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Experience-based plasticity of the human cortex mediates the influence of individual experience on cognition and behavior. The complete loss of a sensory modality is among the most extreme such experiences. Investigating such a selective, yet extreme change in experience allows for the characterization of experience-based plasticity at its boundaries. Here, we investigated information processing in individuals who lost vision at birth or early in life by probing the processing of braille letter information. We characterized the transformation of braille letter information from sensory representations depending on the reading hand to perceptual representations that are independent of the reading hand. Using a multivariate analysis framework in combination with functional magnetic resonance imaging (fMRI), electroencephalography (EEG), and behavioral assessment, we tracked cortical braille representations in space and time, and probed their behavioral relevance. We located sensory representations in tactile processing areas and perceptual representations in sighted reading areas, with the lateral occipital complex as a connecting ‘hinge’ region. This elucidates the plasticity of the visually deprived brain in terms of information processing. Regarding information processing in time, we found that sensory representations emerge before perceptual representations. This indicates that even extreme cases of brain plasticity adhere to a common temporal scheme in the progression from sensory to perceptual transformations. Ascertaining behavioral relevance through perceived similarity ratings, we found that perceptual representations in sighted reading areas, but not sensory representations in tactile processing areas are suitably formatted to guide behavior. Together, our results reveal a nuanced picture of both the potentials and limits of experience-dependent plasticity in the visually deprived brain.

Tactile books for blind children generally contain tactile illustrations referring to a visual world that can be difficult to understand. This study investigates an innovative way to present content to be explored by touch. Following embodied approaches and evidence about the advantages of manipulations in tactile processing, we examined 3D miniatures that children explored using their middle and index fingers to simulate leg movements. This “Action simulations by finger gestures–ASFG” procedure has a symbolic relevance in the context of blindness. The aim of the present study was to show how the ASFG procedure facilitates the identification of objects by blind and sighted children. Experiment 1 examined the identification of 3D miniatures of action objects (e.g. the toboggan, trampoline) by 8 early blind and 15 sighted children, aged 7 to 12, who explored with the ASFG procedure. Results revealed that objects were very well identified by the two groups of children. Results confirmed hypotheses that ASFG procedures are relevant in the identification process regardless of the visual status of subjects. Experiment (control) 2 studied identification of tactile pictures of same action objects by 8 different early blind and 15 sighted children, aged 7 to 12. Results confirmed that almost all objects obtained lower recognition scores in tactile pictures than in 3D miniatures by both groups and showed surprisingly higher scores in blind children than in sighted children. Taken together, our study provides evidence of the contribution of sensorimotor simulation in the identification of objects by touch and brings innovative solutions in book design for blind people. Moreover, it means that only the ASFG procedure has a very inclusive potential to be relevant for a larger number of subjects, regardless of their visual skills.

In the case of a visually impaired person, literal communication often relies on braille, a system predominantly dependent on vision and touch. This study entailed the development of a visual and tactile perception technique for braille character recognition. In the visual perception approach, a braille character recognition was performed using a deep learning model (Faster R-CNN–FPN–ResNet-50), based on custom-made braille dataset collected through data augmentation and preprocessing. The attained performance was indicated by an mAP50 of 94.8 and mAP75 of 70.4 on the generated dataset. In the tactile perception approach, a braille character recognition was performed using a flexible capacitive pressure sensor array. The sensor size and density were designed according to braille standards, and a single sensor with a size of 1.5 mm × 1.5 mm was manufactured into a 5 × 5 sensor array by using a printing technique. Additionally, the sensitivity was improved by incorporating a pressure-sensitive micro dome-structured array layer. Finally, braille character recognition was visualized in the form of a video-based heatmap. These results will potentially be a cornerstone in developing assistive technology for the visually impaired through the fusion of visual-tactile sensing technology.

Smart devices are effective in helping people with impairments, overcome their disabilities, and improve their living standards. Braille is a popular method used for communication by visually impaired people. Touch screen smart devices can be used to take Braille input and instantaneously convert it into a natural language. Most of these schemes require location-specific input that is difficult for visually impaired users. In this study, a position-free accessible touchscreen-based Braille input algorithm is designed and implemented for visually impaired people. It aims to place the least burden on the user, who is only required to tap those dots that are needed for a specific character. The user has input English Braille Grade 1 data (a–z) using a newly designed application. A total dataset comprised of 1258 images was collected. The classification was performed using deep learning techniques, out of which 70%–30% was used for training and validation purposes. The proposed method was thoroughly evaluated on a dataset collected from visually impaired people using Deep Learning (DL) techniques. The results obtained from deep learning techniques are compared with classical machine learning techniques like Naïve Bayes (NB), Decision Trees (DT), SVM, and KNN. We divided the multi-class into two categories, i.e., Category-A (a–m) and Category-B (n–z). The performance was evaluated using Sensitivity, Specificity, Positive Predicted Value (PPV), Negative Predicted Value (NPV), False Positive Rate (FPV), Total Accuracy (TA), and Area under the Curve (AUC). GoogLeNet Model, followed by the Sequential model, SVM, DT, KNN, and NB achieved the highest performance. The results prove that the proposed Braille input method for touch screen devices is more effective and that the deep learning method can predict the user's input with high accuracy.

Purpose: To assess the use of routine Braille prescription in reducing medication errors in visually impaired patients. Methods: This observational, questionnaire-based study was conducted in 100 blind or visually impaired patients who were Braille literate (aged ≥18 years). We initiated our Braille prescription from January 2017 to March 2018. The questionnaire consisted of 8 items that captured patient details on the medication management process in addition to a face-to-face interview with them. It was administered twice to each patient at baseline and at the end. Braille prescription included details regarding all medicines, their dosages, instructions, expiry dates, and major side effects. The prescription was developed easily and quickly with an average turnaround time of 1 hour. Results: It was seen that most of the study patients aged between 30-40 years (n = 80) and majority were men (78%). At baseline, 73% of our respondents faced challenges when self-administering medications as compared to 17.5% at endline. After using Braille prescription, only 5% reported of taking a wrong dosage compared to 46.2% at baseline. Patients missing a dosage significantly reduced after using routine Braille prescription (43.7% vs. 7.5% respectively, P < 0.05). Conclusion: Our study successfully has rolled out Braille prescription as an efficacious method in addressing the key issues to medication safety with the visually impaired.

To assess the use of routine Braille prescription in reducing medication errors in visually impaired patients. This observational, questionnaire-based study was conducted in 100 blind or visually impaired patients who were Braille literate (aged ≥18 years). We initiated our Braille prescription from January 2017 to March 2018. The questionnaire consisted of 8 items that captured patient details on the medication management process in addition to a face-to-face interview with them. It was administered twice to each patient at baseline and at the end. Braille prescription included details regarding all medicines, their dosages, instructions, expiry dates, and major side effects. The prescription was developed easily and quickly with an average turnaround time of 1 hour. It was seen that most of the study patients aged between 30-40 years (n = 80) and majority were men (78). At baseline, 73 of our respondents faced challenges when self-administering medications as compared to 17.5 at endline. After using Braille prescription, only 5 reported of taking a wrong dosage compared to 46.2 at baseline. Patients missing a dosage significantly reduced after using routine Braille prescription (43.7 vs. 7.5 respectively, P < 0.05). Our study successfully has rolled out Braille prescription as an efficacious method in addressing the key issues to medication safety with the visually impaired.

Introduction: This study analyzed survey responses from 141 teachers of students with visual impairments who shared their experiences about the implementation of Unified English Braille (UEB). Methods: Teachers of students with visual impairments in the United States completed an online survey during spring 2016. Results: Although most respondents knew if their state had a UEB transition plan, few participated in its development. Half attended workshops to learn about word-based UEB, but few attended workshops about math-based UEB. They believed their students would be successful in transitioning to word-based UEB but were less sure about their transition to math-based UEB. Discussion: The teachers believed they were more confident in their own skills and their students' future success with word-based UEB compared to math-based UEB. Additional clarification on the relationship between math-based UEB and the Nemeth Braille Code for Mathematics and Science Notation (hereafter, Nemeth code), an increased capacity of math-based UEB training, and clear instruction for high-stakes testing were considered to be urgent issues among these teachers. Implications for practitioners: Issues concerning the implementation of UEB in the United States will continue to challenge the field of visual impairment for the next several years. Although many teachers of visually impaired students had knowledge of word-based UEB and resources for its implementation, as of January 4, 2016, few were prepared to teach math-based UEB. As the United States is maintaining the Nemeth code, future studies, workshops, and the development of resources are needed to ensure braille users have the knowledge and materials they need in order to be literate in all aspects of UEB.

[...]the haptic system is very efficient in the processing of material properties of objects but is less so in the processing of spatial properties that characterize 2-D illustrations (Klatzky, Loomis, Lederman, Wake, & Fujita, 1993; Lederman & Klatzky, 1987). [...]studies showed that blind children identify the object more easily through textured 2-D illustrations than through outlined and thermoformed illustrations (Theurel et al., 2013; Thompson et al., 2006). In a study analyzing a book-reading activity using 2-D and 3-D illustrations, Bara (2014) showed that visually impaired children used a wider variety of exploratory procedures with 3-D illustrations than with 2-D illustrations, which suggested that these children were able to collect more information with the former kind of illustration technique. In this exploratory study, three 6-year-old children with different levels of visual impairment participated in a joint book-reading task. The number of verbal comments during reading, the number of matches between the text and the manual exploration, and the number of story elements recalled by the children were collected.

This study evaluated the usability and effectiveness of an artificial intelligence Braille Tutor designed to supplement the instruction of students with visual impairments as they learned to write braille contractions. Methods: A mixed-methods design was used, which incorporated a single-subject, adapted alternating treatments design as well as qualitative teacher interviews and surveys. Results: Students seemed to reach 100% accuracy faster when using Braille Tutor (average = 7.0 sessions; range 1.0 to 12.0 sessions) than when they did not (average 9.6 sessions with a teacher of students with visual impairments; range 3.0 to 16.0 sessions). Also, students who used Braille Tutor more often tended to learn more contractions overall during the study (average = 21.25; range 13.0 to 30.0) than students who used it less (average 9.0; range 9.0 to 9.0). Discussion: The first trend noted was that students in the teacher of students with visual impairments plus Braille Tutor phase (hereafter, TVI+Tutor) tended to learn contractions more quickly. A second trend surfaced: The students in the TVI+Tutor phase tended to get more frequent reinforcement as opposed to students in the TVI Only phase. A third trend was noted: Students in the TVI+Tutor phase saw a quicker initial jump and tended to be more consistent in that initial jump. Although the prototype version of Braille Tutor in this study needs further development to broaden its capabilities, some students found its use highly motivating. Implications for practitioners: Although there is strong evidence that advanced technologies are not suitable replacements for braille literacy instruction, technology can be used along with quality instruction by a teacher of visually impaired students to enhance proficiency in braille literacy.