VIEW 2018 Conference

In this month’s VICTAR blog, Jane Thistlethwaite reviews the VIEW 2018 conference.

VIEW 2018 was held March in Birmingham with approximately 140 QTVI’s from Sensory Resource Centres and residential school provisions, representatives from RNIB and staff from the QTVI course at the University of Birmingham. The two-day conference included a range of very informative keynote presentations and an array of interesting hands on workshops.

VIEW conference 2018
VIEW conference 2018

Presenters from Great Ormond Street shared two interesting presentations. The first keynote on ‘Understanding Childhood Vision Impairment’ noted the need for a clearer definition of vision impairment (VI) and challenges around VI being a low incidence high cost disability. Certification of children with a VI is not mandatory and registration rates can be low due to parents not wanting their child registered. Additionally, certification does not capture all types of VI and there is a variance in what acuity level should be noted.

Presenters Professor Jugnoo Rahi, Professor of Epidemiology at Great Ormond Street and Lucie Teoh, Research Assistant outlined a longitudinal study they are undertaking. Key points being researched in their study include trends in epidemiology and the distinct difference between functional vision and vision function.

Dr Jenefer Sargent , Consultant Paediatrician in the Neurodisability Service, Great Ormond Street, delivered a most informative presentation on ‘Vision Impairment, Can you See the Whole Child’. This presentation explored how we can get the most out of a functional vision assessment.

Julie Colley (Head Teacher) and Rachel McVeigh SENCO, presented a number of slides demonstrating a range of inclusive programmes in place at Highfields School, where not only students with VI are readily included in outdoor programmes, excursions and classroom based activities, but many learners with a variety of diverse learning requirements. The positive ‘’can do’’ attitude was evident, as was the enthusiasm to ensure they could adapt any programme requirement.

Christina Matawa, QTVI and Regional Tutor on the University of Birmingham QTVI course, and Andrea Ferris, Hammersmith and Fulham Sensory and Language Impairment team, lead delegates through a wonderful workshop session on ‘Learning with iPads’. This was such a useful session for all that included a range of adaptive uses of the iPad. Key themes of this presentation were inclusion and empowerment of the student to manage their own learning through the iPad.

Gwyn McCormack, Positive Eye, led two fabulous, hands on sessions and was available at her stand throughout the conference for delegates to visit and interact with her many resources and view the excellent learning programmes she has developed.

It was Rory Cobb’s last conference as Chair. Rory delivered a witty and reflective journey of his years in the sector with a nautical theme stemming from past roles.

The conference concluded with a presentation by inspirational speaker Amar Latif, who describes himself as the Indian, Scottish, bald, blind guy who is an intrepid traveller! ‘Blind Guy Who Wants to Show you the World’ was the lead line of Amar’s keynote. An excellent delivery by an articulate, well-travelled and grounded advocate for people who are blind. Amar has established his own travel company that specialises in extreme and exciting travel destination tours for people who are blind and want to stretch their horizons.  This was a most positive note to conclude the conference on.

Jane Thistlethwaite

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My first visit to Community Based Childcare Centres in Malawi

In this month’s blog, Dr Anita Soni shares her experiences of visiting Community Based Childcare Centres in Malawi as part of the Let’s Grow Together project. Dr Paul Lynch, Principal Investigator of the study, is currently shortlisted for the University of Birmingham Philanthropic Research Project of 2018. You can watch a video of Paul talking about his plans to develop the Let’s Grow Together project further and vote to help the project team secure further research funding at: https://www.birmingham.ac.uk/alumni/PRP.aspx

In February 2018, I visited Malawi to observe the inclusion of children in the Community Based Childcare Centres (CBCCs). It was an exciting opportunity – I have worked in and with Children’s Centres, nurseries and playgroups for many years as a teacher and more recently as an Educational Psychologist, and observing children is something I love to do. But this was different; I was nervous about what I would see in one of the least developed countries in the world – over 85 percent of the population lives rurally and the infant mortality rate is shockingly high – and how that might make me feel and respond.

So what was my anxiety based on? After all, I’ve worked with children in a range of settings here in the West Midlands, including the poorest in the UK. When I sat down and thought about it, I realised it was about seeing individuals who are probably among the most vulnerable in the world. These kids are young, they are deprived AND they are disabled. A sobering prospect.

The reality was very different. Yes, these children were at childcare settings that were stripped to the bone. Buildings were small and often windowless and roofless, and that’s if they existed at all – at some there was only a tree to provide shade from the scorching African sun. None had running water or toilets. But for the harsh environment, what was striking was how much joy the many of the children got from being with their peers.

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This wasn’t universal. Comfort, a ten year old boy with a physical disability, spent much of his time lonely and sad. His face lit up only when another boy he was particularly friendly with, was near him, or if he was able to play with the single bike that was available to the 70 children. Conversely, nine year old Mercy , who had macrocephaly, was completely involved by staff and other children, helping to lead activities, and adapting games so she could participate. A stark illustration of the difference made by true inclusion.

Gladys

At one point, I realised I had completely relaxed into it. It was raining, and we had buckets out to catch the drips, and staff had provided the children with crockery and cutlery to occupy them. As I looked round, I couldn’t spot the children with disabilities, they were completely engaged in drumming with spoons and using bowls as steering wheels. I could have been anywhere.

Mercy

It brought to mind Dan Goodley’s comments that disability is often regarded as dehumanising, and that’s simply not right. The whole world over, regardless of social and medical issues, everyone has their own normal, and focusing on getting everyone to do the same things leads to exclusion and therefore isolation. Children are children are children, and that’s something to celebrate.

Dr Anita Soni, Co-Investigator (with editing support from Asha Fowells)

Accessible equations

In this guest blog, Professor Dave Smith from University of Birmingham shares his experience of ensuring that mathematical content is accessible to students with vision impairment. Our longitudinal transitions study has highlighted how challenging it can be for VI students studying STEM in Higher Education, with academic staff often unsure of how best to provide support. 

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Professor Dave Smith, School of Mathematics, University of Birmingham

There is a divide in the academic world between those for whom equations and mathematical expressions are their primary tools, and everyone else! Pure and applied mathematicians, computer scientists, physicists and many computational biologists (for the purposes of this blog post I will refer to all of us as mathematicians for short) typically find that widely-used tools such as Microsoft Word and PowerPoint are unsatisfying for the preparation of mathematics. Their main drawbacks are the combination of a clunky point-and-click interface with (to the experienced eye) substandard aesthetics.  The alternative system, still relatively known outside of quantitative disciplines, is the typesetting language LaTeX (pronounced ‘Lay-Tech’ or possibly ‘Lah-Tech’) which was mainly developed in the 1970s and 80s. LaTeX enables the production of professional-quality printed documents with equations that most mathematicians consider rather beautiful; it is no surprise therefore that the vast majority of us produce all of our lecture notes and other course materials (handouts, exercises, slides and even examinations) in LaTeX. Typically the implementation that is used is ‘PDFLaTeX’, which converts LaTeX ‘source code’ into a PDF file that can be viewed electronically or printed. LaTeX has undoubtedly revolutionised mathematical publishing, and has also influenced the development of HTML (hypertext markup language), the basis for the web.

One of the great appeals of PDFLaTeX is that it gives us complete control over the visual layout. However, therein lies a weakness – not everyone consumes lecture material visually, and not all who do see in the same way. The most powerful example of this diversity is the use of screenreaders by blind and visually-impaired students. Equations appearing in PDF files produced by LaTeX are completely unintelligible to a screenreader. A workaround for this difficulty (used with success in the School of Mathematics) involves providing the LaTeX source files so that the code itself can be interpreted – ‘backslashes, curly brackets and all’ by a screenreader. This is a workable solution – and perhaps the best that can be expected in a short timeframe – but wouldn’t it be preferable if the core set of notes were suitable to be adapted by students to their varying needs? Other examples of how materials may need to be ‘consumed’ differently include the use of large print by students with visual impairments, or the use of sans-serif fonts and coloured backgrounds by students with dyslexia. Special materials can be printed out on request, but wouldn’t it be better if students could simply enlarge text, or experiment with changing the font or background to see what works best for them? The issue of how we consume reading material is most acutely relevant to those with visual impairment, however across all of the academic community we now view content across a range of devices, from monitors to laptops to tablets and phones, all of which require text to be able to resize and reflow according to the dimensions of the screen. We wouldn’t expect the Guardian online (or indeed the Big Conversation blog) to comes as a downloadable PDF. It seems reasonable that students should have similar expections of course materials.

HTML-based materials by contrast provide an excellent and up-to-date way to deliver device-friendly, resizable and reformattable content, along with the other advantages of web-based materials (particularly interactivity). The University’s online learning environment Canvas is a user-friendly platform for colleagues unfamilar with HTML code to prepare webpages. But what about mathematics? The best solution I am aware of involves integrating the old and the new: LaTeX expressions – which can be included by enclosing within the symbols \( and \) – within an HTML web page. LaTeX expressions can then be interpreted into mathematics through the online service MathJax, a javascript engine developed by the American Mathematical Society and Society for Industrial and Applied Mathematics. MathJax can be included in a webpage by adding a code snippet to the start of the HTML file; in Canvas this is done automatically. The result is mathematical expressions that look beautiful but more importantly are then available as MathML for the use of screenreaders. Having prepared materials in this way one no longer needs to anticipate all of the possible needs of current or future students – the power is with the student to manipulate the content appropriate to their needs. An example Canvas-LaTeX page is available at this link.

For the lecturer, converting a set of LaTeX notes to ‘Canvas-LaTeX’ or ‘HTML-LaTeX’ is essentially an task of cutting-and-pasting and then modifying commands such as section headings and figures – something that can be accomplished in a few hours for a 20 credit lecture course. Therefore there is a great opportunity to bring our lecture notes into the 21st Century, retaining many of the advantages of LaTeX along with much greater accessibility. This change may require a shift in how we view course materials – our job is to provide content (text and equations), but we need to accept that our control over their precise visual appearance is a luxury which does not meet the needs of blind, visually-impaired or dyslexic students.

Professor Dave Smith, School of Mathematics

What role can assistive technology have in removing barriers to work and helping disabled people stay in work?

This was one of the questions posed by The Work and Pensions committee as part of their inquiry into the disability employment gap; prompted by the UK government’s aim to get one million more disabled people into work over the next 10 years. The committee were interested to learn more about the contribution made by the government funded ‘Access to Work’ scheme which aims to remove barriers to employment for people with disabilities, and how this scheme could be developed moving forward.

In February we had the opportunity to meet with Steve McCabe, local MP for Selly Oak in Birmingham, to present our response to this consultation. We took the opportunity to discuss with him the barriers which are faced by people with vision impairment seeking to participate in the labour market and importantly evidence for how these barriers might be overcome. We also welcomed the opportunity to learn more about his experience on the Work and Pensions committee and the ideas that he and colleagues have developed.

Improving employment outcomes for people with vision impairment has been a key research area at VICTAR over a number of years. For example, Network 1000 provided important estimates of employment rates for people with vision impairment while the ENABLER project developed a toolkit for specialist employment advisers to ascertain how close an individual with vision impairment is to being able to participate in the labour market, and what interventions might be needed.

Most recently our Longitudinal Transitions Study has been investigating the post-16 transitions experiences of young people with a vision impairment as they have left compulsory education and progressed to the labour market. Our secondary data analysis of the UK Labour Force Survey emphasises how important this is, with estimates that 42.8% of young people with vision impairment aged 16-24 are NEET (in comparison to 21.7% of young people in the general population).

Work and Pensions Select Committee Inquiry
Work and Pensions Select Committee response

In our response to the Work and Pensions committee we highlighted that the use of technology such as screen-readers as used by individuals with severe vision impairment requires an extensive period of training and consolidation for the person to be able to develop strategies to use it effectively in the workplace. Therefore the intervention of assistive technology is not enough on its own – individuals need opportunities to develop these skills to enable them to be competitive in the labour market and to advocate for the adjustments which they require.

We also highlighted that young adults with vision impairment have limited opportunities to access work experience opportunities to develop their CV when younger. We have found instead that these young people often look to voluntary opportunities to bridge this gap in their CVs. However, finding appropriate voluntary opportunities can be further complicated by a lack of access to appropriate assistive technology (which is not available through Access to Work).

Further, evidence shows that individuals with vision impairment benefit from using mainstream technology which have inbuilt accessibility options which enable them to use their devices as assistive tools. However, mainstream technology is often not funded by Access to Work as it is not viewed as specialist.

Our meeting with Steve McCabe led to the identification of several positive steps that could be taken forward. These include:

  • Recognising the importance of preparation for adulthood by helping young people with vision impairment to access assistive technology and develop their skills at an earlier stage.
  • Improving specialist training for assistive technology in schools to provide a long-term pathway which prepares young people with vision impairment for the workplace.
  • Developing more opportunities for work experience and voluntary work for young people with special educational needs and disabilities and incorporating this into Education Health and Care Plans.
  • Recognising the opportunity provided by mainstream technology in removing barriers for individuals with disabilities.

Rachel Hewett

Braille or computers? I’ll have both please

“Louis Braille invented his eponymous code nearly 200 years ago. The tactile reading and writing system has transformed the lives of many blind people. More recently, computers and the internet have introduced new opportunities for accessing precious information. If Louis Braille was alive today, he would embrace it all!”

On 4th January, World Braille Day marks Louis Braille’s birthday. Born in 1809, he invented the braille code, or ‘braille’. Braille is a tactile reading and writing system used by many people with severe vision impairments or blindness. A braille character is based upon a matrix of a six raised dots, historically embossed on paper. Different combinations of these dots represent an individual letter, letter combination or word. Louis Braille was blind himself and first proposed the idea while still at school. The braille code he developed has had a profound impact upon the education of people with vision impairment around the world.

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Reading braille

In recent years the emergence of computer technology has raised questions about the future of braille. Some people wonder whether we need braille now that computers and mobile devices can provide speech output. Drawing upon some of the research into braille which has taken place in the Vision Impairment Centre for Teaching and Research (VICTAR), we argue that technology and braille are allies rather than competitors.

It is simplistic to consider braille and technology as having an uneasy relationship. In fact, the reverse is true – after all, braille’s success is closely linked to technological developments that have enabled braille production and writing. This includes braille writing frames, mechanical writing machines such as the Perkins brailler, braille embossers (which are essentially braille printers) and most recently, the refreshable braille display. These braille displays are linked to computers and present a line of braille characters which are refreshed as the user reads.

More braille is available today than ever before. Many products have braille embossed on their packaging (for example, visit Coop shops), and it is now a legal requirement to have braille labels on all medicine packaging (our own research underpins this international standard). This greater availability of braille reflects the improvements in national and international disability legislation, but improved technology has played a crucial role too. The internet means that huge volumes of electronic files are now easily available at any time. These can be accessed online, easily converted into braille and embossed or read using a refreshable braille display. In a recent blog, Amy Mason described how refreshable braille displays have “transformed the way that many of us use braille”.

However it is inaccurate to assume that braille has been the chosen literacy approach amongst blind people since its invention. The history of braille was documented by the late Dr Pamela Lorimer in her University of Birmingham PhD thesis. The adoption of braille was a slow process which involved debates and controversies over many decades, long after Louis Braille’s death. Professor Michael Tobin, Emeritus Professor within VICTAR, carried out research into braille reading for many years. In a recent article he notes how the debates about the braille code continue. He too questions the common assertion that computer technology will render braille obsolete. Instead he argues technology is making access to braille “easier, faster, and cheaper”. This has certainly been true of participants in our ongoing longitudinal transitions study who have benefited from using refreshable braille devices during their studies in higher education. While they do not use braille for all aspects of their studies, the participants highlighted how important their access to braille is in particular scenarios, such as following notes during a lecture or proof reading an essay.

As in many countries, in the UK teachers are required to have a specialist qualification to teach children with vision impairment, and this includes a requirement to know how to teach braille as a route to literacy – Birmingham University has a long established training programme (one of the biggest in the world). Even so, findings from some UK studies suggest considerable variation in approaches to the teaching of braille literacy, which led to our recent literature review. We found no evidence to support the view that technology has an adverse effect on the development of literacy through braille. However, we did find that there is limited information for teachers about how to teach braille literacy in mainstream schools. The review made several recommendations about braille teaching (e.g. in relation to the use of reading schemes, phonological instruction and the order of introducing braille letters) and since then more teaching resources have been developed. However, an area that remains problematic is the need to re-develop a standardised braille reading test (a previous test was developed in the 1990s at the University of Birmingham, but needs updating).

Our research highlights that the dangers to the future of braille are related to educational resources and approaches, not to the emergence of new technology. In the current climate where teaching services are being placed under a great deal of financial pressure, we must guard against braille teaching being neglected. Braille remains a hugely important route to literacy for blind people, and is a key method of accessing information independently, which complements other ‘technology literacies’.

If the brilliant Louis Braille was alive today he would be reading braille with skill and enthusiasm while at the same time surfing the web, marvelling at information he would literally have at his fingertips. His invention remains a potent symbol of disabled people’s independence and empowerment. But most importantly, braille works.

Graeme Douglas, Mike McLinden and Rachel Hewett

Exploring the learning experiences of visually impaired physiotherapy students

Many years ago, as a new and very novice academic I was asked to be personal tutor to a new 1st year physiotherapy student. I agreed, and in passing, heard that he was visually impaired and that because I was nice, I would be a good tutor for him! And that’s where it all started.

Fast forward to today. My entire academic career was changed by meeting this one student. Through worry, lack of knowledge, zero confidence and lack of any skills that I could actually support this student, I learnt so much. I had to ask a lot of questions, ask for lots of support and think creatively and differently about how I could make my classes accessible for him. In retrospect, I was really just using all the skills I’d learnt as a physiotherapist, making assessments, identifying challenges and putting in plans to address them. I encountered barriers and enablers, and had to face many misconceptions, and bias and even discrimination from my colleagues and peers, mainly from ignorance. And that was just me. The lecturer. Imagine how it felt for the student?

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Dr Helen Frank

That one student experience made a huge impact on the way I taught, practiced, communicated and ultimately how I researched. My research as a doctoral student at VICTAR explored the learning experiences of visually impaired physiotherapy students. I learnt an incredible amount about visual impairment and education through my own experience. That very first student showed me that it was ok not to know anything, especially when he politely told me that asking him how much he could see wasn’t very useful. But we worked together, and learnt by asking for support, and exploring and trying out new things in class. And over time we got there, he qualified and is a practicing physiotherapist now. This experience was the start of my need to find out how it really was for visually impaired students learning a profession that had been accessible for visually impaired people for decades, and had a long history of success.

My research used a case study approach and I focused my exploration on the barriers and enablers in learning physiotherapy, both in the university and in the practice setting. My study was nationwide and overall, I interviewed 7 student physiotherapists with varying degrees of visual impairment. Their experiences varied, and there were many examples of really positive, student centered and holistic support. Physiotherapy educators were enthusiastic and motivated to offer proactive support, and to find solutions where challenges arose. They worked closely with the students to ensure they met the requirements of the profession. But there were also some very negative and challenging experiences, where students faced discrimination and difficulties learning their professions. As a physiotherapist, this saddened me. Physiotherapists are caring professionals who work closely with patients to problem solve, to maximise independence and function. It still puzzles me why the same principles were not universally applied to the visually impaired student physiotherapists in my study. The final chapter of my thesis allowed me to consider this and think about why this may be and this will be the focus of a paper in due course. However, I am confident that my being a physiotherapist, as well as a lecturer, was what enabled me to work collaboratively and successfully with students.

In the 10 years I was at that same institution I taught and supported six visually impaired physiotherapy students. I often hear how educators make huge impressions on their students, but I wonder if they know the impact they have made on me?

Helen Frank, Course Leader BSc (Hons) Physiotherapy, University of Worcester

Engaging with the sector – ESRC Festival of Social Science

On 10th November VICTAR and VIEW collaborated to host a workshop entitled ‘Supporting young people with vision impairment through post-16 transition’. This event was arranged as part of the ESRC Festival of Social Science.

Various professionals who have contributed to the Longitudinal Transitions Study and provided teaching support for the MQ programme were invited to attend the event, which was held at Impact Hub Birmingham. The purpose of the event was to present our findings from the ongoing longitudinal study and to discuss the appropriate response of the sector to these findings.

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The event was chaired by VICTAR co-director, Mike McLinden.

The afternoon commenced with a presentation from Graeme Douglas and Rachel Hewett (VICTAR) and Sue Keil (VIEW) who discussed some of the key findings from both the Longitudinal Transition Study and a RNIB Freedom of Information Request of Local Authority specialist services. The presentation focused on the role of specialist services in preparing young people with vision impairment for adulthood, whilst acknowledging the conflicting pressures which local authorities face due to a narrowing of the curriculum and budget constraints.

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Sue Keil presenting findings from the RNIB Freedom of Information request

The second presentation came from Kay Wrench who reflected back on her thirty years’ experience working as a qualified teacher of children and young people with vision impairment (QTVI). She emphasised the importance of QTVIs using their time resource wisely, such as equipping schools to produce materials in alternative formats to allow the QTVI to focus on working with children and young people with vision impairment to develop important skills such as self-advocacy, mobility and assistive technology skills.

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Kay Wrench

Lucy Dixon from RNIB followed by sharing information about a sector wide campaign which is set to highlight dwindling specialist support services for children and young people with vision impairment, and to expose the negative impact that this has on young people with vision impairment being able to fulfill their potential and to live and work independently when adults. Further information about this campaign can be found on the RNIB website.

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Lucy Dixon

The second half of the afternoon allowed opportunity for discussion in small groups and for delegates to provide their thoughts and reflections on the issues raised. Those who attended contributed enthusiastically, drawing upon their wealth of experience working in both educational and voluntary sectors.

The afternoon was concluded by Rory Cobb from VIEW who drew together the main points of these discussions. The outcomes of these will be summarised and shared on the VIEW website for consideration by other QTVIs, and will also guide important discussions between VICTAR, VIEW and members of the steering group for the longitudinal transitions study over the coming months and years.

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We would like to thank ESRC for providing funding to support this event, Impact Hub Birmingham for hosting the event and the delegates who engaged with the workshop with such enthusiasm.

Rachel Hewett