An Experimental Replication of Hand and Finger Usage Patterns among Congenitally
Blind, Braille-Reading Adults: A Pilot Study
Loana K. Mason
American Printing House for the Blind
Research in the Rockies
June 2010
1. Introduction
a. Literacy is linked to positive life outcomes in education, employment,
financial status, & self-esteem (Ryles, 1996)
b. Post-school outcomes for people who are blind & visually impaired are
extremely poor as indicated by an unemployment rate greater than 70%
(AFB, 2010)
c. Braille readers are not acquiring literacy skills at the same rate as their
sighted peers (Emerson, Holbrook, & D’Andrea, 2009)
2. Problem
a. Law mandates the use of research-based practices (NCLB, 2001)
b. Lack of scientifically-based research on literacy for students with visual
impairments (Ferrell, Mason, & Young, 2006)
c. 1 experimental study contradicts current practices regarding braille
mechanics (Ferrell, Mason, & Young, 2006)
d. Fluke or Fact?
i. 14 congenitally blind braille readers between the ages of 8-10 were
studied
ii. Participants’ hand dominance was tested
iii. Participants were asked to read a sentence under each of the
following conditions:
1. Left index finger
2. Right index finger
3. Left middle finger
4. Right middle finger
iv. Found that participants read faster with left middle finger
3. Literature Review
a. 100 plus years of literature on braille mechanics
b. Mechanics Deemed Best by Practitioners
i. Use of both hands independently
ii. Use of at least 4 fingers
iii. Use of light pressure & smooth tracking
c. Research is often inconclusive, contradictory & based on observational
data
d. Literature on Hand Usage
i. Consensus that both hands results in fastest & most accurate
reading
e.
f.
g.
h.
ii. Disagreement over the role that each hand plays
iii. Predominant Patterns of Hand Usage
1. Left = placeholder/Right = reader
2. Both hands parallel
3. Both hands parallel for majority of line
4. Independent hand usage
5. Both hands parallel & then one or both hands track
backwards
iv. Hand Dominance Patterns
1. Left hand superiority
2. Right hand superiority
3. Equal hand superiority
v. Emerging Patterns
1. Left-hand advantage for beginning readers
2. Left-hand advantage for struggling readers
3. Hand use may depend on task & familiarity
Literature on Finger Usage
i. Index, middle, ring, & pinky fingers capable of tactile
discrimination, but index & middle are most sensitive
ii. Index fingers of both hands believed to be primary reading fingers
iii. Little consensus over the role of the left versus the right reading
fingers
Literature on Tracking
i. Good braille readers…
1. Exert light pressure
2. Maintain a continuous left-to-right movement
3. Engage in little scrubbing or retracing
ii. Faint pattern has emerged which suggests that the left hand checks
uncertainties or corrects decoding errors
Literature on Cerebral Processes
i. Hemisphere Specific Functions
1. Left = language processing
2. Right = spatial processing
ii. Contralateral Control
1. Left hemisphere controls right side of body
2. Right hemisphere controls left side of body
Literature on Cerebral Processes & Braille
i. Braille reading requires both language and spatial processing, &
thus, it makes sense that good braille readers would use both
hands
ii. Left hand superiority may indicate a reliance on individual symbol
decoding
iii. Right hand superiority may indicate a reliance on language
processing at the word/short phrase level
i. Literature on Braille Fluency
i. Braille readers have consistently been shown to read slower than
sighted peers
ii. This has typically been attributed to the inability of braille readers
to chunk text
iii. Paucity of research available on strategies to increase fluency for
braille readers
4. Research Questions
a. Which pattern of hand usage and finger usage results in the greatest
degree of fluency?
b. Is there a relationship between handedness and hand usage patterns as
indicated by the greatest degree of fluency?
c. Is there a relationship between certain characteristics of braille instruction
and braille reading fluency?
5. Research Design
a. Constructive replication
b. 2 factor (3x3), counterbalanced, within-subjects experiment
c. Independent Variables
i. Hand usage
ii. Finger usage
d. Dependent Variable
i. Fluency = Correct Words Per Minute (CWPM)
6. Participants
a. Sampling Process
i. Congenitally blind adults braille readers utilized so as not to deplete
the limited sample pool of children with visual impairments
ii. E-mails sent to the coordinators of disability services at 4
Midwestern colleges with information to be sent to potential
participants
iii. Participants were paid $25 for voluntary participation
b. Participant Attributes
i. Participant 1
1. Gender = Female
2. Age = 54
3. Eye Condition = ROP
4. Educational Placement = Public Schools
5. Literacy Modalities = Braille & Auditory
6. Age at which Braille was Introduced = 7
7. Age at which Contracted Braille was Introduced = Gradually
Introduced Early On
8. Number of Years Reading Braille = 47
9. Preferred Braille Mechanics = 2 Handed; Parallel Movements
ii. Participant 2
1. Gender = Female
2.
3.
4.
5.
6.
7.
8.
9.
Age = 25
Eye Condition = Unknown
Educational Placement = Public Schools
Literacy Modalities = Auditory & Braille
Age at which Braille was Introduced = 2 or 3
Age at which Contracted Braille was Introduced = 6 or 7
Number of Years Reading Braille = 22 or 23
Preferred Braille Mechanics = 1 & 2 Handed; Left = Reader
& Right = Placeholder
iii. Participant 3
1. Gender = Female
2. Age = 20
3. Eye Condition = LCA
4. Educational Placement = Public Schools
5. Literacy Modalities = Braille & Auditory
6. Age at which Braille was Introduced = 4
7. Age at which Contracted Braille was Introduced = 6 or 7
8. Number of Years Reading Braille = 16
9. Preferred Braille Mechanics = 2 Handed; Parallel &
Independent Movements
7. Data Collection
a. Individual testing sessions arranged upon receipt of questionnaire &
signed consent forms
b. Baseline & 9 treatment assessments conducted
c. Handedness assessed midway through testing through a variety of predesignated physical tasks
8. Content of Assessments
a. Braille Symbols
i. 63 in baseline
ii. 7 in each treatment condition
b. Graded Word List
i. 10 randomly chosen words from published IRIs
c. Graded Reading Passage
i. Length ranges from 142 -252 words
ii. Randomly selected from published IRIs
9. Instrumentation
a. Randomly assigned assessments to randomly ordered treatment
conditions
b. Reader allowed to utilize preferred braille mechanics during baseline
assessment
c. Use of a variety of IRIs with preference given to passages that have at
least 25 words
d. No data on instrument reliability & validity for this study
10. Treatment Conditions
a.
b.
c.
d.
e.
f.
g.
h.
i.
11. Braille
a.
b.
Condition A = Left Index
Condition B = Right Index
Condition C = Left & Right Index
Condition D = Left Middle
Condition E = Right Middle
Condition F = Left & Right Middle
Condition G = Left Index & Middle
Condition H = Right Index & Middle
Condition I = Left & Right Index & Middle
Reading/Recording Stand
Assessments brailled on transparent paper & dots darkened with marker
Reading patch & hand movements videotaped from below the transparent
surface
c. Oral reading recorded
12. Data Analysis
a. Recorded miscues & determined whether the miscues were significant or
not
b. Calculated CWPM
c. Tallied reading patch activation in multiple finger conditions
d. Determined handedness
13. Results for Participant One
a. Isolated Finger Fluency
i. Condition A
1. Symbols = 7.8
2. Words = 13.2
3. Passage = 37.7
ii. Condition B
1. Symbols = 7.8
2. Words = 16.7
3. Passage = 70.2
iii. Condition D
1. Symbols = 7.5
2. Words = 11.3
3. Passage = 30.2
iv. Condition E
1. Symbols = 10.2
2. Words = 18.8
3. Passage = 51.2
b. Total Fluency
i. Baseline
1. Symbols = 7.1
2. Words = 26.1
3. Passage = 76.5
ii. Condition A
1. Symbols = 7.8
2. Words = 13.2
3. Passage = 37.7
iii. Condition B
1. Symbols = 7.8
2. Words = 16.7
3. Passage = 70.2
iv. Condition C
1. Symbols = 12.4
2. Words = 28.6
3. Passage = 78.7
v. Condition D
1. Symbols = 7.5
2. Words = 11.3
3. Passage = 30.2
vi. Condition E
1. Symbols = 10.2
2. Words = 18.8
3. Passage = 51.2
vii. Condition F
1. Symbols = 10.2
2. Words = 16
3. Passage = 45.3
viii. Condition G
1. Symbols = 6.3
2. Words = 10.4
3. Passage = 28.1
ix. Condition H
1. Symbols = 9.8
2. Words = 24.5
3. Passage = 69.6
x. Condition I
1. Symbols = 11
2. Words = 16.2
3. Passage = 59.1
c. Pre-Existing Hand & Finger Preferences
i. Reading Patch Activation During Baseline
1. Symbols = right index
2. Words = right index
3. Passage = right index
ii. Handedness
1. Left on 6 out of 10 tasks
d. Hand Preference During Dual Treatment Conditions
i. Symbols
1. Left = 0
2. Right = 1
3. Both = 3
ii. Words
1. Left = 0
2. Right = 3
3. Both = 1
iii. Passages
1. Left = 1
2. Right = 2
3. Both = 1
e. Finger Preference During Dual Treatment Conditions
i. Symbols
1. Index = 3
2. Middle = 0
3. Both = 1
ii. Words
1. Index = 2
2. Middle = 0
3. Both = 2
iii. Passages
1. Index = 4
2. Middle = 0
3. Both = 0
14. Results for Participant Two
a. Isolated Finger Fluency
i. Condition A
1. Symbols = 8.7
2. Words = 17.6
3. Passage = 55.7
ii. Condition B
1. Symbols = 7.5
2. Words = 8.3
3. Passage = 12.5
iii. Condition D
1. Symbols = 7.3
2. Words = 11.8
3. Passage = 34.2
iv. Condition E
1. Symbols = 4.1
2. Words = 2.7
3. Passage = 6.5
b. Total Fluency
i. Baseline
1. Symbols = 5.2
2. Words = 4.2
3. Passage = 50.3
ii. Condition A
1. Symbols = 8.7
2. Words = 17.6
3. Passage = 55.7
iii. Condition B
1. Symbols = 7.5
2. Words = 8.3
3. Passage = 12.5
iv. Condition C
1. Symbols = 10.4
2. Words = 24
3. Passage = 53.6
v. Condition D
1. Symbols = 7.3
2. Words = 11.8
3. Passage = 34.2
vi. Condition E
1. Symbols = 4.1
2. Words = 2.7
3. Passage = 6.5
vii. Condition F
1. Symbols = 8.3
2. Words = 13.6
3. Passage = 36.1
viii. Condition G
1. Symbols = 6.9
2. Words = 11.3
3. Passage = 59.5
ix. Condition H
1. Symbols = 7.5
2. Words = 8.4
3. Passage = 17.9
x. Condition I
1. Symbols = 6.7
2. Words = 24
3. Passage = 53.5
c. Pre-Existing Hand & Finger Preferences
i. Reading Patch Activation During Baseline
1. Symbols = left index
2. Words = left index
3. Passage = left index
ii. Handedness
1. Right on 10 out of 10 tasks
d. Hand Preference During Dual Treatment Conditions
i. Symbols
1. Left = 1
2. Right = 0
3. Both = 3
ii. Words
1. Left = 1
2. Right = 1
3. Both = 2
iii. Passages
1. Left = 3
2. Right = 0
3. Both = 1
e. Finger Preference During Dual Treatment Conditions
i. Symbols
1. Index = 3
2. Middle = 0
3. Both = 1
ii. Words
1. Index = 4
2. Middle = 0
3. Both = 0
iii. Passages
1. Index = 4
2. Middle = 0
3. Both = 0
15. Results for Participant Three
a. Isolated Finger Fluency
i. Condition A
1. Symbols = 14.4
2. Words = 31.6
3. Passage = 79.6
ii. Condition B
1. Symbols = 18.7
2. Words = 31.6
3. Passage = 82.9
iii. Condition D
1. Symbols = 11
2. Words = 15.9
3. Passage = 37.6
iv. Condition E
1. Symbols = 8.1
2. Words = 11.4
3. Passage = 29.3
b. Total Fluency
i. Baseline
1. Symbols = 6.4
2. Words = 50
3. Passage = 112.2
ii. Condition A
1. Symbols = 14.4
2. Words = 31.6
3. Passage = 79.6
iii. Condition B
1. Symbols = 18.7
2. Words = 31.6
3. Passage = 82.9
iv. Condition C
1. Symbols = 20.7
2. Words = 50
3. Passages = 116.4
v. Condition D
1. Symbols = 11
2. Words = 15.9
3. Passage = 37.6
vi. Condition E
1. Symbols = 8.1
2. Words = 11.4
3. Passage = 29.3
vii. Condition F
1. Symbols = 15.6
2. Words = 12.9
3. Passage = 65.7
viii. Condition G
1. Symbols = 10.7
2. Words = 37.5
3. Passage = 69
ix. Condition H
1. Symbols = 15.6
2. Words = 40
3. Passage = 93
x. Condition I
1. Symbols = 15.8
2. Words = 37.5
3. Passage = 107.2
c. Pre-Existing Hand & Finger Preferences
i. Reading Patch Activation During Baseline
1. Symbols = left & right index
2. Words = left & right index
3. Passage = left & right index
ii. Handedness
1. Right on 10 out of 10 tasks
d. Hand Preference During Dual Treatment Conditions
i. Symbols
1. Left = 0
2. Right = 0
3. Both = 4
ii. Words
1. Left = 1
2. Right = 2
3. Both = 1
iii. Passages
1. Left = 0
2. Right = 3
3. Both = 1
e. Finger Preference During Dual Treatment Conditions
i. Symbols
1. Index = 2
2. Middle = 0
3. Both = 2
ii. Words
1. Index = 2
2. Middle = 0
3. Both = 2
iii. Passages
1. Index = 3
2. Middle = 0
3. Both = 1
16. Discussion
a. Preferred method used during baseline for all participants was the left &
right index fingers but only both fingers were dominant for 1 participant
b. Baseline not necessarily the most fluent method
c. Best fluency for all participants obtained when using both index fingers
d. While the most fluent method is similar to the preferred method used
during the baseline, patterns of finger dominance vary across the two
conditions
e. Best fluency across all treatment conditions occurred while reading
passages, which may support the theory that effective braille reading
relies on more than symbol decoding
f. Participant with lowest fluency did poorest on conditions using only the
right hand & demonstrated a slight left index finger dominance
g. Different pattern emerging than found by Hermelin & O’Connor
17. Limitations
a. Small sample size prevents statistical analysis
b. There may be an order effect since the treatment conditions were the
same for all participants
c. Hand & finger patterns for a variety of reading levels across a variety of
ages & stages of learning to read were not examined in the pilot study
d. Results may be tied more to the braille mechanics that most closely
approximate the hand & finger usage patterns they have used for many
years