The effectiveness of verbal information provided by electronic travel aids for visually impaired persons.
Article Type: Report
Subject: Verbal ability (Research)
Visually disabled persons (Health aspects)
Visually disabled persons (Research)
Electronic traffic controls (Research)
Authors: Havik, Else M.
Kooijman, Aart C.
Steyvers, Frank J.J.M.
Pub Date: 10/01/2011
Publication: Name: Journal of Visual Impairment & Blindness Publisher: American Foundation for the Blind Audience: Academic Format: Magazine/Journal Subject: Health Copyright: COPYRIGHT 2011 American Foundation for the Blind ISSN: 0145-482X
Issue: Date: Oct-Nov, 2011 Source Volume: 105 Source Issue: 10
Topic: Event Code: 310 Science & research
Product: Product Code: 3662373 Controllers, Signal NAICS Code: 33429 Other Communications Equipment Manufacturing
Geographic: Geographic Scope: Netherlands Geographic Code: 4EUNE Netherlands
Accession Number: 272077509
Full Text: Abstract: The effectiveness of different types of verbal information provided by electronic travel aids was studied in a real-life setting. Assessments included wayfinding performance and the preferences of 24 visually impaired users. The participants preferred a combination of route information and environmental information, even though this information did not always result in their optimal wayfinding performance.


Independent wayfinding is a significant and impeding problem for most people who are visually impaired (that is, those who are blind or have low vision) (Marston & Golledge, 2003). During the past two decades, there has been an increase in research on and the development of electronic travel aids to assist people who are visually impaired with navigation. These aids provide either tactile or auditory feedback about an individual's surroundings and information about the route to be followed (for an overview of existing systems, see Roentgen, Gelderblom, Soede, & de Witte, 2008). To develop electronic travel aids into user-friendly assistive devices, it is essential to discover which information people who are visually impaired require to find their way successfully. The focus of the study presented here was on the effectiveness of different types of verbal information that is delivered by electronic travel aids for navigation.

An electronic navigation system can provide information about a route and about the individual's surroundings (hereafter "environmental information"). Route information contains directional information that the user needs to find his or her destination. Environmental information includes references to landmarks in the environment. Landmarks are salient environmental features that can act as anchor points for organizing spatial information in a wayfinding context for all persons, both visually impaired and sighted (Denis, Michon, & Tom, 2007; Golledge, 1999). Environmental information can "help the traveler keep oriented and develop better mental representations of the environment over multiple trips through it" (Loomis, Golledge, Klatzky, & Marston, 2007, p. 188).

It has been shown that safety and independence while traveling can be improved when the names of landmarks and information about the current location (which is mainly environmental information) are provided to persons who are visually impaired (Crandall, Brabyn, Bentzen, & Myers, 1999; Marston, 2002). Gaunet and Briffault (2005, 2008) defined several guidance functions to assist individuals who are visually impaired verbally as they navigated through urban areas. The verbal guidance could be classified as either route information or environmental information. When these guidance concepts were tested by participants who were blind in a real-life setting (Gannet, 2006), part of the environmental information, concerning the current location and orientation of the participants, was provided at the beginning of the routes and then delivered en route on the participants' demand. The results showed that the participants did not often request this information. Other environmental information (the announcements and descriptions of crossings), which were provided en route, turned out to be too wordy and might have overloaded the wayfinding process. The authors suggested that users be trained and stimulated to use the environmental information (Gaunet, 2006).

Steyvers, Van der Woude, and Kooijman (2005) compared the wayfinding efficiency of persons with visual impairments who were given route information to a pre-entered destination in a navigation device either with or without additional environmental information. The additional environmental information was found to not provide the expected advantages to efficient wayfinding. Steyvers et al. explained this finding by suggesting that the additional information may have led to an information overload. The authors predicted that extended use of the two functions (route and environmental information) would reveal an advantage.

Studies of real-life evaluations have not yet sufficiently demonstrated the effect of the combination of route information and environmental information on efficient wayfinding and on users' satisfaction after repeated use. The study presented here evaluated the effect of the repeated use of a guidance system that provides instructions about the shortest route to an indoor destination (route information), as well as information about nearby landmarks (environmental information). The goals of the study were (1) to evaluate the effect of route information, provided by a guidance system versus no guidance system, on the wayfinding performance of persons with visual impairments; (2) to evaluate the effect of additional environmental information on the participants' wayfinding performance; (3) to assess the participants' preferences with regard to the different types of information; (4) to investigate the effect of the repeated use of the guidance system on the participants' wayfinding performance and preferences; and (5) to investigate differences in performance and preference between the participants who were blind and those with low vision.



The participants were 24 persons with visual impairments (15 men and 9 women), who ranged in age from 18 to 65 (mean age: 49 years). Of the 24, 12 were functionally blind, including 8 who had some light perception. The other 12 had low vision (various disorders; visual acuity < 0.5 Snellen notation; LogMAR equivalent 0.3). Sixteen participants used a white cane, 3 used a dog guide and a white cane, 2 used only a dog guide, and 3 did not use a mobility aid. Eight participants had early-onset visual impairments (before age 5). Twenty-two participants had received mobility training in the past. All the participants reported that they usually needed assistance to find their way inside a public building.



The Groningen Indoor Route Information System (GIRIS) was recently developed to guide users who are visually impaired to a destination inside a building and was tested at the University Medical Center Groningen (UMCG). GIRIS consists of active Radio Frequency IDentification (RFID) beacons and a GIRIS receiver. The GIRIS receiver is a Dell Pocket PC that contains an RFID receiver, navigation software (RouteAssist, powered by GuideID, Deventer, the Netherlands), and an earphone that covers only one ear. The RFID beacons were installed at all "decision" points and at all possible destinations in the public halls of the UMCG hospital (see Figure 1). GIRIS guides the user along the shortest route to the destination that has been entered on the GIRIS receiver. Spoken messages are automatically delivered as soon as the user comes within 5-10 meters (about 16-32 feet) of one of the RFID beacons. When the GIRIS receiver identifies an unexpected (off-route) beacon, the route is automatically recalculated, and a new starting message is delivered. GIRIS can deliver two types of information: route information (directional information about the route to be followed to the next beacon) and environmental information (mentioning addresses of clinics and the names of landmarks that are passed along the route). Both types of information can be delivered separately or in combination. Examples of the types of GIRIS information in various situations are presented in Table 1.


The test site was the ground floor of the UMCG (see Figures 1 and 2), consisting of a main entrance hall; two broad (10-15 meters, or about 33-49 feet), covered, main corridors containing entrances to several outpatient clinics; a shopping corridor; and an atrium patio. The test site also included two outpatient clinics located on higher floors. Four trajectories were chosen that could be traversed in either direction, resulting in eight different test routes. The test routes were similar in length (mean length: 146 meters or about 160 yards, SD: 33 meters or about 36 yards), in the number of beacons passed on the way (seven or eight), and in the number of turns to be made (two or three). Four test routes included the use of an elevator. The number of additional addresses and landmarks varied from four to eight per route.

Each route could be walked under one of four conditions:

* condition "R": GIRIS route information only

* condition "R + E": GIRIS route information and GIRIS environmental information

* condition "D": Desk information only

* condition "D + E": Desk information and GIRIS environmental information

In both conditions containing the so-called desk information, a detailed description of the route was read twice to the participant before he or she started walking. The participant was also asked to repeat as much as he or she remembered, and any errors were corrected. Whereas in condition D, the GIRIS system was not used at all, in condition D + E, the GIRLS system was used to provide environmental information en route at the moment that the participant was passing the particular landmark and location. This additional environmental information delivered en route was equivalent to the environmental information that was added to the route information in condition R + E.


In condition D + E, the names of the landmarks and locations that the participant would hear on the way from GIRIS as environmental information were also included in the route description that was provided preroute (for example, "follow the wall, you pass Poortweg [gatewaystreet] 2; at Poortweg 4, where the wall ends, turn right"), whereas in condition D these landmarks were not mentioned (for instance, "follow the wall, when the wall ends, turn right). The mean length of the route descriptions was 103.5 words for condition D and 107 for condition D + E. Under each condition, two test routes were walked covering the same trajectory but in opposite directions. At each session, a participant walked the same routes under the same conditions. Routecondition combinations were distributed evenly among the participants. The order of the routes was varied per session.


Each participant visited the UMCG once a week for three consecutive weeks. The participants were welcomed by two test leaders, who were nine third-year psychology students who were involved in the project as part of their bachelor thesis research. Before the start of the project, the test leaders had received instruction and training with regard to the orientation and mobility of persons with visual impairments at the Royal Dutch Visio, a center of expertise for people with visual impairments, and for doing the observations.

During the first session, the participant's preferred walking speed (PWS) was measured along a 20-meter (or about a 66-foot) trajectory that was free of obstacles. Next, the participant received some instructions about GIRIS and walked three practice routes outside the test area: one route under condition R, one under condition R + E, and one under condition D + E. During the practice routes, the participant could become accustomed to the type of message and could ask questions, and the test leaders could give feedback. During testing, and when his or her PWS was measured, the participant used his or her regular mobility devices, such as a white cane or a dog guide or both.

After instruction and practice, which lasted about 30 minutes, the navigation experiment started. The test leader entered the destination and other settings into the GIRIS receiver. There was a distinctive, glued-on button on the touch screen of the GIRIS receiver that the participants could push to repeat the last spoken message. In all three sessions, a test leader and an observer accompanied the participants while they walked the eight test routes. The test leader always walked closely behind the participant, while the observer filled in an observation form for each route. In case of a technical problem en route, the walking time was paused to reset the system or the messages were read aloud by the test leader at the appropriate locations.

The test leader intervened only if the participant deviated far enough from the route to be out of reach of any beacon that could send him or her back in the correct direction (conditions R and R + E) or when the participant deviated in such a way from the described route that the test leader judged it unlikely that he or she would spontaneously find his or her way back to the route (conditions D and D + E). In these cases, the participant was led back to the last beacon that was passed or, in the case of condition D, to the point where he or she deviated from the original route, and was asked to continue the route. To assess interobserver reliability, eight test leaders judged for 12 situations from the test site whether a participant was walking in the correct direction, deviated from the route but did not need an intervention, or deviated from the route in such a way that an intervention was needed. The Fleiss kappa, applicable to multiple raters and categorical ratings, was 0.64, indicating a substantial agreement (Landis & Koch, 1977).

After the participants completed four routes, there was a short break. After they completed all eight routes, they were asked to rank the conditions according to their preferences. After the third session, the participants were given an additional evaluation questionnaire on which to assess the content and functionality of the messages that were provided by the system for each condition. They gave their answers on a 5-point Likert scale and supplemented them with some clarification. The results of tests related to cognitive mapping skills, administered during the first and third sessions, will be described in a later paper.


Wayfinding performance was characterized by the percentage of preferred walking speed (PPWS) and by the percentage of routes without interventions from the test leader. Walking time was measured from the start of the route until the destination was reached. For the conditions with GIRLS route information, the route started when the first message was given, and the time needed to listen to the messages en route (including repetitions of messages when required by the participant) was included in the walking time. In contrast, for the conditions with desk information, the time started immediately after the desk information was provided. To compensate for this difference, the time that was necessary to listen to one reading of the desk information (mean: 41.3 seconds, SD: 7.1 seconds) was added to the walking time in conditions D and D + E.

Since some participants deviated from the preplanned route and thus walked a longer distance and some stopped walking while listening to the GIRIS messages, the velocity resulting from the walking time divided by the length of the preplanned route was calculated as an indication of the efficiency of navigation. To correct for individual differences in preferred walking speed (PWS) (mean PWS: 1.3 meters per second, SD: 0.22 meters per second), we calculated the percentage of preferred walking speed (PPWS) and used it as a measure of "walking efficiency."

The PPWS and the percentage of routes without interventions were analyzed using a GLM repeated-measures procedure. The four conditions were covered by two factors: System (with or without GIRIS) and Environment (with or without environmental information). This led to a 3 x 2 x 2 x 2 design with Session (3), System (2), and Environment (2) as the within-subject factors and Visual Impairment (2) as the between-subjects factor.

Since one participant failed to attend the third session and another was missing measurements from one condition in the first session, their data were not included in the repeated-measures analyses. These participants were both dog guide users. Of the 22 remaining participants, 10 were blind and 12 had low vision.



The participants' PPWS increased with each session, but remained lower for the blind group than for the low vision group for all conditions and throughout all sessions (see Figure 3): Session: F(2,40) = 29.09; p < .001); Visual Impairment: F(1,20) = 14.27; p = .001). PPWS increased significantly between Sessions 1 and 2 and between Sessions 1 and 3 (Bonferroni-corrected pairwise comparisons: p < .001).

The blind group consistently showed the highest PPWS for the conditions with desk information, while the low vision group showed the highest PPWS for conditions with GIRLS route information (interaction between System and Visual Impairment: F(1,20) = 11.75; p < .01. The factor Environment had no significant effect.


The blind group walked fewer routes without interventions than did the low vision group under all conditions and throughout all sessions (see Figure 4): F(1,20) = 17.70, p < .001. Both groups walked more routes without interventions under conditions with desk information than under conditions with GIRIS route information: F(1,20) = 4.41, p < .05. The percentage of routes without interventions increased with each session: F(2,40) = 20.18, p < .001. Bonferroni-corrected pairwise comparisons showed a significant increase between Sessions 1 and 2 and between Sessions 1 and 3 (p < .05).



In conditions with GIRIS route information, the additional environmental information did not affect the participants' performance. In contrast, in conditions with desk information, the participants seemed to need fewer interventions when they also received environmental information en route. This interaction between System and Environment was marginally significant: F(1,20) = 4.20; p = .054.


During the first session, 18 of the 24 participants were able to finish at least 1 of the 4 routes using GIRIS without interventions. This number increased to 22 out of 23 participants by the third session. If a participant was not able to walk a route without an intervention, he or she would need assistance once or twice during most of the routes. Participants in the blind group needed assistance at most five times per route, while those in the low vision group needed it at most three times. During Session 3, the blind group completed about 60% of the routes without an intervention, while the low vision group barely needed any assistance at all.


In all the sessions, conditions with GIRIS route information were more frequently preferred than those with desk information (see Figure 5): 87%, 88%, and 78% of all participants preferred either condition R or condition R + E in Sessions l, 2, and 3, respectively. Condition R + E was the most preferred condition (61%, 75%, and 61% for Sessions 1, 2, and 3, respectively). Only one participant, a blind guide dog user, opted for condition D. Four participants changed their preference from GIRIS route information in Session 1 to desk information in Session 3, and two participants changed their preference in the other direction. When asked about their least-appreciated condition, most participants chose condition D (63%, 83%, and 86% in Sessions 1, 2, and 3, respectively). They mentioned that it took too much energy to memorize the instructions; they received too much information at once and did not have any information about where they were on the way.

A correlation analysis did not show any significant relationship between the preferences of the participants and the conditions under which their wayfinding performance was the best, as expressed by their PPWS (all p values .05). Differences between the preferences of the blind and the low vision groups were small.


There were no distinct differences between the ratings of the blind and the low vision participants with regard to the contents and the functionality of the messages. Most of the participants were satisfied with the length of the messages, although some would have preferred shorter messages. The messages were rated as easy to understand.

The environmental information in addition to route information (condition R + E) was appreciated by most (n = 15) participants, since it confirmed that they were walking correctly and provided a timely overview of the situation. Some participants (n = 10) also mentioned that they did not always need the information to orient themselves or to reach their destination. One participant described the environmental information as distracting. Most participants (n = 18), however, reported that they found the environmental information a useful addition to the desk information (in condition D + E) in recognizing points and as a confirmation that they were walking correctly.

The participants gave a number of suggestions to improve the messages. For example, more information should be supplied about the distances from one point to another, a warning should be provided soon after the individual starts going the wrong way, and more frequent but shorter messages should be delivered to assure the participant that he or she is walking in the correct direction. The need for tactile guides or lines in the open hallways was also mentioned. Finally, the guide dog users indicated that the messages were not always suitable for use in combination with a guide dog.


The aim of the study was to compare the efficiency of different types of verbal information in assisting people who are visually impaired with wayfinding. Verbal route information was delivered either at the start of a route by the test leader or en route by GIRIS. It could be complemented with environmental information en route, or not, leading to four conditions. In the following, the results are discussed in the order of the research goals mentioned in the introduction.


The participants with low vision were more comfortable and showed the highest walking efficiency (as expressed by PPWS) when walking routes with GIRIS route information (conditions R and R + E), whereas the walking efficiency of the participants who were blind was the highest under conditions when information about the route was provided as desk information (conditions D and D + E). A plausible explanation for this finding is that people who are blind are more familiar with receiving information presented as in the desk condition. They are more used to relying on their memories for longer route instructions than are people with low vision, who can rely to a certain extent on their remaining vision (Long & Hill, 1997). People who are blind have fewer cues for relating the GIRIS step-by step information to their actual positions and surroundings than do those with low vision, while the full description of a route at the start provides them with a schematic frame that can help integrate the instructions in their minds (Denis et al., 2007).

Both groups walked more routes without intervention (they needed less assistance) under conditions with desk information than under conditions with GIRLS route information. We expect that this effect will disappear when longer or more complex routes are used (that is, when the desk information becomes longer and more difficult to memorize). The routes used in this study were rather short.


The results did not support the hypothesis that the inclusion of environmental information would lead to better wayfinding performance: There were no significant effects of the factor Environment. The consistently higher percentages of routes without intervention under condition D + E than under the other conditions suggest a statistically insignificant advantage of the en route delivery of environmental information. Under condition D + E, the environmental information presented en route was also mentioned earlier in the desk information at the start of the route, in which it was explicitly linked to the turns in the route. Therefore, in combination with the desk information, the environmental information might have been more essential for wayfinding than under condition R + E, in which the environmental information was delivered additionally and without a direct relationship to information about turns. This finding is in accordance with those of earlier studies that indicated that the effectiveness of landmarks in route instructions depends on the explicit relationship between the landmarks and the actions to be performed in their vicinity (Denis et al., 2007; Golledge, 1999).


Condition R + E was the most preferred condition in both the blind and the low vision groups. Most of the participants preferred the GIRIS route information over the desk information at the start of the route, even when their wayfinding performance was not better under these conditions; there was no relationship between the participants' preferences and their walking efficiency. Apart from the fact that the participants were more independent with GIRIS, many reported that they found it difficult and fatiguing to memorize the desk information. Furthermore, throughout all the sessions, most of the participants preferred the conditions with environmental information. The participants reported that they appreciated knowing what was around them and liked receiving the information as a confirmation that they were walking in the correct direction. For example, the order of the addresses (such as Poortweg 2, Poortweg 4) confirmed the participants' correct position or direction.

Condition D (desk information only) was preferred only in Sessions 2 and 3 by one user, who was blind and walked with a guide dog. Since the dog remembered the way after the first session, the GIRLS information became redundant in later sessions.


We hypothesized that an advantage of environmental information was more likely to be found after repeated use than on its first use because of a possible information overload on its first use. Apart from a general increase in performance over time for all users and all conditions, we did not find an interaction between repeated use and the use of environmental information. The percentage of participants who preferred a condition with additional environmental information (R + E or D + E) remained similar from Session 1 to Session 3 (74% and 78% in Sessions 1 and 3, respectively).

This lack of effect can be explained by the fact that the extended use was limited to only three trials within three weeks; perhaps a longer period of use would have produced different results. Another explanation may be that the environmental information was not important enough to induce a pronounced advantage. Per route, the addresses of three to six clinics were mentioned along with one or two other landmarks. The inclusion of more landmarks, explicitly related to the actions to be performed en route, may have led to different results.

While GIRIS route information, either with or without environmental information, was preferred by most participants throughout all the sessions, there was a small increase in the percentage of participants who preferred one of the conditions with desk information (13% in Session 1 to 21% in Session 3). This relative change in preference after repeated use may indicate that some participants had become familiar with the routes and that refreshing their memory with the desk information at the start of a route was enough for them to find their way.


The low vision group performed better than the blind group in all the conditions and throughout all the sessions for both the PPWS and the percentage of routes without intervention. As we noted earlier, for the blind group, walking efficiency (PPWS) was better with desk information, whereas for the low vision group, it was better with GIRIS route information. With respect to their preferences for the different types of information and the levels of detail in the information, however, there were no clear differences between the groups. We therefore recommend that an electronic travel aid should offer all available output options, including a complete description of the route in advance (as in the desk information), instead of defining a specific user profile for each user group. The user should be able to decide how much detail and which type of information he or she would like to receive.

Conclusion and recommendations

Even though a combination of GIRIS route information and environmental information did not always result in an optimal wayfinding performance, most participants preferred it. The results of the wayfinding performance and the evaluation of the messages led to the following recommendations for GIRIS route and environmental information:

1. Include more detailed information, making it easier for users who are blind to link the information to their immediate surroundings.

2. Incorporate the distance to the next information point or beacon, preferably in a number of steps (Kalia, Legge, Roy, & Ogale, 2010) and incorporate the type of crossing.

3. Provide more beacons along the route to assure the individual more frequently that he or she is traveling in the correct direction.

4. Include more landmarks in the environmental information that are explicitly related to the actions to be performed.

5. Pay special attention to the route instructions for guide dog users; prepare them preferably in consultation with guide dog instructors and orientation and mobility specialists.


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Else M. Havik, MA, Ph.D. candidate, University Medical Center Groningen and Royal Dutch Visio; mailing address: PO Box 144, 9750 AC Haren, the Netherlands; e-mail: . Aart C. Kooijman, Ph.D., Visio chair of videology, University of Groningen and Royal Dutch Visio, mailing address: Kerkstraat 4, 9321 HB, Peize, the Netherlands; e-mail: . Frank J. J. M. Steyvers, Ph.D., lecturer, Faculty of Behavioral and Social Sciences, Department of Psychology, Grote Kruisstraat 2/1, 9712 TS Groningen, the Netherlands; e-mail: .

This project was cofinanced by The Netherlands Organization for Health Research and Development (ZonMW), de Stichting Bindenhulp en de Professor Mulderstichting. The authors thank GuideID, Deventer, the Netherlands, for the technical support of the development of the Groningen Indoor Route Information System, and the students of the Department of Psychology, University of Groningen, for their contributions to the study.
Table 1
Examples of parts of the GIRIS route and environmental
information in various situations.

Situation               Message                Type of information

At the start of a       You are at the         Route information
route                   reception desk.
                        Stand with your back
                        to the reception

At the entrance to      You are at             Environmental
an outpatient clinic    [Poortweg 5]           information
or elevator, or at a
turning point

When route continues    Go straight ahead      Route information
in the same

When route turns        Turn right [or left]   Route information

At the start of a       Follow the wall on     Route information
route or after a        your right-hand [or
turn                    left-hand] side

Before a crossing       Cross the [street]     Route information

When an obstacle is     Watch out for          Route information
ahead                   [obstacle] in 10

When passing a          [Toilet] or [shop]     Environmental
landmark on the way     or [restaurant] is     information
                        on your right-hand
                        [or left-hand] side

When the destination    Destination reached    Route information
is reached
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