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
Introduction
Literacy is linked to positive life
outcomes in education, employment,
financial status, & self-esteem (Ryles, 1996)
Post-school outcomes for people who
are blind & visually impaired are
extremely poor as indicated by an
unemployment rate greater than 70%
(AFB, 2010)
Braille readers are not acquiring
literacy skills at the same rate as their
sighted peers (Emerson, Holbrook, & D’Andrea, 2009)
Problem
Law mandates the use of researchbased practices (NCLB, 2001)
Lack of scientifically-based research
on literacy for students with visual
impairments (Ferrell, Mason, & Young, 2006)
One experimental study contradicts
current practices regarding braille
mechanics (Ferrell, Mason, & Young, 2006)
Problem: Fluke or Fact?
14 congenitally blind braille readers
between the ages of 8-10 were tested
 Hand dominance
 Sentence reading with…
 Left index finger
 Right index finger
 Left middle finger
 Right middle finger
Found that participants read faster
with left middle finger
Hermelin & O’Connor, 1971
Literature Review
100+ years of literature on braille
mechanics
Mechanics Deemed Best by
Practitioners
 Use of both hands independently
 Use of at least 4 fingers
 Use of light pressure & smooth
tracking
Research is often inconclusive, contradictory, or based on observational data
Literature on Hand Usage
Consensus that both hands results in
fastest & most accurate reading
Disagreement over the role that each
hand plays
Predominant Patterns of Hand Usage
 Left = placeholder/Right = reader
 Both hands parallel
 Both hands parallel for majority of line
 Independent hand usage
 Both hands parallel & then one or both
hands track backwards
Hand Usage Continued
Hand Dominance Patterns
 Left hand superiority
 Right hand superiority
 Equal hand superiority
Emerging Patterns
 Left-hand advantage for beginning
readers
 Left-hand advantage for struggling
readers
 Hand use may depend on task &
familiarity
Literature on Finger Usage
Index, middle, ring, & pinky fingers
capable of tactile discrimination, but
index & middle are most sensitive
Index fingers of both hands believed
to be primary reading fingers
Little consensus over the role of the
left versus the right reading fingers
Literature on Tracking
Good braille readers…
 Exert light pressure
 Maintain a continuous left-to-right
movement
 Engage in little scrubbing or retracing
Faint pattern has emerged which
suggests that the left hand checks
uncertainties or corrects decoding
errors
Literature on Cerebral
Processes
Language
Processing
Spatial
Processing
Spatial
Processing
X
Language
Processing
Literature on Cerebral
Processes & Braille
Braille reading requires both language
and spatial processing, & thus, it
makes sense that good braille readers
would use both hands
Left hand superiority may indicate a
reliance on individual symbol decoding
Right hand superiority may indicate a
reliance on language processing at the
word/short phrase level
Literature on Braille Fluency
Braille readers have consistently been
shown to read slower than sighted
peers
This has typically been attributed to
the inability of braille readers to chunk
text
Paucity of research available on
strategies to increase fluency for
braille readers
Research Questions
Which pattern of hand usage & finger
usage results in the greatest degree of
fluency?
Is there a relationship between
handedness & hand usage patterns as
indicated by the greatest degree of
fluency?
Is there a relationship between certain
characteristics of braille instruction &
braille reading fluency?
Research Design
Constructive replication
2 factor (3x3), counterbalanced,
within-subjects experiment
Independent Variables
 Hand usage
 Finger usage
Dependent Variable
 Fluency = Correct Words Per Minute
(CWPM)
Participants
Sampling Process
 Congenitally blind adults braille
readers utilized so as not to deplete
the limited sample pool of children
with visual impairments
 E-mails sent to the coordinators of
disability services at 4 Midwestern
colleges with information to be sent
to potential participants
 Participants were paid $25 for
voluntary participation
Participants
#1
#2
#3
Female
Female
Female
54
25
20
ROP
Unknown
LCA
Public Schools
Public Schools
Public Schools
Braille & Auditory
Auditory & Braille
Braille & Auditory
7
2 or 3
4
Gradually
Introduced Early
On
7 or 8
6 or 7
Number of Years
Reading Braille
47
22 or 23
16
Preferred Braille
Mechanics
2 Handed; Parallel
Movements
1 & 2 Handed; Left
= Reader & Right =
Placeholder
2 Handed; Parallel
& independent
Movements
Gender
Age
Eye Condition
Educational
Placement
Literacy Modalities
Age Braille was
Introduced
Age at which
Contracted Braille
was Introduced
Data Collection
Individual testing sessions arranged
upon receipt of signed consent forms
Baseline assessment conducted
9 treatment assessments conducted in
random order
Handedness assessed at midpoint
through a variety of pre-designated
physical tasks
Content of Assessments
Braille Symbols
 63 in baseline
 7 in each treatment condition
Graded Word List
 10 randomly chosen words from
published IRIs
Graded Reading Passage
 Length ranges from 142 -252 words
 Randomly selected from published IRIs
Instrumentation
Randomly assigned assessments to
randomly ordered treatment conditions
Reader allowed to utilize preferred
braille mechanics during baseline
assessment
No data on instrument reliability &
validity for this study
Treatment Conditions
Finger Conditions
Hand Conditions
Left
Right
Both
Index
Condition A
Condition B
Condition C
Middle
Condition D
Condition E
Condition F
Index +
Middle
Condition G
Condition H
Condition I
Braille Reading &
Recording Stand
Assessments brailled
on transparent paper
& dots darkened with
marker
Hand & finger
movements videotaped from below the
transparent surface
Oral reading recorded
Data Analysis
Recorded miscues & determined whether
the miscues were significant or not
Calculated CWPM
Tallied reading patch activation in multiple
finger conditions
Determined handedness
Results for
Participant One
Isolated Finger Fluency
80
70
60
50
Symbols
Words
Passages
40
30
20
10
0
Condition A
Condition B
Condition D
Condition E
Total Fluency
90
80
70
60
50
40
30
20
10
0
Baseline
Condition A
Condition B
Condition C Condition D
Symbols
Condition E
Words
Condition F
Passages
Condition G Condition H
Condition I
Pre-Existing Hand & Finger
Preferences
Reading Patch Activation During Baseline
 Symbols = right index
 Words = right index
 Passage = right index
Handedness
 Left on 6 out of 10 tasks
Hand Preferences During
Dual Treatment Conditions
4
3
Both
Right
Left
2
1
0
Symbols
Words
Passages
Finger Preferences During
Dual Treatment Conditions
4
3
Both
Middle
Index
2
1
0
Symbols
Words
Passages
Results for
Participant Two
Isolated Finger Fluency
60
50
40
Symbols
Words
Passages
30
20
10
0
Condition A
Condition B
Condition D
Condition E
Fluency
100
90
80
70
60
50
40
30
20
10
0
Baseline
Condition A
Condition B
Condition C Condition D
Symbols
Condition E
Words
Condition F
Passages
Condition G Condition H
Condition I
Pre-Existing Hand & Finger
Preferences
Reading Patch Activation During Baseline
 Symbols = left index
 Words = left index
 Passage = left index
Handedness
 Right on 10 out of 10 tasks
Hand Preferences During
Dual Treatment Conditions
4
3
Both
Right
Left
2
1
0
Symbols
Words
Passages
Finger Preferences During
Dual Treatment Conditions
4
3
Both
Middle
Index
2
1
0
Symbols
Words
Passages
Results for
Participant Three
Isolated Finger Fluency
90
80
70
60
50
Symbols
Words
Passages
40
30
20
10
0
Condition A
Condition B
Condition D
Condition E
Fluency
200
180
160
140
120
100
80
60
40
20
0
Baseline
Condition A
Condition B
Condition C Condition D
Symbols
Condition E
Words
Condition F
Passages
Condition G Condition H
Condition I
Pre-Existing Hand & Finger
Preferences
Reading Patch Activation During Baseline
 Symbols = left & right index
 Words = left & right index
 Passage = left & right index
Handedness
 Right on 10 out of 10 tasks
Hand Preferences During
Dual Treatment Conditions
4
3
Both
Right
Left
2
1
0
Symbols
Words
Passages
Finger Preferences During
Dual Treatment Conditions
4
3
Both
Middle
Index
2
1
0
Symbols
Words
Passages
Discussion
Preferred method used during baseline
for all participants was the left & right
index fingers but only both fingers
were dominant for 1 participant
Baseline not necessarily the most
fluent method
Discussion Continued
Best fluency for all participants
obtained when using both index
fingers
While the most fluent method is
similar to the preferred method used
during the baseline, patterns of finger
dominance vary across the two
conditions
Discussion Continued
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
Participant with lowest fluency did
poorest on conditions using only the
right hand & demonstrated a slight left
index finger dominance
Discussion Continued
Different pattern emerging than found
by Hermelin & O’Connor
Limitations
Small sample size prevents statistical
analysis
There may be an order effect since the
treatment conditions were the same
for all participants
Limitations Continued
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
Results may be tied more to the
braille mechanics that most closely
approximate the hand & finger usage
patterns they have used for many
years
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An Experimental Replication of Hand and Finger Usage