Parallel versus sequential processing in print and braille reading

Development of BrailleBunny: a device to enhance braille learning

PURPOSE

Braille use has been linked to higher rates of employment, education, financial self-sufficiency, and self-esteem. One area of the world particularly impacted by braille illiteracy is the Philippines. In 2016, Digital Learning for Development and All Children Reading released a "Grand Challenge for Development" that challenged researchers to address the need for assistive technologies to help children with sensory disabilities learn to read in the Philippines. The purpose of this research was to identify technical specifications, and then co-design and test a device that could be used both in developed and developing countries, specifically Canada and the Philippines.

METHODS

An iterative, co-design process was undertaken to develop a prototypical device, BrailleBunny. The extent to which the device fulfilled the design criteria and directions for future development were determined through a series of case studies with 25 end-users.

RESULTS

The prototypical device requires improvement in financial accessibility, durability and reliability. All other criteria were met.

CONCLUSIONS

Despite identified areas for improvement, the user feedback was positive, with the majority of users identifying that this device could provide transferrable learning to standard-size braille. With improvements, BrailleBunny, could be a valuable tool to increase the uptake of learning braille in the Philippines.

Temporal dynamics of oscillatory activity during nonlexical language decoding: Evidence from Morse code and magnetoencephalography

Understanding encoded languages, such as written script or Morse code, requires nonlexical and lexical processing components that act in a parallel and interactive fashion. Decoding written script-as for example in reading-is typically very fast, making the investigation of the lexical and nonlexical components and their underlying neural mechanisms challenging. In the current study, we aimed to accomplish this problem by using Morse code as a model for language decoding. The decoding of Morse code is slower and thus allows a better and more fine-grained investigation of the lexical and nonlexical components of language decoding. In the current study, we investigated the impact of various components of nonlexical decoding of Morse code using magnetoencephalography. For this purpose, we reconstructed the time-frequency responses below 40 Hz in brain regions significantly involved in Morse code decoding and word comprehension that were identified in a previous study. Event-related reduction in beta- and alpha-band power were found in left inferior frontal cortex and angular gyrus, respectively, while event-related theta-band power increase was found at frontal midline. These induced oscillations reflect working-memory encoding, long-term memory retrieval as well as demanding cognitive control, respectively. In sum, by using Morse code and MEG, we were able to identify a cortical network underlying language decoding in a time- and frequency-resolved manner.

Similarities and differences in the neural correlates of letter and speech sound integration in blind and sighted readers

Learning letter and speech sound (LS) associations is a major step in reading acquisition common for all alphabetic scripts, including Braille used by blind readers. The left superior temporal cortex (STC) plays an important role in audiovisual LS integration in sighted people, but it is still unknown what neural mechanisms are responsible for audiotactile LS integration in blind individuals. Here, we investigated the similarities and differences between LS integration in blind Braille (N = 42, age range: 9-60 y.o.) and sighted print (N = 47, age range: 9-60 y.o.) readers who acquired reading using different sensory modalities. In both groups, the STC responded to both isolated letters and isolated speech sounds, showed enhanced activation when they were presented together, and distinguished between congruent and incongruent letter and speech sound pairs. However, the direction of the congruency effect was different between the groups. Sighted subjects showed higher activity for incongruent LS pairs in the bilateral STC, similarly to previously studied typical readers of transparent orthographies. In the blind, congruent pairs resulted in an increased response in the right STC. These differences may be related to more sequential processing of Braille as compared to print reading. At the same time, behavioral efficiency in LS discrimination decisions and the congruency effect were found to be related to age and reading skill only in sighted participants, suggesting potential differences in the developmental trajectories of LS integration between blind and sighted readers.

The Role of Morphological Awareness in Listening Comprehension of Chinese Blind Children: The Mediation of Vocabulary Knowledge

Background

Listening comprehension is particularly important in children without sight. Little research has focused on listening comprehension. There are strong correlations among syllables, morphemes, and orthographic representations in Chinese. For this reason, vocabulary knowledge may have a mediating role in morphological awareness and listening comprehension in blind children during the elementary school.

Methods

The study that included measures of children’s age, working memory, rapid automatized naming, phonological awareness, morphological awareness, vocabulary knowledge, and listening comprehension was administered to 142 Chinese‐speaking blind children during the early elementary level (Grades 1 to 3) and late (Grades 4 to 6). Through a mediation analysis following the bootstrapping procedures.

Results

The study shows that (1) morphological awareness predicted listening comprehension in blind children directly; (2) after children’s age, working memory, rapid automatized naming, and phonological awareness controlled, vocabulary knowledge plays a mediating role in morphological awareness and listening comprehension.

Conclusion

The findings of the present study indicate the important unique role of morphological awareness and the mediation of vocabulary knowledge in blind children’s listening comprehension during the elementary school years.

Graphomotor memory in Exner's area enhances word learning in the blind

Handwriting is thought to impede vocabulary learning in sighted adults because the motor execution of writing interferes with efficient audiovisual processing during encoding. However, the motor memory of writing may facilitate adult word learning when visual sensory inputs are severely restricted. Using functional MRI, we show that late-blind participants, but not sighted participants, learned novel words by recruiting the left dorsal premotor cortex known as Exner’s writing area and its functional coupling with the left hippocampus. During later recall, the phonological and semantic contents of these words are represented in the activation patterns of the left hippocampus as well as in those of left frontotemporal language areas. These findings suggest that motor codes of handwriting help blind participants maintain word-form representations during learning and retrieval. We propose that such reliance on the motor system reflects a broad architecture of the cerebral language network which encompasses the limb motor system as a hardwired component.

Mizuochi-Endo et al. conduct a fMRI study, which reveals that in blind participants, unlike sighted participants, learning new words is associated with increased activity in Exner’s area—a part of the brain known to play a crucial role in handwriting motor memory. This demonstrates the importance of writing motor memory in vocabulary learning in the blind.

Neural network for Braille reading and the speech-reading convergence in the blind: Similarities and differences to visual reading

All writing systems represent units of spoken language. Studies on the neural correlates of reading in different languages show that this skill relies on access to brain areas dedicated to speech processing. Speech-reading convergence onto a common perisylvian network is therefore considered universal among different writing systems. Using fMRI, we test whether this holds true also for tactile Braille reading in the blind. The neural networks for Braille and visual reading overlapped in the left ventral occipitotemporal (vOT) cortex. Even though we showed similar perisylvian specialization for speech in both groups, blind subjects did not engage this speech system for reading. In contrast to the sighted, speech-reading convergence in the blind was absent in the perisylvian network. Instead, the blind engaged vOT not only in reading but also in speech processing. The involvement of the vOT in speech processing and its engagement in reading in the blind suggests that vOT is included in a modality independent language network in the blind, also evidenced by functional connectivity results. The analysis of individual speech-reading convergence suggests that there may be segregated neuronal populations in the vOT for speech processing and reading in the blind.

The sound of reading: Color-to-timbre substitution boosts reading performance via OVAL, a novel auditory orthography optimized for visual-to-auditory mapping

Reading is a unique human cognitive skill and its acquisition was proven to extensively affect both brain organization and neuroanatomy. Differently from western sighted individuals, literacy rates via tactile reading systems, such as Braille, are declining, thus imposing an alarming threat to literacy among non-visual readers. This decline is due to many reasons including the length of training needed to master Braille, which must also include extensive tactile sensitivity exercises, the lack of proper Braille instruction and the high costs of Braille devices. The far-reaching consequences of low literacy rates, raise the need to develop alternative, cheap and easy-to-master non-visual reading systems. To this aim, we developed OVAL, a new auditory orthography based on a visual-to-auditory sensory-substitution algorithm. Here we present its efficacy for successful words-reading, and investigation of the extent to which redundant features defining characters (i.e., adding specific colors to letters conveyed into audition via different musical instruments) facilitate or impede auditory reading outcomes. Thus, we tested two groups of blindfolded sighted participants who were either exposed to a monochromatic or to a color version of OVAL. First, we showed that even before training, all participants were able to discriminate between 11 OVAL characters significantly more than chance level. Following 6 hours of specific OVAL training, participants were able to identify all the learned characters, differentiate them from untrained letters, and read short words/pseudo-words of up to 5 characters. The Color group outperformed the Monochromatic group in all tasks, suggesting that redundant characters' features are beneficial for auditory reading. Overall, these results suggest that OVAL is a promising auditory-reading tool that can be used by blind individuals, by people with reading deficits as well as for the investigation of reading specific processing dissociated from the visual modality.

The association between tactile, motor and cognitive capacities and braille reading performance: a scoping review of primary evidence to advance research on braille and aging

PURPOSE

As the prevalence of age-related visual impairment increases, a greater understanding of the physiological and cognitive capacities that are recruited during braille reading and the potential implications of age-related declines is required.

METHODS

This scoping review aimed to identify and describe primary studies exploring the relationship between tactile, motor and cognitive capacities and braille reading performance, the instruments used to measure these capacities, and the extent to which age is considered within these investigations. English peer-reviewed articles exploring the relationship between these capacities and braille reading performance were included. Articles were screened by two researchers, and 91% agreement was achieved (kappa = 0.84 [0.81, 0.87], p < 0.01).

RESULTS

2405 articles were considered of which 36 met the inclusion criteria. Fifteen investigated the relationship between tactile capacities and braille reading performance, 25 explored motor capacities, and 5 considered cognitive capacities. Nineteen instruments were used to measure tactile capacity, 4 for motor dexterity, and 7 for cognitive capacity. These studies focus on younger participants and on those who learned braille early in life.

CONCLUSIONS

Although this overview underscores the importance of tactile perception and bimanual reading, future research is needed to explore the unique needs of older adults who learn braille later in life.IMPLICATIONS FOR REHABILITATIONThe studies in this review underscore the importance of developing both haptic tactile perception and efficient hand reading patterns early in the braille learning process.Practitioners should consider whether specific pre-braille readiness activities can be used to address the unique needs of older adults who may experience tactile, motor or cognitive declines.Most of the studies in this review require replication before they should serve as reliable clinical guidelines; however, braille reading (like print) is a complex process that draws on multiple capacities that should be developed in unison.The studies in this review focus heavily on younger participants and on those who learned braille early in life, and highlight the need for future research on braille and aging.

The effects of reading mode and braille reading patterns on braille reading speed and comprehension: A study of students with visual impairments in China

The purpose of this study was to examine the effects of reading mode (oral and silent reading) and braille reading patterns (one-handed pattern, mark pattern, parallel pattern, cooperative pattern) on the reading speed and comprehension of students with visual impairments in China. Seventy-three students with visual impairments aged 10-19 years participated in the study; 48 were students with congenital visual impairments and 25 were students with adventitious visual impairments. The participants' braille reading performance was assessed by the Chinese Reading Comprehension Test. Measurement indicators included reading speed (wpm) and reading comprehension. The results indicated that (1) Reading mode had a significant effect on both reading speed and reading comprehension. More specifically, although participants read faster in silent reading than in oral reading, they demonstrated better reading comprehension in oral reading than in silent reading. (2) There was a significant interaction effect between reading mode and braille reading patterns on reading speed. In particular, participants using cooperative and one-handed patterns read faster than other patterns in silent reading. This difference did not exist in the oral reading mode. (3) There was no difference between the measurement indicators of the students with congenital and adventitious visual impairments. Implications and recommendations are given based on the analyses.

A comparison of sighted and visually impaired children's text comprehension

AIM

Do children with visual impairments outperform their sighted cohorts in reading and auditory comprehension tasks?

METHODS

We address this question by applying panel regression techniques on a comprehensive sample of 16 children with visual impairments from a Greek special school for students with visual impairments.

RESULTS

By comparing the reader comprehender profile for both children types, we find that the children with visual impairments perform better than their sighted counterparts. The better performance is supported both unconditionally and conditionally on idiosyncratic characteristics, such as age, text complexity, modality, sex and reading ability.

CONCLUSION

Decomposing the reader comprehender profile into a literal, global and local type of questions we find that the results are mainly driven by the superior performance of the children with VI in the literal questions.

Orthographic units in the absence of visual processing: Evidence from sublexical structure in braille

Reading relies on the recognition of units larger than single letters and smaller than whole words. Previous research has linked sublexical structures in reading to properties of the visual system, specifically on the parallel processing of letters that the visual system enables. But whether the visual system is essential for this to happen, or whether the recognition of sublexical structures may emerge by other means, is an open question. To address this question, we investigate braille, a writing system that relies exclusively on the tactile rather than the visual modality. We provide experimental evidence demonstrating that adult readers of (English) braille are sensitive to sublexical units. Contrary to prior assumptions in the braille research literature, we find strong evidence that braille readers do indeed access sublexical structure, namely the processing of multi-cell contractions as single orthographic units and the recognition of morphemes within morphologically-complex words. Therefore, we conclude that the recognition of sublexical structure is not exclusively tied to the visual system. However, our findings also suggest that there are aspects of morphological processing on which braille and print readers differ, and that these differences may, crucially, be related to reading using the tactile rather than the visual sensory modality.

Massive cortical reorganization in sighted Braille readers

The brain is capable of large-scale reorganization in blindness or after massive injury. Such reorganization crosses the division into separate sensory cortices (visual, somatosensory...). As its result, the visual cortex of the blind becomes active during tactile Braille reading. Although the possibility of such reorganization in the normal, adult brain has been raised, definitive evidence has been lacking. Here, we demonstrate such extensive reorganization in normal, sighted adults who learned Braille while their brain activity was investigated with fMRI and transcranial magnetic stimulation (TMS). Subjects showed enhanced activity for tactile reading in the visual cortex, including the visual word form area (VWFA) that was modulated by their Braille reading speed and strengthened resting-state connectivity between visual and somatosensory cortices. Moreover, TMS disruption of VWFA activity decreased their tactile reading accuracy. Our results indicate that large-scale reorganization is a viable mechanism recruited when learning complex skills.

DOI:http://dx.doi.org/10.7554/eLife.10762.001

According to most textbooks, our brain is divided into separate areas that are dedicated to specific senses. We have a visual cortex for vision, a tactile cortex for touch, and so on. However, researchers suspect that this division might not be as fixed as the textbooks say. For example, blind people can switch their 'leftover' visual cortex to non-visual purposes, such as reading Braille – a tactile alphabet.

Can this switch in functional organization also happen in healthy people with normal vision? To investigate this, Siuda-Krzywicka, Bola et al. taught a group of healthy, sighted people to read Braille by touch, and monitored the changes in brain activity that this caused using a technique called functional magnetic resonance imaging. According to textbooks, tactile reading should engage the tactile cortex. Yet, the experiment revealed that the brain activity critical for reading Braille by touch did not occur in the volunteers’ tactile cortex, but in their visual cortex.

Further experiments used a technique called transcranial magnetic stimulation to suppress the activity of the visual cortex of the volunteers. This impaired their ability to read Braille by touch. This is a clear-cut proof that sighted adults can re-program their visual cortex for non-visual, tactile purposes.

These results show that intensive training in a complex task can overcome the sensory division-of-labor of our brain. This indicates that our brain is much more flexible than previously thought, and that such flexibility might occur when we learn everyday, complex skills such as driving a car or playing a musical instrument.

The next question that follows from this work is: what enables the brain’s activity to change after learning to read Braille? To understand this, Siuda-Krzywicka, Bola et al. are currently exploring how the physical structure of the brain changes as a result of a person acquiring the ability to read Braille by touch.

DOI:http://dx.doi.org/10.7554/eLife.10762.002

Braille Reading Accuracy of Students who are Visually Impaired: The Effects of Gender, Age at Vision Loss, and Level of Education

Introduction

The present study assesses the performance of students who are visually impaired (that is, those who are blind or have low vision) in braille reading accuracy and examines potential correlations among the error categories on the basis of gender, age at loss of vision, and level of education.

Methods

Twenty-one visually impaired Greek school-aged children participated in the present study. The students who participated were enrolled in different educational settings; that is, special schools and mainstream educational settings. The research tool was a subset (three subscales) of a standardized instrument (Test A, Padeliadu & Antoniou, 2008) that evaluates reading accuracy in Greek. All interactions between researchers and students were videotaped, and the analysis of the obtained data was focused on phonological and nonphonological-type errors.

Results

Significant differences in performance were found between male and female participants— t(19) = 2.12, p < .05—as well as between students who attained primary and secondary education: t(19) = 1.96, p ≊ .05. The average number of errors in the three subscales correlated very highly, signifying that performance was very similar. Positive correlation was found between replacement and subtraction types of error ( p < .05), and replacement and recognition ( p < .001), and the total number of errors was positively correlated with replacement ( p < .001), subtraction ( p = .001), and recognition errors ( p < .001). Male participants made more replacement errors: t(19) = 2.09, p ≊ .05; participants in secondary education made significantly fewer errors of recognition: t(19) = 2.49, p < .05; and students who were congenitally blind made significantly more errors of addition: t(19) = 1.96, p ≊ .05. Regarding the recognition type of error, there was a significant interaction effect between grade and age at loss of vision: F(3/17) = 3.09, p = .05.

Discussion

Participants did not benefit exceptionally from semantic information, and it is unclear whether a higher school level leads to the improvement of braille reading accuracy. “Reading the entire word” seems the most effective decoding strategy. Nevertheless, further research is needed to obtain relevant data from longitudinal studies.

Implications for practitioners

Listing and analyzing braille reading errors systematically may reveal error patterns. Based on these patterns, teachers would be able to differentiate their instruction to improve students’ performances in braille speed and accuracy.

The potential for developing a tactile communication system based on Blissymbolics

OBJECTIVE

To be useful for tactile communication, tactile stimuli need to be discriminable from each other. The objective of this study was to determine whether raised-line renderings of Blissymbols have the capacity for being developed into a tactile communication system as measured by their tactile discriminability.

METHODS

Tactile discrimination of Blissymbols was measured by performance on a task in which participants were asked to feel a target raised-line Blissymbol and then to find the target within an array containing the target and raised-line Blissymbol foils.

RESULTS

The vast majority of tactile Blissymbols had tactile discrimination scores of 90% accuracy or better.

CONCLUSION

Most raised-line Blissymbols can be tactilely discriminated from each other, indicating that they have the potential for being developed into a tactile communication system.

Differential cognitive and perceptual correlates of print reading versus braille reading

The relations between reading, auditory, speech, phonological and tactile spatial processing are investigated in a Dutch speaking sample of blind braille readers as compared to sighted print readers. Performance is assessed in blind and sighted children and adults. Regarding phonological ability, braille readers perform equally well compared to print readers on phonological awareness, better on verbal short-term memory and significantly worse on lexical retrieval. The groups do not differ on speech perception or auditory processing. Braille readers, however, have more sensitive fingers than print readers. Investigation of the relations between these cognitive and perceptual skills and reading performance indicates that in the group of braille readers auditory temporal processing has a longer lasting and stronger impact not only on phonological abilities, which have to satisfy the high processing demands of the strictly serial language input, but also directly on the reading ability itself. Print readers switch between grapho-phonological and lexical reading modes depending on the familiarity of the items. Furthermore, the auditory temporal processing and speech perception, which were substantially interrelated with phonological processing, had no direct associations with print reading measures.