RAIL

by Berry P.L.M. den Brinker, PhD Member,
EBU Commission on Activities of Partially Sighted People

Paper given at the EBU Mobility and Transport Conference held in Paris on 14-15 October 2002

Introduction

I thank the organization of this conference for the invitation to represent the EBU Commission on the Activities of Partially Sighted People. The aim of this conference is, as I see it, to promote a physical world that is fully accessible for visual impaired people (in short VIP). According to the definition of the World Health Organization "visual impaired" means both partially sighted and blind people (1). Such a world can be achieved by three kinds of measures (2) :

It is up to organizations like the EBU to explain the needs of the VIP's to our counterparts, the authorities that are responsible for the implementation of the solutions.

This is the most important question : What are the needs of VIP's and what are the solutions ?

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The difference between the needs of partially sighted and blind people

Until the 1970's, everyone suffering one or another form of a severe form of visual impairment was treated as being blind. All blind people had to learn Braille by touch although many partially sighted people were able to read Braille by vision. Partially sighted people, also called people with low vision, were often blindfolded while learning Braille. From the 1970's onward, with the introduction of new optical and electronic devices, it was possible for low vision people to use their residual vision for reading. Special rehabilitation programs and education systems were developed for partially sighted people to teach them to exploite their visual potentials to solve their problems. From that moment onwards, more and more partially sighted people were looking for visual solutions for their low vision needs.

In an interesting item in a Dutch study (5) was the kind of special aids that visually impaired people were using. A distinction was made between residual sight supporting aids like CCTV magnifiers or lenses (category a) and sight-substitution or sight-supplementing aids like a white cane, Braille, and talking books (category b). It was not surprising to find that the completely blind people were not using aids in category 'a' as no residual vision was available. However, in the next category of visual impaired people, people with a severe visual impairment (about 0.4 per cent of the population) made little use of sight substituting aids, except for talking books. In the remaining category of visually impaired people with a moderate impairment (1.4 per cent of the population) the only aid of category 'b' used was talking books. According to the estimations in this study, about one on every ten visual impaired person is using the white cane.

Yet, within the context of associations of the blind and partially sighted people, there is the idea that low vision and blindness are two sides of a gradual scale and that the interests of VIP's are best looked after by treating them as one single group (3). Intuitively this may sound reasonable, in practice, when advocating the interests of VIP's for inclusive design, this is not true. I will explain this below.

Recently, September 2002, the World Blind Union accepted in a meeting in Havana the following clinical definition of the World Health Organization of Low Vision :

A person with low vision is one who has impairment of visual function even after treatment and/or standard refractive correction and has an acuity of less than 6/18 to light perception or a visual field of less than 10 degrees from the point of fixation, but who uses or is able to use vision for the planning or execution of a task (4).

So the difference between low vision and blindness is not a certain amount of residual vision, but the fact that a person with redused visual functions is able to use vision for planning and executing tasks. People with low vision are often looking for visual solutions of their problems. This does not imply that people with low vision always prefer visual solutions. For example, when a person with a very low visual acuity requires a microscope to get full visual access to text, it is not very useful to use vision for reading.

However, on other occasions, like moving around in a known environment, the same person may rely completely on visual information. On the other hand, people with tunnel vision, having full access to the visual environment, will often prefer non-visual solutions for their mobility problems as the visual solution, scanning the environment, is time consuming and thus not very useful. In contrast to mobility problems, people with tunnel vision may prefer vision for reading. In other words, whenever access to vision results in a usable solution, people with low vision will prefer visual solutions above blind solutions for their problems. This has been found in many studies like in a large Dutch survey in 1998 (5).

People with low vision differ enormously in the number of visual and non-visual solutions they need to solve their daily life problems. These differences form a basis for the idea that low vision and blindness are the extremes of a gradual scale. However, our counterparts, the authorities, have a different view in matters of accessibility and inclusive design. They have to deal with people who want visual solutions for accessibility problems and other VIP's who want non-visual solutions. For the authorities it does not matter whether an individual VIP wants a visual solution in one occasion and a non-visual solution in another occasion, as both solutions have to be implemented to serve the needs of all visually impaired people.

So my first conclusion is that for the authorities responsible for inclusive design one thing matters : there are two categories of VIP's : VIPS claiming visual solutions for their problems and VIP's claiming non-visual solutions.

Moreover, there are more disabilities to take into account : Wheelchair users are also claiming facilities, as do people with hearing problems, dyslexia, etc. A balance has to be found between all the claims because conflicts may arise between solutions for different categories of disabilities.

It is here where the problems arise for partially sighted people. The visual needs are presented in the same package to the authorities, as the non-visual needs. This may lead to formulations that are difficult to understand like the statement I found in a Dutch brochure (6):

For partially sighted and blind people, contrasting colors, tactile guiding and marking are important to enable them to reach and use buildings. (page 5)

It is very difficult for the authorities to decide how important the visual and non-visual needs are and they tend to pay more attention to the blind solutions because they assume that partially sighted people also need non-visual solutions. For example, in a handbook for the accessibility of the built environment (7) the authors take as starting point for designing the public environment :

As the orientation in the public space is of essential importance for functioning in the environment, and people with a visual impairment are not able to make use of 'natural' visual information of the environment, a route oriented approach is essential, that is, a completely closed system with tactile and or auditory markers. (page 63) (7)

It is clear that this statement will be true for blind and severely visually impaired people but not for the majority of partially sighted people.

So my second conclusion is that organizations representing the interests of all visually impaired people have to present the needs and solutions of people with low vision in a separate package from the needs and solutions of blind people.

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How well are the interests of partially sighted people represented ?

The EBU and most of its member organizations are bodies that claim to represent the interests of all visually impaired people. So it is interesting to know how well these organizations represent the partially sighted people. So the first question is about the prevalence of visual impairment and the second question is about participation in services for visually impaired people and membership of associations of visual impaired people.

In recent studies in the UK (8) and The Netherlands (5), the number of VIP's was estimated to be about 2 per cent of the population, of which 5 per cent was estimated to be completely blind. For The Netherlands with a population of 16 million people, this means that 320 thousand people are estimated to be visually impaired of which 16 thousand are completely blind. These numbers are not based on counting, as there is no official registration of people with disabilities in The Netherlands. In any case, according to these estimations in the UK and The Netherlands, there are 20 persons with low vision on every single blind person.

The following question in the Dutch study (5) was the amount of public awareness and participation of organizations for VIP's and associations of VIP's. The results were surprising. There was little public awareness of organizations for the blind and an even lower membership of associations. Of the potential 320,000 members only 5000 VIP's were organized in the Dutch foundation of Blind and Partially Sighted People (N.V.B.S.). It was found that many VIP's with moderate forms of low vision considered themselves as not belonging to the interest group of associations of visually impaired people. In the study it was observed that the less severe the visual impairment and the later emergence of the impairment in life, the weaker the participation in associations.

I assume that similar situations exist in other European countries. Moreover, in many countries, a person is considered to have low vision with a lower threshold for visual acuity than 6/18, the value of the clinical definition of the World Health Organization and the World Blind Union.

So my third conclusion is that not all VIP's in Europe are recognized to belong to the interest group of the members of the EBU and that, even when they are recognized as potential members, many low vision people feel little affinity for organizations of blind and partially sighted people.

As a result, the participation of the low vision people in the organizations for VIP's is very low. As a consequence there has always been, and still is, the danger that the interests of low vision people drift out of the attention of those who are very well represented in the EBU and its member organizations : blind people. This is reflected in the topics that are presented and discussed on this conference. Inclusive design based on visual solutions is not a main theme on this conference. We, the EBU and the member organizations, have to make a conference like this more attractive for low vision people. This would be a nice implementation of in the second statement of the EBU Resolution 1987-1 (3). It is not sufficient to worry about colors and light contrast of guidelines, as most low vision people are not white cane users. Low vision people are more interested in visual solutions for their problems : they want well marked steps on staircases, clearly visible signposts that can easily be found and read with or without their low vision aids. This kind of topics should be presented on a conference like this.

To give you an idea of an interesting low vision paper, I will give an example of an accessibility study. This study is so interesting because it includes a discussion on the measurement of accessibility. This study will function as an introduction to the last part of this paper in which I propose how the EBU could advocate the interests of partially sighted people.

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An example of an objective method to measure the accessibility of buildings

I will discus how a service for PSP can be improved. One of the services for PSP is a list of guidelines for architects to design buildings. I take a single guideline as example : How to mark steps for descending a staircase ? Falling down is a main cause of severe injuries of low vision people. The majority of VIPs are elderly people. Only 1/3 of elderly people recover from such accidents and one-third dies within one year.

In a recently published Dutch guideline (6) for the accessibility a picture was shown of a so-called "well marked staircase". Each step was marked with a row of dots. This method of marking steps was developed by the Dutch Railway System for the general public. In another publication by the RNIB a completely different optimal staircase was depicted. High contrasting lines at the edge of each step marked the steps in this brochure. This difference raises the question : Which of the two systems of marking steps is the best for partially sighted people ?

On the international scientific conference on low vision this year in Gutenberg, I have presented a new objective method to judge the accessibility of buildings for people with macular degeneration. The method is developed in the context of a scientific program, in co-operation with the Dutch organization for Research in Applied Physics (T.N.O.) and financially supported by the Dutch organization for Scientific Research in Health and Care (Z.O.N.-N. W.O.). The method was demonstrated by the measurement of the accessibility to these two kinds of marks on a staircase.

The method consists of two operations on the image of a situation that has to be judged. In the first operation, a photographic picture is processed to simulate how a low vision person sees the situation. This first operation is called "degrading". The second operation is to identify in the blurred image where the low vision person perceives important contours of objects. This operation is called "contour detection". The complete method is called DCD that stands for degrading and contour detection and is to be pronounced as "decide". In the case of descending staircases, it is very important where low vision people locate the edge of the first step. According to the DCD method, the so-called British steps (lines on the edges) were identified correctly. So the British steps are save as the lines coincide with the edges of the steps. The marks on the Dutch steps, the dots, were also visible for low vision people. However, as the dot do not co-inside with the edge of the steps, low vision people could not see, according to the analysis, where the first step was located. Below you will find the pictures that illustrate the analyses, at least when you are reading the version with pictures.

What can we learn from this example ?

New methods are available now to judge the accessibility of buildings for partially sighted people. These photographic procedures can be used for both existing building as for designs of new buildings. These kinds of objective methods enable the architect to measure if people with low vision can perceive objects visually. Another advantage of the method is that the measurement is based on image processing. Thereby the architect is able to look for functional solutions that do not conflict with his ideal design. With such tools, the architect may better be able to design nice buildings where low vision people can find their way by adequately visually marked routes, staircases, obstacles and well placed signposts that are easy to read with or without low vision aids.

So my fourth conclusion is that objective methods are available now that can help to judge the accessibility of the visual environment for partially sighted people that can be used for inclusive design.

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An Award as a method to advocate the interests of partially sighted people

Fifteen minutes are not sufficient to even mention all the improvements in the advocacy of interests of low vision. Therefore I mention only one :

To give an award for the visually most attractive and visually accessible building or building site that is related to transport and mobility.

Candidates for the award are :

To be sure that the architects get the freedom to design things that are nice and beautiful on the one side and functional for partially sighted people on the other side, scientific based procedures, like the DCD method I just demonstrated, have to apply in the evaluation of the designs.

The award should be handed out at every General Assembly.

The task to select candidates for the award could be the primary task for the EBU commission on Activities of Partially Sighted People. The guidelines for the award developed by the commission are updated every 4 years. These guidelines function as a model for the regional members of the EBU, the authorities, the architects, etc.

The task of the taskforce on accessible buildings is to formulate the conditions and rules to be used in the new commission.

So my fifth conclusion is that an award for the authorities that excel in regulations for, the building of and maintenance of low vision accessible buildings and building sites, is an effective tool in the hands of the EBU to promote the interests of partially sighted people.

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Summary of conclusions

1. For the authorities responsible for inclusive design one thing matters: there are two categories of VIP's : VIP's claiming visual solutions for their problems and VIP's claiming non-visual solutions.

2. Organizations representing the interests of all VIP's have to present the needs and solutions of people with low vision in a separate package from the needs and solutions of blind people.

3. Not all VIP's in Europe are recognized to belong to the interest group of the members of the EBU and, for those who are recognized, the participation of the low vision people in the organizations for VIP's is very low.

4. Objective methods are available in the near future that can help to judge the accessibility of the visual environment for partially sighted people that can be used for inclusive design.

5. An award for the authorities that excel in regulations for, the building of and maintenance of low vision accessible buildings and building sites, is an effective tool in the hands of the EBU to promote the interests of partially sighted people.

Thank you for your attention.

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Literature

1. International Classification of Functioning, Disability and Health, the last revision (May 22, 2001) of the International Classification of Impairment, Disability and Handicap, first published by the World Health Organization in 1980 :
www.who.int/msa/mmh/ems/icidh

2. Den Brinker, B.P.L.M. and Geijskens, H. (2001)
A Society for All, including Partially Sighted People, a position paper published by the EBU

3. Resolution 1987-1 passed by the EBU Second General Assembly (Varna, Bulgaria, 3-4 June 1987)

4. Management of Low Vision in Children : Report of a WHO consultation, Bangkok, July 1992

5. Meijer, W.B.A. and Gorter, K.A (1998)
Slechtzienden en Blinder in Nederland : Deelrapport I : Aantallen en kenmerken
Verwey Jonker Instituut, Utrecht (Nederland)
E-mail : secr@verwey-jonker.nl

6. Een Goede Binnenkomer, a brochure downloaded in 2002 from the website of the Dutch Federation for Blind and Partially Sighted People

7. Wijk, M., Drenth, J. and Ditmarsch, M. van (2002)
Handboek voor Toeganeijkheid
Elsevier bedrijfsinformatie, Doetinchem, Nederland (ISBN 90-5439-104-0)

8. Bruce, I., Aubrev, M. and Errol, W. (1991)
Blind and partially sighted in Britain : The RNIB survey, Volume 1
Royal National Institute of the Blind, HMSO, London

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