Parenting & Families
General Information
Assistive Technology: Assessing Your Child's Needs
By Penny Reed, Ph.D., Director of the Wisconsin Assistive Technology Initiative
A mother discovered the talking picture frames available in
department and specialty stores and decided to place them on the
walls throughout the house for her severely communicatively
impaired son with autism. They were attached to walls, closets,
sinks and the refrigerator throughout her home with appropriate
messages for that area of the house. Her son with autism could
ask for items that had meaning to him, and this strategy was
working extremely well. So well, in fact, he was able to use them
without a prompt.
An Assistive Technology Consultant was asked to determine an
appropriate computer for a student with a learning disability and
very poor handwriting. After trying several things, the consultant
determined that what the student actually needed was an adapted pencil grip. The student was happy because he didn’t want to do his writing on the computer (because no one else did). The school was happy to learn there was an inexpensive solution.
Parents and professionals use assistive technology for children and adults with disabilities every day. Sometimes the assistive technology is so natural that it is used without much planning or thought. However, more complicated problems require careful thought, evaluation, and trial use with children and adults with disabilities. In these situations, assistive technology can mean the difference between success and frustration. Parents, professionals, and the person who will actually use it must work together for assistive technology to be successful. The sheer number of things out there that are considered assistive technology and the fact that the 1997 reauthorization of the Individuals with Disabilities Education Act (IDEA) requires that every Individualized Education Program (IEP) committee "consider" the child's need for assistive technology underscore the need to work together to choose assistive technology for an individual.
Exactly what is assistive technology? It is anything that can help a person with a disability do something s/he cannot do or help do it better than s/he can without the device. Anything? Yes, anything. Assistive technology is an extension on a light switch that allows a child in a wheelchair to turn on the light. It is the wheelchair. It is a sound system that makes it easier to hear what the teacher is saying. It is a pencil grip that helps a child better grasp a pencil. It is software that does something special such as speak the words printed on the screen for someone who cannot read the print. It is a clipboard that holds down a piece of paper that helps a child write more legibly. It is thousands and thousands of items that help individuals with all sorts of disabilities and challenges.
Sometimes it is easier to think about what assistive technology is not. It is not a person. A person is never assistive technology. It is not a strategy. It is not a method. It is not a shorter assignment. It is not a different location in the classroom. These are all important to consider for a child with a disability, but they are not assistive technology.
The legal definition of assistive technology first appeared in the Technology Related Assistance for Individuals with Disabilities Act of 1988 (Tech Act). It was also defined in the 1990 reauthorization of IDEA. The definition in IDEA as amended is the same as the definition in the Tech Act, except the word "Individuals" is changed to "children". The definition of assistive technology in IDEA is:
Any item, piece of equipment, or product system, whether acquired
commercially off the shelf, modified, or customized, that is used to
increase, maintain, or improve functional capabilities of a child with a
disability.
Authority: 20 U.S.C. Chapter 33, Section 1401 (25)
It is important to know about assistive technology because it can be
a powerful tool for people with disabilities, allowing many people to
do things they could not do without it. Appropriate assistive
technology compensates for all types of motor limitations, difficulties
with vision or hearing, or less obvious problems with reading, writing,
or memory. The only thing assistive technology cannot do is help
your child to do something that he is not developmentally or
cognitively ready to do. For instance, someone could program
wonderful, appropriate messages in an augmentative communication
device, but if your child doesn't understand those messages, doesn't
have a desire to use them, or doesn't activate the device, it won't
help him communicate. Assistive technology is most appropriate
when a child wants to complete a task, tries to do it, but is
unsuccessful because of a physical or sensory limitation. This is
where assistive technology makes a significant difference.
The range and number of items considered assistive technology is
staggering. The Abledata Database, a national database of
information on assistive technology, now includes over 23,000
entries. These does not include all of the simple, easy-to-make
devices or other items not designed specifically as assistive
technology, but that work that way. One example is the talking
picture frames found in department and specialty stores that frame a
photo and play a personalized, recorded message. Using pictures or
symbols in the frame with a prerecorded message describing the
symbol (such as "I want to go outside."), these talking picture frames
become an inexpensive voice output communication device for
someone whose speech is limited or not easily understood.
To understand this vast array of devices, it helps to think of the
functional tasks the assistive technology is used to accomplish. There
is assistive technology to help with spoken communication, written
communication, mobility, seeing, reading, eating, feeding, hearing,
dressing, and playing. For all of these tasks, and myriad more, there
is a variety of assistive technology ranging from very simple "low" or
"no" tech items to "higher" tech, computer-based devices. There are
assistive technology applications for all disabilities, all ages, and all
abilities. In addition, new assistive technology is being developed
every day.
Uncovering What a Child Needs
Learning about assistive technology in general is one thing. Figuring
out what might help your child with specific tasks is another. The best
place to start is with your local school district or service provider.
Most school districts and Birth-Three agencies make an effort to
understand, acquire, and use assistive technology appropriately.
Meet with your child's teacher to determine if s/he is familiar with
assistive technology. When you do, ask how assistive technology is
being used in the classroom and to see some examples. One of three
things will happen:
- the teacher will show you several things that are being used in the
classroom,
- the teacher will refer you to the occupational therapist or
speech-language pathologist who is taking the lead role in the
provision of assistive technology, or
- the teacher will be at a loss as to what you are talking about.
If you get a response that resembles number 3, ask who in the
agency is familiar with assistive technology. If the teacher does not
know, then go to the principal or Special Education Director and ask
the same question. If no one in the agency or school is well informed
about assistive technology, they need to get started right away.
Whether or not the teacher is knowledgeable about assistive
technology, the next step is to request a formal assistive technology
evaluation for your child. You have a right to that under IDEA and
your school district or Birth-Three program must respond.
The Assistive Technology Evaluation
The key to an effective assistive technology evaluation is to use a
process that involves both parents and service providers equally.
There is no quick, easy method to determine which assistive
technology, if any, will help your child. There is also, no single
"expert" somewhere who knows exactly what will work. Many
individuals, parents, teachers, therapists, as well as the child, have
important pieces of information. When brought together, these pieces
begin to point in some general directions.
A good assistive technology assessment process will include:
- discussions about what tasks your child struggles with the most,
- observations of your child in environments where he spends time, and
- trials with different types of assistive technology (starting with the simplest) to see what works and what appeals to your child.
There can be a marvelous assistive technology tool out there, but if
your child hates it—for any reason—it will not get used. Therefore, it
is not the right solution at this time.
Parents should expect to be part of the process from start to finish.
This process focuses on the question: "What functional task do we
want this child to be able to do at a level that reflects his/her skills
and abilities?" Parents and professionals together identify the tasks
that are most challenging and choose which one to work on first.
Parents, teachers, speech pathologists, occupational therapists, and
anyone else involved with your child then gather data while playing or
working with your child and keeping notes. Ask to be included in the
discussion as the team (which includes you) brainstorms about the
data collected in different environments. The team will discuss what
kind of things might work and where to borrow or rent what you
need for trial, or how to construct it. As the child works and plays
with different tools provided as a result of these observations, more
data collection will be necessary. Finally, there will be a discussion
by the team about what seemed to work best and should be
provided on a long-term basis.
If this sounds like a lot of meetings and discussions, you are right.
Parents and professionals who have been involved with assistive
technology for many years find this process to be like solving a
puzzle: experimenting and trying different methods and tools until a
workable solution is found. It takes time and patience.
The real heart of determining what assistive technology might help is
trying things out. Trial use of assistive technology is critical to deriving
solutions that work. Thousands of dollars are often saved by trying
things before they are purchased. Trials with a variety of items to see
what works effectively and what your child likes to use are a good
investment of everyone's time and energy, but this important step is
often overlooked. Without a trial use, families, school districts, and
insurance providers may spend thousands of dollars on an
augmentative communication device or other tool only to have it sit in
a closet unused. These experiences make everyone wary of making a
commitment to a child’s needs.
Evaluating the Effectiveness of Assistive Technology
Perhaps the most important questions in both short and long term use
of assistive technology are:
- What is it we expect my child to be able to now that he or she has this device?
- How soon will s/he be able to do that?
- Will it happen right away, or is there a need for training first?
- How much time will training take?
- After training, will my child be able to use the device effectively, or is our expected outcome something that my child is not developmentally ready to do?
These questions are critical for parents and service providers to
discuss before investing a great deal of time, energy, and money.
Different expectations can cause real problems. For example, if
parents and service providers spend months determining a way for a
child with severe motor limitations to access a computer, but there is
not clear agreement on what that child will do on the computer, there
is a huge potential for someone to be very unhappy.
Where to Look for Information
If the idea of assistive technology is new to you or the IEP team,
there are a variety of resources available to begin learning what
assistive technology is available. These are listed at the end of this
article.
Conclusion
Remember the original question way back at the beginning of the
process? It was, "what functional task do we want this child to be
able to do that s/he is unable to do at a level that reflects his/her skills
and abilities?" If the team keeps this as the central question, it allows
them to:
- focus on a clear outcome,
- brainstorm about what devices might help achieve that outcome,
- narrow down the list of possibilities until there is agreement two or more devices to try,
- try those devices and determine which ones work, and
- obtain funding to purchase that device.
And, by following these guidelines, no one ends up with a device in
the closet.
Penny Reed, Ph.D., is the Director of the Wisconsin Assistive
Technology Initiative, a statewide technical assistance project in
assistive technology. Her experiences as a teacher, consultant,
and administrator in special education spanning 30 years led to
her interest in assistive technology.
Adapted from Disability Solutions, Vol. 3, Issue 2, July/Aug. 1998
Editor's note: Individuals with disabilities, parents and families
should remember that, under the Individuals with Disabilities
Education Act, the school district is responsible for funding
appropriate assistive technology devices and services if the
student needs them to benefit from his or her educational
program. The factors discussed in the previous article should be
considered when deciding if and what assistive technology
devices (and services) are appropriate.
Use the Assistive Technology Checklist to review your child's needs.
RESOURCES
Several resources exist that address assistive technology needs of
children and adults with disabilities. These national and state
organizations can answer questions about assistive technology and
your child.
NATIONAL ORGANIZATION
- The Alliance for Technology Access (ATA)
2175 East Francisco Blvd., Suite L
San Rafael, CA 94901
Phone: (415) 455-4575, (415) 455-0491 (TTY) Fax: (415) 455 0654
E-mail: atainfo@ataccess.org
This organization, headquartered in San Rafael, CA, is a national network of technology resource centers and technology vendors: 41 community-based technology centers in 27 states and the Virgin Islands, and 60 technology designers and developers. ATA technology resource centers help children and adults with disabilities, parents, teachers, employers, and others to explore computer systems, adaptive devices and software.
FEDERAL PROGRAMS
Resources for funding for assistive technology exist through the
following federal programs:
- Individuals with Disabilities Education Act (IDEA)
Assistive technology devices and services are defined in IDEA (see
definition in article above) and can be considered special education,
related services or supplementary aids and services. According to
the IDEA Amendments of 1997, assistive technology devices and
services must be considered for each student when developing an
Individualized Education Plan.
School districts must pay for a child's assistive technology devices
and services if it is determined by the IEP team that s/he needs them
to benefit from the educational program. Many children throughout
the country are able to benefit from the use of assistive technology
because school personnel and parents worked together to make
technology a reality in the child's life.
Vocational Rehabilitation (VR)
The Rehabilitation Act provides for assistive technology (called
rehabilitation technology) for individuals with disabilities who are
receiving employment-related services through the VR program.
Each state has designated an agency to operate the program. If you
do not know yours, contact your Governor's office, look in the
phone directory under state government agencies, or, if all else fails,
contact the US Department of Education's Office of Special
Education and Rehabilitative Services in Washington DC at 202-205-5465.
If you are having difficulty in dealing with the vocational rehabilitation
system, each state operates a client assistance program (CAP) which
works to resolve disputes between the VR agency and those
receiving services. VR personnel should provide you with a reference
to the CAP if requested, or the agency's central office should do so.
If you are unable to obtain the information, contact your state
Protection and Advocacy agency.
Medicaid
Funding may be available for assistive technology for children and
adults who are eligible to receive Medicaid. Medicaid also operates
through designated state agencies. The eligibility determination must
again be separated from the determination of exactly what medical
services an individual will be provided. To locate your local
Medicaid agency, contact the state Department of Health and Human Services. You also may ask your Governor's
office or your state legislator for the name of the Medicaid program.
State Tech Act Programs
The RESNA Technical Assistance Project can provide contact
information for the project in your state that operates a program
under the Technology-Related Assistance for Individuals with
Disabilities Act which should be able to assist you with problems
related to assistive technology. They may be reached at phone: (703)
524-6686, (703) 524-6639 (TDD), fax: (703) 524-6630, e-mail:
resnata@resna.org.
State Protection and Advocacy Agencies
Each state has a Protection and Advocacy Program for persons with
disabilities whose purpose is to provide legal services. In addition,
each state Protection and Advocacy system has special funding to
address issues related to assistive technology. If you believe you
have a legal problem, you may contact their state offices.
If you cannot locate the Protection and Advocacy program in your
state, call the National Association of Protection and Advocacy
Systems (NAPAS) at phone: (202) 408-9514, (202)
408-9521(TDD), fax: (202) 408-9520, e-mail: napas@earthlink.net.
Parent Information and Training Centers
If you have difficulty with obtaining assistive technology (or any appropriate special education services) through the school, other parent assistance and advocacy resources exist. To find the number for the Parent Training and Information Centers in your state, contact: The Technical Assistance Alliance for Parent Centers, phone: (612) 827-2966, (612) 827-7770 (TDD), fax: (612) 827-3065, e-mail: pacer@pacer.org.
ATFSCP