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Summary

A Guide to Making Documents Accessible
to People Who Are Blind or Visually
Impaired
by Jennifer Sutton
The inclusion of products or services in the body of this guide and the accompanying appendices
should not be viewed as an endorsement by the American Council of the Blind. Resources have
been compiled for informational purposes only, and the American Council of the Blind makes no
guarantees regarding the accessibility or quality of the cited references

For further information, or to provide feedback, contact the American Council of the Blind at the
address, telephone number, or e-mail address below. If you encounter broken links in this guide,
please alert us by sending e-mail to [email protected]

Published by the American Council of the Blind
1155 15th St. NW
Suite 1004
Washington, DC 20005
(202) 467-5081
Fax: (202) 467-5085
Toll-free: (800) 424-8666
Web site: http://www.acb.org
E-mail: [email protected]

This document is available online, in regular print, large print, braille, or on cassette tape

Copyright 2002
American Council of the Blind
Acknowledgements
The American Council of the Blind wishes to recognize and thank AT&T for its generous
donation to support the development of this technical assistance guide to producing documents in
alternate formats

In addition, many individuals too numerous to mention contributed to the development of this
project. Colleagues demonstrated a strong commitment to equal access to information for
everyone by offering suggestions regarding content, and a handful of experts spent time
reviewing and critiquing drafts. The author is grateful for all of the assistance and support she
received

Table of Contents
I. Getting Started
Who Will Find this Technical Assistance Guide Helpful?
Why Provide Your Documents in Accessible Alternate Formats?
How to Use This Guide
Factors for Selecting the Format(s) to Offer
Statistics Concerning the Blind and Visually Impaired Population
Purpose and Portability
Quantity
Assistive Technology
Securing Customers' Personal Information
Who Should Do the Work?
Performing the Work In-House
Hiring a Contractor
II. How to Design with Access in Mind
A Word About Wizards
Dos and Don'ts of Word Processing
Special Kinds of Documents and Formats
Thinking About Images
III. Providing Large Print
Deciding on the Number of Copies
Formatting and Printing for Large Print Readers
Labeling and Binding Large Print Documents
IV. Providing Braille
Braille Translation Software and Word Processing Techniques
Making Visual Information Accessible to Braille Readers
Embossing, Binding, and Labeling Braille Documents
V. Providing An Audio Version of the Text
Selecting a Reader
Recording Tips
Choosing a Tape Format
Providing Audio Files on Compact Disc
Choosing a File Format for a Computer or the Internet
Including Place Markers in Audio Formats
Copying, Labeling, and Packaging Audio Products
VI. Providing Electronic Documents
Word Processing for Maximum Flexibility
Distributing a Text File
Sending Information via E-mail
Putting a Braille File Online
Providing Electronic Files on Compact Disc
Creating Accessible Web Sites
Common Web Site Accessibility Issues
Making Information in Presentations Accessible
Offering Files in Other Specialized Formats
Providing Simultaneous Text and Audio Access
Appendix A: Marketing the Final Product
Appendix B: Resources to Assist with Production of Large Print
Appendix C: Resources to Assist with Production of Braille Documents
Appendix D: Resources to Assist with Production of Audio Formats
Appendix E: Resources to Assist with Production of Electronic Documents
Miscellaneous General Web Sites Concerning Accessibility
Web Page Accessibility Provisions and Guidelines
Web Page Accessibility Tutorials
Tools for Web Page Assessment
Miscellaneous Tools for Publishing Online in Special Formats
Multimedia
Providing Simultaneous Text and Audio Access
I. GETTING STARTED
This document contains a comprehensive discussion about how to make print and
electronic information available to people with visual impairments in a variety of accessible
formats. Consumers who have limited vision or are totally blind have unique access needs

These needs depend on the amount of vision each person has for reading. Some people have
usable vision, allowing them to read large print. Others choose to read braille on paper,
while a third group prefers to use a computer with synthetic speech, or refreshable braille
display, to read electronic documents

To make a text accessible, it is usually necessary to provide it in several formats. Alternate
formats include large print, braille, audio tape, and electronic file. Even within these four
categories, there are choices that are most appropriate, depending on a number of factors

The process of developing alternate format documents can initially seem somewhat
daunting and difficult. You will discover that some formats are easier to produce than
others, but all formats need to be considered since some of the ones that take more effort to
produce are essential for those who need them. Regardless of the alternate formats you are
producing, the process will be easier if you think about it early, perhaps even during the
writing phase. We urge you to take alternate format production as seriously as you would
the production of a document in print. After all, the look, sound, and feel of your final
product represent you to blind people in the same way that a print document represents
you to sighted people. Fortunately, modern computers, when properly used, make this task
easier. It is our purpose to offer helpful guidance in order to make the preparation of
alternate format documents as straightforward as possible

Who Will Find this Technical Assistance Guide Helpful?
You will find this guide helpful if:
 You need to make the manual for a piece of software or an appliance accessible to
blind or visually impaired customers;
 You have been asked to find out how your company will provide bills that blind
customers can read either with or without their computers;
 Your company is preparing for a conference, and you need to provide braille and
large print handouts;
 You are a blind consumer who is advocating that a company make documents
available to you in a form you can read;
 You want to offer a braille menu to the blind customer who comes into your
restaurant;
 You are wondering how to enable blind customers to read forms or tables; or
 You want some basic guidance about how to make it easy for blind people to use a
World Wide Web site

While we cannot possibly discuss every kind of document here, you will find suggestions
that will at least get you started. You will also be directed to other resources that may
provide more detail about what to consider for a specific document type

Many federal and state laws require that accessible documents be provided in certain
situations. Some examples include Section 508 of the Rehabilitation Act, Section 504 of the
Rehabilitation Act, Section 255 of the Telecommunications Act, and Titles II and III of the
Americans with Disabilities Act. Obligations to provide accessible documentation can vary,
depending on factors such as when the document was produced, who is furnishing the
document, for whom, etc. A complete analysis of the laws and regulations pertaining to the
provision of accessible documentation is beyond the purpose and scope of this guide. Here,
we will provide guidance on how to produce accessible documents

Why Provide Your Documents in Accessible Alternate
Formats?
Certainly, as we have seen, the answer to this question could be a simple one. Documents
should be made accessible because federal and some state laws mandate doing so. But we
hope and expect that you will make documents available to blind and visually impaired
people because you are eager to attract this group as loyal customers and because it's the
right thing to do. Having equal and timely access to written information is absolutely
critical for blind and sighted people alike

What you may not realize is that offering accessible information to this consumer group
gives you a chance to effectively target this population with its buying power. If you
publicize how blind consumers can obtain accessible information, you will expand your
customer base, and these customers are sure to spread the word about a company's obvious
commitment to access. Blind consumers are willing to support companies that promote
independence and maximize an individual's abilities

Regardless of why you want to learn how to make information accessible, you will find tips
and tricks here that will make the process much easier. For example, you will find
specifications to consider as you develop a contract, resources to help locate experienced
companies, and a few strategies to use to market and distribute completed alternate format
publications

How to Use This Guide
In order to get the most out of this guide, you are encouraged to carefully read through this
introductory section, as well as the next section, "How to Design with Access in Mind."
Important concepts are introduced that apply to all of the alternate format options. After
you understand the basic principles described in these two sections, you can read the
additional sections that best meet your needs. At any point in the process, you can find
helpful references and resource links in the appendices. A discussion of strategies to assist
with the marketing of the final product is located in Appendix A

This technical assistance guide has been designed to be consulted on the World Wide Web

The online version provides many interactive links and can be found at the website of the
American Council of the Blind. A number of links are cited in the body of the document,
but the appendices contain the majority of the online resources to which you may wish to
refer

The American Council of the Blind is pleased to provide this document on its web site in
HTML and as a braille file for use with a computer's refreshable braille display or portable
note-taker. The braille file is offered to facilitate access for blind consumers. Regular print,
large print, audio tape, and hard copy braille will be provided upon request

Factors for Selecting the Format(s) to Offer
When we begin to consider how to provide accessible documents to people who are blind or
visually impaired, one of the first steps is to decide which formats will be offered. Unlike
documents for sighted people who need legibly printed texts that are appealing in their
presentation, blind or visually impaired people have needs that relate to what level of
reading vision they have, what assistive technologies they will use, and where they will need
to access the information. You may simply decide to offer large print, braille, and cassette
tape, as outlined in various regulations; however, combining one or two of these formats
with an electronic document type can allow for maximum flexibility and some cost-savings

One of the best methods to determine which formats to provide is to contact a
representative sample of customers who are blind or visually impaired. Consumer groups,
like the American Council of the Blind, and other local organizations serving blind people,
often provide suggestions directly, or they may guide you to individuals willing to give
advice. In addition, if texts are being prepared for an activity that requires people to
register, the registration process can be used to ask blind people about their format
preferences. What follows is a discussion of some of the issues and information you will
want to consider

Statistics Concerning the Blind and Visually Impaired
Population
One of the issues to be considered is the number of people who are looking forward to
reading accessible documents. According to the American Foundation for the Blind's
document, "Quick Facts and Figures on Blindness and Low Vision," "every seven minutes,
someone in America will become blind or visually impaired." Additional statistics provided
by the organization indicate that there are almost 8 million Americans with a visual
impairment who have difficulty reading or are unable to read letters in regular print, even
while wearing ordinary glasses. As a result, many in this group can benefit from clear print
that is large enough to make it easy to read. As the population ages, it is reasonable to
expect that the group of older individuals who are blind or have low vision will grow

Approximately 1.5 million people within this group are considered to be legally blind, and
this population is the primary audience for whom alternate format publications are
intended. Generally, a significant number of individuals who are legally blind find large
print or audio texts helpful, while some 8-10 percent of the group use braille as a reading
medium. Almost 200,000 people with a severe limitation in seeing have access to the
Internet, and many of them use a computer on a regular basis

Purpose and Portability
Thinking about the purpose of the document and the circumstances under which it will be
read often determine which alternate formats are most appropriate. When possible,
providing choices to enable blind and visually impaired people to be flexible about the
format they prefer in different situations is ideal. Talking to the person or to groups of
consumers about preferences ahead of time can result in innovative compromises and
access solutions that might not be readily apparent at first. Asking questions like these may
help to make the appropriate format choices clear

 Is this a document that is likely only to be read once and then discarded?
 Are you producing text that will need to be searched?
 Are readers likely to be technologically sophisticated?
 Is this information that must be retained and reviewed over a number of years?
 Will someone need to interact with others while reading the document?
 Will customers need to complete and return the document to you?
The need to read a document only once suggests that all four formats should be considered,
and appropriate ones should be made available depending on where the information will be
read. If someone needs to read an agenda during a meeting, for example, an audio tape is
not ideal, unless the tape is distributed ahead of time. In this situation, braille or large print
may be the best choices, or if the agenda is available beforehand, the person may prefer to
download the electronic file into a portable reading device for review during the meeting

Like sighted people, blind individuals want to follow along with the text and fully
participate. Understandably, handouts may continue to change until close to the time of the
meeting, so time pressure may become a concern. But good planning and communicating in
advance with blind or visually impaired attendees will result in a better experience for
everyone

If sighted people would like to review the text periodically and refer to it over time,
allowing blind people to choose among large print, braille, audio, and electronic file is best

If the information needs to be searched, electronic files may be the best way to make
searching possible

If the document needs to be carried from place to place, such as a conference program, and
it is a long document, it may be unwieldy to carry in braille and to store for future
reference. Readers might appreciate the option of having a shorter calendar portion in
braille, and then being able to load an electronic file of the full program into a portable
note-taking device so that it can be quickly searched and reviewed

Ideally, forms will be generated so that individuals can complete them independently

Distributing a form as a text file makes working with the form effortless for blind or
visually impaired users in comparison to other alternatives. People can enter their
responses, print out the document, and submit the form, though retaining formatting is
difficult. Since interactive forms are increasingly offered in HTML on the World Wide
Web for everyone, this is certainly another option, assuming that the interactive form has
been created according to accessible web page design principles. Offering a form on a web
page for everyone to complete using a specialized format requiring a specific plug-in to
allow users to complete the form can present problems. Although the ability to provide
accessible forms is progressing, the completion of automated forms like these still has some
limitations. Today, completing them often requires the installation of a plug-in and a
commitment to a particular computer operating system. Also, blind and visually impaired
computer users need, but may not have, the most up-to-date specialized technology
available. If the text in such forms is not generated properly, it can become jumbled and
difficult to interpret even when converted by an accessibility plug-in

Quantity
Deciding how many copies of each format to produce will depend, to some extent, upon
whether the work is being done in-house or whether a contract is being established to have
it done. For example, printing material in large print on demand is not difficult. Copying
an accessible file onto a diskette or compact disc and then duplicating that product is
increasingly easy to do and relatively inexpensive. Certainly, presenting a document online
is one of the easiest ways to make copies freely available

But deciding how many copies to produce in large print, in braille, or on cassette or
compact disc is a matter of guesswork and some trial and error. To see some statistics
concerning the blind and visually impaired population, be sure to read the section above
entitled "Statistics Concerning the Blind and Visually Impaired Population."
Here are some additional suggestions that may be helpful

One strategy, which may be useful for distributing braille, would be to have a few copies
produced. Then, keep an electronic copy of the master braille file. An electronic braille file
is basically just like any other computer file, except that it has an unfamiliar three-letter
extension, and it looks rather strange if opened in a typical word processor. A contractor
can easily generate additional paper copies from the electronic file upon request. Updating
information that changes frequently, such as the text of a menu, is important and
appreciated by blind customers

A restaurant might want to have a handful of copies of its menus available in braille. A
hotel could keep several copies of its local area guide and hotel directory on hand in both
large print and braille for guests. Then, if either the restaurant or hotel has a larger group
of blind visitors, it is not difficult to provide more copies for them

If you contract to have your alternate format production needs met, the companies with
which you choose to work can often advise about the quantities needed. Clearly, the advice
you receive will be especially on target if the chosen contractor has previously produced
documents with a similar purpose and audience

Assistive Technology
People who are blind or visually impaired use various assistive technologies to enable them
to access printed texts. Assistive technologies can make text accessible, but they cannot
render graphics or graphical images in meaningful ways without textual information or
representations that web page designers or document producers must provide. Assistive
technologies typically magnify print, verbalize text aloud in synthetic speech or from a
recording, or give the user access to braille

Those who read large print may be able to read a document with the aid of prescription
lenses, but others may use handheld magnifiers for reading. Some of those who read large
print use a closed circuit television (CCTV) at home or in an office. A CCTV is equipped
with a camera that enlarges the print and projects it onto a television-like screen. Those
who read large print may also have software to enlarge the print displayed on the
computer's monitor

Braille readers may read braille on paper or they may have access to a device that can
display refreshable braille. Refreshable braille displays allow the reader to scroll through
the text in an electronic file. Pins on the display move up and down, as needed, in order to
generate the braille "dots" that form the letters read with the fingers. Refreshable braille
displays can be found as part of portable note-takers that are small machines that typically
function for blind people like handheld personal data assistants do for sighted people

Refreshable braille displays may also be attached to a desktop computer. Braille on paper
is generated by using software to translate the text into braille and then using a braille
printer, known as an embosser, to produce the paper copies

Audio recordings are generally produced on cassette tape, but compact discs may be used
in some circumstances, particularly as tape production and duplication become more
difficult. Blind people may use commercially available tape recorders or stereos to listen to
recorded texts, or they may use specialized half-speed, four-track cassette players which
many blind people have available. You may wish to use this non-standard format to
produce cassette tapes, especially if the document you are recording is longer than 90
minutes. Companies that regularly produce audio tapes for blind people are familiar with
the logistics of providing recordings in this specialized format

Electronic files may be read using a refreshable braille display attached to a computer,
using a portable note-taker, or using synthetic speech. Synthetic speech may be built into a
portable note-taker, or it may be produced using software and a voice synthesizer installed
on a computer. Basically, a blind person who uses synthetic speech is able to hear all of the
textual information that is displayed on a sighted person's screen. Electronic files can be
distributed to blind people on World Wide Web pages, by e-mail, on diskettes, or on
compact discs. Sometimes, producing an accessible electronic document can give the user
the most flexibility since an electronic file can be searched, reviewed, and manipulated

Securing Customers' Personal Information
Many companies do not need to consider customer privacy, but those who do must take
this issue seriously, regardless of the alternate format being produced. Customer privacy is
particularly important when a company is providing items like bills or bank statements

Offering this information in large print or braille, or via online access, are all certainly
options. What is most important is that the information be transmitted privately,
accurately, and in a timely fashion. Blind people appreciate the opportunity to handle
financial transactions and maintain written records of such transactions without relying on
the assistance of sighted readers

If you contract to have documents produced in alternate formats, be sure to have your
contractor sign an agreement to prevent the disclosure of private information. Here are
some specific suggestions about each format choice

Simply enlarging and copying a statement on a copy machine tends to yield unsatisfactory
results. The print must be large, clear, and dark to enable people with low vision to read it

Methods for producing braille are dependent upon the computer hardware and software
used to create the document in print. If bank statements, for example, are generated from a
specialized computer system or software, a company may need to have an interface
developed to facilitate the generation of braille using translation software and a braille
embosser. While printing a statement in regular print and then using a scanner to scan it
for production into braille might seem to be an option, scans of documents with columns
and numbers frequently result in a text with errors

Listening to private information read aloud on a recorded medium is the least ideal of all
the format options. This approach allows others, such as those who read the information
aloud, to have too much access to personal information, and tapes are difficult to search
and review

Offering electronic access to private information may be the simplest approach since
companies increasingly allow sighted customers to have the same method of access. This
form of access is the most convenient for those who know how to use computers and note-
taking devices. Though a growing number of blind and visually impaired people do have
access to a computer and the Internet, providing this alternative may not suffice for every
customer. When a company chooses to provide access to private information online, it is
critical that a company pay close attention to web accessibility guidelines. Tables and
columns, for example, must be formatted properly. Customers must be able to enter their
passwords independently, and they must be able to navigate the site using the keyboard for
all tasks. Note that when the World Wide Web Consortium's accessibility guidelines are
followed, it becomes fairly easy to generate braille and large print documents from the
electronic files used on the web site

Who Should Do the Work?
Deciding whether to contract with other companies that can produce alternate format
documents or whether to do the work in-house requires some forethought. You may
conclude that some production tasks can be performed in-house, while some of the
document preparation should be done by companies with particular expertise. In general,
the master copy of large print materials and electronic documents can be produced in-
house. On the other hand, it may be more convenient and efficient to call upon the
expertise of outside contractors familiar with the intricacies of producing text in Braille
and in audio formats. Consider the following questions:
 How many copies of each publication will you need?
 How frequently will you need to produce each document for a given customer?
 Will you be filling requests for accessible documents on an "as needed" basis?
 How often will you be revisiting the publication?
 Will you have a quick turn-around time?
Performing the Work In-House
Consider producing alternate format documents in-house if:
The primary audience for your product is blind or visually impaired people;
You often need to provide accessible information to visually impaired personnel; or
You frequently produce similarly formatted documents using a word processor

Also consider generating alternate format documents in-house if you have a staff member
or two who:
Has strong word processing skills and can understand the concepts necessary to produce
high-quality large print
Has specific computer skills and is familiar with writing the code needed to design web
pages
Has a clear, pleasant reading voice and is familiar with both the content and purpose of the
material to be recorded
If you decide to produce some or all of the alternate format documents in-house, consider
having qualified blind or visually impaired consumers review your work to suggest ways to
improve the quality. It is especially important that a proofreader be hired to offer initial
advice to assist with the smooth production of high-quality braille

Each alternate format section in this guide has basic ideas to keep in mind. Links to
additional references may be found in the appendices

Hiring a Contractor
Since accessible documents may only need to be produced upon request, or when the print
publication is revised, we suggest you consider contracting out some parts of the process

As you will see, it is relatively easy to use word processing software to modify a regular
print document and produce acceptable large print. Web masters or desktop publishing
staff who pay careful attention to detail can convert electronically generated text into a
format that a blind or visually impaired person can read

But producing the other alternate formats, such as braille and audio file, requires some
specialized skill and financial outlay. An organization that chooses to record an audio
version of the text or emboss it in Braille will need to purchase and install braille embossing
equipment, become familiar with specialized software, need a cassette duplicator, and have
some audio production experience

The American Council of the Blind maintains a number of resource lists that contain
helpful general information about blindness and visual impairment, or about companies
that provide products and services of interest. See the American Council of the Blind's
Helpful Resources page

The American Foundation for the Blind offers a comprehensive database on its web site
that will guide you to local organizations that can assist with the production of alternate
format documents. See the AFB Directory of Services for Blind and Visually Impaired
Persons in the United States and Canada

The American Printing House for the Blind has compiled a similar database which offers
information about Accessible Media Producers. See the Accessible Media Producers
Database

the National Library Service for the Blind and Physically Handicapped has recently
revised its resource publication, Sources of Custom-Produced Books: Braille, Audio
Recordings, and Large Print. You can obtain the publication online, or it can be ordered in
braille or print by contacting the Reference Section at the National Library Service for the
Blind and Physically Handicapped, The Library of Congress, Washington, DC 20542

All three of these comprehensive resources allow users to search with more or less
flexibility for local and regional organizations. Searches can be limited to organizations
that perform certain services, such as braille transcription and proofreading, or recording
of documents. Volunteers staff a number of the organizations listed in the resources
mentioned above, but we encourage you to hire contractors, especially due to the time
limitations under which volunteers may be working. As you would when making
arrangements with any contractor, we urge you to seek recommendations from consumers,
use this guide to prepare yourself to ask explicit questions, be able to describe the alternate
format product you expect to receive, and generally make sure that the contractor you
select has had experience providing what you need in a timely fashion

Additional sections that best meet your needs. At any point in the process, you can find helpful references and resource links in the appendices. A discussion of strategies to assist with the marketing of the final product is located in Appendix A. This technical assistance guide has been designed to be consulted on the World Wide Web.