She Reads Funny:
Psychosocial Aspects of
Reading with Low Vision
Cynthia Bachofer M.Ed., CLVT
Getting in Touch with Literacy
Louisville, KY; December 2011
Your early experiences
in learning to read…
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Was learning to read
an easy process for
you?
Was reading
instruction a dreaded
or a favorite time?
Were you aware of
how your reading skill
compared to that of
classmates?
Reading of Standard School Text
(Beginning to Read, M. Adadms, 1990)
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90% of running text in school books consists
of 5,000 common words
10% of text is uncommon words; these carry
a disproportionate amount of meaning
Children expected to learn 17 words per day
Good readers need 4-5 instances of
exposure to learn a word; poor readers need
10-12 exposures
Overview of Presentation
Reading as a personal task and as a public
activity in school and community
 Additional factors of reading with low vision
 Summary of research studies
 Presentation of dissertation data
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Definition of Psychosocial
Psychosocial factors: pertaining to one’s
psychological development in the context of
one’s social environment. Vision-related
psychological factors include personal
autonomy, functional independence, and
psychological well-being.
 Psychosocial impact: the determinant of
how a person perceives the benefit of a
device on quality of life; interaction of user,
device, and environment.
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Reading Experiences of Students
with Low Vision
Finding the right place on the page
 Looking closely at a page
 Reading as fast as peers
 Tiring quickly or needing breaks
 Hearing comments about reading
behaviors
 Using different materials or devices
 Being singled out as needing additional
supports

Reading Experiences of Students
with Low Vision
Reading in a different way but
accomplishing the assignment
 Knowing the text well because of slower
reading
 Remembering features of a text that took
more time to understand
 Making gains in comprehension because
of dual input-audio and visual
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The Desperate State of Young Readers
and Low Vision Research
7% of low vision research focuses on
reading; 90% of low vision research refers
to people who are 60+ years old
 Demographic data indicates that 10% or
fewer of readers will use Braille but the
majority of courses, textbooks that target
VI literacy education will focus on Braille
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Present Levels of Literacy Functioning for
Students with Low Vision (Carver, 1989)
Review of the Literature
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Electronic database search in medical, rehab,
and education (PubMed, Google Scholar,
PsychInfo )
Keywords included 1. Psychosocial 2. Reading
3. Low vision 4. Optical devices 5. Children and
students
Exclusion terms: Reading strategies/processes,
older adult focus, ADL/ILS studies
3 studies highlight psychosocial, reading, and
students
Low Vision Affects the Reading Process
Quantitatively but not Qualitatively
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Reading has physical (visual) aspects AND
psychological aspects
Motivation, language skills (verbal cognitive
ability), reading habits (lack of opportunities for
incidental reading)
Reading performance is determined greatly by
reading experience
Schooling is essentially the same for both groups
Strategies of Low Vision Readers
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Sacrificing accuracy for speed may be a result of
the pressure to keep up the reading pace with
peers; adopt a guessing strategy
Tend to rely on context rather than phonological or
spelling patterns; less effective as text difficulty
increases. reduced context (e.g., math, science,)
Reading lag (speed, comprehension, and
accuracy) increases with each school year
Young readers often accept poor reading
conditions: 1. unable to evaluate their needs; 2.
want to be helpful
Access to Print Literacy…
Douglas, G. et al., 2011
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Long-term difficulty in accessing text leads to
developmental delays in reading (accuracy,
speed, comprehension)
Access to print literacy refers to both providing
accessible materials (LP) and teaching access
skills (e.g., optical devices)
Reading assessment includes taking into account
individual needs of comfort and sustainability:
critical print size with preferred viewing distance;
factors of vision (e.g., contrast, lighting needs)
Reading as a social event: Classmates’
perception of low vision reading
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“. . . She can’t read too good . . . so if you’re her
partner . . . she’s only on the first page and I’m
on the second page. . . . Lisa’ll say “What’s this
word?’ when you read and she only reads the
easy words.” (Grade 1)
“I think he’s pretty lucky. Because it’s easier to
read the books and I’d get done faster if I had
one of those (referring to large print text). (Grade
6)
MacCuspie, A. (1996) Promoting Acceptance of Children
with Disabilities.
How Pupils … Describe Coping with
Reading Activities (Vik & Lassen, 2010)
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Tension of many tools in the toolbox…
Description of students’ subjective experiences
(N=11, grades 5-10, use of print, Braille, audio)
Coping questions: 1. Identify the impact of the
stressor (demand); 2. Identify resources,
strategies
Coping strategies: Problem-focused, emotionfocused (Information-seeking, self-reliance;
support-seeking, social isolation, helplessness)
How Pupils … Describe Coping
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Some students used their communication skills
(expressive-verbal) or help-seeking to compensate
for poor reading skills and avoidance of reading;
emotion-focused strategies allow relaxation,
meaningful activities; social competence (peer and
social support) led to inclusion and enjoyment of
school
Highly adapted education (audio literacy)
minimized reading stress
Active engagement gives platform for inclusion,
peer acknowledgement
Some problems/differences not solved, but endured
Blurred Vision: A Study of the Use of
Low Vision Aids (Mason, 1999)
Primary aim: Establish a clearer
understanding of the problem of known low
usage and its possible causes
 Discovery: Lack of clearly defined criteria to
determine if devices are being used
effectively to 1.) support access to the
curriculum and 2.) increase independence
 Secondary students; 107 schools in the UK
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Description of interviews
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Students with low vision
 User friendliness of devices
 Usage, reasons for reluctant usage
 Avoidance and coping strategies
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Friends of students
 Difficulty of curriculum access with device
 Awareness of coping strategies
 Attitudes of other pupils on LV student/device
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Teacher (vision specialist)
 Criteria to determine successful
 Reasons for reluctant usage
usage
use
Teachers: Assessing Student Progress
Willingness to use
25%
Device used to gain access
22%
Uses for appropriate tasks
20%
Effective use
19%
Speed of use
13%
Reading speed
7%
0%
5% 10% 15% 20% 25% 30%
Teachers: Causes of Reluctant Use
75% : Self-Conscious
50%: Peer pressure (perceived)
18%: Inadequate training,
poor skills;
Inconvenient to use or carry
14%: Other alternatives (e.g.,
large print, support staff);
Device not available when needed
10%: Student does not identify as
low vision;
Lack of school, teacher’s support;
Device does not help, barely helps
Student Responses: Reluctance to Use
Makes eyes tired
51%
Feel different; Self-conscious
42%
Restricted field of view
36%
Device slows me down
35%
Embarrassment
35%
Teasing
27%
Hard to use
9%
Negative attitude from teachers
7%
0%
10% 20% 30% 40% 50% 60%
Series1
Responses from Students on
Coping Strategies
Request help from teacher or peer
 Request enlarged work
 Complete work later or leave unfinished
 Comment on eye fatigue
 Device left at home or not with student
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Students: Best & Worst of device use
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“Helps me to be
independent” vs.
“Slows me down
when I’m reading
from the board.”;
keeping up with
classmates is the
first goal.
Responses from friends
38% of friends reported adverse
comments from or negative attitudes of
fellow students, primarily resentment of
extra attention (e.g., more time in exams,
enlarged papers, support staff)
 40% of friends reported that they helped
with reading from the white board, texts
worksheets or student “would not be able
to keep up”.
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Teacher Feedback
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Comments in interviews showed a high degree of
subjectivity, vagueness, lack of consensus (e.g.,
effective device use, definition of reading speed)
All teachers noted that large print was a way to
adapt, access the curriculum (research on LP)
Teachers noted device use was perceived as
preventing student from keeping up in class;
when available, large print or support staff seen
as preferable over device use
Psychosocial Aspects of Long Term Optical
Device Use by Young Adults with Low Vision
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Descriptive data from dissertation: 32 adult
participants (students previously enrolled in
Project PAVE) who use devices completed phone
interviews responding to personal characteristics,
functioning with devices, and psychosocial
aspects of use
Quantitative data on factors of visual functioning,
VI services, years of use, and response to reading
Qualitative data from open-ended questions
Psychosocial Aspects cont.
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Characteristics: 18 men, 14 women; 18-28 yrs
(mean of 21.8); 19 were 21 or younger
30 used near devices (magnifiers, reading
glasses); 27 used distance (telescopes)
Factors of vision: No problems in central field
(26); Sensitivity to light (27); peripheral field
problem (16)
Acuity: 20 between 20/200-400; 7 between
20/80-150; 2 as or <20/800; 3 no info
Acuities in better eye
12
Number of
participants
10
8
6
4
2
0
80
100
120
125
150
200
Acuity = 20/…
300
360
400
800 1600
Educational and VI services
Services from a TVI: 27 (84%) in
elementary; 5 (16%) in secondary years
 PAVE services: 18 (56%)in elementary;
13 (41%) in secondary years; 1 pre-school
 PAVE influence: 18 (56%) very positively
influenced; 12 (38%) somewhat positively;
2 (6%) no impact
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Examples of Tasks
Near
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8: Pages of print
(highest mean of 3.57
out of 5 on functioning
scale)
6: Computer screen
5: Cell phone screen
3: Phone book/menus
(2.13 on functioning)
Distance
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11: White board/
Powerpoint
5: Watching sports
3: Finding street signs/
watching TV, animals
(highest mean of 3.33
out of 5 on functioning
scale for travel signs)
“Because of your low vision, are you
having difficulty completing tasks?”
18: No
 14: Yes
6: “It takes longer to do things.”
4: “Board work at school is hard.”
4: “Reading” (small print, typing and
checking work)
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Influence of family/friends on device use
Helpful/Encouraging
11: Reminded me
(nagging) to use
 8: Let me do things on
my own, independent
 4: Family learned
about devices
 4: No attention; it’s just
something I use
32 gave responses
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Not supportive
17: No example
 6: Teasing (limited)
 5: Self-conscious, felt
awkward (questions
or comments)
 3: People don’t know
what it is, what it does
15 gave responses
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“What advice would you give… “
2nd grader
12: Device can help
you; it’s helpful to use
 11: Don’t be ashamed,
embarrassed, afraid
 5: You can be successful, independent
 5: It’s tough at first, but
worth it
31 responses
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10th grader
5: You need it to be
responsible (tasks),
meeting goals
 4: Get over the idea of
not being cool, popular
 3: Think about your
future (adult), the long
run
15 responses
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Psychosocial aspects: Reading
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Preferred reading format with regular print:
 Near
device: 15 (47%)
 No device: 11 (35%)
 Auditory: 5 (15%)
 Large print: 1 (3%)
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Percentage of format use: Print with
device (45%); no device use (25%);
auditory (15%); large print/enlarged (13%)
Factors of Reading
Read
without
tiring
Read as fast Read
as I want to different
Print sizes
YES
8 (25%)
14 (44%)
23 (72%)
NO
24 (75%)
18 (56%)
9 (28%)
Summary of Psychosocial Aspects
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Participants described a resigned willingness to
use devices (limited tasks)
“Self-presentation trumps access” continued, but
less of an issue in adult world
Recognized the differences of how peers
complete the same tasks (speed, ease)
Noted a sense of responsibility, achieving goals
Told stories, gave advice, reflected on device use
Final Notes
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Begin the conversation on psychosocial aspects of
reading (device use) ; build student awareness of
reading habits (skill/deficit), coping strategies,
personal interests
Teachers are data rich! Contribute to research:
document progress, set reading goals and assess,
involve student in the process
“The Case of the Reluctant Reader” and
uncovering clues… Help our students “to see
reading as a door, not as a chore.”
References
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Adams, M. (1990). Beginning to Read: Thinking and Learning about
Print. Cambridge, Massachusetts, MIT Press.
Bosman, A., Gompel, M., Vervloed, M., & van Bon, W. (2006). Low
Vision Affects the Reading Process Quantitatively but not Qualitatively.
The Journal of Special Education, 39, 208-19.
Carver, R. (1989). Silent reading rates in grade equivalents. Journal
of Reading Behavior, 21, pp. 158-161.
Corn A., Wall R., Jose, R., Bell, J.K., Wilcox, K. and Perez, A. (2002).
An initial study of reading and comprehension rates for students who
received optical devices. Journal of Visual Impairment and Blindness,
95, 322-34.
Douglas, G., Grimley, M., Hill, E., et al. (2002). The Case of the NARA
for Assessing the Reading Ability of children with Low Vision. British
Journal of Visual Impairment, 20, 68-75.
References
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Douglas, G., McLinden, M., McCall, S., et al. (2011). Access to Print
Literacy for Children and Young People with Visual Impairment:
Findings from a Review of the Literature. European Journal of Special
Needs Education, 16, 25-38.
Erin, J. (2009). Practice Perspective: The Case of the Reluctant
Reader: Insights from Three Professionals. Journal of Visual
Impairment and Blindness, 103, 69-77.
Goodrich, G.L. & Arditi, A. (2004). A Trend Analysis of the Low Vision
Literature. The British Journal of Visual Impairment, 22, 105-6.
MacCuspie, A. (1996). Promoting Acceptance of Children with
Disabilities: From tolerance to inclusion. Atlantic Provinces Special
Education Authority. Halifax, Nova Scotia.
Mason, H. (1999). Blurred Vision: A Study of the Use of Low Vision
Aids by Visually Impaired Secondary School Pupils. British Journal of
Visual Impairment, 17, 94-97.
References
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Spafford, M., Rudman, D.L., Leipert, B., et al. (2010). When Selfpresentation Trumps Access: Why Older Adults with Low Vision Go
without Low Vision Services. Journal of Applied Gerontology, 29,
579-602.
Vik, A.K. & Lassen, L.M. (2010). How Pupils with Severe Visual
Impairment Describe Coping with Reading Activities in the
Norwegian Inclusive School. International Journal of Disability,
Development, and Education, 57, 279-98.
Presenter email: bachoferc@tsbvi.edu