Determining the Appropriate Reading Medium for Students Who Are Blind, Deafblind, or Have Low Vision — A Tool for Teachers of Students with Visual Impairments (TSVI)
How to Use This Tool
Work through each numbered step in order. For each step, read the question and the considerations listed, then record your observations in the notes field and select your team's response using the Yes / No / Flag options. After completing all six steps, use the Outcomes section to record the team's recommended reading medium. All fields can be completed electronically and the page can be printed using the button below.
Important: This tool supports team discussion — it does not replace a current Functional Vision Evaluation (FVE) or Learning Media Assessment (LMA). Final decisions must be made by an interdisciplinary team led by a TSVI.
Student Information
First name or initials only
Decision Steps
1
Step 1 of 6 — Prerequisites
Does the student have a current Functional Vision Evaluation (FVE) and Learning Media Assessment (LMA)?
Consider the following:
The FVE should document visual acuity, critical print size, and functional reading conditions including lighting and contrast preferences.
The LMA should include observed reading rate, reading stamina, tool use, and medium preferences across a variety of tasks.
Both assessments should be updated at least annually, or whenever reading concerns arise or the student's vision changes.
✔ YES → Proceed to Step 2✘ NO → Stop — conduct FVE and LMA first
2
Step 2 of 6 — Print Access
Can the student access grade-level print at or near their critical print size without excessive magnification?
Consider the following:
Critical print size is the smallest font at which the student reads at their personal maximum speed — not the smallest they can detect (Legge, 2007).
Research indicates that low vision readers require a minimum of approximately 8 characters per line to maintain near-maximum reading speed. Fewer than 8 characters per line is a red flag (Legge et al., 2020).
"Excessive magnification" means magnification that requires horizontal scrolling, severely limits words visible per line, or forces word-by-word reading.
Count the characters visible per line under the student's current working conditions and record the result below.
✔ YES → Proceed to Step 3✘ NO → Flag for Dual Media or Braille — also proceed to Step 4
3
Step 3 of 6 — Reading Rate
Is the student's functional reading rate at or approaching 100 words per minute for sustained text?
Consider the following:
100 words per minute (wpm) is the approximate threshold below which reading comprehension begins to break down for sustained passages (Legge et al., 1985).
Grade-level peer reading rate norms: End of Grade 2 ≈ 90 wpm | End of Grade 4 ≈ 120 wpm | End of Grade 6 ≈ 150 wpm (Hasbrouck & Tindal, 2017).
Research shows large print readers average 1.5 to 2 times slower than sighted peers (Perkins School for the Blind, 2022).
Measure rate on grade-level connected text passages — not isolated word lists.
Consider trend over time: is the gap between this student and peers growing, stable, or narrowing?
✔ YES → Proceed to Step 4✘ NO → Flag for Dual Media or Braille — also proceed to Step 5
4
Step 4 of 6 — Stamina and Fatigue
Can the student sustain print reading for grade-appropriate durations without significant fatigue or avoidance?
Consider the following:
Does the student report or show signs of eye strain, headaches, or discomfort during or after reading tasks?
Does the student voluntarily read print for pleasure or information outside of assigned school tasks? Avoidance of independent reading is a functional indicator, not merely a motivation issue.
Does comprehension or accuracy noticeably decline toward the end of a reading session?
Horizontal scrolling on a screen is a reliable indicator that magnification needs are exceeding what the print medium can efficiently support and is a strong signal to explore alternate media (Perkins School for the Blind, 2022).
Consider whether fatigue will worsen as reading volume expectations increase in higher grades.
✔ YES → Proceed to Step 5✘ NO → Flag for Dual Media or Braille — also proceed to Step 5
5
Step 5 of 6 — Tool Access and Portability
Are the student's print access tools portable, individually prescribed, and usable across all relevant contexts?
Consider the following:
Tools should be available and functional in: general education classroom, specials and electives, testing environments, library, community settings, home, and future post-secondary or employment settings.
Fixed large print materials (one size for all students) are not equivalent to an individually calibrated magnification prescription. Research shows individually prescribed tools produce significantly better comprehension outcomes than standard large print (Farmer & Morse, 2007).
If the student must scroll horizontally on any device to read, this is not a portable, efficient long-term solution.
Consider: will the current tools scale to the reading demands of the next two to three grade levels?
✔ YES → Proceed to Step 6⚑ FLAG → Review tool prescription; also proceed to Step 6
6
Step 6 of 6 — Vision Stability
Is the student's eye condition stable and non-progressive?
Consider the following:
Progressive conditions — such as retinitis pigmentosa, Stargardt disease, or glaucoma — indicate an urgent need to build braille skills now, even if the student currently has functional print access.
Even stable conditions warrant Dual Media consideration if current print efficiency is limited by any of the factors identified in Steps 2–5.
"Stable" does not mean unchanging. Ask about any recent changes in acuity, contrast sensitivity, or visual field, and check the most recent ophthalmology or optometry report.
Early braille instruction consistently produces stronger long-term literacy outcomes than delayed intervention (Wormsley, 2004).
✔ YES — Stable → Proceed to Outcome A or B✘ NO — Progressive → Proceed to Outcome C
Recommended Outcomes
Review the three outcome options below, then use the selection field beneath them to record the team's recommendation.
Outcome A — Continue with Print
Student met criteria in Steps 2 through 6
Ensure tools are individually prescribed — not default large print
Monitor reading rate and stamina each semester
Reassess immediately if rate falls below 100 wpm or gap with peers widens
Provide braille exposure as literacy enrichment even if not the primary medium
Reassess annually with an updated LMA.
Outcome B — Dual Media (Print and Braille)
Student can access print for some tasks but not all
Use print for spot reading and visually rich tasks (maps, graphs, images)
Use braille for sustained reading and writing tasks
Begin braille instruction immediately — do not delay
Dual media is not a compromise; it is a strength-based approach
Most common recommendation for students with moderate low vision.
Outcome C — Primary Braille
Student has a progressive condition, OR
Reading rate is significantly below 100 wpm and not improving, OR
Print access requires scrolling or severely limited words per line
Begin comprehensive braille literacy instruction immediately
Vision may supplement braille for specific tasks as appropriate
Early braille instruction produces stronger long-term literacy outcomes.
Team Recommendation
Key Reminders for All Outcomes
Assessment is ongoing. This tool reflects a moment in time. Reassess with each LMA cycle and whenever academic demands shift significantly or vision changes.
Ability to see print is not the same as reading efficiently. The relevant question is never "can the student see print?" but "can the student read print efficiently enough to meet current and future demands?" (Legge, 2007).
The student's voice matters. Fatigue, avoidance, and expressed preference are functional data — not attitude or motivation problems.
Braille is not a last resort. Early braille instruction consistently produces stronger long-term literacy outcomes than delayed intervention. When in doubt, begin braille alongside print (Wormsley, 2004).
Tools must be individually prescribed. Generic large print is not a substitute for a clinically determined magnification strategy. Individually prescribed tools produce significantly better comprehension outcomes (Farmer & Morse, 2007).
References
Farmer, J., & Morse, S. E. (2007). Project Magnify: Increasing reading skills in students with low vision. Journal of Visual Impairment & Blindness, 101(12), 763–768.
Hasbrouck, J., & Tindal, G. (2017). An update to compiled ORF norms (Technical Report No. 1702). Behavioral Research and Teaching, University of Oregon.
Legge, G. E. (2007). Psychophysics of reading in normal and low vision. Lawrence Erlbaum Associates.
Legge, G. E., Kwon, M., & Boccardo, L. (2020). Reconciling print-size and display-size constraints on reading. Proceedings of the National Academy of Sciences, 117(49), 30973–30982. https://doi.org/10.1073/pnas.2010240117
Legge, G. E., Pelli, D. G., Rubin, G. S., & Schleske, M. M. (1985). Psychophysics of reading — I. Normal vision. Vision Research, 25(2), 239–252.
Lovie-Kitchin, J., Feigl, B., & Faulkner, A. (2005). Investigation into font characteristics for optimum reading fluency in readers with sight problems. Clinical and Experimental Optometry, 88(6), 369–375. https://doi.org/10.1111/j.1444-0938.2005.tb05090.x
Perkins School for the Blind. (2022). Bigger is not always better: Understanding magnification. https://www.perkins.org/resource/bigger-not-always-better-understanding-magnification/
Wormsley, D. P. (2004). Braille literacy: A functional approach. AFB Press.
