Proceedings of: Workshop on Improving Building Design for Persons with Low Vision

Issue 24: What are the long-term and short-term targets for guidance?

Comment by Earle Kennett: Let’s go back to some of the things that are targets, long-term targets, short-term targets. We’ve talked a lot about the struggles of employee issues. We can spend days talking about that and we’d need to have a lawyer here to actually help us through that subject. But, where are we going? Fred talked about research. Kurt, you talked about, hey, we can put some of this stuff into action ASAP.

We need to create a tangible list of ways forward, long-term, short-term, middle term so that we know our mission going forward. I think as we near the end of our discussion, I would like to hear things rapidly go on a list.

Stairs, short-term list

I’ll put one up there, short-term, stairs. Stairs is a tangible safety issue and in fact the code has elements of some of the things that we’ve just described as better practices here for codes and guidelines that it’s easy to put our foot on and say that just needs to be enforced.

Response by Marsha Mazz: I think one of the things we can look at is the stair geometry and talking about is stair identification. Well, the tread and monitor Identification and identification of the stairs.

Response by [Participant]: But then again, stair safety would be legitimate for all of these.

Response by Kurt Knight: I think there’s been a number of presentations that have identified a number of issues and as we go through the presentations there’s a lot of consistency, to be quite honest with you, in some of the ideas presented of these shortterm safety type, easy to do solutions.

Contrast and wayfinding, short-term and long-term

Comment by Earle Kennett: You know, the whole contrast, wayfinding –

Response by Kurt Knight: Wayfinding.

But you know what’s really great about that and you know it was interesting. We went in to talk with Susan and you know she’d never even thought about that and we ended up talking an hour and it was very fun to sort of understand where her light bulb sort of started going off: it wasn’t a matter of new technologies or increased cost really. It was a matter of the design team relooking at a problem and coming up with design solutions; [to assure] that many of the decisions that they were making were not made to be barriers to people with low vision.

It just happened that way because they hadn’t thought about it; that if GSA can incorporate that into their criteria, it would be helpful not costly; you know, it clicked. The second thing that I think clicked on her, was this whole idea of changing demographics, because the low vision part, even though we understand it can be from birth, it can happen, as in Fred’s case, at a young age, but much of it happens as in an aging population. Quite frankly, the GSA staff demographics probably will be increasing over the years. All of us, or many of us here, that have not been completely successful in our 401s and pension programs may end up working a few more years.

Comment by Roberta Null: I was just thinking about with the aging there’s been a lot of work done and they’ve had a lot of money for doing this, fall prevention and it was USC and some of these others. I go to their presentations and they really do a good job of thinking about the demographics, aging and the two or three causes of fall. One is medication and that’s the medical and we can do all that and then another one is balance and they do a pretty good job of that with classes and different things like that.

Then they talk about architectural barriers. Well, of course stairs and things like that and they don’t think about it. I mean, they mention it but it’s just like, oh yeah, and then there are architectural barriers. I think that’s where we have a chance through the lighting people and the design people, the architects, you know, to really tap into something that’s already started. They have all kinds of funding and have done some really brilliant research in that area but architectural barriers, well, ‘we’ve got to get rid of the clutter and things like that.’ But I think it’s something that we can really contribute to.

Response by Marsha Mazz: I think if we decided, tomorrow, to start incorporating photo luminescent tread marking on all exit stairs, we would improve the ability of people with low vision and everyone else in the building.

Responses by [three Participant]: The majority of stairs in building are back of house. They’re really egress stairs. So they’re unfinished. They’re not painted, raw steel, the walls are not painted or anything, like the black stairs that Eunice showed in her presentation. So along with stair safety goes finishes, just paint the stupid things. Fifty cents a square foot. Leave the walls white because we can’t increase the lighting because the energy code doesn’t allow us. Give us some light-value finishes, voila we’ve lit the stairs.

Energy utilization, short-term and long-term

Comment and Questions by Cheri Wiggs: Just so I’m going along that point of forward thinking, because I have been thinking about this all along. This kind of guidance is going to help the general population, right. It’s not just a select group but it’s going to be all of us. So it’s wise to take this into account. All of us should be interested in this going forward.

I think I’m going to piggyback on a point that Marsha made earlier that really did resonate with me. I might sound a little contrarian, but this whole notion of the energy regulation, I’ve been hearing how difficult it’s going to make everything. But it is important.

I mean, it really is important for us to get a handle on how much energy we’re using. We’ve got a lot of intelligence in the room where we could say ‘look, this is going to happen and how much light we’re using is going to decrease and if that’s the case, it’s going to be difficult for all of us.’

Can we use this kind of intelligence to use smarter lighting? If they’re saying we can’t use as much, can we get some guidance here in terms of [how] this is going to be difficult? [Are there] ways you could do this in terms of paint colors? Where again, it’s going to be [for] all of us because we’re all going to be in a situation where the lighting is lower.

So it’s really thinking forward and it’s really attaching to what’s happening now. I’m not speaking as NIH here. I’m speaking as somebody who’s sort of been listening to the discussion here and I don’t know if that makes sense. But I also think it’s a lot more palatable if people [understand that] we’re not trying to fight against this. We know this is going to happen. But we could have some smart ways of dealing with this.

Response by [Participant]: We have taken action in that with the photoluminescence and setbacks on the lighting through service lighting systems for stairwells that glow 50 percent and, as soon as there’s motion, they’ll go up to 100 percent. So we’ve already done those types of things.

Research and its applications, medium-term and long term

Comment by Bob Massof: Well, just in two days of discussion I’ve been motivated of thinking how we would approach this from a research perspective. I think there’s a tremendous opportunity here to develop the [support] of this project with bringing together the expertise. I marvel at just the kind of expertise that’s out there and with bringing parties together, I think we can really build a project. So I just want to throw out some of the ideas that I’ve heard. I think first of all that there is a funding mechanism which is through the NIH for supporting these types of collaborations.

So I think it’s not pie-in-the-sky to talk about it. And there’s been some pretty spectacular collaborations, especially the one I’m developing, what’s called adaptive optic supply to the eye. That’s getting right down and seeing individual photoreceptors live through imaging and using technology that – the same type that’s used to look at galaxies thousands of light-years away by correcting for the averages in atmosphere. This corrects for the averages in the eye.

So that was literally pie-in-the-sky until this project started. So while that may sound like it’s too hard but I think the first step in just hearing a lot of the discussion about the regulations, like where do these things come from and what’s behind the recommendations and what’s behind the guidelines. It doesn’t sound like there’s an awful lot of data, and that some of it just is summary type of information. It’s not really getting down to a level of computational type of approach.

Comprehensive modeling of vision

So I think the first step would be to create a physics-based model of the environmental conditions so that you really can computationalize it in a database from any viewpoint of what the illumination of the environment is going to be. So, if I put my eye over here, this is what it’s going to look like. This is before you build anything, before you spend any money on actual hardware that this all can be part of the design phase to create a model that is a physics-based model.

On our side of the world, we’re already building physics–based models of retinal imaging and if you marry these two models together, the physics-based model of the environment becomes [integral] to the physics-based model of producing the image on the retina. What would have to be included in the model of the retina, which is very active research and we know people who are doing this type of research and we probably will be able to talk them into collaborating on this type of project, is some of the more subtle things that is very important to plan.

I think I mentioned yesterday the Stiles-Crawford Effect, which is the directional sensitivity of the photoreceptors. But there are physics-based models for that effect and that could be built into a computational model to handle scatter of light. So you can end up making measurements of fundus reflectance and things of that sort, build those parameters into the model. And so take the environmental, you put a glare source or a point source in the environment and we can look exactly at what would happen to the retinal imaging through those types of models.

The next step is to really fully characterize the population we’ve been talking about with respect to the parameters that we build consensus and support. People talk about contrast, play with color and illumination. So we really want to describe what the characteristics of not only the low vision population but the older population in general. Some of this John Brabyn showed to suggest that low vision is kind of in the eye of the beholder literally.

We can then have a description of the important vision parameters and there are unemployed psychophysicists I think we can put to work on that project and we have collaborative networks set up already to collect these data and we don’t need – well, John will know what I’m talking about – white bars and review systems to do this, that we can do it with equipment that readily can be put into a clinic out in the field and so we can gather rather large quantities of data in a reasonable period of time.

That then also gets added to on most of the people on this side really developing kind of a conceptual model of what are these constraints on the design. You’re bringing in legal requirements, you’re bringing in things that pose constraints on what you can do and so those should factor into whatever model we’re developing so that gets taken into consideration and limits your options.

Every modeling effort has to have constraints. They might as well come from the outside as well as those from the inside. And then, finally, there needs to be some qualitative research that’s done on the side dealing with the aesthetics and dealing with the functional usability both from the standpoint of the owners and from the standpoint of the people who are expected to use it so that if you have this tension between the artistic and the practical, you know, how do you place value on those two things, on those people who have a stake in it, and there are tools out there for doing that.

We’re always doing quality of life research in health care and so many of the concepts and many of the tools that are used for quality of life research could really get transferred over to these various kinds of questions more subjective types of measurements of subjective phenomena, the so-called latent barriers and that ought to be built in.

So by putting a collaboration together with all the appropriate expertise, working in parallel to create these pieces, you can kind of put a whole system together that would allow you to rather than having to build consensus among all parties really allow you to do something in a very quantitative and very objective way and then you’re not – we’re always saying in campaigns, you can have your own opinions but not your own facts. This puts all the facts under the control of something that we all agree to, something that’s all objective, and then now you can get down to making decisions without arguing over how we’re making decisions.

Comment by Fred Krimgold: Well, I just wanted to very strongly endorse what Bob has suggested because I think, you know, that given the expertise that’s been revealed in this room, the idea of developing parallel models of individual visual capability and the salient factors in the environment that influence the functioning of that individual visual system allows us to structure our understandings, our experience, the existing models, [and] the resources available in a way that allows them to interact in such a way that we can evaluate existing environments, we can evaluate hypothetical environments, we can evaluate potential policies.

It gives us a really powerful new tool for looking at this whole set of issues and it certainly qualifies as a serious area of applied research for both physical environment engineering architecture and on the medical ophthalmological side and it can then provide a basis which I think will be tremendously valuable to whatever application comes after it, be it a regulatory application. We have – we will then have an organized foundation for presenting those arguments and for again looking at costs and benefits, if that’s relevant, if that has to be dealt with. And it’s a very exciting possibility.

I think it’s the sort of thing if there is a funding source that would be appropriate for pulling together that kind of cross-disciplinary group -- and by cross-disciplinary I mean not just academic disciplines but practitioners, and -- that is, both medical practitioners and [design and operations] practitioners, we could do something that would be tremendously stimulating and valuable and it might well be done under the auspices of NIBS, which has the kind of relationship with federal agencies that could facilitate this kind of a collaborative effort.

Comment by Cheri Wiggs: What Bob was mentioning is actually a program announcement that is written specifically to encourage the type of collaboration that he described in bioengineering, and bioengineering is defined pretty broadly. So there’s actually a program announcement at NIH that specifically is meant to encourage that kind of research effort. So it exists.

Guidance Documents, short-term

Comment by [Participant]: I think Bob’s absolutely on the right track, and I think that’s one of the sort of things we should start on immediately that will have medium to long-term effect.

And it seems like another medium-term effort should be the things that have come up yesterday and today about the ANSI committees and Illumination Engineering Society committees. [They] are really closely related to this field and we could start developing input for those, which would eventually result in standards that were backed by facts and research and that kind of thing.

It seems like we should also think about maybe some short-term efforts in that some of the things that we’ve all discussed over the past couple of days are kind of so well-agreed upon and obvious that it might be a good idea to try to compile something almost immediately that everyone agrees on. And whether it’s a brochure put out by NIBS or whatever it is, it could be something that could be just used as examples or suggestions for good practices.

Comment by Roberta Null: I wanted to offer sort of a framework that we could start with and I just have – I wrote this book Universal Design. It was called Creative Solutions for ADA Compliance and it came out in ’96, and it’s out of print. But I’ve been working on a revision of that – and with best practices and things that are going on in a whole variety of areas related to universal design.

I just lost my publisher because it was somebody in interior design and very interested in the fluff, and not understanding universal design. I thought, well, I’ve got a lot of it done, so I could bring in the collaborative thing and it started out that way anyhow.

I certainly would be willing to work with anybody who’s interested in really having some examples of things right now. That would be something that I will offer as something that I think could be a solution because I think that I’ve done a good job so far and the book has received a lot of recognition.

I’ve never made a lot of money on it, but the people in Japan think it’s wonderful, because they’ve got this aging population, and of course in working with the elderly. I’m an advocator, and so it’s been written but it’s got a lot --. I’ve found it on Amazon and I can buy the used book. This was in a library someplace and nobody checked it out. So I could get it for $15.

But the other thing, when we were talking about stairs, I worked with a fellow called Jake Paul. He’s working on the international codes and things like that. But we could really bring in, you know, people who, I think the people in this group really recognize, lots of experts in different areas, and I think that that would be a good example because he’s really –

Response by Marsha Mazz: And Jake is on the ANSI A117 committee.

Comment by Jim Woods: I’m going to take a chance on something here and look at it shortterm, mid-term, long-term, and go back to some of the stuff that I used to deal with when I was teaching in the classroom, undergraduate and graduate levels. I’m going to propose three principles and see how far they fly:

• One is to design for health and well-being, not just to prevent disease or infirmity.

• The second is to design for the last day of occupancy, not the first day.

• The third is to minimize energy consumption, don’t build it; otherwise, optimize energy efficiency to achieve the design objectives.

I don’t know if that captures what we were talking about here or not but it gets across both the current situation, the energy issues, but it also, I think, attacks some of the health issues, and we can then start putting the low vision lighting and stuff like that within it. But it would lead us I think in the area of being able to support that with research.

Response by [Participant]: I like your first point, because I think that what Bob has suggested is a starting point on that, which can be supplemented with similar approaches to modeling this individual environment to fit at the same level of sophistication for other types of sensory and physical conditions. And then we have something to work with. I mean, we then have a basis for making rational recommendations and having reasonable answers to the skeptics.

Comment by Erin Schambureck: In the interest of giving ourselves some short-term goals to work on immediately and [to] have something to review, possibly when we consider getting together in three or four months here, would it be a positive thing to – and I’m willing to volunteer for this task – but to take all of the presentations and the notes and things that have been taken from this workshop and compile two lists?

One is a list that would go out on the site that would be the list of the identified problems – not the solutions yet, but the list of the identified problems that we’ve all talked about, and try and define them as we can. Maybe that’s a Google doc that people can access and modify or revise or update, still trying to keep that succinct.

We want it to be obvious what we’re talking about and not go into the hours of discussion that we’ve had here, but to create that list of identified problems, and then the second list to create a list of the proposed solutions to those problems.

So the second list might have that point that says we have a high-contrast strip at the top stair and the bottom stair of each stair section, you know, at each landing – simple solution, two sentence, something that then that second list is again user-friendly where it’s succinct but we’re solving problems or at least attempting to solve problems and creating something almost immediately that can be used at the VA, that can be used at the IRS, that can be used throughout GSA quickly.

[Editor’s Note: Erin has drafted the list: it is included as Appendix G.]

And then as part of the mid-term and long-term solutions, we’re backing that up with research and developing ways to turn that into more long-term implementable solutions, and I’m willing to do that, to cull through the information in my free time.

Responses from [five Participants]: Wow. And create those two lists so that we have a summary of what’s happened. Sold. This can become a living document in the short term. With data of items to move forward.

Comment by Bob Massof: Our deadline is November 16. That’s the deadline for an R-21 proposal to do an exploratory – kind of the equivalent of like a planning grant to put together this type of a collaborative project, and so the next window to do that is – the deadline is November 16, which if we could meet that – it’s a six-page proposal. It’s going to be denser than a New York bagel, but the earliest start date would be July 1.

Comment by Earle Kennett: So to some people who are interested in pursuing that type of thing, you know, raise your hand. We could really get started on this immediately and we’ll set up some conference calls and –

These can be completely parallel.

This is really kind of a framework for things that Kurt –

Response by Kurt Knight: Both are useful, I mean, absolutely.

Well, we can quote your problems in the beginning of the research project.

Comment from Marsha Mazz: Well, it’s kind of hard to hear over here what you’re exactly talking about and I can’t read your lips. So, if you could talk about what the research is again that you’re trying to do?

Response by Bob Massof: Well, the larger project, which is what would be two years preparatory window in terms of before you would actually engage in, there’d be a lot of preliminary groundwork to do: planning and pilot work to see what’s feasible and what direction you go and things of that sort.

So there’s two phases to it, and the first phase is this planning and feasibility phase, and there’s a program announcement within the NIH to support just that for these collaborations, and there are grant types that are called an R-21. It’s an exploratory grant. You don’t need preliminary data to show what you’re going to do. There’s no risk. So it gives you an opportunity to do some things a little wild and crazy.

So it’s providing funding to help people get together, provide funding to get some pilot data, provide funding to try some things out, see what’s going to work, what’s not going to work. And so if we wanted to get on that train, it leaves the station November 16, and we would be able to get started doing work. The earliest start date would be July 1.

And so there, what we would need is for people to basically identify themselves as being interested, wanting to participate and to help shape the larger project. It would involve, you know, conference calls – maybe if NIBS would be interested in hosting these kinds of meetings to help shape that out, then that might all get together on occasion to further refine and put this together, and probably bringing in other people as well who represent certain technical expertise that we may not have represented here. Like, if we’re going to do physics-based modeling, we want people who know how to do physics-based modeling. We want some optical people who do these rate tracing models, and these are kinds of people who design lenses and do things like that. You do that with helicopters, I know.

Comment by David Munson: I do that with architecture. I was one of the guys who invented it. And here’s the problem. Unless you’re doing 100 courtrooms and you’ve got a federal judge who wants to see 100 federal courtrooms, you can’t afford to do it because the cost to build the model is almost as much time as designing a real courtroom and getting the thing finalized. I’ve got a courtroom program right here. You can dial up how many people are on the jury, how many tables the defendants are going to have, what colors, is there skylights; and it will generate a three-dimensional model and you can walk around and you can grab a chair and you can put it over here and you can say, does all of the chairs see everybody’s chair because they’ve got eye heights, and can the judge see all the ones in the jury? And you can go through all the stuff and in the end it’s not very damned practical.

Response by Bob Massof: Well, you’re about 50 years ahead of my thinking.

Comment by David Munson: I was flying three-dimensional computers in 1983. We did raytracing, we did full radiocity calculations.

Response by Bob Massof: So this may never be useful. This is really designed to understand the problem. It’s still a research project. The idea is to create a research tool.

Comment by David Munson: Find five buildings that you find acceptable. Find five buildings that you find acceptable and say these guys work. Find five that don’t work. Publish just the pictures.

Interdisciplinary Communication and Vocabulary

Comment by Jim Woods: The thing that I think is so exciting about where he’s going with this is addressing a little bit of the gap analysis that we talked about yesterday, that the physics in terms of parameters that we can design with are not there, and you know, we’ve got some information on the perception which may or may not be valid. And so you’re starting to address those things at a research level that we can put some certainty to or look at least at the uncertainties to it and have a foundation to work from.

Response by Bob Massof: Research versus common design.

Comment by [Participant]: I don’t think in the end you’re going to get a specification that says this is what it looks like. And unless you’re ready to give an order to say this is what it looks like, you aren’t going to be able to [complete in] a two-year research-worthy project, and I’m exaggerating of course, but to solve these problems on every single project. What I think this is getting to do is to try to really focus [and] maybe to assist us common practitioners, small businesses, who have to solve problems every day with an eight-hour day, 40-hour week draftsman who gets paid a certain amount of money.

Comment by Jim Woods: A basic problem that has come up in the discussions in the last day-and-a-half is that a lot of you talked about the necessity of measurement in order to give instructions, in order to set standards, in order to define objectives, in order to support regulatory activity.

And what we’ve heard from both sides is that the measurements aren’t compatible now, that we don’t have a way of expressing in the physical description of the environment the factors that are relevant for the performance of the individual, and that’s what we have to find in this mutual modeling exercise. It’s not a trivial thing, because what we are trying to do is look at the interaction of two existing bodies of knowledge and two sets of phenomena, and if we arrive at that, then we have the basis for a lot of thinking and a lot of activities beyond specific design.

I think what you’re suggesting about the 10 pictures, five good and five bad, is immediately tangible, practical and something that you could use in terms of getting the job done quickly make sense. But what we’re trying to do with this in parallel to that -- and I think maybe that should be another short-term activity, but what we’re trying to do here is lay the foundation for coherent communication between two bodies of knowledge and to allow for the construction of interaction of an understanding of individual human capacity as it may change and is changing, and of dynamic environments which can be modified and can be supportive or less supportive depending on how they’re designed.

And by taking pictures of what’s out there and what’s worked, it’s a rough-and-ready summary of what combination of things happened to have worked but it’s kind of an artistic approach rather than one of trying to identify what those specific relationships are and what the mechanisms of relationship are which we were trying to approach in the modeling.

Response by Bob Massof: Where the differences are derived, the physics of the picture are very different from the physics of the environment. So to get this picture and use it, looking at the simulation [is only a start].

Comment by Vijay Gupta: I’ve been thinking that it’s [encouraging] that the medical community and the engineering and design community [are here] and I think that’s a good solution right there. We need the support of the medical community to meet Marsha’s needs, and not only Marsha’s needs but to meet other needs. So the medical community and architectural and engineering community needs to get to get together.

Response by [Participant]: And we need to begin that vocabulary list.

Comment by Jim Woods: I think we said that yesterday and I think that’s got to be on one of our big list items here. We don’t have a common vocabulary list, just the way of speaking a language together besides the research, so we can understand some of what you’re saying and you can understand, and we can begin to talk more fluently on the subject.

Comment by [Participant]: Well, a final project would support continuous interaction between representatives of each of the communities and that would be in itself –

Response by Bob Massof: And maybe that’s part of what goes into this planning grant. We need to develop a common language.

Response by [Participant]: From our perspective, we really need you guys to help us and I think this would be a perfect collaboration to provide both directions.