VISION RESEARCH NEWS
WINTER 2006/2007
This is a Joint Publication on Behalf of
Further information on articles contained within this publication can be obtained by using the contact points within the articles or by accessing the websites mentioned above.
Contents: Page No:
Completed Published Research:
Thomas Pocklington Trust 3
Royal National Institute of the Blind 5
Guide Dogs 6
VISION 2020 UK 11
Research Plans:
Thomas Pocklington Trust 19
Royal National Institute of the Blind 19
Guide Dogs 19
VISION 2020 UK 19
Other Research News:
Department of Health: Chronically Sick and
Disabled Persons Act 1970 – Research and
Development Work Relating to Assistive
Technology 2005-06 20
Why Research - what research should be done? 20
Office of Disability Issues (ODI) – Monthly Research
Summary November/December 2006 22
COMPLETED PUBLISHED RESEARCH
THOMAS POCKLINGTON TRUST
An Investigation into the circumstances of older people with sight loss: analysis of the English Longitudinal Study of Ageing (ELSA).
This was the first large study to explore the circumstances of those with sight loss in a nationally representative sample of people living in private households. It was conducted by Professor James Nazroo and Dr Edlira Gjonca, Department of Epidemiology and Public Health, University College of London (UCL).
Aims
This study focused on the demographic profile and social circumstances of 11,500 people aged 50 and older in England who had a self assessed visual impairment. It looked at the demography of people with visual impairments, how sight loss relates to other impairments; and the social and economic circumstances of those with such conditions.
Methodology
The project used cross sectional data from the first wave of the ELSA. However, the measure of eyesight was based on a self reported assessment and although this is a nationally representative sample, it covers only those who live in private residences. Because the data presented is cross sectional, causal relationships cannot be assigned with any certainty.
Findings
Whilst there were some limitations of methodology, the findings indicate that people with sight loss face significant inequality. This is a matter of great concern which requires an appropriate policy response. The main findings were:-
- Among the population aged 50 and older, 4 per cent of people report that they have poor vision or are registered blind.
- Over a third reporting poor vision or registered blind have no diagnosis for their eye problems.
- Older people with sight loss are disadvantaged socially and economically.
- Those with poor vision or registered blind are three times more likely to report their health as poor or fair.
- Increasing levels of visual impairment are related to increased risk of falls.
- Visual impairment is strongly related to poverty.
Further Information
Research Findings number 9 is currently available from Thomas Pocklington Trust at A report in the form of Occasional Paper number 9 will also shortly be available
Dementia and Sight Loss
This research examined the information available and issues concerning people who have both dementia and sight loss.
Aims
The report reviewed the research evidence, the number of people affected by the conditions, the problems that those with both conditions may face and areas where intervention may lead to improvements in quality of life.
Methodology
The research was carried out by Richard Trigg MSC, Health Psychologist and Roy Jones FRCP, Professor and Director, Research Institute for the Care of the Elderly, St Martins Hospital Bath. Information was obtained from a wide ranging search of the literature for the period 1981-2004.
Findings
Most strikingly, the review concludes that there continues to be a lack of formal research and reliable data concerning the population in the UK with both visual impairment and dementia; no comprehensive study was found covering both conditions. Few documents address the characteristics and needs of people with both dementia and visual impairment.
The literature review was unable to identify conclusively the numbers of people with both dementia and visual impairment, although it was suggested that about 2% of people over the age of 75 are affected. This figure is likely to be conservative as studies of visual impairment will not have accounted for individuals who are deemed to be untestable and it is likely that this group would have included subjects with dementia.
The review did however highlight areas for potential future research including:-
- Epidemiological studies.
- Assessing the effectiveness of routine assessments.
- The experience and needs of people with dementia and sight loss.
- Research to assess the impact of optimising vision on the occurrence and severity of hallucinations in people with dementia.
- Understanding vision impairments resulting from dementia.
- Improving educational programmes for care staff.
- Review of current models of rehabilitation.
- Environmental design.
- The development of appropriate assessments.
Further Information
Research Findings number 6 is currently available from Thomas Pocklington Trust at A report in the form of Occasional paper number 11 will also shortly be available.
ROYAL NATIONAL INSTITUTE OF THE BLIND
Too little, too late: Provision of school textbooks for blind and partially sighted pupils
Research into the provision of school textbooks in accessible formats for blind and partially sighted pupils was carried out during the summer term in 2006.
Aims
The research aimed:
To establish the methods used by Visual Impairment (VI), or in Northern Ireland, Vision Support (VS) services and schools to obtain textbooks in alternative formats.
To identify issues related to the sourcing, funding and local production of school textbooks in alternative formats.
Methodology
A postal questionnaire survey of VI Advisory services and schools in England and Wales and of VS Services in Northern Ireland was undertaken, along with case studies of VI services in England and Wales. Face to face interviews were also carried out with blind and partially sighted pupils in England, Wales and Northern Ireland.
Findings
- There is evidence that the current system of accessible textbook provision in the UK is complex, inefficient and outdated
- It leads to inconsistency in quality
- The inefficiencies inherent in the system are inconsistent with principles of inclusion and in the view of many teachers, have a negative impact on blind and partially sighted pupils in terms of their educational progress and their social inclusion
- There is a clear need for the system to be revised and brought up to date in a way that makes the most of digital technology
GUIDE DOGS
Functionality and the Needs of Blind and Partially-Sighted Adults in the UK: An Interim Report (Pey T, Nzegwu F and Dooley, G. 2006)
In 2005 the Rehabilitation Project Group (RPG) was jointly established by the Guide Dogs for the Blind Association, the Royal National Institute of the Blind (RNIB), Action for Blind People and the National Association of Local Societies for Visually Impaired People (NALSVI). Its purpose was to work with other statutory and voluntary agencies in the visual impairment sector in order to “enable radical improvement for blind and partially sighted people, through the provision of better rehabilitation services.” It was acknowledged by the RPG that the case for the advancement of rehabilitation services in the UK had to be predicated on a detailed, evidence-based understanding of the nature of the needs of the population, as well as the nature and extent of existing rehabilitation and other related services currently available to blind and partially sighted people. This study was commissioned to provide the required evidence base.
Aims
- To describe the experiences of the registered population of blind and partially sighted people, and specifically how they function, in a range of life situations
- To understand the factors that enable or act as barriers to the achievement of individual priorities
Methodology
The survey was administered in a 70-minute telephone interview to a total of 1428 blind and partially sighted people on lists of voluntary local associations of blind and partially sighted people, Trusts and Social Work departments around the country.
Findings
Home circumstances
59% lived with family, 35% lived alone
Sight condition
7% had some residual vision
24% had AMD, 13% glaucoma, 12% cataracts
56% had experienced deterioration in eye condition over the past year
Needs assessment and services
19% had not been visited by a social or rehabilitation worker to have their needs assessed
Younger people were more likely not to have had their needs assessed
It is estimated that each year, in excess of 6,000 newly registered people in England alone are not getting a needs assessment following registration
Of those who did have an assessment, only 56% were offered services
Younger people were more likely to have been offered services than those aged 75+
More recently registered people were more likely to have been offered services than those registered many years ago
37% had received mobility training and 17% independent living skills training
87% who had received services believed these met their needs
where services had not met needs, common issues were the assessment process itself, inadequate information about type and location of services, limited scope of services in employment and mobility, and that services not inclusive particularly for younger people, minority groups and mothers with children
Low vision aids
71% were provided with low vision aids at a low vision clinic – of these 40% had received some training in their use
49% of respondents had acquired low vision aids through a non-clinic route, and here the training rate was much lower
Independent living skills (ILS)
79% had difficulties with identifying food and medication labels
More than 50% had difficulties dealing with mail, shopping, and setting the controls on household appliances
Braille users reported less difficulty than non Braille users in telling the time and setting the controls on household appliances
50% of under 40s reported difficulties making friends vs 32% aged 80+
Difficulties with ILS were not associated with age, physical health or service provision. They were associated with gender, confidence, general mental health, amount of residual vision and mobility
Mobility
38% had conditions other than their sight condition that made it difficult for them to move around
A significant number said steps or stairs were a particular problem when moving around their own home environment
71% went out by themselves at least once a week, but 18% said they were never able to go out alone
39% of those who never went out alone were 75+
Barriers were fear, lack of confidence, or presence of obstacles in the street
67% used at least one type of cane
79% of 60-80 year olds used a cane vs 54% of under 40s
16% were current guide dog owners – an over representation as in the general VI population the proportion is around 2%
Only 2% used electronic travel aids (ETAs)
37% had received some kind of mobility and/or orientation skills training
26% of those who had not received it felt it would be useful to them
The majority who used tactile pavings found them very useful or invaluable
Significant factors in ease of mobility in a variety of situations were confidence, mental well-being and physical health. Whether they had received mobility training was not a significant factor in any mobility situation
Guide dog owners reported less restricted mobility than non guide dog owners
Public transport
Substantial difficulty was reported in using all forms of public transport – taxis were the easiest to use and the underground the most difficult
On average, women report more difficulty than men
Higher mental health scores are associated with lower Public Transport difficulty scores
Guide dog ownership is associated with lower Public Transport difficulty scores
Pregnancy and childbirth (experiences over the last 20 years)
51% felt the antenatal support met their needs as a blind or partially sighted person and 62% felt their post natal support met their needs
83% felt they were kept informed and participated in decisions during their pregnancy and labour
most difficulties were as result of lack of staff awareness on issues to do with needs of people with VI, sometimes exacerbated by non-disclosure by the person with VI about the condition of their vision
Education
17% of working age respondents were educated to degree level vs 16% of the general UK population
39% had no qualifications vs 18% of the UK population under age 60
The data suggest that legislative advances and heightened social awareness in recent years have had a [positive] impact on the educational experiences of blind and partially sighted people, BUT
Educational provision urgently needs to ensure that students are prepared for the outside world:
Equipped with appropriate social skills, including building their self confidence and levels of empowerment
Better and more effective careers advice and options for HE
Employment
29% of those aged under 60 were in paid employment
Of those employed, 31% were educated to degree level or above and 6% had no qualifications
Respondents identified need for action to improve employment rates by:
Information dissemination
Education of key stakeholders
Changes in training approach and content of programmes designed to support blind and partially sighted people into work
Empowerment of blind and PS people, beginning with children but also through targeted government policy and action
Quality of life
Self confidence plays a critical role in the enhancement of functionality and bringing about greater levels of social inclusion in people’s communities
29% did not feel socially isolated at all
20% felt substantially to completely cut off from their surroundings – this was most marked in the younger age groups
There is an association between older age, greater mobility, greater residual vision, greater mental health component scores and an enhanced quality of life
Leisure activities
A wide range of hobbies and pastimes were reported
31% reported listening to music, 26% reading and 14% outdoor activities such as walking or rambling
21% visited friends, 17% went to the theatre or concerts and 16% dined out
Computers and mobile phone usage
90% of under 40 years used mobile phones vs 23% aged 80+
Computer ownership and usage were somewhat higher than the general UK population [controlled for age?]
Up to 44% used a PC, 52% have access to one in their home
70% of those who use a computer have access to the internet
Access to information
Local societies, local authorities, RNIB and family emerged as significant sources of information and support to this group
What is needed?
About 50% said there were things they needed but could not get. These were:
Low vision and communication aids (particularly mobile phones)
Most commonly mentioned single device was CCTV
About 33% wanted hardware or software for PCs
Expense was often a barrier to these items
Single most important thing overall was greater awareness/understanding from the general public
Other responses related to employment, increase in finances, access to various forms of information (including acquiring, and receiving training on computers), and support – emotional and practical
Further Information
Copies of the report are downloadable from Guide Dogs website at the following link:
Rehabilitation Project Group (RPG) Consultation
The RPG launched its consultation exercise in December 2006, with the publication of the report Independence and well-being in sight - Developing the vision, following its year long investigation into the services available to blind and partially sighted adults in the UK. The consultation exercise seeks the views and encourages the participation of as many organisations and individuals as possible in order to inform proposals on the content and delivery of services to blind and partially-sighted adults. It is not just open to those who use or provide specialist visual impairment services, but to people in the wider community. The consultation period runs to 28 February 2007.
Further Information
The report and consultation documents are downloadable from Guide Dogs website at
For further details please contact: Public Policy and Campaigns (RPG Consultation), Hillfields, Burghfield Common, Reading RG7 3YG
VISION 2020 UK
Network 1000: Opinions and circumstances of visually impaired people in Great Britain: report based on over 1000 interviews (Graeme Douglas, Christine Corcoran, and Sue Pavey, VICTAR, University of Birmingham,August 2006)
Aims
To establish a sample of 1000 people who are registered as blind or partially sighted which is as far as possible representative of the visually impaired population in the UK, and then to begin to consult them on a range of issues. The sample has been built up using a rigorous statistical approach (stratified random sampling – weighted in relation to age to ensure a spread of participants across different age groups) to give authority to the results and enable them to be generalised.
Methodology
The 1007 research participants are all registered blind or partially sighted people who live in Great Britain. This sample was taken from the registers of blind and partially sighted people held by 20 social services departments in England, Wales and Scotland. The participants were recruited by sending out information packs containing details of the project in print and tape format to approximately 6,000 people.
This sampling process was carefully designed to generate a ‘random sample’ stratified and weighted for age. This means that the sample is statistically robust (‘unbiased’), while still containing a range of people of different ages. The sample contains approximately equal numbers of participants in five different age groups: 18-29 year olds; 30-49 year olds; 50-64 year olds; 65 to 74 year olds; and 75 years and upwards. The sampling means that the information gathered from the sample can be statistically generalised to the visually impaired people on the registers of blind and partially sighted people in England, Wales and Scotland (approximately 360,000 people).