Beyond the Page: Exploring Reading Accessibility for Blind and Low Vision Adults

About this project

I created this project as a student to understand how blind and low vision (visually impaired or VI) readers access books for a variety of needs including school/professional enrichment and leisure reading.

Project Duration: October-December 2022

UX Discipline: Research

Methods & Deliverables: User interviews, affinity diagramming, persona creation, user journey map

Context

Accessing physical books can pose a challenge for blind and VI readers. For the visually impaired, large print books have limited availability at local libraries and can be an expensive investment. Alternatively, regular print books require the use of visual aids like magnifiers which can make reading cumbersome.For the (more) totally blind, access to Braille is even more scarce: Braille books are massive in size and are even more expensive due to minimal transcribers available nationwide.

In the age of technology, many have found digital solutions, including e-readers or tablets with adjustable font size, OCR scanning, digital Braille displays that refresh when connected to a device, audiobooks, or a combination of digital and analog tools like magnifiers. However, none of these solutions are as simple as opening and reading a physical book, and come with issues of their own.

Additionally, user research involving participants with disabilities are few and far between. I wanted to seize this opportunity by focusing my project on blind and low vision readers specifically.

Research Themes

1. How do blind and low vision readers find and access books they want to read?
2. What barriers do readers encounter when looking for books?
3. When and how do blind and low vision readers read?
4. What makes reading difficult?

Process

Participant Recruitment & Interviews

Since this project would be generative and platform independent, I opted for participant interviews as this would allow me to ask broad questions.

I was told by my stakeholder (professor of my class) that I would need to recruit six initial participants from which to base my personas, followed by another three for follow-up conversations, making nine total.

Having been in blind and low vision spaces before, I suspected blind and low vision readers’ needs would differ slightly, so I developed two target users (or in this case, readers).

Blind Readers

Readers who cannot visually read for extended periods.

Low Vision Readers

Readers who can visually read for extended periods, using accommodations.

I developed an interview guide from my research themes and began recruiting participants from connections I had made when attending blind and low vision nonprofit conferences, including the National Organization for Albinism and Hypopigmentation and the American Council of the Blind.

I recruited participants not only on the limits of their vision, but also on their interest in reading: they had to enjoy it and read regularly, at least a few times a week.

After recruitment, I scheduled time with each participant for a 45-minute interview session. All interviews were conducted over Zoom and recorded with participant consent to be shared with project stakeholders. Each participant received an incentive for talking with me: a $5 gift card to Starbucks to enjoy coffee or tea with their next good read.

Interim Synthesis

After my first six participants, I synthesized the data by creating an affinity chart on Trello with each answer to a question on the interview guide and grouping them into similar themes.

Personas

I then developed two distinct personas to capture each type of reader.

User Journey

I developed a user journey following the Maria persona’s process to find and read an audiobook that her friend recommended to her. This user journey highlights the book-finding process and potential difficulty in knowing which platform will have it.

Follow-up Interviews

Using the personas as a guide, I sought after low vision readers that read for more than leisure alone, so I recruited students, continued learners, or on-the-job readers. I also noticed more diversity within low vision readers and wanted to learn more.

Finally, I compiled a final report with an executive summary, domain terms, participant overview, detailed synthesis, personas, persona journey, recommendations, and an appendix.

High-Level Results

Accessing Books

Leisure Reading

When it came to finding books to read, readers often had a variety of tools they used in conjunction with one another. However, leisure reading saw more consistency in accessing reading materials.

Blind readers:

• Audio: 3 of 4 blind readers used BARD Mobile and Audible as a backup or because they preferred the Audible reader
• Braille: Bookshare or BARD for use with their Braille displays

Low Vision readers:

• Audio (4 of 5 read audiobooks at all): low vision readers had diverse approaches, including Learning Ally, Libby, BARD Mobile, or even having files custom read by a personal reader
• Visual reading: 4 of 5 used Bookshare, 2 naming it as their first choice and the other 2 as a backup option

Non-Leisure Reading

When reading for school, professional enrichment, and certification work, all got materials in unique ways, depending on the piece they needed. These included:

• Academic journals PDFs from their journals’ websites or library archives
• Textbooks from:
  • University’s Office of Disability Services
  • Library archives
  • Friends
  • Book hosting platforms, like O’Reilly or Learning Ally
• Specialized materials directly from the source requiring the reading, like an organization providing a certification
• iBooks or Kindle

“I’m grateful for all the access that has been given to us with books and all the [technological] improvements… and improved quality of it.”
– P4, on accessing books

Barriers to Book Access

All nine said in different ways that accessing books is easier now than it’s ever been. Most added that they remembered times where audiobooks weren’t as popular and were happy that sighted people embraced them as well so the supply of quality audiobooks is wider.

All readers had a personalized “decision tree” of their preferences and would check their “first choice” preferred reading source, then move along various nodes depending where they could find the book they wanted in the form they wanted it in (audio, Braille, digital).

• For most (7 of 9), their preferred source was free, using services like Libby, BARD, Bookshare/Learning Ally (for students), or their university library
• Most would then settle for buying a book if their preferred didn’t have it or they needed it immediately, using Kindle, iBooks, or even Amazon for a physical copy to get it scanned by OCR software

Although rare, readers approached difficulty finding a book in a variety of ways:

• If for leisure, most readers would just find a different book
• If required for a course, 3 of 9 mentioned working with their professors or their school’s disability services to find an accommodation, either as a PDF version or alternative book or reaching out directly to Bookshare to add the book to their library which would take about a week.

“I feel like now there’s often options [when you can’t find a book], not necessarily in the most preferred format.” – P8, on searching for books

When & How Readers Read

Every participant described reading as a ritual, meaning that they would get most pleasure from reading in their homes with cozy environments in silence or with some music.

Accommodations & Customizations

• Audiobook readers adjusted the speed somehow, depending if they wanted to focus on comprehension, speed, or enjoyment
• Low Vision visual readers increased the font size considerably and most inverted the contrast to minimize eye strain
• Braille readers described it as more of a conscious choice to improve comprehension or keep up their literacy skills

Ingenuity for PDF Inaccessibility

When it came to poorly accessible non-leisure reading workarounds:

• 3 of 4 blind readers would use screen readers with reading apps that didn’t have an audio component
• All low vision readers accessed PDFs for non-leisure reading and read them using different strategies, like:
  • Using screen magnification on their computers
  • Copying & pasting PDF contents into MS Word and selecting the “Read Aloud” functionality
  • Importing academic journal PDFs into the Notability note-taking app on iPad and would magnify and pan back and forth to read
  • Using Adobe Premium (provided by participant employer) which would OCR PDFs so she could use a screen reader to listen to its contents
  • Having a hired reader for school materials and uploaded files on a shared drive
  • Creating DIY PDFs by using her phone’s Notes app to scan pages and upload them on Google Drive

“When you have a disability, you become smart with what you need to do.” – P7, on reading workarounds

Difficulties in Reading

Limitations of Audio as a Medium

Some readers mentioned that audio doesn’t always fit their needs, like:

• Reading unique writing style, like Choose Your Own Adventure novels
• Poor audiobook quality or narrators with heavy accents or who mumble
• Proofreading, which is difficult using a screen reader, since it often doesn’t capture missing punctuation or spelling errors
• Technical reading using a speech synthesizer on an application like Bookshare, which isn’t able to interpret complex formulas, images, charts, tables, and figures that require more audio description best done by a human

Challenges with PDF Reading

Low vision readers struggle with PDF reading. PDFs are not editable, readers can’t increase font size or contrast. All low vision readers used workarounds to read, none of which were ideal. Thus, low vision readers weren’t able to read PDFs for as long as they could read leisure materials before feeling strained.

“I’m very interested in making those [PDFs] more accessible… There’s no reason screen readers shouldn’t be able to read equations.”
– P6, on PDF accessibility and audio limitations

Physical Books

One final, fascinating discovery emerged: every reader mentioned missing the feel of reading physical books, either print or Braille. Readers were almost embarrassed to admit this since they couldn’t read them anymore, but this shows that books are much more than simply printed words. 

Blind readers laughed at the impracticality of reading volumes of Braille manuscripts while explaining that some books they ordered came in several boxes of bulky volumes, but they got to read a physical book.

Low vision readers wished they had the option to read comfortably, with P1 saying, “If I weren’t disabled, I would never use an e-reader,” but was grateful to have the option.

For some, physical books served a purpose beyond reading, like:

• Collectors’ items, like beautiful boxed sets or signed copies
• Trophies of accomplishment that they would purchase as proof of reading
• Good luck charms by a nightstand
• Sensory stimulation, seeking out bookstores or libraries for that magical “book smell”
• Social connections with sighted friends by loaning physical copies of favorite books so they could discuss them together

“If I didn’t have a disability, I’d still definitely want to read physical books.” – P1, on physical books

Recommendations

1. Leverage nonprofits to ensure all blind and low vision readers know about the services available to them.
   In casual conversation after interviews, the only two participants who didn’t use services specific to the blind like BARD were unaware of them or had learned about them years ago but never adopted. This gap in knowledge could have easily been prevented by nonprofits they were involved with promoting these services.
2. Allow readers to perform one search for a book by leveraging a service they already use.
   As mentioned in the journey map above, readers could use something like Google, Goodreads, or an accessible reading equivalent like the National Library Services for the Blind to know where books are available across platforms. More research would need to be done to determine where it would best benefit readers.
3. Ensure reading platforms have granular levels of customization.
   Many readers mentioned choosing one platform over another because they liked the customization options. Companies wishing to make their platforms competitive should allow deeper customization to attract more readers (e.g. RGB-level color tweaking as opposed to color presets, increasing speed by 0.1x rather than 0.25x).
4. Prioritize audio quality improvement on older recordings.
   While this won’t solve all audio limitations, it will benefit users who primarily rely on audio as a medium.
5. Work with a company like Adobe to allow access to open-source or free to print disabled PDF resources to improve accessibility.
   Ultimately, PDFs will always be imperfect, but they are here to stay. Putting accessibility behind a paywall is in itself inaccessible. Low vision and blind readers should have PDF customization options in addition to library services since nearly all readers interviewed dealt with them.
6. Offer more large print and Braille books in mainstream stores and libraries.
   It doesn’t have to be a large section, but carrying books in a format that blind and low vision readers can use sends a powerful message that they belong.

Final Report

The final report with detailed synthesis can be found below, in the link and the document viewer.