accepted. No student should be denied the right to literacy or 'the joy of reading' because we, as educators, did not provide the correct medium. As educators, we also need to keep in mind that the education and purpose of optometrists, and ophthalmologists is based on the care of the eye and the ability to fix or alleviate the vision problem. It is therefore understandable that for some clinical personnel the use of braille is seen as a failure rather than an enhancement for success.

Two points of view are seen in this debate - the medical view and the educational view. Each student with low vision must be regarded as an individual with unique needs. Only through collaboration and the mutual respect for differing mandates and philosophies of the educational and medical models will students with low vision have the opportunity to rise to the pinnacle of their potential for life-long learning.


One day a man saw, at a distance, his pastor hugging the wife of another church member. He was aghast. The first thing he did was tell other members of the church what he saw 'just between the two of us.' That Sunday at services the Pastor announced that one of the church members had a tragedy earlier in the week. It turned out that what the gossiping church member saw was the Pastor consoling the wife. Ashamed of what he had done, he went to the Pastor to confess what he had done. He asked for the Pastors forgiveness, which he granted. The Pastor asked only that the gossiper do him a favor. The church member feeling very guilty, jumped at the chance. The Pastor said, 'Take this feather pillow to the top of the hill in the middle of the town. Tear it open and release all of the feathers to the wind. Then come back to me when you're finished.' The church member thinking he realized what the lesson was, obliged. When he came back to the Pastor, he told the Pastor that he understood the lesson. The lesson was that gossip can spread quickly and easily. The Pastor said, 'That is true, but for the most important part of the lesson: Now go gather each feather."

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