Opportunities for Supporting Self-efficacy Through Orientation & Mobility Training Technologies for Blind and Partially Sighted People

Abstract

Figure 1: Factors that influence self-efficacy belief of blind and partially sighted people Orientation and mobility (O&M) training provides essential skills and techniques for safe and independent mobility for blind and partially sighted (BPS) people. The demand for O&M training is increasing as the number of people living with vision impairment increases. Despite the growing portfolio of HCI research on assistive technologies (AT), few studies have examined the experiences of BPS people during O&M training, including the use of technology to aid O&M training. To address this gap, we conducted semi-structured interviews with 20 BPS people and 8 Mobility and Orientation Trainers (MOT). The interviews were thematically analysed and organised into four overarching themes discussing factors influencing the self-efficacy belief of BPS people: Tools and Strategies for O&M training, Technology Use in O&M Training, Changing Personal and Social Circumstances, and Social Influences. We further highlight opportunities for combinations of multimodal technologies to increase access to and effectiveness of O&M training.

Full text

Opportunities for Supporting Self-efficacy Through
Orientation & Mobility Training Technologies for Blind and
Partially Sighted People
Maryam Bandukda12, Catherine Holloway12, Aneesha Singh1, Giulia Barbareschi1, Nadia Berthouze1
1UCL Interaction Centre, 2Global Disability Innovation Hub
{m.bandukda; c.holloway; aneesha.singh; giulia.barbareschi.14; n.berthouze}@ucl.ac.uk
Figure 1: Factors that influence self-efficacy belief of blind and partially sighted people
Orientation and mobility (O&M) training provides essential skills and techniques for safe and independent mobility for
blind and partially sighted (BPS) people. The demand for O&M training is increasing as the number of people living with
vision impairment increases. Despite the growing portfolio of HCI research on assistive technologies (AT), few studies
have examined the experiences of BPS people during O&M training, including the use of technology to aid O&M training.
To address this gap, we conducted semi-structured interviews with 20 BPS people and 8 Mobility and Orientation Trainers
(MOT). The interviews were thematically analysed and organised into four overarching themes discussing factors
influencing the self-efficacy belief of BPS people: Tools and Strategies for O&M training, Technology Use in O&M
Training, Changing Personal and Social Circumstances, and Social Influences. We further highlight opportunities for
combinations of multimodal technologies to increase access to and effectiveness of O&M training.
CCS CONCEPTS •Human-centered computing ~ Accessibility ~ Empirical studies in accessibility • Human-centered
computing ~ Human computer interaction (HCI)~Empirical studies in HCI

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Additional Keywords and Phrases: Orientation and mobility training; self-efficacy; blind and partially sighted people
1 Introduction
Although a large number of the 2.2 billion people living with vision impairment are due to refractive errors and therefore
easily correctable, the number of people who live with uncorrectable vision impairment and blindness is increasing,
partially due to the ageing population, and is expected to triple by 2050 [10]. The leading causes of blindness in adults
are age-related macular degeneration, cataract, diabetic retinopathy, and glaucoma. Vision loss can occur suddenly or
develop over a long period of time and can either be present at birth or acquired later in life. Vision loss affects multiple
domains of life as people depend on vision to integrate sensory information and a loss of vision can make it more
challenging to perceive and create mental maps of the environment, especially for people who lose their vision later in
life [25, 71]. Therefore, vision loss is an evolving challenge that requires significant adjustments to people’s way of
living.
To overcome the challenges related to mobility, in the UK, BPS people are offered orientation and mobility (O&M)
training to support the learning of independent life skills including developing safe, independent mobility and learning
strategies for familiarization with one’s surroundings. O&M training is delivered by qualified mobility and orientation
trainers (MOT), also known as habilitation specialists and mobility instructors. O&M training focuses on the acquisition
of skills and strategies necessary to complete daily activities and is often provided only at specific points in BPS people’s
life (e.g. at school [67]). Furthermore, the availability of continual support for adults in response to their deteriorating
vision is severely limited – in the UK, only 17% of people are offered emotional support, 27% are in employment, 39%
struggle to make ends meet, and 31% are rarely or never optimistic about their future [39].
Traditional ATs are now complemented with mobile apps that support better route planning and spatial awareness
(e.g., Blindsquare
1
, Soundscape
2
, Lazarillo
3
) and problem solving (e.g., BeMyEyes
4
, Aira
5
) and a growing number of
different AT solutions, such as smart canes [7, 47] and wearable sensors [38], which have been developed to help
increase the ease of mobility for BPS people. These newer technologies, however, are often not integrated into formal
O&M training, due to lack of awareness and limited resources of many of the training programs [21]. Moreover, the
focus of O&M training is subtly different to that of new digital technologies. O&M training aims to develop the skills
and the self-efficacy for independent mobility and whilst new technologies aim to make it easier to navigate without
necessarily building the confidence and self-efficacy of the user.
To better understand how technology can support access to and delivery of O&M training, we conducted semi-
structured interviews with 20 BPS people and 8 MOTs. What emerged from their accounts was a strong desire to develop
and maintain self-efficacy and confidence through changing life circumstances. Our findings demonstrate that self-
efficacy is influenced by the acquisition and the adaptation of O&M skills and by changing personal and social
circumstances (illustrated in Figure 1). In this light, O&M training becomes more than a single learning experience
situated at a particular point in life and is instead an evolving and personalized experience taking place across people’s
lives and within specific contexts. This calls for a rethink of how technology is designed to support self-efficacy through
in O&M training for BPS people especially as the O&M needs of people change over time. Our contributions in this
paper include:
• An in-depth insight into the factors which affect O&M training, including the role of technology, and how
these impact self-efficacy beliefs of BPS people
• An exploration of the intersections of the social network, life events and O&M challenges which impact
self-efficacy. Additionally, we explore the crucial role of O&M training in supporting self-efficacy and
confidence in mobility for BPS people.
1
https://www.blindsquare.com/
2
https://www.microsoft.com/en-us/research/product/soundscape/
3
https://lazarillo.app/
4
https://www.bemyeyes.com/
5
https://aira.io/

3
• Evidence of multisensory nature of O&M training and a discussion on the possible future directions for
technology design to support development and maintenance of self-efficacy belief across changing
circumstances.
2 Related Work
Below we review the literature on habilitation and accessibility research, building on the extensive work on O&M
rehabilitation practices and AT for supporting independent mobility of BPS people.
2.1 O&M Training
Orientation and mobility (O&M) training refers to the teaching and learning of skills and techniques for safe and
independent travel by blind and partially sighted people [74]. It aims to develop functional mobility and independent
living skills by integrating the O&M learning in activities of daily living (ADLs) which are carried out in the home, at
school, and in outdoor settings. O&M training is often delivered in different formats to children and adults. For children
with congenital blindness, who often experience developmental delays [17], an MOT works with children and parents to
support the development of the physiological, sensory, and cognitive skills required to understand, move around, and
interact with the environment. For adults, the O&M training aims to improve self-management in ADLs and problem-
solving through goal setting and the development of self-efficacy in functional mobility [58].
2.2 Self-efficacy
Self-efficacy is defined by Bandura as one’s belief in their capabilities to perform a given task [4]. According to
Bandura [4] and Rosenthal [59], the perception of self-efficacy is driven from four main sources; performance
accomplishments, vicarious experience, verbal persuasion, and emotional and physiological states; each having a varying
influence on self-efficacy belief. Performance accomplishments in past experiences have the highest influence on the
individual’s self-efficacy [2]. As self-efficacy perception is evolving, past performance on a similar task can affect an
individual’s belief about their ability to perform the task — previous successes raise the self-efficacy belief whereas
previous failures lower it [4]. Cmar [18] suggest that, in O&M training, age-appropriate goals and increasingly difficult
challenges are important to progressively develop the learner’s O&M skills and confidence in goal attainment. Vicarious
experiences modelled by others also affect how the individual perceives themselves to perform in an activity. Studies
indicate that the impact of the vicarious experience is stronger if the observer considers the actor to have similar abilities
to the observer– the greater the similarity, the stronger the effects of success and failure on the observer’s perceived self-
efficacy [1, 24, 36]. Irvin and Inouye [15] found that the impact of models’ perceived similarity in the competence of the
observer’s perceived self-efficacy in both success and failure scenarios. Jang et al. conducted studies on virtual vicarious
experiences through avatars and found that avatar self-similarity influenced the player’s mastery experience and general
self-efficacy in gameplay [36]. Research on behavior change and physical activity also suggests that observers perceive a
higher level of self-efficacy when faced with actors of similar abilities who succeed in an activity [40]. Cmar [18]
suggest that successfully employed BPS individuals can share their experience and serve as role models for young BPS
people to develop self-efficacy belief and positive outcome expectations from their training and aspiration to pursue
independent living. Verbal persuasion from O&M instructors, family members, and peers is effective in boosting the
confidence in the short-term to improve performance outcome but is less effective in building a long-term self-efficacy
belief as a sole strategy [4]. Bandura further emphasized that the impact of verbal persuasion on self-efficacy varies
significantly depending on the trustworthiness and credibility of the persuader [4]. Finally, research on chronic pain [65]
has shown that emotional and physiological states, such as fear and anxiety may lower the individual’s perceived self-
efficacy and confidence in their capabilities. Hence, strategies to manage fear, anxiety, and stress related to O&M
training in BPS people are employed by MOTs, including, guiding the learner through verbal instructions, adapting the
training plan, and reducing walking speed [74].

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O&M skills are important to develop self-efficacy in mobility and support independent living. Research shows that
higher self-efficacy belief in BPS people is linked to higher post-secondary education rates, employment, and better
overall quality of life [18, 78]. A positive self-efficacy belief has also been found to improve an individual’s judgement
of their capabilities, personal agency, motivation, and affective self-regulation [5]. Studies have also demonstrated a
positive association between the O&M training and BPS individuals’ mobility skills, independent use of public
transportation [19], and their performance in attaining and maintaining employment [9, 18, 27]. O&M training underpins
the development BPS people’s self-efficacy beliefs through progressive goal-based learning of O&M skills, opportunities
to observe and compare performance with others, verbal persuasion and quality relationship with the MOT, and
strategies to manage emotional and physiological stress (refer to Table 1).
Table 1: Self-efficacy Factors and Strategies for O&M Training
Factor
Definition and Examples in Literature
Strategies for O&M Training
Performance
accomplishments
Self- assessment of accomplishments which are
raised or lowered by historic perceived
achievements.
Age-appropriate goals and increasingly difficult
challenges in O&M skills training (e.g. learning to
navigate small indoor spaces to large outdoor spaces)
[18].
Vicarious experience
Alter efficacious beliefs through transmission of
competencies and comparisons with attainment of
others [4]. For example, observing others of
similar abilities perform a physical activity task
motivated others (‘if they can do it, so can I’)
[40].
Opportunities to observe and listen to experiences of
BPS role models and compare performance with
others can help develop a sense of competition and
motivate the learner to work harder and practice their
O&M skills.
Verbal persuasion
Encouragement or discouragement from others.
Receiving positive feedback and encouragement
raises self-efficacy belief [72]. Supportive
feedback from mentors and peers is linked with
higher self-determination in BPS individuals [52].
Positive feedback, encouragement and reassurance
from MOT, family members and peer group can help
learners overcome self-doubt and raise self-esteem.
Emotional and
physiological states
Stressful and taxing situations generally elicit
emotional response such as fear and anxiety [4].
Many BPS people (particularly those who
experience sight loss as opposed to being blind by
birth [34]) experience fear of physical injury and
getting lost [7]. Also common is the anxiety and
stress related to making mistakes, shame and
embarrassment and negative attitudes from the
public [34].
MOTs employ systematic desensitization strategies
to overcome anxiety and fear in training by gradually
exposing the learner to stressful situations with
increased level of support [76], reduce the walking
speed to gradually help the learner gain confidence.
2.3 Technologies for O&M
The majority of existing O&M technologies aims to support the functional needs of BPS people, such as travelling from
one point to another. Examples of these systems include mobile apps to support pedestrian route navigation,
transportation, spatial awareness and wayfinding [48, 50, 75]. Notably, accessible mainstream navigation and
transportation apps such as Google maps, Apple maps, Uber, Ola are also used by BPS people for independent mobility
[38]. Furthermore, smart canes [12, 73] and autonomous navigation robots [12, 23, 29] have been developed to extend
the mobility support in complex unfamiliar environments (e.g. airports [28]). Most of these devices use multisensory i.e.,
vibrotactile and auditory feedback to alert the BPS people user of obstacles and to indicate a change of direction when
leading along a route [29].

5
Human-assisted commercial applications BeMyEyes [8] and Aira [35] have become increasingly popular in the BPS
people community. These mobile apps are operated by volunteers (BeMyEeyes [8]) and trained agents (Aira [35]) and
use mobile phone camera to provide sighted assistance to BPS people. As many BPS people depend on sighted support
in homes and outside, human-assisted apps provide opportunities for BPS people to become more independent in
activities of daily living (ADLs) (e.g., as cooking, grocery shopping, etc.) and mobility. Automated sighted assistance
apps such as SeeingAI [62] and TapTapSee [69] are among the new wave of artificially intelligent mobile technologies
that use computer vision to support independence of BPS people in ADLs, from reading books and labels, to identifying
currency notes, colors, and describing photos of people and the environment.
More recently, Augmented and Virtual Reality (A/VR) [44, 51, 55, 57, 63, 79, 80] have been used to supplement
O&M training by creating a virtual environment for BPS people to practice their skills and receive multisensory
feedback similar to real life navigation with a long cane. For example, Canetroller [80] simulates navigation with a long
cane for BPS people in VR by providing vibrotactile and spatial 3D auditory feedback as the cane interacts with different
elements in the VR environment. Canetroller demonstrates the potential of VR assistive technologies in creating a sense
of presence and providing a safe environment for exploration. Lahav et al. [42] used a force feedback Phantom® [54]
haptic device to enable the participants to navigate a VR environment using an avatar. The participants used the
Phantom® stylus to control the avatar’s movement on an unfamiliar VR map. The findings from this research suggest
that VR environments can be used to complement the traditional O&M training by allowing BPS people to build
cognitive maps of unfamiliar routes. Mott et al. [49] hypothesize that VR could support self-efficacy of BPS people by
allowing MOTs and BPS people to explore complex environments such train stations, unfamiliar education and work
settings, by virtually previewing training routes prior to travelling to increase familiarity. Additionally, auditory A/VR
reality applications enhance spatial awareness and support mental mapping of the environment by announcing functional
information [11, 26, 32, 41], i.e., turn-by-turn instructions, building entrances, points of interest, and road intersections.
These studies indicate the growing research on ATs for supporting independent mobility of BPS individuals and
efforts to support O&M skills through technology. The literature reviewed also highlights that O&M training is essential
for developing self-efficacy and self-confidence to maintain an independent lifestyle. We build on this growing body of
research to identify opportunities for technology to support BPS people’s self-efficacy in independent mobility through
changing life circumstances.
3 Methods
3.1 Participant Recruitment
We conducted semi-structured interviews with BPS people and MOTs who provide O&M training, and family members
of BPS people. A total of 28 participants - 8 MOTs (1 male, 1 partially sighted) and 20 BPS people (aged 25 – 65 years)–
refer to Tables Table 2Table 3 participated in the interviews. The MOTs had formal qualification in habilitation and
O&M training, were employed by the local authorities in the United Kingdom and worked between 15 (part-time) to 70
(full-time) simultaneous cases (full-time). All participants were recruited through authors’ personal networks, social
media, and non-profit organisations. Interviews were conducted remotely over the phone, Skype, Facetime, and Zoom
according to participants’ preference, were audio recorded and lasted between 30 and 80 minutes. Twenty BPS people (9
female) had varying levels of residual vision; 50% had total blindness, while the other 50% had vision varying from light
perception to partial sightedness; 70% had congenital vision impairments (Table 3).
Participants responded to the study advertisement by email and on Twitter direct message. Further information about
the study in the form of an information sheet and a consent form was sent to the participants prior to the interview. The
information sheet and consent forms were created in MS Word and emailed to all participants; some were signed
digitally and returned via email. Verbal consent protocol [14] was used for a majority of the participants to ensure full
accessibility of the study. As part of this procedure, participants answered questions at the beginning of the interview
confirming their age (18+), consent to participate in the study, and consent to be audio recorded. Any questions raised
were answered to the participant’s satisfaction before moving forward with the interview; verbal consent was recorded

6
by the first author. Ethical approval was obtained from the university departmental ethics committee (anonymized for
review).
Table 2: O&M Specialists (MOT) Participants
P#
Gender
Experience
Navigation technologies used
MOT1
F
18 years
Not mentioned
MOT2 (Partially Sighted)
F
32 years
Google Maps, CityMapper
MOT3
F
15 years
Google Maps, CityMapper
MOT4
M
5 years
Lazarillo, TapTapSee
MOT5
F
8 years
Moovit, SeeingAI, Tactile
Maps and Models for
understanding layout
MOT6
F
10+ years
Google Maps
MOT7
F
10+ years
Google Maps
MOT8
F
5 years
Tactile Maps

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Table 3: Blind and Partially Sighted Participants
P#
Age
Gender
Age at VI
diagnosis
Visual function
Mobile phone
Navigation technology used
Primary mobility
aid
P1
28
M
14
Partially sighted
iPhone
BlindSquare, Clew
Guide dog
P2
40
F
0
Totally blind
iPhone
Bus Checker, BeMyEyes
Long cane
P3
62
M
0
Totally blind
Not specified
Not mentioned
Long cane
P4
38
F
0
Albinism, partial vision,
No depth perception
Not specified
Not mentioned
Long cane
P5
42
F
0
No vision in right eye;
2% in right eye
iPhone
RNIB Navigator
Long cane
P6
25
M
0
Partially sighted
Not specified
Not mentioned
Guide dog
P7
35
M
0
Partially sighted
Not specified
Not mentioned
Symbol cane
P8
56
M
0
Partially sighted; night
blindness
Not specified
Not mentioned
Guide dog
P9
61
M
30s
Totally blind
Android
NotNav
Guide dog
P10
36
M
24
Totally blind
iPhone
Not mentioned
Guide dog
P11
60
M
0
Totally blind
iPhone
RNIB Navigator, Soundscape
Guide dog and long
cane
P12
36
F
0
Totally blind
Not specified
Not mentioned
Guide dog
P13
65
M
0
Totally blind
Not specified
Soundscape
Guide dog
P14
40
F
10
Totally blind
iPhone
BlindSquare, Soundscape
Long cane
P15
50
M
0
Totally blind
iPhone
Victor Trek
Long cane
P16
40
M
5
Totally blind
iPhone
Not mentioned
Long cane
P17
26
F
0
Light perception, color
contrast
iPhone
Not mentioned
Long cane
P18
25
F
0
Light perception, large
shapes
iPhone
Apple maps, Soundscape
Long cane
P19
35
F
0
Light perception
iPhone
Apple Maps, Google Maps
Long cane
P20
40
F
17
Light perception, color
contrast
iPhone
Not mentioned
Guide dog
3.2 Data Collection and Analysis
The semi-structured interviews with MOTs explored their experiences delivering O&M training, the challenges they
encounter during training and strategies to overcome these, and their perception of mobile technologies in supporting
O&M training. In the interviews, we asked BPS people about their experience of O&M training, their sociocultural
environment, the technologies they used for mobility, and the impact of O&M training on their confidence and
independence in daily life. Interviews were transcribed and thematically analyzed [13] using inductive approach to
coding which evolved throughout the analysis process and were collated to develop common themes across the data.

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4 Findings:
4.1 Tools and Strategies for O&M Training
The MOTs employed a variety of tools and strategies (summarized in Figure 2) in O&M training, ranging from
teaching long cane usage, environmental familiarization to using mobile apps for outdoor spatial awareness, route
learning and public transportation. When conducting an outdoor route training MOTs carried out an environmental
assessment. The purposes of this were to identify multisensory landmarks and cues along the route which could support
students in mentally mapping the environment, and identifying challenging points such as road crossings, narrow
pavements, and crowded spaces which could hinder the learning process. MOTs emphasized the importance of teaching
the safest (not the fastest) route to ensure safety of BPS people when navigating independently - “even if it’s a little bit
longer and I would teach the safest route” (MOT4).
The participants described how they used non-visual senses to navigate and make sense of their surroundings. In
O&M training, multisensory landmarks and clues were important to help students orientate and learn routes. MOTs noted
that they often used olfactory clues such as coffee shops and bakeries when teaching a route; they built these clues in the
route to help the students identify their surroundings and their location along the route – “we would stop and smell and
see if we could work out where we were on the route” (MOT3). MOTs also used auditory clues such as traffic sounds and
water bodies as clues to guide the students along the route – “They know they're going the right way because they're
heading towards that sound” (MOT3).
Tactile landmarks (e.g., road crossings, lamp posts, phone box, etc.) were used to divide the route; at which point the
students would take an action such as cross the road or turn right or left. MOTs divided the training route into sections
that could be easily learned by the students over a few sessions, and then gradually increased the route length and added
more landmarks as the students became more confident in navigating the route independently. MOTs also used tactile
markers and maps to support indoor and outdoor mapping skills. Students were encouraged to create tactile maps using
LEGO bricks to explore the environment and enhance their cognitive maps of the space.
“I’ve used LEGOS for turning right turning left and to describe crossroads.” (MOT8)
The MOTs placed the tactile markers at key points in indoor environments such as door handles, handrails, and on the
floor to indicate different rooms and floors in the building enabling students to locate different classrooms and find their
way around the school. These markers could also be employed to create tactile guidelines along the floor to help children
learn the routes around the schools. For example, screws of different shapes were used along the handrails to help
children learn the routes on different floors.
Tactile markers were also useful as landmarks in indoor and outdoor route learning and to understand the travel
distance (measured in time travelled, number of trees, walls, and hedges - changes in the path) between markers. MOTs
installed these markers at certain distances in the route to enable the student to gauge the distance between the markers
and therefore understand the overall length of the route. This was particularly useful on routes which didn’t have natural
landmarks, i.e., “no changes in the shoreline”. MOT3 noted that the tactile markers also made route learning more fun
and engaging for students. Once the students became competent in their route navigation, the MOTs gradually removed
the tactile markers from the route.
“I put certain articles on it like a treasure hunt. We developed some little things to give him some
support in learning that part of the route... Then, I took them away gradually... We use trees and
things, all sorts, walls, brick walls, hedges because there’s lots of different changes on your
shoreline [pavement edge].” (MOT3)

9
Figure 2: Common O&M Training Strategies
4.2 Technology Use in O&M Training
4.2.1 MOT’s Knowledge of Technology
Technology has been part of O&M training and as mentioned in previous section, MOTs use a variety of low and
high-tech tools and strategies including tactile indicators and maps, as well as sounds as landmarks and clues. Some
participants also acknowledged that technology has been a part of O&M training since before the wide availability of
modern smartphones. P10 recalled using voice recorders and Dictaphones for recording landmark-based navigation
instructions for memorizing the routes (similar to today’s navigation apps), magnifiers to support wayfinding for low
vision learners, and tactile maps for mental mapping. This is particularly useful for younger learners or those who may
be used to mobile assistive technologies and aids in the learner’s sensorimotor functioning and self-efficacy for
independent O&M training.
Despite this, participants agreed that the use of navigation technologies was contingent on the MOTs’ expertise and
perception of technology. Some BPS participants reported that there was little encouragement from the MOTs to use
technology for mobility – “whilst they recognize the technology, there’s not really a huge push to say it may enhance
your O&M” (P10). P1 noted that the little uptake in technology use in O&M training depended on how well the MOTs
understood the accessibility features of the mobile phones and available navigation apps – “even if the mobility teacher
doesn't have to teach the accessibility features of that phone, they're still going to have to learn what the apps are and
how to use them”.
4.2.2 Effectiveness of O&M Technologies
MOTs emphasized that existing navigation technologies (built on GPS) are not reliable as an effective O&M learning
tool and can limit the learner’s mental mapping abilities and self-reliance in the absence of such technology – “When
using satnav, you’re not actually paying attention to the details of the route, you’re just following instructions on the
app. When satnav fails, you’re stuck,” (MOT4). P1 acknowledged that many navigation apps available are not suited for
O&M training but could be used for outdoor route familiarization – “The problem is that you've got these apps that are
not specifically for learning mobility skills […] there are lots of apps that would help [with route learning]”.
Additionally,+participants+desire+for+technology+to+go+beyond+route+navigation+and+support+the+challenges+in+
locating+building+entrances+and+safe+road+crossings,+[60].+Particularly,+incorrectly+tagged+building+entrances+–+
“entrance marked at the wrong side of the road” (P1)+and+inaccuracy+of+GPS+location+“suggesting the entrance is near
when it is in fact 10ft further down” (P1)+was+challenging.+As+many+BPS+people+relied+on+route+memorization+and+

10
tactile+paving+to+locate+road+crossings,+participants+expressed+less+trust+in+GPS+technology+alone+for+navigating+for+
example:+“I would never use an app for the first time on a route I’ve never done before” (P5)+and+“figuring out where
to cross the road would be tricky” (P1)+on+unfamiliar+routes.+This+was+also+elaborated+on+by+P3“if you are crossing a
road straight away you've and you've never done it before you could end up not knowing if you have cross the road and
going up somebody's driveway. And technology won't help you there, would it?” +
4.2.3 Technologies to Supplement O&M Training
Despite the varying views on effectiveness of commercial navigation technologies for O&M training, many
participants (including BPS people and MOTs) acknowledged that mobile technology is increasingly become a part of
O&M training practice. MOTs agreed that technology can be used to complement the O&M training practice by
enhancing the learner’s spatial awareness - “It is important for pupils [BPS children and young people] to learn the
physical route and landmarks and technology can enhance that.” (MOT4). Mobile apps like Lazarillo and Soundscape
[48][47][47]that announce nearby landmarks and points of interest (e.g. bus stops, road intersections, and street names),
were encouraged to improve spatial awareness while on public transport. Many of our participants used mainstream and
AT navigation apps for outdoor navigation. Preferred features of these apps were announcing the landmarks using “clock
face” directions (RNIB Navigator
6
) and audio beacons (Microsoft Soundscape) which P5 suggested was essential to their
day-to-day navigation and should be integrated with the O&M training – “I just think it should be built in as part of the
whole mobility process. I don't see the point in it not being because it's so, so useful.”++
P1+noted+that+there’s+a+place+for+navigation+technology+for+BPS+people+confident+in+their+mobility+skills+but+the+
current+navigation+apps+alone+are+not+suitable+for+BPS+learning+outdoor+navigation+and+crossing+roads+without+an+
MOT.+Instead,+participants+suggested+that+a+more+suitable+technology+for+O&M+route+learning+should+enable+the+
MOT+to+“record+landmarks”+along+the+route+which+can+be+traced+by+the+learner+as+they+practice+route+navigation+–+
“like Clew app for outdoors”. P1 further commented that the fundamental O&M skills should be taught by a human
MOT, however, technology could be used to support practice and enforcement of O&M skills between training sessions
by ensuring the learners practice the correct “patterns” of movement when using a long cane – “if you think about it it’s
all based on patterns, walking in step is a pattern and sighted guiding is also a pattern. Technology can recognize those
patterns and alert you based on small deviations. Maybe that is some way to look at it”. (P1)
MOT2 noted that integrating technology in O&M training could also help with engaging young learners, who are
already familiar with various mobile technologies. She explained how suggesting navigation apps enabled a young
learner (11 years old) to not only take more interest but also improved his confidence and develop a sense of agency in
relation to mobility.
“The next session I met him at school. He said, ‘The next bus is in 10 minutes.’ I thought, ‘Oh,
goodness me, engagement! That's fantastic! He's taking responsibility.’ He'd also downloaded
Google Map, and actually traced his journey to his new address, with quite a lot of confidence as
well as then listening to the bus.” (MOT2)
Some BPS participants also suggested that technology could be integrated with O&M training to overcome the shortage
of MOTs such that remote O&M support could be provided to BPS people who are experienced and independent in their
mobility, as suggested by P1 – “If you are a local council then maybe you could augment your trainers through
technology and think, right we are going to get you 75% towards getting able to walk in step with your cane, but then
when you do your homework, or when you practice outside the session, use this app and it will help you reach 100%”.
So, the fundamentals of O&M training (e.g., long cane techniques and negotiating navigation in outdoor environments –
avoiding veering, detecting obstacles using long cane, and understanding changes in the floor surface) must be taught in
a face-to-face through O&M training session with an MOT, and once the learner is confident in their mobility skills.
They also added that further assistance such as sighted assistance in unfamiliar or challenging situation can be provided
remotely by MOTs and volunteers through an app (e.g., Aira, BeMyEyes) which would be useful in building their
6
https://www.senderogroup.com/products/RNIBGPS/index.html

11
confidence in outdoor mobility knowing that “there’s additional support there as and when needed is always
comforting” (P7).
4.3 Changing Personal and Social Circumstances
4.3.1 Deteriorating Vision
The experience of early O&M support varied between people who were blind from birth or at a young age to those who
experienced sight loss or deteriorating vision as adults. While early O&M support for young children was available at
schools and pediatric healthcare services, adult support was less accessible. Despite the statutory right to O&M support
[16], participants (experiencing sight loss as adults) were often faced with long delays or lack of support from the local
authorities, which was the experience of P9 - “I kept persuading them [local authority disability team] to do so but they
didn't have the disability team anymore, they [had] disbanded it”. The impact of the delays and the lack of appropriate
mobility services, which are critical for blind and partially sighted people, were seen as a barrier in becoming
independent. P10, who has as degenerative vision impairment, felt helpless due to the lack of early O&M support when
first experiencing vision loss.
“I received zero mobility training when I left, that was it. It was cut lose, there was no
facilitation for service. I wouldn't even know who to contact if I suddenly lost some more sight
and I felt, gosh, I really can't' deal with it. I wouldn't know where to go or who to speak to.”
(P10)
Participants who experienced severe vision loss as adults experienced a more profound impact on their quality of life;
from being independent adults and having a full-time career and responsibilities to losing their independence completely
– “I ended up having to give up my nursing career that I was doing because of my sight change.” (P8). P3 reported
feeling loss of freedom and isolation; being unable to carry on with their normal activities “getting frustrated and bored
and getting angry for not having any freedom”. Vision loss also impacted participants’ family dynamics as they became
dependent on family members for mobility, as P9 described -
“I was essentially housebound. I couldn’t go out without my wife or one of my children hanging
onto my arm.” (P9)
4.3.2 Familiarizing with New Environments
Moving to a new area can be a daunting experience for everyone, but for BPS people, this is often exacerbated by new
accessibility challenges associated with a novel physical space and sociocultural environment. ‘Sighted memory’ is the
mental representation of the local area developed through repeated sighted navigation or ego-centric mental maps
developed through route learning over time, which participants described as - “imagining what the place looks like. I've
literally walked around, and I can remember it what the place looked like.” (P10). This type of memory is dependent on
the individual being familiar with the surrounding environment and often needs to be completely rebuilt when the person
finds themselves in a new or unknown location. For people who are used to navigating based on sighted memory,
learning a new route can be quite unnerving, as described by P10 – “For the first time ever I was really nervous, and I
had no idea what the area looked like.”
As many of our participants were confident in independently navigating several familiar routes learned through
previous O&M training, they sought O&M training through their new local authority. However, the level of support
available varied in different cities and the confidence regained from training varied, depending on the overall physical
environment, opportunities to seek support from public if needed, and the distance participants had to travel.
“I am receiving training here, but the roads and the pavements aren’t as clear. The bus stop is
quite far from where I am and it’s very complicated to get to, and there’s hardly anybody outside
to ask if you’re stuck. It’s this kind of thing. It isolates you a little bit, so I’ve decided to move
back for that reason.” (P2)

12
Similarly, when P5 moved to a new city for a new job, she found that being in a new unfamiliar environment made it
difficult to be self-reliant. She relied on volunteer sighted guides until she could get further O&M training to familiarize
herself with the environment. She described her experience as, “I got my confidence back, and now I will literally go
anywhere with my cane and I don’t even think twice about it.” (P5).
4.3.3 Becoming Parents
Becoming parents is one of the most significant life transitions, demanding not only an adjustment to lifestyle but also a
seismic shift of identity from non-parents to parents, from being independent and only responsible for oneself to being
responsible for another person. Many of our BPS participants reported how their mobility needs changed when travelling
with young children. For example, P5 reported that she lost her independence after having a baby as she could not go out
with the baby in the pram. As a long cane user, she was unable to effectively navigate with the pram and the long cane,
which led her to lose her confidence in independently performing outdoor activities - “Consequently, I had to be
completely reliant. I couldn’t go out on my own. I had to rely on my husband at the time, or my mum and dad, or as I
made friends who had young children, we could go out together, but I could never just go for a walk on my own with my
son.” (P5). P16, another long cane user, commented that using a child carrier (on the back) freed up his hands to
effectively navigate using the long cane and enabled him to be independent and continue his regular activities and at the
same time spend time with his son – “I quite like that carrier for independence because I'm a cane user to it frees up my
hands. One to use the cane and the other to open doors and carry things”.
P5 also indicated the lack of O&M support for new parents as they navigate practical challenges – “I did go…to ask
them [local authority disability team] what help there was, and he just said, there isn’t. Come back when your son can
walk”. P5 resorted to seeking support from her family and making social contacts with other new parents who could
support her mobility needs to avoid losing her independence.
For our participants, the difficulties associated with the transformation from single individual to a parent often
challenged confidence and self-efficacy. “I started having kids and I realized I couldn’t take them to the park, and I
couldn’t on my own. I couldn’t be a dad in the way I wanted to be. I wanted to be independent for them so I could
participate fully and if they had a doctor’s appointment or if they had to go to hospital. I wanted to get to do those things
on my own.” (P10). P10, who is a guide dog user, relied on sighted assistance for navigation prior to this realization that
led him to pursue further O&M training privately to be able to navigate independently without the help of a sighted
guide. P16 shared a similar concern about wanting to be involved in leisure activities with his son but often struggled to
monitor his son’s movements. He attached bells to his son’s shoes to be able to hear his son and track his location around
the house but still found it challenging to locate his son when in an open park space.
“I'm totally blind, so once I lose [son] and he's quite demanding and once he's run off or
something and we're kind of stuck with that. And we're trying to kind of cope with that.” (P16)
4.4 Social Influences on O&M
Although the majority of O&M training was conducted in one-to-one sessions with the learner, MOTs acknowledged
that the home environment of the learner played an important role and family members’ perceptions, and attitudes have
to be considered for effective O&M skills development. Particularly, parents of BPS children and young people
influenced their independence the most. MOT6 who conducts workshops and counselling with parents reported that
many parents initially react strongly when they find out about their child’s vision impairment, “They break down in fear
and upset”. Parents often cope with the anxiety and fear related to their child’s vision impairment by becoming
overprotective and inadvertently undermining their independence, “I think the temptation is for majority of the families
even though they get the awareness training from us, they still want to just guide. They want to have that physical contact
with their child and keep them safe...” (MOT4). MOTs felt that this tendency towards shielding and overprotection was
exacerbated by the lack of opportunities for many parents to observe the O&M skills of BPS children and young people
as O&M training was often conducted at school. P2 commented that family members can be helpful in supporting O&M
skills and promoting independence if they had awareness through proper resources and training to enable them to support
BPS individuals – “I think they need more awareness, some piece of technology that could -- or maybe now because we

13
have apps and so on, maybe an app that can always, they can tap into and teach them how to guide a blind person in the
family or so on.” (P2)
MOTs also commented that the sociocultural perspectives and parents’ own self-efficacy beliefs affect their ability to
support their children; having low self-expectations impacted their belief and expectations of self-efficacy and
independence from their children - You get different levels of expectations, like ‘this is my child, but they will never be
able to achieve independence. They certainly will never be working, and I don’t expect them to be working,’ their
expectations of themselves are low so the expectations they put on their child is just at the same level.” (MOT4).
Our BPS participants shared experiences from their childhood which highlighted the key role of family members in
influencing self-efficacy belief. Participants recognized that the lack of awareness and the attitudes of parents towards
mobility limited their opportunities to practice and further develop their O&M skills. Many participants reported that
they were often guided by family members when outdoors instead of using their O&M skills independently – “In terms
of anything outside of our house/garden, I would have just gone with my mum. I wouldn't have gone out on my own,”
(P1).
Participants suggested that a positive and encouraging home environment can have a profound impact on the learner’s
self-confidence and create opportunities for families to spend time together. P6 commented that having his mother
involved in practicing O&M skills enabled him to explore outdoors with confidence - “I think the more I done it, the
more confident I was. Obviously, mom was still there to make sure I don't get run over.” (P6). P3 also commented on
how parents’ support can support BPS children and young people by providing them with opportunities to explore new
spaces – “I would still recommend that they should learn the cane training and go to a park or something with their
parents and go for a little wander on their own because it's a very great sense of freedom and the parents could keep an
eye on them. It would be best for their child to feel that they are on their own and they can control where they're going.
that could be done for the individual because of the parents make them a little map of the park.” (P3)
MOTs suggested that parents can also benefit from being part of a community of parents of BPS children and young
people to share ideas and concerns about supporting their children – “if you've got a parent that's reluctant, it's trying to
get them to meet up with somebody else who's allowing their child a little bit more freedom and encouraging that
freedom” (MOT7). Similarly, MOT6 commented that having a group outing can be an opportunity for parents to learn
from others and for BPS children and young people to also learn vicariously from others by observing their O&M skills
and sharing experiences; a healthy competition can also engage them with their O&M training and develop self-efficacy
as they compete with each other – “Then when you go into your next lesson and they go, ‘Has he started doing this
show? Can she do that?’ I'll say, ‘Yes, they've definitely,’ even if they've not quite got there, just to pull them up a notch”
(MOT6).
5 Discussion
The stories shared by participants in this study highlight how the self-efficacy belief of BPS individuals is developed
overtime through O&M training and that this belief is influenced by a series of factors– including personal (physical)
factors such as changes to the individual’s vision, environmental factors such as changes moving to a new city or getting
a job in a new area, and lifestyle changes such as added responsibilities of caring for a new child. In addition to these
elements, the self-efficacy belief is shaped by different social dynamics such as the home environment and the
encouragement (or lack thereof) and feedback the individual receives from the family members and peers. All these
elements play an important role in building up or destroying their self-efficacy belief and confidence in independent
mobility. Below we revisit our findings and discuss the opportunities for HCI research to support the evolving self-
efficacy needs of BPS people.
5.1 Social Influences on Self-efficacy in O&M
Our findings illustrate the importance of O&M training in building self-efficacy belief and confidence of BPS people
through the iterative learning processes that people undertake to be able to independently master life skills. In addition,
we discuss the crucial role of the family environment and, as previously mentioned, the limited availability of specialist
support from MOTs. Many BPS people receive limited O&M training over a set period of time and furthermore, the

14
wider sociocultural environment affected participants’ mobility and independence level outside of O&M training. Thus,
the learner’s family and friends play an important part in the maintenance and boosting of O&M skills outside of
training, particularly for BPS children and young people who still rely on the family members as caregivers. Our
findings show that, parents of BPS children and young people often tend to be anxious about their child’s disability and
feel unsure about their own capacity to help them fully become independent in mobility and other aspects of living. Their
overprotective attitude harms the individual’s perceived self-efficacy by denying opportunities to practice O&M skills
outside formal training and lack of encouragement (verbal persuasion) from family members which might increase
personal fears of the BPS individual.
The sociocultural context is important here, as disabled people and their families still face stigma and discrimination in
many cultures leading parents to feel a sense of shame and guilt [46]. Parents often have low expectations of their
disabled children, who they expect will not to be independent [66] or be employed [MOT4]. Particularly, when parents’
own self-efficacy beliefs and outcome expectations are projected on their children, as reported by MOT4, this limits the
child’s opportunities to grow and become independent. We argue that technology-assisted counselling and behavioral
interventions could support family members in developing their own self-efficacy beliefs and better equip them to not
only support but also take active role in developing their children’s O&M and life skills. We realize that these negative
stereotypes of disability are deep-rooted within the social and cultural environment but are often a product of lack of
awareness and understanding and can be improved through appropriate interventions [61, 70].
The importance of involvement and support from family members has been further highlighted by the recent COVID-19
lockdown due to which all in-person learning, including O&M training was discontinued – and MOTs were furloughed
in the UK [33]. As the world moves to online communication and learning platforms, there is a crucial opportunity for
online O&M training support to complement the face-to-face training in the future [21]. The technology for making this
possible exists today, for example, mobile assistance apps like BeMyEyes, Aira, and other technologies that support
O&M skills like walking in a straight line [53] could be adopted to provide additional support for learners between
training sessions.
5.2 Influences of Social Networks on Self-Efficacy in Changing
Circumstances
Our findings show that there are various events that occur in the lives of BPS people which can influence their self-
efficacy belief. These events occur at different stages in people’s lives and are not always related to vision deterioration.
In fact, these transitions can depict overall positive changes in people’s lives, e.g., moving to a new city and having
children, but they can also have a negative impact on people’s confidence.
Particularly, having children means people have more responsibilities and require significant adjustments to their
existing skills and strategies to adapt to their new identity as a parent. There is also a change in social network when one
becomes a parent as parents seek support and information from other parents - this social network has been found to be
important when understanding the needs of BPS people in previous research. For example, [6] explored the use of the
social network in low resource settings for BPS people finding that interactions with technology could often be mediated
and facilitated by various actors and allies both positively and negatively.
During the transition from single individual to becoming a parent, adapting to the new circumstances (e.g., navigating
with buggies/prams as opposed to the mobility aid alone) can be challenging and have a negative effect on the
individual’s self-efficacy. Unfortunately, additional O&M training is often unavailable at this stage for many BPS people
due to lack of resources and limited availability of MOTs. To overcome this lack of O&M support, BPS people develop
personalized strategies to deal with both the physical and the emotional challenges presented by the added
responsibilities. Many of these strategies involved tapping on their social network, as people would seek support from
family and friends, alongside devising individual innovative techniques to maintain independent mobility while
balancing their role as parents. This finding supports the existing work on BPS peoples’ self-efficacy and involvement in
parenting which has found that despite being good at mobility, blind parents experienced a loss of freedom and self-
efficacy in mobility [20]. This resulted in people reducing their range of activities that required mobility when they

15
became parents, unless their social network of family and friends could help with interactions with the child during
physical activity and outings, then BPS people’s activity levels increased [20].
As many BPS people are active users of mobile technologies and social media, sharing coping strategies in the BPS
community (and thus supporting self-efficacy through learning from these vicarious experiences) via digital platforms
can better prepare BPS parents to navigate the challenges of new parenthood. Recent research has explored how disabled
people use social media for advocacy, supporting self-esteem and identity, addressing cyberbullying and accessibility
issues, and developing online communities of practice. While we did not study how BPS people use online communities
(Facebook groups, YouTube, mailing lists, twitter hashtags and sub-communities) as part of this study, future work
should consider how communities of practice [68] in this area could support individuals overcome the shortage of O&M
training, share personal experiences and further foster the self-efficacy in individuals and the community more generally.
5.3 Novel Interactions for Technology to Support O&M learning in
New and Unfamiliar Environments
Another of the major challenges described by BPS participants was navigating new and unfamiliar environments. As
outdoor navigation is heavily dependent on route learning through landmarks and clues in O&M training, the BPS
participants found it difficult to navigate new and unfamiliar routes. Despite a significant body of AT research focuses on
navigation for BPS people, the availability of commercial AT for route familiarization is limited, therefore, BPS people
often rely on sighted help for assistance in unfamiliar outdoor environments [30, 77]. As noted in previous research,
having prior understanding of the route and surroundings is essential for independent mobility [37, 77].
In the absence of appropriate human assistance, virtual environments integrated within the O&M training program can be
valuable to support route familiarization and independent mobility by enabling “walking” the virtual route and
familiarizing with the surroundings – [43] found that integrating a virtual stimulation of a route can be effective in route
learning and reducing frustration and fear of navigating public paths. Growing research on virtual delivery of O&M
training using virtual long canes [80] and VR environments for route familiarization [31, 42, 43] is promising for
supporting O&M skill development and practice to reduce reliance on face-to-face interaction with MOTs.
Although technology for navigation was broadly described as useful, our findings show that it was not always widely
embraced by MOTs due to their limited knowledge of and experience with modern technologies. This is aligned with
Deverell et al. [21] who found that MOTs need to expand their knowledge of mainstream and assistive technologies to
better support the needs of their clients who may be proficient technology users. In our research the reasons for this lack
of adoption appear to be the desire to ensure a working memory for BPS people, which will not be fully developed if
people solely learn to navigate via mobile applications and therefore on ‘autopilot’. However, it is clear that mobile
applications in particular are being used by BPS people and have been shown in some cases to aid engagement in O&M
training along with an increased confidence through improved performance accomplishments. There remain
opportunities for novel interaction development within O&M training which takes account of the dimensions of self-
efficacy and solves the last few meters problem (something we found, and was previously reported by [60]).
The+multisensorial+aspect+of+O&M+learning+was+also+evident+in+our+findings+—+BPS people use sensory cues from the
environment (olfactory, auditory, and tactile) to develop a rich understanding of their surroundings. These senses are an
integral part of O&M training and navigation beyond training. One+possible+route+for+this+is+to+incorporate+
multisensory+elements+into+new+O&M+technologies,+a+second+is+in+the+development+of+virtual/mixed+or+
augmented+reality+interactions+to+complement+face-to-face+learning.
The existing commercial AT and research predominantly employs haptic and auditory (verbal and non-verbal) feedback
to convey spatial and navigation information to the user (e.g., obstacles, landmarks, and turn-by-turn navigation
instructions) in real and VR environments. In addition, smell-based interactions can convey emotional, spatial, and
temporal information for enhanced sensorial A/VR experiences [45]. For example, Season Traveler [56] demonstrates
that multisensory stimuli can enhance immersion in VR environments using smell and haptic sensations (temperature and
wind). Multisensory stimuli can also be used to provide safe experiences of dangerous situations and influence human
behavior, e.g. in a fire evacuation VR [64], varied intensity audiovisual, thermal, and olfactory cues were used to indicate

16
urgency and avoid adverse situations. Similarly, the effect of olfactory stimulations to promote emotional well-being and
improve physiological response has also been studied with non-disabled persons in non-VR context [22, 47].
These studies emphasize the possibilities for immersive and novel interactions to support O&M training of BPS people
where face-to-face O&M training is not available or due to environmental crises such as the recent COVID-19 pandemic,
which made face-to-face instruction impossible. Harnessing novel interaction modalities to design and develop blended
learning experiences for O&M training could lead to more resilient service delivery solutions. A second possible avenue
of research would be to explore the role of O&M training beyond navigation and towards exploration of surroundings.
VR and AR could help people build confidence in exploring, which could then be used in everyday life, allowing people
to hear or smell something which could serve as navigation clues but also encourage exploration and connect with the
environment [3].
5.4 Limitations
Our BPS participants cohort was aged between 18 and 65 years and living in the UK, Ireland, and the USA. All
participants were proficient mobile AT users and had experience of using a long cane or guide dog mobility aid. The
majority of participants had received O&M training at some point in their lives and therefore the experiences of the
participant group presented in this paper may not be generalizable to BPS population in the participants’ countries or
globally. Furthermore, the childhood experiences of O&M training have been synthesized from BPS participants’
recollection of events from their childhood and experiences of MOTs working with BPS children and young people. As
with BPS people, MOTs were recruited through convenience sampling and were located across the United Kingdom and
had obtained a formal qualification in habilitation and O&M training. However, after the interviews, it became evident
that the majority of the MOTs worked with BPS children and young people up to 19 years old. This points to the current
state of O&M services in the country as also reported in the findings. Experiences of sight loss related to ageing and the
impact of O&M training on the self-efficacy of older population (65 and above) was not in the scope of this study.
6 Conclusion
In this paper we presented the findings from semi-structured interviews with BPS people and MOTs exploring how self-
efficacy belief is developed through O&M training and how different life transitions (deteriorating vision, new
environments, and new responsibilities) can affect the individual’s self-confidence. We also report that the individual’s
sociocultural environment and lack of O&M support at these crucial stages can severely deteriorate their independence
and quality of life. These findings have uncovered new possible opportunities for the ASSETS community to explore,
including: (i) how BPS people can be better supported at key life transitions through technology-assisted interventions,
(ii) how the sociocultural environment can be adapted to reinforce self-efficacy and confidence of BPS people, and (iii)
how immersive and novel multisensory interactions can support the O&M skills.
ACKNOWLEDGMENTS
We thank our study participants for sharing their experiences and valuable insights. This work is funded by Engineering
and Physical Sciences Research Council (EPSRC) Doctoral Training Program EP/N509577/1.
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