Maxime Bleau

Background: Though independent mobility has a considerable impact on an individual’s quality of life, employability, and social participation, few studies have examined the impact of specialized mobility services for people with visual impairments (PVI) globally. This study examines the impact of these services on independent travel and how it relates to social determinants of health for adults with low vision and blindness. Methods: PVI 18 years of age or older were recruited via social media platforms or associations for the visually impaired to respond to online questionnaires translated in English, French, Spanish, and Mandarin. Survey 1 included questions related to place of residence, level of functional vision, travel habits, age, ethnicity, employment, and education. Survey 2 included questions related to the types of travel and mobility services received and perceived well-being. Results: Responses were received from 752 PVI in survey 1 and 584 PVI in survey 2 residing in 38 different countries. Only 35.6% of participants received specialized mobility services. Those who were more likely to have received services mentioned their vision is useless for navigation ( p <.001), had an early diagnosis of visual impairment (< 14 years old; p <.05), and lived in urban areas ( p <.001). The reasons for not receiving instruction varied significantly based on the region ( p <.001), with the most common reason being the lack of availability. Those who received these services had higher perceived well-being ( p <.001), economic success ( p <.01), and level of education completed ( p <.01) and ask for assistance less frequently ( p <.05). Conclusions: Specialized mobility instruction is associated with higher independence and well-being of PVI around the world. These services should be made more accessible to promote independent travel amongst PVI and potentially reduce the burden on caregivers and society. Attention should be given to individuals living in rural areas, with a lower socioeconomic status, and a later onset of visual impairment, as many do not have access to these services.

Cognitive maps encode spatial relationships between locations and support flexible navigation. However, how these mental representations form in the absence of visual experience remains unclear. Here, we introduce a multisensory virtual navigation paradigm that allows to track the temporal dynamics of non-visual cognitive map formation. Sixteen early blind (EB), 17 late blind (LB), and 29 sighted controls (SC) learned the layout of a tactile maze. Participants repeatedly performed virtual pointing (estimating directions between locations) and navigation (reaching locations) tasks, which measured cognitive maps across multiple stages of learning. This method also enabled algorithmic inference of cognitive maps, providing insights into how mental distortions are progressively corrected. Although there were no group differences in average navigation performance, EB showed slower knowledge accumulation compared to LB and SC. In addition, both EB and LB had difficulties translating cognitive maps into first-person perspectives, resulting in reduced pointing and cognitive map accuracy. Yet, cognitive map accuracy improved progressively in all groups and a subset of EB and LB achieved expert-level performance with high navigation and pointing precision. In sum, this study provides a scalable framework for tracking alterations in cognitive map formation in blindness and other neurological conditions. Importantly, it demonstrates that cognitive map formation in the absence of vision is experience-dependent and trainable. Spatial disadvantages often observed in EB and LB thus do not reflect cognitive deficits but result from adaptive behavioral strategies constraining the use of allocentric cognitive maps.

Mainstream smartphone applications are increasingly replacing the use of traditional visual aids to facilitate independent travel for people with blindness or low vision. However, little is known about which navigation apps are being used, the factors underpinning these decisions and why apps are not used in certain contexts. The goal of this study was to explore the navigation-based apps used by individuals who are blind or who have low vision, the factors influencing these decisions, and perceptions about gaps to address future needs in navigation. An international online survey was conducted with 139 participants who self-identified as blind or low vision. Findings indicate that the decision to use an app based on artificial intelligence (AI) versus live video assistance is related to whether the task is dynamic or static in nature. Although most participants rely on apps only during unfamiliar routes (60.9%), apps are shown to supplement rather than replace traditional tools such as the white cane and dog guide. Participants underscore the need for future apps to better assist with indoor navigation and to provide more precise information about points of interest (POI). These results provide vital insights for technology developers about the perceived utility of smartphone apps for people with low vision or blindness during navigation. Our results highlight the importance of built-in accessibility features for users with visual impairments. As additional technology-based solutions are developed, it is essential that blind and low vision users, including rehabilitation professionals, are meaningfully included within design.

For people with visual impairments (PVI), understanding space is crucial for independence and tactile maps are useful tools to gain spatial information and improve orientation. However, their popularity and impacts in the PVI population are not yet fully understood. Thus, this study aims to determine the prevalence of tactile map usage and their effects on independent travel and well-being internationally. To do so, two online surveys were completed by PVI (n₁ = 752, n₂ = 510) in 40 countries from which information was collected related to travel habits, spatial abilities, experience with tactile maps, mobility services, and perceived well-being. The surveys revealed that only 17.15% of respondents have had experience with tactile maps and that this tactile map experience was related to better cognitive mapping skills, a higher level of education, a higher perceived well-being and a higher sense of independence (i.e., perceiving the area of living as more accessible, and requiring assistance less often). This study confirms that tactile maps have a positive impact on the independent travel and well-being of PVI around the world, including both individuals with low-vision and blindness, and demonstrates the importance of early tactile map exposure, as tactile maps support the development of generalizable spatial concepts and abilities.

Navigation is a fundamental cognitive ability that relies on the hippocampus, a brain region that is known for its role in spatial representation and memory. In individuals with congenital blindness, the absence of visual input leads to significant neuroplastic adaptations that support alternative navigation strategies. This review examines the structural and functional modifications of the hippocampus in individuals who are blind and explores the broader neural mechanisms underlying their spatial abilities. We discuss how cross-modal plasticity repurposes the visual cortex for navigation, the role of sensory substitution devices in facilitating spatial learning, and behavioral performance in navigation tasks. Additionally, we highlight the implications of these findings for assistive technologies and brain-machine interfaces designed to enhance mobility in blind individuals. By synthesizing recent research, this review provides insights into the remarkable adaptability of the brain in response to sensory loss and underscores the importance of understanding neural plasticity for developing effective navigation aids.

There is a growing body of evidence on practical applications of three-dimensional (3D) printing to support the rehabilitation of individuals with sensory impairments. However, applications in the field of deafblindness, or the combination of vision and hearing impairment, remain scarce. Therefore, the present study aimed to explore actual and potential applications of 3D printing in deafblindness rehabilitation from the perspective of rehabilitation professionals in two focus group discussions that involved orientation and mobility specialists, vision rehabilitation specialists, audiologists, and braille technicians. Participants exchanged on 1) 3D printing applications to address their clients' rehabilitation needs, 2) factors that can impact its integration into their practice, and 3) the ideal logistics for producing and delivering 3D printed products. Educative models and functional adaptations were identified to improve communication, learning, mobility, and independent living skills for individuals with deafblindness. Professionals agreed that the main barriers limiting 3D printing adoption were linked to time constraints and insufficient awareness or knowledge about this technology, while the most crucial facilitator was the promotion of interdisciplinary collaborations with 3D printing experts. The present findings thus emphasize the need for global collaborations, knowledge dissemination, and ongoing research and validation of 3D printing applications to support individuals with deafblindness.

The Open-Science fabrication laboratory movement is an ongoing student initiative at the School of Optometry of the University of Montreal. The pilot project, the OptoFAB, is a collaborative space specially dedicated to producing low-cost material for research purposes based on the Open-Science and Maker movements. It aims to:1.Promote Open-Science and the fast dissemination and replication of research.2.Provide accessible training for students in a multitude of disciplines (i.e., 3D printing, 3D modeling, coding, robotics).3.Encourage interdisciplinary collaborations between the different programs (e.g., research, clinical, engineering).Our laboratory model will benefit laboratories and provide students with more opportunities during and beyond their (under)graduate studies. As students are the next generation of researchers, the Open-Science fabrication laboratory aims to give them more resources to develop multi-faceted skills, improve their self-efficacy and help them build their research careers. This paper describes our model and how we aim to measure our impact ongoingly and to improve the tools and services we put at students’ disposition. We hope that, through this paper, other universities might join the movement and replicate our model within their research programs.

For blind individuals, tactile maps are useful tools to form cognitive maps through touch. However, they still experience challenges in cognitive map formation and independent navigation. Three-dimensional (3D) tactile information is thus increasingly being considered to convey enriched spatial information, but it remains unclear if it can facilitate cognitive map formation compared to traditional two-dimensional (2D) tactile information. Consequently, the present study investigated the impact of the type of sensory input (tactile vs. visual) on cognitive map formation. To do so, early blind (EB, n=13), late blind (LB, n=12), and sighted (SC, n=14) participants were tasked to learn the layouts of mazes produced with different sensory information (visual vs. tactile 2D vs. tactile 3D) and to infer routes from memory. Results show that EB only manifested stronger cognitive map formation with 3D mazes. LB performed equally well with 2D and 3D mazes, and SC manifested equivalent cognitive map formation with visual and 3D tactile mazes. 3D tactile maps therefore have the potential to improve spatial learning for EB and newly blind individuals through a reduction of cognitive overload. Installation of 3D tactile maps in public spaces should be considered to promote universal accessibility and reduce blind individuals’ wayfinding deficits related to the inaccessibility of spatial information through non-visual means.

Additive manufacturing (AM), also known as 3D printing, is a promising tool to produce assistive technology. For instance, individuals with deafblindness (concurrent vision and hearing loss) could benefit from tactile AM-based products as touch may be their main gateway to access information. This study thus aimed to synthesize evidence on the current and potential practices involving AM in the context of deafblindness rehabilitation and to inform healthcare professionals and family caregivers on how AM can improve functioning and quality of life. A comprehensive literature search of ten databases (PsycINFO, MEDLINE, Global Health, PubMed, CINAHL, EMBASE, ERIC, Web of Science, Engineering Village, and Scopus) was performed to identify sources focusing on the use of AM toward rehabilitation goals of individuals with deafblindness. Nine of 1,397 studies met the inclusion criteria. The findings reveal that AM can counter barriers to full accessibility by enabling professionals to produce customized adapted material and communication devices, thus assisting individuals with deafblindness in communication, mobility, and learning. However, this review highlights a need for more AM research, resources, and training: interdisciplinary collaborations with AM specialists thus appear essential in improving rehabilitation services with AM.

In the course of evolution, animals have obtained the capacity to perceive and encode their environment via the development of sensory systems such as touch, olfaction, audition, and vision