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T. Gross et al. (Eds.): INTERACT 2009, Part I, LNCS 5726, pp. 36–49, 2009.
© IFIP International Federation for Information Processing 2009
Video Gaming for Blind Learners School Integration in
Jaime Sánchez and Mauricio Sáenz
Department of Computer Science, Center for Advanced Research in Education (CARE)
University of Chile
Abstract. In this study we evaluate how the use of audio-based technology can
facilitate school integration of blind learners through the interaction with a
science videogame. This experience consisted of designing and implementing
The Natomy’s Journey Game to be played by blind and sighted middle school
students. The use of the videogame and its impact on the integration of blind
learners into mainstream schools was also evaluated, through the participation
of both teachers and learners. In the end, the goal was for blind learners to be
able to interact and become socially integrated through active science video
gaming and the application of specific science content. The results of this study
provide initial data and evidence that the use of video games such as The
Natomy’s Journey Game can improve the process for the school integration of
learners with visual disabilities.
Keywords: Visual disability, sound interface, school integration, science learning.
The use and integration of ICTs into education has been the focus of discussion for
many researchers and developers [2,6]. The use of this kind of technology in
education, and in particular for complex content such as science, make its integration
for use by the visually disabled through educational activities especially complicated.
This is mainly due to the kind of resources required and these students’ lack of one of
the most important senses for the process of observing natural phenomenon: vision
[9,14]. Children with visual disability have more problems accessing information,
learning and putting basic operations into practice, and solving problems than their
sighted peers [23,13]. However, the use of technology that is correctly adapted for
this kind of disablement can lead to an efficient solution.
As such, we might ask: In what way can we create a context in which sighted and
blind students could work collaboratively for effective science learning? In general, in
several countries there are special schools for children with visual disabilities that
work only with legally blind students as a segregated population. In these cases, there
are usually scarce resources, which impede working in the same conditions as their
peers in school integrated classes (mainstreaming).
Video Gaming for Blind Learners School Integration in Science Classes 37
Several studies have shown that audio interfaces can be used to foment learning
and cognition in blind children [22,24,33]. The use of these audio-based applications
stimulates the utilization of general cognitive processes, such as tempo-spatial
orientation, abstract memory and haptic perception [22,24,27].
In recent years, video games have become a part of the daily life of children and
school-aged youth [15,17]. With the progress of ICTs, video games have become a
powerful force representing a part of the daily activities, concerns and interests of
children and youth. In our country, 50% of students use the Internet to play games
[1,32]. In the USA, young people between 8 and 18 years old play an average of 49
minutes of video games daily, almost the same amount of time dedicated to doing
homework (50 minutes) and reading (43 minutes) .
In this way, computer-based video games represent an alternative that has
penetrated distinct areas of education, mainly in their use in the classroom [12,30].
Such data demonstrates the potential importance of video games in education as a
structure for the development of different cognitive abilities, such as problem solving,
analysis, communication, collaboration and information management [29,31].
In taking into account the high degree of learners’ motivation and interest in video
games, the potential of these games to develop abilities and the need to integrate their
use into the formal education of both blind and sighted users, we designed and
developed a video game called The Natomy’s Journey Game, for interactive
collaboration between sighted and blind students. We also evaluated the usability of
The Natomy’s Journey Game, as well as its impact on the process of school integration
between blind students and their sighted peers.
2 Related Work
In the last few years several software applications [20,22,24] have been developed
involving blind users as the main participants, in order to assist them in their learning
with interactive technology, focusing mainly on haptic interfaces  and desktop
applications [22,24]. Also, there are several studies that show the importance of using
video games for education [12,29,31]. Some important cognitive aspects that can be
developed through the use of video games are the development of competition and
concentration skills, mobility skills, language and mathematical skills, visual skills
and problem-solving skills [3,4,25].
However, there is consensus in the literature that problem solving is the most
important one of all, in that it provides students with tools that can be used not only in
a school context, but in social and work contexts as well.
Polya  described the process for problem solving in four fundamental steps that
consist of understanding the problem, devising a plan, carrying out the plan and
examining the solution obtained. If this does not solve the problem, a new plan has to
The current literature includes several studies related to virtual environments and
problem solving for the blind. In , an aid system is proposed for the mobility of a
38 J. Sánchez and M. Sáenz
blind user through virtual reality mechanisms. In  the authors developed virtual
reality tools so blind users could explore information constructively. In another study,
a game with 3D navigation, Terraformers, was developed for stimulating development
and solving tasks in an entertaining way . Recently, some software programs for
problem solving through interaction with virtual environments designed for users with
visual disabilities have been developed [22,24]. These programs use labyrinths
represented in different ways through spatial and stereo audio [34,35]. Access Invaders
 is a video game that allows for online playing between blind users to solve a
School integration is a very important subject nowadays. There are several studies
about the present state of integration in the classroom as shown in [10,11,28]. On the
other hand, several studies on the way that technology can aid in the school
integration of users with different kinds of disabilities in the classroom have been
developed [7,8]. In another example, in [19, p.57] it was concluded that, “With the
large number of mildly disabled students in our schools, it is very important that
teachers make every effort to educate their students as best as possible. Evidence has
shown that technology is one of the best ways to implement this successfully. Using a
variety of software and technology tools this process is becoming easier every day.
Teachers must also make sure that they are educated in how to use these tools to
better instruct their students’ learning. As advancements in the field of technology
continue to be made, more and more opportunities for this level of learning will be
available to students and, as evidence has shown; more students will have better
opportunities to receive the best education possible.”
In this study, our proposal is The Natomy’s Journey Game, a sound-based game
that uses mobile technology so that blind and sighted children can interact, become
socially integrated and learn science. In the following we present the main
characteristics of the software, as well as an evaluation of its use by blind users and its
impact on the process of school integration with their sighted peers.
3 The Video Game
3.1 Video Game Description
The Natomy’s Journey Game represents four systems of the human body in which the
student adopts a character with which he/she can interact with other characters in the
game or in his/her work group, and thus complete the collaborative tasks necessary to
achieve a main goal. These four systems are: the digestive system, the respiratory
system, the cardiovascular system and the nervous system. The main problem to solve
is to heal certain sicknesses by using the clues that are provided to the students
through their interaction and investigation throughout the video game.
The video game was made to be used by workgroups of four students working
simultaneously in a computer lab (with a maximum of 12 groups working at the same
Video Gaming for Blind Learners School Integration in Science Classes 39
The interaction with the legally blind students is based mainly on the use of the
keyboard and feedback provided on their actions through a spatial sound system (4 or
more speakers distributed in the end-user’s surroundings) (see Figure 3).
The game can be played in an individual or a group mode. The user must interact
with the characters and objects in the video game that provide clues and symptoms in
order to solve the problem at hand. To these ends, the progress of each student
depends on the progress of the rest of his/her team, thus creating a variety of
interactions between the members of the group.
The game consists of two sicknesses to be discovered (Cholera and Rubella). As
the player interacts with the characters, they provide information on the sickness and,
at the same time, on the different organs and specific functions of the human body
necessary to make decisions. The students must get to a place in the human body
called the Center of Operations, where they enter an area of mini-video games that
they must successfully complete in order to pass to the next level and to beat the
game. Each system of the human body consists of 12 scenes that make up the totality
of the virtual world with which the users must interact.
3.2 The Video Game Metaphor
The video game metaphor consists of a journey to within a sick human body. This
journey is taken by a group of four friends who must go to the city of Natomy, where
a crazy genius (Uncle Isaiah) provides them with a pill that they must take in order to
shrink in size, to be able to enter the human body.
3.3 Video Game Architecture
This game was developed for a PC platform in Macromedia Director using Lingo
language. The following system requirements are needed to run the game: 1 GHz
processor or higher, Microsoft Windows XP SP2, 256 MB RAM, 32 MB DirectX 8
compatible video and sound card, 4 speakers or headphones for audio, and keyboard.
The software architecture upon which The Natomy’s Journey Game is based has
two main components: 1. Video game engine, responsible for controlling all the
players’ interactions, the logical relations and the dependencies between the different
systems, 2. Interfaces module, responsible for receiving the users’ actions through the
keyboard and, at the same time, producing the necessary feedback through graphic
objects and audio.
Each of the participating users interacts with the interfaces available in the video
game. The users with visual disabilities (legally blind) mostly used the audio
interfaces, which orients them and provides updated information on the state of the
video game. On the other hand, the sighted users use both interfaces (audio and
visual) to receive all the necessary information to be able to play the game correctly.
The information received through the interfaces is processed as input into the
game’s engine, which evaluates and processes the different logical interactions
between all the software’s components and the dependencies of these components.
Afterwards, it takes the new information produced by the users’ interaction, which is
then sent to the interfaces to be provided to the users (see Figure 1).
40 J. Sánchez and M. Sáenz
Fig. 1. Architecture of The Natomy’s Journey
Fig. 2. Networking Architecture of The
Natomy’s Journey Game
3.4 Networking Architecture
The video game’s multi-user interaction is carried out through architecture designed
over a local network, in which both desktop computers and wireless mobile
computers connected through WIFI can be used (see Figure 2).
Audio Interfaces. The audio interface developed for The Natomy’s Journey Game
consists of a combination of stereo and spatial sound. The stereo sound is utilized
mostly for the voices in the game used for the instructions, the different menus,
dialogues and some objects in the different scenes. The spatial sound is used mostly to
identify the objects in the spatial environment (see Figure 3). This last system was
designed so that the students with visual disabilities could orient themselves and
recognize the position of the objects, doors and characters in the scene. This
corresponds to certain audio elements that are constantly reproduced during the game,
such as the entry, exit and doors to the systems of the human body, as well as other
elements that are reproduced on-demand, such as the position of objects and
To create a spatial immersion of the user into the virtual environment, the speaker
system must be located properly. The front left and front right speakers must be
placed in an angle of 45 or 60 degrees. In addition, the 3 frontal speakers must be
placed at the same level. The rear speakers must be located behind the user and a little
above his ears (see Figure 3). Depending upon how the sound was used, different
levels of user immersion were attained. The use of the spatial sound attained the
highest level of user’s immersion allowing for a high fidelity representation of the
audio in a real environment which points out to the user the position of objects and
their location within the environment.
Audio interfaces were implemented using MS Directx, in particular the dxSound
for Lingo library. This allowed for producing and controlling dynamically the spatial
sound of the video game.
Video Gaming for Blind Learners School Integration in Science Classes 41
Fig. 3. Scenario for the use of the spatial sound
Visual Interfaces. The visual interfaces developed for the video game The Natomy’s
Journey Game correspond to caricaturized abstractions of the systems and organs of
the human body as well as objects in the game.
Fig. 4. Systems of the Human Body Representations in The Natomy’s Journey Game
The graphic interfaces for the systems of the human body correspond to an
integrated set of scenes that are coherently represented for the simulation of traveling
through each of the systems. The figure 4 corresponds to the maps of each system of
the human body, subdivided into 12 scenes with which the student interacts and
through which he/she travels.
Fig. 5. Some Avatars and Characters in The Natomy’s Journey Game
Avatars and Characters. Each student can pick from a total of 8 characters. The
characters designed correspond mainly to organs of the human body, made into
caricatures so that the students interact with them naturally and in the context of the
system in which they are playing. Figure 5 shows some characters in the biological
Main Interfaces. The game begins with an animated introduction according to the
metaphor defined, which explains to the student the tasks that he/she has to undertake
in the video game. Then there is an interface that corresponds to the main menu,
42 J. Sánchez and M. Sáenz
where the user can select the kind of play (stand alone or group work), the group with
which he/she will play in the game and the avatar, which will be the character that
will represent him/her in the video game (see Figure 6a). After this, the student begins
to play and can travel through the systems where he/she will be able to meet up with
the other members of his/her group (see Figure 6b).
Fig. 6. Visual Interfaces of the The Natomy’s Journey Game
3.6 Model for the Virtual Environment
The navigation through different virtual environments and spaces replicates a
successful model used for commercial videogames which follow a third-person
metaphor with a camera view fixed from an above and behind position. This model
of navigation has been adjusted to the needs of blind children, having added auditory
cues of spatial sound which allows them to form a mental construction of the space.
The representation of the surroundings is described in a XML file in which all the
attributes that characterize the different scenes can be found. The XML structure
contains a series of elements that define the storylines, which can also be modified,
extended or eliminated.
4.1 The Sample
To evaluate the impact of the use of The Natomy’s Journey Game, a study was made
with sixth and seventh-grade blind and sighted children between the ages of 11 and 14
years old. Tests were applied in seven mainstream public schools in Santiago de Chile
during 4 months, with the participation of 15 teachers and 326 learners. Eight legally
blind learners participated in this study (2 with partial vision and 6 totally blind).
4.2 Evaluation Instruments
End-user questionnaire: This instrument was applied to evaluate the interface of The
Natomy’s Journey Game through 4 dimensions: game satisfaction, control and use,
images and sounds quality . This questionnaire consisted of 18 sentences for
which the users must define to what degree each of them was fulfilled, on a scale
from A Little to A Lot, with quantitative values from 1 (a little) to 10 (a lot). Some of
the sentences were: “I like the videogame”, “The videogame makes me active”, “I felt
Video Gaming for Blind Learners School Integration in Science Classes 43
I could control the videogame’s situations”, “The videogame is interactive”, “The
videogame allowed me to understand new things”, “I like the sounds in the
videogame”, “The sounds in the videogame are clearly identifiable”, and “The sounds
in the videogame provide me with information”
Written guideline for the evaluation of school integration: To evaluate the level of
integration, a written guideline was applied in which each participating student had to
answer with opinions regarding the following four dimensions:
- Autonomy refers to the help that the students received to carry out the activities,
such as tasks or movements (on a scale of 1 to 5, the higher the score, the higher
- Teaching/learning style refers to how the students perceived their learning style in
relation to the way in which classes are held in the school (scale of 1 to 5, the
higher the score the lower the agreement with the teaching style).
- Belonging to the school refers to the sense of belonging that the students had
regarding their school; this asked if they felt integrated and if they identified with
their class and school (on a scale of 1 to 5, the higher the score the higher the sense
- School Integration refers to the opinion that they had on discriminatory practices or
practices of school integration (on a scale of 1 to 5, the higher the score, the higher
their disagreement with discrimination).
The entire intervention lasted for 4 months in each school. This period was divided
into 24 work sessions: 12 of group work with the software in the computer lab in each
school, and 12 of group work in the classroom using material designed specifically
for the study (board games, models and activities involving the building of objects
having to do with the concepts of the human body).
All throughout the execution of the study we also performed constant monitoring
of the participating schools, which implied visits to the classrooms and computer labs,
as well as communicating the activities through telephone and email. By the end of
the fourth month of intervention and after the last gaming session, the students
answered the end-user questionnaire.
Among the methods for evaluating the results, a series of both qualitative and
quantitative applications were used, collecting data from the actors involved in the
development of the study, teachers and the participating students. In the case of the
students, quantitative instruments were applied at the beginning and the end of
the study, in order to obtain opinions on the development of the stuffy and to prove that
the users accepted the video game, and that it motivated them to use these virtual tools.
Usability Results: The results obtained from the application of the end user usability
test could be grouped into 4 dimensions: Game satisfaction, control and use of the
videogame, sound quality, and image and color quality.
44 J. Sánchez and M. Sáenz
Fig. 7. (a) Usability Results by Dimension. (b) Usability Results by Gender.
As can be seen in the figure 7a, the means obtained in each of the dimensions were
high and showed that there were no big differences between the learners´ valuations
of the different areas analyzed regarding the usability of the software, as all the
answers were located in the “agree” category.
Although there were no big differences, it could be observed that the area with the
highest score was that related to the quality of the game’s sounds (mean of 4 points
out of a maximum of 5), which were agreeable and identifiable for the users. This
ends up being very important considering that the game was designed so that learners
with visual disabilities could participate. The game’s images and the satisfaction with
the game came in a close second, having obtained 3.9 points, which indicated that the
design of the images helped to transmit information to the user and that the students
liked the software in general, had fun with it, were challenged by it, believed that they
learned from it and that it was able to capture their attention. The evaluation of the
control and use of the game was similar (3.8 points), based on the fact that the users
felt in control of the game, that they could perform different actions or stop
performing actions whenever they wanted to, and on their perception that the game
was interactive and easy to play, easy to use, motivating and with an interface that
allowed the users to do anything simply and quickly.
It is important to point out the differentiation between the results obtained for the
men and the women (figure 7b), as statistically significant differences were found in 3
of the 4 dimensions. In all 4 dimensions the women presented higher means than the
men, and it was in the areas concerning use and control of the game (t = 3.905;
p<0.05), sound quality (t = 4.202; p<0.05) and image quality (t = 2.322; p<0.05) that
the differences were statistically significant. As for the dimension having to do with
“game satisfaction”, although the women presented a higher mean score than the men,
this difference was not significant (t = 1.915; p>0.05).
To better understand the result of the usability evaluation is necessary to do a
context analysis where the game was used. As a collaborative game, learners played
in a group of 4 students and synchronically, sometimes saturating the audio between
the four games. In general, the game contained heavy load of speech audio; audio that
could be boring for the sighted gamers. Although there were high quality graphics in
The Natomy's Journey Game including significant details, color and animation, they
were not 3D graphics as learners are used today. Being primarily oriented to legally
blind learners, the interaction relied strongly on keyboard, leaving aside devices such
as mouse, joystick or gamepad.
School Integration Results: Regarding the items that referred to the students’
autonomy in carrying out their activities, we focused on the students with visual
Video Gaming for Blind Learners School Integration in Science Classes 45
disabilities. As shown in the figure 8a, there was an increase in the score between the
pretest and the posttest for each one of the items. For the statement indicating that the
students carried out most of their activities without assistance, there was an increase
of 1.1 points between the pretest and the posttest (pretest = 2.2 points; posttest = 3.3
points). For the item indicating that the students tried to carry out their activities
without help, there was an increase of 0.9 points (pretest = 2.9 points; posttest = 3.8
points); and for the item on whether or not the student studied with help from his/her
parents or another person, there was an increase of 0.2 points (pretest = 4.2 points;
posttest = 4.4 points).
Fig. 8. Integration Results. (a) Autonomy. (b) Learning Style.
As for the proximity between the classes and the students’ learning styles, the figure
8b shows the means obtained from the students before and after having participated in
the study, demonstrating very similar means. Only for the item that indicated that the
students felt that their way of learning was different from their classmates was there a
decrease pretest-posttest of 0.2 points (pretest = 3.6 points; posttest = 3.4 points) with a
significant difference (t = 2.431; p<0.05; df= 546). This showed that after the study the
blind students considered their way of learning to be closer to those of their sighted
classmates than when they first began to use the video game.
Regarding the sense of belonging that the students had with their class and their
school, there were no major differences in the opinions provided before and after the
study (see Figure 9). For the item indicating that they felt identified with the majority
of their classmates, a higher mean was obtained (a difference of 0.4 points between
the pretest and the posttest, pretest=2.2 points; posttest=2.6 points), which was also
statistically significant (t= -2.374; p<0.05; df= 538). This is to say that by the end of
the study the students’ experienced a higher degree of identification with their class,
even though this was one of the lowest scoring items. The other items in which there
was a pretest – posttest gain were: “I don’t feel that my classmates bother me” (0.1
points difference, pretest=3.1 points; posttest=3.2 points; t= -0.077; p<0.05; df= 539)
A. I carry out most of my activities without the help of my
parents or another person.
B. I study with the help of my parents or another person.
C. I try to carry out my activities without help.
A. I feel that my way of learning is different from that of
B. My way of learning has nothing to do with the classes
taught by the teachers.
C. I wish the classes were different
46 J. Sánchez and M. Sáenz
and “I feel a part of my class” (0.2 points difference, pretest=3.7 points; posttest=3.9
points; t= -1.610; p<0.05; df= 536). The items that had no variation were: “I identify
with my group of classmates” (mean of 3.5 points in both tests, t= 2.793; p<0.05; df=
538) and “I like my classmates” (mean of 3.1 points in both tests, t= 0.022; p<0.05;
Fig. 9. Integration Results. Sense of belonging to their school.
The scores obtained for the opinions provided on the students’ perspectives on
school integration or discriminatory practices did not present any pretest – posttest
gains (see Figure 10). It is important to point out that the students’ opinions, both
before and after the intervention, had means higher than 4.4 points, which indicated
their rejection of discriminatory practices and their approval of the idea that all
students have the right to an education and that everyone is different.
As for the opinions provided by the participating teachers regarding school
integration, measurements were taken both at the beginning of the study and at the
end, to be able to compare the possible changes that took place. One important
situation that was observed is that there was an increase in the percentage of teachers
that stated having had experience with school integration, from 60% at the beginning
to 72.7% at the end, so considering this experience with The Natomy’s Journey Game
as school integration with technology.
Fig. 10. Integration Results. School Integration.
In asking the teachers if they had implemented some strategy in the past three
months for the integration of a student with visual disability, we also found that there
was an increase in the final measurement, in that while initially 77.8% of the teachers
had indicated “yes”, at the end of the study 90.9% responded with a “yes”.
Finally, in asking the teachers about how they felt working in the classroom with
visually disabled students, an increase in those teachers that indicated feeling self-assured
A. I feel like I identify with most of my
B. I don’t feel that my classmates bother
C. I feel a part of my class.
D. I identify with my group of
E. I like my classmates.
A. Discrimination is a bad thing.
B. All of us students have a right
C. All of us students are
Video Gaming for Blind Learners School Integration in Science Classes 47
was observed, going from 50% for the initial measurement to 63.7% in the final
It is important to mention that the integration of learners with visual disabilities
with the classroom and school classmates requires extended and sustained amount of
work time that must be transversal at all school activities. Even though this fact it was
possible to observe some advances as some participating teachers mentioned: “ I felt
that in some moments he (the blind child) became part of something”, “I saw him for
the first time integrated to a team work…and the group accepted him for sharing
purposes”, “I saw him integrated and a little more respected by their classmates
because he tend to establish a negative relation with his classmates, in a defensive
mode, but at the end of this experience his classmates accepted him well”. All this
assertions evidence qualitative relevant changes for the learner’s integration
considering that at the beginning it was observed that students were mostly excluded
from their class, ending up as a result of participating in this study, with a more
egalitarian participation in the project.
As a result of this study a video game for science learning by middle school blind and
sighted learners was constructed and evaluated, to judge whether blind learners can
interact and become socially integrated through the use of problem-solving skills and
the application of specific science content.
The results of this study provide initial data and evidence that the use of video
games such as The Natomy’s Journey Game can improve the process for the school
integration of learners with visual disabilities.
During the implementation process we made a non-participant observation to collect
information about how learners and teachers appropriated and learned the methodology
used. From these observations we could detect similar behaviors between learners during
video gaming, as far as understanding controls and discovering new paths and goals. The
participation of blind learners in particular was active and with high motivation.
The Natomy’s Journey Game proposes a new way to learn science, especially the
systems of the human body. The main achievement after using this game is that
learners take an active role, learning in an interactive and motivated way. The learners
enjoyed this new way of learning, felt motivated and participated actively and
collaboratively in the tasks they had to undertake in the game.
In terms of school integration, this game helps to create a work environment in
which differences are forgotten and children interact freely. They share ideas on how
to solve the proposed problem as well as content knowledge among all four members
of each team.
The Natomy’s Journey Game allows blind children to become more socially
integrated with their sighted classmates, to participate actively in society, and to be
interested in the active learning of contents and new pedagogical ways of learning
such as digital mobile gaming. Based on the children’s comments, we point to the fact
that the game allowed legally blind children to work together with their sighted peers,
feeling part of the group, and this is very important issue in order to achieve a better
and more complete education not only in terms of learning contents, but of school
integration and teamwork skills as well.
48 J. Sánchez and M. Sáenz
Acknowledgments. This report was funded by the Chilean Ministry of Education,
Innovation Program, Project “Digital Inclusion for the Science Learning” and Project
CIE-05 Program Center Education PBCT-CONICYT.
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