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)

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.

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