Go to previous article
Go to next article
Return to 2003 Table of Contents
Karen McCall, M.Ed.
Adaptive Technology Consulting and Training Practice
A CCTV, or closed circuit television, is a magnification device for people who are blind or visually disabled. With the increased portability of CCTV technology, it is becoming obvious that a client might need more than one kind of CCTV to be most independent. A stationary CCTV and a portable CCTV might best facilitate access to the most information. A truly portable CCTV might be used at the grocery store to read labels, ingredients and cooking instructions. A stationary CCTV might be used at home as it is integrated with the computer and provides a more stable platform for writing. We need to listen to the clients and hear what their needs are in order to recommend and prescribe the best tool for them.
This paper provides a framework for assessment and training for CCTV's. The approach is client based and holistic. We begin by looking at the types and features of CCTV's and how to match them with the client needs.
Current CCTV Models
Inline -monitor usually mounted on top of camera
Out of line - camera and monitor sit beside each other [monitor is generally a television]
Computer integrated - the CCTV camera uses a computer monitor, either VGA or flat-screen for it's display
Handheld - a small camera usually shaped like a computer mouse, that attaches to a television
Portable - a mouse like camera with a small LCD based display, or can be connected to a laptop computer
Video like - devices that integrate into eyeglasses, look like video recorders, push the envelope of our idea of what a CCTV should look like
Letting the client read using the available features will help guide our assessment process. Listed below are some of the more common features of CCTV's, but these are growing with each new iteration of the product.
False colours , both set and user defined [this feature is for clients who have colour deficits]
Guiding lines - on top or bottom of text, or both top and bottom
Reverse polarity - the capability to view in black text on white background or white text on black background
Freeze frame - the capability to freeze an image such as a prescription, cooking instructions, appliance manuals or recipes for those with motor disabilities or who learning disabilities
Buttons, knobs and ergonomics - are the buttons large enough, have enough contrast, movable by someone with a motor disability?
Writing area - clear, accessible for large hands, small hands, functional enough for the CCTV's that are portable [sometimes writing ability is not as good as with an inline or outline model]
Colour is not included as a "feature". It is especially critical for pre-school and school age children [elementary and secondary] to have access to colour. Colour is how we learn numbers, counting, shapes, geography, history and art appreciation. Even if the child has a degenerative eye condition, the learning of colour concepts is a useful tool throughout their lifetime.
Talk to the client before they come to the assessment. This will give you an idea of where to start in terms of monitor size and features. Some people begin with the smaller monitors and work their way up to the larger ones. If clients have a sense of "failure" because they can't see the smaller monitor it affects the attitude for the rest of the assessment. If, on the other hand, they start at the larger monitor and can really use the smaller one, they feel a sense of success and that their visual disability is more manageable than they thought. This is especially true for people who have just lost vision or whose vision is deteriorating.
As the focus of this resource is on the client and what works for them, this is always the central point of reference and comfort level. Try to make the CCTV assessment as unobtrusive as possible. Find ways of measuring the things you need to without being terribly obvious about it. Clients often feel that they are being "tested" and that any admittance of inability to see anything might mean that they don't get equipment that might help them. Always keep in mind the attitude and comfort levels of the client you are assessing or training.
Reading is one of the most "often missed" activities by people experiencing vision loss. Writing becomes secondary to remembrances of reading childhood books, magazines, or the latest top selling novel. We grow up feeling that books and reading are an integral part of who we are and crucial to our learning process. Not to be able to read, can be, isolating and depressing for clients. We need to be sensitive to this sense of extreme loss during the assessment and training process.
One of the first things to caution client's against is trying to read "War and peace" at the first attempt at using a CCTV. This comment usually breaks the ice and slows clients down to a more manageable reading speed with manageable expectations.
As one of the most common side effects of reading using a CCTV is a sensation of being sea sick, trying to read the entire newspaper or recipe book on the first attempt at using a CCTV often results in it being their last attempt. Training slows client's down and gets them to think about what they are doing. It allows for an adjustment time for the way they are now reading.
We are taught, from our youngest age, when we could first hold a book, that we can put the book in front of us, in our lap or braced against our knees in a tree house, and read quietly looking down toward the pages. For people who are experiencing vision loss, having to read using a table and a monitor breaks this comfortable and "safe" process of gathering information or pleasure reading. So, our physical relationship to print material has been altered and our cognitive acquisition of knowledge and information from that print material has been disrupted. However, our expectations of the technology have not - we want to "read" again, just like we did before.
This is a tall order for even the most experienced trainer. Where to begin. Start with material the client might be familiar with, such as a book they have read before, and have read often. Being able to recognize familiar friends/characters provides an "instant success." It also allows clients to practice their word prediction skills in this new environment. Success at predicting words and being able to "comprehend" what they are reading lowers the stress level and the impossible seems possible. "I might be able to use this thing to read after all!"
Writing is something that is often overlooked in CCTV use and training. It is possible to use a CCTV to write at speeds with the same accuracy and overall "aesthetics" as if you were using reading glasses.
In the beginning, the obstacle to writing is eye-hand coordination. As with reading, we are used to looking in a downward direction when we write. Our physical posture has been established and corrected as we moved through elementary school. Now, we have to have our hands in front of us, on a tray, and be looking in an upward direction. This breaks the physical and cognitive connection between the elements of the writing process.
Once training is completed, it is a good idea to contact the client three or four months down the road to see how they are using their CCTV. This allows them to talk about their success. It also gives your centre/practice some feedback on how your assessment and training process are working for clients. This in turn helps develop new training materials and strategies and builds in accountability measures.
Sample Outcome Based Questions
This presentation is meant as a resource and guideline to encourage you to see and feel the assessment process, the training process and the daily use of a CCTV from a client's perspective. We often know the purely clinical aspects of eye conditions and diseases but forget that people have to live with the results of these conditions and diseases on a daily basis.
The technology, both CCTV's and computer based are tools, nothing more. They are not a total substitution for vision. Just as we use different pens and pencils for different tasks, and outgrow them or use them until they run out of ink or lead, our needs in terms of adaptive technology change as we learn how to use it, how we might be able to use it and the potential it has for providing increased access to the information people often take for granted.
MagniSight web pages offer a document on "Tips and Tricks" to a CCTV assessment at http://www.magnisight.com/home.htm
McCall, Karen, M.Ed., Line art Drawing CCTV Assessment Tool [ includes rationale for drawings], 2001, Karlen Communications, 5 pp.
McCall, Karen M.Ed. "The Box Came Today...Now What Do I Do? A Resource for CCTV Assessment and Training, 2002, Karlen Communications 52pp.
PulseData have created a magnification measurement process which can be used to identify magnification levels http://pulsedata.org
Texas School for the Blind, "Steps for Completing a CCTV Assessment" can be found at http://www.tsbvi.edu/technology/cctv-assess.htm
Go to previous article
Go to next article
Return to 2003 Table of Contents
Return to Table of Proceedings