Guest Editorial
Assistive technology for students with visual
disability: Classification matters
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Disability is a global health concern that affects all people
irrespective of age.[1] The International Classification of
Functioning, Disability, and Health, WHO (ICF‑WHO 2001)
defines disability as a term including impairment, activity
limitation, and participation restriction. It denotes the
negative aspects of the interaction between an individual with
a given health problem and that individual’s environmental
and social factors.[2] Persons with disabilities may have lack
of access to health‑care services due to various reasons,
and lesser opportunities for education and employment,
as well as participation in social and cultural events, or
to enjoy social protection. Addressing disability needs a
multidimensional approach, including the appropriate use
of assistive technology (AT).
ASSISTIVE TECHNOLOGY
The World Health Organization defines AT as “any piece
of equipment, product, or tool, whether it is acquired
commercially, modified, or customized, that is used to
increase, maintain, or improve the functional capabilities
of individuals with disabilities” based on the International
Standard Organization.[3] The ICF‑WHO later introduced
the term “Health Technology” and redefines it into AT and
assistive products (AP).[4]
AT includes the AP as well as the system and service provision
related to these products.
AP is any form of external product (e.g., low vision aids, large
print books, liquid level sensor, and computer software),
especially designed and produced, whose primary purpose
is to maintain or improve an individual’s functioning and
independence to facilitate participation in society and to
enhance overall well‑being. These products are ranged from
very simple, low‑technology devices such as walking cane to
very sophisticated and highly specialized technology, e.g.,
specialized computer hardware and software.
86 © 2019 Kerala Journal of Ophthalmology | Published by Wolters Kluwer - Medknow
Following the WHO report on disability published in 2011,
the World Health Organization introduced the Global
Cooperation on Assistive Technology (GATE) in 2014 to
address the substantial gap between the demand and
provision of AT for persons with disabilities in all countries.
The vision of the GATE initiative is to create a world where
everyone in need has high‑quality, affordable AP to lead
a healthy, productive, and dignified life. Under this global
initiative, the WHO published the first list of 50 priority
AP list needed by people with disability.[5] This list is for
all types of disabilities. These 50 priority AP were selected
through an extensive consultative process among users
and potential users as well as experts and stakeholders
from across the globe. There are sixteen assistive devices
in the GATE list, which can be used by people with visual
impairment.
ASSISTIVE TECHNOLOGY FOR STUDENTS WITH VISUAL
DISABILITY: ITS CLASSIFICATION
Educating students with visual loss poses a great challenge
unlike sighted children who can learn easily so many
things by observing and imitating. However, education is
an indispensable for every citizen, irrespective of health
condition or disability. According to The Universal Declaration
of Human Rights, Article 26 United Nation, everyone as the
right to education and technical& professional education
shall be available to all.[6] The important aspect of educating
the children with visual disability is to make them literate,
self‑reliant, and useful individuals to the society. The child
with visual impairment needs more time to learn things or
in performing basic life activities. They require a guidance
and supervision from special educators and trainers or
other rehabilitation professionals. The visual impairment to
a child necessitates the use of special educational methods
or adaption to materials. They need to use special aids and
AT to be able to accomplish various educational activities
while learning.
 Senjam: Assistive technology for visually disabled students
AT for visually impaired (low vision) and blind people is based
on the use of sight or other senses, e.g., touch or vibration,
sound, and smell. For example, braille and embossed print
require touch to generate information for visually impaired
and blind people. Over the last few years, the development on
AT, including technology for people with visual impairment,
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is significantly improved mainly in industrialized countries.
Despite such a rapid development of AT, there is no
internationally accepted uniform and holistic classification
of AT for visually impaired and blind people, especially for
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students with visual loss. Special educators, academics,
and occupational therapists have tried to classify AT of
visual impairment without specific mentioning for students’
learning and teaching.[7‑11] Evidence shows that there is no
consensus and uniform classification on AT for students with
visual impairment.
FIELD OBSERVATION AT SCHOOLS FOR THE BLIND
We visited National Association for the Blind New Delhi to
evaluate students’ activities at the school. The target group
was students in grades nine and ten as they would be better
familiar with schools’ learning environment. Moreover, we
expected that we could receive more information about
the various activities of students from higher grades. We
also did extensive conversation with teachers or tutors of
the National Association for the Blind regarding medium of
teaching for writing, reading and various discipline to learn by
the students with visual loss. Further, we took expert opinion
about various application and usage of assistive technologies
while teaching and training to students with visual loss.
The National Association for the Blind, Delhi, established in
1979, is a leading nonprofit organization working for visual
loss children with special emphasis on education and skill
development among students with visual loss. The association
is a pioneer in initiating integrated education in Delhi.[12]
A similar consultation with rehabilitation experts about varied
applications and role of assistive technologies to younger
patients visiting visual rehabilitation clinic of a tertiary eye
care hospital in Delhi was also done. As a result of extensive
consultation and expert opinion, the assistive technology
could be categorized into, first, three domains base on the
body sense used [Table 1] and second, eight different domains
as long as students’ activities and educational purpose
are concerned at the schools for the blind [Table 2]. Using
same domain for the application of assistive technology in
students with visual impairment, the author has published
few original articles in peer-review journal.[13,14] However,
there is no standardized classification on AT for students
with visual loss documented in the paper or anywhere else
as evidence showed.
Kerala Journal of Ophthalmology / Volume 31 / Issue 2 / May-August 2019
Therefore, it is an overarching important to have a
classification of AT, which is simple and understandable to
laypersons as well as students with visual loss. This paper
describes a simplified classification of AT for students with
visual loss based on (a) the sense being used and (b) the activity
to be undertaken by students at schools for the blind. Such
classification would be helpful in implementation as well as
application of assistive technologies in schools for the blind.
We explained AT based on the various activities of the
students with visual disability in schools for the blind.
Considering students’ activities in the schools for the blind, it
is not only worthy but also a potential applicability for the AT.
ASSISTIVE TECHNOLOGY FOR EDUCATION
Preacademic learning
These are technologies that support early learning in children
with low vision and blindness. Supporting the learning of
young children with visual impairment and blindness can
enhance their academic and functional performance at a
later stage of their education. The development of visual
behaviors, haptic or tactile awareness, fine motor skills and
use of the residual vision in playing, and social interaction
enable the learning of more sophisticated and complex
functional behaviors and skills in subsequent years. [15,16]
Technologies enhancing the sense of touch and haptic
awareness are available, for example, simple tactile toys or
kits, toys that give off light or produce sound, and embossed
print toys [Figure 1].
Reading
The act of reading is fundamental to many learning activities
for the school students. Literacy is a requisite skill and
knowledge for a wide range of work‑related, leisure, and
other life maintenance activities in today’s societies. AT
to support reading and learning depend on the student’s
level of visual functioning and their literacy level as well
as the environment and task demands. These technologies
help students' academic performance whenever possible in
the classroom or later in life. Few examples are large print
books, multiple window typoscope, optical magnifiers, DAISY
books, braille reading materials, refreshable braille display,
and screen readers [Figures 2‑4].
Writing
Students with visual impairment and blindness face a lot
of challenges in writing tasks involving typical writing and
visual writing, such as ink on paper or type on a computer
screen. Students with visual impairment and blindness
can experience difficulties in learning the mechanics of
writing (e.g., punctuation and spelling), taking notes
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 Senjam: Assistive technology for visually disabled students

during classes, and engaging in the various phases of
composing (e.g., prewriting, drafting, and editing) due to
limitations of their visual acuity, visual field. There are variety
of assistive devices used to support students with visual
impairment and blindness for writing tasks. Few common
devices are braille slate and stylus, Jot a Dot, Perkins Brailler,
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depended on visually oriented concepts and information.
Although this visual information is not made widely available
in a format which can be easily accessed to visually impaired
students, there are some devices which can be used for
science teaching, for example, tactile maps, tactile diagram
set for sciences, tactile anatomy atlas, animal models, plants,

and braille electronic notetaker [Figures 5 and 6].
Mathematics
Majority of mathematics relies on visual instruction, so
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or three‑dimensional models objects, e.g., DNA twist model.
Students can touch and explore it [Figures 10 and 11].
Table 1: Assistive technology based on the sense being used

learning mathematical concepts is a great challenging task for Sense Example AT

students with visual impairment and blindness. For instance, Visual based Large print books, optical and nonoptical magnifiers
concepts such as direction, quantification, and shape require Tactile based Braille reading books, mobility canes
substantially more cognitive processing when visualization Sound based DAISY, liquid sensor, color detector, notetaker
is not possible. Textual and audio supports, such as braille AT – Assistive technology, DAISY – Digital accessible information system

textbooks and talking calculators, are useful in facilitating

Table 2: Assistive technology based on the activity being
student’s access to mathematics materials; however, tactile
undertaken
support and haptic technology at times offer advantages in
Activity Example AT
the promotion of concrete mathematical understandings in
Education
students with visual impairment and blindness. There are Pre‑academic learning Embossed print or sound toys
some assistive devices that use in mathematical learning. Reading Optical magnifiers (near/distance)
Few examples are abacus, braille compass, braille ruler or Writing Typoscope (multiple window), Brailler
protractor, raised line graph, talking calculator, and tactile Mathematics Braille compass, Brailler ruler
geometric kits [Figures 7‑9]. Sciences Tactile maps/tactile anatomy charts
Orientation and Mobility Long walking cane, Guide cane
Science Games and leisure Braille cube, Braille chess
Daily living activities Notex, talking watch
Similar to math learning, science course is also traditionally

Figure 1: Tactile toys animal model

Figure 2: Multiple window typoscope

Figure 3: Optical magnifiers Figure 4: DAISY books

88 Kerala Journal of Ophthalmology / Volume 31 / Issue 2 / May-August 2019

 Senjam: Assistive technology for visually disabled students
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Figure 5: Braille and stylus
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Figure 7: Tactile geometric kit
Figure 9: Braille cube
ORIENTATION AND MOBILITY
Orientation and mobility is a building block of students’
learning. It is critically important for students with
visual disability as they need to learn to move safely and
independently throughout school environments with the use
of their remaining senses. Students should be taught on how
to move around in the classrooms, library, halls, doorways,
stairs, kerbs, parks, and refectory. Various mobility devices
are long walking cane, children’s walking cane, guide cane,
symbol cane, and support cane [Figure 12].
Kerala Journal of Ophthalmology / Volume 31 / Issue 2 / May-August 2019
Figure 6: Perkins Brailler
Figure 8: Braille protractor
Figure 10: Tactile human digestive system
GAMES AND LEISURE
Many games and toys help children to develop cognitive skills
such as recognizing shapes, numbers, textures, and letters. It
also promotes the development of social skills such as taking a
turn around, interacting with peers, and participating in group
activities. It is important to keep in mind that children with
visual impairment or blind will need to learn to play toys and
games with a sense other than sight. Few games can be played
by most blind children with no special skills adaptation, e.g.,
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 Senjam: Assistive technology for visually disabled students

Simon memory game, Cootie game to develop fine motor,
and Hot Potato game for social interaction.
There are numerous adaptation games that will allow
blind and visually impaired children to play. The selection
of appropriate game is very important. The games should
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ACTIVITIES OF DAILY LIVING
Students with visual disability require a range of
assistive technology for their daily living activities.
These AT help in improving independence living,
enhance their productivity in routine works. Assistive

be aimed at the appropriate development of the child and
adaptability of the child. Few examples of adaptive games
are tactile dice, peg boards, audible balls, large print paly
cards, and braille chess [Figures 13 and 14].
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technologies for activities daily living are available.
Few examples are liquid level sensor, talking color
detector, talking watch or alarm clock, and talking money
Identifier [Figures 15 and 16].

Figure 12: Orientation and mobility canes

Figure 11: Tactile anatomy kit

Figure 14: Large print cards

Figure 13: Braille chess

Figure 15: Color detector Figure 16: Talking watch

90 Kerala Journal of Ophthalmology / Volume 31 / Issue 2 / May-August 2019

 Senjam: Assistive technology for visually disabled students
The accomplishment of educational learning in students with
visual challenge depends greatly on the use to AT. Children
with visual impairment also have the potential to learn
various skills if they are properly guided. Classification of
AT for the education of students with visual loss will help in
thinking about what AT will assist individual student to their
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learning. We developed a simple classification based on the
activity to be undertaken and the sense to be used.
Financial support and sponsorship
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Nil.
Conflicts of interest
There are no conflicts of interest.
Suraj Singh Senjam
Department of Community Ophthalmology, Dr. Rajendra Prasad
Centre for Ophthalmic Sciences, All India Institute of Medical
Sciences, New Delhi, India
E‑mail: drsurajaiims@gmail.com
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How to cite this article: Senjam SS. Assistive technology for students
with visual disability: Classification matters. Kerala J Ophthalmol
2019;31:86-91.
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