Introduction: The study reported here evaluated whether there was a difference in students' outcomes for braille fluency when instruction was provided with traditional braille media or refreshable braille. Students' and teachers' perceptions of the efficacy of the use of the different instructional media were analyzed. Methods: Nine students from public and residential schools, using the "Patterns" reading series, participated in the study. In an alternating-treatments design, weekly curriculum-based measures that were developed to measure oral reading fluency and word-writing fluency were used to monitor the students' progress with each instructional medium. Semistructured interviews at the conclusion of the study gathered information about the benefits and challenges of each medium. Results: Throughout the 18 weeks of instruction, there were no consistent differences between students' use of the refreshable braille display and their use of paper and the Perkins Brailler. All students achieved gains in their knowledge of braille letters and contractions, and many achieved an increase in fluency, although the increase was not tied to one instructional medium. The participants identified both the advantages and disadvantages of each medium. Discussion: The study did not reveal consistent differences among the students between the outcomes of instruction with the traditional Perkins Brailler and paper or the electronic braille notetaker with a refreshable braille display. The teachers were concerned about the inability of students to obtain spatial relationships using refreshable braille. Implications for practitioners: This study did not provide a clear answer to questions regarding differences in outcomes. The findings suggest that following some instruction with the technology, students can quickly learn to use an electronic braille device, are motivated to use these devices, and may demonstrate enhanced outcomes. (Contains 3 tables and 2 figures.)