Written and edited by

Katharin A Kelker EdD

Roger Holt ATP

Published byParents Letrsquos Unite for Kids

516 N 32nd StBillings MT 59101-6003

406-255-0540 406-255-0523 (fax)800-222-7585 (toll free in MT)

plukinfoplukorg bull httpwwwplukorg

Family Guide to

Assistive

Technology

Published byParents Letrsquos Unite for Kids (PLUK)

516 N 32nd StBillings MT 59101-6003

406255-0540406255-0523 (fax)

800-222-7585 (in MT)plukinfoplukorg

httpwwwplukorg

April 1997

Written and edited byKatharin A Kelker EdD

Roger Holt ATP

Illustrations byKaren Moses

This guide was funded through a subcontract between the Federation and Parents Letrsquos Unite for Kids frommonies awarded to the Federation by the Office of Special Education and Rehabilitation Services (OSERS)US Department of Education Points of view or opinions herein do not necessarily represent the EducationDepartmentrsquos position or policy

The Department of Education ensures equal employment equal educational opportunities and affirmativeaction regardless of race sex color national origin religion marital status age or disability

This material is available upon request in alternative formats by calling 406255-0540

Table of ContentsIntroduction 1Defining Assistive Technology 2

Sara 7Making Assistive Technology Decisions 9

Sierra 23Funding Assistive Technology 24

Ted 31Gloria 32

Making Assistive Technology a Part of Childrsquos Education 33Emily 38Bryan39Tracy 40

Advocating for Assistive Technology 42More Questions and Answers 44Appendix 50

Glossary 50Documents 53

Schrag Letter on Assistive Technology 53Individuals with Disabilities Education Law Report 54Letter Requesting an Assistive Technology Evaluation 56Assistive TechnologyIssues to Address 56

Examples 57Educational Software Evaluation 57Software Features 59Alternative Input 59Processing Aids 59Alternative Output 59Specialized Products 59Assistive Technology Evaluation 60

Resources 62Parent Training and Information Centers 62Alliance for Technology Access Resource Centers 65State Tech Act Projects 67SoftwareHardware Vendors 70

1

A ssistive technology is redefining what ispossible for people with a wide range ofcognitive and physical disabilities In the

home classroom workplace and communityassistive technology is enabling individuals withdisabilities to be more independent self-confi-dent productive and better integrated into themainstream

Beginning early in life technology is makingit possible for children with disabilities to domore for themselves A child who cannot use herhands can operate a computer with a switch andan on-screen keyboard A child with speech prob-lems can communicate using a portable electronicdevice that ldquospeaksrdquo A child who is unable toget in and out of the bathtub can be safely andeasily lifted using a mechanical device Theseare just a few examples of the wide variety ofequipment called assistive technology that isavailable today

Assistive technology can mean anything fromsimple homemade devices to highly sophisti-cated environmental control systems It can beadapted toys computers powered mobility aug-mentative communication devices specialswitches and thousands of commercially avail-able or adapted tools to assist an individual withlearning working and interacting socially

As wonderful as assistive technology can beit is not always easy to acquire It takes expertiseand persistence to find the correct devices andfigure out ways to pay for them For examplechildren with disabilities who are eligible for spe-cial education have a legal right to technology toassist them with learning Both the Individual-ized Family Service Plan (IFSP) and the Individu-alized Education Program (IEP) which are re-quired by tthe Individuals with Disabilities Edu-cation Act (IDEA) are potentially powerful toolsfor incorporating assistive technology into theeducation of students with disabilities But

assistive technology does not become part of astudentrsquos special education plan unless parentsare knowledgeable about technology and knowwhat to do to ensure that assistive technologybecomes an integral part of their childrsquos program

This Guide is intended to help parents learnmore about assistive technology and how it canhelp their children The Guide includes tips forgetting started ideas about where to look formoney and suggestions for what to do whenapplying for funding Places to contact for moreinformation or to find software and equipmentare listed in the Appendix at the end of the Guide

Finding and paying for the right technologyrequires commitment and energy Professionalsin education and medicine can help but parentscannot rely on professionals to do everything thatis necessary to get the equipment As a parentyou have a much better chance of getting what isneeded if you and your child are involved in se-lecting the technology and planning for its useThis Guide should help you to understand theprocesses for acquiring assistive technology andprovide you with the tools to advocate for yourchildrsquos special technology needs

Introduction

2

Defining Assistive Technology

A ssistive technology devices are mechani-cal aids which substitute for or enhancethe function of some physical or mental

ability that is impaired Assistive technology canbe anything homemade purchased off the shelfmodified or commercially available which isused to help an individual perform some task ofdaily living The term assistive technology encom-passes a broad range of devices from ldquolow techrdquo(eg pencil grips splints paper stabilizers) toldquohigh techrdquo (eg computers voice synthesizersbraille readers) These devices include the entirerange of supportive tools and equipment fromadapted spoons to wheelchairs and computersystems for environmental control

The Individuals with Disabilities EducationAct (IDEA) the federal special education lawprovides the following legal definition of anassistive technology device ldquoany item piece ofequipment or product system that is used toincrease maintain or improve functional capa-bilities of individuals with disabilitiesrdquo UnderIDEA assistive technology devices can be usedin the educational setting to provide a variety ofaccommodations or adaptations for people withdisabilities

The IDEA also lists the services a school dis-trict may need to provide in order to ensure thatassistive technology is useful to a student in theschool setting The law defines assistive technol-ogy service as ldquoany service that directly assistsan individual with a disability in the selectionacquisition or use of an assistive technologydevicerdquo This service includes all of the follow-ing possibilities

bull evaluation of the technology needs of theindividual including a functional evalua-tion in the individualrsquos customary environ-ment

bull purchasing leasing or otherwise provid-

ing for the acquisition of assistive technol-ogy devices for individuals with disabili-ties

bull selecting designing fitting customizingadapting applying maintaining repair-ing or replacing of assistive technologydevices

bull coordinating and using other therapiesinterventions or services with assistivetechnology devices such as those associ-ated with existing education and rehabili-tation plans and programs

bull assistive technology training or technicalassistance with assistive technology for anindividual with a disability or where ap-propriate the family of an individual withdisabilities

bull training or technical assistance for profes-sionals employers or other individualswho provide services to employ or other-wise are substantially involved in the ma-jor life functions of individuals with dis-abilities

The intention of the special education law isthat if a student with disabilities needs technol-ogy in order to be able to learn the school dis-trict will (a) evaluate the studentrsquos technologyneeds (b) acquire the necessary technology (c)coordinate technology use with other therapiesand interventions and (d) provide training forthe individual the individualrsquos family and theschool staff in the effective use of the technology

During the time that students with disabili-ties are in school they can have the opportunityto learn to use technology at the same time thatthey are learning academic subjects and socialskills The efficient and effective use of assistivetechnology can be as basic a skill for students withdisabilities as reading writing and arithmeticsince the use of technology can go a long way

3

toward circumventing the limitations of disabil-ity and providing students with disabilities witha ldquolevel playing fieldrdquo in every area of life ac-complishment

What is an accommodation

Accommodations are reasonable modifica-tions that are made to compensate for skills orabilities that an individual lacks For example ifa person does not digest spicy foods well wemight accommodate this individual by adjustinghis or her diet so that the person was eating onlybland foods

When the word accommodation is used in con-nection with disability issues it refers to a wayof modifying a task or assignment so that a per-son with a disability can participate in spite ofwhatever challenges the disability may pose Forexample when a student who is unable to re-member math facts is allowed to do math prob-lems with a calculator the use of the calculator isan accommodation which allows the student towork around his or her disability With an ac-commodation the student can still perform mathproblems but the student does so using a differ-ent method

In the school setting sometimes it is neces-sary to make accommodations for individualswith disabilities in order to compensate for skillsor abilities that they do not have For examplefor some students with learning disabilities learn-ing to spell words correctly may be a skill theynever acquire or never acquire with a highenough degree of fluency to do them any goodin written expression To compensate for thisinability to spell such students may be encour-aged to use alternative methods for spelling likea spell check software program on the computeror a hand-held spelling device

What is an adaptation How does adaptationdiffer from accommodation

Adaptation means developing unique devicesor methods designed specifically to assist persons

with disabilities to perform daily tasks An ad-aptation is something specially designed whichis not normally used by other people An accom-modation on the other hand is simply a changein routine method or approach which may beused by people with or without disabilities Ex-amples of adaptations include special grips toturn stove knobs or specially designed keyboardsto operate computers

What are common types of assistive technol-ogy Does assistive technology just meancomputers

Assistive technology certainly includes com-puters but it also refers to a number of other typesof accommodations and adaptations which en-able individuals with disabilities to function moreindependently Computers are an important typeof assistive technology because they open up somany exciting possibilities for writing speakingfinding information or controlling anindividualrsquos environment But computers are notthe only avenues to solving problems throughtechnology There are many low tech (and lowcost) solutions for problems that disabilities poseExamples of inexpensive low tech solutions in-clude wrist splints clip boards for holding pa-pers steady or velcro tabs to keep positioningpads in place

The following is a list of common assistivetechnology applications

Positioning In the classroom individualswith physical disabilities may need assistancewith their positions for seating so that they canparticipate effectively in school work Generallytherapists try to achieve an upright forward fac-ing position by using padding structured chairsstraps supports or restraints to hold the body ina stable and comfortable manner Also consid-ered is the studentrsquos position in relation to peersand the teacher Often it is necessary to designpositioning systems for a variety of settings sothat the student can participate in multiple ac-tivities at school Examples of equipment used

4

for positioning are side lying frames walkerscrawling assists floor sitters chair inserts wheel-chairs straps trays standing aids bean bagchairs sand bags and so forth

Access In order to participate in school taskssome students require special devices that pro-vide access to computers or environmental con-trols The first step in providing access is to de-termine which body parts can be used to indi-cate the studentrsquos intentions Controllable ana-tomical sites like eye blinks head or neck move-ments mouth movements may be used to oper-ate equipment which provides access to the com-puter Once a controllable anatomical site hasbeen determined then decisions can be madeabout input devices selection techniques (directscanning) and acceleration strategies (codingprediction) Input devices include such thingsas switches alternative keyboards mousetrackball touch window speech recognition andhead pointers Once computer access has beenestablished it should be coordinated with othersystems that the student is using including pow-ered mobility communication or listening de-vices and environmental control systems

Access can also refer to physical entrance andexit of buildings or facilities This kind of assistivetechnology includes modifications to buildingsrooms and other facilities that let people with

physical impairments use ramps and door open-ers to enter allow people with visual disabilitiesto follow braille directions and move more freelywithin a facility and people of short stature orpeople who use wheelchairs to reach pay phonesor operate elevators Accessibility to shoppingcenters places of business schools recreationtransportation is possible because of assistivetechnology modifications

Environmental Control Independent useof equipment in the classroom can be achievedfor students with physical disabilities throughvarious types of environmental controls includ-ing remote control switches and special adapta-tions of onoff switches to make them accessible(eg velcro attachments pointer sticks)

Robotic arms and other environmental con-trol systems turn lights on and off open doorsoperate appliances Locational and orientationsystems give people with vision impairmentsinformation about where they are what theground nearby is like and whether or not thereis a curb close by

Augmentative Communication Every stu-dent in school needs some method of communi-cation in order to interact with others and learnfrom social contact Students who are nonverbalor whose speech is not fluent or understandableenough to communicate effectively may benefit

figure 1 Alternative and Pr ocessing Computer Access Methods

Inputbull Alternate keyboardsbull Interface devicesbull Joysticksbull Keyboard modificationsbull Keyboard additionsbull Optical pointing devicesbull Pointing and typing aidsbull Switches with scanningbull Scanners amp optical character recognitionbull Trackballsbull Touch screensbull Voice recognition

Processingbull Abbreviationexpansion and macro programsbull Access utilitiesbull Menu management programsbull Reading comprehension programsbull Writing composition programsbull Writing enhancement tools (ie grammar checkers)

Outputbull Braille displays and embossersbull Monitor additionsbull Screen enlargement programsbull Screen readersbull Speech synthesizersbull Talking and large print word processors

5

from using some type of communication deviceor devices Communication devices include suchthings as symbol systems communication boardsand wallets programmable switches electroniccommunication devices speech synthesizers re-corded speech devices communication enhance-ment software and voiced word processing

Assistive Listening Much of the time inschool students are expected to learn through lis-tening Students who have hearing impairmentsor auditory processing problems can be at a dis-tinct disadvantage unless they learn to use thehearing they have or they develop alternativemeans for getting information Hearing problemsmay be progressive permanent or intermittentAny of these impairments may interfere signifi-cantly with learning to speak read and followdirections Assistive devices to help with hear-ing and auditory processing problems includehearing aids personal FM units sound field FMsystems Phonic Ear TDDs or closed caption TV

Visual Aids Vision is also a major learningmode General methods for assisting with visionproblems include increasing contrast enlargingstimuli and making use of tactile and auditorymodels Devices that assist with vision includescreen readers screen enlargers magnifierslarge-type books taped books Braillers lightboxes high contrast materials thermoformgraphics synthesizers and scanners

Mobility Individuals whose physical impair-ments limit their mobility may need any of a num-ber of devices to help them get around in theschool building and participate in student activi-ties Mobility devices include such things as self-propelled walkers manual or powered wheel-chairs and powered recreational vehicles likebikes and scooters

Computer-Based Instruction Computer-based instruction can make possible independentparticipation in activities related to the curricu-lum Software can be selected which mirrors theconceptual framework of the regular curriculum

but offers an alternative way of responding to ex-ercises and learning activities Software can pro-vide the tools for written expression spelling cal-culation reading basic reasoning and higherlevel thinking skills The computer can also beused to access a wide variety of databases

Social Interaction and Recreation Studentswith disabilities want to have fun and interactsocially with their peers Assistive technologycan help them to participate in all sorts of recre-ational activities which can be interactive withfriends Some adapted recreational activities in-clude drawing software computer games com-puter simulations painting with a head or mouthwand interactive laser disks and adaptedpuzzles

Self Care In order to benefit from educa-tion some students require assistance with selfcare activities like feeding dressing and toiletingAssistive devices which assist with self care in-clude such things as robotics electric feedersadapted utensils specially designed toilet seatsand aids for tooth brushing washing dressingand grooming

What sort of students might use assistivetechnology

Students who require assistive technology arethose with mental or physical impairments thatinterfere with learning or other life functions Thetechnology helps the student to overcome or com-pensate for the impairment and be more inde-pendent in participating at school Students whobenefit from assistive technology may have mildlearning problems like learning disabilities orthey may have physical or cognitive disabilitiesthat range from mild to severe Assistive tech-nology is not necessary or helpful for every stu-dent in special education but it is an importantpart of the support system for many studentswith identified disabilities

Isnrsquot assistive technology appropriate only forstudents with more severe disabilities

Assistive technology is simply a set of tools

6

that can be used to compensate for some deficitthat a person may have For individuals with se-vere mental or physical disabilities the techno-logical solutions can help to solve multiple andcomplex problems But individuals with less in-volved problems also can benefit from assistivetechnology For example individuals with learn-ing disabilities who have difficulty with readingor writing can benefit educationally from usingthe word processing and voiced reading capa-bilities of computers

Isnrsquot assistive technology just a crutch Wonrsquotstudents become too dependent on technol-ogy and not learn to use the skills they have

Assistive technology should be used as sup-port for access learning and performing dailytasks In general assistive technology is appro-priate when it compensates for disabilities so thatthe individual can function as normally as pos-sible If assistive technology is necessary for astudent to have access to educational opportuni-ties or to benefit from education then it is not aldquocrutchrdquo but a legitimate support

Some skills are too laborious or taxing to ac-complish at a rate or with degree of proficiencyto allow for participation in the least restrictiveenvironment With assistive technology the stu-dent can participate more fully and more closelyapproximate the levels of achievement and in-teraction of his or her peers

The use of assistive technology enhancesfunction and increases skills and opportunitiesThough a student may be dependent upon a par-ticular device in order to perform skillfully de-nying the device denies the student an opportu-nity ever to achieve success at the level of his orher potential

When is using assistive technology appropri-ate

Assistive technology may be considered ap-propriate when it does any or all of the follow-ing things

bull Enables an individual to perform functions

that can be achieved by no other means

bull Enables an individual to approximate nor-mal fluency rate or standardsmdasha level ofaccomplishment which could not beachieved by any other means

bull Provides access for participation in pro-grams or activities which otherwise wouldbe closed to the individual

bull Increases endurance or ability to persevereand complete tasks that otherwise are toolaborious to be attempted on a routine ba-sis

bull Enables an individual to concentrate onlearning or employment tasks rather thanmechanical tasks

bull Provides greater access to information

bull Supports normal social interactions withpeers and adults

bull Supports participation in the least restric-tive educational environment

SummaryAssistive technology means any device which

helps an individual with an impairment to per-form tasks of daily living There is a wide rangeof types of devices in assistive technology fromlow tech homemade aids to computers and so-phisticated electronic equipment Assistive tech-nology is one of the services which can be pro-vided in a special education program under theIndividuals with Disabilities Education Act(IDEA) The requirements of IDEA say that stu-dents who need assistive technology are entitledto the aids and devices and the assistive technol-ogy services (eg evaluation for assistive tech-nology and modification and maintenance ofequipment) that are necessary for the student tobenefit from a free appropriate public education

Hints for Parents

It is never too soon to consider using assistive tech-nology Some infants with physical disabilities for ex-

7

ample really benefit from early interaction with toysthat operate by switch Here are suggestions for timesto evaluate a child for assistive technology

bull When disability limits interaction with the envi-ronment and interferes with experiential learn-ing

Assistive technology can be used to providephysical access to the environment (egswitch toys floor scooters touch window)

bull When a significant gap exists between receptiveand expressive abilities

Assistive technology can assist with expres-sion through the use of programmableswitches electronic communication devicesvoiced word processing braille embossingand so forth

bull When an individualrsquos performance falls behindthat of his or her peers

If an individualrsquos handwriting for exampleis very slow laborious and difficult to readuse of a word processing device can be sub-stituted for handwriting thus allowing theindividual to keep up with others in termsof written expression

bull When a physical disability is impeding the edu-cationalvocational potential of an individual

Assistive technology can provide access tothe workplace for example by allowing anindividual who is blind to learn to use ascreen reader and voiced word processingto do clerical tasks that would otherwise beimpossible

bull When a disability is impeding the independenceof an individual

Sometimes assistive technology can be usedto allow a person with a disability to func-tion more independently For example hav-ing a power wheelchair allows an individualto travel independently without the neces-sity of having someone to push the wheel-chair

SaraSara who has Down syndrome is eight

years-old Her language and speech skills arethree years delayed but she has age appropriatesocial skills Sara has spent part of her schoolday in a regular classroom ever since kindergar-ten but this year her third grade teacher is sug-gesting that Sara really cannot keep up with herclassmates The teacher thinks that Sara wouldbe better off in a self-contained class with stu-dents who work at her pace Sara has some finemotor coordination problems and she has haddifficulty learning to write in cursive Her oralreading is hampered by her speech difficultiesHowever Sara has learned to do addition andsubtraction problems well and has mastered add-ing with carrying and subtraction with borrow-ing She reads at about a second grade level withreasonably good comprehension Sararsquos parentswould like to see her continue in the regular class-room for as much time as possible but they rec-ognize that Sararsquos writing and speaking problemsare keeping her from doing her best work

What are Sararsquos needs

What kinds of technology should go in SararsquosIEP

How would you make a case for puttingassistive technology into her IEP

8

Sararsquos SolutionSararsquos IEP Team met to discuss her needs and

concluded that she is doing well in a regular class-room setting she is making adequate progressin academic skills and has learned how to inter-act socially with her peers It is to be expectedthat Sara will have difficulty keeping up with thepace in a third grade but as long as she is mak-ing progress toward her individual goals theregular classroom is a good setting for her How-ever some simple accommodations and technol-ogy may help Sara to work faster and more effi-ciently

At this point Sara may need some assistancewith handwriting and speaking but the solutionsto her problems in these areas need not be com-plex ones The team decided that Sara shouldcontinue to practice cursive until she has mas-tered all the letters and can be more facile in us-ing script However while she is still learningcursive she needs other means for respondingin writing For short written responses the teamagreed that Sara should be encouraged to usemanuscript printing When speed is importantor when writing assignments are longer Sarashould have access to a computer with an adap-tive keyboard (eg IntelliKeys) The adaptivekeyboard is helpful for Sara because the ldquokeysrdquoare larger and easier to see Using the keyboardrequires only a very light touch so Sara finds iteasier to use than a standard computer keyboard

In terms of oral reading the team decided tohave Sara practice reading into a tape recorderHer speech therapist will work with her on slow-ing down her rate of speech and reading withexpression When Sara has a good tape of heroral reading she will submit it to her teacher forreview

Solution SummaryPractice cursiveUse manuscript printing for short assign-

ments

Use computer with adaptive keyboard forlonger assignments

Practice oral reading using a tape recorder

9

Making Assistive Technology Decisions

W hen parents learn about assistive tech-nology and the wonderful opportuni-ties it can provide they want to jump

right in and get the latest in technology for theirchildren Who wouldnrsquot want an augmentativecommunication device for a child who cannottalk What parents wouldnrsquot want to buy a com-puter if it would help their child learn

When the world of assistive technology opensup for parents it can be like entering a great toystoremdasheverything looks so wonderful that itmakes it hard to know what to select Choosingthe right device to meet an individualrsquos needsrequires technical knowledge and indepth under-standing of the individualrsquos functional capabili-ties Not only is the selection of a device madedifficult by the complexity of the equipment andthe demands of the individualrsquos impairmentassistive technology devices can be very expen-sive Making such purchases is a major financialcommitment for most families one that takes agreat deal of soul searching and sometimes sig-nificant sacrifice

Families invest more than money in theirchildrenrsquos assistive technology Practical invest-ments of time and effort and emotional invest-ments of hope and enthusiasm are made withevery assistive technology purchase Because ofthe high level of financial personal and emotionalcommitment family disappointment is greatwhen equipment fails to perform as expected

Buying and then not using a device becauseof dissatisfaction can be a devastating experiencefor all concerned That is why it is so importantfor parents to proceed cautiously into the worldof assistive technology and make purchases onlyafter careful evaluation and trials with the newdevice Following is a summary of some sug-gestions for parents to consider before makingany assistive technology purchase be realisticabout your childrsquos capabilities and needs get a

multidisciplinary evaluation examine availabletechnology with a critical eye match the childrsquosneeds to specific equipment features do not makea purchase until you have used the device for atrial period identify next steps and determinewhat needs to be done for follow-up after pur-chase

Guidelines for Making Assistive TechnologyDecisions

bull Be realistic about your childrsquos capabilitiesand needs

Assistive technology can open up excitingnew opportunities for a child but it is not magicThere are certain basic requirements for any in-dividual to be successful with technology and itis important to face these requirements squarelyThere is nothing more disappointing or discour-aging than purchasing expensive equipment fora child which is beyond his or her capabilities touse

Prerequisites for Computer Use Physicalor sensory impairments do not limit access tocomputers but cognition is a factor in computeroperation The major prerequisite for using acomputer (with or without adaptations) is thecognitive ability to understand cause and effectThe child must be able to understand that thecomputer operates (eg changes does some-thing) because the child has activated the equip-ment through some volitional movement or ac-tivity (eg eyebeam speaking puffing into astraw hitting a switch) Some children enjoyplaying with switches by hitting them randomlybut may not be able to connect their own behav-ior to the response their movement activates Inorder to be successful in interacting with a com-puter the user must be able to control some voli-tional activity and to do so consistently For ex-ample the child would have to be able to acti-vate the computer in response to a visual tactileor auditory prompt

10

Another prerequisite to computer use is theability to make conscious meaningful choicesbetween alternatives like yes and no The choicescan be very simple ones but there has to be evi-dence that the child has made an actual decisionand not merely acted randomly

If a child does not have the concept of causeand effect or cannot make consistent choices us-ing a computer is probably not a worthwhile nextstep at this point in the childrsquos developmentOther types of activities may be more appropri-ate less expensive and just as rewarding devel-opmentally and personally

Prerequisites for Augmentative Communi-cation Augmentative communication devicescan literally give voice to the thoughts of indi-viduals who cannot speak or cannot speak clearlybutmdashagainmdashthese devices are not magic Elec-tronic communication devices are of no valueunless the user has some communicative intentThat is for a communication device to be help-ful the user has to have some basic understand-ing of the communication process and must beintentional in expressing choices desires orneeds

For example Maggie is a four-year-old whois nonverbal She communicates her wants andneeds by using eyeblinks as responses to yes orno questions When Maggiersquos dad asks her if shewould like another glass of milk she indicatesher choice by raising her eyes up vertically foryes or moving her eyes down for no Maggieclearly knows what she wants to communicateshe has a consistent method for making herwishes known and she expects that her dad willunderstand her communication and act on it

Dan who is also nonverbal communicatesin a different way He points to objects and makesgestures to show what he wants or needs Hisgestures are clear and used consistently so thatfamily members and even people who do notknow Dan well can understand most of the timewhat he is communicating

Shelley communicates very basic informationabout how she feels by crying when she is un-comfortable or wants attention and by laughingwhen she enjoys something like music brightlights or water running Shelley does not how-ever respond to yes or no questions She doesnot make choices even when objects are pre-sented to her individually or in pairs She can-not respond to a question like ldquoDo you want someice cream nowrdquo Or ldquoWould you like the teddybear or the dollrdquo

Maggie and Dan may benefit from usingsome communication device because they arealready using communication systems meaning-fully and consistently Shelley however mayneed to develop greater ability to communicatemeaningfully before moving on to electroniccommunication

Communication skills fall along a continuumAt one end of the continuum are very simplecommunications like expressing preferences byindicating yes or no pointing or gesturing towardobjects or pointing to pictures Use of sign is amore complex form of communication becauseit requires that the user understand that the signsare symbols for meaningful communicationsWhen an individual is able to string togethersigns or words into meaningful phrases this isan additional step toward more complex com-munication When a person understands syntaxand is aware of typical word order this is anotherstep forward Each of these advances along thecommunication continuum represents a step to-ward more complex and sophisticated commu-nication Whatever assistive communicationdevice is chosen should match or just slightlyexceed the place on the continuum where the in-dividual is functioning It makes no sense forexample to purchase an elaborate electronic com-munication device that requires understandingsymbols and syntax when the individual usingthe device is just at the point of learning how toexpress yes and no preferences

An electronic device does not teach commu-

11

nication it enhances communication by givingaudible expression to thoughts that already existin the mind of the user If the thoughts are notthere yet or are not completely formed they can-not be expressed by the device

Physical and Sensory Impairments Are NotBarriers Mastery of a few simple prerequisiteskills is necessary before computers or electroniccommunication devices should be consideredbut it is not necessary for a child to master everydevelopmental milestone before entering theworld of assistive technology Physical or sensoryimpairments can often be circumvented by thetechnology itself and typical developmentalmilestones can sometimes be bypassed so thatassistive technology can be used For examplesome educators assume that students cannot usecomputers until they have completely masteredkeyboarding skills This is a false assumptionMany students benefit from using computerseven though they operate the machine using aldquohunt and peckrdquo method or only one or two keysIn a similar fashion students with limited verbalability who have not mastered oral speech ben-efit from using augmentative communicationdevices while they continue to develop oral lan-guage

Overall the keys to knowing when to tryassistive technology are (a) being realistic aboutthe childrsquos cognitive abilities and potential and(b) being open to trying the level of technology

which meets the child where he or she is

bull Get a multidisciplinary evaluation

Evaluations for assistive technology are notalways easy to arrange In many parts of theUnited States there is no convenient center orldquoplacerdquo to go for an assessment The availablecenters may be far away in another city or evenanother state Since assistive technology is a newfield the systems for disseminating informationand providing assistance are in the process ofevolving Parents may have to be ldquoassistive tech-nology detectivesrdquo in order to put together theinformation needed for a complete AT evalua-tion for their child

The place to start the evaluation is by consid-ering the functions the child needs to performand cannot because of impairment The physi-cians teachers and therapists currently workingwith the child as well as family members andfriends who are around the child on a daily ba-sis can provide very valuable information aboutfunctional problems and potential solutions

Finding Functional Solutions The Alliancefor Technology Access (ATA) a national networkof assistive technology centers has developed aninformal method for using the functional infor-mation available from professionals family mem-bers and friends as a basis for analyzing assistivetechnology needs This process called a Solu-tion Circle is a means to bring people togetherin an informal session that allows for creative

figure 2 Factors to consider when selecting Assistive T echnology

Cognitive Factorsbull Diminished Cognitive Abilitiesbull Learning Disabilitiesbull Attention Deficitsbull SensoryPerceptual Deficitsbull Memory Deficitsbull Abstract Reasoning Deficitsbull Problem-Solving Deficits

Motor Factorsbull Voluntary Motor Deficitsbull Involuntary Motor Deficitsbull Fixed Posture amp Positioning Deficitsbull Recurring Purposeless Motionbull Motor Paralysisbull Low Muscle Tonebull Rigiditybull Spasticitybull Tremors

12

thinking and is not inhibited by what is ldquolegalrdquoldquocurrently availablerdquo or ldquowhat has been done be-forerdquo The individual with a disability and 4-10family members professionals and friends gettogether to brainstorm ideas about the technol-ogy which may help the individual perform func-tions that are hard or impossible to do becauseof disability The Circle usually includes a bal-ance between people who know the person whoneeds the technology and people who have spe-cialized knowledge about technology educationor work-related issues

Solution Circle for Tom To demonstratehow the Solution Circle works letrsquos take a lookat how this process was used in the case of Toma high school student with a learning disabilityFor Tom the print in textbooks is a significantbarrier to learning Tom is ldquoprint disabledrdquo thatis he cannot read the printed word with muchcomprehension Reading is a slow unproductiveprocess for him even though he is intelligent andeager to learn Tom and his parents were hopingthat there might be a way that new technologycould help Tom overcome or work around hisproblem with reading so that he could get moreout of school and perhaps go on to college

Tomrsquos Solution Circle included his parentsBetty and Bob his resource teacher a friendDarrell his soccer coach his 4-H leader and theowner of a local computer store This group mettogether to think about how Tom could partici-pate more fully in school and prepare himself forcollege even though he could not read with com-prehension past the second or third grade level

Solution Circles generally take 1 to 1 12 hoursto complete The steps include the following

1 Star Time The individual for whom theSolution Circle is being held is described in a ho-listic way The emphasis is on how the individualis functioning at home and in the communityWhat does he or she like and dislike What arehisher goals Interests If possible the indi-vidual with a disability speaks for himself or her-self or a video or pictures may be presented The

point of this part of the discussion is give a clearpicture of the individual as a whole person

At Tomrsquos Solution Circle he explained hisdream of going to college and becoming an agri-cultural botanist Tom loves plants he is inter-ested in breeding new strains of wheat and per-fecting various types of grain crops Tomrsquos 4-Hleader agreed that Tom had real gifts in under-standing plant growth and physiology and thathe already had sophisticated knowledge aboutbotany which would prepare him well for col-lege study

2 Strengths With a complete picture of theindividual in mind the group then makes an ex-haustive list of the individualrsquos strengths particu-larly noting any technological accommodationswhich the individual is already using What doesthe individual do well What are his or her un-impaired functions Often this discussion revealsan incredible number of adaptations that the in-dividual has already achieved

Tomrsquos Solution Circle discovered that he hadmany strengths including keen intelligence per-severance and thoroughness when approachinga task Tom already had some effective learningstrategies for remembering material that heheard He had also learned to use a small taperecorder for keeping track of information pro-vided in class

3 Obstacles With the individualrsquos strengthsin mind the group then turns its attention to aconsideration of the environment in which theindividual is functioning and the activities inwhich the individual wants to participate butcannot at this time The group considers whatthe obstacles and barriers might be for the indi-vidual in his or her environment and makes alist of these impediments

For Tom reading was a serious obstacle Hecould not keep up with homework assignmentsbecause it took him so long to read his textbooksIn addition he had difficulty reading directionson tests and often misread assignments on the

13

COGNITIVE FACTORSCognitive Ability

Documented below average abilityDocumented significant overall delayDoes not appear age appropriateLacks understanding of cause amp ef-

fectPaying Attention

Difficulty following prompts or direc-tions

Difficulty with multi-step proceduresDifficulty filtering informationDifficulty staying on task

PerceptionNeeds lengthened response timeRequires multi-sensory inputDifficulty with rapid changeSignificant visualperceptual problemsSlow visual-motor dexterity

MemoryDifficulty with recallRequires reteaching learned skillsRequires repeated practice

Abstract ReasoningDifficulty analyzing simple proceduresUnable to reproduce a sequenceUnable to analyze or synthesize in-

formationProblem Solving

Unable to use prompts or cues to ac-complish tasks

Unable to modify attempts and try an-other way

MOTOR FACTORSMobility

Needs help to be mobileNeeds motorized help to be indepen-

dentNeeds help boarding transportationUnable to transfer independentlyCannot climb stairsCannot open doors independentlyCannot carry materials in hands or

armsCannot lift weight

Voluntary MotorLimited control of head trunk or ex-

tremitiesVisual motor deficitsFixed position and posture

figure 3 ASSISTIVE TECHNOLOGY EVALUATIONIndividual Functional Analysis

Name Date

Needs support to sit or standNeeds adaptations in order to use

technologyMotor Paralysis

Changes in muscle tone interfere inmotor movements

Spastic movements result in poor con-trol

Limited movement of head arms orlegs

Difficulty balancing in sitting positionDifficulty maintaining good posture

Low Muscle ToneLimited use of arms or legsPoor posture controlFatigues quickly

RigidityInhibits arm and leg movementInhibits balance to sitInhibits good posture

SpasticityLimited upper range of motionLimited lower range of motionInterferes with accuracy and consis-

tency of motor movements on oneside

TremorsPresent all the timePresent when doing purposeful upper

extremity taskUnable to compensate for tremors

Extraneous MovementAthetoid (constant)Ataxia (poor coordination in move-

ment)FINE MOTOR

DexterityLimited fine motor controlHas limited hand movement

HandwritingWriting or copying ability is signifi-

cantly below peersSignificant legibility factor--written

work not readableCannot keep up with the pace of writ-

ten workIs frustrated by writingFatigue is a factorTyping appears to be potentially faster

than handwriting

SELF CARENeeds assistance with going to the

bathroomUnable to be toilet trainedNeeds assistance to eatCannot take in food orallyNeeds suctioning routinelyHas degenerative medical conditionIs medically fragileSeizures limit alertnessNeeds to rest frequentlyNeeds assistance to zip coat or tie

shoesCOMMUNICATION

Receptive LanguageReceptive language is significantly

lower than abilityReceptive language is significantly

higher than expressiveExpressive Language

Speech is unintelligibleExpressive language is significantly

lower than abilityMean Length of Utterance (MLU) is 3

words or lessSpontaneous or self initiated language

is significantly limitedDoes not make choices consistentlyDoes not respond appropriately with

yes or noDoes not have communicative intent

SENSORYVision

Requires corrective lensesRequires large print to readRequires mobility trainingHas blind spot

HearingRequires preferential seatingHearing limitations affect the language

thresholdsRequires assistance to receive lan-

guageRequires sign language to receive lan-

guageHas fluctuating hearing lossNeeds visual signals for safety pur-

poses

14

blackboard

4 The Enemy Within Physical and cogni-tive impairments may pose difficult obstacles foran individual but often the feelings that peoplehave about the individualrsquos disability or aboutassistive technology pose greater problems thanthe disabilities themselves The Solution Circleprocess recognizes that human fears concernsreservations and prejudices might stand in theway of a personrsquos success as much as other typesof limitations Getting these fears and concernsout on the table often helps the group to deal moreconstructively with what is possible and whatneeds to be done

One of the serious issues in Tomrsquos situationwas that his resource teacher felt he should con-tinue to try to read for himself instead of using aldquocrutchrdquo like assistive technology The teacherthought that if Tom did not have to read all thematerial he would lose what little reading skillhe had In some ways the teacherrsquos oppositionto considering assistive technology actually poseda greater barrier than the reading problem itself

5 Solutions The exciting part of a SolutionCircle occurs when the group takes each obstacleor concern and turns it into a possible solutionthrough the use of technology or some other typeof adaptation Not all solutions suggested even-tually prove to be feasible but the point of thediscussion is to produce many possible solutionsso that the individual and his or her family havean array of options from which to choose Withgood minds puzzling over the problems and aspirit of cooperation and collaboration seeminglyimpossible barriers can be removed or conqueredThe process recognizes the expertise and contri-butions of all participants including the indi-vidual with disabilities and his or her familymembers The freewheeling format of the dis-cussion promotes ingenuity and innovation Allinvolved come away from a Solution Circle ener-gized by the new possibilities

Tomrsquos Solution Circle became excited about

the possibility of solving his reading problem byusing computerized texts The computer storeoperator mentioned he had heard that Record-ings for the Blind (RFB) offered textbooks on diskTomrsquos parents got in touch with Recordings forthe Blind and ordered texts for Tom to try on hiscomputer at school Soon Tom found that hecould keep up with his classmates and study ex-actly the same material that they were coveringBecause Tom had good strategies for memoriz-ing information that he heard he learned quicklyfrom the texts that were read aloud to him by thecomputer When given oral tests by his classroomteachers he was able to recite appropriate an-swers which would have eluded him if he hadhad to read the tests for himself

Technology has made all the difference forTom he has every reason to think that he will beable to go to college and pursue his intellectualinterests His resource teacher is now completelysold on the idea of assistive technology and us-ing computerized books and wants to use thetechnique with other students More than thatTomrsquos teacher also appreciates the process of theSolution Circle which allowed professionals andnonprofessionals to work together to find prac-tical solutions without being too concerned aboutthe formalities of the special education processThe informal nature of the Solution Circle vali-dated the expertise of all the participants andgave everyone a chance to offer suggestions Thecombination of a new process for planning andnew technology made Tom a winner This samecombination holds potential for many studentslike Tom who benefit from technologies whicheliminate barriers and open up new possibilitiesfor learning

From Function to Technology Solution Ithappened that a participant in Tomrsquos SolutionCircle hit on a great idea for a solution to his func-tional problem with reading This was a fortu-nate connection to make At the suggestions ofhis Solution Circle Tom began to use computer-ized books which he ldquoreadsrdquo by having the com-

15

puter speak the words as he follows along withthe text For Tom computerized books proved tobe a successful solution to his reading problembecause they help him to get the information heneeds without struggling with the reading pro-cess

Not every Solution Circle will be like Tomrsquosand identify the exact technology that the indi-vidual needs But if a Solution Circle has workedwell the end result will be a clear analysis of thefunctions that need to be performed This func-tional information can then be brought to techni-cians who can make suggestions for possibleassistive technology solutions There are over 50assistive technology centers in the United Stateswhere knowledgeable individuals can assistpeople with disabilities and their families withmaking a match between functions that need tobe performed and the technology that is availableto perform those tasks A list of assistive technol-ogy centers is available in the Appendix to thisGuide

Formal Assessment Solution Circles are aneffective informal way to identify functionalneeds that can be met through technology How-ever in the school setting it is also necessary toestablish a studentrsquos needs for technology in amore formal way Formal evaluations for assistivetechnology must be multi-disciplinary involvingeducators and therapists who are knowledgeableabout the school curriculum and the particulartypes of impairments that the student being as-sessed may have For example for a student withcerebral palsy the assistive technology evaluationmight involve a teacher a physical therapist aspeech and language clinician and an occupa-tional therapist The teacher would assist thetherapists in determining what skills the studentneeded to learn and how technology might assistthe student in acquiring those skills Someassistive technology evaluations might require theadditional services of an A-V technician adap-tive physical education teacher a rehabilitationcounselor or speech and language pathologist

with specialized training in augmentative com-munication In school districts where there is nospecialized expertise in technology and its appli-cations it may be necessary to contract for evalu-ations with special education cooperatives medi-cal centers or centers that focus on technologyassessment

Individuals conducting an assistive technol-ogy evaluation should

bull Be knowledgeable of the studentrsquosstrengths and weaknesses medical needsmobility fine and gross motor skills cog-nitive ability communication abilities vo-cational potential self help needs sensoryabilities level of academic achievementand area(s) of disability

bull Have knowledge of and access to an arrayof assistive technology devices

bull Be familiar with the studentrsquos educationalsetting and educational needs

bull Be able to communicate effectively withparents and educators

Because the assistive technology field is sonew there are no particular licenses orcredentialing processes to identify a professionalas qualified to do assistive technology evalua-tions Generally speaking individuals with pro-fessional licenses as occupational or physicaltherapists special educators speech pathologistsor rehabilitative counselors may have the exper-tise to conduct an AT evaluation When consid-ering an evaluator it is wise to ask about theevaluatorrsquos specific experience with assistivetechnology It is also important to recognize thatno one person or discipline will know everythingabout assistive technology therefore access toknowledgeable people at the local level andthrough other agencies programs or services isessential

Conducting the AT Evaluation The assistivetechnology evaluation must be tailored to theunique needs of the student In some cases theevaluation may be conducted by at team of indi-

16

viduals in other cases the evaluation may beconducted by a single individual (eg the speechpathologist) Questions to be addressed duringthe assessment should be related to the specifictasks the student needs to be able to perform andwhat if any assistive technology would helpThe following questions may be considered dur-ing the assessment

bull What tasks does the student need to per-form that he or she cannot perform

bull Is there a low tech device which will ad-dress the studentrsquos needs satisfactorily

bull What types of high tech assistive devicesmay help the student in performing thetask

bull Will assistive technology help the studentto perform the task in the least restrictiveenvironment

bull Is the device being considered suited to thestudentrsquos educational needs and abilities

bull Will the assistive technology device remainsuitable over time How long lasting willthis solution potentially be

The above are only a few of the considerationswhich need to be addressed as part of the evalu-ation process There is no specific ldquotestrdquo forevaluating the need for assistive technologyTherefore prior to conducting the evaluation theindividuals doing the assessment need to have awell planned process in mind

The formal written assistive technologyevaluation report should address but not belimited to the following points

bull Procedures used to evaluate the student

bull Instruments employed in the evaluationassuring that a range of levels of technolo-gies has been considered

bull Results of evaluations including bothqualitative and quantitative measures

bull Recommendations for levels of technologyappropriate to the studentrsquos capabilitiesand potentials and

bull Implications for educational program-ming including discussion of both indi-vidual technology needs and recom-mended environmental and instructionalmodifications

In the end an assistive technology evaluationshould provide recommendations for accommo-dations adaptations devices and services basedon the individualrsquos strengths needs and pre-ferred lifestyle The evaluation should indicate(a) whether devices and services have potentialfor improving function and (b) what trainingmay be necessary in order to use the technologyequipment safely and effectively

bull Examine available technology with a criti-cal eye

It is easy to be dazzled by the possibilities innew assistive technology but it is important forparents to be wise consumers and ask probingquestions about the features and quality of anassistive technology device The following is alist of questions to consider when evaluating aparticular assistive technology device

Performance

Does it work efficiently and effectively

Is it easy to learn to use this device

Is it compatible with other devices

Does this device serve only one purposeor is it flexible

ldquoElegancerdquo

Does this device represent the simplestmost efficient way to accomplish the task

Or is this device too elaborate too com-plicated to be worthwhile

Ergonomics

Does it fit the individual

Is it convenient to use in the environment

Is the equipment portable enough to gowhere the user goes

Are different devices needed in differentenvironments

17

Reliability

What is the manufacturerrsquos reputation forreliability

Does it stand up well to normal use

Is it durable

Safety

Is it safe to use

What is the power source for the deviceIs it safe

Is a margin built in for foreseeable mis-use

Practicality

Do company sales people seem knowl-edgeable and helpful

Are the companyrsquos service people knowl-edgeable and helpful

Does the device have a warranty Howlong is the device guaranteed to function

How available are repair services Atwhat cost

Can this device be leased

Is this device available for a trial periodbefore purchase

Will this device soon be outdated Issomething better on the horizon

Will the company update the device

Does the manufacturer provide trainingin using the device

Aesthetics

Is this device attractive to the eye

Does the device fit well into the userrsquoslifestyle

Normalization

Does the device assist the user with morenormalized living

Can the user operate the device indepen-dently or with a minimum of assistance

Or does the device ldquostick outrdquo too muchand advertise the disability of the user

Does the equipment minimize differenceor exaggerate difference

Does the device have the potential to in-crease the quantity and quality of time spentwith nondisabled peers Or does the de-vice separate the user from others

Cost effectiveness

Do the benefits the device provides jus-tify the cost

Are there less expensive devices or mod-els that serve the purpose as well

Personal acceptance

Is this device the userrsquos own choice

Does the potential user like this deviceand want to use it

Does the potential user view this deviceas life-enhancing

Would the user have preferred some otherdevice or means to perform the task

Will using the device always be a choreor can using it become a habit

There are several ways that consumers canfind answers to their specific questions aboutassistive technology devices Most vendors willprovide good basic information about the prod-uct Call the vendor and ask for brochures prod-uct specifications price list and any other writ-ten information This is a place to start A sec-ond step is to read reviews of the product in trademagazines or Closing the Gap a widely respectedpublication that reviews new assistive technol-ogy products If possible it is very helpful totalk to other consumers who are already usingthe product Ask them about the pros and consof using the device Then visit a preview centerif there is one nearby and try out several typesof devices Ask for general recommendationsfrom the preview centerrsquos staff After identify-ing a device that appears to meet the potentialuserrsquos needs try the device out for a month tosix weeks to make sure that it performs as adver-tised and fits in well with the userrsquos lifestyle

18

During the trial period it will be possible to iden-tify training needs for the user family membersand school staff The trial period will also be atime for the user to test the device in several set-tings to determine its portability and flexibility

bull Match the Individualrsquos Needs to SpecificEquipment Features

When considering an assistive technologydevice it is very important to consider how adevice matches up with the particularindividualrsquos needs and habits In some ways anassistive device becomes an extension of theuserrsquos mind and body As such it is a highly per-sonal item A device may work as advertisedbut still not meet an individualrsquos needs becausethe individual just does not feel ldquocomfortablerdquo inusing it For example Cindy a fourteen-year-oldwho is totally blind and has mild cerebral palsyaffecting her hands and arms was being taughtMorse Code as a means to speed up her writingShe had difficulty using a Brailler because her armstrength was so limited so her teacher thoughtMorse Code would be an easier method of writ-ing for Cindy The only problem was that Cindydid not like using Morse Code To her it seemedlike she was having to learn another complicatedlanguage when she already knew braille andliked to use it Cindy admitted that writing inbraille was slow for her but she was more com-fortable with it Cindy and her teacher were atan impasse until a friend suggested to Cindy thatshe try writing on a voice-output computerCindy loved the computer With a headset at-tached to the sound system she could listen care-fully to the computer as it read aloud the lettersand words she was typing on a light touch tac-tile-marked keyboard This computer also had afeature of printing out text in either standard printor braille Cindy was delightedmdashshe could writecopy for herself to read in braille and for hersighted teachers to read in regular print Thissolution worked because it met Cindyrsquos learningneeds and responded to her own ideas about her-self She did not want to use Morse Code because

it was a separate type of communication knownonly to a few With her computer voiced soft-ware and dual printer she had the best of twoworldsmdashshe could ldquohearrdquo her writing as shetyped she could read it over in braille and hersighted teachers could read her finished prod-uct This solution helped Cindy to improve hercomposition skills speed up her writing timeand communicate more easily with sightedpeople

Cindy was fortunate because her assistivetechnology solution met her needs almost per-fectly Such a close match is not however al-ways possible Nonetheless every effort shouldbe made to have the match be as close as it canbe In general when assistive technology solu-tions are individualized simple to use and re-sponsive to the whole person they are more likelyto be used by the individual When the deviceperforms a task well but does not ldquofitrdquo the indi-vidual the technology is likely to be abandonedby the user in favor of something else whichmeets the need more exactly Too often devicesare purchased because of their technical poten-tial without thought to their relationship to theindividual and his or her lifestyle These mis-matched devices are the ones that end up lan-guishing in their packing boxesmdasha sad reminderof time and money spent to no avail

bull Try the Device Before Buying

It cannot be emphasized enough how vital itis to try out assistive technology devices andequipment before buying Trying out a devicefor several weeks provides the user with an op-portunity to learn how to use the device and howto adapt to its features while at the same timetesting the device in the various environmentswhere it will be used For example Mike triedout a communication device which attachednicely to his wheelchair tray and was compat-ible with his computer that he used for doingschool work Though the communication deviceworked well and was relatively easy to program

19

MOTORSELF CARE

manual wheelchairpower wheelchairbus liftsupportive classroom

chairstanderwalkerlift for transferspositioning devicecanes or crutchesadapted commodesuctioning devicebraces or supportsother ____________

________________

________________

________________

________________

________________

________________

________________

________________

________________

________________

________________

figure 4 ASSISTIVE TECHNOLOGY EVALUATION

Device or Equipment Features or Functions

Name Date

FINE MOTOR

word processorword processor with

predictionvoiced word proces-

sor with predictionadapted keyboardkeyguardalternative key

arrangementvoice activated

computer accessinfrared computer

accessmouse accesstrackballjoystickpower padswitch (eg mouth

lip chin)touch screenpointersdrag and click desk

accessorysticky keysonscreen keyboardprinter for written

work

adapted feedingutensils

braces or splintsother ____________

________________

________________

COGNITIVECOMMU-NICATION

communciationboard(s)

communication wallettotal communicationmanual signword processor with

voiceprogrammed voice

outputicon predictionelectronic communi-

cation deviceprogrammable switch

with voice output

no-reading-neces-sary word proces-sor

spell checkergrammar checkeroutlining programother ____________

________________

________________

________________

________________

________________

________________

________________

SENSORYPERCEP-TUAL

hearing aid(s)

classroom amplifica-tion

boosted signal tonoise ratio (egheadset to keepfocus during wordprocessing)

corrective lensesenlarged printtaped booksvoiced word process-

ingvoiced screen

directionsCCTVother ____________

________________

________________

________________

________________

________________

________________

________________

________________

________________

________________

20

Mike found out quickly that the device was justtoo bulky to be useful for him When he trav-eled around the school the communication de-vice blocked his view of the terrain and of peoplepassing by He found he missed opportunitiesto communicate because he could not see whowas coming his way Mike also discovered thatthe communication device did not serve him wellin crowds like at pep rallies or basketball gamesAfter a month of working with this communica-tion device Mike decided it was not for him andselected instead a device that was less compli-cated smaller and more portable The seconddevice was not as sophisticated as the first but itbetter met his needs for quick communicationwith friends in social settings If he had not hadthe opportunity to try out both devices for anextended period of time Mike might not haverealized the value of the second device and mayhave been stuck with a communication devicethat was too large and too sophisticated to matchhis lifestyle

Similarly Marilyn benefited from a trial pe-riod with her communication device She foundout the first week that the particular device shehad chosen would not work for her because itbroke too easily and it was difficult to get re-paired During the first week that Marilyn hadthe device for trial her teacher broke one of thebuttons during a programming session It tooktwo weeks to contact the manufacturer and thenthe device had to be mailed back to the factoryfor repairs The device was gone for over sixweeks and the manufacturer would not supplya ldquoloanerrdquo while Marilyn waited for repairs tothe first device This experience taught Marilynthe importance of having a responsive manufac-turer who is willing to repair devices quickly andto supply substitutes for the user while repairsare being made Marilyn decided on a differentdevice with similar features and a great helplineto provide assistance with the maintenance of themachine

The information that can be learned during a

trial period with a device is invaluable to the userIt is discouraging to find out during the trial thata device is not all it is purported to be or that itdoes not work as well as advertised but it is farbetter to learn before purchase that a device doesnot meet the userrsquos needs than to learn after pur-chase and be stuck with an expensive unusablemachine For the consumer it is daunting to thinkabout starting over again with the process of se-lecting a device Nonetheless it is worthwhileto seek more information and look again Hav-ing been through a trial even when the outcomeis not successful provides the user with greaterclarity about what an appropriate device willhave to be able to do The second time aroundthe search is likely to go faster and come out witha better result

bull Identify Next Steps

Once a device has been selected the con-sumer becomes impatient to have one and beginusing it right away But at this point importantwork still needs to be done Funding the deviceis a major consideration Sometimes families willpay for the device themselves but under othercircumstances the device will be purchased by aschool district through Medicaid or private in-surance or through some other means Parentsneed to become familiar with the various fund-ing options and determine which one will workfor them (See Funding Assistive Technology foradditional information about funding sources)

Also when considering funding familiesshould think about costs beyond the price of thedevice itself For example a computer set-upwith a keyboard monitor and printer might cost$3500 This equipment is basically useless un-less other equipment is purchased as well soft-ware adaptive devices paper manuals up-grades Prices for these additions can raise theactual cost of the device by hundreds of dollars

Devices often require training for the userfamily members and others to ensure effectiveand safe use How much does training cost Who

21

will provide it Repair and maintenance are othercosts usually additional to the price of the equip-ment Sometimes families will also want to insurethe assistive device so insurance payments be-come part of the overall cost

Since making an assistive technology pur-chase is such an important personal and finan-cial decision it is wise to have a realistic budgetin mind that includes all of the equipment andservices that are necessary to make the assistivetechnology work effectively With this budget inmind it becomes easier to plan the purchase seekout funding sources and make a compelling casefor financial assistance

bull Determine What Follow-up Is Needed

After the assistive technology device has beenpurchased and put to use there are additionalfollow-up activities that need to take place Theoriginal assistive technology evaluation shouldinclude a way to monitor the use of the devicePeriodic scheduled reviews the by evaluator fol-low-up calls to and from the family are some waysto help assure effective safe use Families whotravel great distances for evaluation need to becertain that services like maintenance repair andreplacement of devices are available within a rea-sonable distance from home

Assistive technology devices are used bestwhen all the people in the life of the individualwith disabilities understand the devices in thesame way At first devices may seem to exagger-ate differences between a person and the rest ofthe world Care should be taken to explain thatassistive equipment is a difference equalizer nota difference maker Classmates and friends needto understand that the adapted seating or adaptedkeyboard helps the individual do what other stu-dents do Adults in a childrsquos life need to under-stand that devices work to make life easier bet-ter and more functional People need to knowthat ramps help keep individuals with mobilitydisabilities from being separated from peers thatcommunication technology allows people to

ldquospeakrdquo their thoughts

Close communication between parents andtheir childrsquos helpersmdashteachers therapists daycare workers and othersmdashis essential to makesure devices and services are being used safelyand effectively If the device is working well butthe child is not being integrated into the class-room or other environments then there may bea need for additional training for the children andadults who interact with the child

Besides keeping track of how the device isworking and being used it is important to ob-serve progress in the areas of technology whichare useful to the individual with the assistivetechnology device As upgrades of equipmentoccur or more sophisticated models come on themarket the user may want to consider modify-ing or replacing the equipment that is currentlyin use Also as the individual becomes moreskilled at using technology the individual mayoutgrow the current device and need to look formore advanced equipment It can be assumedwith most high tech items that in three to fiveyears there will be a need for upgrade or replace-ment The wise consumer begins early to planfor the next step in technology including savingmoney for a new device and staying alert to thenew options that become available

What kinds of training are important to occurwhen a child has a new assistive technologydevice

Because assistive technology of the high techvariety is so new it is particularly important thattraining be provided to all those who may needit In the school setting it is helpful for all edu-cators and administrators to have some aware-ness training so that they have a general idea ofwhat assistive technology is Areas to be cov-ered in inservice training might include

bull legal issues related to assistive technology

bull awareness training concerning how toserve students with assistive technologyneeds

22

bull information on how assistive technologyrelates to the evaluation process

bull how to write IEPs for students who requireuse of assistive technology devices

bull the relationship between technology andstudent placement

bull the nature of common assistive technologydevices

bull resources to contact for information onassistive technology

Beyond these awareness activities thosemembers of the school staff who work directlywith a student who uses technology need to havetraining on the specifics of using the device andhow it is maintained and serviced Trainingshould include but not be limited to the follow-ing

bull review of the studentrsquos educational andassistive technology needs

bull review of goals and objectives supplemen-tary aids and services and related serviceson the IEP or IFSP

bull training on how to use and maintain thedevice

bull training on proper transport of the devicewithin the school building and from hometo school

bull training on how to program the device ifneeded

bull training on how to use the device effec-tively during instruction

bull training in trouble-shooting when the de-vice is not working properly

bull information about what to do when thedevice is not functioning or broken

bull information about how to coordinateassistive technology with all the activitiesin the studentrsquos day

bull training in methods to evaluate the effec-tiveness of assistive technology

Depending on the type of assistive technol-

ogy used by the student and the studentrsquos needsit may be advantageous for assistive technologyinformation to be shared with the studentrsquos peersSuch training will help fellow students to gainan understanding of the studentrsquos assistive de-vice foster acceptance in the social environmentand reduce fears other students may have aboutsocializing with the student who uses technol-ogy In some cases parents and the student maywant to be involved in the peer training

Parents may require training too in order forthe device to be used at home for the student tocomplete homework assignments or participatein extended school year services Once trainedthe parents can become a resource to the studentfor proper care and maintenance of the device

Most importantly the student himself or her-self will need training in how to use the deviceas independently as possible Training for thestudent may be written into the IEP as a separategoal or may be included as a related service thatsupports the studentrsquos special education pro-gram

SummaryPurchasing a high tech assistive technology

device is a major life decision because of the po-tential impact on the individual and because suchdevices can be costly When considering anassistive technology device it is important to dothe following be realistic about the consumerrsquoscapabilities and needs get a multidisciplinaryevaluation examine available technology with acritical eye match the individualrsquos needs to spe-cific equipment features test the device for a trialperiod identify next steps and determine whatneeds to be done for follow-up after purchaseEvaluations for assistive technology both infor-mal and formal should consider first of all thefunctions that the consumer wishes to performusing technology When evaluating a particularpiece of equipment consideration should begiven to the following features performance sim-

23

plicity of design ergonomics reliability safetypracticality aesthetics normalization cost effec-tiveness and personal acceptance Good sourcesof information about assistive devices are manu-facturers publications trade journals previewcenters and consumers who are already using thedevice Once a device is selected the consumerwill need to secure funding for the purchase andbe aware of additional costs for related equip-ment insurance and training

Hints for Parents

Donrsquot let the cost of assistive technology deter youfrom considering it for your child High tech assistivetechnology can be quite costly but it can also makethe difference for your child in terms of becoming welleducated employable and a fully-included member ofthe community Donrsquot leave any stone unturned whenlooking for funding sources Consider any or all ofthe following for funding or assistance

bull Early intervention programs

bull Schools

bull Transition programs

bull Vocational Rehabilitation

bull State Programs for Children with SpecialHealth Care Needs

bull Medicaid

bull Medicare

bull State Technology Resources

bull Used Equipment

bull Leasing

bull Equipment Loan Programs

bull Disability Organizations

SierraSierra wants to play with dolls like other chil-

dren her age but she has a muscle disease thathas caused her to lose muscle tone except in onehand What could be done to allow Sierra to dressand undress her dolls comb their hair and bathethem

Sierrarsquos SolutionThe assistive technology solution for Sierra

involved her whole family While vacationingin Mexico Sierrarsquos grandmother found her a fash-ion doll that was a bit larger than the typicalldquoBarbie dollrdquo The larger doll was easier for Si-erra to manipulate Sierrarsquos mother sewed sev-eral outfits for the doll using velcro instead ofsnaps or buttons as fasteners

Sierrarsquos dad bought doll stands at a toy storeand fastened several stands with clamps toSierrarsquos wheelchair tray He also fastened a plas-tic pouch to the tray Sierra puts the small dollaccessories in the pouch When Sierra wants todress her doll she puts the doll in one of thestands In this way the doll is held securely andSierra can dress and undress the doll with onehand

Sierrarsquos friends also use the doll stands fortheir dolls With this arrangement two or threegirls can play together

Solution SummaryLarger doll

Velcro fasteners

Plastic pouch

Doll stands

Clamps

24

Funding Assistive Technology

F unding for assistive technology is availablefrom a variety of public and privatesources To receive public or private fund-

ing the individual must meet eligibility criteriafor the specific program and provide sufficientdocumentation of the need for assistive technol-ogy

The following list includes some of the pro-grams which may pay for equipment if the indi-vidual needing the device meets their require-ments Many of these programs are run by dif-ferent agencies in different states making themhard to find In general the statersquos Tech Act of-fice can assist consumers and family members infinding and using these programs (See Appen-dix under Resources)

PUBLIC PROGRAMSEarly Intervention Programs (Individuals withDisabilities Education Act Part H)

Young children (0-3) and their families mayreceive help through early intervention programsin evaluating what the child needs in gettingassistive technology and in learning how to useit Equipment and services must be included ina written plan called an Individualized FamilyService Plan (IFSP) To find the program for aparticular state call National Early ChildhoodTechnical Assistance System (NECTAS) at 919-962-2001 or 919-966-4041 (TDD)

Head StartThis child development program provides

comprehensive educational and health servicesfor eligible children ages 3-5 Since 1982 federallaw has required that at least 10 percent of thetotal number of placements must be available tochildren who are disabled and require specialservices Head Start is a mainstream placementoption for children whose IEP calls for placementwith nondisabled children The January 1993Head Start regulations specifically require the

consideration of assistive technology services anddevices For more information contact NationalHead Start Association 201 N Union St Suite320 Alexandria VA 22314 703-739-0875

Schools (IDEA Part B)This program mandates a free appropriate

public education for preschoolers children andyouth with disabilities An Individualized Edu-cation Program (IEP) is required for all childrenwith a disability These children are entitled tospecial education related services or supplemen-tary aids If the IEP team determines that assistivetechnology is required for a free appropriatepublic education then it must be provided at nocost to the child The technology must be in-cluded in the childrsquos Individualized EducationProgram (IEP) Parents have a right to be in-volved and should help to develop the IEP goalswhich may include technology For help in get-ting assistive technology in the IEP call the TAPPFocus Center on Assistive Technology at 1-800-222-7585

State Operated and Supported Schools (Chap-ter I)

This program provides federal assistance tohelp educate children with disabilities who areenrolled in state-operated and state-supportedprograms Federal funds must be used to payfor services that supplement a childrsquos basic spe-cial education program such as construction andthe purchase of equipment For more informa-tion contact your State Department of Education

Section 504 of the Rehabilitation Act of 1973Section 504 provides a civil-rights mandate

that requires accommodations for students whohave disabilities such as orthopedic impairmentsbut who do not qualify for special education ser-vices It denies federal funds to any institutionincluding a school whose practices or policiesdiscriminate against individuals with disabilities

25

This legislation has resulted in a number of out-comes including various actions to remove physi-cal barriers to education which may incorporateassistive technology For more information con-tact the nearest regional Office of Civil Rights orthe State Vocational Rehabilitation Agency

State Programs for Children with SpecialHealth Care Needs

These programs provide and pay for servicesfor eligible children CSHCN programs varywidely from state to state in the services they of-fer the number of children served and the re-quirements for eligibility Some CSHCN pro-grams do pay for assistive technology deviceswhen no other funding source is available andthe equipment is necessary for health-related rea-sons Most CSHCN programs are run by the statehealth agency To contact CSHCN ask informa-tion for the telephone number of the state healthagency

School-to-Work Transition ProgramsTransition Programs are charged with assist-

ing students with disabilities to receive the jobrelated training and placement services to helpthem move from school to work Sometimesassistive technology may be necessary in orderfor a student to make a successful transition andbecome employable If technology is needed fortransition purposes it can be written into thestudentrsquos Individualized Transition Plan (ITP) Toreceive more information about transition andtechnology call the Parent Training and Informa-tion Center (PTI) in your state (See Appendix)

Vocational Rehabilitation ServicesState vocational rehabilitation agencies pro-

vide information evaluation services trainingand funding for technology and education to helpadults go to work or live more independently Iftechnology is necessary for an individual to workVocational Rehabilitation may pay for the equip-ment as part of an Individualized Work-RelatedPlan (IWRP) To locate the nearest Vocational Re-habilitation Agency look in the telephone book

under state government

Plan to Achieve Self-Support (PASS)One of many Social Security Administration

work incentive programs this program providesan income and resource exclusion that allows ablind or disabled person to set aside income andresources for a work goal such as educationequipment purchase vocational training andstarting a business It should be considered forall students with vocational goals who are receiv-ing social security benefits

This program provides a mechanism forpeople to set aside funds to purchase work-re-lated equipment such as assistive technologydevices and services In many cases if an indi-vidual is a recipient of SSI and writes a PASS topurchase education or equipment an additionalSSI check will be provided to cover other livingexpenses Sometimes if a person receives SocialSecurity Disability Insurance (SSDI) and designsa PASS it may make the individual eligible forSSI because the SSDI has been allocated for equip-ment and services

Impairment-Related Work Expense (IRWE)Impairment-Related Work Expense (IRWE)mdash

one of the Social Security Administrationrsquos workincentive programsmdashallows an employed indi-vidual with a disability who receives or is eligiblefor SSI or SSDI to deduct work-related expensesfrom gross reported income

This deduction allows the person to continuedrawing SSDI or SSI and associated benefits(Medicaid or Medicare) if the IRWE deductionreduces earning below the Substantial GainfulActivity (SGA) Test

Although this method does not provide fund-ing to pay for a device or service it is a way ofallowing the use of the individualrsquos own moneyto pay for assistive devices and services neces-sary to return to work The following is a list ofpossible work-related expenses special transpor-tation to and from work personal assistance onthe job structural modifications durable medi-

26

cal equipment prostheses medical supplies andservices work-related equipment non-medicalappliances and equipment routine drug andmedical costs and diagnostic procedure costs

MedicaidMedicaid is a joint federal and state program

which covers some equipment if it is consideredmedically necessary For more information aboutMedicaid and who and what is covered contactthe local Department of Human Services office

MedicareAlthough not a usual source of funds for

assistive technology Part B of Medicare providescoverage for some durable medical equipment ifit is considered medically necessary and is foruse in the personrsquos home For more informationabout Medicare benefits contact the Social Secu-rity Administration Regional Office

Technology-Related Assistance for Individualswith Disabilities Act of 1988

This federal competitive grants program pro-vides monies for states to establish a statewideconsumer-responsive service delivery system de-signed to effect systems change regardingassistive technology In most Tech Act states afunding specialist or policy analyst is availableto assist with accessing assistive technology Sev-eral states operate loan programs to help withthe purchase of devices and services For moreinformation contact RESNA Technology Assis-tance Project 1700 N Moore ST Suite 1540 Ar-lington VA 22209-1903 703-524-6686

PRIVATE PROGRAMS

Private InsuranceSome health insurance plans will buy equip-

ment but it depends on the specific wording ofthe policy Unless the policy says the equipmentis not covered it makes sense to ask the insur-ance company to pay for it The equipment mustbe considered medically necessary and thereforerequires a doctorrsquos prescription

Loans

There are several low or no interest loansavailable to help buy technology Call the stateTech Act program or the manufacturer of theequipment may know where to get this type ofloan

Non-Profit Disability AssociationsThere are many disability organizations

some of which may be able to loan equipment orprovide information about other funding sourcesor support groups These organizations includeNational Easter Seal Society March of DimesMuscular Dystrophy Association United WayUnited Cerebral Palsy Association and the BrailleInstitute

FoundationsSome private foundations have been set up

specifically to provide help to people with dis-abilities A listing of such foundations can befound at the library or may be available from thestate Tech Act program

Programs Providing Assistive TechnologyThe state Tech Act programs offer referrals

for evaluation and equipment recommendationsas well as assistance with identifying funding orequipment lending sources A therapy depart-ment in a local hospital or Disabled StudentsCenter at a local college or university may alsooffer to help locate technology programs in thearea Alliance for Technology Access Centers(ATA) sometimes have loan programs or infor-mation about purchasing used equipment orrenting equipment

Civic OrganizationsThere are many local civic and service orga-

nizations which may provide money to helpsomeone in their community Lists of these or-ganizations are available from the Chamber ofCommerce Examples of these organizations areLions Club Masons Grotto Veterans of ForeignWars (VFW) Elks Club Rotary Club KiwanisKnights of Columbus and Soroptomists Someof these organizations have a national focus on

27

disability or on a particular disability Others willfund devices for a particular child who is knownto the local club

Charities and Fund-RaisersLocal churches high school groups neighbor-

hood organizations labor unions or special in-terest groups (eg computer clubs ham opera-tors) may plan a fund-raiser to help purchaseassistive technology College student organiza-tions (fraternities and sororities) may give moneyor studentsrsquo time to help a special cause Even ifmoney is not available they may be willing tohelp organize a fund raiser

Local media (radio television newspapers)sometimes will sponsor fund-raising activities tofund devices They may not contribute moneybut will help with organizing the fund-raisingactivity and publicizing it to the community

OTHER OPTIONS

In addition to federal and private fundingsources there are a number of education-relatedgrants corporate technology donation programsand funding options that consumers should con-sider Information on these alternative options isavailable through a number of sources includ-ing the following

NewslettersEducation Grants Alert Capital Publications

Inc PO Box 1453 Alexandria VA 22313-2052800-655-5597

Education Technology News Business Publish-ers Inc 951 Pershing Dr Silver Spring MD 20910-4464 301-5878-6300

Financing Assistive Technology Smiling Inter-face PO Box 2792 Church St Station New YorkNY 10008-2792 415-864-2220

Special Education Report Capital PublicationsInc PO Box 1453 Alexandria VA 22313-2053800-655-5597

Technology and Learning Peter Li Inc Publish-ing 330 Progress Rd Dayton OH 45449 415-457-4333

Technology ManufacturersIf it is not possible financially to purchase

equipment consumers can sometimes rent orborrow equipment directly from the manufac-turer

Used EquipmentUsed equipment is often advertised for sale

in disability-related publications or the consumercan place a newspaper ad to see if used equip-ment can be purchased locally Several compa-nies refurbish old computers and sell them at lowprices Listings of used computer outlets can beobtained from ATA Centers or state Tech Act pro-grams

LeasingMany manufacturers of assistive technology

devices have equipment which is available forrent or lease Sometimes the rent or lease pay-ments can be applied toward purchase Checkwith the manufacturer to see if this is an option

Equipment Loan ProgramsMany states have equipment loan programs

as do some rehabilitation facilities and disabilityorganizations Information about loan programsis available from Tech Act programs

HOW TO APPLY FOR FUNDING

There is an art to applying for funding forassistive technology It is necessary to use justthe right words to suit the particular agency thatmight be the funding source It is also crucial todocument the need for and projected outcome ofassistive technology This documentation shouldinclude at minimum

bull A written statement of medical need fromdoctors or other health professionals If thechild had an evaluation by a rehabilitationprofession also include this report

bull A description of the childrsquos problems re-sulting from the disability This descrip-tion can come from the doctor or other pro-fessional who evaluated the child

28

bull Description of how the technology helpsthe child For example the equipment maymake the child safer or allow the child todo things more independently Be sure topoint out how money will be saved if useof the equipment allows attendant care tobe reduced

bull A clear statement based on assessmentthat the child is a good candidate who hasthe cognitive and physical capacities nec-essary for using the technology

In summary the documentation to supportan assistive technology funding request shouldinclude a physicianrsquos prescription the childrsquos as-sessment an explanation of projected benefitfrom use of the technology or service and anycorrespondence obtained from professionals thatwould support the childrsquos need for technology

The initial funding request should include notonly the cost of the device but also the cost ofongoing support and instruction in the use of thetechnology Assistive devices often have ldquohid-denrdquo expenses that are incurred with their pur-chase and these expenses are frequently costlyover time Battery-powered devices may requirefrequent charging or cleaning Upgrades for com-puter software may be necessary Special modi-fications of the home or school environment maybe necessary for the technology to be used Ineach of these examples costs associated with thetechnology may have to be assumed by the fam-ily if they are not considered in the initial appli-cation for funding

It is also helpful to include with the fundingrequest a picture or a descriptive brochure aboutthe device being requested This is importantbecause often persons who are reviewing theapplication do not know about the wide rangeof technologies that might be appropriate

Appropriate wording on the application isabsolutely necessary Key concepts for Medic-aid include ldquomedical necessityrdquo and ldquorestore thepatient to his or her best functional levelrdquo The

term medical necessity means that the device isincluded in the course of treatment being pro-vided to the child and that a professional suchas a physician or speech therapist is supervisingits use Medicaid and private insurers alike gen-erally pay for technologies that help restorepeople to ldquofunctioning levelsrdquo and take the placeof a body part that is not working Typically theseprograms do not pay for technologies or serviceswhose function is educational or life-enhancingrather than health related

The key for private insurance is ldquoterms of thepolicyrdquo It must be remembered that coverageby any insurance company does not set a prece-dent Just because one child receives needed tech-nology under a particular policy issued by a com-pany does not mean that all other covered chil-dren will also have technology paid for by thatcompany Each application stands on its ownbased on the expressed terms of the policy

It is usually under the major medical provi-sions of a health policy that assistive technologycan be provided as ldquoother medical services andsuppliesrdquo It may however be necessary to pur-chase additional insurance coverage or a ldquoriderrdquoin order for technology costs to be included inthe terms of the policy It is important to remem-ber that heath insurance policies are oriented to-ward health care and not toward changes in theenvironment or rehabilitation

Both private health insurance policies andMedicaid sometimes impose limits on the num-ber of assistive technology devices over a certaincost that can be purchased within a certain timeframe Sometimes the rule is that the fundingsource will purchase only one device in theindividualrsquos lifetime With these kinds of restric-tions it is all the more critical to be sure that thetechnology choice is the right one

TIPS THAT LEAD TO SUCCESS

bull Apply to several funding sources at thesame time Be sure to meet the require-

29

ments of each agency

bull Find out if agencies will share costs

bull Fill in the agencyrsquos forms correctly Manyapplications are denied because forms arenot filled out properly

bull In addition to the standard form includeany other information that describes orshows what the equipment does and howit benefits the child Assume no knowledgeon the part of the reviewers

bull Turn in all documentation at the same time

bull Avoid using jargon define all unfamiliarterms

bull Take the funding request package to theagency in person While there have itchecked to make sure everything requiredhas been included Get the name of theperson who reviewed the application

bull Call regularly to check on the funding re-quest each time try to talk to the same per-son

bull Be super politemdashand persistent

WHAT IF FUNDING IS DENIED

It is not at all unusual for an initial fundingrequest to be denied Even when family mem-bers and professionals have been meticulous inpreparing applications requesting funding forneeded technology denials should be anticipatedMaking an appeal is worth the effort since manydenials are reversed at the appeal level

To start the appeal process obtain any docu-mentation or information provided by the fund-ing agency (eg Medicaid or the private insur-ance company) relating to appeal proceduresforms to use timelines and filing procedures forinstance This information will help in the promptpreparation for appeal The kind of appeal to bemade depends on the reason for denial Whendeveloping an appeal find out the following

bull Why the request was denied Ask for thereason in writing Sometimes requests are

denied because a reviewer lacks under-standing of the technology or there maybe an error in the paperwork

bull If needed correct any mistakes or includemore information then resubmit the re-quest

Going to appeal makes sense because gener-ally the appeal places the application before moreexperienced persons in the decision-making hi-erarchy The technology requested is often newand the initial examiners in the process may beunaware of its usefulness Also insufficient docu-mentation may have been provided in the origi-nal application and the problem can be remediedon appeal

Donrsquot be daunted by the length of the appealprocess Follow it through to its completion Insome states families may be able to appeal a de-nial beyond the first level For example somestates have ldquounfair claims settlement practicesrdquoregulations which are administered through theinsurance commissionerrsquos office

Always make your appeal in person and takethe child and the equipment if possible If onlypart of the money is offered by one agency askanother agency to share costs If the appeal isdenied try again Submit the funding request toanother agency Being persistent will nearly al-ways result in success

When going through the appeal process turnto the state Protection and Advocacy Program (Pamp A) for guidance and support P amp A advocatescan help make sure that a childrsquos rights to tech-nology and related services are not denied

Who pays when assistive technology is neededat school

The party who is responsible for paying forassistive technology depends upon the circum-stances under which the technology is purchasedUnder the special education law students withdisabilities who are eligible for special educationare entitled to a free appropriate public educa-tion Parents do not have to pay for school ser-

30

vices including assistive technology if that ser-vice is part of the studentrsquos Individualized Edu-cation Program (IEP) If the student is eligible forMedicaid the school district can request thatMedicaid pay for the device If parents choose todo so they may agree to use private insurance topay for a device that is used at school Parentscannot however be forced to use their insurancein this way If the private insurance requires aco-payment the school district would have to paythis amount since parents should not have to payany special education related costs

Does Section 504 pay for assistive technologySection 504 part of the Rehabilitation Act of

1973 is basically a piece of civil rights legislationthat is intended to prevent discrimination againstindividuals with disabilities in any programwhich receives federal funding Students whohave disabilities but who do not qualify for spe-cial education may still be eligible for accommo-dations under Section 504 of the RehabilitationAct of 1973 Section 504 however does not pro-vide any funding for accommodations

Like the special education law Section 504requires public schools to provide students withdisabilities with a free appropriate public educa-tion and in addition ensures that students withdisabilities are afforded an equal opportunity toparticipate in school programs For students withdisabilities this means that schools may need tomake special arrangements so that these studentshave access to the full range of programs andactivities offered For example a student whoneeds a wheelchair lift on a school bus to get toschool must be provided with this technologyOther modifications which might be requiredunder Section 504 include installing ramps intobuildings and modifying bathrooms to provideaccess for individuals with physical disabilitiesEven though required by the law none of thesetypes of modifications would be funded by Sec-tion 504

Under what circumstances does private health

insurance pay for assistive technologySome private health insurance policies will

pay all or part of the cost for some assistive tech-nology devices The devices are unlikely to belisted specifically in the policy but may be in-cluded under some generic term like ldquotherapeu-tic aidsrdquo Usually the devices have to be pre-scribed by a physician in order to be covered bythe policy

When does Medicaid cover assistive technol-ogy

Medicaid (Title XIX) will pay for ldquoprostheticdevicesrdquondashthat is replacement corrective or sup-portive devices prescribed by a physician or otherlicensed person Each state has some flexibilityin determining which prosthetic devices it willinclude in its list of Medicaid covered expensesDevices that are frequently covered by Medicaidare canes crutches walkers manual wheelchairshospital beds and hearing aids or eyeglasses forchildren and youth

SummaryAssistive technology can be expensive to pur-

chase but there are a number of public and pri-vate sources for funding devices Common pub-lic funding sources include early childhood in-tervention programs schools Vocational Reha-bilitation and Medicaid Private sources mayinvolve health insurance personal loans chari-table donations or fundraising It is very impor-tant to provide proper documentation and usecorrect wording and procedures when request-ing funding Initial requests for funding are fre-quently turned down but appeals can be success-ful

31

TEDTed is an active four-year old who lives in a

small rural community with his parents andyounger sisters He was identified as speech im-paired and has been attending preschool specialeducation classes Ted has normal mental capa-bilities but his mild cerebral palsy impairs hisability to speak Because of the speech therapyhe has received Ted is able to make some speechsounds but he says no intelligible words Heuses sign to communicate with his special edu-cation teacher and his parents No one else inhis community uses sign so Ted is limited in hisability to communicate with others

As Tedrsquos IEP Team looks ahead to his entryinto elementary school the Team recognizes thathe will need better communication skills in or-der to participate successfully in the regular class-room His speech therapist has recommendedthat Ted begin to use an AlphaTalker

What funding sources might pay for theAlphaTalker

What case could you make for funding Arethere any obstacles to seeking funding

TEDrsquoS SOLUTIONAt this point Tedrsquos ability to communi-

cate is somewhat primitive Because of his cere-bral palsy he is not able to make conventionalsigns so the gestures he makes are understoodonly by those who know him well A simple elec-tronic communication device may work for Tedbut there are some prerequisite communicationskills he will have to master first Augmentativecommunication devices operate on the principleof choosing icons (abstract symbols) that repre-sent certain basic communications like a cup toindicate ldquoI want a drinkrdquo

In order to make a picturesymbol systemmeaningful and functional for Ted at his youngage his speech therapist began to work on point-to-object and point-to-picture activities WhenTed had mastered point-to-picture activities histherapist made a picture ring for him On thering were picture symbols (icons) for things thatTed might want to say Tedrsquos family his teacherand his classmates began to ask him to use hispictures to explain what he wanted Soon Tedwas using pictures to communicate simple wantsand needs effectively His word ring went withhim everywhere and helped him to ldquotalkrdquo topeople he did not know as well as to friends andfamily members

An unexpected bonus to the picture practiceis that Ted is verbalizing more and his speech hasbecome more intelligible He has even begun tosing An electronic communication device maybe in Tedrsquos future but for now he is learning tocommunicate well with his picture ring and somespoken words

Solution SummaryPoint-to-picture practice

Use of picture ring

32

GLORIAGloria an eighteen year-old with mild cog-

nitive delays and CP is about to finish highschool She has been using a laptop computerand switch access hardware and software in lieuof a pencil and paper to complete work in highschool The equipment and software were pro-vided by the school district through the IEP pro-cess Gloriarsquos current goal articulated in her In-dividual Transition Plan (ITP) as mandated byIDEA is to have a full-time job by the time she is22 She wants to work in an office and woulduse a computer system similar to her currentsetup As she moves into the transition periodthese questions must be addressed

Will the laptop computer she has been usingbe functional for her in the workplace

Will she need to consider new equipmentWhat would influence a decision to purchase newequipment

What funding sources might help Gloria topurchase new equipment

What case should Gloria make for funding

GLORIArsquoS SOLU-TION

Gloria is fortunate to have learned computerand word processing skills while she was inschool Now she must learn ways to transferthese skills into the work setting Laptop com-puters are not typical in offices instead whatGloria is more likely to encounter is a desktopworkstation with computer and printer In or-der to use a standard computer Gloria will needa switch access device and an onscreen keyboardto do word processing and data entry

Since single switch access is necessary forGloria to become employed in an office settingGloriarsquos Vocational Rehabilitation Counselor waswilling to make such a purchase for her Gloriaapplied to be a data processor with a temporaryemployment firm and got the job Gloriarsquos VRcounselor helped her to select switch access hard-ware compatible with most IBM compatible com-puters In her new job Gloria changes office set-tings frequently Each time she moves she takesher switch access device and onscreen keyboardsoftware with her With these portable items sheis able to adapt each new office setting to meether needs Having the right technology has madeGloria an adaptable and successful temporaryoffice employee

Solution SummarySwitch access

Onscreen keyboard software

33

Making Assistive Technology a Part ofChildrsquos Education

The ideal time for a child with a disabilityto learn to use assistive technology is whenthe child is learning all sorts of others skills

in early intervention services preschool and K-12 education Children who are eligible for earlyintervention services under Part C or special edu-cation under Part B of the Individuals with Dis-abilities Education Act (IDEA) are entitled to beevaluated for assistive technology needs and toreceive assistive technology devices and servicesif they are necessary to providing a free appro-priate public education In order for children toreceive the assistive technology to which they areentitled parents must be knowledgeable abouthow assistive technology fits into special educa-tion and the ways that AT can be included in achildrsquos Individualized Family Service Plan (IFSP)or Individualized Education Program (IEP)

ASSISTIVE TECHNOLOGY FOR YOUNG CHILDRENParents are often surprised to learn that

assistive technology can be appropriate for in-fants and toddlers Very young children whohave disabilities that limit their ability to inter-act with the environment by crawling touchingseeing or hearing can benefit from technologythat improves their interactions Federal educa-tion amendments require states to ldquopromote theuse of assistive technology devices and assistivetechnology services where appropriate to en-hance the development of infants and toddlerswith disabilitiesrdquo These amendments furtherrequire states to ldquofacilitate the transition of in-fants with disabilitiesfrom medical care to earlyintervention services and the transition fromearly intervention services to preschool specialeducation or regular education servicesrdquo

When Kayla was an infant her interactionswith the environment were very limited because

she has a genetic condition resulting in abnor-mally short arms and legs She could not turnover or crawl she had difficulty touching andgrasping objects As part of her early interven-tion program Kayla was introduced at the ageof six months to the use of switches When theswitches were positioned correctly she could ac-tivate switch-operated toys or noisemakers Theopportunity to interact with toys opened upKaylarsquos world She soon began to hunt for theswitches and to activate certain toys on com-mand She used the switches to make choicesbetween toys or sounds She became verballymore expressive and began to interact morereadily and more often with her parents and sib-lings

By the time that Kayla was three and readyfor preschool special education she was able tosit up and interact with a computer activated byswitches She could identify objects on the com-puter screen and match those objects to real ob-jects in the world around her At three Kaylacould identify and match some letters and shapeson the computer screen Though limited in hermobility Kayla became an active participant inclassroom activities She could interact withclassmates by playing computer games joiningin at circle time and participating in allpreacademic learning activities

Assistive technology was an integral and nec-essary part of Kaylarsquos early intervention servicesKaylarsquos parents were involved in writing the In-dividualized Family Service Plans (IFSPs) thatoutlined the services Kayla and their familyneeded From the beginning Kaylarsquos family hadthe opportunity to see how assistive technologycould be included in the IFSP and really make adifference in Kaylarsquos education and her life

Kaylarsquos story illustrates how assistive tech-

34

nology can be utilized from an early age and canbe part of the transition from medical treatmentto early intervention and from early interventioninto preschool special education or regular edu-cation Because of the availability of early inter-vention services there is no reason to wait untila child is of school age before trying assistive tech-nology Early use of the necessary technology willenhance a childrsquos development by increasingopportunities to interact with the environment

ASSISTIVE TECHNOLOGY AT SCHOOL AGE ANDBEYOND

When students enter kindergarten and begintheir regular public school years assistive tech-nology can continue to be a part of their specialeducation programs For students who are eli-gible for special education assistive technologymust be provided when it is necessary

(1) to support placement in the least restric-tive environment

(2) to ensure that a student benefits from hisor her education or

(3) to implement the goals and objectives inthe studentrsquos IEP

Needs for assistive technology should be oneof the considerations when a student is assessedto determine eligibility for special education Ifan assessment reveals that a student is eligiblefor special education then the multi-disciplinaryteam should consider assistive technology needswhen making recommendations for the Individu-alized Education Program (IEP) The team shouldanalyze what is required of nondisabled studentsof the same age and determine how many of theserequirements could be completely or partiallyfulfilled by the student being assessed if that stu-dent had access to appropriate assistive technol-ogy

In addition when information is being col-lected for the present level of performance sec-tion of the IEP part of that assessment should bea consideration of whether or not assistive tech-nology is necessary for the student to achieve

educational or social goals benefit from educa-tion or make reasonable progress in the least re-strictive educational setting Whoever is collect-ing the information might experiment withassistive technology applications to determinewhich ones might work for the particular student

Assistive technology should be considered asan option for every IEP Some students of coursewill not require technology but many studentswill benefit from technology that helps them tocompensate for their impairments School dis-tricts are not required to provide all of the pos-sible assistive devices that might be nice to haveor might provide the best possible arrangementsAssistive technology is required however whenits presence enables the student to make reason-able progress toward the goals the IEP Team iden-tifies

HOW TO INCLUDE ASSISTIVE TECHNOLOGY INTHE IEP

Assistive technology can be included in theIEP in a number of ways It may appear as partof the studentrsquos annual goals or short term objec-tives It may also appear in a list of specific ac-commodations which need to be made in orderfor the student to function in the least restrictiveenvironment For example the IEP might includesuch accommodations as the use of word pro-cessing use of a calculator use of a hand heldspell checker and so forth In addition the IEPmay specify that as a related service necessaryfor the student to benefit from his or her educa-tion the student will receive training in the useof assistive equipment like an electronic commu-nication device a power wheelchair or a personalcomputer

WHERE TO PUT ASSISTIVE TECHNOLOGY IN THEIEP

There are three places in the IEP whereassistive technology may appear (1) in the an-nual goals and short term objectives (2) in theenumeration of supplementary aids and servicesnecessary to maintain the student in the least re-

35

strictive educational setting and (3) in the list ofrelated services necessary for the student to ben-efit from his or her education

Assistive technology can be a part of the an-nual goals and short term objectives on an IEPbut there must be a certain degree of specificityin the goal in order for the role of assistive tech-nology to be clear An annual goal for the IEPshould express an estimate of what the studentcan accomplish in a particular domain during thecourse of one year under what conditions theskill is to be developed and what criteria will beused to indicate whether or not the skill has beenlearned

Many times IEP goals are broad vague andtotally nonspecific Such goals are impossible tomeasure and do not give any indication of whatis realistic to expect in terms of the studentrsquos be-havior or skill level in the course of a yearrsquos timeSuch broad goals are not useful in addressingassistive technology The inclusion of assistivetechnology in the IEP requires a degree of speci-ficity so that it is clear how and why the technol-ogy will be used to accomplish a particular goal

An annual goal which includes assistive tech-nology may indicate that the technology will bepart of the conditions under which some aca-demic or social skill will be acquired For ex-ample an IEP goal for a student with a learningdisability in written expression may look like this

10 Using a word processing program with spell-ing checker Shawn will compose three paragraphthemes composed of fifteen or more sentences with 80or better accuracy in the use of spelling punctuationand grammar

Objectives leading to this goal might includepreliminary exploration of the word processingprogram trials to learn effective use of the spell-ing checker drill and practice in writing singleparagraphs to the 80 level of accuracy in spell-ing punctuation and grammar increasing thelength of writing to two paragraphs and theneventually moving to three paragraphs with

gradually increasing degrees of accuracy

Another type of annual goal may address askill which is necessary for using assistive tech-nology Such a goal might appear this way

20 Using an adapted computer keyboard Rachelwill type 12 words per minute with no errors over 10or more consecutive trials

In this case Rachel would spend a year learn-ing keyboarding skills with the goal of achievingat least 12 words per minute with complete ac-curacy For a young student who experiencessome fine motor difficulties this goal would bechallenging but it might be achievable in a yearrsquostime Objectives leading to this goal might in-volve preliminary exploration of the keyboardgradual introduction of the letters and numberson the keyboard practice to build speed and ac-curacy and eventually timed trials until 10 con-secutive trials could be achieved with no errorsat a rate of 12 words per minute or better

Still another type of annual goal might ad-dress a social issue like communication withpeers

30 Using an electronic communication deviceSara will respond appropriately to social inquiries fromclassmates 5 times out of 5 opportunities over 5 con-secutive days

Objectives leading to this goal might includetraining in the use of particular words andphrases on the communication device drill andpractice in responding with the device in struc-tured settings increasing accuracy in respond-ing in structured settings practice in unstruc-tured conversational opportunities and gradualachievement of accuracy in unstructured conver-sational settings with peers

ASSISTIVE TECHNOLOGY AS A RELATED SERVICEAssistive technology can be a related service

just like audiology physical therapy or speech ifit is necessary for the student to benefit from hisor her education For a student to be successfulin using assistive technology he or she must be

36

trained in its use Training to use a computer anaugmentative communication device a PhonicEar or large type viewer or other similar devicescan occur as a related service which supports thestudentrsquos educational program Preparation forthe use of assistive technology can also be workedinto other related services like occupationaltherapy Occupational therapy may involve de-termining correct positioning to take advantageof assistive technology and exercises to preparethe student to use a computer keyboard or a com-munication board

Margo who has muscular dystrophy uses alaptop computer every day in her sixth gradeclass Margorsquos upper body strength is diminish-ing and she is gradually having greater andgreater difficulty using her hands for writing ordrawing Using a computer saves her energy andallows her to keep performing well in the class-room As a related service in her IEP Margo isreceiving occupational therapy designed to pre-pare her for even more adaptations which maybe necessary as she loses more strength Margoand her therapist are experimenting with com-puter access devices (eg switches trackball) andon screen keyboards to determine what methodMargo would like to use when her hands are nolonger strong enough to type on a standard key-board This special training for assistive technol-ogy is written into Margorsquos IEP as a related ser-vice because such training is necessary for her tocontinue to benefit from her education

ASSISTIVE TECHNOLOGY SUPPORT FOR PLACE-MENT IN THE LEAST RESTRICTIVE ENVIRON-MENT

One important feature of assistive technologyis the fact that it can make it easier for studentswith and without disabilities to learn togetherStudents with disabilities are guaranteed the rightto be with nondisabled peers and to receive theireducation in the setting which is the least restric-tive environment In order to be successful in theleast restrictive environment students are to be

afforded whatever supplementary aids and ser-vices are necessary Among the supplementaryaids which may allow a student to remain in aless restrictive environment are a variety ofassistive devices that compensate for disabilityand allow the student to perform educational andsocial tasks Assistive technology is necessary asa supplementary aid if its presence (along withother necessary aids) supports the student suffi-ciently to maintain the placement and its absencerequires the studentrsquos removal to a more restric-tive setting For example if a student with mul-tiple physical disabilities can make progress onhis or her IEP goals in the regular classroom withthe use of a computer and an augmentative com-munication device and cannot make suchprogress in that setting without the devices thenthose devices are necessary supplementary aids

Lyle a fourth grader with cerebral palsy is agood example of a student who thrives in theregular classroom if he has the use of appropri-ate technology Lyle is able to keep up academi-cally with his classmates if he has access to a com-puter with an adapted keyboard and word pre-diction software Lyle has learned to type welland is able to do written assignments in relativelythe same amount of time as other students in hisclass Without a computer Lyle could not keepup at all Handwriting is a laborious task for Lyleand his written product tends to be messy andbarely readable If he could not use a computerLyle would have to rely on others to do hand-writing for him or he would have to do alterna-tive assignments that require no writing

Lyle likes being a regular fourth grader Heis proud of his writing on the computer becausehe is using his own words and learning to editout his mistakes by himself With his computerhe does not need the services of an aide and canbe completely independent in doing his schoolwork

Assistive technology in the form of a com-puter with appropriate software and keyboard

37

adaptations is necessary for Lyle to remain in theregular classroom working independently Thisuse of the computer can be written into his IEPas a supplementary aid which is necessary tosupport Lylersquos placement in the least restrictiveenvironment

Does assistive technology include access toschool buildings

AT certainly can mean devices that provideaccess to school buildings and facilities Oneimportant part of a free appropriate public edu-cation is that students with disabilities are ableto get to school get into the school and use theschool building and facilities Assistive technol-ogy can be used to provide access to the schoolbus classroom playground gymnasium audi-torium lunchroom or the equipment in themAny or all of these needs can be addressed in theIEP

Bus modifications for improved access andappropriate seating can help with transportationto and from school and school activities Doorswalkways handles switches stairs steps can bemodified so that a student with disabilities canuse them as effectively as classmates Appropri-ate seating and playground modifications canhelp include students who have disabilities atclassroom lunchroom and recess times

When an individual graduates from publicschool is it still possible to have assistivetechnology

If individuals benefit from the use of assistivetechnology during their school years the likeli-hood is that assistive technology will be evenmore important for them in adult livingAssistive technology can certainly be part of anindividualrsquos future after high school but it is nec-essary to begin planning for the transition fromhigh school so that the technology and other nec-essary services are available when needed

The earlier a family can estimate their childrsquospost-high school needs including needs for tech-nology the earlier transition planning can begin

Federal legislation says that transition planningcan begin in school as early as ldquo14 or youngerrdquoEach student with a disability who has an Indi-vidualized Education Program (IEP) should havea ldquostatement of transition servicesbeginning nolater than age 16rdquo This means that as early asmiddle school but probably not later than fresh-man year in high school families should begintransition planning

Unlike school services services in the adultworld are not mandated An individual may beeligible for a disability service but not receive itbecause all of the slots are filled or funding is notavailable If an individual does not own his orher own assistive technology devices then partof transition planning will be looking into fund-ing sources that could help with technology pur-chases If technology is necessary for the indi-vidual to become employed it is possible thatVocational Rehabilitation will pay for the devicesas part of an Individual Work-Related Plan(IWRP) Students who go on to postsecondaryeducation at community college vocational-tech-nical schools or universities can expect to be ableto receive certain accommodations for their dis-abilities while on campus Most postsecondaryinstitutions have Student Support Services thathelp with assistive technology needs alternativetesting readers and notetakers

SummaryAssistive technology can be included as an

integral part of a studentrsquos education but par-ents have to be knowledgeable about how to goabout getting assistive technology into theirchildrenrsquos educational plans Assistive technol-ogy can be written into the Individualized Fam-ily Service Plan (IFSP) for infants and toddlers inearly intervention programs and into the Indi-vidualized Education Program (IEP) forpreschoolers and students in grades K through12 Assistive technology can appear in threeplaces in the IEP (a) as part of the goals and ob-jectives (b) as a supplementary aid to support

38

placement in the least restrictive environmentand (c) as a related service Assistive technologycan also be a part of studentsrsquo transition planningas they move from high school into adult pur-suits Assistive technology is available throughVocational Rehabilitation and other adult disabil-ity services but these services are not mandatedTo ensure continued use of assistive technologyit is important to plan ahead and secure fundingfor devices needed in the work or postsecondaryeducation environments

Hints for Parents

If your child is a successful assistive technologyuser begin to save money early in your childrsquos lifemdashjust as you might save for college Gradually accu-mulate enough funding to purchase the kinds of tech-nology your child will need as an adult Technologychanges so fast that it is impossible to predict whatwill be available fifteen years from now But a parentcan be certain that assistive technology of the futurewill be even better than what is available today

EmilyEmily is a seventh grade student who has

learning disabilities She is in regular classes allday in her neighborhood middle school A spe-cial education teacher monitors Emilyrsquos progressand provides the regular classroom teachers withassistance by modifying some of Emilyrsquos assign-ments giving her oral tests helping to organizeEmilyrsquos work and reteaching certain skills asnecessary In elementary school Emily did wellwith the limited amount of support she receivedin the regular classroom In middle school how-ever she is having trouble keeping up with as-signments Emilyrsquos spelling is inaccurate sheoften misspells the same word three or four dif-ferent ways on the same page Her handwritingis very slow and laborious so she spends manyhours each evening working on her homeworkShe has tried tape recording assignments but shefinds this process also to be laborious because itis so time consuming to correct mistakes

It has been recommended that Emily be re-moved from some of her academic classes andreceive instruction in the resource programEmily wants to remain in regular classes but shecanrsquot keep up with the pace

How could assistive technology help Emily

What are her needs

What case could be made for assistive tech-nology for her

39

Emilyrsquos SolutionEmily has reached the point in her educa-

tional career when she cannot keep pace with thedemands of the written work On observingEmily the occupational therapist noted that ittook Emily five times as long as the average stu-dent in her English class to complete written as-signments

Emilyrsquos IEP Team decided she was spendingfar too much time on the handwriting processTo help her with this problem the team agreedthat Emily should learn to use a computer with aword processing program and a voiced spellchecker One period per day Emily goes to theresource room to practice keyboarding and workon longer written assignments During her regu-lar classes Emily uses a portable word proces-sor (eg AlphaSmart) to take notes which shecan print out later in the resource room

These simple solutions allow Emily to speedup her writing time and produce written workthat is easy to correct and edit With technologyto aid her Emily is spending less time on thehandwriting process and more time on thinkingand processing information Her homework timehas been cut in half and Emily is much more re-laxed and confident at school

Solution SummaryKeyboarding training

Use of computer with word processingsoftware

Use of voiced spell checker

Use of portable word processor

BryanBryan is a seventh grader with a neuro-mus-

cular disease that has caused him to lose physi-cal function He is a bright student with excel-lent academic skills Bryan uses a laptop com-puter with a trackball and an onscreen keyboardto do all his written work He navigates skill-fully around the school building using a powerwheelchair Technology has really helped Bryanto fit in and do well at school However now asa young adolescent Bryan is beginning to feelleft out socially He requires so much help withhis physical needs that he has to spend lots oftime with adults Bryan wants to ldquohang outrdquo likethe other kids his age and escape adult scrutinyonce in a while

Bryan is nonverbal He uses a complex so-phisticated electronic communication device toparticipate in class The device is programmedwith phrases that Bryan frequently uses and healso can select icons to create sentences of hisown Bryanrsquos communication device works wellfor him in formal classroom settings but it isbulky and cumbersome to use in casual conver-sation with friends Bryan has come to believethat his communication device is actually a bar-rier to the kinds of informal interactions he wantsto have

Bryan knows that he has the best in technol-ogy and that the equipment he uses was very ex-pensive He doesnrsquot want to appear ldquogreedyrdquo ordemanding so he has not told his parents abouthis dissatisfaction with his ability to communi-cate One of Bryanrsquos friends Michael howevernoticed that Bryan was acting pensive and un-usually quiet Michael gently coaxed the truthout of Bryan and offered to help his friend thinkof a new way to ldquotalkrdquo that would provide himwith more flexibility and independence

40

Bryanrsquos SolutionWhen Bryan and Michael put their heads to-

gether they came up with lots of ideas The onethey settled on as the most feasible involved us-ing the laptop that Bryan already had The laptophad some advantages because it was small andportable and Bryan already knew how to use itvery well In a catalog of special needs softwarethe friends found communication software thatoperated on an icon system and the price wasright--around $100 With communication soft-ware installed on the laptop Bryan had asimplermore portable device for talking in ca-sual settings

Next Michael asked his father to help themmake a tray for Bryanrsquos wheelchair that wouldhold the laptop and fold down beside the chairout of the way when not in use Michaelrsquos dadcame up with a clever tray on hinges that foldedto the side The laptop fastened to the tray withwide rubber bands A handle on the tray allowedBryan to raise and lower the tray as needed

In addition to his laptop Bryan also neededa device for quick greetings and spontaneous re-torts Bryan and Michael chose a programmableswitch with the capacity to record up to 12 mes-sages Bryan could operate the switch quickly byhitting it with his elbow He and Michael had agreat time recording messages suitable for talk-ing to their friends or to girls

What Bryan found out was that he neededmultiple ways to communicate so that he couldcustomize his electronic speech to fit the settingand the occasion For a relatively small financialinvestment Bryan and Michael were able to ex-pand communication possibilities for Bryan andallow him greater control and personal choiceabout what he said how he said it and to whom

Solution SummaryCommunication softwareDrop-down wheelchair trayProgrammable switch

TracyTracy is a man in his mid-thirties who has

been blind from birth Since graduating fromcollege he has held a series of entry level jobs atminimum wage and without benefits Tracy isfrustrated by the lack of challenge in the jobs hehas had he would like to have a managerial po-sition with some opportunities for advancementbetter pay and benefits

Currently Tracy is working at a Pizza Hutrestaurant where he prepares pizzas for the ovenHe enjoys his co-workers and regular customersbut Tracy wants more A management traineeopening has been announced in the companynewsletter and Tracy decides to apply This newposition involves taking pizza orders over thetelephone and sending the order via computerand modem to the appropriate Pizza Hut outletwhere the pizzas will be made Having madeevery possible type and size of pizza Tracy isvery familiar with the options But how couldhe operate the computer and record orders asthey come in over the telephone Would he havea chance for this job which could be his first stepup

41

Tracyrsquos SolutionTracy and his Vocational Rehabilitation Coun-

selor filled out the job application for the posi-tion at Pizza Hutrsquos central ordering facility andTracy was called to set up an interview Prior tothe interview Tracy and his job counselor wentto the central ordering facility for Pizza Hut tostudy aspects of the job and to determine if tech-nology could assist Tracy to perform the essen-tial job functions The job involved the follow-ing steps (1) greeting the customer and takingdown customer information (2) asking a seriesof questions about the customerrsquos order (egtype size toppings) (3) simultaneous record-ing of the order via computer and (4) sendingthe order to the appropriate Pizza Hut outlet

After studying the process of taking ordersTracy and his counselor decided upon the follow-ing technology

(a) A computer compatible with the Pizza Hutnetwork

(b) Voiced software so that Tracy couldldquohearrdquo what he was typing

(c) A telephone headset to listen to the cus-tomer with one ear

(d) an ear piece to listen to the computer

At his interview for the job Tracy explainedhis qualifications for the position--college degreeexperience with Pizza Hut He also told the in-terview team about how technology would al-low him to do the job as efficiently and effectivelyas other workers

The interview team members were impressedby Tracyrsquos initiative and his work ethic Theychose him over several other qualified candi-dates Though it took some detective work toput together a computersoftware package com-patible with Pizza Hutrsquos system Tracy was ableto do it

From the first day on the job Tracy knew he

was going to like it better than anything he haddone before Listening to the computer and thecustomer simultaneously was challenging at firstbut soon Tracy had mastered the process Afterthree months in his new position Tracy wasasked to become the manager for his shift Nowhe hires and trains new order clerks schedulesworkers and evaluates their job performanceTracy has what he wanted--a managerial posi-tion better wages and a future with the com-pany

Solution SummaryCompatible computer terminal

Voiced software

Telephone headset

Ear piece for computer

42

Advocating forAssistive Technology

In the area of Assistive Technology mdash just as in so many areas of need mdash parents must betheir childrenrsquos best advocates Federal and

state laws support providing assistive technol-ogy to individuals with disabilities but theselaws are only meaningful when parents knowabout them and can use legal processes to securetheir childrenrsquos rights Here are just a few of thelaws on which parents can rely when advocat-ing for assistive technology for their children

THE AMERICANS WITH DISABILITIES ACT OF1990

The Americans with Disabilities Act (ADA)proposes to eliminate ldquodiscrimination againstindividuals with disabilitiesto address the ma-jor areas of discrimination faced day-to-day bypeople with disabilitiesrdquo The ADA applies spe-cifically to the areas of employment public ac-commodations and government functions Inthese areas the ADA requires that reasonable ac-commodations be made so that people with dis-abilities can have an equal opportunity to par-ticipate in employment opportunities public ac-commodations and government functions TheADArsquos definition of ldquoauxiliary aids and servicesrdquoits mandates for ldquoacquisition or modifications ofequipment and devicesrdquo and ldquoreasonable accom-modationsrdquo support the provision of assistivetechnology devices and services to individualswith disabilities

THE REHABILITATION ACT OF 1973Section 504 of the Rehabilitation Act requires

that any ldquoprogram or activity receiving Federalfinancial assistancerdquo comply with non-discrimi-nation rules Section 504 Regulations require thatpublic schools provide students who have dis-abilities an educational opportunity equal to theeducational opportunity provided to students

without disabilities Section 504 also uses theterm ldquoreasonable accommodationsrdquo which canmean the provision of assistive technology de-vices and services

THE INDIVIDUALS WITH DISABILITIES EDUCA-TION ACT (IDEA)

The Individuals with Disabilities EducationAct (IDEA) requires free appropriate public edu-cation (FAPE) for students with disabilities IDEAmandates education in the least restrictive envi-ronment requires schools to use supplementaryaids and services special and related services tohelp assure that students with disabilities par-ticipate in and benefit from public educationAssistive technology is specifically mentioned inIDEA as a service which school districts may haveto provide in order for a student with disabilitiesto benefit from special education

THE CARL PERKINS ACTThe Carl Perkins Act assures that Vocational

Education programs in public schools are madeaccessible to students with disabilities The lawassures supplementary services including class-room curriculum and equipment modificationssupportive personnel instructional aides and in-structional devices

PARENT RESPONSIBILITIESIn order to be effective advocates for their

children parents need to familiarize themselveswith all the laws that support the provision ofassistive technology Copies of the laws and theirregulations are available from the offices of mem-bers of the House of Representatives and the Sen-ate

Besides knowing the law parents must par-ticipate actively in developing plans for theirchildrenrsquos education that include assistive tech-nology when it is needed Parents must attend

43

IFSP and IEP meetings and be prepared to workcooperatively with other team members Whena parent questions an assistive technology evalu-ation or an IEP Team recommendation the par-ent must be prepared to follow-up on those ques-tions including using due process rights whennecessary

What should a parent do when an agencyrefuses to pay for assistive technology that achild needs

Agencies like early intervention programsand school districts are mandated to provideassistive technology if the need for technology isin the childrsquos written plan If one of these agen-cies refuses to pay for needed technology then aparent must consider using due process rightsIn early intervention services the parent wouldfollow the appeal process laid out by the leadagency for Part C When school district servicesare involved the parent can file a complaint ifservices in the IEP are not provided or can askfor a due process hearing if the parent and theschool district disagree about the need forassistive technology If a parent disagrees withthe results of an evaluation for assistive technol-ogy the parent can ask for an independent evalu-ation at school district expense

SummaryOverall getting the devices and services for

children with disabilities means that parents mustbe part of the planning team at every level of theirchildrenrsquos education It means talking with otherfamilies and users of assistive technology aboutdevices and services learning how they foundthe best technology and figuring out where togo when resources are few Getting assistive de-vices and services is not always an easy job Buthelp is available Working with professionalstalking with consumers and other families par-ents can find the best avenues for providing theirchildren with the assistive technology they needIn the end the effort is worth it because assistive

technology is not just a civil right guaranteed bylaw it is also a means to achieve human rights togrow up happy independent and self-sufficientas possible

Hints for Parents

When advocating for your child in the special edu-cation arena donrsquot forget the following facts aboutassistive technology and the IEP

bull Assistive technology needs must be con-sidered along with a studentrsquos other edu-cational needs

bull Needs for technology must be identifiedon an individual basis

bull Identification of technology needs mustinvolve parents the student when appro-priate and a multidisciplinary team

bull Parents or other IEP Team members can askfor additional evaluation or an indepen-dent evaluation to determine assistive tech-nology needs

bull When an evaluation is being conductedconsider mobility fine-motor skills com-munication and alternatives to traditionallearning approaches

bull Lack of availability of equipment or costalone cannot be used as an excuse for de-nying assistive technology services

bull If included in the IEP assistive technologyservices and devices must be provided atno cost to the family

bull Parents always have the right to appeal ifassistive technology services are denied

44

More Questions and Answers

A re schools required to pay forassistive technology devices andservices

It is the responsibility of the school dis-trict to provide for the equipment services orprograms identified in the IEP The school dis-trict may pay for the equipment service or pro-grams itself utilize other resources to provide orpay for the device or utilize private insurancefunds Medicaid or other sources of funds as longas the device or services identified in the IEP areprovided at no cost to the parent Private insur-ance or Medicaid may be used ony if the parentagrees

Can schools require the parents to payfor an assistive technology device orservice identified in the studentrsquos IEPor require the parents to use theirown private health insurance to payfor the device or service

No The ldquofreerdquo in FAPE means that parentsof students with disabilities who require assistivetechnology devices or services do not have to payfor these items As stated in IDEA and its regu-lations all special education and related servicesidentified in the studentrsquos IEP must be providedldquoat no cost to the parentrdquo The term ldquofreerdquo is in-terpreted broadly and goes far beyond the simplepaying of deductibles and co-payments Thecourts have interpreted ldquofreerdquo to apply to butnot be limited to future insurability depletionof maximum lifetime caps raised premiums dis-continuation of policies and preexisting condi-tion exclusions If the family agrees to allow theschool to access their Medicaid or private insur-ance this decision must be strictly voluntary onthe part of the family

How can school districts use Medicaidfunds to purchase assistive technologydevices

If Medicaid is capitated in any way concern-

ing its use for assistive devices school districtsmust request from parents the right to use Med-icaid funds However parents are not obligatedto use their Medicaid funds to purchase devicesor services used at school With permission aparentrsquos private insurance must be accessed be-fore Medicaid can be used for assistive technol-ogy devices Medicaid regulations vary some-what from state to state so it is wise to consultthe state Medicaid Service Bureau before mak-ing any assumptions about Medicaid and thepurchase of assistive technology

Are there other options for schools toconsider in lieu of purchasing theassistive technology device

Yes There are times when the outright pur-chase of equipment or devices is not necessaryor even advisable In such instances schoolsmight consider rental or long-term lease optionsThere are certain advantages to renting or leas-ing depending on the individual needs of thestudent For example renting equipment mightbe a reasonable strategy if the student is expectedto improve or deteriorate in a short period of timeor when it is necessary to try out the equipmentbefore purchase Long-term leasing or leasepurchase agreements also have potential benefitsfor schools which include no obligation on be-half of the school to purchase the device abilityto return leased equipment and thus reduce ob-solete inventory flexible leasing terms use ofequipment without a lump-sum purchase up-grading of equipment as more improved tech-nology becomes available and upgrading ofequipment as the studentrsquos needs change

Isnrsquot assistive technology just acrutch Wonrsquot students become toodependent on technology and notlearn to use the skills they have

Assistive technology should be used as sup-port for access learning and performing daily

45

tasks In general assistive technology is appro-priate when it compensates for disabilities so thatthe individual can function as normally as pos-sible If assistive technology is necessary for astudent to have access to educational opportuni-ties or to benefit from education then it is not aldquocrutchrdquo but a legitimate support Some skillsare too laborious or taxing to accomplish at a rateor with degree of proficiency to allow for partici-pation in the least restrictive environment Withassistive technology the student can participatemore fully and more closely approximate the lev-els of achievement and interaction of his or herpeers In general the use of assistive technologyenhances function and increases skills and op-portunities Though a student may be dependentupon a particular device in order to perform skill-fully denying the device denies the student anopportunity ever to achieve success at the levelof his or her potential

When is assistive technology appropri-ate

Assistive technology may be considered ap-propriate when it does any or all of the follow-ing things

bull Enables students to perform functions thatcan be achieved by no other means

bull Enables students to approximate normalfluency rate or standardsmdasha level of ac-complishment which could not beachieved by any other means

bull Provides access for participation in pro-grams or activities which otherwise wouldbe closed to the individual

bull Increases endurance or ability to persevereand complete tasks that otherwise are toolaborious to be attempted on a routine ba-sis

bull Enables students to concentrate on learn-ing tasks rather than mechanical tasks

bull Provides greater access to information

bull Supports normal social interactions with

peers and adults

bull Supports participation in the least restric-tive educational environment

Who owns the special equipment thatis purchased for students

If the school district purchases the equipmentthe equipment belongs to the district Someschool districts designate that a particular deviceis to be used by a specific student during the timewhen that device remains appropriate for thatstudent Other districts have ldquopoolsrdquo of assistivedevices and distribute them for use by a varietyof students The distribution and use of devicesis under the districtrsquos control as long as the needsdescribed in studentsrsquo IEPs are being met

If devices are purchased for a particular stu-dent using that studentrsquos Medicaid funds or pri-vate insurance then the device belongs to the stu-dent and is meant for the exclusive use of thatstudent

When a student moves from one levelof schooling to another like elemen-tary school to middle school does thedevice follow the student

If an assistive device is necessary in order tofulfill the requirements of a studentrsquos IEP such adevice must be provided in whatever school thestudent attends The same device may not nec-essarily follow the student from one school toanother but a comparable device which fulfillsthe IEP requirements would have to be providedin the new school that the student attends

If a family moves from one schooldistrict to another can a studentrsquosassistive technology go along

Devices bought by the school belong to theschool not the student who uses them When afamily moves from one school district to anotherthe equipment the student has been using doesnot automatically move to the new school

Assistive equipment can go with a studentto a new school if the sending school district

46

agrees to sell or give the device to the family orthe new school district

If the device was purchased by the familythrough the familyrsquos private health insurance orby Medicaid for this particular student then thedevice belongs to the student and can go withthe student to a new school district

What happens to assistive technologydevices when students leave the schoolsystem at graduation

If the school district purchased the device thedevice is the property of the school The schoolcould keep the device for use by other studentssell it or decide to transfer the device to anotherdistrict or loan program If the family or anotherfunding source purchased the device it is theproperty of the student and the family

If a piece of assistive technology is nolonger needed or relevant to a studentand the device was paid for by Medic-aid or private insurance can it bedonated for another studentrsquos benefit

Yes it is a parental decision The parentscould donate the device to the school for use byother students with disabilities or to some otherorganization which loans out equipment

Can assistive devices be insured

Many school district liability policies willcover devices purchased by the district for stu-dent use Devices purchased by other fundingsources may or may not be covered while onschool premises or involved in school activitiesIt is important for school staff to investigate thedistrictrsquos property insurance to determine whatthe policy currently covers and whether or notthe policy insures against loss or damage ofassistive devices

Parents who own assistive devices that areused at home and at school may also wish to pur-chase home owners or rentersrsquo insurance with aspecial rider that covers damage to or loss of thedevice

Who is responsible for the repair and

maintenance of assistive devices

In general the school district is responsiblefor repair and maintenance of assistive devicesused to support educational programs describedin the IEP or covered by Section 504

If a device is broken and is beyondrepair who replaces the broken de-vice

If an assistive device is necessary for thestudentrsquos IEP to be implemented then the schooldistrict will have to replace a broken lost or sto-len device

If a device is broken and sent off forrepairs must the school district sup-ply a substitute device until the origi-nal device is returned

If the assistive technology device is vital tothe studentrsquos daily special education program itis not reasonable for the student to be without adevice for long periods of time If a device isgoing to be unavailable for more than a day ortwo the district should provide a backup ma-chine which allows the student to continue work-ing on IEP goals

Is the school district obligated totrain substitute teachers and aides tooperate assistive technology devices

Again if the assistive technology device isvital to the studentrsquos daily special education pro-gram it is not reasonable for the student not tobe able to use the device for long periods of timebecause a substitute is teaching the class If thesubstitute is only going to be in the classroomfor a day or two it is probably not necessary toprovide elaborate training However if the sub-stitute is going to be in the classroom for an ex-tended time training should be provided

Must school districts allow students totake assistive devices home on schoolnights to do homework Over week-ends During school vacations Overthe summer

In many cases it is desirable for students to

47

have the opportunity to use the same assistivetechnology devices at home and in school Forexample when a student is completing home-work assignments assistive technology may benecessary to produce the type of product that isrequired Some school districts have policieswhich allow the devices to go home with the stu-dents overnight on weekends or during vaca-tion or summer periods In general these kindsof policies are a local district matter and may bedetermined according to local district needs Ifhowever a studentrsquos IEP includes a provisionwhich says the student is to have access to anassistive device both at school and at home thenthe school district would be obligated to allowthe student to take a device home or provide twodevices one for home use and one for school

What professionals are consideredqualified to assess a student in thearea of assistive technology

Because assistive technology is such a newfield there are no national standards and few lo-cal or state standards for licensing or certificationfor specialists in assistive technology Howeverschool districts often have professionals who havereceived training in conducting assistive technol-ogy evaluations and are able to provide the ser-vices identified in the IEP If a district does nothave personnel who are knowledgeable in con-ducting such evaluations the district can arrangefor such services from other knowledgeable pro-vidersndash such as Independent Living Projects Al-liance for Technology Access Centers or Tech ActProjects

How can one distinguish betweenassistive technology and personalitems (eg wheelchairs hearing aidseyeglasses crutches)

Currently IDEA does not make a clear dis-tinction between assistive technology devices andpersonal items This confusion stems in large partfrom IDEArsquos broad definition of assistive technol-ogy For example if a student with a disability

needs eye glasses in order to obtain FAPE thenthe school district is obligated to provide themat no cost to the parents In general howeverschool districts do not purchase personally pre-scribed devices such as hearing aids or glasses

Who determines how assistive tech-nology will be purchased and withwhat available funding resourcesmdashtheIEP Team or school administration

Once the IEP team makes the determinationthat assistive technology must be provided aspart of the studentrsquos IEP it is the responsibilityof school administration to determine how theassistive technology will be provided and withwhich funding sources

Is a school district responsible forproviding ldquostate of the artrdquo equip-ment for a student

No The school district need provide onlyappropriate technology in order to meet thestudentrsquos needs as described in the IEP The de-cision as to what type of assistive technology isappropriate should be based on the assistive tech-nology evaluation recommendations and IEPteam decision There may be ldquodevicesrdquo or fea-tures of equipment which may be nice for the stu-dent to have but if they are not necessary forFAPE the school district is not obligated to pro-vide them If a specific device is necessary toensure FAPE and no other device can meet thestudentrsquos needs then the district must providethe required device even though it is costly If aless expensive device would accomplish the samegoals the IEP team is under no obligation tochoose a more expensive option

If a student needs a computer can aschool owned computer be used in thelab or classroom

Yes a school owned computer can be used ifthe student has access to the equipment when heor she needs it If the student does not have thenecessary access then the appropriate equipmentshould be purchased for the studentrsquos use

48

Can school district administratorsinstruct personnel not to includecostly assistive technology devices inthe IEP

IEP teams are charged with the responsibil-ity for determining a studentrsquos need for assistivetechnology devices and services and for specify-ing those devices and services Therefore it isimportant that IEP teams are clearly informed oftheir responsibility to determine if a studentneeds a device and the need for an assistive tech-nology evaluation to assist in making the deter-mination A school district may not have a policywhich prevents IEP teams from identifying astudentrsquos need for assistive devices or services

How does assistive technology getintegrated into the curriculum

The IEP team needs to discuss how the de-vice will be used by the student and how it willbe integrated into the curriculum The IEP teamshould identify on the IEP how the device willbe used by the student in the classroom Thisinformation should be shared with the generalclassroom teachers so that they are aware of howit is to be used

How can assistive technology be pro-vided from year to year with a degreeof continuity

As part of the annual review of the IEP a pointshould be made to devise ways to communicatewith next yearrsquos teachers about the technologythe student uses and how it should be integratedinto the curriculum Teachers who are new toworking with the student who uses technologyshould be provided training if they are unfamil-iar with the device and its use Training for teach-ers and support staff should be written into theIEP as a related service

Can an assistive technology device beused by more than one student

Yes if the device is the property of the schooldistrict and if all of the students using the devicehave access to the equipment when they need it

Can an independent evaluation berequested to address assistive tech-nology

Yes The school district is required to evalu-ate a student in all areas of suspected disabilityincluding if appropriate evaluating the studentrsquosneed for assistive technology A parent has theright to an independent educational evaluationat public expense if the parent disagrees with anevaluation obtained by the school district How-ever the school district may initiate a due pro-cess hearing to show that its evaluation is appro-priate If the final decision is that the evaluationis appropriate the parent still has the right to anindependent educational evaluation but not atpublic expense If the parent obtains an inde-pendent educational evaluation at private ex-pense the results of the evaluation (a) must beconsidered by the school district in any decisionmade with respect to the provision of FAPE tothe child and (b) may be presented as evidenceat a due process hearing

What is a product system

A product system is more than one piece ofequipment working together to produce a resultFor example an FM system that works in con-junction with a studentrsquos hearing aid is a prod-uct system

Can the school district require a stu-dent to bring a personally ownedassistive device such as an augmenta-tive communication system or laptopcomputer to school in order to doschoolwork

No However the family may wish the childto use his or her equipment in school since thechild may be more familiar or comfortable withit The IEP team should decide who is respon-sible for repair and maintenance of family owneddevices

Is it sufficient for a school district tosupply access to a district-ownedcomputer but provide no software

49

that is appropriate for the student touse

Just providing access to a computer does notfulfill the districtrsquos obligation to provide assistivetechnology to support FAPE The educationalaspect of the computer is very much related tothe software that the student uses If no appro-priate software is available then the student can-not pursue the IEP goals

50

Appendix

GlossaryASSISTIVE TECHNOLOGY any sort of aidincluding computers switches calculators spell-ing devices communication devices and voicesynthesizers which is used to help an individualperform some task of daily livingALTERNATIVE KEYBOARD may include en-larged reduced varied key placement one-handed braille chordic or any other device forentering text on a computerAUGMENTATIVE COMMUNICATION anydevice (electronic or otherwise) to enhance com-munication for a person with limited speechBRAILLE EMBOSSER a printer for producingbraille output either manually or when connectedto a computer When printing standard text froma computer it must first be translated into brailleBRANCHING describes the process of choos-ing among a sequence of choices or actions toproduce another sequence of choices This pro-cess is used in the ldquoscanningrdquo method of accessCD-ROM ldquoCompact Disk Read-Only Memoryrdquorefers to the 4-inch silver disks that typically hold700 megabytes of digital information and theplayers that access the information on these disksCURSOR either the flashing vertical or horizon-tal line on a computer screen that indicates theinsertion point for text or the arrow or I-beamthat indicates the position of the mouse pointeron the computer screenDESK ACCESSARY a small utility program thatruns on a computer and may be accessed fromany program at any time (such as a calculator)DRILL AND PRACTICE presents questionsrepetetively but is not a tutorial Software thatis only drill and practise doesnrsquot necessarily teachthe concepts needed to answer the questions pre-sented

ENVIRONMENTAL CONTROL any type ofdevice that an individual may use to control theirenvironment (lights appliances TV telephoneetc) This may include anything from simplereachers or sticks to computers and voice-acti-vated electronic systemsFM SYSTEM a local wireless broadcast systemthat consists of a microphone and transmitter forthe speaker and ldquowalkman-likerdquo receivers withheadphones for listeners with hearingimpairements or attention disordersHIGH TECH use of electronics or computers asa solutionICON a small computer graphic that appears onthe computer screen and may represent differ-ent types of objects (files or applications) or ac-tions depending on the context Use the mousepointer to click on icons that open files or per-form other actionsINDIVIDUAL FAMILY SERVICE PLAN (IFSP)the written document which defines the earlyintervention services provided to the child andfamily The program is designed to meet theneeds of the child and the family and is based onfamily-identified prioritiesINDIVIDUALIZED EDUCATION PROGRAM(IEP) a written plan specifying instructionalgoals and any special education and related ser-vices a student may need which must be writ-ten and reviewed annually Included are (1) thepresent educational levels of the student (2) astatement of annual goals including short-termobjectives (3) a statement of specific services ifneeded (4) the programs (5) the date when spe-cial services are to begin and the expected dura-tion of these services and (6) the tests and otherrequirements or information used to guage thestudentrsquos progress to determine if the instruc-tional objectives are being metINPUT the information that is transmitted to acomputer from a keyboard mouse or other in-

51

put deviceKEYBOARD a device for inputing text and com-mands to a computerKEYGUARD a plexiglass or other cover for akeyboard with holes for the individual keys Itallows more precise selection of keys for an indi-vidual with fine motor difficultiesKEYPAD a small keyboard with a 10-key setupfor numeric input or it may also be used as a con-trol for a screen-reader programLAPTOP a portable battery-powered computerthat is typically the size of a 3-ring binder weighs5-10 pounds and consists of a screen keyboardand disk-drivesLASER DISCS large (12-inch) CD-ROMs thatnormally contain moviesLOW TECH indicates use of low cost non-elec-tronic solutionsMACRO a simple short program that performsan action on a computer They are usually cre-ated by recording the keyboard andor mouseinput and storing them as an icon or key combi-nationMEGABYTE 1000 X 210 bytes of informationwhich basically means over one million key-strokes of computer storage (about 10 novels)MORSE CODE a direct method for computerinput using one to three switches and coded in-put to replace the keyboard and mouseMOUSE the name given to the pointing deviceused to control graphical user interfaces (GUI) ofmodern personal computersONSCREEN KEYBOARD a software programthat places the keyboard on the screen of the com-puter and may be accessed using a mouse or otherpointing device This is ideal for individuals whocannot use a regular keyboard but can use sometype of pointing deviceOPTICAL CHARACTER RECOGNITION(OCR) a process that utilizes special computersoftware to convert the scanned image of text intoactual text that may be edited by a word proces-sorOUTPUT computer-generated information for

the user This may be printed output from aprinter visual information from the screen orsounds from speakersSCANNER an electronic copier connected to acomputer Scanners are used to input drawingspictures or printed text into the computerSCANNING has nothing to do with the elec-tronic copier above It is another method for ac-cessing a computer or communication deviceusing one or more switches Scanning involvespresenting a group of choices cycling amongthem and making choices by activating a switchSCREEN READER software that reads text ona computer screen using a speech synthesizerThis allows individuals with visual impairmentsor other print disabilities to access text on thecomputer screenSIMULATION software that simulates real-world situations on a computer This may rangefrom a joystick trainer for driving an electricwheelchair to running citiesSPEECH SYNTHESIZER hardware or softwarefor producing electronic human speech on a com-puterSPELL CHECKER utility for checking the spell-ing in a documentSTICKY KEYS software or mechanical utility forallowing typing of multiple keystrokes with onefinger (using the shift or other modifier keys)SWITCH a device that is like a single button ofa keyboard or mouse Switches may be used byan individual with servere motor difficulties byany controllable muscle in their body (headhand toe eye breath etc) to operate any typeof computer communication or environmentalcontrol deviceSWITCH INTERFACE black box that connectsto a computer or other device that has plugs forswitchesTDD a text telephone used for communicatingin typed text over a phone line A TDD has akeyboard and text display or small printer Bothparties who are communicating over a phone linemust have TDDs

52

TOUCH WINDOW a computer input devicethat uses a touch-sensitive transparent windowplaced on the computer screen It performsmouse functions with a finger or stylus directlyon the screenTRACKBALL another replacement for themouse pointing device that uses a rolling ball toperform mouse movementsTUTORIAL teaches concepts presents informa-tion as opposed to simple drill and practiceVOICE RECOGNITION computer softwareand microphone that allows input and controlwith voice commandsWORD PREDICTION productivity softwarethat increases typing speed for one-finger typistsand others by predicting and choosing completewordsWORD PROCESSOR software for inputing andformatting textUSER person using a computerUTILITY software for adding function or per-forming housekeeping tasks on a computer

53

DocumentsSCHRAG LETTER ON ASSISTIVE TECHNOLOGY

August 10 1990

Dear Ms Goodman

This is in response to your recent letter to the Office of Special

Education Programs (OSEP) concerning the obligations of public

agencies under Part B of the Education of the Handicapped Act

(EHA-B) to provide assistive technology to children with handi-

caps

Specifically your letter asks

1 Can a school district presumptively deny assistive technol-

ogy to a handicapped student

2 Should the need for assistive technology be considered on

an individual case-by-case basis in the development of the

childs Individual Education Program

In brief it is impermissible under EHA-B for public agencies

(including school districts) to presumptively deny assistive tech-

nology to a child with handicaps before a determination is made

as to whether such technology is an element of a free appropriate

public education (FAPE) for that child Thus consideration of a

childs need for assistive technology must occur on a case-by-

case basis in connection with development of a childs individual-

ized education program (IEP)

We note that your inquiry does not define the term assistive

technology and that the term is not used either in the EHA-B

statute or regulations The technology Related Assistance for

Individuals with Disabilities Act of 1988 PL 100-407 contains

broad definitions of both the terms assistive technology device

and ldquoassistive technology service See Section 3 of PL 100-

407 codified as 29 USC 2201 2202 Our response will use

assistive technology to encompass assistive technology ser-

vices and ldquoassistive technology devices

Under EHA-B State and local educational agencies have re-

sponsibility to ensure that eligible children with handicaps receive

FAPE which includes the provision of special education and re-

lated services without charge in conformity with an IEP 20 USC

1401(18) 34 CFR S3004(a) and (d) The term special educa-

tion is defined as specially designed instruction at no cost to

the parent to meet the unique needs of a handicapped child 34

CFR S30014(a) Further related services is defined as includ-

ing transportation and such developmental corrective and other

supportive services as are required to assist a handicapped child

to benefit from special education 34 CFR ss33013 (a)

The EHA-B regulation includes as examples 13 services that

qualify as related services under EHA-B See 34 CFR S30013

(b)(1)-(13) We emphasize that this list is not exhaustive and

may include other developmental corrective or other supportive

servicesif they are required to assist a handicapped child to

benefit from special education 34 CFR S30013 and Comment

Thus under EHA-B assistive technology could qualify as spe-

cial education or related services

A determination of what is an appropriate educational program

for each child must be individualized and must be reflected in the

content of each childs IEP Each childs IEP must be developed

at a meeting which includes parents and school officials 34 CFR

S300343-300344 Thus if the participants on the IEP team de-

termine that child with handicaps requires assistive technology in

order to receive FAPE and designate such assistive technology

as either special education or a related service the childs IEP

must include a specific statement of such services including the

nature and amount of such services 34 CFR S300346(c) App

C to 34 CFR Part 3000 (Ques 51)

EHA-Bs least restrictive environment (LRE) provisions require

each agency to ensure (t)hat special classes separate school-

ing or other removal of handicapped children from their regular

educational environment occurs only when the nature or severity

of the handicap is such that education in regular classes with the

use of supplementary aids and services cannot be achieved sat-

isfactorily Part 121a 42FR 4251113 (August 23 1977)

Assistive technology can be a form of supplementary aid or ser-

vice utilized to facilitate a childs education in a regular educa-

tional environment Such supplementary aids and services or

modifications to the regular education program must be included

in a childs IEP Id Appendix C to 34 CF art 300 (Ques 48)

In sum a childs needs for assistive technology must be deter-

mined on a case-by-case basis and could be special education

related services or supplementary aids and services for children

with handicaps who are educated in regular classes

I hope the above information has been helpful If we may pro-

vide further assistance please let me know

Sincerely

Judy A Schrag EdD

Director Office of Special Education Programs

54

INDIVIDUALS WITH DISABILITIES EDUCATIONLAW REPORT

Cite as 18 IDELR 627

Digest of Inquiry

(Inquirerrsquos Name Not Provided)

(Date Not Provided)

bull Is a school district responsible to provide assistive

technology devices for home use

bull May a school board overrule a determination by an IEP

team that a child with a disability needs access to an

assistive technology device at home

bull What is the time limit on implementation of an IEP

Digest of Response

(November 27 1991)

Assistive Technology Devices May Be Required for Home Use

If an IEP team determines that a child with a disability needs

access to an assistive technology device at home as a matter of

FAPE then the school district must provide the device for home

use in order to implement the childrsquos IEP

School Board May Not Change IEP Teamrsquos Determination

Under Part B a school board has no authority to unilaterally

change any statement of special education or related services

contained in an IEP including a statement of a childrsquos need to

have access to an assistive technology device at home Without

reconvening the IEP team the school board may not change the

IEP and the school district is obligated to implement the IEP re-

quirements regardless of the school boardrsquos objections

IEPs Must Generally Be Implemented

Under Reg 300342(b) an IEP must be in effect before the

provision of special education or related services and must be

implemented as soon as possible following the conclusion of the

IEP meeting(s) In accordance with Appendix C to the Part 300

regulations an IEP should generally be implemented without de-

lay after being finalized although a reasonable delay may be per-

missible in limited circumstances

__________________

Text of Inquiry

I would like to have a copy of the policy classification on

Assistive Technology

I also have a question to ask regarding Assistive Technology

such as a closed circuit TV

My daughter uses a CCTV in school and it is on her IEP

program My daughter is visually impaired The initial request

was made by me the parent to the appropriate people involved

in her education and discussed and approved by the committee

on an individual basis

My question is I would like to make the request to the ap-

propriate officials for another CCTV for home use to accomplish

the same results at home as is done in school (For homework

reading books any assignments from school)

Another question is If the committee approves this request

it will go to School Board for approval I would like to know what

happens if the School Board doesnrsquot approve the proposal Is it

impartial hearing time

Thank you for your assistance in this matter

Any information regarding Assistive Technology Informative

for school and home use would be greatly appreciated

Is there a time limit on implementation of yearly updated

IEPs[] Every year I have long delays on implementation of board

approved IEPs[]

Text of Response

This is in response to your recent letter to the Office of Spe-

cial Education Programs (OSEP) requesting a copy of any OSEP

policy clarifications on assistive technology as well as asking spe-

cific questions concerning the assistive technology needs for your

daughter You also asked a question about the time limits for

implementation of an individualized education program (IEP)

In response to your request I am enclosing a copy of OSEPrsquos

August 10 1990 letter to Ms Susan Goodman concerning the

obligations of public agencies under Part B of the Individuals with

Disabilities Education Act (Part B) formerly cited as Part B of the

Education of the Handicapped Act to provide assistive technol-

55

ogy to children with disabilities along with some additional infor-

mation on assistive technology and a copy of the Part B regula-

tions I would also like to provide you with OSEPrsquos response to

each of your specific questions as stated below

I would like to make the request to the appropriate officials

for another CCTV for home use to accomplish the same

results as is done in school (For homework reading books

any assignment from school)

The IEP which must be developed at a meeting that includes

parents and school officials must contain among other things a

statement of the specific special education and related services

to be provided to the child See 34 CFR sectsect 300343-300346 As

stated in OSEPrsquos letter to Ms Goodman if the IEP team deter-

mines that a child with disabilities requires assistive technology in

order to receive a free appropriate public education (FAPE) and

designate such assistive technology as either special education

or a related service the childrsquos IEP must include a specific state-

ment of such services including the nature and amount of such

services See 34 CFR sect 300346(c) App C to 34 CFR Part 300

(Ques 51) The need for assistive technology is determined on a

case-by-case basis taking into consideration the unique need of

each individual child If the IEP team determines that a particular

assistive technology item is required for home use in order for a

particular child to be provided FAPE the technology must be pro-

vided to implement the IEP

If the committee approves this request it will go to the School

Board for approval I would like to know what happens if

the School Board doesnrsquot approve the proposal Is it im-

partial hearing time

As part of the public agencyrsquos part B obligation to provide

FAPE to an eligible child with disabilities the public agency must

ensure that special education and related services are provided

in conformity with an IEP which meets the requirements of 34

CFR sectsect 300340-300349 One requirement at 34 CFR sect

300343(a) is that the public agency conduct a meeting to de-

velop review and revise a childrsquos IEP The Regulations require

that certain participants attend the IEP meeting See 34 CFR sect

300344 The role of the participants at the IEP meeting is to

determine the specific special education and related services that

a child needs in order to receive FAPE Once the determination is

made at a meeting convened pursuant to 34 CFR sect 300343(a)

Part B does not recognize any authority on the part of a local

School Board to unilaterally change the statement of special edu-

cation and related services contained in the IEP After the IEP is

developed and the placement decision is made by a group of

persons knowledgeable about the child the meaning of the evalu-

ation data and placement options the public agency must imple-

ment the IEP See 34 CFR sect 300533(a)(3) Without reconven-

ing the IEP meeting the local school board could not change the

IEP

Is there a time limit on implementation of updated IEPrsquos[]

Every year I have long delays on implementation of Board

approved IEPrsquos[]

Part B imposes no specific time limits for the implementation

of IEPs The Part B regulations at 34 CFR sect 300342(b) require

that an IEP (1) must be in effect before special education and

related services are provided to a child and (2) must be imple-

mented as soon as possible following the meetings required to

develop review or revise a childrsquos IEP The answer to Question 4

in Appendix C to the Part 300 regulations states that no delay is

permissible between the time a childrsquos IEP is finalized and when

special education and related services is provided It is expected

that the special education and related services set out in the IEP

will be provided by the agency beginning immediately after the

IEP is finalized In certain circumstances such as when the IEP

meeting occurs during the summer or a vacation period or where

there are circumstances which require a short delay (eg work-

ing out transportation arrangements) the implementation may not

be immediate See Comment 34 CFR sect 300342

I hope that this information is helpful to you Please let us

know if you have any additional questions or concerns

Judy A Schrag

Director

Office of Special Education Programs

_______________________

Cite as 18 IDELR 628

56

Sample Letter Requesting an Assistive Tech-nology Evaluation

March 1997

Dear Sir

Our daughter Catherine an IDEA-eligiblestudent is currently receiving special educationand supportive therapies through the publicschool district As she is progressing through theelementary school grades the curriculum is de-manding more and more written work from herAt this point teachers or assistants are writingfor her but this method does not allow Catherinethe opportunity to compose written work on herown

As Catherinersquos parents we think the time hascome to consider assistive technology forCatherine to allow her to learn to do written workon her own so that she can learn the mechanicsof writing and can put her own thoughts downon paper for others to read

To this end we are requesting an assistivetechnology evaluation for Catherine to determinewhat kinds of technology are necessary to assisther with written expression We are assumingthat the assistive technology evaluation will beperformed at district expense by professionalswho are qualified to determine (a) what assistivetechnology may be necessary for Catherine (b)what assistive technology devices might be help-ful and (c) what occupational and physicaltherapy services may be necessary to support thetechnology

We would like to have this evaluation com-pleted so that information is available prior tothe convening of the IEP Team to writeCatherinersquos Individualized Education Programfor next year

We appreciate your assistance with this mat-ter and look forward to hearing from you

Yours truly

Assistive TechnologyIssues to Address

_____What are the individualrsquos current unmetneeds for access to communication writ-ing or educational materials

_____What are the short and long term educa-tional goals

_____What are the daily educational demandswhich require the use of assistive technol-ogy

_____Have the appropriate team members in-cluding parents been involved in the as-sessment process

_____What are the features of the technology thatwould assist the individual in meetingdaily classroom demands

_____Why is the selected equipment more appro-priate than other alternatives

_____Have all of the individualrsquos environmentsbeen considered

_____Does the selected equipment reflect the leastrestrictive intervention strategy

_____Is the equipment necessary to achieve edu-cationallife goals

_____How will the individual physically man-age the equipment in all environments

_____How will the equipment be integrated intothe individualrsquos daily life

_____How will the use of the assistive technol-ogy promote inclusion of the individualinto activities in the school and commu-nity

_____Which members of the education team willbe trained to use the equipment

_____How will the individual be trained to usethe equipment

_____How will the family be involved with theindividual and the equipment

57

ExamplesEDUCATIONAL SOFTWARE EVALUATION

A IDENTIFYING INFORMATION

Name of instructional program

Publisher

Cost ____________Computer platform(PCMac)

Other equipment needed to run program

Grade level of the program

Skill levels required of users

Special needs addressed by program

B DESCRIPTIVE INFORMATION

1 What is the purpose of the instructional program as stated by

its publisher

2 What curriculum area or areas does it address

3 What type of instructional program is it

tutorial drill and practice___ arcade game type___

drill and practice ____ simulation ___

problem solving___ educational game___

teacher utility___ other___

4 For what type of learner was the program designed

age level __________ grade level ____________

ability level ________ interest level ___________

5 What skills or information does the program attempt to teach

or review

6 How does the program present information

__text __graphics __animation __color __sound effects

__music __speech __other __________________________

7 Is the information presented clearly

Is text legible and readable

Are graphics comprehensible

Are sounds audible and intelligible

8 Are directions for using the program clearly stated and under-

standable Where do directions appear

_____ within the program

_____ in the programs documentation or manual

9 Is the program under user control that is can the user control

the programs movement from screen to screen

Review directions at any time

Exit the program at any time

10 What computer use demands are placed on the learner

_____ insert disk and turn on computer

_____ select from menu

other ______________________________

11 What academic demands are placed on the learner

reading level _______________________________

spelling level _______________________________

other _____________________________________

12 What physical demands are placed on the learner

_____ keyboard must be used to enter responses

_____ press any key

_____ press a key from one half or one quadrant of key-

board

_____ press on specific key

_____ press several keys in order

_____ other devices used to enter responses

13 What speed demands are placed on the learner

_____ presentation of information controlled by program (

moderate fast or slow)

_____ presentation of information under user control

_____ unlimited response time

_____ response time set by program (moderate fast slow)

_____ response time varied by user

58

14 What accuracy demands are placed on the learner

_____ user can correct typing errors

_____ program does not allow correction of typing errors

_____ program locates common errors

_____ program requires correct spelling of all responses

_____ program allows only one correct response for most

questions

15 Is feedback about response accuracy provided to learners

appropriately

_____ knowledge of results provided after each response

_____ correct responses confirmed

_____ learner informed if response incorrect

_____ another trial provided if response incorrect

_____ number of trials provided

_____ correct response demonstrated if learner fails to an-

swer correctly

_____ learner allowed opportunity to respond after demon-

stration of correct response

16 Does the program use any branching procedures besides

differential treatment of correct and incorrect responses

17 What techniques are used for reinforcement and motivation

_____ knowledge of results and confirmation of correct re-

sponses

_____ summary information about learner performance

_____ text message of praise for correct responses

_____ graphics display and or sound for correct responses

_____ competitive game in which correct response earn

points

_____ other _________________________________

Reinforcement is _____ continuous _____ intermittent

18 What user options are available to students and teachers

Students can select

_____ activity from menu difficulty

_____ number of questions type of questions

_____ other ____________________________

Teacher or parent can select

_____ sound on or off

_____ number of questions

_____ type of questions

_____ sequence of instruction

_____ number of trials

_____ speed of presentation

_____ speed demands for responses

_____ other_________________________________

Teacher or parent can

_____ enter own content into program

_____ review student records

_____ other________________________________

19 Is the programs documentation adequate

All program features fully and clearly explained

Rationale for program purpose and objectives included

Print materials provided for students

20 Other comments about the instructional program

C OVERALL EVALUATION

Rate the appropriateness of the instructional program in each of

the following areas using this scale

excellent adequate inadequate

1 2 3

1 2 3 Curricular content (program addresses important skills

1 2 3 Interest level

1 2 3 Ease of use for learners

1 2 3 Demands on learner (eg computer use academic)

1 2 3 Instructional procedures

1 2 3 Motivational value

1 2 3 Appropriate use of the medium

1 2 3 Important instructional variables under teacher control

1 2 3 Other _______________________________

59

Software Featuresbull Easy-to-Read Screensbull Consistency in Formatbull Intuitive Characteristicsbull Logical Labelsbull Instructional Choicesbull Graphicsbull Friendly Documentationbull On-Screen Instructionsbull Auditory Cuesbull Visual Cuesbull Built-in Access Methodsbull Alternatives to a Mousebull Optional Cursorsbull Creation of Custom Programs

Alternative Inputbull Switches and Switch Softwarebull Alternative Keyboardsbull Keyboard Additionsbull Access Utilitiesbull Interface Devicesbull Voice Recognitionbull Optical Character Recognition

and Scannersbull Electronic pointing Devicesbull Pointing and Typing Aidsbull Touch Screensbull Joysticksbull Trackballsbull Arm and Wrist Supports

Processing Aidsbull Abbreviation Expansion and

Macro Programsbull Word Predictionbull Talking and Large Print Word

Processorsbull Grammar and Spell Checkersbull Reading Comprehension Pro-

gramsbull Writing Composition Pro-

gramsbull Electronic Reference Toolsbull Menu Management Programs

Alternative Outputbull Braille Embossers and Transla-

torsbull Refreshable Braille Displaysbull Speech Synthesizersbull Screen Readersbull Screen Enlargement Programsbull Monitor Additions

Specialized Productsbull Closed Circuit Television

(CCTV)bull Environmental Control Units

(ECU)bull Notetakersbull Reading Machinesbull Text Telephone (TDD)

60

Next

Ste

p

Try

havi

ng C

huck

use

earp

hone

s w

hen

he is

wor

d pr

oces

sing

Curre

nt S

tatu

s

Chu

ck is

abl

e to

do

grad

ele

vel a

ssig

nmen

ts b

ut h

e is

very

lite

ral i

n hi

s in

terp

reta

-tio

ns e

spec

ially

of a

bstra

ctco

ncep

ts

Chu

ck is

ver

y ea

sily

dis

-tra

cted

bot

h vi

sual

ly a

ndau

dito

rily

Chu

ck h

as a

blin

d sp

otw

hich

mak

es it

diff

icul

t for

him

to tr

ack

from

line

to lin

ew

hen

he is

read

ing

He

also

has

troub

le d

istin

guis

hing

the

figur

e fro

m t

he b

ack-

grou

nd

Bec

ause

of

per-

cept

ion

prob

lem

s C

huck

mus

t hav

e a

larg

e di

spla

ysc

reen

on

his

com

pute

r

Need

Cog

nitiv

e Ab

ility

Atte

ndin

g

Perc

eptio

n

ASSI

STIV

E TE

CHN

OLO

GY

EVAL

UATI

ON

Func

tion

al A

naly

sis

Nam

e C

huck

Dat

eG

rade

Lev

el

Sixt

h

Ove

rall D

escr

iptio

n C

huck

is a

six

th g

rade

stu

dent

who

rece

ives

all o

f his

inst

ruct

ion

in th

ere

gula

r cla

ssro

om

Chu

ck h

as ri

ght h

emip

legi

a H

is ri

ght u

pper

ext

rem

ity is

mor

e af

fect

edth

an h

is lo

wer

ext

rem

ity

He

has

diffi

culty

with

tota

l bod

y m

ovem

ents

requ

iring

bila

tera

lco

ordi

natio

n e

spec

ially

with

upp

er e

xtre

miti

es

Chu

ck h

as a

leg

leng

th d

iscr

epan

cy w

ith

Crite

ria fo

r Suc

cess

Com

plet

ion

of g

rade

leve

las

sign

men

ts w

ith e

vide

nce

of u

nder

stan

ding

of

mai

nco

ncep

ts

Chu

ck w

ill be

on

task

65-7

0 o

f tim

e du

ring

inde

-pe

nden

t wor

k pe

riods

Chu

ck w

ill co

mpl

ete

mod

ified

ass

ignm

ents

inde

-pe

nden

tly a

t leas

t 85

of t

hetim

e

Supp

ort R

equi

red

Lim

it re

quire

men

ts to

a fe

wco

ncre

te c

once

pts

in e

ach

acad

emic

uni

t

Dis

trac

tion

free

env

iron-

men

t st

udy

carre

l pr

oxim

-ity

to te

ache

r or a

ide

Enl

arge

wor

kshe

ets

and

read

ing

mat

eria

l H

ighl

ight

key

voca

bula

ry w

ords

U

sea

card

boar

d w

indo

w to

iso-

late

indi

vidu

al li

nes

whe

nre

adin

g E

nlar

ge o

n sc

reen

disp

lay

whe

n do

ing

wor

dpr

oces

sing

Loca

tions

Hom

eSc

hool

Com

mun

ityW

ork

Rec

reat

ion

Hom

eSc

hool

Com

mun

ityW

ork

Rec

reat

ion

Hom

eSc

hool

Com

mun

ityW

ork

Rec

reat

ion

his

right

leg

bein

g sh

orte

r tha

n hi

s le

ft H

e w

ars

a lif

t in

his

shoe

to c

ompe

nsat

e fo

r the

diffe

renc

e C

huck

has

low

ave

rage

inte

lligen

ce a

nd n

orm

al s

peec

h H

e re

ads

at th

eth

ird g

rade

leve

l a

nd d

oes

mat

h at

gra

de le

vel

exce

pt fo

r sto

ry p

robl

ems

Chu

ck is

very

con

cret

e in

his

thin

king

and

has

gre

at d

iffic

ulty

und

erst

andi

ng fi

gura

tive

lang

uage

C

huck

has

a fu

ll tim

e ai

de in

the

regu

lar

clas

sroo

m w

ho m

odifi

es a

ssig

nmen

ts a

ndhe

lps

to k

eep

him

on

task

So

cial

ly C

huck

is p

olite

and

wel

l-beh

aved

but

app

ears

tobe

imm

atur

e in

his

soc

ial r

elat

ions

hips

61

ASSI

STIV

E TE

CHN

OLO

GY

EVAL

UATI

ON

Func

tion

al A

naly

sis

Nam

e C

huck

Dat

eG

rade

Lev

el

Sixt

h

Ove

rall

Des

crip

tion

Chu

ck is

a s

ixth

gra

de s

tude

nt w

ho re

ceiv

es a

ll of

his

inst

ruct

ion

inth

e re

gula

r cla

ssro

om

Chu

ck h

as ri

ght h

emip

legi

a H

is ri

ght u

pper

ext

rem

ity is

mor

eaf

fect

ed th

an h

is lo

wer

ext

rem

ity

He

has

diffi

culty

with

tota

l bod

y m

ovem

ents

requ

iring

Need

Fine

Mot

or Han

d W

ritin

g

Not

e Ta

king

Self

Hel

p

Curre

nt S

tatu

s

Chu

ck c

an u

se o

nly

one

hand

for f

ine

mot

or ta

sks

incl

udin

g ty

ping

C

huck

isan

exc

elle

nt o

ne-h

ande

dty

pist

bot

h in

term

s of

spee

d an

d ac

cura

cy

Chu

ck c

an w

rite

in c

ursi

ve

but h

andw

ritin

g is

ver

yla

bor i

nten

sive

and

tirin

gfo

r him

H

e pr

oduc

esm

uch

bette

r writ

ten

prod

ucts

usi

ng a

com

pute

rC

huck

can

not t

ake

note

san

d lis

ten

at th

e sa

me

time

Chu

ck c

anno

t tie

his

ow

nsh

oes

and

he h

as d

iffic

ulty

zipp

ing

his

jack

et w

ith o

neha

nd

Next

Ste

p

Try

givi

ng C

huck

not

esbe

fore

the

clas

sroo

mpr

esen

tatio

n H

ave

him

hig

hlig

ht k

eyw

ords

with

a h

ighl

ight

ing

pen

as h

e is

list

enin

g to

the

disc

ussi

on

Try

havi

ng a

pee

rbu

ddy

assi

st C

huck

with

his

sho

es a

ndja

cket

bila

tera

l coo

rdin

atio

n e

spec

ially

with

upp

er e

xtre

miti

es

Chu

ck h

as a

leg

leng

thdi

scre

panc

y w

ith h

is ri

ght l

eg b

eing

sho

rter t

han

his

left

He

war

s a

lift i

n hi

s sh

oe to

com

pens

ate

for t

he d

iffer

ence

C

huck

has

low

ave

rage

inte

lligen

ce a

nd n

orm

alsp

eech

H

e re

ads

at th

e th

ird g

rade

leve

l a

nd d

oes

mat

h at

gra

de le

vel

exce

pt fo

rst

ory

prob

lem

s C

huck

is v

ery

conc

rete

in h

is th

inki

ng a

nd h

as g

reat

diff

icul

ty u

nder

-st

andi

ng fi

gura

tive

lang

uage

C

huck

has

a fu

ll tim

e ai

de in

the

regu

lar c

lass

room

who

mod

ifies

ass

ignm

ents

and

hel

ps to

kee

p hi

m o

n ta

sk

Soci

ally

Chu

ck is

pol

ite a

ndw

ell-b

ehav

ed b

ut a

ppea

rs to

be

imm

atur

e in

his

soc

ial r

elat

ions

hips

Crite

ria fo

r Suc

cess

Chu

ck w

ill be

abl

e to

prod

uce

writ

ten

wor

k at

abou

t the

sam

e pa

ce a

sot

her s

tude

nts

in h

is c

lass

Chu

ck w

ill be

abl

e to

rece

ive

help

with

am

inim

um o

f fus

s or

emba

rrass

men

t

Supp

ort R

equi

red

Lapt

op c

ompu

ter

Prin

ter

Enla

rged

scr

een

disp

lay

Co-

Writ

er w

ith W

rite-

Out

-Lo

ud fo

r wor

d pr

oces

sing

and

wor

d pr

edic

tion

Chu

ck n

eeds

to u

se w

ord

proc

essi

ng w

hene

ver

writ

ten

assi

gnm

ents

are

requ

ired

Whe

neve

rpo

ssib

le h

is w

ritte

nas

sign

men

ts s

houl

d be

shor

tene

d or

he

shou

ld b

eex

pect

ed to

resp

ond

usin

gm

ultip

le c

hoic

e or

one

wor

dan

swer

s

Teac

her s

uppo

rt of

the

peer

bud

dy re

latio

nshi

p

Loca

tions

Hom

eSc

hool

Com

mun

ityW

ork

Rec

reat

ion

Hom

eSc

hool

Com

mun

ityW

ork

Rec

reat

ion

62

ResourcesParent Trainingand InformationCenters

AlabamaSpecial Education ActionCommittee Inc (SEAC)600 Bel Air Blvd 210Mobile AL 36606-3501334-478-1208334-473-7877 FAX1-800-222-7322 AL onlyseacmob1junocomhttpwwwhsvtisnet~cja

AlaskaPARENTS ResourceCenter4743 E Northern Lights BlvdAnchorage AK 99508907-337-7678907-337-7671 FAX1-800-478-7678 in AKparentsalaskanethttpwwwalaskanet~parents

American SamoaAmerican Samoa ParentNetworkPO Box 3432Pago Pago AS 96799684-633-2407684-633-7707 (fax)

ArizonaPilot Parent Partnerships4750 N Black Canyon Hwy 101Phoenix AZ 85017-3621602-242-4366800-237-3007 (AZ only)602-242-4306 (fax)

ArkansasArkansas Disability Coalition2801 Lee Ave Suite BLittle Rock AR 72205501-614-7020501-614-9082 FAX1-800-223-1330 AR onlyadcceinet

FOCUS Inc305 W Jefferson AveJonesboro AR 72401870-935-2750870-931-3755 FAXfocusincipanet

CaliforniaDREDF2212 Sixth StreetBerkeley CA 94710510-644-2555510-841-8645 (fax)1-800-466-4232dredfdredforghttpwwwdredforg

Exceptional Parents Unlimited(EPU)4120 N First StreetFresno CA 93726209-229-2000209-229-2956 (fax)epu1cybergatecom

Matrix555 Northgate Dr Ste ASan Rafael CA 94903415-499-3877415-499-3854 (TDD)415-507-9457 (fax)1-800-578-2592matrixmatrixparentsorghttpwwwmatrixparentsorg

Parents Helping Parents - SanFrancisco594 Monterey BlvdSan Francisco CA 94127-2416415-841-8820415-841-8824 (fax)

Parents Helping Parents -Santa Clara3041 Olcott StSanta Clara CA 95054-3222408-727-5775408-727-7655 (TDD)408-727-0182 (fax)infophpcomhttpwwwphpco

Support for Families ofChildren with Disabilities2601 Mission 710San Francisco CA 94110-3111415-282-7494415-282-1226 (fax)sfcdmissaolcom

TASK100 W Cerritos AveAnaheim CA 92805-6546714-533-TASK (8275)714-533-2533 (fax)taskcaaolcom

TASK- San Diego3750 Convoy St Ste 303San Diego CA 92111-3741619-874-2386619-874-2375 (fax)

ColoradoPEAK Parent Center Inc6055 Lehman Drive Ste 101Colorado Springs CO 80918719-531-9400719-531-9403 (TDD)800-284-0251719-531-9452 (fax)PKPARENTaolcom

ConnecticutCPAC338 Main StreetNiantic CT 06357860-739-3089860-739-7460 (fax)1-800-445-2722 (in CT)cpacincaolcomhttpwwwmembersaolcomcpacinccpachtm

DelawareParent Information Center(PIC) of Delaware Inc700 Barksdale Road Ste 3Newark DE 19711302-366-0152302-366-0178 (TDD)302-366-0276 (fax)PEP700aolcom

FloridaFamily Network on Disabilitiesof Florida2735 Whitney RoadClearwater FL 24620813-523-1130800-285-5736 (FL only)813-523-8687 (fax)fndgatenethttpwwwgatenet~fnd

GeorgiaParents Educating Parentsand Professionals for AllChildren (PEPPAC)8318 Durelee Lane Ste 101Douglasville GA 30134770-577-7771770-577-7774 (fax)peppacbellsouthnet

HawaiiAWARELearning DisabilitiesAssociation of Hawaii200 N Vineyard Blvd Ste 310Honolulu HI 96817808-536-9684808-536-2280 (TTY)808-537-6780 (fax)ldahgtenet

IdahoIdaho Parents Unlimited Inc(IPUL)Parents Education amp ResourceCenter4696 Overland Rd Ste 478Boise ID 83705208-342-5884800-242-IPUL (4785)208-342-1408 (fax)ipulrmcinethttpwwwhomermcinetIPUL

IllinoisDesigns for Change6 N Michigan Ave Ste 1600Chicago IL 60602312-857-9292312-857-1013 (TDD)312-857-9299 (fax)1-800-851-8728DFC1aolcom

Family Resource Center onDisabilities (FRCD)20 East Jackson Blvd Rm 900Chicago IL 60604312-939-3513312-939-3519 (TDDTTY)312-939-7297 (fax)1-800-952-4199 (IL only)

Family TIES Network830 South Spring StreetSpringfield IL 62704800-865-7842217-544-6018 (fax)ftiesnaolcom

National Center for Latinoswith Disabilities1921 South Blue IslandChicago IL 60608312-666-3393312-666-1788 (TDD)312-666-1787 (fax)1-800-532-3393ncldinteraccesscom

Published byParents Letrsquos Unite for Kids (PLUK)

516 N 32nd StBillings MT 59101-6003

406255-0540406255-0523 (fax)

800-222-7585 (in MT)plukinfoplukorg

httpwwwplukorg

April 1997

Written and edited byKatharin A Kelker EdD

Roger Holt ATP

Illustrations byKaren Moses

This guide was funded through a subcontract between the Federation and Parents Letrsquos Unite for Kids frommonies awarded to the Federation by the Office of Special Education and Rehabilitation Services (OSERS)US Department of Education Points of view or opinions herein do not necessarily represent the EducationDepartmentrsquos position or policy

The Department of Education ensures equal employment equal educational opportunities and affirmativeaction regardless of race sex color national origin religion marital status age or disability

This material is available upon request in alternative formats by calling 406255-0540

Table of ContentsIntroduction 1Defining Assistive Technology 2

Sara 7Making Assistive Technology Decisions 9

Sierra 23Funding Assistive Technology 24

Ted 31Gloria 32

Making Assistive Technology a Part of Childrsquos Education 33Emily 38Bryan39Tracy 40

Advocating for Assistive Technology 42More Questions and Answers 44Appendix 50

Glossary 50Documents 53

Schrag Letter on Assistive Technology 53Individuals with Disabilities Education Law Report 54Letter Requesting an Assistive Technology Evaluation 56Assistive TechnologyIssues to Address 56

Examples 57Educational Software Evaluation 57Software Features 59Alternative Input 59Processing Aids 59Alternative Output 59Specialized Products 59Assistive Technology Evaluation 60

Resources 62Parent Training and Information Centers 62Alliance for Technology Access Resource Centers 65State Tech Act Projects 67SoftwareHardware Vendors 70

1

A ssistive technology is redefining what ispossible for people with a wide range ofcognitive and physical disabilities In the

home classroom workplace and communityassistive technology is enabling individuals withdisabilities to be more independent self-confi-dent productive and better integrated into themainstream

Beginning early in life technology is makingit possible for children with disabilities to domore for themselves A child who cannot use herhands can operate a computer with a switch andan on-screen keyboard A child with speech prob-lems can communicate using a portable electronicdevice that ldquospeaksrdquo A child who is unable toget in and out of the bathtub can be safely andeasily lifted using a mechanical device Theseare just a few examples of the wide variety ofequipment called assistive technology that isavailable today

Assistive technology can mean anything fromsimple homemade devices to highly sophisti-cated environmental control systems It can beadapted toys computers powered mobility aug-mentative communication devices specialswitches and thousands of commercially avail-able or adapted tools to assist an individual withlearning working and interacting socially

As wonderful as assistive technology can beit is not always easy to acquire It takes expertiseand persistence to find the correct devices andfigure out ways to pay for them For examplechildren with disabilities who are eligible for spe-cial education have a legal right to technology toassist them with learning Both the Individual-ized Family Service Plan (IFSP) and the Individu-alized Education Program (IEP) which are re-quired by tthe Individuals with Disabilities Edu-cation Act (IDEA) are potentially powerful toolsfor incorporating assistive technology into theeducation of students with disabilities But

assistive technology does not become part of astudentrsquos special education plan unless parentsare knowledgeable about technology and knowwhat to do to ensure that assistive technologybecomes an integral part of their childrsquos program

This Guide is intended to help parents learnmore about assistive technology and how it canhelp their children The Guide includes tips forgetting started ideas about where to look formoney and suggestions for what to do whenapplying for funding Places to contact for moreinformation or to find software and equipmentare listed in the Appendix at the end of the Guide

Finding and paying for the right technologyrequires commitment and energy Professionalsin education and medicine can help but parentscannot rely on professionals to do everything thatis necessary to get the equipment As a parentyou have a much better chance of getting what isneeded if you and your child are involved in se-lecting the technology and planning for its useThis Guide should help you to understand theprocesses for acquiring assistive technology andprovide you with the tools to advocate for yourchildrsquos special technology needs

Introduction

2

Defining Assistive Technology

A ssistive technology devices are mechani-cal aids which substitute for or enhancethe function of some physical or mental

ability that is impaired Assistive technology canbe anything homemade purchased off the shelfmodified or commercially available which isused to help an individual perform some task ofdaily living The term assistive technology encom-passes a broad range of devices from ldquolow techrdquo(eg pencil grips splints paper stabilizers) toldquohigh techrdquo (eg computers voice synthesizersbraille readers) These devices include the entirerange of supportive tools and equipment fromadapted spoons to wheelchairs and computersystems for environmental control

The Individuals with Disabilities EducationAct (IDEA) the federal special education lawprovides the following legal definition of anassistive technology device ldquoany item piece ofequipment or product system that is used toincrease maintain or improve functional capa-bilities of individuals with disabilitiesrdquo UnderIDEA assistive technology devices can be usedin the educational setting to provide a variety ofaccommodations or adaptations for people withdisabilities

The IDEA also lists the services a school dis-trict may need to provide in order to ensure thatassistive technology is useful to a student in theschool setting The law defines assistive technol-ogy service as ldquoany service that directly assistsan individual with a disability in the selectionacquisition or use of an assistive technologydevicerdquo This service includes all of the follow-ing possibilities

bull evaluation of the technology needs of theindividual including a functional evalua-tion in the individualrsquos customary environ-ment

bull purchasing leasing or otherwise provid-

ing for the acquisition of assistive technol-ogy devices for individuals with disabili-ties

bull selecting designing fitting customizingadapting applying maintaining repair-ing or replacing of assistive technologydevices

bull coordinating and using other therapiesinterventions or services with assistivetechnology devices such as those associ-ated with existing education and rehabili-tation plans and programs

bull assistive technology training or technicalassistance with assistive technology for anindividual with a disability or where ap-propriate the family of an individual withdisabilities

bull training or technical assistance for profes-sionals employers or other individualswho provide services to employ or other-wise are substantially involved in the ma-jor life functions of individuals with dis-abilities

The intention of the special education law isthat if a student with disabilities needs technol-ogy in order to be able to learn the school dis-trict will (a) evaluate the studentrsquos technologyneeds (b) acquire the necessary technology (c)coordinate technology use with other therapiesand interventions and (d) provide training forthe individual the individualrsquos family and theschool staff in the effective use of the technology

During the time that students with disabili-ties are in school they can have the opportunityto learn to use technology at the same time thatthey are learning academic subjects and socialskills The efficient and effective use of assistivetechnology can be as basic a skill for students withdisabilities as reading writing and arithmeticsince the use of technology can go a long way

3

toward circumventing the limitations of disabil-ity and providing students with disabilities witha ldquolevel playing fieldrdquo in every area of life ac-complishment

What is an accommodation

Accommodations are reasonable modifica-tions that are made to compensate for skills orabilities that an individual lacks For example ifa person does not digest spicy foods well wemight accommodate this individual by adjustinghis or her diet so that the person was eating onlybland foods

When the word accommodation is used in con-nection with disability issues it refers to a wayof modifying a task or assignment so that a per-son with a disability can participate in spite ofwhatever challenges the disability may pose Forexample when a student who is unable to re-member math facts is allowed to do math prob-lems with a calculator the use of the calculator isan accommodation which allows the student towork around his or her disability With an ac-commodation the student can still perform mathproblems but the student does so using a differ-ent method

In the school setting sometimes it is neces-sary to make accommodations for individualswith disabilities in order to compensate for skillsor abilities that they do not have For examplefor some students with learning disabilities learn-ing to spell words correctly may be a skill theynever acquire or never acquire with a highenough degree of fluency to do them any goodin written expression To compensate for thisinability to spell such students may be encour-aged to use alternative methods for spelling likea spell check software program on the computeror a hand-held spelling device

What is an adaptation How does adaptationdiffer from accommodation

Adaptation means developing unique devicesor methods designed specifically to assist persons

with disabilities to perform daily tasks An ad-aptation is something specially designed whichis not normally used by other people An accom-modation on the other hand is simply a changein routine method or approach which may beused by people with or without disabilities Ex-amples of adaptations include special grips toturn stove knobs or specially designed keyboardsto operate computers

What are common types of assistive technol-ogy Does assistive technology just meancomputers

Assistive technology certainly includes com-puters but it also refers to a number of other typesof accommodations and adaptations which en-able individuals with disabilities to function moreindependently Computers are an important typeof assistive technology because they open up somany exciting possibilities for writing speakingfinding information or controlling anindividualrsquos environment But computers are notthe only avenues to solving problems throughtechnology There are many low tech (and lowcost) solutions for problems that disabilities poseExamples of inexpensive low tech solutions in-clude wrist splints clip boards for holding pa-pers steady or velcro tabs to keep positioningpads in place

The following is a list of common assistivetechnology applications

Positioning In the classroom individualswith physical disabilities may need assistancewith their positions for seating so that they canparticipate effectively in school work Generallytherapists try to achieve an upright forward fac-ing position by using padding structured chairsstraps supports or restraints to hold the body ina stable and comfortable manner Also consid-ered is the studentrsquos position in relation to peersand the teacher Often it is necessary to designpositioning systems for a variety of settings sothat the student can participate in multiple ac-tivities at school Examples of equipment used

4

for positioning are side lying frames walkerscrawling assists floor sitters chair inserts wheel-chairs straps trays standing aids bean bagchairs sand bags and so forth

Access In order to participate in school taskssome students require special devices that pro-vide access to computers or environmental con-trols The first step in providing access is to de-termine which body parts can be used to indi-cate the studentrsquos intentions Controllable ana-tomical sites like eye blinks head or neck move-ments mouth movements may be used to oper-ate equipment which provides access to the com-puter Once a controllable anatomical site hasbeen determined then decisions can be madeabout input devices selection techniques (directscanning) and acceleration strategies (codingprediction) Input devices include such thingsas switches alternative keyboards mousetrackball touch window speech recognition andhead pointers Once computer access has beenestablished it should be coordinated with othersystems that the student is using including pow-ered mobility communication or listening de-vices and environmental control systems

Access can also refer to physical entrance andexit of buildings or facilities This kind of assistivetechnology includes modifications to buildingsrooms and other facilities that let people with

physical impairments use ramps and door open-ers to enter allow people with visual disabilitiesto follow braille directions and move more freelywithin a facility and people of short stature orpeople who use wheelchairs to reach pay phonesor operate elevators Accessibility to shoppingcenters places of business schools recreationtransportation is possible because of assistivetechnology modifications

Environmental Control Independent useof equipment in the classroom can be achievedfor students with physical disabilities throughvarious types of environmental controls includ-ing remote control switches and special adapta-tions of onoff switches to make them accessible(eg velcro attachments pointer sticks)

Robotic arms and other environmental con-trol systems turn lights on and off open doorsoperate appliances Locational and orientationsystems give people with vision impairmentsinformation about where they are what theground nearby is like and whether or not thereis a curb close by

Augmentative Communication Every stu-dent in school needs some method of communi-cation in order to interact with others and learnfrom social contact Students who are nonverbalor whose speech is not fluent or understandableenough to communicate effectively may benefit

figure 1 Alternative and Pr ocessing Computer Access Methods

Inputbull Alternate keyboardsbull Interface devicesbull Joysticksbull Keyboard modificationsbull Keyboard additionsbull Optical pointing devicesbull Pointing and typing aidsbull Switches with scanningbull Scanners amp optical character recognitionbull Trackballsbull Touch screensbull Voice recognition

Processingbull Abbreviationexpansion and macro programsbull Access utilitiesbull Menu management programsbull Reading comprehension programsbull Writing composition programsbull Writing enhancement tools (ie grammar checkers)

Outputbull Braille displays and embossersbull Monitor additionsbull Screen enlargement programsbull Screen readersbull Speech synthesizersbull Talking and large print word processors

5

from using some type of communication deviceor devices Communication devices include suchthings as symbol systems communication boardsand wallets programmable switches electroniccommunication devices speech synthesizers re-corded speech devices communication enhance-ment software and voiced word processing

Assistive Listening Much of the time inschool students are expected to learn through lis-tening Students who have hearing impairmentsor auditory processing problems can be at a dis-tinct disadvantage unless they learn to use thehearing they have or they develop alternativemeans for getting information Hearing problemsmay be progressive permanent or intermittentAny of these impairments may interfere signifi-cantly with learning to speak read and followdirections Assistive devices to help with hear-ing and auditory processing problems includehearing aids personal FM units sound field FMsystems Phonic Ear TDDs or closed caption TV

Visual Aids Vision is also a major learningmode General methods for assisting with visionproblems include increasing contrast enlargingstimuli and making use of tactile and auditorymodels Devices that assist with vision includescreen readers screen enlargers magnifierslarge-type books taped books Braillers lightboxes high contrast materials thermoformgraphics synthesizers and scanners

Mobility Individuals whose physical impair-ments limit their mobility may need any of a num-ber of devices to help them get around in theschool building and participate in student activi-ties Mobility devices include such things as self-propelled walkers manual or powered wheel-chairs and powered recreational vehicles likebikes and scooters

Computer-Based Instruction Computer-based instruction can make possible independentparticipation in activities related to the curricu-lum Software can be selected which mirrors theconceptual framework of the regular curriculum

but offers an alternative way of responding to ex-ercises and learning activities Software can pro-vide the tools for written expression spelling cal-culation reading basic reasoning and higherlevel thinking skills The computer can also beused to access a wide variety of databases

Social Interaction and Recreation Studentswith disabilities want to have fun and interactsocially with their peers Assistive technologycan help them to participate in all sorts of recre-ational activities which can be interactive withfriends Some adapted recreational activities in-clude drawing software computer games com-puter simulations painting with a head or mouthwand interactive laser disks and adaptedpuzzles

Self Care In order to benefit from educa-tion some students require assistance with selfcare activities like feeding dressing and toiletingAssistive devices which assist with self care in-clude such things as robotics electric feedersadapted utensils specially designed toilet seatsand aids for tooth brushing washing dressingand grooming

What sort of students might use assistivetechnology

Students who require assistive technology arethose with mental or physical impairments thatinterfere with learning or other life functions Thetechnology helps the student to overcome or com-pensate for the impairment and be more inde-pendent in participating at school Students whobenefit from assistive technology may have mildlearning problems like learning disabilities orthey may have physical or cognitive disabilitiesthat range from mild to severe Assistive tech-nology is not necessary or helpful for every stu-dent in special education but it is an importantpart of the support system for many studentswith identified disabilities

Isnrsquot assistive technology appropriate only forstudents with more severe disabilities

Assistive technology is simply a set of tools

6

that can be used to compensate for some deficitthat a person may have For individuals with se-vere mental or physical disabilities the techno-logical solutions can help to solve multiple andcomplex problems But individuals with less in-volved problems also can benefit from assistivetechnology For example individuals with learn-ing disabilities who have difficulty with readingor writing can benefit educationally from usingthe word processing and voiced reading capa-bilities of computers

Isnrsquot assistive technology just a crutch Wonrsquotstudents become too dependent on technol-ogy and not learn to use the skills they have

Assistive technology should be used as sup-port for access learning and performing dailytasks In general assistive technology is appro-priate when it compensates for disabilities so thatthe individual can function as normally as pos-sible If assistive technology is necessary for astudent to have access to educational opportuni-ties or to benefit from education then it is not aldquocrutchrdquo but a legitimate support

Some skills are too laborious or taxing to ac-complish at a rate or with degree of proficiencyto allow for participation in the least restrictiveenvironment With assistive technology the stu-dent can participate more fully and more closelyapproximate the levels of achievement and in-teraction of his or her peers

The use of assistive technology enhancesfunction and increases skills and opportunitiesThough a student may be dependent upon a par-ticular device in order to perform skillfully de-nying the device denies the student an opportu-nity ever to achieve success at the level of his orher potential

When is using assistive technology appropri-ate

Assistive technology may be considered ap-propriate when it does any or all of the follow-ing things

bull Enables an individual to perform functions

that can be achieved by no other means

bull Enables an individual to approximate nor-mal fluency rate or standardsmdasha level ofaccomplishment which could not beachieved by any other means

bull Provides access for participation in pro-grams or activities which otherwise wouldbe closed to the individual

bull Increases endurance or ability to persevereand complete tasks that otherwise are toolaborious to be attempted on a routine ba-sis

bull Enables an individual to concentrate onlearning or employment tasks rather thanmechanical tasks

bull Provides greater access to information

bull Supports normal social interactions withpeers and adults

bull Supports participation in the least restric-tive educational environment

SummaryAssistive technology means any device which

helps an individual with an impairment to per-form tasks of daily living There is a wide rangeof types of devices in assistive technology fromlow tech homemade aids to computers and so-phisticated electronic equipment Assistive tech-nology is one of the services which can be pro-vided in a special education program under theIndividuals with Disabilities Education Act(IDEA) The requirements of IDEA say that stu-dents who need assistive technology are entitledto the aids and devices and the assistive technol-ogy services (eg evaluation for assistive tech-nology and modification and maintenance ofequipment) that are necessary for the student tobenefit from a free appropriate public education

Hints for Parents

It is never too soon to consider using assistive tech-nology Some infants with physical disabilities for ex-

7

ample really benefit from early interaction with toysthat operate by switch Here are suggestions for timesto evaluate a child for assistive technology

bull When disability limits interaction with the envi-ronment and interferes with experiential learn-ing

Assistive technology can be used to providephysical access to the environment (egswitch toys floor scooters touch window)

bull When a significant gap exists between receptiveand expressive abilities

Assistive technology can assist with expres-sion through the use of programmableswitches electronic communication devicesvoiced word processing braille embossingand so forth

bull When an individualrsquos performance falls behindthat of his or her peers

If an individualrsquos handwriting for exampleis very slow laborious and difficult to readuse of a word processing device can be sub-stituted for handwriting thus allowing theindividual to keep up with others in termsof written expression

bull When a physical disability is impeding the edu-cationalvocational potential of an individual

Assistive technology can provide access tothe workplace for example by allowing anindividual who is blind to learn to use ascreen reader and voiced word processingto do clerical tasks that would otherwise beimpossible

bull When a disability is impeding the independenceof an individual

Sometimes assistive technology can be usedto allow a person with a disability to func-tion more independently For example hav-ing a power wheelchair allows an individualto travel independently without the neces-sity of having someone to push the wheel-chair

SaraSara who has Down syndrome is eight

years-old Her language and speech skills arethree years delayed but she has age appropriatesocial skills Sara has spent part of her schoolday in a regular classroom ever since kindergar-ten but this year her third grade teacher is sug-gesting that Sara really cannot keep up with herclassmates The teacher thinks that Sara wouldbe better off in a self-contained class with stu-dents who work at her pace Sara has some finemotor coordination problems and she has haddifficulty learning to write in cursive Her oralreading is hampered by her speech difficultiesHowever Sara has learned to do addition andsubtraction problems well and has mastered add-ing with carrying and subtraction with borrow-ing She reads at about a second grade level withreasonably good comprehension Sararsquos parentswould like to see her continue in the regular class-room for as much time as possible but they rec-ognize that Sararsquos writing and speaking problemsare keeping her from doing her best work

What are Sararsquos needs

What kinds of technology should go in SararsquosIEP

How would you make a case for puttingassistive technology into her IEP

8

Sararsquos SolutionSararsquos IEP Team met to discuss her needs and

concluded that she is doing well in a regular class-room setting she is making adequate progressin academic skills and has learned how to inter-act socially with her peers It is to be expectedthat Sara will have difficulty keeping up with thepace in a third grade but as long as she is mak-ing progress toward her individual goals theregular classroom is a good setting for her How-ever some simple accommodations and technol-ogy may help Sara to work faster and more effi-ciently

At this point Sara may need some assistancewith handwriting and speaking but the solutionsto her problems in these areas need not be com-plex ones The team decided that Sara shouldcontinue to practice cursive until she has mas-tered all the letters and can be more facile in us-ing script However while she is still learningcursive she needs other means for respondingin writing For short written responses the teamagreed that Sara should be encouraged to usemanuscript printing When speed is importantor when writing assignments are longer Sarashould have access to a computer with an adap-tive keyboard (eg IntelliKeys) The adaptivekeyboard is helpful for Sara because the ldquokeysrdquoare larger and easier to see Using the keyboardrequires only a very light touch so Sara finds iteasier to use than a standard computer keyboard

In terms of oral reading the team decided tohave Sara practice reading into a tape recorderHer speech therapist will work with her on slow-ing down her rate of speech and reading withexpression When Sara has a good tape of heroral reading she will submit it to her teacher forreview

Solution SummaryPractice cursiveUse manuscript printing for short assign-

ments

Use computer with adaptive keyboard forlonger assignments

Practice oral reading using a tape recorder

9

Making Assistive Technology Decisions

W hen parents learn about assistive tech-nology and the wonderful opportuni-ties it can provide they want to jump

right in and get the latest in technology for theirchildren Who wouldnrsquot want an augmentativecommunication device for a child who cannottalk What parents wouldnrsquot want to buy a com-puter if it would help their child learn

When the world of assistive technology opensup for parents it can be like entering a great toystoremdasheverything looks so wonderful that itmakes it hard to know what to select Choosingthe right device to meet an individualrsquos needsrequires technical knowledge and indepth under-standing of the individualrsquos functional capabili-ties Not only is the selection of a device madedifficult by the complexity of the equipment andthe demands of the individualrsquos impairmentassistive technology devices can be very expen-sive Making such purchases is a major financialcommitment for most families one that takes agreat deal of soul searching and sometimes sig-nificant sacrifice

Families invest more than money in theirchildrenrsquos assistive technology Practical invest-ments of time and effort and emotional invest-ments of hope and enthusiasm are made withevery assistive technology purchase Because ofthe high level of financial personal and emotionalcommitment family disappointment is greatwhen equipment fails to perform as expected

Buying and then not using a device becauseof dissatisfaction can be a devastating experiencefor all concerned That is why it is so importantfor parents to proceed cautiously into the worldof assistive technology and make purchases onlyafter careful evaluation and trials with the newdevice Following is a summary of some sug-gestions for parents to consider before makingany assistive technology purchase be realisticabout your childrsquos capabilities and needs get a

multidisciplinary evaluation examine availabletechnology with a critical eye match the childrsquosneeds to specific equipment features do not makea purchase until you have used the device for atrial period identify next steps and determinewhat needs to be done for follow-up after pur-chase

Guidelines for Making Assistive TechnologyDecisions

bull Be realistic about your childrsquos capabilitiesand needs

Assistive technology can open up excitingnew opportunities for a child but it is not magicThere are certain basic requirements for any in-dividual to be successful with technology and itis important to face these requirements squarelyThere is nothing more disappointing or discour-aging than purchasing expensive equipment fora child which is beyond his or her capabilities touse

Prerequisites for Computer Use Physicalor sensory impairments do not limit access tocomputers but cognition is a factor in computeroperation The major prerequisite for using acomputer (with or without adaptations) is thecognitive ability to understand cause and effectThe child must be able to understand that thecomputer operates (eg changes does some-thing) because the child has activated the equip-ment through some volitional movement or ac-tivity (eg eyebeam speaking puffing into astraw hitting a switch) Some children enjoyplaying with switches by hitting them randomlybut may not be able to connect their own behav-ior to the response their movement activates Inorder to be successful in interacting with a com-puter the user must be able to control some voli-tional activity and to do so consistently For ex-ample the child would have to be able to acti-vate the computer in response to a visual tactileor auditory prompt

10

Another prerequisite to computer use is theability to make conscious meaningful choicesbetween alternatives like yes and no The choicescan be very simple ones but there has to be evi-dence that the child has made an actual decisionand not merely acted randomly

If a child does not have the concept of causeand effect or cannot make consistent choices us-ing a computer is probably not a worthwhile nextstep at this point in the childrsquos developmentOther types of activities may be more appropri-ate less expensive and just as rewarding devel-opmentally and personally

Prerequisites for Augmentative Communi-cation Augmentative communication devicescan literally give voice to the thoughts of indi-viduals who cannot speak or cannot speak clearlybutmdashagainmdashthese devices are not magic Elec-tronic communication devices are of no valueunless the user has some communicative intentThat is for a communication device to be help-ful the user has to have some basic understand-ing of the communication process and must beintentional in expressing choices desires orneeds

For example Maggie is a four-year-old whois nonverbal She communicates her wants andneeds by using eyeblinks as responses to yes orno questions When Maggiersquos dad asks her if shewould like another glass of milk she indicatesher choice by raising her eyes up vertically foryes or moving her eyes down for no Maggieclearly knows what she wants to communicateshe has a consistent method for making herwishes known and she expects that her dad willunderstand her communication and act on it

Dan who is also nonverbal communicatesin a different way He points to objects and makesgestures to show what he wants or needs Hisgestures are clear and used consistently so thatfamily members and even people who do notknow Dan well can understand most of the timewhat he is communicating

Shelley communicates very basic informationabout how she feels by crying when she is un-comfortable or wants attention and by laughingwhen she enjoys something like music brightlights or water running Shelley does not how-ever respond to yes or no questions She doesnot make choices even when objects are pre-sented to her individually or in pairs She can-not respond to a question like ldquoDo you want someice cream nowrdquo Or ldquoWould you like the teddybear or the dollrdquo

Maggie and Dan may benefit from usingsome communication device because they arealready using communication systems meaning-fully and consistently Shelley however mayneed to develop greater ability to communicatemeaningfully before moving on to electroniccommunication

Communication skills fall along a continuumAt one end of the continuum are very simplecommunications like expressing preferences byindicating yes or no pointing or gesturing towardobjects or pointing to pictures Use of sign is amore complex form of communication becauseit requires that the user understand that the signsare symbols for meaningful communicationsWhen an individual is able to string togethersigns or words into meaningful phrases this isan additional step toward more complex com-munication When a person understands syntaxand is aware of typical word order this is anotherstep forward Each of these advances along thecommunication continuum represents a step to-ward more complex and sophisticated commu-nication Whatever assistive communicationdevice is chosen should match or just slightlyexceed the place on the continuum where the in-dividual is functioning It makes no sense forexample to purchase an elaborate electronic com-munication device that requires understandingsymbols and syntax when the individual usingthe device is just at the point of learning how toexpress yes and no preferences

An electronic device does not teach commu-

11

nication it enhances communication by givingaudible expression to thoughts that already existin the mind of the user If the thoughts are notthere yet or are not completely formed they can-not be expressed by the device

Physical and Sensory Impairments Are NotBarriers Mastery of a few simple prerequisiteskills is necessary before computers or electroniccommunication devices should be consideredbut it is not necessary for a child to master everydevelopmental milestone before entering theworld of assistive technology Physical or sensoryimpairments can often be circumvented by thetechnology itself and typical developmentalmilestones can sometimes be bypassed so thatassistive technology can be used For examplesome educators assume that students cannot usecomputers until they have completely masteredkeyboarding skills This is a false assumptionMany students benefit from using computerseven though they operate the machine using aldquohunt and peckrdquo method or only one or two keysIn a similar fashion students with limited verbalability who have not mastered oral speech ben-efit from using augmentative communicationdevices while they continue to develop oral lan-guage

Overall the keys to knowing when to tryassistive technology are (a) being realistic aboutthe childrsquos cognitive abilities and potential and(b) being open to trying the level of technology

which meets the child where he or she is

bull Get a multidisciplinary evaluation

Evaluations for assistive technology are notalways easy to arrange In many parts of theUnited States there is no convenient center orldquoplacerdquo to go for an assessment The availablecenters may be far away in another city or evenanother state Since assistive technology is a newfield the systems for disseminating informationand providing assistance are in the process ofevolving Parents may have to be ldquoassistive tech-nology detectivesrdquo in order to put together theinformation needed for a complete AT evalua-tion for their child

The place to start the evaluation is by consid-ering the functions the child needs to performand cannot because of impairment The physi-cians teachers and therapists currently workingwith the child as well as family members andfriends who are around the child on a daily ba-sis can provide very valuable information aboutfunctional problems and potential solutions

Finding Functional Solutions The Alliancefor Technology Access (ATA) a national networkof assistive technology centers has developed aninformal method for using the functional infor-mation available from professionals family mem-bers and friends as a basis for analyzing assistivetechnology needs This process called a Solu-tion Circle is a means to bring people togetherin an informal session that allows for creative

figure 2 Factors to consider when selecting Assistive T echnology

Cognitive Factorsbull Diminished Cognitive Abilitiesbull Learning Disabilitiesbull Attention Deficitsbull SensoryPerceptual Deficitsbull Memory Deficitsbull Abstract Reasoning Deficitsbull Problem-Solving Deficits

Motor Factorsbull Voluntary Motor Deficitsbull Involuntary Motor Deficitsbull Fixed Posture amp Positioning Deficitsbull Recurring Purposeless Motionbull Motor Paralysisbull Low Muscle Tonebull Rigiditybull Spasticitybull Tremors

12

thinking and is not inhibited by what is ldquolegalrdquoldquocurrently availablerdquo or ldquowhat has been done be-forerdquo The individual with a disability and 4-10family members professionals and friends gettogether to brainstorm ideas about the technol-ogy which may help the individual perform func-tions that are hard or impossible to do becauseof disability The Circle usually includes a bal-ance between people who know the person whoneeds the technology and people who have spe-cialized knowledge about technology educationor work-related issues

Solution Circle for Tom To demonstratehow the Solution Circle works letrsquos take a lookat how this process was used in the case of Toma high school student with a learning disabilityFor Tom the print in textbooks is a significantbarrier to learning Tom is ldquoprint disabledrdquo thatis he cannot read the printed word with muchcomprehension Reading is a slow unproductiveprocess for him even though he is intelligent andeager to learn Tom and his parents were hopingthat there might be a way that new technologycould help Tom overcome or work around hisproblem with reading so that he could get moreout of school and perhaps go on to college

Tomrsquos Solution Circle included his parentsBetty and Bob his resource teacher a friendDarrell his soccer coach his 4-H leader and theowner of a local computer store This group mettogether to think about how Tom could partici-pate more fully in school and prepare himself forcollege even though he could not read with com-prehension past the second or third grade level

Solution Circles generally take 1 to 1 12 hoursto complete The steps include the following

1 Star Time The individual for whom theSolution Circle is being held is described in a ho-listic way The emphasis is on how the individualis functioning at home and in the communityWhat does he or she like and dislike What arehisher goals Interests If possible the indi-vidual with a disability speaks for himself or her-self or a video or pictures may be presented The

point of this part of the discussion is give a clearpicture of the individual as a whole person

At Tomrsquos Solution Circle he explained hisdream of going to college and becoming an agri-cultural botanist Tom loves plants he is inter-ested in breeding new strains of wheat and per-fecting various types of grain crops Tomrsquos 4-Hleader agreed that Tom had real gifts in under-standing plant growth and physiology and thathe already had sophisticated knowledge aboutbotany which would prepare him well for col-lege study

2 Strengths With a complete picture of theindividual in mind the group then makes an ex-haustive list of the individualrsquos strengths particu-larly noting any technological accommodationswhich the individual is already using What doesthe individual do well What are his or her un-impaired functions Often this discussion revealsan incredible number of adaptations that the in-dividual has already achieved

Tomrsquos Solution Circle discovered that he hadmany strengths including keen intelligence per-severance and thoroughness when approachinga task Tom already had some effective learningstrategies for remembering material that heheard He had also learned to use a small taperecorder for keeping track of information pro-vided in class

3 Obstacles With the individualrsquos strengthsin mind the group then turns its attention to aconsideration of the environment in which theindividual is functioning and the activities inwhich the individual wants to participate butcannot at this time The group considers whatthe obstacles and barriers might be for the indi-vidual in his or her environment and makes alist of these impediments

For Tom reading was a serious obstacle Hecould not keep up with homework assignmentsbecause it took him so long to read his textbooksIn addition he had difficulty reading directionson tests and often misread assignments on the

13

COGNITIVE FACTORSCognitive Ability

Documented below average abilityDocumented significant overall delayDoes not appear age appropriateLacks understanding of cause amp ef-

fectPaying Attention

Difficulty following prompts or direc-tions

Difficulty with multi-step proceduresDifficulty filtering informationDifficulty staying on task

PerceptionNeeds lengthened response timeRequires multi-sensory inputDifficulty with rapid changeSignificant visualperceptual problemsSlow visual-motor dexterity

MemoryDifficulty with recallRequires reteaching learned skillsRequires repeated practice

Abstract ReasoningDifficulty analyzing simple proceduresUnable to reproduce a sequenceUnable to analyze or synthesize in-

formationProblem Solving

Unable to use prompts or cues to ac-complish tasks

Unable to modify attempts and try an-other way

MOTOR FACTORSMobility

Needs help to be mobileNeeds motorized help to be indepen-

dentNeeds help boarding transportationUnable to transfer independentlyCannot climb stairsCannot open doors independentlyCannot carry materials in hands or

armsCannot lift weight

Voluntary MotorLimited control of head trunk or ex-

tremitiesVisual motor deficitsFixed position and posture

figure 3 ASSISTIVE TECHNOLOGY EVALUATIONIndividual Functional Analysis

Name Date

Needs support to sit or standNeeds adaptations in order to use

technologyMotor Paralysis

Changes in muscle tone interfere inmotor movements

Spastic movements result in poor con-trol

Limited movement of head arms orlegs

Difficulty balancing in sitting positionDifficulty maintaining good posture

Low Muscle ToneLimited use of arms or legsPoor posture controlFatigues quickly

RigidityInhibits arm and leg movementInhibits balance to sitInhibits good posture

SpasticityLimited upper range of motionLimited lower range of motionInterferes with accuracy and consis-

tency of motor movements on oneside

TremorsPresent all the timePresent when doing purposeful upper

extremity taskUnable to compensate for tremors

Extraneous MovementAthetoid (constant)Ataxia (poor coordination in move-

ment)FINE MOTOR

DexterityLimited fine motor controlHas limited hand movement

HandwritingWriting or copying ability is signifi-

cantly below peersSignificant legibility factor--written

work not readableCannot keep up with the pace of writ-

ten workIs frustrated by writingFatigue is a factorTyping appears to be potentially faster

than handwriting

SELF CARENeeds assistance with going to the

bathroomUnable to be toilet trainedNeeds assistance to eatCannot take in food orallyNeeds suctioning routinelyHas degenerative medical conditionIs medically fragileSeizures limit alertnessNeeds to rest frequentlyNeeds assistance to zip coat or tie

shoesCOMMUNICATION

Receptive LanguageReceptive language is significantly

lower than abilityReceptive language is significantly

higher than expressiveExpressive Language

Speech is unintelligibleExpressive language is significantly

lower than abilityMean Length of Utterance (MLU) is 3

words or lessSpontaneous or self initiated language

is significantly limitedDoes not make choices consistentlyDoes not respond appropriately with

yes or noDoes not have communicative intent

SENSORYVision

Requires corrective lensesRequires large print to readRequires mobility trainingHas blind spot

HearingRequires preferential seatingHearing limitations affect the language

thresholdsRequires assistance to receive lan-

guageRequires sign language to receive lan-

guageHas fluctuating hearing lossNeeds visual signals for safety pur-

poses

14

blackboard

4 The Enemy Within Physical and cogni-tive impairments may pose difficult obstacles foran individual but often the feelings that peoplehave about the individualrsquos disability or aboutassistive technology pose greater problems thanthe disabilities themselves The Solution Circleprocess recognizes that human fears concernsreservations and prejudices might stand in theway of a personrsquos success as much as other typesof limitations Getting these fears and concernsout on the table often helps the group to deal moreconstructively with what is possible and whatneeds to be done

One of the serious issues in Tomrsquos situationwas that his resource teacher felt he should con-tinue to try to read for himself instead of using aldquocrutchrdquo like assistive technology The teacherthought that if Tom did not have to read all thematerial he would lose what little reading skillhe had In some ways the teacherrsquos oppositionto considering assistive technology actually poseda greater barrier than the reading problem itself

5 Solutions The exciting part of a SolutionCircle occurs when the group takes each obstacleor concern and turns it into a possible solutionthrough the use of technology or some other typeof adaptation Not all solutions suggested even-tually prove to be feasible but the point of thediscussion is to produce many possible solutionsso that the individual and his or her family havean array of options from which to choose Withgood minds puzzling over the problems and aspirit of cooperation and collaboration seeminglyimpossible barriers can be removed or conqueredThe process recognizes the expertise and contri-butions of all participants including the indi-vidual with disabilities and his or her familymembers The freewheeling format of the dis-cussion promotes ingenuity and innovation Allinvolved come away from a Solution Circle ener-gized by the new possibilities

Tomrsquos Solution Circle became excited about

the possibility of solving his reading problem byusing computerized texts The computer storeoperator mentioned he had heard that Record-ings for the Blind (RFB) offered textbooks on diskTomrsquos parents got in touch with Recordings forthe Blind and ordered texts for Tom to try on hiscomputer at school Soon Tom found that hecould keep up with his classmates and study ex-actly the same material that they were coveringBecause Tom had good strategies for memoriz-ing information that he heard he learned quicklyfrom the texts that were read aloud to him by thecomputer When given oral tests by his classroomteachers he was able to recite appropriate an-swers which would have eluded him if he hadhad to read the tests for himself

Technology has made all the difference forTom he has every reason to think that he will beable to go to college and pursue his intellectualinterests His resource teacher is now completelysold on the idea of assistive technology and us-ing computerized books and wants to use thetechnique with other students More than thatTomrsquos teacher also appreciates the process of theSolution Circle which allowed professionals andnonprofessionals to work together to find prac-tical solutions without being too concerned aboutthe formalities of the special education processThe informal nature of the Solution Circle vali-dated the expertise of all the participants andgave everyone a chance to offer suggestions Thecombination of a new process for planning andnew technology made Tom a winner This samecombination holds potential for many studentslike Tom who benefit from technologies whicheliminate barriers and open up new possibilitiesfor learning

From Function to Technology Solution Ithappened that a participant in Tomrsquos SolutionCircle hit on a great idea for a solution to his func-tional problem with reading This was a fortu-nate connection to make At the suggestions ofhis Solution Circle Tom began to use computer-ized books which he ldquoreadsrdquo by having the com-

15

puter speak the words as he follows along withthe text For Tom computerized books proved tobe a successful solution to his reading problembecause they help him to get the information heneeds without struggling with the reading pro-cess

Not every Solution Circle will be like Tomrsquosand identify the exact technology that the indi-vidual needs But if a Solution Circle has workedwell the end result will be a clear analysis of thefunctions that need to be performed This func-tional information can then be brought to techni-cians who can make suggestions for possibleassistive technology solutions There are over 50assistive technology centers in the United Stateswhere knowledgeable individuals can assistpeople with disabilities and their families withmaking a match between functions that need tobe performed and the technology that is availableto perform those tasks A list of assistive technol-ogy centers is available in the Appendix to thisGuide

Formal Assessment Solution Circles are aneffective informal way to identify functionalneeds that can be met through technology How-ever in the school setting it is also necessary toestablish a studentrsquos needs for technology in amore formal way Formal evaluations for assistivetechnology must be multi-disciplinary involvingeducators and therapists who are knowledgeableabout the school curriculum and the particulartypes of impairments that the student being as-sessed may have For example for a student withcerebral palsy the assistive technology evaluationmight involve a teacher a physical therapist aspeech and language clinician and an occupa-tional therapist The teacher would assist thetherapists in determining what skills the studentneeded to learn and how technology might assistthe student in acquiring those skills Someassistive technology evaluations might require theadditional services of an A-V technician adap-tive physical education teacher a rehabilitationcounselor or speech and language pathologist

with specialized training in augmentative com-munication In school districts where there is nospecialized expertise in technology and its appli-cations it may be necessary to contract for evalu-ations with special education cooperatives medi-cal centers or centers that focus on technologyassessment

Individuals conducting an assistive technol-ogy evaluation should

bull Be knowledgeable of the studentrsquosstrengths and weaknesses medical needsmobility fine and gross motor skills cog-nitive ability communication abilities vo-cational potential self help needs sensoryabilities level of academic achievementand area(s) of disability

bull Have knowledge of and access to an arrayof assistive technology devices

bull Be familiar with the studentrsquos educationalsetting and educational needs

bull Be able to communicate effectively withparents and educators

Because the assistive technology field is sonew there are no particular licenses orcredentialing processes to identify a professionalas qualified to do assistive technology evalua-tions Generally speaking individuals with pro-fessional licenses as occupational or physicaltherapists special educators speech pathologistsor rehabilitative counselors may have the exper-tise to conduct an AT evaluation When consid-ering an evaluator it is wise to ask about theevaluatorrsquos specific experience with assistivetechnology It is also important to recognize thatno one person or discipline will know everythingabout assistive technology therefore access toknowledgeable people at the local level andthrough other agencies programs or services isessential

Conducting the AT Evaluation The assistivetechnology evaluation must be tailored to theunique needs of the student In some cases theevaluation may be conducted by at team of indi-

16

viduals in other cases the evaluation may beconducted by a single individual (eg the speechpathologist) Questions to be addressed duringthe assessment should be related to the specifictasks the student needs to be able to perform andwhat if any assistive technology would helpThe following questions may be considered dur-ing the assessment

bull What tasks does the student need to per-form that he or she cannot perform

bull Is there a low tech device which will ad-dress the studentrsquos needs satisfactorily

bull What types of high tech assistive devicesmay help the student in performing thetask

bull Will assistive technology help the studentto perform the task in the least restrictiveenvironment

bull Is the device being considered suited to thestudentrsquos educational needs and abilities

bull Will the assistive technology device remainsuitable over time How long lasting willthis solution potentially be

The above are only a few of the considerationswhich need to be addressed as part of the evalu-ation process There is no specific ldquotestrdquo forevaluating the need for assistive technologyTherefore prior to conducting the evaluation theindividuals doing the assessment need to have awell planned process in mind

The formal written assistive technologyevaluation report should address but not belimited to the following points

bull Procedures used to evaluate the student

bull Instruments employed in the evaluationassuring that a range of levels of technolo-gies has been considered

bull Results of evaluations including bothqualitative and quantitative measures

bull Recommendations for levels of technologyappropriate to the studentrsquos capabilitiesand potentials and

bull Implications for educational program-ming including discussion of both indi-vidual technology needs and recom-mended environmental and instructionalmodifications

In the end an assistive technology evaluationshould provide recommendations for accommo-dations adaptations devices and services basedon the individualrsquos strengths needs and pre-ferred lifestyle The evaluation should indicate(a) whether devices and services have potentialfor improving function and (b) what trainingmay be necessary in order to use the technologyequipment safely and effectively

bull Examine available technology with a criti-cal eye

It is easy to be dazzled by the possibilities innew assistive technology but it is important forparents to be wise consumers and ask probingquestions about the features and quality of anassistive technology device The following is alist of questions to consider when evaluating aparticular assistive technology device

Performance

Does it work efficiently and effectively

Is it easy to learn to use this device

Is it compatible with other devices

Does this device serve only one purposeor is it flexible

ldquoElegancerdquo

Does this device represent the simplestmost efficient way to accomplish the task

Or is this device too elaborate too com-plicated to be worthwhile

Ergonomics

Does it fit the individual

Is it convenient to use in the environment

Is the equipment portable enough to gowhere the user goes

Are different devices needed in differentenvironments

17

Reliability

What is the manufacturerrsquos reputation forreliability

Does it stand up well to normal use

Is it durable

Safety

Is it safe to use

What is the power source for the deviceIs it safe

Is a margin built in for foreseeable mis-use

Practicality

Do company sales people seem knowl-edgeable and helpful

Are the companyrsquos service people knowl-edgeable and helpful

Does the device have a warranty Howlong is the device guaranteed to function

How available are repair services Atwhat cost

Can this device be leased

Is this device available for a trial periodbefore purchase

Will this device soon be outdated Issomething better on the horizon

Will the company update the device

Does the manufacturer provide trainingin using the device

Aesthetics

Is this device attractive to the eye

Does the device fit well into the userrsquoslifestyle

Normalization

Does the device assist the user with morenormalized living

Can the user operate the device indepen-dently or with a minimum of assistance

Or does the device ldquostick outrdquo too muchand advertise the disability of the user

Does the equipment minimize differenceor exaggerate difference

Does the device have the potential to in-crease the quantity and quality of time spentwith nondisabled peers Or does the de-vice separate the user from others

Cost effectiveness

Do the benefits the device provides jus-tify the cost

Are there less expensive devices or mod-els that serve the purpose as well

Personal acceptance

Is this device the userrsquos own choice

Does the potential user like this deviceand want to use it

Does the potential user view this deviceas life-enhancing

Would the user have preferred some otherdevice or means to perform the task

Will using the device always be a choreor can using it become a habit

There are several ways that consumers canfind answers to their specific questions aboutassistive technology devices Most vendors willprovide good basic information about the prod-uct Call the vendor and ask for brochures prod-uct specifications price list and any other writ-ten information This is a place to start A sec-ond step is to read reviews of the product in trademagazines or Closing the Gap a widely respectedpublication that reviews new assistive technol-ogy products If possible it is very helpful totalk to other consumers who are already usingthe product Ask them about the pros and consof using the device Then visit a preview centerif there is one nearby and try out several typesof devices Ask for general recommendationsfrom the preview centerrsquos staff After identify-ing a device that appears to meet the potentialuserrsquos needs try the device out for a month tosix weeks to make sure that it performs as adver-tised and fits in well with the userrsquos lifestyle

18

During the trial period it will be possible to iden-tify training needs for the user family membersand school staff The trial period will also be atime for the user to test the device in several set-tings to determine its portability and flexibility

bull Match the Individualrsquos Needs to SpecificEquipment Features

When considering an assistive technologydevice it is very important to consider how adevice matches up with the particularindividualrsquos needs and habits In some ways anassistive device becomes an extension of theuserrsquos mind and body As such it is a highly per-sonal item A device may work as advertisedbut still not meet an individualrsquos needs becausethe individual just does not feel ldquocomfortablerdquo inusing it For example Cindy a fourteen-year-oldwho is totally blind and has mild cerebral palsyaffecting her hands and arms was being taughtMorse Code as a means to speed up her writingShe had difficulty using a Brailler because her armstrength was so limited so her teacher thoughtMorse Code would be an easier method of writ-ing for Cindy The only problem was that Cindydid not like using Morse Code To her it seemedlike she was having to learn another complicatedlanguage when she already knew braille andliked to use it Cindy admitted that writing inbraille was slow for her but she was more com-fortable with it Cindy and her teacher were atan impasse until a friend suggested to Cindy thatshe try writing on a voice-output computerCindy loved the computer With a headset at-tached to the sound system she could listen care-fully to the computer as it read aloud the lettersand words she was typing on a light touch tac-tile-marked keyboard This computer also had afeature of printing out text in either standard printor braille Cindy was delightedmdashshe could writecopy for herself to read in braille and for hersighted teachers to read in regular print Thissolution worked because it met Cindyrsquos learningneeds and responded to her own ideas about her-self She did not want to use Morse Code because

it was a separate type of communication knownonly to a few With her computer voiced soft-ware and dual printer she had the best of twoworldsmdashshe could ldquohearrdquo her writing as shetyped she could read it over in braille and hersighted teachers could read her finished prod-uct This solution helped Cindy to improve hercomposition skills speed up her writing timeand communicate more easily with sightedpeople

Cindy was fortunate because her assistivetechnology solution met her needs almost per-fectly Such a close match is not however al-ways possible Nonetheless every effort shouldbe made to have the match be as close as it canbe In general when assistive technology solu-tions are individualized simple to use and re-sponsive to the whole person they are more likelyto be used by the individual When the deviceperforms a task well but does not ldquofitrdquo the indi-vidual the technology is likely to be abandonedby the user in favor of something else whichmeets the need more exactly Too often devicesare purchased because of their technical poten-tial without thought to their relationship to theindividual and his or her lifestyle These mis-matched devices are the ones that end up lan-guishing in their packing boxesmdasha sad reminderof time and money spent to no avail

bull Try the Device Before Buying

It cannot be emphasized enough how vital itis to try out assistive technology devices andequipment before buying Trying out a devicefor several weeks provides the user with an op-portunity to learn how to use the device and howto adapt to its features while at the same timetesting the device in the various environmentswhere it will be used For example Mike triedout a communication device which attachednicely to his wheelchair tray and was compat-ible with his computer that he used for doingschool work Though the communication deviceworked well and was relatively easy to program

19

MOTORSELF CARE

manual wheelchairpower wheelchairbus liftsupportive classroom

chairstanderwalkerlift for transferspositioning devicecanes or crutchesadapted commodesuctioning devicebraces or supportsother ____________

________________

________________

________________

________________

________________

________________

________________

________________

________________

________________

________________

figure 4 ASSISTIVE TECHNOLOGY EVALUATION

Device or Equipment Features or Functions

Name Date

FINE MOTOR

word processorword processor with

predictionvoiced word proces-

sor with predictionadapted keyboardkeyguardalternative key

arrangementvoice activated

computer accessinfrared computer

accessmouse accesstrackballjoystickpower padswitch (eg mouth

lip chin)touch screenpointersdrag and click desk

accessorysticky keysonscreen keyboardprinter for written

work

adapted feedingutensils

braces or splintsother ____________

________________

________________

COGNITIVECOMMU-NICATION

communciationboard(s)

communication wallettotal communicationmanual signword processor with

voiceprogrammed voice

outputicon predictionelectronic communi-

cation deviceprogrammable switch

with voice output

no-reading-neces-sary word proces-sor

spell checkergrammar checkeroutlining programother ____________

________________

________________

________________

________________

________________

________________

________________

SENSORYPERCEP-TUAL

hearing aid(s)

classroom amplifica-tion

boosted signal tonoise ratio (egheadset to keepfocus during wordprocessing)

corrective lensesenlarged printtaped booksvoiced word process-

ingvoiced screen

directionsCCTVother ____________

________________

________________

________________

________________

________________

________________

________________

________________

________________

________________

20

Mike found out quickly that the device was justtoo bulky to be useful for him When he trav-eled around the school the communication de-vice blocked his view of the terrain and of peoplepassing by He found he missed opportunitiesto communicate because he could not see whowas coming his way Mike also discovered thatthe communication device did not serve him wellin crowds like at pep rallies or basketball gamesAfter a month of working with this communica-tion device Mike decided it was not for him andselected instead a device that was less compli-cated smaller and more portable The seconddevice was not as sophisticated as the first but itbetter met his needs for quick communicationwith friends in social settings If he had not hadthe opportunity to try out both devices for anextended period of time Mike might not haverealized the value of the second device and mayhave been stuck with a communication devicethat was too large and too sophisticated to matchhis lifestyle

Similarly Marilyn benefited from a trial pe-riod with her communication device She foundout the first week that the particular device shehad chosen would not work for her because itbroke too easily and it was difficult to get re-paired During the first week that Marilyn hadthe device for trial her teacher broke one of thebuttons during a programming session It tooktwo weeks to contact the manufacturer and thenthe device had to be mailed back to the factoryfor repairs The device was gone for over sixweeks and the manufacturer would not supplya ldquoloanerrdquo while Marilyn waited for repairs tothe first device This experience taught Marilynthe importance of having a responsive manufac-turer who is willing to repair devices quickly andto supply substitutes for the user while repairsare being made Marilyn decided on a differentdevice with similar features and a great helplineto provide assistance with the maintenance of themachine

The information that can be learned during a

trial period with a device is invaluable to the userIt is discouraging to find out during the trial thata device is not all it is purported to be or that itdoes not work as well as advertised but it is farbetter to learn before purchase that a device doesnot meet the userrsquos needs than to learn after pur-chase and be stuck with an expensive unusablemachine For the consumer it is daunting to thinkabout starting over again with the process of se-lecting a device Nonetheless it is worthwhileto seek more information and look again Hav-ing been through a trial even when the outcomeis not successful provides the user with greaterclarity about what an appropriate device willhave to be able to do The second time aroundthe search is likely to go faster and come out witha better result

bull Identify Next Steps

Once a device has been selected the con-sumer becomes impatient to have one and beginusing it right away But at this point importantwork still needs to be done Funding the deviceis a major consideration Sometimes families willpay for the device themselves but under othercircumstances the device will be purchased by aschool district through Medicaid or private in-surance or through some other means Parentsneed to become familiar with the various fund-ing options and determine which one will workfor them (See Funding Assistive Technology foradditional information about funding sources)

Also when considering funding familiesshould think about costs beyond the price of thedevice itself For example a computer set-upwith a keyboard monitor and printer might cost$3500 This equipment is basically useless un-less other equipment is purchased as well soft-ware adaptive devices paper manuals up-grades Prices for these additions can raise theactual cost of the device by hundreds of dollars

Devices often require training for the userfamily members and others to ensure effectiveand safe use How much does training cost Who

21

will provide it Repair and maintenance are othercosts usually additional to the price of the equip-ment Sometimes families will also want to insurethe assistive device so insurance payments be-come part of the overall cost

Since making an assistive technology pur-chase is such an important personal and finan-cial decision it is wise to have a realistic budgetin mind that includes all of the equipment andservices that are necessary to make the assistivetechnology work effectively With this budget inmind it becomes easier to plan the purchase seekout funding sources and make a compelling casefor financial assistance

bull Determine What Follow-up Is Needed

After the assistive technology device has beenpurchased and put to use there are additionalfollow-up activities that need to take place Theoriginal assistive technology evaluation shouldinclude a way to monitor the use of the devicePeriodic scheduled reviews the by evaluator fol-low-up calls to and from the family are some waysto help assure effective safe use Families whotravel great distances for evaluation need to becertain that services like maintenance repair andreplacement of devices are available within a rea-sonable distance from home

Assistive technology devices are used bestwhen all the people in the life of the individualwith disabilities understand the devices in thesame way At first devices may seem to exagger-ate differences between a person and the rest ofthe world Care should be taken to explain thatassistive equipment is a difference equalizer nota difference maker Classmates and friends needto understand that the adapted seating or adaptedkeyboard helps the individual do what other stu-dents do Adults in a childrsquos life need to under-stand that devices work to make life easier bet-ter and more functional People need to knowthat ramps help keep individuals with mobilitydisabilities from being separated from peers thatcommunication technology allows people to

ldquospeakrdquo their thoughts

Close communication between parents andtheir childrsquos helpersmdashteachers therapists daycare workers and othersmdashis essential to makesure devices and services are being used safelyand effectively If the device is working well butthe child is not being integrated into the class-room or other environments then there may bea need for additional training for the children andadults who interact with the child

Besides keeping track of how the device isworking and being used it is important to ob-serve progress in the areas of technology whichare useful to the individual with the assistivetechnology device As upgrades of equipmentoccur or more sophisticated models come on themarket the user may want to consider modify-ing or replacing the equipment that is currentlyin use Also as the individual becomes moreskilled at using technology the individual mayoutgrow the current device and need to look formore advanced equipment It can be assumedwith most high tech items that in three to fiveyears there will be a need for upgrade or replace-ment The wise consumer begins early to planfor the next step in technology including savingmoney for a new device and staying alert to thenew options that become available

What kinds of training are important to occurwhen a child has a new assistive technologydevice

Because assistive technology of the high techvariety is so new it is particularly important thattraining be provided to all those who may needit In the school setting it is helpful for all edu-cators and administrators to have some aware-ness training so that they have a general idea ofwhat assistive technology is Areas to be cov-ered in inservice training might include

bull legal issues related to assistive technology

bull awareness training concerning how toserve students with assistive technologyneeds

22

bull information on how assistive technologyrelates to the evaluation process

bull how to write IEPs for students who requireuse of assistive technology devices

bull the relationship between technology andstudent placement

bull the nature of common assistive technologydevices

bull resources to contact for information onassistive technology

Beyond these awareness activities thosemembers of the school staff who work directlywith a student who uses technology need to havetraining on the specifics of using the device andhow it is maintained and serviced Trainingshould include but not be limited to the follow-ing

bull review of the studentrsquos educational andassistive technology needs

bull review of goals and objectives supplemen-tary aids and services and related serviceson the IEP or IFSP

bull training on how to use and maintain thedevice

bull training on proper transport of the devicewithin the school building and from hometo school

bull training on how to program the device ifneeded

bull training on how to use the device effec-tively during instruction

bull training in trouble-shooting when the de-vice is not working properly

bull information about what to do when thedevice is not functioning or broken

bull information about how to coordinateassistive technology with all the activitiesin the studentrsquos day

bull training in methods to evaluate the effec-tiveness of assistive technology

Depending on the type of assistive technol-

ogy used by the student and the studentrsquos needsit may be advantageous for assistive technologyinformation to be shared with the studentrsquos peersSuch training will help fellow students to gainan understanding of the studentrsquos assistive de-vice foster acceptance in the social environmentand reduce fears other students may have aboutsocializing with the student who uses technol-ogy In some cases parents and the student maywant to be involved in the peer training

Parents may require training too in order forthe device to be used at home for the student tocomplete homework assignments or participatein extended school year services Once trainedthe parents can become a resource to the studentfor proper care and maintenance of the device

Most importantly the student himself or her-self will need training in how to use the deviceas independently as possible Training for thestudent may be written into the IEP as a separategoal or may be included as a related service thatsupports the studentrsquos special education pro-gram

SummaryPurchasing a high tech assistive technology

device is a major life decision because of the po-tential impact on the individual and because suchdevices can be costly When considering anassistive technology device it is important to dothe following be realistic about the consumerrsquoscapabilities and needs get a multidisciplinaryevaluation examine available technology with acritical eye match the individualrsquos needs to spe-cific equipment features test the device for a trialperiod identify next steps and determine whatneeds to be done for follow-up after purchaseEvaluations for assistive technology both infor-mal and formal should consider first of all thefunctions that the consumer wishes to performusing technology When evaluating a particularpiece of equipment consideration should begiven to the following features performance sim-

23

plicity of design ergonomics reliability safetypracticality aesthetics normalization cost effec-tiveness and personal acceptance Good sourcesof information about assistive devices are manu-facturers publications trade journals previewcenters and consumers who are already using thedevice Once a device is selected the consumerwill need to secure funding for the purchase andbe aware of additional costs for related equip-ment insurance and training

Hints for Parents

Donrsquot let the cost of assistive technology deter youfrom considering it for your child High tech assistivetechnology can be quite costly but it can also makethe difference for your child in terms of becoming welleducated employable and a fully-included member ofthe community Donrsquot leave any stone unturned whenlooking for funding sources Consider any or all ofthe following for funding or assistance

bull Early intervention programs

bull Schools

bull Transition programs

bull Vocational Rehabilitation

bull State Programs for Children with SpecialHealth Care Needs

bull Medicaid

bull Medicare

bull State Technology Resources

bull Used Equipment

bull Leasing

bull Equipment Loan Programs

bull Disability Organizations

SierraSierra wants to play with dolls like other chil-

dren her age but she has a muscle disease thathas caused her to lose muscle tone except in onehand What could be done to allow Sierra to dressand undress her dolls comb their hair and bathethem

Sierrarsquos SolutionThe assistive technology solution for Sierra

involved her whole family While vacationingin Mexico Sierrarsquos grandmother found her a fash-ion doll that was a bit larger than the typicalldquoBarbie dollrdquo The larger doll was easier for Si-erra to manipulate Sierrarsquos mother sewed sev-eral outfits for the doll using velcro instead ofsnaps or buttons as fasteners

Sierrarsquos dad bought doll stands at a toy storeand fastened several stands with clamps toSierrarsquos wheelchair tray He also fastened a plas-tic pouch to the tray Sierra puts the small dollaccessories in the pouch When Sierra wants todress her doll she puts the doll in one of thestands In this way the doll is held securely andSierra can dress and undress the doll with onehand

Sierrarsquos friends also use the doll stands fortheir dolls With this arrangement two or threegirls can play together

Solution SummaryLarger doll

Velcro fasteners

Plastic pouch

Doll stands

Clamps

24

Funding Assistive Technology

F unding for assistive technology is availablefrom a variety of public and privatesources To receive public or private fund-

ing the individual must meet eligibility criteriafor the specific program and provide sufficientdocumentation of the need for assistive technol-ogy

The following list includes some of the pro-grams which may pay for equipment if the indi-vidual needing the device meets their require-ments Many of these programs are run by dif-ferent agencies in different states making themhard to find In general the statersquos Tech Act of-fice can assist consumers and family members infinding and using these programs (See Appen-dix under Resources)

PUBLIC PROGRAMSEarly Intervention Programs (Individuals withDisabilities Education Act Part H)

Young children (0-3) and their families mayreceive help through early intervention programsin evaluating what the child needs in gettingassistive technology and in learning how to useit Equipment and services must be included ina written plan called an Individualized FamilyService Plan (IFSP) To find the program for aparticular state call National Early ChildhoodTechnical Assistance System (NECTAS) at 919-962-2001 or 919-966-4041 (TDD)

Head StartThis child development program provides

comprehensive educational and health servicesfor eligible children ages 3-5 Since 1982 federallaw has required that at least 10 percent of thetotal number of placements must be available tochildren who are disabled and require specialservices Head Start is a mainstream placementoption for children whose IEP calls for placementwith nondisabled children The January 1993Head Start regulations specifically require the

consideration of assistive technology services anddevices For more information contact NationalHead Start Association 201 N Union St Suite320 Alexandria VA 22314 703-739-0875

Schools (IDEA Part B)This program mandates a free appropriate

public education for preschoolers children andyouth with disabilities An Individualized Edu-cation Program (IEP) is required for all childrenwith a disability These children are entitled tospecial education related services or supplemen-tary aids If the IEP team determines that assistivetechnology is required for a free appropriatepublic education then it must be provided at nocost to the child The technology must be in-cluded in the childrsquos Individualized EducationProgram (IEP) Parents have a right to be in-volved and should help to develop the IEP goalswhich may include technology For help in get-ting assistive technology in the IEP call the TAPPFocus Center on Assistive Technology at 1-800-222-7585

State Operated and Supported Schools (Chap-ter I)

This program provides federal assistance tohelp educate children with disabilities who areenrolled in state-operated and state-supportedprograms Federal funds must be used to payfor services that supplement a childrsquos basic spe-cial education program such as construction andthe purchase of equipment For more informa-tion contact your State Department of Education

Section 504 of the Rehabilitation Act of 1973Section 504 provides a civil-rights mandate

that requires accommodations for students whohave disabilities such as orthopedic impairmentsbut who do not qualify for special education ser-vices It denies federal funds to any institutionincluding a school whose practices or policiesdiscriminate against individuals with disabilities

25

This legislation has resulted in a number of out-comes including various actions to remove physi-cal barriers to education which may incorporateassistive technology For more information con-tact the nearest regional Office of Civil Rights orthe State Vocational Rehabilitation Agency

State Programs for Children with SpecialHealth Care Needs

These programs provide and pay for servicesfor eligible children CSHCN programs varywidely from state to state in the services they of-fer the number of children served and the re-quirements for eligibility Some CSHCN pro-grams do pay for assistive technology deviceswhen no other funding source is available andthe equipment is necessary for health-related rea-sons Most CSHCN programs are run by the statehealth agency To contact CSHCN ask informa-tion for the telephone number of the state healthagency

School-to-Work Transition ProgramsTransition Programs are charged with assist-

ing students with disabilities to receive the jobrelated training and placement services to helpthem move from school to work Sometimesassistive technology may be necessary in orderfor a student to make a successful transition andbecome employable If technology is needed fortransition purposes it can be written into thestudentrsquos Individualized Transition Plan (ITP) Toreceive more information about transition andtechnology call the Parent Training and Informa-tion Center (PTI) in your state (See Appendix)

Vocational Rehabilitation ServicesState vocational rehabilitation agencies pro-

vide information evaluation services trainingand funding for technology and education to helpadults go to work or live more independently Iftechnology is necessary for an individual to workVocational Rehabilitation may pay for the equip-ment as part of an Individualized Work-RelatedPlan (IWRP) To locate the nearest Vocational Re-habilitation Agency look in the telephone book

under state government

Plan to Achieve Self-Support (PASS)One of many Social Security Administration

work incentive programs this program providesan income and resource exclusion that allows ablind or disabled person to set aside income andresources for a work goal such as educationequipment purchase vocational training andstarting a business It should be considered forall students with vocational goals who are receiv-ing social security benefits

This program provides a mechanism forpeople to set aside funds to purchase work-re-lated equipment such as assistive technologydevices and services In many cases if an indi-vidual is a recipient of SSI and writes a PASS topurchase education or equipment an additionalSSI check will be provided to cover other livingexpenses Sometimes if a person receives SocialSecurity Disability Insurance (SSDI) and designsa PASS it may make the individual eligible forSSI because the SSDI has been allocated for equip-ment and services

Impairment-Related Work Expense (IRWE)Impairment-Related Work Expense (IRWE)mdash

one of the Social Security Administrationrsquos workincentive programsmdashallows an employed indi-vidual with a disability who receives or is eligiblefor SSI or SSDI to deduct work-related expensesfrom gross reported income

This deduction allows the person to continuedrawing SSDI or SSI and associated benefits(Medicaid or Medicare) if the IRWE deductionreduces earning below the Substantial GainfulActivity (SGA) Test

Although this method does not provide fund-ing to pay for a device or service it is a way ofallowing the use of the individualrsquos own moneyto pay for assistive devices and services neces-sary to return to work The following is a list ofpossible work-related expenses special transpor-tation to and from work personal assistance onthe job structural modifications durable medi-

26

cal equipment prostheses medical supplies andservices work-related equipment non-medicalappliances and equipment routine drug andmedical costs and diagnostic procedure costs

MedicaidMedicaid is a joint federal and state program

which covers some equipment if it is consideredmedically necessary For more information aboutMedicaid and who and what is covered contactthe local Department of Human Services office

MedicareAlthough not a usual source of funds for

assistive technology Part B of Medicare providescoverage for some durable medical equipment ifit is considered medically necessary and is foruse in the personrsquos home For more informationabout Medicare benefits contact the Social Secu-rity Administration Regional Office

Technology-Related Assistance for Individualswith Disabilities Act of 1988

This federal competitive grants program pro-vides monies for states to establish a statewideconsumer-responsive service delivery system de-signed to effect systems change regardingassistive technology In most Tech Act states afunding specialist or policy analyst is availableto assist with accessing assistive technology Sev-eral states operate loan programs to help withthe purchase of devices and services For moreinformation contact RESNA Technology Assis-tance Project 1700 N Moore ST Suite 1540 Ar-lington VA 22209-1903 703-524-6686

PRIVATE PROGRAMS

Private InsuranceSome health insurance plans will buy equip-

ment but it depends on the specific wording ofthe policy Unless the policy says the equipmentis not covered it makes sense to ask the insur-ance company to pay for it The equipment mustbe considered medically necessary and thereforerequires a doctorrsquos prescription

Loans

There are several low or no interest loansavailable to help buy technology Call the stateTech Act program or the manufacturer of theequipment may know where to get this type ofloan

Non-Profit Disability AssociationsThere are many disability organizations

some of which may be able to loan equipment orprovide information about other funding sourcesor support groups These organizations includeNational Easter Seal Society March of DimesMuscular Dystrophy Association United WayUnited Cerebral Palsy Association and the BrailleInstitute

FoundationsSome private foundations have been set up

specifically to provide help to people with dis-abilities A listing of such foundations can befound at the library or may be available from thestate Tech Act program

Programs Providing Assistive TechnologyThe state Tech Act programs offer referrals

for evaluation and equipment recommendationsas well as assistance with identifying funding orequipment lending sources A therapy depart-ment in a local hospital or Disabled StudentsCenter at a local college or university may alsooffer to help locate technology programs in thearea Alliance for Technology Access Centers(ATA) sometimes have loan programs or infor-mation about purchasing used equipment orrenting equipment

Civic OrganizationsThere are many local civic and service orga-

nizations which may provide money to helpsomeone in their community Lists of these or-ganizations are available from the Chamber ofCommerce Examples of these organizations areLions Club Masons Grotto Veterans of ForeignWars (VFW) Elks Club Rotary Club KiwanisKnights of Columbus and Soroptomists Someof these organizations have a national focus on

27

disability or on a particular disability Others willfund devices for a particular child who is knownto the local club

Charities and Fund-RaisersLocal churches high school groups neighbor-

hood organizations labor unions or special in-terest groups (eg computer clubs ham opera-tors) may plan a fund-raiser to help purchaseassistive technology College student organiza-tions (fraternities and sororities) may give moneyor studentsrsquo time to help a special cause Even ifmoney is not available they may be willing tohelp organize a fund raiser

Local media (radio television newspapers)sometimes will sponsor fund-raising activities tofund devices They may not contribute moneybut will help with organizing the fund-raisingactivity and publicizing it to the community

OTHER OPTIONS

In addition to federal and private fundingsources there are a number of education-relatedgrants corporate technology donation programsand funding options that consumers should con-sider Information on these alternative options isavailable through a number of sources includ-ing the following

NewslettersEducation Grants Alert Capital Publications

Inc PO Box 1453 Alexandria VA 22313-2052800-655-5597

Education Technology News Business Publish-ers Inc 951 Pershing Dr Silver Spring MD 20910-4464 301-5878-6300

Financing Assistive Technology Smiling Inter-face PO Box 2792 Church St Station New YorkNY 10008-2792 415-864-2220

Special Education Report Capital PublicationsInc PO Box 1453 Alexandria VA 22313-2053800-655-5597

Technology and Learning Peter Li Inc Publish-ing 330 Progress Rd Dayton OH 45449 415-457-4333

Technology ManufacturersIf it is not possible financially to purchase

equipment consumers can sometimes rent orborrow equipment directly from the manufac-turer

Used EquipmentUsed equipment is often advertised for sale

in disability-related publications or the consumercan place a newspaper ad to see if used equip-ment can be purchased locally Several compa-nies refurbish old computers and sell them at lowprices Listings of used computer outlets can beobtained from ATA Centers or state Tech Act pro-grams

LeasingMany manufacturers of assistive technology

devices have equipment which is available forrent or lease Sometimes the rent or lease pay-ments can be applied toward purchase Checkwith the manufacturer to see if this is an option

Equipment Loan ProgramsMany states have equipment loan programs

as do some rehabilitation facilities and disabilityorganizations Information about loan programsis available from Tech Act programs

HOW TO APPLY FOR FUNDING

There is an art to applying for funding forassistive technology It is necessary to use justthe right words to suit the particular agency thatmight be the funding source It is also crucial todocument the need for and projected outcome ofassistive technology This documentation shouldinclude at minimum

bull A written statement of medical need fromdoctors or other health professionals If thechild had an evaluation by a rehabilitationprofession also include this report

bull A description of the childrsquos problems re-sulting from the disability This descrip-tion can come from the doctor or other pro-fessional who evaluated the child

28

bull Description of how the technology helpsthe child For example the equipment maymake the child safer or allow the child todo things more independently Be sure topoint out how money will be saved if useof the equipment allows attendant care tobe reduced

bull A clear statement based on assessmentthat the child is a good candidate who hasthe cognitive and physical capacities nec-essary for using the technology

In summary the documentation to supportan assistive technology funding request shouldinclude a physicianrsquos prescription the childrsquos as-sessment an explanation of projected benefitfrom use of the technology or service and anycorrespondence obtained from professionals thatwould support the childrsquos need for technology

The initial funding request should include notonly the cost of the device but also the cost ofongoing support and instruction in the use of thetechnology Assistive devices often have ldquohid-denrdquo expenses that are incurred with their pur-chase and these expenses are frequently costlyover time Battery-powered devices may requirefrequent charging or cleaning Upgrades for com-puter software may be necessary Special modi-fications of the home or school environment maybe necessary for the technology to be used Ineach of these examples costs associated with thetechnology may have to be assumed by the fam-ily if they are not considered in the initial appli-cation for funding

It is also helpful to include with the fundingrequest a picture or a descriptive brochure aboutthe device being requested This is importantbecause often persons who are reviewing theapplication do not know about the wide rangeof technologies that might be appropriate

Appropriate wording on the application isabsolutely necessary Key concepts for Medic-aid include ldquomedical necessityrdquo and ldquorestore thepatient to his or her best functional levelrdquo The

term medical necessity means that the device isincluded in the course of treatment being pro-vided to the child and that a professional suchas a physician or speech therapist is supervisingits use Medicaid and private insurers alike gen-erally pay for technologies that help restorepeople to ldquofunctioning levelsrdquo and take the placeof a body part that is not working Typically theseprograms do not pay for technologies or serviceswhose function is educational or life-enhancingrather than health related

The key for private insurance is ldquoterms of thepolicyrdquo It must be remembered that coverageby any insurance company does not set a prece-dent Just because one child receives needed tech-nology under a particular policy issued by a com-pany does not mean that all other covered chil-dren will also have technology paid for by thatcompany Each application stands on its ownbased on the expressed terms of the policy

It is usually under the major medical provi-sions of a health policy that assistive technologycan be provided as ldquoother medical services andsuppliesrdquo It may however be necessary to pur-chase additional insurance coverage or a ldquoriderrdquoin order for technology costs to be included inthe terms of the policy It is important to remem-ber that heath insurance policies are oriented to-ward health care and not toward changes in theenvironment or rehabilitation

Both private health insurance policies andMedicaid sometimes impose limits on the num-ber of assistive technology devices over a certaincost that can be purchased within a certain timeframe Sometimes the rule is that the fundingsource will purchase only one device in theindividualrsquos lifetime With these kinds of restric-tions it is all the more critical to be sure that thetechnology choice is the right one

TIPS THAT LEAD TO SUCCESS

bull Apply to several funding sources at thesame time Be sure to meet the require-

29

ments of each agency

bull Find out if agencies will share costs

bull Fill in the agencyrsquos forms correctly Manyapplications are denied because forms arenot filled out properly

bull In addition to the standard form includeany other information that describes orshows what the equipment does and howit benefits the child Assume no knowledgeon the part of the reviewers

bull Turn in all documentation at the same time

bull Avoid using jargon define all unfamiliarterms

bull Take the funding request package to theagency in person While there have itchecked to make sure everything requiredhas been included Get the name of theperson who reviewed the application

bull Call regularly to check on the funding re-quest each time try to talk to the same per-son

bull Be super politemdashand persistent

WHAT IF FUNDING IS DENIED

It is not at all unusual for an initial fundingrequest to be denied Even when family mem-bers and professionals have been meticulous inpreparing applications requesting funding forneeded technology denials should be anticipatedMaking an appeal is worth the effort since manydenials are reversed at the appeal level

To start the appeal process obtain any docu-mentation or information provided by the fund-ing agency (eg Medicaid or the private insur-ance company) relating to appeal proceduresforms to use timelines and filing procedures forinstance This information will help in the promptpreparation for appeal The kind of appeal to bemade depends on the reason for denial Whendeveloping an appeal find out the following

bull Why the request was denied Ask for thereason in writing Sometimes requests are

denied because a reviewer lacks under-standing of the technology or there maybe an error in the paperwork

bull If needed correct any mistakes or includemore information then resubmit the re-quest

Going to appeal makes sense because gener-ally the appeal places the application before moreexperienced persons in the decision-making hi-erarchy The technology requested is often newand the initial examiners in the process may beunaware of its usefulness Also insufficient docu-mentation may have been provided in the origi-nal application and the problem can be remediedon appeal

Donrsquot be daunted by the length of the appealprocess Follow it through to its completion Insome states families may be able to appeal a de-nial beyond the first level For example somestates have ldquounfair claims settlement practicesrdquoregulations which are administered through theinsurance commissionerrsquos office

Always make your appeal in person and takethe child and the equipment if possible If onlypart of the money is offered by one agency askanother agency to share costs If the appeal isdenied try again Submit the funding request toanother agency Being persistent will nearly al-ways result in success

When going through the appeal process turnto the state Protection and Advocacy Program (Pamp A) for guidance and support P amp A advocatescan help make sure that a childrsquos rights to tech-nology and related services are not denied

Who pays when assistive technology is neededat school

The party who is responsible for paying forassistive technology depends upon the circum-stances under which the technology is purchasedUnder the special education law students withdisabilities who are eligible for special educationare entitled to a free appropriate public educa-tion Parents do not have to pay for school ser-

30

vices including assistive technology if that ser-vice is part of the studentrsquos Individualized Edu-cation Program (IEP) If the student is eligible forMedicaid the school district can request thatMedicaid pay for the device If parents choose todo so they may agree to use private insurance topay for a device that is used at school Parentscannot however be forced to use their insurancein this way If the private insurance requires aco-payment the school district would have to paythis amount since parents should not have to payany special education related costs

Does Section 504 pay for assistive technologySection 504 part of the Rehabilitation Act of

1973 is basically a piece of civil rights legislationthat is intended to prevent discrimination againstindividuals with disabilities in any programwhich receives federal funding Students whohave disabilities but who do not qualify for spe-cial education may still be eligible for accommo-dations under Section 504 of the RehabilitationAct of 1973 Section 504 however does not pro-vide any funding for accommodations

Like the special education law Section 504requires public schools to provide students withdisabilities with a free appropriate public educa-tion and in addition ensures that students withdisabilities are afforded an equal opportunity toparticipate in school programs For students withdisabilities this means that schools may need tomake special arrangements so that these studentshave access to the full range of programs andactivities offered For example a student whoneeds a wheelchair lift on a school bus to get toschool must be provided with this technologyOther modifications which might be requiredunder Section 504 include installing ramps intobuildings and modifying bathrooms to provideaccess for individuals with physical disabilitiesEven though required by the law none of thesetypes of modifications would be funded by Sec-tion 504

Under what circumstances does private health

insurance pay for assistive technologySome private health insurance policies will

pay all or part of the cost for some assistive tech-nology devices The devices are unlikely to belisted specifically in the policy but may be in-cluded under some generic term like ldquotherapeu-tic aidsrdquo Usually the devices have to be pre-scribed by a physician in order to be covered bythe policy

When does Medicaid cover assistive technol-ogy

Medicaid (Title XIX) will pay for ldquoprostheticdevicesrdquondashthat is replacement corrective or sup-portive devices prescribed by a physician or otherlicensed person Each state has some flexibilityin determining which prosthetic devices it willinclude in its list of Medicaid covered expensesDevices that are frequently covered by Medicaidare canes crutches walkers manual wheelchairshospital beds and hearing aids or eyeglasses forchildren and youth

SummaryAssistive technology can be expensive to pur-

chase but there are a number of public and pri-vate sources for funding devices Common pub-lic funding sources include early childhood in-tervention programs schools Vocational Reha-bilitation and Medicaid Private sources mayinvolve health insurance personal loans chari-table donations or fundraising It is very impor-tant to provide proper documentation and usecorrect wording and procedures when request-ing funding Initial requests for funding are fre-quently turned down but appeals can be success-ful

31

TEDTed is an active four-year old who lives in a

small rural community with his parents andyounger sisters He was identified as speech im-paired and has been attending preschool specialeducation classes Ted has normal mental capa-bilities but his mild cerebral palsy impairs hisability to speak Because of the speech therapyhe has received Ted is able to make some speechsounds but he says no intelligible words Heuses sign to communicate with his special edu-cation teacher and his parents No one else inhis community uses sign so Ted is limited in hisability to communicate with others

As Tedrsquos IEP Team looks ahead to his entryinto elementary school the Team recognizes thathe will need better communication skills in or-der to participate successfully in the regular class-room His speech therapist has recommendedthat Ted begin to use an AlphaTalker

What funding sources might pay for theAlphaTalker

What case could you make for funding Arethere any obstacles to seeking funding

TEDrsquoS SOLUTIONAt this point Tedrsquos ability to communi-

cate is somewhat primitive Because of his cere-bral palsy he is not able to make conventionalsigns so the gestures he makes are understoodonly by those who know him well A simple elec-tronic communication device may work for Tedbut there are some prerequisite communicationskills he will have to master first Augmentativecommunication devices operate on the principleof choosing icons (abstract symbols) that repre-sent certain basic communications like a cup toindicate ldquoI want a drinkrdquo

In order to make a picturesymbol systemmeaningful and functional for Ted at his youngage his speech therapist began to work on point-to-object and point-to-picture activities WhenTed had mastered point-to-picture activities histherapist made a picture ring for him On thering were picture symbols (icons) for things thatTed might want to say Tedrsquos family his teacherand his classmates began to ask him to use hispictures to explain what he wanted Soon Tedwas using pictures to communicate simple wantsand needs effectively His word ring went withhim everywhere and helped him to ldquotalkrdquo topeople he did not know as well as to friends andfamily members

An unexpected bonus to the picture practiceis that Ted is verbalizing more and his speech hasbecome more intelligible He has even begun tosing An electronic communication device maybe in Tedrsquos future but for now he is learning tocommunicate well with his picture ring and somespoken words

Solution SummaryPoint-to-picture practice

Use of picture ring

32

GLORIAGloria an eighteen year-old with mild cog-

nitive delays and CP is about to finish highschool She has been using a laptop computerand switch access hardware and software in lieuof a pencil and paper to complete work in highschool The equipment and software were pro-vided by the school district through the IEP pro-cess Gloriarsquos current goal articulated in her In-dividual Transition Plan (ITP) as mandated byIDEA is to have a full-time job by the time she is22 She wants to work in an office and woulduse a computer system similar to her currentsetup As she moves into the transition periodthese questions must be addressed

Will the laptop computer she has been usingbe functional for her in the workplace

Will she need to consider new equipmentWhat would influence a decision to purchase newequipment

What funding sources might help Gloria topurchase new equipment

What case should Gloria make for funding

GLORIArsquoS SOLU-TION

Gloria is fortunate to have learned computerand word processing skills while she was inschool Now she must learn ways to transferthese skills into the work setting Laptop com-puters are not typical in offices instead whatGloria is more likely to encounter is a desktopworkstation with computer and printer In or-der to use a standard computer Gloria will needa switch access device and an onscreen keyboardto do word processing and data entry

Since single switch access is necessary forGloria to become employed in an office settingGloriarsquos Vocational Rehabilitation Counselor waswilling to make such a purchase for her Gloriaapplied to be a data processor with a temporaryemployment firm and got the job Gloriarsquos VRcounselor helped her to select switch access hard-ware compatible with most IBM compatible com-puters In her new job Gloria changes office set-tings frequently Each time she moves she takesher switch access device and onscreen keyboardsoftware with her With these portable items sheis able to adapt each new office setting to meether needs Having the right technology has madeGloria an adaptable and successful temporaryoffice employee

Solution SummarySwitch access

Onscreen keyboard software

33

Making Assistive Technology a Part ofChildrsquos Education

The ideal time for a child with a disabilityto learn to use assistive technology is whenthe child is learning all sorts of others skills

in early intervention services preschool and K-12 education Children who are eligible for earlyintervention services under Part C or special edu-cation under Part B of the Individuals with Dis-abilities Education Act (IDEA) are entitled to beevaluated for assistive technology needs and toreceive assistive technology devices and servicesif they are necessary to providing a free appro-priate public education In order for children toreceive the assistive technology to which they areentitled parents must be knowledgeable abouthow assistive technology fits into special educa-tion and the ways that AT can be included in achildrsquos Individualized Family Service Plan (IFSP)or Individualized Education Program (IEP)

ASSISTIVE TECHNOLOGY FOR YOUNG CHILDRENParents are often surprised to learn that

assistive technology can be appropriate for in-fants and toddlers Very young children whohave disabilities that limit their ability to inter-act with the environment by crawling touchingseeing or hearing can benefit from technologythat improves their interactions Federal educa-tion amendments require states to ldquopromote theuse of assistive technology devices and assistivetechnology services where appropriate to en-hance the development of infants and toddlerswith disabilitiesrdquo These amendments furtherrequire states to ldquofacilitate the transition of in-fants with disabilitiesfrom medical care to earlyintervention services and the transition fromearly intervention services to preschool specialeducation or regular education servicesrdquo

When Kayla was an infant her interactionswith the environment were very limited because

she has a genetic condition resulting in abnor-mally short arms and legs She could not turnover or crawl she had difficulty touching andgrasping objects As part of her early interven-tion program Kayla was introduced at the ageof six months to the use of switches When theswitches were positioned correctly she could ac-tivate switch-operated toys or noisemakers Theopportunity to interact with toys opened upKaylarsquos world She soon began to hunt for theswitches and to activate certain toys on com-mand She used the switches to make choicesbetween toys or sounds She became verballymore expressive and began to interact morereadily and more often with her parents and sib-lings

By the time that Kayla was three and readyfor preschool special education she was able tosit up and interact with a computer activated byswitches She could identify objects on the com-puter screen and match those objects to real ob-jects in the world around her At three Kaylacould identify and match some letters and shapeson the computer screen Though limited in hermobility Kayla became an active participant inclassroom activities She could interact withclassmates by playing computer games joiningin at circle time and participating in allpreacademic learning activities

Assistive technology was an integral and nec-essary part of Kaylarsquos early intervention servicesKaylarsquos parents were involved in writing the In-dividualized Family Service Plans (IFSPs) thatoutlined the services Kayla and their familyneeded From the beginning Kaylarsquos family hadthe opportunity to see how assistive technologycould be included in the IFSP and really make adifference in Kaylarsquos education and her life

Kaylarsquos story illustrates how assistive tech-

34

nology can be utilized from an early age and canbe part of the transition from medical treatmentto early intervention and from early interventioninto preschool special education or regular edu-cation Because of the availability of early inter-vention services there is no reason to wait untila child is of school age before trying assistive tech-nology Early use of the necessary technology willenhance a childrsquos development by increasingopportunities to interact with the environment

ASSISTIVE TECHNOLOGY AT SCHOOL AGE ANDBEYOND

When students enter kindergarten and begintheir regular public school years assistive tech-nology can continue to be a part of their specialeducation programs For students who are eli-gible for special education assistive technologymust be provided when it is necessary

(1) to support placement in the least restric-tive environment

(2) to ensure that a student benefits from hisor her education or

(3) to implement the goals and objectives inthe studentrsquos IEP

Needs for assistive technology should be oneof the considerations when a student is assessedto determine eligibility for special education Ifan assessment reveals that a student is eligiblefor special education then the multi-disciplinaryteam should consider assistive technology needswhen making recommendations for the Individu-alized Education Program (IEP) The team shouldanalyze what is required of nondisabled studentsof the same age and determine how many of theserequirements could be completely or partiallyfulfilled by the student being assessed if that stu-dent had access to appropriate assistive technol-ogy

In addition when information is being col-lected for the present level of performance sec-tion of the IEP part of that assessment should bea consideration of whether or not assistive tech-nology is necessary for the student to achieve

educational or social goals benefit from educa-tion or make reasonable progress in the least re-strictive educational setting Whoever is collect-ing the information might experiment withassistive technology applications to determinewhich ones might work for the particular student

Assistive technology should be considered asan option for every IEP Some students of coursewill not require technology but many studentswill benefit from technology that helps them tocompensate for their impairments School dis-tricts are not required to provide all of the pos-sible assistive devices that might be nice to haveor might provide the best possible arrangementsAssistive technology is required however whenits presence enables the student to make reason-able progress toward the goals the IEP Team iden-tifies

HOW TO INCLUDE ASSISTIVE TECHNOLOGY INTHE IEP

Assistive technology can be included in theIEP in a number of ways It may appear as partof the studentrsquos annual goals or short term objec-tives It may also appear in a list of specific ac-commodations which need to be made in orderfor the student to function in the least restrictiveenvironment For example the IEP might includesuch accommodations as the use of word pro-cessing use of a calculator use of a hand heldspell checker and so forth In addition the IEPmay specify that as a related service necessaryfor the student to benefit from his or her educa-tion the student will receive training in the useof assistive equipment like an electronic commu-nication device a power wheelchair or a personalcomputer

WHERE TO PUT ASSISTIVE TECHNOLOGY IN THEIEP

There are three places in the IEP whereassistive technology may appear (1) in the an-nual goals and short term objectives (2) in theenumeration of supplementary aids and servicesnecessary to maintain the student in the least re-

35

strictive educational setting and (3) in the list ofrelated services necessary for the student to ben-efit from his or her education

Assistive technology can be a part of the an-nual goals and short term objectives on an IEPbut there must be a certain degree of specificityin the goal in order for the role of assistive tech-nology to be clear An annual goal for the IEPshould express an estimate of what the studentcan accomplish in a particular domain during thecourse of one year under what conditions theskill is to be developed and what criteria will beused to indicate whether or not the skill has beenlearned

Many times IEP goals are broad vague andtotally nonspecific Such goals are impossible tomeasure and do not give any indication of whatis realistic to expect in terms of the studentrsquos be-havior or skill level in the course of a yearrsquos timeSuch broad goals are not useful in addressingassistive technology The inclusion of assistivetechnology in the IEP requires a degree of speci-ficity so that it is clear how and why the technol-ogy will be used to accomplish a particular goal

An annual goal which includes assistive tech-nology may indicate that the technology will bepart of the conditions under which some aca-demic or social skill will be acquired For ex-ample an IEP goal for a student with a learningdisability in written expression may look like this

10 Using a word processing program with spell-ing checker Shawn will compose three paragraphthemes composed of fifteen or more sentences with 80or better accuracy in the use of spelling punctuationand grammar

Objectives leading to this goal might includepreliminary exploration of the word processingprogram trials to learn effective use of the spell-ing checker drill and practice in writing singleparagraphs to the 80 level of accuracy in spell-ing punctuation and grammar increasing thelength of writing to two paragraphs and theneventually moving to three paragraphs with

gradually increasing degrees of accuracy

Another type of annual goal may address askill which is necessary for using assistive tech-nology Such a goal might appear this way

20 Using an adapted computer keyboard Rachelwill type 12 words per minute with no errors over 10or more consecutive trials

In this case Rachel would spend a year learn-ing keyboarding skills with the goal of achievingat least 12 words per minute with complete ac-curacy For a young student who experiencessome fine motor difficulties this goal would bechallenging but it might be achievable in a yearrsquostime Objectives leading to this goal might in-volve preliminary exploration of the keyboardgradual introduction of the letters and numberson the keyboard practice to build speed and ac-curacy and eventually timed trials until 10 con-secutive trials could be achieved with no errorsat a rate of 12 words per minute or better

Still another type of annual goal might ad-dress a social issue like communication withpeers

30 Using an electronic communication deviceSara will respond appropriately to social inquiries fromclassmates 5 times out of 5 opportunities over 5 con-secutive days

Objectives leading to this goal might includetraining in the use of particular words andphrases on the communication device drill andpractice in responding with the device in struc-tured settings increasing accuracy in respond-ing in structured settings practice in unstruc-tured conversational opportunities and gradualachievement of accuracy in unstructured conver-sational settings with peers

ASSISTIVE TECHNOLOGY AS A RELATED SERVICEAssistive technology can be a related service

just like audiology physical therapy or speech ifit is necessary for the student to benefit from hisor her education For a student to be successfulin using assistive technology he or she must be

36

trained in its use Training to use a computer anaugmentative communication device a PhonicEar or large type viewer or other similar devicescan occur as a related service which supports thestudentrsquos educational program Preparation forthe use of assistive technology can also be workedinto other related services like occupationaltherapy Occupational therapy may involve de-termining correct positioning to take advantageof assistive technology and exercises to preparethe student to use a computer keyboard or a com-munication board

Margo who has muscular dystrophy uses alaptop computer every day in her sixth gradeclass Margorsquos upper body strength is diminish-ing and she is gradually having greater andgreater difficulty using her hands for writing ordrawing Using a computer saves her energy andallows her to keep performing well in the class-room As a related service in her IEP Margo isreceiving occupational therapy designed to pre-pare her for even more adaptations which maybe necessary as she loses more strength Margoand her therapist are experimenting with com-puter access devices (eg switches trackball) andon screen keyboards to determine what methodMargo would like to use when her hands are nolonger strong enough to type on a standard key-board This special training for assistive technol-ogy is written into Margorsquos IEP as a related ser-vice because such training is necessary for her tocontinue to benefit from her education

ASSISTIVE TECHNOLOGY SUPPORT FOR PLACE-MENT IN THE LEAST RESTRICTIVE ENVIRON-MENT

One important feature of assistive technologyis the fact that it can make it easier for studentswith and without disabilities to learn togetherStudents with disabilities are guaranteed the rightto be with nondisabled peers and to receive theireducation in the setting which is the least restric-tive environment In order to be successful in theleast restrictive environment students are to be

afforded whatever supplementary aids and ser-vices are necessary Among the supplementaryaids which may allow a student to remain in aless restrictive environment are a variety ofassistive devices that compensate for disabilityand allow the student to perform educational andsocial tasks Assistive technology is necessary asa supplementary aid if its presence (along withother necessary aids) supports the student suffi-ciently to maintain the placement and its absencerequires the studentrsquos removal to a more restric-tive setting For example if a student with mul-tiple physical disabilities can make progress onhis or her IEP goals in the regular classroom withthe use of a computer and an augmentative com-munication device and cannot make suchprogress in that setting without the devices thenthose devices are necessary supplementary aids

Lyle a fourth grader with cerebral palsy is agood example of a student who thrives in theregular classroom if he has the use of appropri-ate technology Lyle is able to keep up academi-cally with his classmates if he has access to a com-puter with an adapted keyboard and word pre-diction software Lyle has learned to type welland is able to do written assignments in relativelythe same amount of time as other students in hisclass Without a computer Lyle could not keepup at all Handwriting is a laborious task for Lyleand his written product tends to be messy andbarely readable If he could not use a computerLyle would have to rely on others to do hand-writing for him or he would have to do alterna-tive assignments that require no writing

Lyle likes being a regular fourth grader Heis proud of his writing on the computer becausehe is using his own words and learning to editout his mistakes by himself With his computerhe does not need the services of an aide and canbe completely independent in doing his schoolwork

Assistive technology in the form of a com-puter with appropriate software and keyboard

37

adaptations is necessary for Lyle to remain in theregular classroom working independently Thisuse of the computer can be written into his IEPas a supplementary aid which is necessary tosupport Lylersquos placement in the least restrictiveenvironment

Does assistive technology include access toschool buildings

AT certainly can mean devices that provideaccess to school buildings and facilities Oneimportant part of a free appropriate public edu-cation is that students with disabilities are ableto get to school get into the school and use theschool building and facilities Assistive technol-ogy can be used to provide access to the schoolbus classroom playground gymnasium audi-torium lunchroom or the equipment in themAny or all of these needs can be addressed in theIEP

Bus modifications for improved access andappropriate seating can help with transportationto and from school and school activities Doorswalkways handles switches stairs steps can bemodified so that a student with disabilities canuse them as effectively as classmates Appropri-ate seating and playground modifications canhelp include students who have disabilities atclassroom lunchroom and recess times

When an individual graduates from publicschool is it still possible to have assistivetechnology

If individuals benefit from the use of assistivetechnology during their school years the likeli-hood is that assistive technology will be evenmore important for them in adult livingAssistive technology can certainly be part of anindividualrsquos future after high school but it is nec-essary to begin planning for the transition fromhigh school so that the technology and other nec-essary services are available when needed

The earlier a family can estimate their childrsquospost-high school needs including needs for tech-nology the earlier transition planning can begin

Federal legislation says that transition planningcan begin in school as early as ldquo14 or youngerrdquoEach student with a disability who has an Indi-vidualized Education Program (IEP) should havea ldquostatement of transition servicesbeginning nolater than age 16rdquo This means that as early asmiddle school but probably not later than fresh-man year in high school families should begintransition planning

Unlike school services services in the adultworld are not mandated An individual may beeligible for a disability service but not receive itbecause all of the slots are filled or funding is notavailable If an individual does not own his orher own assistive technology devices then partof transition planning will be looking into fund-ing sources that could help with technology pur-chases If technology is necessary for the indi-vidual to become employed it is possible thatVocational Rehabilitation will pay for the devicesas part of an Individual Work-Related Plan(IWRP) Students who go on to postsecondaryeducation at community college vocational-tech-nical schools or universities can expect to be ableto receive certain accommodations for their dis-abilities while on campus Most postsecondaryinstitutions have Student Support Services thathelp with assistive technology needs alternativetesting readers and notetakers

SummaryAssistive technology can be included as an

integral part of a studentrsquos education but par-ents have to be knowledgeable about how to goabout getting assistive technology into theirchildrenrsquos educational plans Assistive technol-ogy can be written into the Individualized Fam-ily Service Plan (IFSP) for infants and toddlers inearly intervention programs and into the Indi-vidualized Education Program (IEP) forpreschoolers and students in grades K through12 Assistive technology can appear in threeplaces in the IEP (a) as part of the goals and ob-jectives (b) as a supplementary aid to support

38

placement in the least restrictive environmentand (c) as a related service Assistive technologycan also be a part of studentsrsquo transition planningas they move from high school into adult pur-suits Assistive technology is available throughVocational Rehabilitation and other adult disabil-ity services but these services are not mandatedTo ensure continued use of assistive technologyit is important to plan ahead and secure fundingfor devices needed in the work or postsecondaryeducation environments

Hints for Parents

If your child is a successful assistive technologyuser begin to save money early in your childrsquos lifemdashjust as you might save for college Gradually accu-mulate enough funding to purchase the kinds of tech-nology your child will need as an adult Technologychanges so fast that it is impossible to predict whatwill be available fifteen years from now But a parentcan be certain that assistive technology of the futurewill be even better than what is available today

EmilyEmily is a seventh grade student who has

learning disabilities She is in regular classes allday in her neighborhood middle school A spe-cial education teacher monitors Emilyrsquos progressand provides the regular classroom teachers withassistance by modifying some of Emilyrsquos assign-ments giving her oral tests helping to organizeEmilyrsquos work and reteaching certain skills asnecessary In elementary school Emily did wellwith the limited amount of support she receivedin the regular classroom In middle school how-ever she is having trouble keeping up with as-signments Emilyrsquos spelling is inaccurate sheoften misspells the same word three or four dif-ferent ways on the same page Her handwritingis very slow and laborious so she spends manyhours each evening working on her homeworkShe has tried tape recording assignments but shefinds this process also to be laborious because itis so time consuming to correct mistakes

It has been recommended that Emily be re-moved from some of her academic classes andreceive instruction in the resource programEmily wants to remain in regular classes but shecanrsquot keep up with the pace

How could assistive technology help Emily

What are her needs

What case could be made for assistive tech-nology for her

39

Emilyrsquos SolutionEmily has reached the point in her educa-

tional career when she cannot keep pace with thedemands of the written work On observingEmily the occupational therapist noted that ittook Emily five times as long as the average stu-dent in her English class to complete written as-signments

Emilyrsquos IEP Team decided she was spendingfar too much time on the handwriting processTo help her with this problem the team agreedthat Emily should learn to use a computer with aword processing program and a voiced spellchecker One period per day Emily goes to theresource room to practice keyboarding and workon longer written assignments During her regu-lar classes Emily uses a portable word proces-sor (eg AlphaSmart) to take notes which shecan print out later in the resource room

These simple solutions allow Emily to speedup her writing time and produce written workthat is easy to correct and edit With technologyto aid her Emily is spending less time on thehandwriting process and more time on thinkingand processing information Her homework timehas been cut in half and Emily is much more re-laxed and confident at school

Solution SummaryKeyboarding training

Use of computer with word processingsoftware

Use of voiced spell checker

Use of portable word processor

BryanBryan is a seventh grader with a neuro-mus-

cular disease that has caused him to lose physi-cal function He is a bright student with excel-lent academic skills Bryan uses a laptop com-puter with a trackball and an onscreen keyboardto do all his written work He navigates skill-fully around the school building using a powerwheelchair Technology has really helped Bryanto fit in and do well at school However now asa young adolescent Bryan is beginning to feelleft out socially He requires so much help withhis physical needs that he has to spend lots oftime with adults Bryan wants to ldquohang outrdquo likethe other kids his age and escape adult scrutinyonce in a while

Bryan is nonverbal He uses a complex so-phisticated electronic communication device toparticipate in class The device is programmedwith phrases that Bryan frequently uses and healso can select icons to create sentences of hisown Bryanrsquos communication device works wellfor him in formal classroom settings but it isbulky and cumbersome to use in casual conver-sation with friends Bryan has come to believethat his communication device is actually a bar-rier to the kinds of informal interactions he wantsto have

Bryan knows that he has the best in technol-ogy and that the equipment he uses was very ex-pensive He doesnrsquot want to appear ldquogreedyrdquo ordemanding so he has not told his parents abouthis dissatisfaction with his ability to communi-cate One of Bryanrsquos friends Michael howevernoticed that Bryan was acting pensive and un-usually quiet Michael gently coaxed the truthout of Bryan and offered to help his friend thinkof a new way to ldquotalkrdquo that would provide himwith more flexibility and independence

40

Bryanrsquos SolutionWhen Bryan and Michael put their heads to-

gether they came up with lots of ideas The onethey settled on as the most feasible involved us-ing the laptop that Bryan already had The laptophad some advantages because it was small andportable and Bryan already knew how to use itvery well In a catalog of special needs softwarethe friends found communication software thatoperated on an icon system and the price wasright--around $100 With communication soft-ware installed on the laptop Bryan had asimplermore portable device for talking in ca-sual settings

Next Michael asked his father to help themmake a tray for Bryanrsquos wheelchair that wouldhold the laptop and fold down beside the chairout of the way when not in use Michaelrsquos dadcame up with a clever tray on hinges that foldedto the side The laptop fastened to the tray withwide rubber bands A handle on the tray allowedBryan to raise and lower the tray as needed

In addition to his laptop Bryan also neededa device for quick greetings and spontaneous re-torts Bryan and Michael chose a programmableswitch with the capacity to record up to 12 mes-sages Bryan could operate the switch quickly byhitting it with his elbow He and Michael had agreat time recording messages suitable for talk-ing to their friends or to girls

What Bryan found out was that he neededmultiple ways to communicate so that he couldcustomize his electronic speech to fit the settingand the occasion For a relatively small financialinvestment Bryan and Michael were able to ex-pand communication possibilities for Bryan andallow him greater control and personal choiceabout what he said how he said it and to whom

Solution SummaryCommunication softwareDrop-down wheelchair trayProgrammable switch

TracyTracy is a man in his mid-thirties who has

been blind from birth Since graduating fromcollege he has held a series of entry level jobs atminimum wage and without benefits Tracy isfrustrated by the lack of challenge in the jobs hehas had he would like to have a managerial po-sition with some opportunities for advancementbetter pay and benefits

Currently Tracy is working at a Pizza Hutrestaurant where he prepares pizzas for the ovenHe enjoys his co-workers and regular customersbut Tracy wants more A management traineeopening has been announced in the companynewsletter and Tracy decides to apply This newposition involves taking pizza orders over thetelephone and sending the order via computerand modem to the appropriate Pizza Hut outletwhere the pizzas will be made Having madeevery possible type and size of pizza Tracy isvery familiar with the options But how couldhe operate the computer and record orders asthey come in over the telephone Would he havea chance for this job which could be his first stepup

41

Tracyrsquos SolutionTracy and his Vocational Rehabilitation Coun-

selor filled out the job application for the posi-tion at Pizza Hutrsquos central ordering facility andTracy was called to set up an interview Prior tothe interview Tracy and his job counselor wentto the central ordering facility for Pizza Hut tostudy aspects of the job and to determine if tech-nology could assist Tracy to perform the essen-tial job functions The job involved the follow-ing steps (1) greeting the customer and takingdown customer information (2) asking a seriesof questions about the customerrsquos order (egtype size toppings) (3) simultaneous record-ing of the order via computer and (4) sendingthe order to the appropriate Pizza Hut outlet

After studying the process of taking ordersTracy and his counselor decided upon the follow-ing technology

(a) A computer compatible with the Pizza Hutnetwork

(b) Voiced software so that Tracy couldldquohearrdquo what he was typing

(c) A telephone headset to listen to the cus-tomer with one ear

(d) an ear piece to listen to the computer

At his interview for the job Tracy explainedhis qualifications for the position--college degreeexperience with Pizza Hut He also told the in-terview team about how technology would al-low him to do the job as efficiently and effectivelyas other workers

The interview team members were impressedby Tracyrsquos initiative and his work ethic Theychose him over several other qualified candi-dates Though it took some detective work toput together a computersoftware package com-patible with Pizza Hutrsquos system Tracy was ableto do it

From the first day on the job Tracy knew he

was going to like it better than anything he haddone before Listening to the computer and thecustomer simultaneously was challenging at firstbut soon Tracy had mastered the process Afterthree months in his new position Tracy wasasked to become the manager for his shift Nowhe hires and trains new order clerks schedulesworkers and evaluates their job performanceTracy has what he wanted--a managerial posi-tion better wages and a future with the com-pany

Solution SummaryCompatible computer terminal

Voiced software

Telephone headset

Ear piece for computer

42

Advocating forAssistive Technology

In the area of Assistive Technology mdash just as in so many areas of need mdash parents must betheir childrenrsquos best advocates Federal and

state laws support providing assistive technol-ogy to individuals with disabilities but theselaws are only meaningful when parents knowabout them and can use legal processes to securetheir childrenrsquos rights Here are just a few of thelaws on which parents can rely when advocat-ing for assistive technology for their children

THE AMERICANS WITH DISABILITIES ACT OF1990

The Americans with Disabilities Act (ADA)proposes to eliminate ldquodiscrimination againstindividuals with disabilitiesto address the ma-jor areas of discrimination faced day-to-day bypeople with disabilitiesrdquo The ADA applies spe-cifically to the areas of employment public ac-commodations and government functions Inthese areas the ADA requires that reasonable ac-commodations be made so that people with dis-abilities can have an equal opportunity to par-ticipate in employment opportunities public ac-commodations and government functions TheADArsquos definition of ldquoauxiliary aids and servicesrdquoits mandates for ldquoacquisition or modifications ofequipment and devicesrdquo and ldquoreasonable accom-modationsrdquo support the provision of assistivetechnology devices and services to individualswith disabilities

THE REHABILITATION ACT OF 1973Section 504 of the Rehabilitation Act requires

that any ldquoprogram or activity receiving Federalfinancial assistancerdquo comply with non-discrimi-nation rules Section 504 Regulations require thatpublic schools provide students who have dis-abilities an educational opportunity equal to theeducational opportunity provided to students

without disabilities Section 504 also uses theterm ldquoreasonable accommodationsrdquo which canmean the provision of assistive technology de-vices and services

THE INDIVIDUALS WITH DISABILITIES EDUCA-TION ACT (IDEA)

The Individuals with Disabilities EducationAct (IDEA) requires free appropriate public edu-cation (FAPE) for students with disabilities IDEAmandates education in the least restrictive envi-ronment requires schools to use supplementaryaids and services special and related services tohelp assure that students with disabilities par-ticipate in and benefit from public educationAssistive technology is specifically mentioned inIDEA as a service which school districts may haveto provide in order for a student with disabilitiesto benefit from special education

THE CARL PERKINS ACTThe Carl Perkins Act assures that Vocational

Education programs in public schools are madeaccessible to students with disabilities The lawassures supplementary services including class-room curriculum and equipment modificationssupportive personnel instructional aides and in-structional devices

PARENT RESPONSIBILITIESIn order to be effective advocates for their

children parents need to familiarize themselveswith all the laws that support the provision ofassistive technology Copies of the laws and theirregulations are available from the offices of mem-bers of the House of Representatives and the Sen-ate

Besides knowing the law parents must par-ticipate actively in developing plans for theirchildrenrsquos education that include assistive tech-nology when it is needed Parents must attend

43

IFSP and IEP meetings and be prepared to workcooperatively with other team members Whena parent questions an assistive technology evalu-ation or an IEP Team recommendation the par-ent must be prepared to follow-up on those ques-tions including using due process rights whennecessary

What should a parent do when an agencyrefuses to pay for assistive technology that achild needs

Agencies like early intervention programsand school districts are mandated to provideassistive technology if the need for technology isin the childrsquos written plan If one of these agen-cies refuses to pay for needed technology then aparent must consider using due process rightsIn early intervention services the parent wouldfollow the appeal process laid out by the leadagency for Part C When school district servicesare involved the parent can file a complaint ifservices in the IEP are not provided or can askfor a due process hearing if the parent and theschool district disagree about the need forassistive technology If a parent disagrees withthe results of an evaluation for assistive technol-ogy the parent can ask for an independent evalu-ation at school district expense

SummaryOverall getting the devices and services for

children with disabilities means that parents mustbe part of the planning team at every level of theirchildrenrsquos education It means talking with otherfamilies and users of assistive technology aboutdevices and services learning how they foundthe best technology and figuring out where togo when resources are few Getting assistive de-vices and services is not always an easy job Buthelp is available Working with professionalstalking with consumers and other families par-ents can find the best avenues for providing theirchildren with the assistive technology they needIn the end the effort is worth it because assistive

technology is not just a civil right guaranteed bylaw it is also a means to achieve human rights togrow up happy independent and self-sufficientas possible

Hints for Parents

When advocating for your child in the special edu-cation arena donrsquot forget the following facts aboutassistive technology and the IEP

bull Assistive technology needs must be con-sidered along with a studentrsquos other edu-cational needs

bull Needs for technology must be identifiedon an individual basis

bull Identification of technology needs mustinvolve parents the student when appro-priate and a multidisciplinary team

bull Parents or other IEP Team members can askfor additional evaluation or an indepen-dent evaluation to determine assistive tech-nology needs

bull When an evaluation is being conductedconsider mobility fine-motor skills com-munication and alternatives to traditionallearning approaches

bull Lack of availability of equipment or costalone cannot be used as an excuse for de-nying assistive technology services

bull If included in the IEP assistive technologyservices and devices must be provided atno cost to the family

bull Parents always have the right to appeal ifassistive technology services are denied

44

More Questions and Answers

A re schools required to pay forassistive technology devices andservices

It is the responsibility of the school dis-trict to provide for the equipment services orprograms identified in the IEP The school dis-trict may pay for the equipment service or pro-grams itself utilize other resources to provide orpay for the device or utilize private insurancefunds Medicaid or other sources of funds as longas the device or services identified in the IEP areprovided at no cost to the parent Private insur-ance or Medicaid may be used ony if the parentagrees

Can schools require the parents to payfor an assistive technology device orservice identified in the studentrsquos IEPor require the parents to use theirown private health insurance to payfor the device or service

No The ldquofreerdquo in FAPE means that parentsof students with disabilities who require assistivetechnology devices or services do not have to payfor these items As stated in IDEA and its regu-lations all special education and related servicesidentified in the studentrsquos IEP must be providedldquoat no cost to the parentrdquo The term ldquofreerdquo is in-terpreted broadly and goes far beyond the simplepaying of deductibles and co-payments Thecourts have interpreted ldquofreerdquo to apply to butnot be limited to future insurability depletionof maximum lifetime caps raised premiums dis-continuation of policies and preexisting condi-tion exclusions If the family agrees to allow theschool to access their Medicaid or private insur-ance this decision must be strictly voluntary onthe part of the family

How can school districts use Medicaidfunds to purchase assistive technologydevices

If Medicaid is capitated in any way concern-

ing its use for assistive devices school districtsmust request from parents the right to use Med-icaid funds However parents are not obligatedto use their Medicaid funds to purchase devicesor services used at school With permission aparentrsquos private insurance must be accessed be-fore Medicaid can be used for assistive technol-ogy devices Medicaid regulations vary some-what from state to state so it is wise to consultthe state Medicaid Service Bureau before mak-ing any assumptions about Medicaid and thepurchase of assistive technology

Are there other options for schools toconsider in lieu of purchasing theassistive technology device

Yes There are times when the outright pur-chase of equipment or devices is not necessaryor even advisable In such instances schoolsmight consider rental or long-term lease optionsThere are certain advantages to renting or leas-ing depending on the individual needs of thestudent For example renting equipment mightbe a reasonable strategy if the student is expectedto improve or deteriorate in a short period of timeor when it is necessary to try out the equipmentbefore purchase Long-term leasing or leasepurchase agreements also have potential benefitsfor schools which include no obligation on be-half of the school to purchase the device abilityto return leased equipment and thus reduce ob-solete inventory flexible leasing terms use ofequipment without a lump-sum purchase up-grading of equipment as more improved tech-nology becomes available and upgrading ofequipment as the studentrsquos needs change

Isnrsquot assistive technology just acrutch Wonrsquot students become toodependent on technology and notlearn to use the skills they have

Assistive technology should be used as sup-port for access learning and performing daily

45

tasks In general assistive technology is appro-priate when it compensates for disabilities so thatthe individual can function as normally as pos-sible If assistive technology is necessary for astudent to have access to educational opportuni-ties or to benefit from education then it is not aldquocrutchrdquo but a legitimate support Some skillsare too laborious or taxing to accomplish at a rateor with degree of proficiency to allow for partici-pation in the least restrictive environment Withassistive technology the student can participatemore fully and more closely approximate the lev-els of achievement and interaction of his or herpeers In general the use of assistive technologyenhances function and increases skills and op-portunities Though a student may be dependentupon a particular device in order to perform skill-fully denying the device denies the student anopportunity ever to achieve success at the levelof his or her potential

When is assistive technology appropri-ate

Assistive technology may be considered ap-propriate when it does any or all of the follow-ing things

bull Enables students to perform functions thatcan be achieved by no other means

bull Enables students to approximate normalfluency rate or standardsmdasha level of ac-complishment which could not beachieved by any other means

bull Provides access for participation in pro-grams or activities which otherwise wouldbe closed to the individual

bull Increases endurance or ability to persevereand complete tasks that otherwise are toolaborious to be attempted on a routine ba-sis

bull Enables students to concentrate on learn-ing tasks rather than mechanical tasks

bull Provides greater access to information

bull Supports normal social interactions with

peers and adults

bull Supports participation in the least restric-tive educational environment

Who owns the special equipment thatis purchased for students

If the school district purchases the equipmentthe equipment belongs to the district Someschool districts designate that a particular deviceis to be used by a specific student during the timewhen that device remains appropriate for thatstudent Other districts have ldquopoolsrdquo of assistivedevices and distribute them for use by a varietyof students The distribution and use of devicesis under the districtrsquos control as long as the needsdescribed in studentsrsquo IEPs are being met

If devices are purchased for a particular stu-dent using that studentrsquos Medicaid funds or pri-vate insurance then the device belongs to the stu-dent and is meant for the exclusive use of thatstudent

When a student moves from one levelof schooling to another like elemen-tary school to middle school does thedevice follow the student

If an assistive device is necessary in order tofulfill the requirements of a studentrsquos IEP such adevice must be provided in whatever school thestudent attends The same device may not nec-essarily follow the student from one school toanother but a comparable device which fulfillsthe IEP requirements would have to be providedin the new school that the student attends

If a family moves from one schooldistrict to another can a studentrsquosassistive technology go along

Devices bought by the school belong to theschool not the student who uses them When afamily moves from one school district to anotherthe equipment the student has been using doesnot automatically move to the new school

Assistive equipment can go with a studentto a new school if the sending school district

46

agrees to sell or give the device to the family orthe new school district

If the device was purchased by the familythrough the familyrsquos private health insurance orby Medicaid for this particular student then thedevice belongs to the student and can go withthe student to a new school district

What happens to assistive technologydevices when students leave the schoolsystem at graduation

If the school district purchased the device thedevice is the property of the school The schoolcould keep the device for use by other studentssell it or decide to transfer the device to anotherdistrict or loan program If the family or anotherfunding source purchased the device it is theproperty of the student and the family

If a piece of assistive technology is nolonger needed or relevant to a studentand the device was paid for by Medic-aid or private insurance can it bedonated for another studentrsquos benefit

Yes it is a parental decision The parentscould donate the device to the school for use byother students with disabilities or to some otherorganization which loans out equipment

Can assistive devices be insured

Many school district liability policies willcover devices purchased by the district for stu-dent use Devices purchased by other fundingsources may or may not be covered while onschool premises or involved in school activitiesIt is important for school staff to investigate thedistrictrsquos property insurance to determine whatthe policy currently covers and whether or notthe policy insures against loss or damage ofassistive devices

Parents who own assistive devices that areused at home and at school may also wish to pur-chase home owners or rentersrsquo insurance with aspecial rider that covers damage to or loss of thedevice

Who is responsible for the repair and

maintenance of assistive devices

In general the school district is responsiblefor repair and maintenance of assistive devicesused to support educational programs describedin the IEP or covered by Section 504

If a device is broken and is beyondrepair who replaces the broken de-vice

If an assistive device is necessary for thestudentrsquos IEP to be implemented then the schooldistrict will have to replace a broken lost or sto-len device

If a device is broken and sent off forrepairs must the school district sup-ply a substitute device until the origi-nal device is returned

If the assistive technology device is vital tothe studentrsquos daily special education program itis not reasonable for the student to be without adevice for long periods of time If a device isgoing to be unavailable for more than a day ortwo the district should provide a backup ma-chine which allows the student to continue work-ing on IEP goals

Is the school district obligated totrain substitute teachers and aides tooperate assistive technology devices

Again if the assistive technology device isvital to the studentrsquos daily special education pro-gram it is not reasonable for the student not tobe able to use the device for long periods of timebecause a substitute is teaching the class If thesubstitute is only going to be in the classroomfor a day or two it is probably not necessary toprovide elaborate training However if the sub-stitute is going to be in the classroom for an ex-tended time training should be provided

Must school districts allow students totake assistive devices home on schoolnights to do homework Over week-ends During school vacations Overthe summer

In many cases it is desirable for students to

47

have the opportunity to use the same assistivetechnology devices at home and in school Forexample when a student is completing home-work assignments assistive technology may benecessary to produce the type of product that isrequired Some school districts have policieswhich allow the devices to go home with the stu-dents overnight on weekends or during vaca-tion or summer periods In general these kindsof policies are a local district matter and may bedetermined according to local district needs Ifhowever a studentrsquos IEP includes a provisionwhich says the student is to have access to anassistive device both at school and at home thenthe school district would be obligated to allowthe student to take a device home or provide twodevices one for home use and one for school

What professionals are consideredqualified to assess a student in thearea of assistive technology

Because assistive technology is such a newfield there are no national standards and few lo-cal or state standards for licensing or certificationfor specialists in assistive technology Howeverschool districts often have professionals who havereceived training in conducting assistive technol-ogy evaluations and are able to provide the ser-vices identified in the IEP If a district does nothave personnel who are knowledgeable in con-ducting such evaluations the district can arrangefor such services from other knowledgeable pro-vidersndash such as Independent Living Projects Al-liance for Technology Access Centers or Tech ActProjects

How can one distinguish betweenassistive technology and personalitems (eg wheelchairs hearing aidseyeglasses crutches)

Currently IDEA does not make a clear dis-tinction between assistive technology devices andpersonal items This confusion stems in large partfrom IDEArsquos broad definition of assistive technol-ogy For example if a student with a disability

needs eye glasses in order to obtain FAPE thenthe school district is obligated to provide themat no cost to the parents In general howeverschool districts do not purchase personally pre-scribed devices such as hearing aids or glasses

Who determines how assistive tech-nology will be purchased and withwhat available funding resourcesmdashtheIEP Team or school administration

Once the IEP team makes the determinationthat assistive technology must be provided aspart of the studentrsquos IEP it is the responsibilityof school administration to determine how theassistive technology will be provided and withwhich funding sources

Is a school district responsible forproviding ldquostate of the artrdquo equip-ment for a student

No The school district need provide onlyappropriate technology in order to meet thestudentrsquos needs as described in the IEP The de-cision as to what type of assistive technology isappropriate should be based on the assistive tech-nology evaluation recommendations and IEPteam decision There may be ldquodevicesrdquo or fea-tures of equipment which may be nice for the stu-dent to have but if they are not necessary forFAPE the school district is not obligated to pro-vide them If a specific device is necessary toensure FAPE and no other device can meet thestudentrsquos needs then the district must providethe required device even though it is costly If aless expensive device would accomplish the samegoals the IEP team is under no obligation tochoose a more expensive option

If a student needs a computer can aschool owned computer be used in thelab or classroom

Yes a school owned computer can be used ifthe student has access to the equipment when heor she needs it If the student does not have thenecessary access then the appropriate equipmentshould be purchased for the studentrsquos use

48

Can school district administratorsinstruct personnel not to includecostly assistive technology devices inthe IEP

IEP teams are charged with the responsibil-ity for determining a studentrsquos need for assistivetechnology devices and services and for specify-ing those devices and services Therefore it isimportant that IEP teams are clearly informed oftheir responsibility to determine if a studentneeds a device and the need for an assistive tech-nology evaluation to assist in making the deter-mination A school district may not have a policywhich prevents IEP teams from identifying astudentrsquos need for assistive devices or services

How does assistive technology getintegrated into the curriculum

The IEP team needs to discuss how the de-vice will be used by the student and how it willbe integrated into the curriculum The IEP teamshould identify on the IEP how the device willbe used by the student in the classroom Thisinformation should be shared with the generalclassroom teachers so that they are aware of howit is to be used

How can assistive technology be pro-vided from year to year with a degreeof continuity

As part of the annual review of the IEP a pointshould be made to devise ways to communicatewith next yearrsquos teachers about the technologythe student uses and how it should be integratedinto the curriculum Teachers who are new toworking with the student who uses technologyshould be provided training if they are unfamil-iar with the device and its use Training for teach-ers and support staff should be written into theIEP as a related service

Can an assistive technology device beused by more than one student

Yes if the device is the property of the schooldistrict and if all of the students using the devicehave access to the equipment when they need it

Can an independent evaluation berequested to address assistive tech-nology

Yes The school district is required to evalu-ate a student in all areas of suspected disabilityincluding if appropriate evaluating the studentrsquosneed for assistive technology A parent has theright to an independent educational evaluationat public expense if the parent disagrees with anevaluation obtained by the school district How-ever the school district may initiate a due pro-cess hearing to show that its evaluation is appro-priate If the final decision is that the evaluationis appropriate the parent still has the right to anindependent educational evaluation but not atpublic expense If the parent obtains an inde-pendent educational evaluation at private ex-pense the results of the evaluation (a) must beconsidered by the school district in any decisionmade with respect to the provision of FAPE tothe child and (b) may be presented as evidenceat a due process hearing

What is a product system

A product system is more than one piece ofequipment working together to produce a resultFor example an FM system that works in con-junction with a studentrsquos hearing aid is a prod-uct system

Can the school district require a stu-dent to bring a personally ownedassistive device such as an augmenta-tive communication system or laptopcomputer to school in order to doschoolwork

No However the family may wish the childto use his or her equipment in school since thechild may be more familiar or comfortable withit The IEP team should decide who is respon-sible for repair and maintenance of family owneddevices

Is it sufficient for a school district tosupply access to a district-ownedcomputer but provide no software

49

that is appropriate for the student touse

Just providing access to a computer does notfulfill the districtrsquos obligation to provide assistivetechnology to support FAPE The educationalaspect of the computer is very much related tothe software that the student uses If no appro-priate software is available then the student can-not pursue the IEP goals

50

Appendix

GlossaryASSISTIVE TECHNOLOGY any sort of aidincluding computers switches calculators spell-ing devices communication devices and voicesynthesizers which is used to help an individualperform some task of daily livingALTERNATIVE KEYBOARD may include en-larged reduced varied key placement one-handed braille chordic or any other device forentering text on a computerAUGMENTATIVE COMMUNICATION anydevice (electronic or otherwise) to enhance com-munication for a person with limited speechBRAILLE EMBOSSER a printer for producingbraille output either manually or when connectedto a computer When printing standard text froma computer it must first be translated into brailleBRANCHING describes the process of choos-ing among a sequence of choices or actions toproduce another sequence of choices This pro-cess is used in the ldquoscanningrdquo method of accessCD-ROM ldquoCompact Disk Read-Only Memoryrdquorefers to the 4-inch silver disks that typically hold700 megabytes of digital information and theplayers that access the information on these disksCURSOR either the flashing vertical or horizon-tal line on a computer screen that indicates theinsertion point for text or the arrow or I-beamthat indicates the position of the mouse pointeron the computer screenDESK ACCESSARY a small utility program thatruns on a computer and may be accessed fromany program at any time (such as a calculator)DRILL AND PRACTICE presents questionsrepetetively but is not a tutorial Software thatis only drill and practise doesnrsquot necessarily teachthe concepts needed to answer the questions pre-sented

ENVIRONMENTAL CONTROL any type ofdevice that an individual may use to control theirenvironment (lights appliances TV telephoneetc) This may include anything from simplereachers or sticks to computers and voice-acti-vated electronic systemsFM SYSTEM a local wireless broadcast systemthat consists of a microphone and transmitter forthe speaker and ldquowalkman-likerdquo receivers withheadphones for listeners with hearingimpairements or attention disordersHIGH TECH use of electronics or computers asa solutionICON a small computer graphic that appears onthe computer screen and may represent differ-ent types of objects (files or applications) or ac-tions depending on the context Use the mousepointer to click on icons that open files or per-form other actionsINDIVIDUAL FAMILY SERVICE PLAN (IFSP)the written document which defines the earlyintervention services provided to the child andfamily The program is designed to meet theneeds of the child and the family and is based onfamily-identified prioritiesINDIVIDUALIZED EDUCATION PROGRAM(IEP) a written plan specifying instructionalgoals and any special education and related ser-vices a student may need which must be writ-ten and reviewed annually Included are (1) thepresent educational levels of the student (2) astatement of annual goals including short-termobjectives (3) a statement of specific services ifneeded (4) the programs (5) the date when spe-cial services are to begin and the expected dura-tion of these services and (6) the tests and otherrequirements or information used to guage thestudentrsquos progress to determine if the instruc-tional objectives are being metINPUT the information that is transmitted to acomputer from a keyboard mouse or other in-

51

put deviceKEYBOARD a device for inputing text and com-mands to a computerKEYGUARD a plexiglass or other cover for akeyboard with holes for the individual keys Itallows more precise selection of keys for an indi-vidual with fine motor difficultiesKEYPAD a small keyboard with a 10-key setupfor numeric input or it may also be used as a con-trol for a screen-reader programLAPTOP a portable battery-powered computerthat is typically the size of a 3-ring binder weighs5-10 pounds and consists of a screen keyboardand disk-drivesLASER DISCS large (12-inch) CD-ROMs thatnormally contain moviesLOW TECH indicates use of low cost non-elec-tronic solutionsMACRO a simple short program that performsan action on a computer They are usually cre-ated by recording the keyboard andor mouseinput and storing them as an icon or key combi-nationMEGABYTE 1000 X 210 bytes of informationwhich basically means over one million key-strokes of computer storage (about 10 novels)MORSE CODE a direct method for computerinput using one to three switches and coded in-put to replace the keyboard and mouseMOUSE the name given to the pointing deviceused to control graphical user interfaces (GUI) ofmodern personal computersONSCREEN KEYBOARD a software programthat places the keyboard on the screen of the com-puter and may be accessed using a mouse or otherpointing device This is ideal for individuals whocannot use a regular keyboard but can use sometype of pointing deviceOPTICAL CHARACTER RECOGNITION(OCR) a process that utilizes special computersoftware to convert the scanned image of text intoactual text that may be edited by a word proces-sorOUTPUT computer-generated information for

the user This may be printed output from aprinter visual information from the screen orsounds from speakersSCANNER an electronic copier connected to acomputer Scanners are used to input drawingspictures or printed text into the computerSCANNING has nothing to do with the elec-tronic copier above It is another method for ac-cessing a computer or communication deviceusing one or more switches Scanning involvespresenting a group of choices cycling amongthem and making choices by activating a switchSCREEN READER software that reads text ona computer screen using a speech synthesizerThis allows individuals with visual impairmentsor other print disabilities to access text on thecomputer screenSIMULATION software that simulates real-world situations on a computer This may rangefrom a joystick trainer for driving an electricwheelchair to running citiesSPEECH SYNTHESIZER hardware or softwarefor producing electronic human speech on a com-puterSPELL CHECKER utility for checking the spell-ing in a documentSTICKY KEYS software or mechanical utility forallowing typing of multiple keystrokes with onefinger (using the shift or other modifier keys)SWITCH a device that is like a single button ofa keyboard or mouse Switches may be used byan individual with servere motor difficulties byany controllable muscle in their body (headhand toe eye breath etc) to operate any typeof computer communication or environmentalcontrol deviceSWITCH INTERFACE black box that connectsto a computer or other device that has plugs forswitchesTDD a text telephone used for communicatingin typed text over a phone line A TDD has akeyboard and text display or small printer Bothparties who are communicating over a phone linemust have TDDs

52

TOUCH WINDOW a computer input devicethat uses a touch-sensitive transparent windowplaced on the computer screen It performsmouse functions with a finger or stylus directlyon the screenTRACKBALL another replacement for themouse pointing device that uses a rolling ball toperform mouse movementsTUTORIAL teaches concepts presents informa-tion as opposed to simple drill and practiceVOICE RECOGNITION computer softwareand microphone that allows input and controlwith voice commandsWORD PREDICTION productivity softwarethat increases typing speed for one-finger typistsand others by predicting and choosing completewordsWORD PROCESSOR software for inputing andformatting textUSER person using a computerUTILITY software for adding function or per-forming housekeeping tasks on a computer

53

DocumentsSCHRAG LETTER ON ASSISTIVE TECHNOLOGY

August 10 1990

Dear Ms Goodman

This is in response to your recent letter to the Office of Special

Education Programs (OSEP) concerning the obligations of public

agencies under Part B of the Education of the Handicapped Act

(EHA-B) to provide assistive technology to children with handi-

caps

Specifically your letter asks

1 Can a school district presumptively deny assistive technol-

ogy to a handicapped student

2 Should the need for assistive technology be considered on

an individual case-by-case basis in the development of the

childs Individual Education Program

In brief it is impermissible under EHA-B for public agencies

(including school districts) to presumptively deny assistive tech-

nology to a child with handicaps before a determination is made

as to whether such technology is an element of a free appropriate

public education (FAPE) for that child Thus consideration of a

childs need for assistive technology must occur on a case-by-

case basis in connection with development of a childs individual-

ized education program (IEP)

We note that your inquiry does not define the term assistive

technology and that the term is not used either in the EHA-B

statute or regulations The technology Related Assistance for

Individuals with Disabilities Act of 1988 PL 100-407 contains

broad definitions of both the terms assistive technology device

and ldquoassistive technology service See Section 3 of PL 100-

407 codified as 29 USC 2201 2202 Our response will use

assistive technology to encompass assistive technology ser-

vices and ldquoassistive technology devices

Under EHA-B State and local educational agencies have re-

sponsibility to ensure that eligible children with handicaps receive

FAPE which includes the provision of special education and re-

lated services without charge in conformity with an IEP 20 USC

1401(18) 34 CFR S3004(a) and (d) The term special educa-

tion is defined as specially designed instruction at no cost to

the parent to meet the unique needs of a handicapped child 34

CFR S30014(a) Further related services is defined as includ-

ing transportation and such developmental corrective and other

supportive services as are required to assist a handicapped child

to benefit from special education 34 CFR ss33013 (a)

The EHA-B regulation includes as examples 13 services that

qualify as related services under EHA-B See 34 CFR S30013

(b)(1)-(13) We emphasize that this list is not exhaustive and

may include other developmental corrective or other supportive

servicesif they are required to assist a handicapped child to

benefit from special education 34 CFR S30013 and Comment

Thus under EHA-B assistive technology could qualify as spe-

cial education or related services

A determination of what is an appropriate educational program

for each child must be individualized and must be reflected in the

content of each childs IEP Each childs IEP must be developed

at a meeting which includes parents and school officials 34 CFR

S300343-300344 Thus if the participants on the IEP team de-

termine that child with handicaps requires assistive technology in

order to receive FAPE and designate such assistive technology

as either special education or a related service the childs IEP

must include a specific statement of such services including the

nature and amount of such services 34 CFR S300346(c) App

C to 34 CFR Part 3000 (Ques 51)

EHA-Bs least restrictive environment (LRE) provisions require

each agency to ensure (t)hat special classes separate school-

ing or other removal of handicapped children from their regular

educational environment occurs only when the nature or severity

of the handicap is such that education in regular classes with the

use of supplementary aids and services cannot be achieved sat-

isfactorily Part 121a 42FR 4251113 (August 23 1977)

Assistive technology can be a form of supplementary aid or ser-

vice utilized to facilitate a childs education in a regular educa-

tional environment Such supplementary aids and services or

modifications to the regular education program must be included

in a childs IEP Id Appendix C to 34 CF art 300 (Ques 48)

In sum a childs needs for assistive technology must be deter-

mined on a case-by-case basis and could be special education

related services or supplementary aids and services for children

with handicaps who are educated in regular classes

I hope the above information has been helpful If we may pro-

vide further assistance please let me know

Sincerely

Judy A Schrag EdD

Director Office of Special Education Programs

54

INDIVIDUALS WITH DISABILITIES EDUCATIONLAW REPORT

Cite as 18 IDELR 627

Digest of Inquiry

(Inquirerrsquos Name Not Provided)

(Date Not Provided)

bull Is a school district responsible to provide assistive

technology devices for home use

bull May a school board overrule a determination by an IEP

team that a child with a disability needs access to an

assistive technology device at home

bull What is the time limit on implementation of an IEP

Digest of Response

(November 27 1991)

Assistive Technology Devices May Be Required for Home Use

If an IEP team determines that a child with a disability needs

access to an assistive technology device at home as a matter of

FAPE then the school district must provide the device for home

use in order to implement the childrsquos IEP

School Board May Not Change IEP Teamrsquos Determination

Under Part B a school board has no authority to unilaterally

change any statement of special education or related services

contained in an IEP including a statement of a childrsquos need to

have access to an assistive technology device at home Without

reconvening the IEP team the school board may not change the

IEP and the school district is obligated to implement the IEP re-

quirements regardless of the school boardrsquos objections

IEPs Must Generally Be Implemented

Under Reg 300342(b) an IEP must be in effect before the

provision of special education or related services and must be

implemented as soon as possible following the conclusion of the

IEP meeting(s) In accordance with Appendix C to the Part 300

regulations an IEP should generally be implemented without de-

lay after being finalized although a reasonable delay may be per-

missible in limited circumstances

__________________

Text of Inquiry

I would like to have a copy of the policy classification on

Assistive Technology

I also have a question to ask regarding Assistive Technology

such as a closed circuit TV

My daughter uses a CCTV in school and it is on her IEP

program My daughter is visually impaired The initial request

was made by me the parent to the appropriate people involved

in her education and discussed and approved by the committee

on an individual basis

My question is I would like to make the request to the ap-

propriate officials for another CCTV for home use to accomplish

the same results at home as is done in school (For homework

reading books any assignments from school)

Another question is If the committee approves this request

it will go to School Board for approval I would like to know what

happens if the School Board doesnrsquot approve the proposal Is it

impartial hearing time

Thank you for your assistance in this matter

Any information regarding Assistive Technology Informative

for school and home use would be greatly appreciated

Is there a time limit on implementation of yearly updated

IEPs[] Every year I have long delays on implementation of board

approved IEPs[]

Text of Response

This is in response to your recent letter to the Office of Spe-

cial Education Programs (OSEP) requesting a copy of any OSEP

policy clarifications on assistive technology as well as asking spe-

cific questions concerning the assistive technology needs for your

daughter You also asked a question about the time limits for

implementation of an individualized education program (IEP)

In response to your request I am enclosing a copy of OSEPrsquos

August 10 1990 letter to Ms Susan Goodman concerning the

obligations of public agencies under Part B of the Individuals with

Disabilities Education Act (Part B) formerly cited as Part B of the

Education of the Handicapped Act to provide assistive technol-

55

ogy to children with disabilities along with some additional infor-

mation on assistive technology and a copy of the Part B regula-

tions I would also like to provide you with OSEPrsquos response to

each of your specific questions as stated below

I would like to make the request to the appropriate officials

for another CCTV for home use to accomplish the same

results as is done in school (For homework reading books

any assignment from school)

The IEP which must be developed at a meeting that includes

parents and school officials must contain among other things a

statement of the specific special education and related services

to be provided to the child See 34 CFR sectsect 300343-300346 As

stated in OSEPrsquos letter to Ms Goodman if the IEP team deter-

mines that a child with disabilities requires assistive technology in

order to receive a free appropriate public education (FAPE) and

designate such assistive technology as either special education

or a related service the childrsquos IEP must include a specific state-

ment of such services including the nature and amount of such

services See 34 CFR sect 300346(c) App C to 34 CFR Part 300

(Ques 51) The need for assistive technology is determined on a

case-by-case basis taking into consideration the unique need of

each individual child If the IEP team determines that a particular

assistive technology item is required for home use in order for a

particular child to be provided FAPE the technology must be pro-

vided to implement the IEP

If the committee approves this request it will go to the School

Board for approval I would like to know what happens if

the School Board doesnrsquot approve the proposal Is it im-

partial hearing time

As part of the public agencyrsquos part B obligation to provide

FAPE to an eligible child with disabilities the public agency must

ensure that special education and related services are provided

in conformity with an IEP which meets the requirements of 34

CFR sectsect 300340-300349 One requirement at 34 CFR sect

300343(a) is that the public agency conduct a meeting to de-

velop review and revise a childrsquos IEP The Regulations require

that certain participants attend the IEP meeting See 34 CFR sect

300344 The role of the participants at the IEP meeting is to

determine the specific special education and related services that

a child needs in order to receive FAPE Once the determination is

made at a meeting convened pursuant to 34 CFR sect 300343(a)

Part B does not recognize any authority on the part of a local

School Board to unilaterally change the statement of special edu-

cation and related services contained in the IEP After the IEP is

developed and the placement decision is made by a group of

persons knowledgeable about the child the meaning of the evalu-

ation data and placement options the public agency must imple-

ment the IEP See 34 CFR sect 300533(a)(3) Without reconven-

ing the IEP meeting the local school board could not change the

IEP

Is there a time limit on implementation of updated IEPrsquos[]

Every year I have long delays on implementation of Board

approved IEPrsquos[]

Part B imposes no specific time limits for the implementation

of IEPs The Part B regulations at 34 CFR sect 300342(b) require

that an IEP (1) must be in effect before special education and

related services are provided to a child and (2) must be imple-

mented as soon as possible following the meetings required to

develop review or revise a childrsquos IEP The answer to Question 4

in Appendix C to the Part 300 regulations states that no delay is

permissible between the time a childrsquos IEP is finalized and when

special education and related services is provided It is expected

that the special education and related services set out in the IEP

will be provided by the agency beginning immediately after the

IEP is finalized In certain circumstances such as when the IEP

meeting occurs during the summer or a vacation period or where

there are circumstances which require a short delay (eg work-

ing out transportation arrangements) the implementation may not

be immediate See Comment 34 CFR sect 300342

I hope that this information is helpful to you Please let us

know if you have any additional questions or concerns

Judy A Schrag

Director

Office of Special Education Programs

_______________________

Cite as 18 IDELR 628

56

Sample Letter Requesting an Assistive Tech-nology Evaluation

March 1997

Dear Sir

Our daughter Catherine an IDEA-eligiblestudent is currently receiving special educationand supportive therapies through the publicschool district As she is progressing through theelementary school grades the curriculum is de-manding more and more written work from herAt this point teachers or assistants are writingfor her but this method does not allow Catherinethe opportunity to compose written work on herown

As Catherinersquos parents we think the time hascome to consider assistive technology forCatherine to allow her to learn to do written workon her own so that she can learn the mechanicsof writing and can put her own thoughts downon paper for others to read

To this end we are requesting an assistivetechnology evaluation for Catherine to determinewhat kinds of technology are necessary to assisther with written expression We are assumingthat the assistive technology evaluation will beperformed at district expense by professionalswho are qualified to determine (a) what assistivetechnology may be necessary for Catherine (b)what assistive technology devices might be help-ful and (c) what occupational and physicaltherapy services may be necessary to support thetechnology

We would like to have this evaluation com-pleted so that information is available prior tothe convening of the IEP Team to writeCatherinersquos Individualized Education Programfor next year

We appreciate your assistance with this mat-ter and look forward to hearing from you

Yours truly

Assistive TechnologyIssues to Address

_____What are the individualrsquos current unmetneeds for access to communication writ-ing or educational materials

_____What are the short and long term educa-tional goals

_____What are the daily educational demandswhich require the use of assistive technol-ogy

_____Have the appropriate team members in-cluding parents been involved in the as-sessment process

_____What are the features of the technology thatwould assist the individual in meetingdaily classroom demands

_____Why is the selected equipment more appro-priate than other alternatives

_____Have all of the individualrsquos environmentsbeen considered

_____Does the selected equipment reflect the leastrestrictive intervention strategy

_____Is the equipment necessary to achieve edu-cationallife goals

_____How will the individual physically man-age the equipment in all environments

_____How will the equipment be integrated intothe individualrsquos daily life

_____How will the use of the assistive technol-ogy promote inclusion of the individualinto activities in the school and commu-nity

_____Which members of the education team willbe trained to use the equipment

_____How will the individual be trained to usethe equipment

_____How will the family be involved with theindividual and the equipment

57

ExamplesEDUCATIONAL SOFTWARE EVALUATION

A IDENTIFYING INFORMATION

Name of instructional program

Publisher

Cost ____________Computer platform(PCMac)

Other equipment needed to run program

Grade level of the program

Skill levels required of users

Special needs addressed by program

B DESCRIPTIVE INFORMATION

1 What is the purpose of the instructional program as stated by

its publisher

2 What curriculum area or areas does it address

3 What type of instructional program is it

tutorial drill and practice___ arcade game type___

drill and practice ____ simulation ___

problem solving___ educational game___

teacher utility___ other___

4 For what type of learner was the program designed

age level __________ grade level ____________

ability level ________ interest level ___________

5 What skills or information does the program attempt to teach

or review

6 How does the program present information

__text __graphics __animation __color __sound effects

__music __speech __other __________________________

7 Is the information presented clearly

Is text legible and readable

Are graphics comprehensible

Are sounds audible and intelligible

8 Are directions for using the program clearly stated and under-

standable Where do directions appear

_____ within the program

_____ in the programs documentation or manual

9 Is the program under user control that is can the user control

the programs movement from screen to screen

Review directions at any time

Exit the program at any time

10 What computer use demands are placed on the learner

_____ insert disk and turn on computer

_____ select from menu

other ______________________________

11 What academic demands are placed on the learner

reading level _______________________________

spelling level _______________________________

other _____________________________________

12 What physical demands are placed on the learner

_____ keyboard must be used to enter responses

_____ press any key

_____ press a key from one half or one quadrant of key-

board

_____ press on specific key

_____ press several keys in order

_____ other devices used to enter responses

13 What speed demands are placed on the learner

_____ presentation of information controlled by program (

moderate fast or slow)

_____ presentation of information under user control

_____ unlimited response time

_____ response time set by program (moderate fast slow)

_____ response time varied by user

58

14 What accuracy demands are placed on the learner

_____ user can correct typing errors

_____ program does not allow correction of typing errors

_____ program locates common errors

_____ program requires correct spelling of all responses

_____ program allows only one correct response for most

questions

15 Is feedback about response accuracy provided to learners

appropriately

_____ knowledge of results provided after each response

_____ correct responses confirmed

_____ learner informed if response incorrect

_____ another trial provided if response incorrect

_____ number of trials provided

_____ correct response demonstrated if learner fails to an-

swer correctly

_____ learner allowed opportunity to respond after demon-

stration of correct response

16 Does the program use any branching procedures besides

differential treatment of correct and incorrect responses

17 What techniques are used for reinforcement and motivation

_____ knowledge of results and confirmation of correct re-

sponses

_____ summary information about learner performance

_____ text message of praise for correct responses

_____ graphics display and or sound for correct responses

_____ competitive game in which correct response earn

points

_____ other _________________________________

Reinforcement is _____ continuous _____ intermittent

18 What user options are available to students and teachers

Students can select

_____ activity from menu difficulty

_____ number of questions type of questions

_____ other ____________________________

Teacher or parent can select

_____ sound on or off

_____ number of questions

_____ type of questions

_____ sequence of instruction

_____ number of trials

_____ speed of presentation

_____ speed demands for responses

_____ other_________________________________

Teacher or parent can

_____ enter own content into program

_____ review student records

_____ other________________________________

19 Is the programs documentation adequate

All program features fully and clearly explained

Rationale for program purpose and objectives included

Print materials provided for students

20 Other comments about the instructional program

C OVERALL EVALUATION

Rate the appropriateness of the instructional program in each of

the following areas using this scale

excellent adequate inadequate

1 2 3

1 2 3 Curricular content (program addresses important skills

1 2 3 Interest level

1 2 3 Ease of use for learners

1 2 3 Demands on learner (eg computer use academic)

1 2 3 Instructional procedures

1 2 3 Motivational value

1 2 3 Appropriate use of the medium

1 2 3 Important instructional variables under teacher control

1 2 3 Other _______________________________

59

Software Featuresbull Easy-to-Read Screensbull Consistency in Formatbull Intuitive Characteristicsbull Logical Labelsbull Instructional Choicesbull Graphicsbull Friendly Documentationbull On-Screen Instructionsbull Auditory Cuesbull Visual Cuesbull Built-in Access Methodsbull Alternatives to a Mousebull Optional Cursorsbull Creation of Custom Programs

Alternative Inputbull Switches and Switch Softwarebull Alternative Keyboardsbull Keyboard Additionsbull Access Utilitiesbull Interface Devicesbull Voice Recognitionbull Optical Character Recognition

and Scannersbull Electronic pointing Devicesbull Pointing and Typing Aidsbull Touch Screensbull Joysticksbull Trackballsbull Arm and Wrist Supports

Processing Aidsbull Abbreviation Expansion and

Macro Programsbull Word Predictionbull Talking and Large Print Word

Processorsbull Grammar and Spell Checkersbull Reading Comprehension Pro-

gramsbull Writing Composition Pro-

gramsbull Electronic Reference Toolsbull Menu Management Programs

Alternative Outputbull Braille Embossers and Transla-

torsbull Refreshable Braille Displaysbull Speech Synthesizersbull Screen Readersbull Screen Enlargement Programsbull Monitor Additions

Specialized Productsbull Closed Circuit Television

(CCTV)bull Environmental Control Units

(ECU)bull Notetakersbull Reading Machinesbull Text Telephone (TDD)

60

Next

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pt fo

r sto

ry p

robl

ems

Chu

ck is

very

con

cret

e in

his

thin

king

and

has

gre

at d

iffic

ulty

und

erst

andi

ng fi

gura

tive

lang

uage

C

huck

has

a fu

ll tim

e ai

de in

the

regu

lar

clas

sroo

m w

ho m

odifi

es a

ssig

nmen

ts a

ndhe

lps

to k

eep

him

on

task

So

cial

ly C

huck

is p

olite

and

wel

l-beh

aved

but

app

ears

tobe

imm

atur

e in

his

soc

ial r

elat

ions

hips

61

ASSI

STIV

E TE

CHN

OLO

GY

EVAL

UATI

ON

Func

tion

al A

naly

sis

Nam

e C

huck

Dat

eG

rade

Lev

el

Sixt

h

Ove

rall

Des

crip

tion

Chu

ck is

a s

ixth

gra

de s

tude

nt w

ho re

ceiv

es a

ll of

his

inst

ruct

ion

inth

e re

gula

r cla

ssro

om

Chu

ck h

as ri

ght h

emip

legi

a H

is ri

ght u

pper

ext

rem

ity is

mor

eaf

fect

ed th

an h

is lo

wer

ext

rem

ity

He

has

diffi

culty

with

tota

l bod

y m

ovem

ents

requ

iring

Need

Fine

Mot

or Han

d W

ritin

g

Not

e Ta

king

Self

Hel

p

Curre

nt S

tatu

s

Chu

ck c

an u

se o

nly

one

hand

for f

ine

mot

or ta

sks

incl

udin

g ty

ping

C

huck

isan

exc

elle

nt o

ne-h

ande

dty

pist

bot

h in

term

s of

spee

d an

d ac

cura

cy

Chu

ck c

an w

rite

in c

ursi

ve

but h

andw

ritin

g is

ver

yla

bor i

nten

sive

and

tirin

gfo

r him

H

e pr

oduc

esm

uch

bette

r writ

ten

prod

ucts

usi

ng a

com

pute

rC

huck

can

not t

ake

note

san

d lis

ten

at th

e sa

me

time

Chu

ck c

anno

t tie

his

ow

nsh

oes

and

he h

as d

iffic

ulty

zipp

ing

his

jack

et w

ith o

neha

nd

Next

Ste

p

Try

givi

ng C

huck

not

esbe

fore

the

clas

sroo

mpr

esen

tatio

n H

ave

him

hig

hlig

ht k

eyw

ords

with

a h

ighl

ight

ing

pen

as h

e is

list

enin

g to

the

disc

ussi

on

Try

havi

ng a

pee

rbu

ddy

assi

st C

huck

with

his

sho

es a

ndja

cket

bila

tera

l coo

rdin

atio

n e

spec

ially

with

upp

er e

xtre

miti

es

Chu

ck h

as a

leg

leng

thdi

scre

panc

y w

ith h

is ri

ght l

eg b

eing

sho

rter t

han

his

left

He

war

s a

lift i

n hi

s sh

oe to

com

pens

ate

for t

he d

iffer

ence

C

huck

has

low

ave

rage

inte

lligen

ce a

nd n

orm

alsp

eech

H

e re

ads

at th

e th

ird g

rade

leve

l a

nd d

oes

mat

h at

gra

de le

vel

exce

pt fo

rst

ory

prob

lem

s C

huck

is v

ery

conc

rete

in h

is th

inki

ng a

nd h

as g

reat

diff

icul

ty u

nder

-st

andi

ng fi

gura

tive

lang

uage

C

huck

has

a fu

ll tim

e ai

de in

the

regu

lar c

lass

room

who

mod

ifies

ass

ignm

ents

and

hel

ps to

kee

p hi

m o

n ta

sk

Soci

ally

Chu

ck is

pol

ite a

ndw

ell-b

ehav

ed b

ut a

ppea

rs to

be

imm

atur

e in

his

soc

ial r

elat

ions

hips

Crite

ria fo

r Suc

cess

Chu

ck w

ill be

abl

e to

prod

uce

writ

ten

wor

k at

abou

t the

sam

e pa

ce a

sot

her s

tude

nts

in h

is c

lass

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ck w

ill be

abl

e to

rece

ive

help

with

am

inim

um o

f fus

s or

emba

rrass

men

t

Supp

ort R

equi

red

Lapt

op c

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ter

Prin

ter

Enla

rged

scr

een

disp

lay

Co-

Writ

er w

ith W

rite-

Out

-Lo

ud fo

r wor

d pr

oces

sing

and

wor

d pr

edic

tion

Chu

ck n

eeds

to u

se w

ord

proc

essi

ng w

hene

ver

writ

ten

assi

gnm

ents

are

requ

ired

Whe

neve

rpo

ssib

le h

is w

ritte

nas

sign

men

ts s

houl

d be

shor

tene

d or

he

shou

ld b

eex

pect

ed to

resp

ond

usin

gm

ultip

le c

hoic

e or

one

wor

dan

swer

s

Teac

her s

uppo

rt of

the

peer

bud

dy re

latio

nshi

p

Loca

tions

Hom

eSc

hool

Com

mun

ityW

ork

Rec

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ion

Hom

eSc

hool

Com

mun

ityW

ork

Rec

reat

ion

62

ResourcesParent Trainingand InformationCenters

AlabamaSpecial Education ActionCommittee Inc (SEAC)600 Bel Air Blvd 210Mobile AL 36606-3501334-478-1208334-473-7877 FAX1-800-222-7322 AL onlyseacmob1junocomhttpwwwhsvtisnet~cja

AlaskaPARENTS ResourceCenter4743 E Northern Lights BlvdAnchorage AK 99508907-337-7678907-337-7671 FAX1-800-478-7678 in AKparentsalaskanethttpwwwalaskanet~parents

American SamoaAmerican Samoa ParentNetworkPO Box 3432Pago Pago AS 96799684-633-2407684-633-7707 (fax)

ArizonaPilot Parent Partnerships4750 N Black Canyon Hwy 101Phoenix AZ 85017-3621602-242-4366800-237-3007 (AZ only)602-242-4306 (fax)

ArkansasArkansas Disability Coalition2801 Lee Ave Suite BLittle Rock AR 72205501-614-7020501-614-9082 FAX1-800-223-1330 AR onlyadcceinet

FOCUS Inc305 W Jefferson AveJonesboro AR 72401870-935-2750870-931-3755 FAXfocusincipanet

CaliforniaDREDF2212 Sixth StreetBerkeley CA 94710510-644-2555510-841-8645 (fax)1-800-466-4232dredfdredforghttpwwwdredforg

Exceptional Parents Unlimited(EPU)4120 N First StreetFresno CA 93726209-229-2000209-229-2956 (fax)epu1cybergatecom

Matrix555 Northgate Dr Ste ASan Rafael CA 94903415-499-3877415-499-3854 (TDD)415-507-9457 (fax)1-800-578-2592matrixmatrixparentsorghttpwwwmatrixparentsorg

Parents Helping Parents - SanFrancisco594 Monterey BlvdSan Francisco CA 94127-2416415-841-8820415-841-8824 (fax)

Parents Helping Parents -Santa Clara3041 Olcott StSanta Clara CA 95054-3222408-727-5775408-727-7655 (TDD)408-727-0182 (fax)infophpcomhttpwwwphpco

Support for Families ofChildren with Disabilities2601 Mission 710San Francisco CA 94110-3111415-282-7494415-282-1226 (fax)sfcdmissaolcom

TASK100 W Cerritos AveAnaheim CA 92805-6546714-533-TASK (8275)714-533-2533 (fax)taskcaaolcom

TASK- San Diego3750 Convoy St Ste 303San Diego CA 92111-3741619-874-2386619-874-2375 (fax)

ColoradoPEAK Parent Center Inc6055 Lehman Drive Ste 101Colorado Springs CO 80918719-531-9400719-531-9403 (TDD)800-284-0251719-531-9452 (fax)PKPARENTaolcom

ConnecticutCPAC338 Main StreetNiantic CT 06357860-739-3089860-739-7460 (fax)1-800-445-2722 (in CT)cpacincaolcomhttpwwwmembersaolcomcpacinccpachtm

DelawareParent Information Center(PIC) of Delaware Inc700 Barksdale Road Ste 3Newark DE 19711302-366-0152302-366-0178 (TDD)302-366-0276 (fax)PEP700aolcom

FloridaFamily Network on Disabilitiesof Florida2735 Whitney RoadClearwater FL 24620813-523-1130800-285-5736 (FL only)813-523-8687 (fax)fndgatenethttpwwwgatenet~fnd

GeorgiaParents Educating Parentsand Professionals for AllChildren (PEPPAC)8318 Durelee Lane Ste 101Douglasville GA 30134770-577-7771770-577-7774 (fax)peppacbellsouthnet

HawaiiAWARELearning DisabilitiesAssociation of Hawaii200 N Vineyard Blvd Ste 310Honolulu HI 96817808-536-9684808-536-2280 (TTY)808-537-6780 (fax)ldahgtenet

IdahoIdaho Parents Unlimited Inc(IPUL)Parents Education amp ResourceCenter4696 Overland Rd Ste 478Boise ID 83705208-342-5884800-242-IPUL (4785)208-342-1408 (fax)ipulrmcinethttpwwwhomermcinetIPUL

IllinoisDesigns for Change6 N Michigan Ave Ste 1600Chicago IL 60602312-857-9292312-857-1013 (TDD)312-857-9299 (fax)1-800-851-8728DFC1aolcom

Family Resource Center onDisabilities (FRCD)20 East Jackson Blvd Rm 900Chicago IL 60604312-939-3513312-939-3519 (TDDTTY)312-939-7297 (fax)1-800-952-4199 (IL only)

Family TIES Network830 South Spring StreetSpringfield IL 62704800-865-7842217-544-6018 (fax)ftiesnaolcom

National Center for Latinoswith Disabilities1921 South Blue IslandChicago IL 60608312-666-3393312-666-1788 (TDD)312-666-1787 (fax)1-800-532-3393ncldinteraccesscom

Table of ContentsIntroduction 1Defining Assistive Technology 2

Sara 7Making Assistive Technology Decisions 9

Sierra 23Funding Assistive Technology 24

Ted 31Gloria 32

Making Assistive Technology a Part of Childrsquos Education 33Emily 38Bryan39Tracy 40

Advocating for Assistive Technology 42More Questions and Answers 44Appendix 50

Glossary 50Documents 53

Schrag Letter on Assistive Technology 53Individuals with Disabilities Education Law Report 54Letter Requesting an Assistive Technology Evaluation 56Assistive TechnologyIssues to Address 56

Examples 57Educational Software Evaluation 57Software Features 59Alternative Input 59Processing Aids 59Alternative Output 59Specialized Products 59Assistive Technology Evaluation 60

Resources 62Parent Training and Information Centers 62Alliance for Technology Access Resource Centers 65State Tech Act Projects 67SoftwareHardware Vendors 70

1

A ssistive technology is redefining what ispossible for people with a wide range ofcognitive and physical disabilities In the

home classroom workplace and communityassistive technology is enabling individuals withdisabilities to be more independent self-confi-dent productive and better integrated into themainstream

Beginning early in life technology is makingit possible for children with disabilities to domore for themselves A child who cannot use herhands can operate a computer with a switch andan on-screen keyboard A child with speech prob-lems can communicate using a portable electronicdevice that ldquospeaksrdquo A child who is unable toget in and out of the bathtub can be safely andeasily lifted using a mechanical device Theseare just a few examples of the wide variety ofequipment called assistive technology that isavailable today

Assistive technology can mean anything fromsimple homemade devices to highly sophisti-cated environmental control systems It can beadapted toys computers powered mobility aug-mentative communication devices specialswitches and thousands of commercially avail-able or adapted tools to assist an individual withlearning working and interacting socially

As wonderful as assistive technology can beit is not always easy to acquire It takes expertiseand persistence to find the correct devices andfigure out ways to pay for them For examplechildren with disabilities who are eligible for spe-cial education have a legal right to technology toassist them with learning Both the Individual-ized Family Service Plan (IFSP) and the Individu-alized Education Program (IEP) which are re-quired by tthe Individuals with Disabilities Edu-cation Act (IDEA) are potentially powerful toolsfor incorporating assistive technology into theeducation of students with disabilities But

assistive technology does not become part of astudentrsquos special education plan unless parentsare knowledgeable about technology and knowwhat to do to ensure that assistive technologybecomes an integral part of their childrsquos program

This Guide is intended to help parents learnmore about assistive technology and how it canhelp their children The Guide includes tips forgetting started ideas about where to look formoney and suggestions for what to do whenapplying for funding Places to contact for moreinformation or to find software and equipmentare listed in the Appendix at the end of the Guide

Finding and paying for the right technologyrequires commitment and energy Professionalsin education and medicine can help but parentscannot rely on professionals to do everything thatis necessary to get the equipment As a parentyou have a much better chance of getting what isneeded if you and your child are involved in se-lecting the technology and planning for its useThis Guide should help you to understand theprocesses for acquiring assistive technology andprovide you with the tools to advocate for yourchildrsquos special technology needs

Introduction

2

Defining Assistive Technology

A ssistive technology devices are mechani-cal aids which substitute for or enhancethe function of some physical or mental

ability that is impaired Assistive technology canbe anything homemade purchased off the shelfmodified or commercially available which isused to help an individual perform some task ofdaily living The term assistive technology encom-passes a broad range of devices from ldquolow techrdquo(eg pencil grips splints paper stabilizers) toldquohigh techrdquo (eg computers voice synthesizersbraille readers) These devices include the entirerange of supportive tools and equipment fromadapted spoons to wheelchairs and computersystems for environmental control

The Individuals with Disabilities EducationAct (IDEA) the federal special education lawprovides the following legal definition of anassistive technology device ldquoany item piece ofequipment or product system that is used toincrease maintain or improve functional capa-bilities of individuals with disabilitiesrdquo UnderIDEA assistive technology devices can be usedin the educational setting to provide a variety ofaccommodations or adaptations for people withdisabilities

The IDEA also lists the services a school dis-trict may need to provide in order to ensure thatassistive technology is useful to a student in theschool setting The law defines assistive technol-ogy service as ldquoany service that directly assistsan individual with a disability in the selectionacquisition or use of an assistive technologydevicerdquo This service includes all of the follow-ing possibilities

bull evaluation of the technology needs of theindividual including a functional evalua-tion in the individualrsquos customary environ-ment

bull purchasing leasing or otherwise provid-

ing for the acquisition of assistive technol-ogy devices for individuals with disabili-ties

bull selecting designing fitting customizingadapting applying maintaining repair-ing or replacing of assistive technologydevices

bull coordinating and using other therapiesinterventions or services with assistivetechnology devices such as those associ-ated with existing education and rehabili-tation plans and programs

bull assistive technology training or technicalassistance with assistive technology for anindividual with a disability or where ap-propriate the family of an individual withdisabilities

bull training or technical assistance for profes-sionals employers or other individualswho provide services to employ or other-wise are substantially involved in the ma-jor life functions of individuals with dis-abilities

The intention of the special education law isthat if a student with disabilities needs technol-ogy in order to be able to learn the school dis-trict will (a) evaluate the studentrsquos technologyneeds (b) acquire the necessary technology (c)coordinate technology use with other therapiesand interventions and (d) provide training forthe individual the individualrsquos family and theschool staff in the effective use of the technology

During the time that students with disabili-ties are in school they can have the opportunityto learn to use technology at the same time thatthey are learning academic subjects and socialskills The efficient and effective use of assistivetechnology can be as basic a skill for students withdisabilities as reading writing and arithmeticsince the use of technology can go a long way

3

toward circumventing the limitations of disabil-ity and providing students with disabilities witha ldquolevel playing fieldrdquo in every area of life ac-complishment

What is an accommodation

Accommodations are reasonable modifica-tions that are made to compensate for skills orabilities that an individual lacks For example ifa person does not digest spicy foods well wemight accommodate this individual by adjustinghis or her diet so that the person was eating onlybland foods

When the word accommodation is used in con-nection with disability issues it refers to a wayof modifying a task or assignment so that a per-son with a disability can participate in spite ofwhatever challenges the disability may pose Forexample when a student who is unable to re-member math facts is allowed to do math prob-lems with a calculator the use of the calculator isan accommodation which allows the student towork around his or her disability With an ac-commodation the student can still perform mathproblems but the student does so using a differ-ent method

In the school setting sometimes it is neces-sary to make accommodations for individualswith disabilities in order to compensate for skillsor abilities that they do not have For examplefor some students with learning disabilities learn-ing to spell words correctly may be a skill theynever acquire or never acquire with a highenough degree of fluency to do them any goodin written expression To compensate for thisinability to spell such students may be encour-aged to use alternative methods for spelling likea spell check software program on the computeror a hand-held spelling device

What is an adaptation How does adaptationdiffer from accommodation

Adaptation means developing unique devicesor methods designed specifically to assist persons

with disabilities to perform daily tasks An ad-aptation is something specially designed whichis not normally used by other people An accom-modation on the other hand is simply a changein routine method or approach which may beused by people with or without disabilities Ex-amples of adaptations include special grips toturn stove knobs or specially designed keyboardsto operate computers

What are common types of assistive technol-ogy Does assistive technology just meancomputers

Assistive technology certainly includes com-puters but it also refers to a number of other typesof accommodations and adaptations which en-able individuals with disabilities to function moreindependently Computers are an important typeof assistive technology because they open up somany exciting possibilities for writing speakingfinding information or controlling anindividualrsquos environment But computers are notthe only avenues to solving problems throughtechnology There are many low tech (and lowcost) solutions for problems that disabilities poseExamples of inexpensive low tech solutions in-clude wrist splints clip boards for holding pa-pers steady or velcro tabs to keep positioningpads in place

The following is a list of common assistivetechnology applications

Positioning In the classroom individualswith physical disabilities may need assistancewith their positions for seating so that they canparticipate effectively in school work Generallytherapists try to achieve an upright forward fac-ing position by using padding structured chairsstraps supports or restraints to hold the body ina stable and comfortable manner Also consid-ered is the studentrsquos position in relation to peersand the teacher Often it is necessary to designpositioning systems for a variety of settings sothat the student can participate in multiple ac-tivities at school Examples of equipment used

4

for positioning are side lying frames walkerscrawling assists floor sitters chair inserts wheel-chairs straps trays standing aids bean bagchairs sand bags and so forth

Access In order to participate in school taskssome students require special devices that pro-vide access to computers or environmental con-trols The first step in providing access is to de-termine which body parts can be used to indi-cate the studentrsquos intentions Controllable ana-tomical sites like eye blinks head or neck move-ments mouth movements may be used to oper-ate equipment which provides access to the com-puter Once a controllable anatomical site hasbeen determined then decisions can be madeabout input devices selection techniques (directscanning) and acceleration strategies (codingprediction) Input devices include such thingsas switches alternative keyboards mousetrackball touch window speech recognition andhead pointers Once computer access has beenestablished it should be coordinated with othersystems that the student is using including pow-ered mobility communication or listening de-vices and environmental control systems

Access can also refer to physical entrance andexit of buildings or facilities This kind of assistivetechnology includes modifications to buildingsrooms and other facilities that let people with

physical impairments use ramps and door open-ers to enter allow people with visual disabilitiesto follow braille directions and move more freelywithin a facility and people of short stature orpeople who use wheelchairs to reach pay phonesor operate elevators Accessibility to shoppingcenters places of business schools recreationtransportation is possible because of assistivetechnology modifications

Environmental Control Independent useof equipment in the classroom can be achievedfor students with physical disabilities throughvarious types of environmental controls includ-ing remote control switches and special adapta-tions of onoff switches to make them accessible(eg velcro attachments pointer sticks)

Robotic arms and other environmental con-trol systems turn lights on and off open doorsoperate appliances Locational and orientationsystems give people with vision impairmentsinformation about where they are what theground nearby is like and whether or not thereis a curb close by

Augmentative Communication Every stu-dent in school needs some method of communi-cation in order to interact with others and learnfrom social contact Students who are nonverbalor whose speech is not fluent or understandableenough to communicate effectively may benefit

figure 1 Alternative and Pr ocessing Computer Access Methods

Inputbull Alternate keyboardsbull Interface devicesbull Joysticksbull Keyboard modificationsbull Keyboard additionsbull Optical pointing devicesbull Pointing and typing aidsbull Switches with scanningbull Scanners amp optical character recognitionbull Trackballsbull Touch screensbull Voice recognition

Processingbull Abbreviationexpansion and macro programsbull Access utilitiesbull Menu management programsbull Reading comprehension programsbull Writing composition programsbull Writing enhancement tools (ie grammar checkers)

Outputbull Braille displays and embossersbull Monitor additionsbull Screen enlargement programsbull Screen readersbull Speech synthesizersbull Talking and large print word processors

5

from using some type of communication deviceor devices Communication devices include suchthings as symbol systems communication boardsand wallets programmable switches electroniccommunication devices speech synthesizers re-corded speech devices communication enhance-ment software and voiced word processing

Assistive Listening Much of the time inschool students are expected to learn through lis-tening Students who have hearing impairmentsor auditory processing problems can be at a dis-tinct disadvantage unless they learn to use thehearing they have or they develop alternativemeans for getting information Hearing problemsmay be progressive permanent or intermittentAny of these impairments may interfere signifi-cantly with learning to speak read and followdirections Assistive devices to help with hear-ing and auditory processing problems includehearing aids personal FM units sound field FMsystems Phonic Ear TDDs or closed caption TV

Visual Aids Vision is also a major learningmode General methods for assisting with visionproblems include increasing contrast enlargingstimuli and making use of tactile and auditorymodels Devices that assist with vision includescreen readers screen enlargers magnifierslarge-type books taped books Braillers lightboxes high contrast materials thermoformgraphics synthesizers and scanners

Mobility Individuals whose physical impair-ments limit their mobility may need any of a num-ber of devices to help them get around in theschool building and participate in student activi-ties Mobility devices include such things as self-propelled walkers manual or powered wheel-chairs and powered recreational vehicles likebikes and scooters

Computer-Based Instruction Computer-based instruction can make possible independentparticipation in activities related to the curricu-lum Software can be selected which mirrors theconceptual framework of the regular curriculum

but offers an alternative way of responding to ex-ercises and learning activities Software can pro-vide the tools for written expression spelling cal-culation reading basic reasoning and higherlevel thinking skills The computer can also beused to access a wide variety of databases

Social Interaction and Recreation Studentswith disabilities want to have fun and interactsocially with their peers Assistive technologycan help them to participate in all sorts of recre-ational activities which can be interactive withfriends Some adapted recreational activities in-clude drawing software computer games com-puter simulations painting with a head or mouthwand interactive laser disks and adaptedpuzzles

Self Care In order to benefit from educa-tion some students require assistance with selfcare activities like feeding dressing and toiletingAssistive devices which assist with self care in-clude such things as robotics electric feedersadapted utensils specially designed toilet seatsand aids for tooth brushing washing dressingand grooming

What sort of students might use assistivetechnology

Students who require assistive technology arethose with mental or physical impairments thatinterfere with learning or other life functions Thetechnology helps the student to overcome or com-pensate for the impairment and be more inde-pendent in participating at school Students whobenefit from assistive technology may have mildlearning problems like learning disabilities orthey may have physical or cognitive disabilitiesthat range from mild to severe Assistive tech-nology is not necessary or helpful for every stu-dent in special education but it is an importantpart of the support system for many studentswith identified disabilities

Isnrsquot assistive technology appropriate only forstudents with more severe disabilities

Assistive technology is simply a set of tools

6

that can be used to compensate for some deficitthat a person may have For individuals with se-vere mental or physical disabilities the techno-logical solutions can help to solve multiple andcomplex problems But individuals with less in-volved problems also can benefit from assistivetechnology For example individuals with learn-ing disabilities who have difficulty with readingor writing can benefit educationally from usingthe word processing and voiced reading capa-bilities of computers

Isnrsquot assistive technology just a crutch Wonrsquotstudents become too dependent on technol-ogy and not learn to use the skills they have

Assistive technology should be used as sup-port for access learning and performing dailytasks In general assistive technology is appro-priate when it compensates for disabilities so thatthe individual can function as normally as pos-sible If assistive technology is necessary for astudent to have access to educational opportuni-ties or to benefit from education then it is not aldquocrutchrdquo but a legitimate support

Some skills are too laborious or taxing to ac-complish at a rate or with degree of proficiencyto allow for participation in the least restrictiveenvironment With assistive technology the stu-dent can participate more fully and more closelyapproximate the levels of achievement and in-teraction of his or her peers

The use of assistive technology enhancesfunction and increases skills and opportunitiesThough a student may be dependent upon a par-ticular device in order to perform skillfully de-nying the device denies the student an opportu-nity ever to achieve success at the level of his orher potential

When is using assistive technology appropri-ate

Assistive technology may be considered ap-propriate when it does any or all of the follow-ing things

bull Enables an individual to perform functions

that can be achieved by no other means

bull Enables an individual to approximate nor-mal fluency rate or standardsmdasha level ofaccomplishment which could not beachieved by any other means

bull Provides access for participation in pro-grams or activities which otherwise wouldbe closed to the individual

bull Increases endurance or ability to persevereand complete tasks that otherwise are toolaborious to be attempted on a routine ba-sis

bull Enables an individual to concentrate onlearning or employment tasks rather thanmechanical tasks

bull Provides greater access to information

bull Supports normal social interactions withpeers and adults

bull Supports participation in the least restric-tive educational environment

SummaryAssistive technology means any device which

helps an individual with an impairment to per-form tasks of daily living There is a wide rangeof types of devices in assistive technology fromlow tech homemade aids to computers and so-phisticated electronic equipment Assistive tech-nology is one of the services which can be pro-vided in a special education program under theIndividuals with Disabilities Education Act(IDEA) The requirements of IDEA say that stu-dents who need assistive technology are entitledto the aids and devices and the assistive technol-ogy services (eg evaluation for assistive tech-nology and modification and maintenance ofequipment) that are necessary for the student tobenefit from a free appropriate public education

Hints for Parents

It is never too soon to consider using assistive tech-nology Some infants with physical disabilities for ex-

7

ample really benefit from early interaction with toysthat operate by switch Here are suggestions for timesto evaluate a child for assistive technology

bull When disability limits interaction with the envi-ronment and interferes with experiential learn-ing

Assistive technology can be used to providephysical access to the environment (egswitch toys floor scooters touch window)

bull When a significant gap exists between receptiveand expressive abilities

Assistive technology can assist with expres-sion through the use of programmableswitches electronic communication devicesvoiced word processing braille embossingand so forth

bull When an individualrsquos performance falls behindthat of his or her peers

If an individualrsquos handwriting for exampleis very slow laborious and difficult to readuse of a word processing device can be sub-stituted for handwriting thus allowing theindividual to keep up with others in termsof written expression

bull When a physical disability is impeding the edu-cationalvocational potential of an individual

Assistive technology can provide access tothe workplace for example by allowing anindividual who is blind to learn to use ascreen reader and voiced word processingto do clerical tasks that would otherwise beimpossible

bull When a disability is impeding the independenceof an individual

Sometimes assistive technology can be usedto allow a person with a disability to func-tion more independently For example hav-ing a power wheelchair allows an individualto travel independently without the neces-sity of having someone to push the wheel-chair

SaraSara who has Down syndrome is eight

years-old Her language and speech skills arethree years delayed but she has age appropriatesocial skills Sara has spent part of her schoolday in a regular classroom ever since kindergar-ten but this year her third grade teacher is sug-gesting that Sara really cannot keep up with herclassmates The teacher thinks that Sara wouldbe better off in a self-contained class with stu-dents who work at her pace Sara has some finemotor coordination problems and she has haddifficulty learning to write in cursive Her oralreading is hampered by her speech difficultiesHowever Sara has learned to do addition andsubtraction problems well and has mastered add-ing with carrying and subtraction with borrow-ing She reads at about a second grade level withreasonably good comprehension Sararsquos parentswould like to see her continue in the regular class-room for as much time as possible but they rec-ognize that Sararsquos writing and speaking problemsare keeping her from doing her best work

What are Sararsquos needs

What kinds of technology should go in SararsquosIEP

How would you make a case for puttingassistive technology into her IEP

8

Sararsquos SolutionSararsquos IEP Team met to discuss her needs and

concluded that she is doing well in a regular class-room setting she is making adequate progressin academic skills and has learned how to inter-act socially with her peers It is to be expectedthat Sara will have difficulty keeping up with thepace in a third grade but as long as she is mak-ing progress toward her individual goals theregular classroom is a good setting for her How-ever some simple accommodations and technol-ogy may help Sara to work faster and more effi-ciently

At this point Sara may need some assistancewith handwriting and speaking but the solutionsto her problems in these areas need not be com-plex ones The team decided that Sara shouldcontinue to practice cursive until she has mas-tered all the letters and can be more facile in us-ing script However while she is still learningcursive she needs other means for respondingin writing For short written responses the teamagreed that Sara should be encouraged to usemanuscript printing When speed is importantor when writing assignments are longer Sarashould have access to a computer with an adap-tive keyboard (eg IntelliKeys) The adaptivekeyboard is helpful for Sara because the ldquokeysrdquoare larger and easier to see Using the keyboardrequires only a very light touch so Sara finds iteasier to use than a standard computer keyboard

In terms of oral reading the team decided tohave Sara practice reading into a tape recorderHer speech therapist will work with her on slow-ing down her rate of speech and reading withexpression When Sara has a good tape of heroral reading she will submit it to her teacher forreview

Solution SummaryPractice cursiveUse manuscript printing for short assign-

ments

Use computer with adaptive keyboard forlonger assignments

Practice oral reading using a tape recorder

9

Making Assistive Technology Decisions

W hen parents learn about assistive tech-nology and the wonderful opportuni-ties it can provide they want to jump

right in and get the latest in technology for theirchildren Who wouldnrsquot want an augmentativecommunication device for a child who cannottalk What parents wouldnrsquot want to buy a com-puter if it would help their child learn

When the world of assistive technology opensup for parents it can be like entering a great toystoremdasheverything looks so wonderful that itmakes it hard to know what to select Choosingthe right device to meet an individualrsquos needsrequires technical knowledge and indepth under-standing of the individualrsquos functional capabili-ties Not only is the selection of a device madedifficult by the complexity of the equipment andthe demands of the individualrsquos impairmentassistive technology devices can be very expen-sive Making such purchases is a major financialcommitment for most families one that takes agreat deal of soul searching and sometimes sig-nificant sacrifice

Families invest more than money in theirchildrenrsquos assistive technology Practical invest-ments of time and effort and emotional invest-ments of hope and enthusiasm are made withevery assistive technology purchase Because ofthe high level of financial personal and emotionalcommitment family disappointment is greatwhen equipment fails to perform as expected

Buying and then not using a device becauseof dissatisfaction can be a devastating experiencefor all concerned That is why it is so importantfor parents to proceed cautiously into the worldof assistive technology and make purchases onlyafter careful evaluation and trials with the newdevice Following is a summary of some sug-gestions for parents to consider before makingany assistive technology purchase be realisticabout your childrsquos capabilities and needs get a

multidisciplinary evaluation examine availabletechnology with a critical eye match the childrsquosneeds to specific equipment features do not makea purchase until you have used the device for atrial period identify next steps and determinewhat needs to be done for follow-up after pur-chase

Guidelines for Making Assistive TechnologyDecisions

bull Be realistic about your childrsquos capabilitiesand needs

Assistive technology can open up excitingnew opportunities for a child but it is not magicThere are certain basic requirements for any in-dividual to be successful with technology and itis important to face these requirements squarelyThere is nothing more disappointing or discour-aging than purchasing expensive equipment fora child which is beyond his or her capabilities touse

Prerequisites for Computer Use Physicalor sensory impairments do not limit access tocomputers but cognition is a factor in computeroperation The major prerequisite for using acomputer (with or without adaptations) is thecognitive ability to understand cause and effectThe child must be able to understand that thecomputer operates (eg changes does some-thing) because the child has activated the equip-ment through some volitional movement or ac-tivity (eg eyebeam speaking puffing into astraw hitting a switch) Some children enjoyplaying with switches by hitting them randomlybut may not be able to connect their own behav-ior to the response their movement activates Inorder to be successful in interacting with a com-puter the user must be able to control some voli-tional activity and to do so consistently For ex-ample the child would have to be able to acti-vate the computer in response to a visual tactileor auditory prompt

10

Another prerequisite to computer use is theability to make conscious meaningful choicesbetween alternatives like yes and no The choicescan be very simple ones but there has to be evi-dence that the child has made an actual decisionand not merely acted randomly

If a child does not have the concept of causeand effect or cannot make consistent choices us-ing a computer is probably not a worthwhile nextstep at this point in the childrsquos developmentOther types of activities may be more appropri-ate less expensive and just as rewarding devel-opmentally and personally

Prerequisites for Augmentative Communi-cation Augmentative communication devicescan literally give voice to the thoughts of indi-viduals who cannot speak or cannot speak clearlybutmdashagainmdashthese devices are not magic Elec-tronic communication devices are of no valueunless the user has some communicative intentThat is for a communication device to be help-ful the user has to have some basic understand-ing of the communication process and must beintentional in expressing choices desires orneeds

For example Maggie is a four-year-old whois nonverbal She communicates her wants andneeds by using eyeblinks as responses to yes orno questions When Maggiersquos dad asks her if shewould like another glass of milk she indicatesher choice by raising her eyes up vertically foryes or moving her eyes down for no Maggieclearly knows what she wants to communicateshe has a consistent method for making herwishes known and she expects that her dad willunderstand her communication and act on it

Dan who is also nonverbal communicatesin a different way He points to objects and makesgestures to show what he wants or needs Hisgestures are clear and used consistently so thatfamily members and even people who do notknow Dan well can understand most of the timewhat he is communicating

Shelley communicates very basic informationabout how she feels by crying when she is un-comfortable or wants attention and by laughingwhen she enjoys something like music brightlights or water running Shelley does not how-ever respond to yes or no questions She doesnot make choices even when objects are pre-sented to her individually or in pairs She can-not respond to a question like ldquoDo you want someice cream nowrdquo Or ldquoWould you like the teddybear or the dollrdquo

Maggie and Dan may benefit from usingsome communication device because they arealready using communication systems meaning-fully and consistently Shelley however mayneed to develop greater ability to communicatemeaningfully before moving on to electroniccommunication

Communication skills fall along a continuumAt one end of the continuum are very simplecommunications like expressing preferences byindicating yes or no pointing or gesturing towardobjects or pointing to pictures Use of sign is amore complex form of communication becauseit requires that the user understand that the signsare symbols for meaningful communicationsWhen an individual is able to string togethersigns or words into meaningful phrases this isan additional step toward more complex com-munication When a person understands syntaxand is aware of typical word order this is anotherstep forward Each of these advances along thecommunication continuum represents a step to-ward more complex and sophisticated commu-nication Whatever assistive communicationdevice is chosen should match or just slightlyexceed the place on the continuum where the in-dividual is functioning It makes no sense forexample to purchase an elaborate electronic com-munication device that requires understandingsymbols and syntax when the individual usingthe device is just at the point of learning how toexpress yes and no preferences

An electronic device does not teach commu-

11

nication it enhances communication by givingaudible expression to thoughts that already existin the mind of the user If the thoughts are notthere yet or are not completely formed they can-not be expressed by the device

Physical and Sensory Impairments Are NotBarriers Mastery of a few simple prerequisiteskills is necessary before computers or electroniccommunication devices should be consideredbut it is not necessary for a child to master everydevelopmental milestone before entering theworld of assistive technology Physical or sensoryimpairments can often be circumvented by thetechnology itself and typical developmentalmilestones can sometimes be bypassed so thatassistive technology can be used For examplesome educators assume that students cannot usecomputers until they have completely masteredkeyboarding skills This is a false assumptionMany students benefit from using computerseven though they operate the machine using aldquohunt and peckrdquo method or only one or two keysIn a similar fashion students with limited verbalability who have not mastered oral speech ben-efit from using augmentative communicationdevices while they continue to develop oral lan-guage

Overall the keys to knowing when to tryassistive technology are (a) being realistic aboutthe childrsquos cognitive abilities and potential and(b) being open to trying the level of technology

which meets the child where he or she is

bull Get a multidisciplinary evaluation

Evaluations for assistive technology are notalways easy to arrange In many parts of theUnited States there is no convenient center orldquoplacerdquo to go for an assessment The availablecenters may be far away in another city or evenanother state Since assistive technology is a newfield the systems for disseminating informationand providing assistance are in the process ofevolving Parents may have to be ldquoassistive tech-nology detectivesrdquo in order to put together theinformation needed for a complete AT evalua-tion for their child

The place to start the evaluation is by consid-ering the functions the child needs to performand cannot because of impairment The physi-cians teachers and therapists currently workingwith the child as well as family members andfriends who are around the child on a daily ba-sis can provide very valuable information aboutfunctional problems and potential solutions

Finding Functional Solutions The Alliancefor Technology Access (ATA) a national networkof assistive technology centers has developed aninformal method for using the functional infor-mation available from professionals family mem-bers and friends as a basis for analyzing assistivetechnology needs This process called a Solu-tion Circle is a means to bring people togetherin an informal session that allows for creative

figure 2 Factors to consider when selecting Assistive T echnology

Cognitive Factorsbull Diminished Cognitive Abilitiesbull Learning Disabilitiesbull Attention Deficitsbull SensoryPerceptual Deficitsbull Memory Deficitsbull Abstract Reasoning Deficitsbull Problem-Solving Deficits

Motor Factorsbull Voluntary Motor Deficitsbull Involuntary Motor Deficitsbull Fixed Posture amp Positioning Deficitsbull Recurring Purposeless Motionbull Motor Paralysisbull Low Muscle Tonebull Rigiditybull Spasticitybull Tremors

12

thinking and is not inhibited by what is ldquolegalrdquoldquocurrently availablerdquo or ldquowhat has been done be-forerdquo The individual with a disability and 4-10family members professionals and friends gettogether to brainstorm ideas about the technol-ogy which may help the individual perform func-tions that are hard or impossible to do becauseof disability The Circle usually includes a bal-ance between people who know the person whoneeds the technology and people who have spe-cialized knowledge about technology educationor work-related issues

Solution Circle for Tom To demonstratehow the Solution Circle works letrsquos take a lookat how this process was used in the case of Toma high school student with a learning disabilityFor Tom the print in textbooks is a significantbarrier to learning Tom is ldquoprint disabledrdquo thatis he cannot read the printed word with muchcomprehension Reading is a slow unproductiveprocess for him even though he is intelligent andeager to learn Tom and his parents were hopingthat there might be a way that new technologycould help Tom overcome or work around hisproblem with reading so that he could get moreout of school and perhaps go on to college

Tomrsquos Solution Circle included his parentsBetty and Bob his resource teacher a friendDarrell his soccer coach his 4-H leader and theowner of a local computer store This group mettogether to think about how Tom could partici-pate more fully in school and prepare himself forcollege even though he could not read with com-prehension past the second or third grade level

Solution Circles generally take 1 to 1 12 hoursto complete The steps include the following

1 Star Time The individual for whom theSolution Circle is being held is described in a ho-listic way The emphasis is on how the individualis functioning at home and in the communityWhat does he or she like and dislike What arehisher goals Interests If possible the indi-vidual with a disability speaks for himself or her-self or a video or pictures may be presented The

point of this part of the discussion is give a clearpicture of the individual as a whole person

At Tomrsquos Solution Circle he explained hisdream of going to college and becoming an agri-cultural botanist Tom loves plants he is inter-ested in breeding new strains of wheat and per-fecting various types of grain crops Tomrsquos 4-Hleader agreed that Tom had real gifts in under-standing plant growth and physiology and thathe already had sophisticated knowledge aboutbotany which would prepare him well for col-lege study

2 Strengths With a complete picture of theindividual in mind the group then makes an ex-haustive list of the individualrsquos strengths particu-larly noting any technological accommodationswhich the individual is already using What doesthe individual do well What are his or her un-impaired functions Often this discussion revealsan incredible number of adaptations that the in-dividual has already achieved

Tomrsquos Solution Circle discovered that he hadmany strengths including keen intelligence per-severance and thoroughness when approachinga task Tom already had some effective learningstrategies for remembering material that heheard He had also learned to use a small taperecorder for keeping track of information pro-vided in class

3 Obstacles With the individualrsquos strengthsin mind the group then turns its attention to aconsideration of the environment in which theindividual is functioning and the activities inwhich the individual wants to participate butcannot at this time The group considers whatthe obstacles and barriers might be for the indi-vidual in his or her environment and makes alist of these impediments

For Tom reading was a serious obstacle Hecould not keep up with homework assignmentsbecause it took him so long to read his textbooksIn addition he had difficulty reading directionson tests and often misread assignments on the

13

COGNITIVE FACTORSCognitive Ability

Documented below average abilityDocumented significant overall delayDoes not appear age appropriateLacks understanding of cause amp ef-

fectPaying Attention

Difficulty following prompts or direc-tions

Difficulty with multi-step proceduresDifficulty filtering informationDifficulty staying on task

PerceptionNeeds lengthened response timeRequires multi-sensory inputDifficulty with rapid changeSignificant visualperceptual problemsSlow visual-motor dexterity

MemoryDifficulty with recallRequires reteaching learned skillsRequires repeated practice

Abstract ReasoningDifficulty analyzing simple proceduresUnable to reproduce a sequenceUnable to analyze or synthesize in-

formationProblem Solving

Unable to use prompts or cues to ac-complish tasks

Unable to modify attempts and try an-other way

MOTOR FACTORSMobility

Needs help to be mobileNeeds motorized help to be indepen-

dentNeeds help boarding transportationUnable to transfer independentlyCannot climb stairsCannot open doors independentlyCannot carry materials in hands or

armsCannot lift weight

Voluntary MotorLimited control of head trunk or ex-

tremitiesVisual motor deficitsFixed position and posture

figure 3 ASSISTIVE TECHNOLOGY EVALUATIONIndividual Functional Analysis

Name Date

Needs support to sit or standNeeds adaptations in order to use

technologyMotor Paralysis

Changes in muscle tone interfere inmotor movements

Spastic movements result in poor con-trol

Limited movement of head arms orlegs

Difficulty balancing in sitting positionDifficulty maintaining good posture

Low Muscle ToneLimited use of arms or legsPoor posture controlFatigues quickly

RigidityInhibits arm and leg movementInhibits balance to sitInhibits good posture

SpasticityLimited upper range of motionLimited lower range of motionInterferes with accuracy and consis-

tency of motor movements on oneside

TremorsPresent all the timePresent when doing purposeful upper

extremity taskUnable to compensate for tremors

Extraneous MovementAthetoid (constant)Ataxia (poor coordination in move-

ment)FINE MOTOR

DexterityLimited fine motor controlHas limited hand movement

HandwritingWriting or copying ability is signifi-

cantly below peersSignificant legibility factor--written

work not readableCannot keep up with the pace of writ-

ten workIs frustrated by writingFatigue is a factorTyping appears to be potentially faster

than handwriting

SELF CARENeeds assistance with going to the

bathroomUnable to be toilet trainedNeeds assistance to eatCannot take in food orallyNeeds suctioning routinelyHas degenerative medical conditionIs medically fragileSeizures limit alertnessNeeds to rest frequentlyNeeds assistance to zip coat or tie

shoesCOMMUNICATION

Receptive LanguageReceptive language is significantly

lower than abilityReceptive language is significantly

higher than expressiveExpressive Language

Speech is unintelligibleExpressive language is significantly

lower than abilityMean Length of Utterance (MLU) is 3

words or lessSpontaneous or self initiated language

is significantly limitedDoes not make choices consistentlyDoes not respond appropriately with

yes or noDoes not have communicative intent

SENSORYVision

Requires corrective lensesRequires large print to readRequires mobility trainingHas blind spot

HearingRequires preferential seatingHearing limitations affect the language

thresholdsRequires assistance to receive lan-

guageRequires sign language to receive lan-

guageHas fluctuating hearing lossNeeds visual signals for safety pur-

poses

14

blackboard

4 The Enemy Within Physical and cogni-tive impairments may pose difficult obstacles foran individual but often the feelings that peoplehave about the individualrsquos disability or aboutassistive technology pose greater problems thanthe disabilities themselves The Solution Circleprocess recognizes that human fears concernsreservations and prejudices might stand in theway of a personrsquos success as much as other typesof limitations Getting these fears and concernsout on the table often helps the group to deal moreconstructively with what is possible and whatneeds to be done

One of the serious issues in Tomrsquos situationwas that his resource teacher felt he should con-tinue to try to read for himself instead of using aldquocrutchrdquo like assistive technology The teacherthought that if Tom did not have to read all thematerial he would lose what little reading skillhe had In some ways the teacherrsquos oppositionto considering assistive technology actually poseda greater barrier than the reading problem itself

5 Solutions The exciting part of a SolutionCircle occurs when the group takes each obstacleor concern and turns it into a possible solutionthrough the use of technology or some other typeof adaptation Not all solutions suggested even-tually prove to be feasible but the point of thediscussion is to produce many possible solutionsso that the individual and his or her family havean array of options from which to choose Withgood minds puzzling over the problems and aspirit of cooperation and collaboration seeminglyimpossible barriers can be removed or conqueredThe process recognizes the expertise and contri-butions of all participants including the indi-vidual with disabilities and his or her familymembers The freewheeling format of the dis-cussion promotes ingenuity and innovation Allinvolved come away from a Solution Circle ener-gized by the new possibilities

Tomrsquos Solution Circle became excited about

the possibility of solving his reading problem byusing computerized texts The computer storeoperator mentioned he had heard that Record-ings for the Blind (RFB) offered textbooks on diskTomrsquos parents got in touch with Recordings forthe Blind and ordered texts for Tom to try on hiscomputer at school Soon Tom found that hecould keep up with his classmates and study ex-actly the same material that they were coveringBecause Tom had good strategies for memoriz-ing information that he heard he learned quicklyfrom the texts that were read aloud to him by thecomputer When given oral tests by his classroomteachers he was able to recite appropriate an-swers which would have eluded him if he hadhad to read the tests for himself

Technology has made all the difference forTom he has every reason to think that he will beable to go to college and pursue his intellectualinterests His resource teacher is now completelysold on the idea of assistive technology and us-ing computerized books and wants to use thetechnique with other students More than thatTomrsquos teacher also appreciates the process of theSolution Circle which allowed professionals andnonprofessionals to work together to find prac-tical solutions without being too concerned aboutthe formalities of the special education processThe informal nature of the Solution Circle vali-dated the expertise of all the participants andgave everyone a chance to offer suggestions Thecombination of a new process for planning andnew technology made Tom a winner This samecombination holds potential for many studentslike Tom who benefit from technologies whicheliminate barriers and open up new possibilitiesfor learning

From Function to Technology Solution Ithappened that a participant in Tomrsquos SolutionCircle hit on a great idea for a solution to his func-tional problem with reading This was a fortu-nate connection to make At the suggestions ofhis Solution Circle Tom began to use computer-ized books which he ldquoreadsrdquo by having the com-

15

puter speak the words as he follows along withthe text For Tom computerized books proved tobe a successful solution to his reading problembecause they help him to get the information heneeds without struggling with the reading pro-cess

Not every Solution Circle will be like Tomrsquosand identify the exact technology that the indi-vidual needs But if a Solution Circle has workedwell the end result will be a clear analysis of thefunctions that need to be performed This func-tional information can then be brought to techni-cians who can make suggestions for possibleassistive technology solutions There are over 50assistive technology centers in the United Stateswhere knowledgeable individuals can assistpeople with disabilities and their families withmaking a match between functions that need tobe performed and the technology that is availableto perform those tasks A list of assistive technol-ogy centers is available in the Appendix to thisGuide

Formal Assessment Solution Circles are aneffective informal way to identify functionalneeds that can be met through technology How-ever in the school setting it is also necessary toestablish a studentrsquos needs for technology in amore formal way Formal evaluations for assistivetechnology must be multi-disciplinary involvingeducators and therapists who are knowledgeableabout the school curriculum and the particulartypes of impairments that the student being as-sessed may have For example for a student withcerebral palsy the assistive technology evaluationmight involve a teacher a physical therapist aspeech and language clinician and an occupa-tional therapist The teacher would assist thetherapists in determining what skills the studentneeded to learn and how technology might assistthe student in acquiring those skills Someassistive technology evaluations might require theadditional services of an A-V technician adap-tive physical education teacher a rehabilitationcounselor or speech and language pathologist

with specialized training in augmentative com-munication In school districts where there is nospecialized expertise in technology and its appli-cations it may be necessary to contract for evalu-ations with special education cooperatives medi-cal centers or centers that focus on technologyassessment

Individuals conducting an assistive technol-ogy evaluation should

bull Be knowledgeable of the studentrsquosstrengths and weaknesses medical needsmobility fine and gross motor skills cog-nitive ability communication abilities vo-cational potential self help needs sensoryabilities level of academic achievementand area(s) of disability

bull Have knowledge of and access to an arrayof assistive technology devices

bull Be familiar with the studentrsquos educationalsetting and educational needs

bull Be able to communicate effectively withparents and educators

Because the assistive technology field is sonew there are no particular licenses orcredentialing processes to identify a professionalas qualified to do assistive technology evalua-tions Generally speaking individuals with pro-fessional licenses as occupational or physicaltherapists special educators speech pathologistsor rehabilitative counselors may have the exper-tise to conduct an AT evaluation When consid-ering an evaluator it is wise to ask about theevaluatorrsquos specific experience with assistivetechnology It is also important to recognize thatno one person or discipline will know everythingabout assistive technology therefore access toknowledgeable people at the local level andthrough other agencies programs or services isessential

Conducting the AT Evaluation The assistivetechnology evaluation must be tailored to theunique needs of the student In some cases theevaluation may be conducted by at team of indi-

16

viduals in other cases the evaluation may beconducted by a single individual (eg the speechpathologist) Questions to be addressed duringthe assessment should be related to the specifictasks the student needs to be able to perform andwhat if any assistive technology would helpThe following questions may be considered dur-ing the assessment

bull What tasks does the student need to per-form that he or she cannot perform

bull Is there a low tech device which will ad-dress the studentrsquos needs satisfactorily

bull What types of high tech assistive devicesmay help the student in performing thetask

bull Will assistive technology help the studentto perform the task in the least restrictiveenvironment

bull Is the device being considered suited to thestudentrsquos educational needs and abilities

bull Will the assistive technology device remainsuitable over time How long lasting willthis solution potentially be

The above are only a few of the considerationswhich need to be addressed as part of the evalu-ation process There is no specific ldquotestrdquo forevaluating the need for assistive technologyTherefore prior to conducting the evaluation theindividuals doing the assessment need to have awell planned process in mind

The formal written assistive technologyevaluation report should address but not belimited to the following points

bull Procedures used to evaluate the student

bull Instruments employed in the evaluationassuring that a range of levels of technolo-gies has been considered

bull Results of evaluations including bothqualitative and quantitative measures

bull Recommendations for levels of technologyappropriate to the studentrsquos capabilitiesand potentials and

bull Implications for educational program-ming including discussion of both indi-vidual technology needs and recom-mended environmental and instructionalmodifications

In the end an assistive technology evaluationshould provide recommendations for accommo-dations adaptations devices and services basedon the individualrsquos strengths needs and pre-ferred lifestyle The evaluation should indicate(a) whether devices and services have potentialfor improving function and (b) what trainingmay be necessary in order to use the technologyequipment safely and effectively

bull Examine available technology with a criti-cal eye

It is easy to be dazzled by the possibilities innew assistive technology but it is important forparents to be wise consumers and ask probingquestions about the features and quality of anassistive technology device The following is alist of questions to consider when evaluating aparticular assistive technology device

Performance

Does it work efficiently and effectively

Is it easy to learn to use this device

Is it compatible with other devices

Does this device serve only one purposeor is it flexible

ldquoElegancerdquo

Does this device represent the simplestmost efficient way to accomplish the task

Or is this device too elaborate too com-plicated to be worthwhile

Ergonomics

Does it fit the individual

Is it convenient to use in the environment

Is the equipment portable enough to gowhere the user goes

Are different devices needed in differentenvironments

17

Reliability

What is the manufacturerrsquos reputation forreliability

Does it stand up well to normal use

Is it durable

Safety

Is it safe to use

What is the power source for the deviceIs it safe

Is a margin built in for foreseeable mis-use

Practicality

Do company sales people seem knowl-edgeable and helpful

Are the companyrsquos service people knowl-edgeable and helpful

Does the device have a warranty Howlong is the device guaranteed to function

How available are repair services Atwhat cost

Can this device be leased

Is this device available for a trial periodbefore purchase

Will this device soon be outdated Issomething better on the horizon

Will the company update the device

Does the manufacturer provide trainingin using the device

Aesthetics

Is this device attractive to the eye

Does the device fit well into the userrsquoslifestyle

Normalization

Does the device assist the user with morenormalized living

Can the user operate the device indepen-dently or with a minimum of assistance

Or does the device ldquostick outrdquo too muchand advertise the disability of the user

Does the equipment minimize differenceor exaggerate difference

Does the device have the potential to in-crease the quantity and quality of time spentwith nondisabled peers Or does the de-vice separate the user from others

Cost effectiveness

Do the benefits the device provides jus-tify the cost

Are there less expensive devices or mod-els that serve the purpose as well

Personal acceptance

Is this device the userrsquos own choice

Does the potential user like this deviceand want to use it

Does the potential user view this deviceas life-enhancing

Would the user have preferred some otherdevice or means to perform the task

Will using the device always be a choreor can using it become a habit

There are several ways that consumers canfind answers to their specific questions aboutassistive technology devices Most vendors willprovide good basic information about the prod-uct Call the vendor and ask for brochures prod-uct specifications price list and any other writ-ten information This is a place to start A sec-ond step is to read reviews of the product in trademagazines or Closing the Gap a widely respectedpublication that reviews new assistive technol-ogy products If possible it is very helpful totalk to other consumers who are already usingthe product Ask them about the pros and consof using the device Then visit a preview centerif there is one nearby and try out several typesof devices Ask for general recommendationsfrom the preview centerrsquos staff After identify-ing a device that appears to meet the potentialuserrsquos needs try the device out for a month tosix weeks to make sure that it performs as adver-tised and fits in well with the userrsquos lifestyle

18

During the trial period it will be possible to iden-tify training needs for the user family membersand school staff The trial period will also be atime for the user to test the device in several set-tings to determine its portability and flexibility

bull Match the Individualrsquos Needs to SpecificEquipment Features

When considering an assistive technologydevice it is very important to consider how adevice matches up with the particularindividualrsquos needs and habits In some ways anassistive device becomes an extension of theuserrsquos mind and body As such it is a highly per-sonal item A device may work as advertisedbut still not meet an individualrsquos needs becausethe individual just does not feel ldquocomfortablerdquo inusing it For example Cindy a fourteen-year-oldwho is totally blind and has mild cerebral palsyaffecting her hands and arms was being taughtMorse Code as a means to speed up her writingShe had difficulty using a Brailler because her armstrength was so limited so her teacher thoughtMorse Code would be an easier method of writ-ing for Cindy The only problem was that Cindydid not like using Morse Code To her it seemedlike she was having to learn another complicatedlanguage when she already knew braille andliked to use it Cindy admitted that writing inbraille was slow for her but she was more com-fortable with it Cindy and her teacher were atan impasse until a friend suggested to Cindy thatshe try writing on a voice-output computerCindy loved the computer With a headset at-tached to the sound system she could listen care-fully to the computer as it read aloud the lettersand words she was typing on a light touch tac-tile-marked keyboard This computer also had afeature of printing out text in either standard printor braille Cindy was delightedmdashshe could writecopy for herself to read in braille and for hersighted teachers to read in regular print Thissolution worked because it met Cindyrsquos learningneeds and responded to her own ideas about her-self She did not want to use Morse Code because

it was a separate type of communication knownonly to a few With her computer voiced soft-ware and dual printer she had the best of twoworldsmdashshe could ldquohearrdquo her writing as shetyped she could read it over in braille and hersighted teachers could read her finished prod-uct This solution helped Cindy to improve hercomposition skills speed up her writing timeand communicate more easily with sightedpeople

Cindy was fortunate because her assistivetechnology solution met her needs almost per-fectly Such a close match is not however al-ways possible Nonetheless every effort shouldbe made to have the match be as close as it canbe In general when assistive technology solu-tions are individualized simple to use and re-sponsive to the whole person they are more likelyto be used by the individual When the deviceperforms a task well but does not ldquofitrdquo the indi-vidual the technology is likely to be abandonedby the user in favor of something else whichmeets the need more exactly Too often devicesare purchased because of their technical poten-tial without thought to their relationship to theindividual and his or her lifestyle These mis-matched devices are the ones that end up lan-guishing in their packing boxesmdasha sad reminderof time and money spent to no avail

bull Try the Device Before Buying

It cannot be emphasized enough how vital itis to try out assistive technology devices andequipment before buying Trying out a devicefor several weeks provides the user with an op-portunity to learn how to use the device and howto adapt to its features while at the same timetesting the device in the various environmentswhere it will be used For example Mike triedout a communication device which attachednicely to his wheelchair tray and was compat-ible with his computer that he used for doingschool work Though the communication deviceworked well and was relatively easy to program

19

MOTORSELF CARE

manual wheelchairpower wheelchairbus liftsupportive classroom

chairstanderwalkerlift for transferspositioning devicecanes or crutchesadapted commodesuctioning devicebraces or supportsother ____________

________________

________________

________________

________________

________________

________________

________________

________________

________________

________________

________________

figure 4 ASSISTIVE TECHNOLOGY EVALUATION

Device or Equipment Features or Functions

Name Date

FINE MOTOR

word processorword processor with

predictionvoiced word proces-

sor with predictionadapted keyboardkeyguardalternative key

arrangementvoice activated

computer accessinfrared computer

accessmouse accesstrackballjoystickpower padswitch (eg mouth

lip chin)touch screenpointersdrag and click desk

accessorysticky keysonscreen keyboardprinter for written

work

adapted feedingutensils

braces or splintsother ____________

________________

________________

COGNITIVECOMMU-NICATION

communciationboard(s)

communication wallettotal communicationmanual signword processor with

voiceprogrammed voice

outputicon predictionelectronic communi-

cation deviceprogrammable switch

with voice output

no-reading-neces-sary word proces-sor

spell checkergrammar checkeroutlining programother ____________

________________

________________

________________

________________

________________

________________

________________

SENSORYPERCEP-TUAL

hearing aid(s)

classroom amplifica-tion

boosted signal tonoise ratio (egheadset to keepfocus during wordprocessing)

corrective lensesenlarged printtaped booksvoiced word process-

ingvoiced screen

directionsCCTVother ____________

________________

________________

________________

________________

________________

________________

________________

________________

________________

________________

20

Mike found out quickly that the device was justtoo bulky to be useful for him When he trav-eled around the school the communication de-vice blocked his view of the terrain and of peoplepassing by He found he missed opportunitiesto communicate because he could not see whowas coming his way Mike also discovered thatthe communication device did not serve him wellin crowds like at pep rallies or basketball gamesAfter a month of working with this communica-tion device Mike decided it was not for him andselected instead a device that was less compli-cated smaller and more portable The seconddevice was not as sophisticated as the first but itbetter met his needs for quick communicationwith friends in social settings If he had not hadthe opportunity to try out both devices for anextended period of time Mike might not haverealized the value of the second device and mayhave been stuck with a communication devicethat was too large and too sophisticated to matchhis lifestyle

Similarly Marilyn benefited from a trial pe-riod with her communication device She foundout the first week that the particular device shehad chosen would not work for her because itbroke too easily and it was difficult to get re-paired During the first week that Marilyn hadthe device for trial her teacher broke one of thebuttons during a programming session It tooktwo weeks to contact the manufacturer and thenthe device had to be mailed back to the factoryfor repairs The device was gone for over sixweeks and the manufacturer would not supplya ldquoloanerrdquo while Marilyn waited for repairs tothe first device This experience taught Marilynthe importance of having a responsive manufac-turer who is willing to repair devices quickly andto supply substitutes for the user while repairsare being made Marilyn decided on a differentdevice with similar features and a great helplineto provide assistance with the maintenance of themachine

The information that can be learned during a

trial period with a device is invaluable to the userIt is discouraging to find out during the trial thata device is not all it is purported to be or that itdoes not work as well as advertised but it is farbetter to learn before purchase that a device doesnot meet the userrsquos needs than to learn after pur-chase and be stuck with an expensive unusablemachine For the consumer it is daunting to thinkabout starting over again with the process of se-lecting a device Nonetheless it is worthwhileto seek more information and look again Hav-ing been through a trial even when the outcomeis not successful provides the user with greaterclarity about what an appropriate device willhave to be able to do The second time aroundthe search is likely to go faster and come out witha better result

bull Identify Next Steps

Once a device has been selected the con-sumer becomes impatient to have one and beginusing it right away But at this point importantwork still needs to be done Funding the deviceis a major consideration Sometimes families willpay for the device themselves but under othercircumstances the device will be purchased by aschool district through Medicaid or private in-surance or through some other means Parentsneed to become familiar with the various fund-ing options and determine which one will workfor them (See Funding Assistive Technology foradditional information about funding sources)

Also when considering funding familiesshould think about costs beyond the price of thedevice itself For example a computer set-upwith a keyboard monitor and printer might cost$3500 This equipment is basically useless un-less other equipment is purchased as well soft-ware adaptive devices paper manuals up-grades Prices for these additions can raise theactual cost of the device by hundreds of dollars

Devices often require training for the userfamily members and others to ensure effectiveand safe use How much does training cost Who

21

will provide it Repair and maintenance are othercosts usually additional to the price of the equip-ment Sometimes families will also want to insurethe assistive device so insurance payments be-come part of the overall cost

Since making an assistive technology pur-chase is such an important personal and finan-cial decision it is wise to have a realistic budgetin mind that includes all of the equipment andservices that are necessary to make the assistivetechnology work effectively With this budget inmind it becomes easier to plan the purchase seekout funding sources and make a compelling casefor financial assistance

bull Determine What Follow-up Is Needed

After the assistive technology device has beenpurchased and put to use there are additionalfollow-up activities that need to take place Theoriginal assistive technology evaluation shouldinclude a way to monitor the use of the devicePeriodic scheduled reviews the by evaluator fol-low-up calls to and from the family are some waysto help assure effective safe use Families whotravel great distances for evaluation need to becertain that services like maintenance repair andreplacement of devices are available within a rea-sonable distance from home

Assistive technology devices are used bestwhen all the people in the life of the individualwith disabilities understand the devices in thesame way At first devices may seem to exagger-ate differences between a person and the rest ofthe world Care should be taken to explain thatassistive equipment is a difference equalizer nota difference maker Classmates and friends needto understand that the adapted seating or adaptedkeyboard helps the individual do what other stu-dents do Adults in a childrsquos life need to under-stand that devices work to make life easier bet-ter and more functional People need to knowthat ramps help keep individuals with mobilitydisabilities from being separated from peers thatcommunication technology allows people to

ldquospeakrdquo their thoughts

Close communication between parents andtheir childrsquos helpersmdashteachers therapists daycare workers and othersmdashis essential to makesure devices and services are being used safelyand effectively If the device is working well butthe child is not being integrated into the class-room or other environments then there may bea need for additional training for the children andadults who interact with the child

Besides keeping track of how the device isworking and being used it is important to ob-serve progress in the areas of technology whichare useful to the individual with the assistivetechnology device As upgrades of equipmentoccur or more sophisticated models come on themarket the user may want to consider modify-ing or replacing the equipment that is currentlyin use Also as the individual becomes moreskilled at using technology the individual mayoutgrow the current device and need to look formore advanced equipment It can be assumedwith most high tech items that in three to fiveyears there will be a need for upgrade or replace-ment The wise consumer begins early to planfor the next step in technology including savingmoney for a new device and staying alert to thenew options that become available

What kinds of training are important to occurwhen a child has a new assistive technologydevice

Because assistive technology of the high techvariety is so new it is particularly important thattraining be provided to all those who may needit In the school setting it is helpful for all edu-cators and administrators to have some aware-ness training so that they have a general idea ofwhat assistive technology is Areas to be cov-ered in inservice training might include

bull legal issues related to assistive technology

bull awareness training concerning how toserve students with assistive technologyneeds

22

bull information on how assistive technologyrelates to the evaluation process

bull how to write IEPs for students who requireuse of assistive technology devices

bull the relationship between technology andstudent placement

bull the nature of common assistive technologydevices

bull resources to contact for information onassistive technology

Beyond these awareness activities thosemembers of the school staff who work directlywith a student who uses technology need to havetraining on the specifics of using the device andhow it is maintained and serviced Trainingshould include but not be limited to the follow-ing

bull review of the studentrsquos educational andassistive technology needs

bull review of goals and objectives supplemen-tary aids and services and related serviceson the IEP or IFSP

bull training on how to use and maintain thedevice

bull training on proper transport of the devicewithin the school building and from hometo school

bull training on how to program the device ifneeded

bull training on how to use the device effec-tively during instruction

bull training in trouble-shooting when the de-vice is not working properly

bull information about what to do when thedevice is not functioning or broken

bull information about how to coordinateassistive technology with all the activitiesin the studentrsquos day

bull training in methods to evaluate the effec-tiveness of assistive technology

Depending on the type of assistive technol-

ogy used by the student and the studentrsquos needsit may be advantageous for assistive technologyinformation to be shared with the studentrsquos peersSuch training will help fellow students to gainan understanding of the studentrsquos assistive de-vice foster acceptance in the social environmentand reduce fears other students may have aboutsocializing with the student who uses technol-ogy In some cases parents and the student maywant to be involved in the peer training

Parents may require training too in order forthe device to be used at home for the student tocomplete homework assignments or participatein extended school year services Once trainedthe parents can become a resource to the studentfor proper care and maintenance of the device

Most importantly the student himself or her-self will need training in how to use the deviceas independently as possible Training for thestudent may be written into the IEP as a separategoal or may be included as a related service thatsupports the studentrsquos special education pro-gram

SummaryPurchasing a high tech assistive technology

device is a major life decision because of the po-tential impact on the individual and because suchdevices can be costly When considering anassistive technology device it is important to dothe following be realistic about the consumerrsquoscapabilities and needs get a multidisciplinaryevaluation examine available technology with acritical eye match the individualrsquos needs to spe-cific equipment features test the device for a trialperiod identify next steps and determine whatneeds to be done for follow-up after purchaseEvaluations for assistive technology both infor-mal and formal should consider first of all thefunctions that the consumer wishes to performusing technology When evaluating a particularpiece of equipment consideration should begiven to the following features performance sim-

23

plicity of design ergonomics reliability safetypracticality aesthetics normalization cost effec-tiveness and personal acceptance Good sourcesof information about assistive devices are manu-facturers publications trade journals previewcenters and consumers who are already using thedevice Once a device is selected the consumerwill need to secure funding for the purchase andbe aware of additional costs for related equip-ment insurance and training

Hints for Parents

Donrsquot let the cost of assistive technology deter youfrom considering it for your child High tech assistivetechnology can be quite costly but it can also makethe difference for your child in terms of becoming welleducated employable and a fully-included member ofthe community Donrsquot leave any stone unturned whenlooking for funding sources Consider any or all ofthe following for funding or assistance

bull Early intervention programs

bull Schools

bull Transition programs

bull Vocational Rehabilitation

bull State Programs for Children with SpecialHealth Care Needs

bull Medicaid

bull Medicare

bull State Technology Resources

bull Used Equipment

bull Leasing

bull Equipment Loan Programs

bull Disability Organizations

SierraSierra wants to play with dolls like other chil-

dren her age but she has a muscle disease thathas caused her to lose muscle tone except in onehand What could be done to allow Sierra to dressand undress her dolls comb their hair and bathethem

Sierrarsquos SolutionThe assistive technology solution for Sierra

involved her whole family While vacationingin Mexico Sierrarsquos grandmother found her a fash-ion doll that was a bit larger than the typicalldquoBarbie dollrdquo The larger doll was easier for Si-erra to manipulate Sierrarsquos mother sewed sev-eral outfits for the doll using velcro instead ofsnaps or buttons as fasteners

Sierrarsquos dad bought doll stands at a toy storeand fastened several stands with clamps toSierrarsquos wheelchair tray He also fastened a plas-tic pouch to the tray Sierra puts the small dollaccessories in the pouch When Sierra wants todress her doll she puts the doll in one of thestands In this way the doll is held securely andSierra can dress and undress the doll with onehand

Sierrarsquos friends also use the doll stands fortheir dolls With this arrangement two or threegirls can play together

Solution SummaryLarger doll

Velcro fasteners

Plastic pouch

Doll stands

Clamps

24

Funding Assistive Technology

F unding for assistive technology is availablefrom a variety of public and privatesources To receive public or private fund-

ing the individual must meet eligibility criteriafor the specific program and provide sufficientdocumentation of the need for assistive technol-ogy

The following list includes some of the pro-grams which may pay for equipment if the indi-vidual needing the device meets their require-ments Many of these programs are run by dif-ferent agencies in different states making themhard to find In general the statersquos Tech Act of-fice can assist consumers and family members infinding and using these programs (See Appen-dix under Resources)

PUBLIC PROGRAMSEarly Intervention Programs (Individuals withDisabilities Education Act Part H)

Young children (0-3) and their families mayreceive help through early intervention programsin evaluating what the child needs in gettingassistive technology and in learning how to useit Equipment and services must be included ina written plan called an Individualized FamilyService Plan (IFSP) To find the program for aparticular state call National Early ChildhoodTechnical Assistance System (NECTAS) at 919-962-2001 or 919-966-4041 (TDD)

Head StartThis child development program provides

comprehensive educational and health servicesfor eligible children ages 3-5 Since 1982 federallaw has required that at least 10 percent of thetotal number of placements must be available tochildren who are disabled and require specialservices Head Start is a mainstream placementoption for children whose IEP calls for placementwith nondisabled children The January 1993Head Start regulations specifically require the

consideration of assistive technology services anddevices For more information contact NationalHead Start Association 201 N Union St Suite320 Alexandria VA 22314 703-739-0875

Schools (IDEA Part B)This program mandates a free appropriate

public education for preschoolers children andyouth with disabilities An Individualized Edu-cation Program (IEP) is required for all childrenwith a disability These children are entitled tospecial education related services or supplemen-tary aids If the IEP team determines that assistivetechnology is required for a free appropriatepublic education then it must be provided at nocost to the child The technology must be in-cluded in the childrsquos Individualized EducationProgram (IEP) Parents have a right to be in-volved and should help to develop the IEP goalswhich may include technology For help in get-ting assistive technology in the IEP call the TAPPFocus Center on Assistive Technology at 1-800-222-7585

State Operated and Supported Schools (Chap-ter I)

This program provides federal assistance tohelp educate children with disabilities who areenrolled in state-operated and state-supportedprograms Federal funds must be used to payfor services that supplement a childrsquos basic spe-cial education program such as construction andthe purchase of equipment For more informa-tion contact your State Department of Education

Section 504 of the Rehabilitation Act of 1973Section 504 provides a civil-rights mandate

that requires accommodations for students whohave disabilities such as orthopedic impairmentsbut who do not qualify for special education ser-vices It denies federal funds to any institutionincluding a school whose practices or policiesdiscriminate against individuals with disabilities

25

This legislation has resulted in a number of out-comes including various actions to remove physi-cal barriers to education which may incorporateassistive technology For more information con-tact the nearest regional Office of Civil Rights orthe State Vocational Rehabilitation Agency

State Programs for Children with SpecialHealth Care Needs

These programs provide and pay for servicesfor eligible children CSHCN programs varywidely from state to state in the services they of-fer the number of children served and the re-quirements for eligibility Some CSHCN pro-grams do pay for assistive technology deviceswhen no other funding source is available andthe equipment is necessary for health-related rea-sons Most CSHCN programs are run by the statehealth agency To contact CSHCN ask informa-tion for the telephone number of the state healthagency

School-to-Work Transition ProgramsTransition Programs are charged with assist-

ing students with disabilities to receive the jobrelated training and placement services to helpthem move from school to work Sometimesassistive technology may be necessary in orderfor a student to make a successful transition andbecome employable If technology is needed fortransition purposes it can be written into thestudentrsquos Individualized Transition Plan (ITP) Toreceive more information about transition andtechnology call the Parent Training and Informa-tion Center (PTI) in your state (See Appendix)

Vocational Rehabilitation ServicesState vocational rehabilitation agencies pro-

vide information evaluation services trainingand funding for technology and education to helpadults go to work or live more independently Iftechnology is necessary for an individual to workVocational Rehabilitation may pay for the equip-ment as part of an Individualized Work-RelatedPlan (IWRP) To locate the nearest Vocational Re-habilitation Agency look in the telephone book

under state government

Plan to Achieve Self-Support (PASS)One of many Social Security Administration

work incentive programs this program providesan income and resource exclusion that allows ablind or disabled person to set aside income andresources for a work goal such as educationequipment purchase vocational training andstarting a business It should be considered forall students with vocational goals who are receiv-ing social security benefits

This program provides a mechanism forpeople to set aside funds to purchase work-re-lated equipment such as assistive technologydevices and services In many cases if an indi-vidual is a recipient of SSI and writes a PASS topurchase education or equipment an additionalSSI check will be provided to cover other livingexpenses Sometimes if a person receives SocialSecurity Disability Insurance (SSDI) and designsa PASS it may make the individual eligible forSSI because the SSDI has been allocated for equip-ment and services

Impairment-Related Work Expense (IRWE)Impairment-Related Work Expense (IRWE)mdash

one of the Social Security Administrationrsquos workincentive programsmdashallows an employed indi-vidual with a disability who receives or is eligiblefor SSI or SSDI to deduct work-related expensesfrom gross reported income

This deduction allows the person to continuedrawing SSDI or SSI and associated benefits(Medicaid or Medicare) if the IRWE deductionreduces earning below the Substantial GainfulActivity (SGA) Test

Although this method does not provide fund-ing to pay for a device or service it is a way ofallowing the use of the individualrsquos own moneyto pay for assistive devices and services neces-sary to return to work The following is a list ofpossible work-related expenses special transpor-tation to and from work personal assistance onthe job structural modifications durable medi-

26

cal equipment prostheses medical supplies andservices work-related equipment non-medicalappliances and equipment routine drug andmedical costs and diagnostic procedure costs

MedicaidMedicaid is a joint federal and state program

which covers some equipment if it is consideredmedically necessary For more information aboutMedicaid and who and what is covered contactthe local Department of Human Services office

MedicareAlthough not a usual source of funds for

assistive technology Part B of Medicare providescoverage for some durable medical equipment ifit is considered medically necessary and is foruse in the personrsquos home For more informationabout Medicare benefits contact the Social Secu-rity Administration Regional Office

Technology-Related Assistance for Individualswith Disabilities Act of 1988

This federal competitive grants program pro-vides monies for states to establish a statewideconsumer-responsive service delivery system de-signed to effect systems change regardingassistive technology In most Tech Act states afunding specialist or policy analyst is availableto assist with accessing assistive technology Sev-eral states operate loan programs to help withthe purchase of devices and services For moreinformation contact RESNA Technology Assis-tance Project 1700 N Moore ST Suite 1540 Ar-lington VA 22209-1903 703-524-6686

PRIVATE PROGRAMS

Private InsuranceSome health insurance plans will buy equip-

ment but it depends on the specific wording ofthe policy Unless the policy says the equipmentis not covered it makes sense to ask the insur-ance company to pay for it The equipment mustbe considered medically necessary and thereforerequires a doctorrsquos prescription

Loans

There are several low or no interest loansavailable to help buy technology Call the stateTech Act program or the manufacturer of theequipment may know where to get this type ofloan

Non-Profit Disability AssociationsThere are many disability organizations

some of which may be able to loan equipment orprovide information about other funding sourcesor support groups These organizations includeNational Easter Seal Society March of DimesMuscular Dystrophy Association United WayUnited Cerebral Palsy Association and the BrailleInstitute

FoundationsSome private foundations have been set up

specifically to provide help to people with dis-abilities A listing of such foundations can befound at the library or may be available from thestate Tech Act program

Programs Providing Assistive TechnologyThe state Tech Act programs offer referrals

for evaluation and equipment recommendationsas well as assistance with identifying funding orequipment lending sources A therapy depart-ment in a local hospital or Disabled StudentsCenter at a local college or university may alsooffer to help locate technology programs in thearea Alliance for Technology Access Centers(ATA) sometimes have loan programs or infor-mation about purchasing used equipment orrenting equipment

Civic OrganizationsThere are many local civic and service orga-

nizations which may provide money to helpsomeone in their community Lists of these or-ganizations are available from the Chamber ofCommerce Examples of these organizations areLions Club Masons Grotto Veterans of ForeignWars (VFW) Elks Club Rotary Club KiwanisKnights of Columbus and Soroptomists Someof these organizations have a national focus on

27

disability or on a particular disability Others willfund devices for a particular child who is knownto the local club

Charities and Fund-RaisersLocal churches high school groups neighbor-

hood organizations labor unions or special in-terest groups (eg computer clubs ham opera-tors) may plan a fund-raiser to help purchaseassistive technology College student organiza-tions (fraternities and sororities) may give moneyor studentsrsquo time to help a special cause Even ifmoney is not available they may be willing tohelp organize a fund raiser

Local media (radio television newspapers)sometimes will sponsor fund-raising activities tofund devices They may not contribute moneybut will help with organizing the fund-raisingactivity and publicizing it to the community

OTHER OPTIONS

In addition to federal and private fundingsources there are a number of education-relatedgrants corporate technology donation programsand funding options that consumers should con-sider Information on these alternative options isavailable through a number of sources includ-ing the following

NewslettersEducation Grants Alert Capital Publications

Inc PO Box 1453 Alexandria VA 22313-2052800-655-5597

Education Technology News Business Publish-ers Inc 951 Pershing Dr Silver Spring MD 20910-4464 301-5878-6300

Financing Assistive Technology Smiling Inter-face PO Box 2792 Church St Station New YorkNY 10008-2792 415-864-2220

Special Education Report Capital PublicationsInc PO Box 1453 Alexandria VA 22313-2053800-655-5597

Technology and Learning Peter Li Inc Publish-ing 330 Progress Rd Dayton OH 45449 415-457-4333

Technology ManufacturersIf it is not possible financially to purchase

equipment consumers can sometimes rent orborrow equipment directly from the manufac-turer

Used EquipmentUsed equipment is often advertised for sale

in disability-related publications or the consumercan place a newspaper ad to see if used equip-ment can be purchased locally Several compa-nies refurbish old computers and sell them at lowprices Listings of used computer outlets can beobtained from ATA Centers or state Tech Act pro-grams

LeasingMany manufacturers of assistive technology

devices have equipment which is available forrent or lease Sometimes the rent or lease pay-ments can be applied toward purchase Checkwith the manufacturer to see if this is an option

Equipment Loan ProgramsMany states have equipment loan programs

as do some rehabilitation facilities and disabilityorganizations Information about loan programsis available from Tech Act programs

HOW TO APPLY FOR FUNDING

There is an art to applying for funding forassistive technology It is necessary to use justthe right words to suit the particular agency thatmight be the funding source It is also crucial todocument the need for and projected outcome ofassistive technology This documentation shouldinclude at minimum

bull A written statement of medical need fromdoctors or other health professionals If thechild had an evaluation by a rehabilitationprofession also include this report

bull A description of the childrsquos problems re-sulting from the disability This descrip-tion can come from the doctor or other pro-fessional who evaluated the child

28

bull Description of how the technology helpsthe child For example the equipment maymake the child safer or allow the child todo things more independently Be sure topoint out how money will be saved if useof the equipment allows attendant care tobe reduced

bull A clear statement based on assessmentthat the child is a good candidate who hasthe cognitive and physical capacities nec-essary for using the technology

In summary the documentation to supportan assistive technology funding request shouldinclude a physicianrsquos prescription the childrsquos as-sessment an explanation of projected benefitfrom use of the technology or service and anycorrespondence obtained from professionals thatwould support the childrsquos need for technology

The initial funding request should include notonly the cost of the device but also the cost ofongoing support and instruction in the use of thetechnology Assistive devices often have ldquohid-denrdquo expenses that are incurred with their pur-chase and these expenses are frequently costlyover time Battery-powered devices may requirefrequent charging or cleaning Upgrades for com-puter software may be necessary Special modi-fications of the home or school environment maybe necessary for the technology to be used Ineach of these examples costs associated with thetechnology may have to be assumed by the fam-ily if they are not considered in the initial appli-cation for funding

It is also helpful to include with the fundingrequest a picture or a descriptive brochure aboutthe device being requested This is importantbecause often persons who are reviewing theapplication do not know about the wide rangeof technologies that might be appropriate

Appropriate wording on the application isabsolutely necessary Key concepts for Medic-aid include ldquomedical necessityrdquo and ldquorestore thepatient to his or her best functional levelrdquo The

term medical necessity means that the device isincluded in the course of treatment being pro-vided to the child and that a professional suchas a physician or speech therapist is supervisingits use Medicaid and private insurers alike gen-erally pay for technologies that help restorepeople to ldquofunctioning levelsrdquo and take the placeof a body part that is not working Typically theseprograms do not pay for technologies or serviceswhose function is educational or life-enhancingrather than health related

The key for private insurance is ldquoterms of thepolicyrdquo It must be remembered that coverageby any insurance company does not set a prece-dent Just because one child receives needed tech-nology under a particular policy issued by a com-pany does not mean that all other covered chil-dren will also have technology paid for by thatcompany Each application stands on its ownbased on the expressed terms of the policy

It is usually under the major medical provi-sions of a health policy that assistive technologycan be provided as ldquoother medical services andsuppliesrdquo It may however be necessary to pur-chase additional insurance coverage or a ldquoriderrdquoin order for technology costs to be included inthe terms of the policy It is important to remem-ber that heath insurance policies are oriented to-ward health care and not toward changes in theenvironment or rehabilitation

Both private health insurance policies andMedicaid sometimes impose limits on the num-ber of assistive technology devices over a certaincost that can be purchased within a certain timeframe Sometimes the rule is that the fundingsource will purchase only one device in theindividualrsquos lifetime With these kinds of restric-tions it is all the more critical to be sure that thetechnology choice is the right one

TIPS THAT LEAD TO SUCCESS

bull Apply to several funding sources at thesame time Be sure to meet the require-

29

ments of each agency

bull Find out if agencies will share costs

bull Fill in the agencyrsquos forms correctly Manyapplications are denied because forms arenot filled out properly

bull In addition to the standard form includeany other information that describes orshows what the equipment does and howit benefits the child Assume no knowledgeon the part of the reviewers

bull Turn in all documentation at the same time

bull Avoid using jargon define all unfamiliarterms

bull Take the funding request package to theagency in person While there have itchecked to make sure everything requiredhas been included Get the name of theperson who reviewed the application

bull Call regularly to check on the funding re-quest each time try to talk to the same per-son

bull Be super politemdashand persistent

WHAT IF FUNDING IS DENIED

It is not at all unusual for an initial fundingrequest to be denied Even when family mem-bers and professionals have been meticulous inpreparing applications requesting funding forneeded technology denials should be anticipatedMaking an appeal is worth the effort since manydenials are reversed at the appeal level

To start the appeal process obtain any docu-mentation or information provided by the fund-ing agency (eg Medicaid or the private insur-ance company) relating to appeal proceduresforms to use timelines and filing procedures forinstance This information will help in the promptpreparation for appeal The kind of appeal to bemade depends on the reason for denial Whendeveloping an appeal find out the following

bull Why the request was denied Ask for thereason in writing Sometimes requests are

denied because a reviewer lacks under-standing of the technology or there maybe an error in the paperwork

bull If needed correct any mistakes or includemore information then resubmit the re-quest

Going to appeal makes sense because gener-ally the appeal places the application before moreexperienced persons in the decision-making hi-erarchy The technology requested is often newand the initial examiners in the process may beunaware of its usefulness Also insufficient docu-mentation may have been provided in the origi-nal application and the problem can be remediedon appeal

Donrsquot be daunted by the length of the appealprocess Follow it through to its completion Insome states families may be able to appeal a de-nial beyond the first level For example somestates have ldquounfair claims settlement practicesrdquoregulations which are administered through theinsurance commissionerrsquos office

Always make your appeal in person and takethe child and the equipment if possible If onlypart of the money is offered by one agency askanother agency to share costs If the appeal isdenied try again Submit the funding request toanother agency Being persistent will nearly al-ways result in success

When going through the appeal process turnto the state Protection and Advocacy Program (Pamp A) for guidance and support P amp A advocatescan help make sure that a childrsquos rights to tech-nology and related services are not denied

Who pays when assistive technology is neededat school

The party who is responsible for paying forassistive technology depends upon the circum-stances under which the technology is purchasedUnder the special education law students withdisabilities who are eligible for special educationare entitled to a free appropriate public educa-tion Parents do not have to pay for school ser-

30

vices including assistive technology if that ser-vice is part of the studentrsquos Individualized Edu-cation Program (IEP) If the student is eligible forMedicaid the school district can request thatMedicaid pay for the device If parents choose todo so they may agree to use private insurance topay for a device that is used at school Parentscannot however be forced to use their insurancein this way If the private insurance requires aco-payment the school district would have to paythis amount since parents should not have to payany special education related costs

Does Section 504 pay for assistive technologySection 504 part of the Rehabilitation Act of

1973 is basically a piece of civil rights legislationthat is intended to prevent discrimination againstindividuals with disabilities in any programwhich receives federal funding Students whohave disabilities but who do not qualify for spe-cial education may still be eligible for accommo-dations under Section 504 of the RehabilitationAct of 1973 Section 504 however does not pro-vide any funding for accommodations

Like the special education law Section 504requires public schools to provide students withdisabilities with a free appropriate public educa-tion and in addition ensures that students withdisabilities are afforded an equal opportunity toparticipate in school programs For students withdisabilities this means that schools may need tomake special arrangements so that these studentshave access to the full range of programs andactivities offered For example a student whoneeds a wheelchair lift on a school bus to get toschool must be provided with this technologyOther modifications which might be requiredunder Section 504 include installing ramps intobuildings and modifying bathrooms to provideaccess for individuals with physical disabilitiesEven though required by the law none of thesetypes of modifications would be funded by Sec-tion 504

Under what circumstances does private health

insurance pay for assistive technologySome private health insurance policies will

pay all or part of the cost for some assistive tech-nology devices The devices are unlikely to belisted specifically in the policy but may be in-cluded under some generic term like ldquotherapeu-tic aidsrdquo Usually the devices have to be pre-scribed by a physician in order to be covered bythe policy

When does Medicaid cover assistive technol-ogy

Medicaid (Title XIX) will pay for ldquoprostheticdevicesrdquondashthat is replacement corrective or sup-portive devices prescribed by a physician or otherlicensed person Each state has some flexibilityin determining which prosthetic devices it willinclude in its list of Medicaid covered expensesDevices that are frequently covered by Medicaidare canes crutches walkers manual wheelchairshospital beds and hearing aids or eyeglasses forchildren and youth

SummaryAssistive technology can be expensive to pur-

chase but there are a number of public and pri-vate sources for funding devices Common pub-lic funding sources include early childhood in-tervention programs schools Vocational Reha-bilitation and Medicaid Private sources mayinvolve health insurance personal loans chari-table donations or fundraising It is very impor-tant to provide proper documentation and usecorrect wording and procedures when request-ing funding Initial requests for funding are fre-quently turned down but appeals can be success-ful

31

TEDTed is an active four-year old who lives in a

small rural community with his parents andyounger sisters He was identified as speech im-paired and has been attending preschool specialeducation classes Ted has normal mental capa-bilities but his mild cerebral palsy impairs hisability to speak Because of the speech therapyhe has received Ted is able to make some speechsounds but he says no intelligible words Heuses sign to communicate with his special edu-cation teacher and his parents No one else inhis community uses sign so Ted is limited in hisability to communicate with others

As Tedrsquos IEP Team looks ahead to his entryinto elementary school the Team recognizes thathe will need better communication skills in or-der to participate successfully in the regular class-room His speech therapist has recommendedthat Ted begin to use an AlphaTalker

What funding sources might pay for theAlphaTalker

What case could you make for funding Arethere any obstacles to seeking funding

TEDrsquoS SOLUTIONAt this point Tedrsquos ability to communi-

cate is somewhat primitive Because of his cere-bral palsy he is not able to make conventionalsigns so the gestures he makes are understoodonly by those who know him well A simple elec-tronic communication device may work for Tedbut there are some prerequisite communicationskills he will have to master first Augmentativecommunication devices operate on the principleof choosing icons (abstract symbols) that repre-sent certain basic communications like a cup toindicate ldquoI want a drinkrdquo

In order to make a picturesymbol systemmeaningful and functional for Ted at his youngage his speech therapist began to work on point-to-object and point-to-picture activities WhenTed had mastered point-to-picture activities histherapist made a picture ring for him On thering were picture symbols (icons) for things thatTed might want to say Tedrsquos family his teacherand his classmates began to ask him to use hispictures to explain what he wanted Soon Tedwas using pictures to communicate simple wantsand needs effectively His word ring went withhim everywhere and helped him to ldquotalkrdquo topeople he did not know as well as to friends andfamily members

An unexpected bonus to the picture practiceis that Ted is verbalizing more and his speech hasbecome more intelligible He has even begun tosing An electronic communication device maybe in Tedrsquos future but for now he is learning tocommunicate well with his picture ring and somespoken words

Solution SummaryPoint-to-picture practice

Use of picture ring

32

GLORIAGloria an eighteen year-old with mild cog-

nitive delays and CP is about to finish highschool She has been using a laptop computerand switch access hardware and software in lieuof a pencil and paper to complete work in highschool The equipment and software were pro-vided by the school district through the IEP pro-cess Gloriarsquos current goal articulated in her In-dividual Transition Plan (ITP) as mandated byIDEA is to have a full-time job by the time she is22 She wants to work in an office and woulduse a computer system similar to her currentsetup As she moves into the transition periodthese questions must be addressed

Will the laptop computer she has been usingbe functional for her in the workplace

Will she need to consider new equipmentWhat would influence a decision to purchase newequipment

What funding sources might help Gloria topurchase new equipment

What case should Gloria make for funding

GLORIArsquoS SOLU-TION

Gloria is fortunate to have learned computerand word processing skills while she was inschool Now she must learn ways to transferthese skills into the work setting Laptop com-puters are not typical in offices instead whatGloria is more likely to encounter is a desktopworkstation with computer and printer In or-der to use a standard computer Gloria will needa switch access device and an onscreen keyboardto do word processing and data entry

Since single switch access is necessary forGloria to become employed in an office settingGloriarsquos Vocational Rehabilitation Counselor waswilling to make such a purchase for her Gloriaapplied to be a data processor with a temporaryemployment firm and got the job Gloriarsquos VRcounselor helped her to select switch access hard-ware compatible with most IBM compatible com-puters In her new job Gloria changes office set-tings frequently Each time she moves she takesher switch access device and onscreen keyboardsoftware with her With these portable items sheis able to adapt each new office setting to meether needs Having the right technology has madeGloria an adaptable and successful temporaryoffice employee

Solution SummarySwitch access

Onscreen keyboard software

33

Making Assistive Technology a Part ofChildrsquos Education

The ideal time for a child with a disabilityto learn to use assistive technology is whenthe child is learning all sorts of others skills

in early intervention services preschool and K-12 education Children who are eligible for earlyintervention services under Part C or special edu-cation under Part B of the Individuals with Dis-abilities Education Act (IDEA) are entitled to beevaluated for assistive technology needs and toreceive assistive technology devices and servicesif they are necessary to providing a free appro-priate public education In order for children toreceive the assistive technology to which they areentitled parents must be knowledgeable abouthow assistive technology fits into special educa-tion and the ways that AT can be included in achildrsquos Individualized Family Service Plan (IFSP)or Individualized Education Program (IEP)

ASSISTIVE TECHNOLOGY FOR YOUNG CHILDRENParents are often surprised to learn that

assistive technology can be appropriate for in-fants and toddlers Very young children whohave disabilities that limit their ability to inter-act with the environment by crawling touchingseeing or hearing can benefit from technologythat improves their interactions Federal educa-tion amendments require states to ldquopromote theuse of assistive technology devices and assistivetechnology services where appropriate to en-hance the development of infants and toddlerswith disabilitiesrdquo These amendments furtherrequire states to ldquofacilitate the transition of in-fants with disabilitiesfrom medical care to earlyintervention services and the transition fromearly intervention services to preschool specialeducation or regular education servicesrdquo

When Kayla was an infant her interactionswith the environment were very limited because

she has a genetic condition resulting in abnor-mally short arms and legs She could not turnover or crawl she had difficulty touching andgrasping objects As part of her early interven-tion program Kayla was introduced at the ageof six months to the use of switches When theswitches were positioned correctly she could ac-tivate switch-operated toys or noisemakers Theopportunity to interact with toys opened upKaylarsquos world She soon began to hunt for theswitches and to activate certain toys on com-mand She used the switches to make choicesbetween toys or sounds She became verballymore expressive and began to interact morereadily and more often with her parents and sib-lings

By the time that Kayla was three and readyfor preschool special education she was able tosit up and interact with a computer activated byswitches She could identify objects on the com-puter screen and match those objects to real ob-jects in the world around her At three Kaylacould identify and match some letters and shapeson the computer screen Though limited in hermobility Kayla became an active participant inclassroom activities She could interact withclassmates by playing computer games joiningin at circle time and participating in allpreacademic learning activities

Assistive technology was an integral and nec-essary part of Kaylarsquos early intervention servicesKaylarsquos parents were involved in writing the In-dividualized Family Service Plans (IFSPs) thatoutlined the services Kayla and their familyneeded From the beginning Kaylarsquos family hadthe opportunity to see how assistive technologycould be included in the IFSP and really make adifference in Kaylarsquos education and her life

Kaylarsquos story illustrates how assistive tech-

34

nology can be utilized from an early age and canbe part of the transition from medical treatmentto early intervention and from early interventioninto preschool special education or regular edu-cation Because of the availability of early inter-vention services there is no reason to wait untila child is of school age before trying assistive tech-nology Early use of the necessary technology willenhance a childrsquos development by increasingopportunities to interact with the environment

ASSISTIVE TECHNOLOGY AT SCHOOL AGE ANDBEYOND

When students enter kindergarten and begintheir regular public school years assistive tech-nology can continue to be a part of their specialeducation programs For students who are eli-gible for special education assistive technologymust be provided when it is necessary

(1) to support placement in the least restric-tive environment

(2) to ensure that a student benefits from hisor her education or

(3) to implement the goals and objectives inthe studentrsquos IEP

Needs for assistive technology should be oneof the considerations when a student is assessedto determine eligibility for special education Ifan assessment reveals that a student is eligiblefor special education then the multi-disciplinaryteam should consider assistive technology needswhen making recommendations for the Individu-alized Education Program (IEP) The team shouldanalyze what is required of nondisabled studentsof the same age and determine how many of theserequirements could be completely or partiallyfulfilled by the student being assessed if that stu-dent had access to appropriate assistive technol-ogy

In addition when information is being col-lected for the present level of performance sec-tion of the IEP part of that assessment should bea consideration of whether or not assistive tech-nology is necessary for the student to achieve

educational or social goals benefit from educa-tion or make reasonable progress in the least re-strictive educational setting Whoever is collect-ing the information might experiment withassistive technology applications to determinewhich ones might work for the particular student

Assistive technology should be considered asan option for every IEP Some students of coursewill not require technology but many studentswill benefit from technology that helps them tocompensate for their impairments School dis-tricts are not required to provide all of the pos-sible assistive devices that might be nice to haveor might provide the best possible arrangementsAssistive technology is required however whenits presence enables the student to make reason-able progress toward the goals the IEP Team iden-tifies

HOW TO INCLUDE ASSISTIVE TECHNOLOGY INTHE IEP

Assistive technology can be included in theIEP in a number of ways It may appear as partof the studentrsquos annual goals or short term objec-tives It may also appear in a list of specific ac-commodations which need to be made in orderfor the student to function in the least restrictiveenvironment For example the IEP might includesuch accommodations as the use of word pro-cessing use of a calculator use of a hand heldspell checker and so forth In addition the IEPmay specify that as a related service necessaryfor the student to benefit from his or her educa-tion the student will receive training in the useof assistive equipment like an electronic commu-nication device a power wheelchair or a personalcomputer

WHERE TO PUT ASSISTIVE TECHNOLOGY IN THEIEP

There are three places in the IEP whereassistive technology may appear (1) in the an-nual goals and short term objectives (2) in theenumeration of supplementary aids and servicesnecessary to maintain the student in the least re-

35

strictive educational setting and (3) in the list ofrelated services necessary for the student to ben-efit from his or her education

Assistive technology can be a part of the an-nual goals and short term objectives on an IEPbut there must be a certain degree of specificityin the goal in order for the role of assistive tech-nology to be clear An annual goal for the IEPshould express an estimate of what the studentcan accomplish in a particular domain during thecourse of one year under what conditions theskill is to be developed and what criteria will beused to indicate whether or not the skill has beenlearned

Many times IEP goals are broad vague andtotally nonspecific Such goals are impossible tomeasure and do not give any indication of whatis realistic to expect in terms of the studentrsquos be-havior or skill level in the course of a yearrsquos timeSuch broad goals are not useful in addressingassistive technology The inclusion of assistivetechnology in the IEP requires a degree of speci-ficity so that it is clear how and why the technol-ogy will be used to accomplish a particular goal

An annual goal which includes assistive tech-nology may indicate that the technology will bepart of the conditions under which some aca-demic or social skill will be acquired For ex-ample an IEP goal for a student with a learningdisability in written expression may look like this

10 Using a word processing program with spell-ing checker Shawn will compose three paragraphthemes composed of fifteen or more sentences with 80or better accuracy in the use of spelling punctuationand grammar

Objectives leading to this goal might includepreliminary exploration of the word processingprogram trials to learn effective use of the spell-ing checker drill and practice in writing singleparagraphs to the 80 level of accuracy in spell-ing punctuation and grammar increasing thelength of writing to two paragraphs and theneventually moving to three paragraphs with

gradually increasing degrees of accuracy

Another type of annual goal may address askill which is necessary for using assistive tech-nology Such a goal might appear this way

20 Using an adapted computer keyboard Rachelwill type 12 words per minute with no errors over 10or more consecutive trials

In this case Rachel would spend a year learn-ing keyboarding skills with the goal of achievingat least 12 words per minute with complete ac-curacy For a young student who experiencessome fine motor difficulties this goal would bechallenging but it might be achievable in a yearrsquostime Objectives leading to this goal might in-volve preliminary exploration of the keyboardgradual introduction of the letters and numberson the keyboard practice to build speed and ac-curacy and eventually timed trials until 10 con-secutive trials could be achieved with no errorsat a rate of 12 words per minute or better

Still another type of annual goal might ad-dress a social issue like communication withpeers

30 Using an electronic communication deviceSara will respond appropriately to social inquiries fromclassmates 5 times out of 5 opportunities over 5 con-secutive days

Objectives leading to this goal might includetraining in the use of particular words andphrases on the communication device drill andpractice in responding with the device in struc-tured settings increasing accuracy in respond-ing in structured settings practice in unstruc-tured conversational opportunities and gradualachievement of accuracy in unstructured conver-sational settings with peers

ASSISTIVE TECHNOLOGY AS A RELATED SERVICEAssistive technology can be a related service

just like audiology physical therapy or speech ifit is necessary for the student to benefit from hisor her education For a student to be successfulin using assistive technology he or she must be

36

trained in its use Training to use a computer anaugmentative communication device a PhonicEar or large type viewer or other similar devicescan occur as a related service which supports thestudentrsquos educational program Preparation forthe use of assistive technology can also be workedinto other related services like occupationaltherapy Occupational therapy may involve de-termining correct positioning to take advantageof assistive technology and exercises to preparethe student to use a computer keyboard or a com-munication board

Margo who has muscular dystrophy uses alaptop computer every day in her sixth gradeclass Margorsquos upper body strength is diminish-ing and she is gradually having greater andgreater difficulty using her hands for writing ordrawing Using a computer saves her energy andallows her to keep performing well in the class-room As a related service in her IEP Margo isreceiving occupational therapy designed to pre-pare her for even more adaptations which maybe necessary as she loses more strength Margoand her therapist are experimenting with com-puter access devices (eg switches trackball) andon screen keyboards to determine what methodMargo would like to use when her hands are nolonger strong enough to type on a standard key-board This special training for assistive technol-ogy is written into Margorsquos IEP as a related ser-vice because such training is necessary for her tocontinue to benefit from her education

ASSISTIVE TECHNOLOGY SUPPORT FOR PLACE-MENT IN THE LEAST RESTRICTIVE ENVIRON-MENT

One important feature of assistive technologyis the fact that it can make it easier for studentswith and without disabilities to learn togetherStudents with disabilities are guaranteed the rightto be with nondisabled peers and to receive theireducation in the setting which is the least restric-tive environment In order to be successful in theleast restrictive environment students are to be

afforded whatever supplementary aids and ser-vices are necessary Among the supplementaryaids which may allow a student to remain in aless restrictive environment are a variety ofassistive devices that compensate for disabilityand allow the student to perform educational andsocial tasks Assistive technology is necessary asa supplementary aid if its presence (along withother necessary aids) supports the student suffi-ciently to maintain the placement and its absencerequires the studentrsquos removal to a more restric-tive setting For example if a student with mul-tiple physical disabilities can make progress onhis or her IEP goals in the regular classroom withthe use of a computer and an augmentative com-munication device and cannot make suchprogress in that setting without the devices thenthose devices are necessary supplementary aids

Lyle a fourth grader with cerebral palsy is agood example of a student who thrives in theregular classroom if he has the use of appropri-ate technology Lyle is able to keep up academi-cally with his classmates if he has access to a com-puter with an adapted keyboard and word pre-diction software Lyle has learned to type welland is able to do written assignments in relativelythe same amount of time as other students in hisclass Without a computer Lyle could not keepup at all Handwriting is a laborious task for Lyleand his written product tends to be messy andbarely readable If he could not use a computerLyle would have to rely on others to do hand-writing for him or he would have to do alterna-tive assignments that require no writing

Lyle likes being a regular fourth grader Heis proud of his writing on the computer becausehe is using his own words and learning to editout his mistakes by himself With his computerhe does not need the services of an aide and canbe completely independent in doing his schoolwork

Assistive technology in the form of a com-puter with appropriate software and keyboard

37

adaptations is necessary for Lyle to remain in theregular classroom working independently Thisuse of the computer can be written into his IEPas a supplementary aid which is necessary tosupport Lylersquos placement in the least restrictiveenvironment

Does assistive technology include access toschool buildings

AT certainly can mean devices that provideaccess to school buildings and facilities Oneimportant part of a free appropriate public edu-cation is that students with disabilities are ableto get to school get into the school and use theschool building and facilities Assistive technol-ogy can be used to provide access to the schoolbus classroom playground gymnasium audi-torium lunchroom or the equipment in themAny or all of these needs can be addressed in theIEP

Bus modifications for improved access andappropriate seating can help with transportationto and from school and school activities Doorswalkways handles switches stairs steps can bemodified so that a student with disabilities canuse them as effectively as classmates Appropri-ate seating and playground modifications canhelp include students who have disabilities atclassroom lunchroom and recess times

When an individual graduates from publicschool is it still possible to have assistivetechnology

If individuals benefit from the use of assistivetechnology during their school years the likeli-hood is that assistive technology will be evenmore important for them in adult livingAssistive technology can certainly be part of anindividualrsquos future after high school but it is nec-essary to begin planning for the transition fromhigh school so that the technology and other nec-essary services are available when needed

The earlier a family can estimate their childrsquospost-high school needs including needs for tech-nology the earlier transition planning can begin

Federal legislation says that transition planningcan begin in school as early as ldquo14 or youngerrdquoEach student with a disability who has an Indi-vidualized Education Program (IEP) should havea ldquostatement of transition servicesbeginning nolater than age 16rdquo This means that as early asmiddle school but probably not later than fresh-man year in high school families should begintransition planning

Unlike school services services in the adultworld are not mandated An individual may beeligible for a disability service but not receive itbecause all of the slots are filled or funding is notavailable If an individual does not own his orher own assistive technology devices then partof transition planning will be looking into fund-ing sources that could help with technology pur-chases If technology is necessary for the indi-vidual to become employed it is possible thatVocational Rehabilitation will pay for the devicesas part of an Individual Work-Related Plan(IWRP) Students who go on to postsecondaryeducation at community college vocational-tech-nical schools or universities can expect to be ableto receive certain accommodations for their dis-abilities while on campus Most postsecondaryinstitutions have Student Support Services thathelp with assistive technology needs alternativetesting readers and notetakers

SummaryAssistive technology can be included as an

integral part of a studentrsquos education but par-ents have to be knowledgeable about how to goabout getting assistive technology into theirchildrenrsquos educational plans Assistive technol-ogy can be written into the Individualized Fam-ily Service Plan (IFSP) for infants and toddlers inearly intervention programs and into the Indi-vidualized Education Program (IEP) forpreschoolers and students in grades K through12 Assistive technology can appear in threeplaces in the IEP (a) as part of the goals and ob-jectives (b) as a supplementary aid to support

38

placement in the least restrictive environmentand (c) as a related service Assistive technologycan also be a part of studentsrsquo transition planningas they move from high school into adult pur-suits Assistive technology is available throughVocational Rehabilitation and other adult disabil-ity services but these services are not mandatedTo ensure continued use of assistive technologyit is important to plan ahead and secure fundingfor devices needed in the work or postsecondaryeducation environments

Hints for Parents

If your child is a successful assistive technologyuser begin to save money early in your childrsquos lifemdashjust as you might save for college Gradually accu-mulate enough funding to purchase the kinds of tech-nology your child will need as an adult Technologychanges so fast that it is impossible to predict whatwill be available fifteen years from now But a parentcan be certain that assistive technology of the futurewill be even better than what is available today

EmilyEmily is a seventh grade student who has

learning disabilities She is in regular classes allday in her neighborhood middle school A spe-cial education teacher monitors Emilyrsquos progressand provides the regular classroom teachers withassistance by modifying some of Emilyrsquos assign-ments giving her oral tests helping to organizeEmilyrsquos work and reteaching certain skills asnecessary In elementary school Emily did wellwith the limited amount of support she receivedin the regular classroom In middle school how-ever she is having trouble keeping up with as-signments Emilyrsquos spelling is inaccurate sheoften misspells the same word three or four dif-ferent ways on the same page Her handwritingis very slow and laborious so she spends manyhours each evening working on her homeworkShe has tried tape recording assignments but shefinds this process also to be laborious because itis so time consuming to correct mistakes

It has been recommended that Emily be re-moved from some of her academic classes andreceive instruction in the resource programEmily wants to remain in regular classes but shecanrsquot keep up with the pace

How could assistive technology help Emily

What are her needs

What case could be made for assistive tech-nology for her

39

Emilyrsquos SolutionEmily has reached the point in her educa-

tional career when she cannot keep pace with thedemands of the written work On observingEmily the occupational therapist noted that ittook Emily five times as long as the average stu-dent in her English class to complete written as-signments

Emilyrsquos IEP Team decided she was spendingfar too much time on the handwriting processTo help her with this problem the team agreedthat Emily should learn to use a computer with aword processing program and a voiced spellchecker One period per day Emily goes to theresource room to practice keyboarding and workon longer written assignments During her regu-lar classes Emily uses a portable word proces-sor (eg AlphaSmart) to take notes which shecan print out later in the resource room

These simple solutions allow Emily to speedup her writing time and produce written workthat is easy to correct and edit With technologyto aid her Emily is spending less time on thehandwriting process and more time on thinkingand processing information Her homework timehas been cut in half and Emily is much more re-laxed and confident at school

Solution SummaryKeyboarding training

Use of computer with word processingsoftware

Use of voiced spell checker

Use of portable word processor

BryanBryan is a seventh grader with a neuro-mus-

cular disease that has caused him to lose physi-cal function He is a bright student with excel-lent academic skills Bryan uses a laptop com-puter with a trackball and an onscreen keyboardto do all his written work He navigates skill-fully around the school building using a powerwheelchair Technology has really helped Bryanto fit in and do well at school However now asa young adolescent Bryan is beginning to feelleft out socially He requires so much help withhis physical needs that he has to spend lots oftime with adults Bryan wants to ldquohang outrdquo likethe other kids his age and escape adult scrutinyonce in a while

Bryan is nonverbal He uses a complex so-phisticated electronic communication device toparticipate in class The device is programmedwith phrases that Bryan frequently uses and healso can select icons to create sentences of hisown Bryanrsquos communication device works wellfor him in formal classroom settings but it isbulky and cumbersome to use in casual conver-sation with friends Bryan has come to believethat his communication device is actually a bar-rier to the kinds of informal interactions he wantsto have

Bryan knows that he has the best in technol-ogy and that the equipment he uses was very ex-pensive He doesnrsquot want to appear ldquogreedyrdquo ordemanding so he has not told his parents abouthis dissatisfaction with his ability to communi-cate One of Bryanrsquos friends Michael howevernoticed that Bryan was acting pensive and un-usually quiet Michael gently coaxed the truthout of Bryan and offered to help his friend thinkof a new way to ldquotalkrdquo that would provide himwith more flexibility and independence

40

Bryanrsquos SolutionWhen Bryan and Michael put their heads to-

gether they came up with lots of ideas The onethey settled on as the most feasible involved us-ing the laptop that Bryan already had The laptophad some advantages because it was small andportable and Bryan already knew how to use itvery well In a catalog of special needs softwarethe friends found communication software thatoperated on an icon system and the price wasright--around $100 With communication soft-ware installed on the laptop Bryan had asimplermore portable device for talking in ca-sual settings

Next Michael asked his father to help themmake a tray for Bryanrsquos wheelchair that wouldhold the laptop and fold down beside the chairout of the way when not in use Michaelrsquos dadcame up with a clever tray on hinges that foldedto the side The laptop fastened to the tray withwide rubber bands A handle on the tray allowedBryan to raise and lower the tray as needed

In addition to his laptop Bryan also neededa device for quick greetings and spontaneous re-torts Bryan and Michael chose a programmableswitch with the capacity to record up to 12 mes-sages Bryan could operate the switch quickly byhitting it with his elbow He and Michael had agreat time recording messages suitable for talk-ing to their friends or to girls

What Bryan found out was that he neededmultiple ways to communicate so that he couldcustomize his electronic speech to fit the settingand the occasion For a relatively small financialinvestment Bryan and Michael were able to ex-pand communication possibilities for Bryan andallow him greater control and personal choiceabout what he said how he said it and to whom

Solution SummaryCommunication softwareDrop-down wheelchair trayProgrammable switch

TracyTracy is a man in his mid-thirties who has

been blind from birth Since graduating fromcollege he has held a series of entry level jobs atminimum wage and without benefits Tracy isfrustrated by the lack of challenge in the jobs hehas had he would like to have a managerial po-sition with some opportunities for advancementbetter pay and benefits

Currently Tracy is working at a Pizza Hutrestaurant where he prepares pizzas for the ovenHe enjoys his co-workers and regular customersbut Tracy wants more A management traineeopening has been announced in the companynewsletter and Tracy decides to apply This newposition involves taking pizza orders over thetelephone and sending the order via computerand modem to the appropriate Pizza Hut outletwhere the pizzas will be made Having madeevery possible type and size of pizza Tracy isvery familiar with the options But how couldhe operate the computer and record orders asthey come in over the telephone Would he havea chance for this job which could be his first stepup

41

Tracyrsquos SolutionTracy and his Vocational Rehabilitation Coun-

selor filled out the job application for the posi-tion at Pizza Hutrsquos central ordering facility andTracy was called to set up an interview Prior tothe interview Tracy and his job counselor wentto the central ordering facility for Pizza Hut tostudy aspects of the job and to determine if tech-nology could assist Tracy to perform the essen-tial job functions The job involved the follow-ing steps (1) greeting the customer and takingdown customer information (2) asking a seriesof questions about the customerrsquos order (egtype size toppings) (3) simultaneous record-ing of the order via computer and (4) sendingthe order to the appropriate Pizza Hut outlet

After studying the process of taking ordersTracy and his counselor decided upon the follow-ing technology

(a) A computer compatible with the Pizza Hutnetwork

(b) Voiced software so that Tracy couldldquohearrdquo what he was typing

(c) A telephone headset to listen to the cus-tomer with one ear

(d) an ear piece to listen to the computer

At his interview for the job Tracy explainedhis qualifications for the position--college degreeexperience with Pizza Hut He also told the in-terview team about how technology would al-low him to do the job as efficiently and effectivelyas other workers

The interview team members were impressedby Tracyrsquos initiative and his work ethic Theychose him over several other qualified candi-dates Though it took some detective work toput together a computersoftware package com-patible with Pizza Hutrsquos system Tracy was ableto do it

From the first day on the job Tracy knew he

was going to like it better than anything he haddone before Listening to the computer and thecustomer simultaneously was challenging at firstbut soon Tracy had mastered the process Afterthree months in his new position Tracy wasasked to become the manager for his shift Nowhe hires and trains new order clerks schedulesworkers and evaluates their job performanceTracy has what he wanted--a managerial posi-tion better wages and a future with the com-pany

Solution SummaryCompatible computer terminal

Voiced software

Telephone headset

Ear piece for computer

42

Advocating forAssistive Technology

In the area of Assistive Technology mdash just as in so many areas of need mdash parents must betheir childrenrsquos best advocates Federal and

state laws support providing assistive technol-ogy to individuals with disabilities but theselaws are only meaningful when parents knowabout them and can use legal processes to securetheir childrenrsquos rights Here are just a few of thelaws on which parents can rely when advocat-ing for assistive technology for their children

THE AMERICANS WITH DISABILITIES ACT OF1990

The Americans with Disabilities Act (ADA)proposes to eliminate ldquodiscrimination againstindividuals with disabilitiesto address the ma-jor areas of discrimination faced day-to-day bypeople with disabilitiesrdquo The ADA applies spe-cifically to the areas of employment public ac-commodations and government functions Inthese areas the ADA requires that reasonable ac-commodations be made so that people with dis-abilities can have an equal opportunity to par-ticipate in employment opportunities public ac-commodations and government functions TheADArsquos definition of ldquoauxiliary aids and servicesrdquoits mandates for ldquoacquisition or modifications ofequipment and devicesrdquo and ldquoreasonable accom-modationsrdquo support the provision of assistivetechnology devices and services to individualswith disabilities

THE REHABILITATION ACT OF 1973Section 504 of the Rehabilitation Act requires

that any ldquoprogram or activity receiving Federalfinancial assistancerdquo comply with non-discrimi-nation rules Section 504 Regulations require thatpublic schools provide students who have dis-abilities an educational opportunity equal to theeducational opportunity provided to students

without disabilities Section 504 also uses theterm ldquoreasonable accommodationsrdquo which canmean the provision of assistive technology de-vices and services

THE INDIVIDUALS WITH DISABILITIES EDUCA-TION ACT (IDEA)

The Individuals with Disabilities EducationAct (IDEA) requires free appropriate public edu-cation (FAPE) for students with disabilities IDEAmandates education in the least restrictive envi-ronment requires schools to use supplementaryaids and services special and related services tohelp assure that students with disabilities par-ticipate in and benefit from public educationAssistive technology is specifically mentioned inIDEA as a service which school districts may haveto provide in order for a student with disabilitiesto benefit from special education

THE CARL PERKINS ACTThe Carl Perkins Act assures that Vocational

Education programs in public schools are madeaccessible to students with disabilities The lawassures supplementary services including class-room curriculum and equipment modificationssupportive personnel instructional aides and in-structional devices

PARENT RESPONSIBILITIESIn order to be effective advocates for their

children parents need to familiarize themselveswith all the laws that support the provision ofassistive technology Copies of the laws and theirregulations are available from the offices of mem-bers of the House of Representatives and the Sen-ate

Besides knowing the law parents must par-ticipate actively in developing plans for theirchildrenrsquos education that include assistive tech-nology when it is needed Parents must attend

43

IFSP and IEP meetings and be prepared to workcooperatively with other team members Whena parent questions an assistive technology evalu-ation or an IEP Team recommendation the par-ent must be prepared to follow-up on those ques-tions including using due process rights whennecessary

What should a parent do when an agencyrefuses to pay for assistive technology that achild needs

Agencies like early intervention programsand school districts are mandated to provideassistive technology if the need for technology isin the childrsquos written plan If one of these agen-cies refuses to pay for needed technology then aparent must consider using due process rightsIn early intervention services the parent wouldfollow the appeal process laid out by the leadagency for Part C When school district servicesare involved the parent can file a complaint ifservices in the IEP are not provided or can askfor a due process hearing if the parent and theschool district disagree about the need forassistive technology If a parent disagrees withthe results of an evaluation for assistive technol-ogy the parent can ask for an independent evalu-ation at school district expense

SummaryOverall getting the devices and services for

children with disabilities means that parents mustbe part of the planning team at every level of theirchildrenrsquos education It means talking with otherfamilies and users of assistive technology aboutdevices and services learning how they foundthe best technology and figuring out where togo when resources are few Getting assistive de-vices and services is not always an easy job Buthelp is available Working with professionalstalking with consumers and other families par-ents can find the best avenues for providing theirchildren with the assistive technology they needIn the end the effort is worth it because assistive

technology is not just a civil right guaranteed bylaw it is also a means to achieve human rights togrow up happy independent and self-sufficientas possible

Hints for Parents

When advocating for your child in the special edu-cation arena donrsquot forget the following facts aboutassistive technology and the IEP

bull Assistive technology needs must be con-sidered along with a studentrsquos other edu-cational needs

bull Needs for technology must be identifiedon an individual basis

bull Identification of technology needs mustinvolve parents the student when appro-priate and a multidisciplinary team

bull Parents or other IEP Team members can askfor additional evaluation or an indepen-dent evaluation to determine assistive tech-nology needs

bull When an evaluation is being conductedconsider mobility fine-motor skills com-munication and alternatives to traditionallearning approaches

bull Lack of availability of equipment or costalone cannot be used as an excuse for de-nying assistive technology services

bull If included in the IEP assistive technologyservices and devices must be provided atno cost to the family

bull Parents always have the right to appeal ifassistive technology services are denied

44

More Questions and Answers

A re schools required to pay forassistive technology devices andservices

It is the responsibility of the school dis-trict to provide for the equipment services orprograms identified in the IEP The school dis-trict may pay for the equipment service or pro-grams itself utilize other resources to provide orpay for the device or utilize private insurancefunds Medicaid or other sources of funds as longas the device or services identified in the IEP areprovided at no cost to the parent Private insur-ance or Medicaid may be used ony if the parentagrees

Can schools require the parents to payfor an assistive technology device orservice identified in the studentrsquos IEPor require the parents to use theirown private health insurance to payfor the device or service

No The ldquofreerdquo in FAPE means that parentsof students with disabilities who require assistivetechnology devices or services do not have to payfor these items As stated in IDEA and its regu-lations all special education and related servicesidentified in the studentrsquos IEP must be providedldquoat no cost to the parentrdquo The term ldquofreerdquo is in-terpreted broadly and goes far beyond the simplepaying of deductibles and co-payments Thecourts have interpreted ldquofreerdquo to apply to butnot be limited to future insurability depletionof maximum lifetime caps raised premiums dis-continuation of policies and preexisting condi-tion exclusions If the family agrees to allow theschool to access their Medicaid or private insur-ance this decision must be strictly voluntary onthe part of the family

How can school districts use Medicaidfunds to purchase assistive technologydevices

If Medicaid is capitated in any way concern-

ing its use for assistive devices school districtsmust request from parents the right to use Med-icaid funds However parents are not obligatedto use their Medicaid funds to purchase devicesor services used at school With permission aparentrsquos private insurance must be accessed be-fore Medicaid can be used for assistive technol-ogy devices Medicaid regulations vary some-what from state to state so it is wise to consultthe state Medicaid Service Bureau before mak-ing any assumptions about Medicaid and thepurchase of assistive technology

Are there other options for schools toconsider in lieu of purchasing theassistive technology device

Yes There are times when the outright pur-chase of equipment or devices is not necessaryor even advisable In such instances schoolsmight consider rental or long-term lease optionsThere are certain advantages to renting or leas-ing depending on the individual needs of thestudent For example renting equipment mightbe a reasonable strategy if the student is expectedto improve or deteriorate in a short period of timeor when it is necessary to try out the equipmentbefore purchase Long-term leasing or leasepurchase agreements also have potential benefitsfor schools which include no obligation on be-half of the school to purchase the device abilityto return leased equipment and thus reduce ob-solete inventory flexible leasing terms use ofequipment without a lump-sum purchase up-grading of equipment as more improved tech-nology becomes available and upgrading ofequipment as the studentrsquos needs change

Isnrsquot assistive technology just acrutch Wonrsquot students become toodependent on technology and notlearn to use the skills they have

Assistive technology should be used as sup-port for access learning and performing daily

45

tasks In general assistive technology is appro-priate when it compensates for disabilities so thatthe individual can function as normally as pos-sible If assistive technology is necessary for astudent to have access to educational opportuni-ties or to benefit from education then it is not aldquocrutchrdquo but a legitimate support Some skillsare too laborious or taxing to accomplish at a rateor with degree of proficiency to allow for partici-pation in the least restrictive environment Withassistive technology the student can participatemore fully and more closely approximate the lev-els of achievement and interaction of his or herpeers In general the use of assistive technologyenhances function and increases skills and op-portunities Though a student may be dependentupon a particular device in order to perform skill-fully denying the device denies the student anopportunity ever to achieve success at the levelof his or her potential

When is assistive technology appropri-ate

Assistive technology may be considered ap-propriate when it does any or all of the follow-ing things

bull Enables students to perform functions thatcan be achieved by no other means

bull Enables students to approximate normalfluency rate or standardsmdasha level of ac-complishment which could not beachieved by any other means

bull Provides access for participation in pro-grams or activities which otherwise wouldbe closed to the individual

bull Increases endurance or ability to persevereand complete tasks that otherwise are toolaborious to be attempted on a routine ba-sis

bull Enables students to concentrate on learn-ing tasks rather than mechanical tasks

bull Provides greater access to information

bull Supports normal social interactions with

peers and adults

bull Supports participation in the least restric-tive educational environment

Who owns the special equipment thatis purchased for students

If the school district purchases the equipmentthe equipment belongs to the district Someschool districts designate that a particular deviceis to be used by a specific student during the timewhen that device remains appropriate for thatstudent Other districts have ldquopoolsrdquo of assistivedevices and distribute them for use by a varietyof students The distribution and use of devicesis under the districtrsquos control as long as the needsdescribed in studentsrsquo IEPs are being met

If devices are purchased for a particular stu-dent using that studentrsquos Medicaid funds or pri-vate insurance then the device belongs to the stu-dent and is meant for the exclusive use of thatstudent

When a student moves from one levelof schooling to another like elemen-tary school to middle school does thedevice follow the student

If an assistive device is necessary in order tofulfill the requirements of a studentrsquos IEP such adevice must be provided in whatever school thestudent attends The same device may not nec-essarily follow the student from one school toanother but a comparable device which fulfillsthe IEP requirements would have to be providedin the new school that the student attends

If a family moves from one schooldistrict to another can a studentrsquosassistive technology go along

Devices bought by the school belong to theschool not the student who uses them When afamily moves from one school district to anotherthe equipment the student has been using doesnot automatically move to the new school

Assistive equipment can go with a studentto a new school if the sending school district

46

agrees to sell or give the device to the family orthe new school district

If the device was purchased by the familythrough the familyrsquos private health insurance orby Medicaid for this particular student then thedevice belongs to the student and can go withthe student to a new school district

What happens to assistive technologydevices when students leave the schoolsystem at graduation

If the school district purchased the device thedevice is the property of the school The schoolcould keep the device for use by other studentssell it or decide to transfer the device to anotherdistrict or loan program If the family or anotherfunding source purchased the device it is theproperty of the student and the family

If a piece of assistive technology is nolonger needed or relevant to a studentand the device was paid for by Medic-aid or private insurance can it bedonated for another studentrsquos benefit

Yes it is a parental decision The parentscould donate the device to the school for use byother students with disabilities or to some otherorganization which loans out equipment

Can assistive devices be insured

Many school district liability policies willcover devices purchased by the district for stu-dent use Devices purchased by other fundingsources may or may not be covered while onschool premises or involved in school activitiesIt is important for school staff to investigate thedistrictrsquos property insurance to determine whatthe policy currently covers and whether or notthe policy insures against loss or damage ofassistive devices

Parents who own assistive devices that areused at home and at school may also wish to pur-chase home owners or rentersrsquo insurance with aspecial rider that covers damage to or loss of thedevice

Who is responsible for the repair and

maintenance of assistive devices

In general the school district is responsiblefor repair and maintenance of assistive devicesused to support educational programs describedin the IEP or covered by Section 504

If a device is broken and is beyondrepair who replaces the broken de-vice

If an assistive device is necessary for thestudentrsquos IEP to be implemented then the schooldistrict will have to replace a broken lost or sto-len device

If a device is broken and sent off forrepairs must the school district sup-ply a substitute device until the origi-nal device is returned

If the assistive technology device is vital tothe studentrsquos daily special education program itis not reasonable for the student to be without adevice for long periods of time If a device isgoing to be unavailable for more than a day ortwo the district should provide a backup ma-chine which allows the student to continue work-ing on IEP goals

Is the school district obligated totrain substitute teachers and aides tooperate assistive technology devices

Again if the assistive technology device isvital to the studentrsquos daily special education pro-gram it is not reasonable for the student not tobe able to use the device for long periods of timebecause a substitute is teaching the class If thesubstitute is only going to be in the classroomfor a day or two it is probably not necessary toprovide elaborate training However if the sub-stitute is going to be in the classroom for an ex-tended time training should be provided

Must school districts allow students totake assistive devices home on schoolnights to do homework Over week-ends During school vacations Overthe summer

In many cases it is desirable for students to

47

have the opportunity to use the same assistivetechnology devices at home and in school Forexample when a student is completing home-work assignments assistive technology may benecessary to produce the type of product that isrequired Some school districts have policieswhich allow the devices to go home with the stu-dents overnight on weekends or during vaca-tion or summer periods In general these kindsof policies are a local district matter and may bedetermined according to local district needs Ifhowever a studentrsquos IEP includes a provisionwhich says the student is to have access to anassistive device both at school and at home thenthe school district would be obligated to allowthe student to take a device home or provide twodevices one for home use and one for school

What professionals are consideredqualified to assess a student in thearea of assistive technology

Because assistive technology is such a newfield there are no national standards and few lo-cal or state standards for licensing or certificationfor specialists in assistive technology Howeverschool districts often have professionals who havereceived training in conducting assistive technol-ogy evaluations and are able to provide the ser-vices identified in the IEP If a district does nothave personnel who are knowledgeable in con-ducting such evaluations the district can arrangefor such services from other knowledgeable pro-vidersndash such as Independent Living Projects Al-liance for Technology Access Centers or Tech ActProjects

How can one distinguish betweenassistive technology and personalitems (eg wheelchairs hearing aidseyeglasses crutches)

Currently IDEA does not make a clear dis-tinction between assistive technology devices andpersonal items This confusion stems in large partfrom IDEArsquos broad definition of assistive technol-ogy For example if a student with a disability

needs eye glasses in order to obtain FAPE thenthe school district is obligated to provide themat no cost to the parents In general howeverschool districts do not purchase personally pre-scribed devices such as hearing aids or glasses

Who determines how assistive tech-nology will be purchased and withwhat available funding resourcesmdashtheIEP Team or school administration

Once the IEP team makes the determinationthat assistive technology must be provided aspart of the studentrsquos IEP it is the responsibilityof school administration to determine how theassistive technology will be provided and withwhich funding sources

Is a school district responsible forproviding ldquostate of the artrdquo equip-ment for a student

No The school district need provide onlyappropriate technology in order to meet thestudentrsquos needs as described in the IEP The de-cision as to what type of assistive technology isappropriate should be based on the assistive tech-nology evaluation recommendations and IEPteam decision There may be ldquodevicesrdquo or fea-tures of equipment which may be nice for the stu-dent to have but if they are not necessary forFAPE the school district is not obligated to pro-vide them If a specific device is necessary toensure FAPE and no other device can meet thestudentrsquos needs then the district must providethe required device even though it is costly If aless expensive device would accomplish the samegoals the IEP team is under no obligation tochoose a more expensive option

If a student needs a computer can aschool owned computer be used in thelab or classroom

Yes a school owned computer can be used ifthe student has access to the equipment when heor she needs it If the student does not have thenecessary access then the appropriate equipmentshould be purchased for the studentrsquos use

48

Can school district administratorsinstruct personnel not to includecostly assistive technology devices inthe IEP

IEP teams are charged with the responsibil-ity for determining a studentrsquos need for assistivetechnology devices and services and for specify-ing those devices and services Therefore it isimportant that IEP teams are clearly informed oftheir responsibility to determine if a studentneeds a device and the need for an assistive tech-nology evaluation to assist in making the deter-mination A school district may not have a policywhich prevents IEP teams from identifying astudentrsquos need for assistive devices or services

How does assistive technology getintegrated into the curriculum

The IEP team needs to discuss how the de-vice will be used by the student and how it willbe integrated into the curriculum The IEP teamshould identify on the IEP how the device willbe used by the student in the classroom Thisinformation should be shared with the generalclassroom teachers so that they are aware of howit is to be used

How can assistive technology be pro-vided from year to year with a degreeof continuity

As part of the annual review of the IEP a pointshould be made to devise ways to communicatewith next yearrsquos teachers about the technologythe student uses and how it should be integratedinto the curriculum Teachers who are new toworking with the student who uses technologyshould be provided training if they are unfamil-iar with the device and its use Training for teach-ers and support staff should be written into theIEP as a related service

Can an assistive technology device beused by more than one student

Yes if the device is the property of the schooldistrict and if all of the students using the devicehave access to the equipment when they need it

Can an independent evaluation berequested to address assistive tech-nology

Yes The school district is required to evalu-ate a student in all areas of suspected disabilityincluding if appropriate evaluating the studentrsquosneed for assistive technology A parent has theright to an independent educational evaluationat public expense if the parent disagrees with anevaluation obtained by the school district How-ever the school district may initiate a due pro-cess hearing to show that its evaluation is appro-priate If the final decision is that the evaluationis appropriate the parent still has the right to anindependent educational evaluation but not atpublic expense If the parent obtains an inde-pendent educational evaluation at private ex-pense the results of the evaluation (a) must beconsidered by the school district in any decisionmade with respect to the provision of FAPE tothe child and (b) may be presented as evidenceat a due process hearing

What is a product system

A product system is more than one piece ofequipment working together to produce a resultFor example an FM system that works in con-junction with a studentrsquos hearing aid is a prod-uct system

Can the school district require a stu-dent to bring a personally ownedassistive device such as an augmenta-tive communication system or laptopcomputer to school in order to doschoolwork

No However the family may wish the childto use his or her equipment in school since thechild may be more familiar or comfortable withit The IEP team should decide who is respon-sible for repair and maintenance of family owneddevices

Is it sufficient for a school district tosupply access to a district-ownedcomputer but provide no software

49

that is appropriate for the student touse

Just providing access to a computer does notfulfill the districtrsquos obligation to provide assistivetechnology to support FAPE The educationalaspect of the computer is very much related tothe software that the student uses If no appro-priate software is available then the student can-not pursue the IEP goals

50

Appendix

GlossaryASSISTIVE TECHNOLOGY any sort of aidincluding computers switches calculators spell-ing devices communication devices and voicesynthesizers which is used to help an individualperform some task of daily livingALTERNATIVE KEYBOARD may include en-larged reduced varied key placement one-handed braille chordic or any other device forentering text on a computerAUGMENTATIVE COMMUNICATION anydevice (electronic or otherwise) to enhance com-munication for a person with limited speechBRAILLE EMBOSSER a printer for producingbraille output either manually or when connectedto a computer When printing standard text froma computer it must first be translated into brailleBRANCHING describes the process of choos-ing among a sequence of choices or actions toproduce another sequence of choices This pro-cess is used in the ldquoscanningrdquo method of accessCD-ROM ldquoCompact Disk Read-Only Memoryrdquorefers to the 4-inch silver disks that typically hold700 megabytes of digital information and theplayers that access the information on these disksCURSOR either the flashing vertical or horizon-tal line on a computer screen that indicates theinsertion point for text or the arrow or I-beamthat indicates the position of the mouse pointeron the computer screenDESK ACCESSARY a small utility program thatruns on a computer and may be accessed fromany program at any time (such as a calculator)DRILL AND PRACTICE presents questionsrepetetively but is not a tutorial Software thatis only drill and practise doesnrsquot necessarily teachthe concepts needed to answer the questions pre-sented

ENVIRONMENTAL CONTROL any type ofdevice that an individual may use to control theirenvironment (lights appliances TV telephoneetc) This may include anything from simplereachers or sticks to computers and voice-acti-vated electronic systemsFM SYSTEM a local wireless broadcast systemthat consists of a microphone and transmitter forthe speaker and ldquowalkman-likerdquo receivers withheadphones for listeners with hearingimpairements or attention disordersHIGH TECH use of electronics or computers asa solutionICON a small computer graphic that appears onthe computer screen and may represent differ-ent types of objects (files or applications) or ac-tions depending on the context Use the mousepointer to click on icons that open files or per-form other actionsINDIVIDUAL FAMILY SERVICE PLAN (IFSP)the written document which defines the earlyintervention services provided to the child andfamily The program is designed to meet theneeds of the child and the family and is based onfamily-identified prioritiesINDIVIDUALIZED EDUCATION PROGRAM(IEP) a written plan specifying instructionalgoals and any special education and related ser-vices a student may need which must be writ-ten and reviewed annually Included are (1) thepresent educational levels of the student (2) astatement of annual goals including short-termobjectives (3) a statement of specific services ifneeded (4) the programs (5) the date when spe-cial services are to begin and the expected dura-tion of these services and (6) the tests and otherrequirements or information used to guage thestudentrsquos progress to determine if the instruc-tional objectives are being metINPUT the information that is transmitted to acomputer from a keyboard mouse or other in-

51

put deviceKEYBOARD a device for inputing text and com-mands to a computerKEYGUARD a plexiglass or other cover for akeyboard with holes for the individual keys Itallows more precise selection of keys for an indi-vidual with fine motor difficultiesKEYPAD a small keyboard with a 10-key setupfor numeric input or it may also be used as a con-trol for a screen-reader programLAPTOP a portable battery-powered computerthat is typically the size of a 3-ring binder weighs5-10 pounds and consists of a screen keyboardand disk-drivesLASER DISCS large (12-inch) CD-ROMs thatnormally contain moviesLOW TECH indicates use of low cost non-elec-tronic solutionsMACRO a simple short program that performsan action on a computer They are usually cre-ated by recording the keyboard andor mouseinput and storing them as an icon or key combi-nationMEGABYTE 1000 X 210 bytes of informationwhich basically means over one million key-strokes of computer storage (about 10 novels)MORSE CODE a direct method for computerinput using one to three switches and coded in-put to replace the keyboard and mouseMOUSE the name given to the pointing deviceused to control graphical user interfaces (GUI) ofmodern personal computersONSCREEN KEYBOARD a software programthat places the keyboard on the screen of the com-puter and may be accessed using a mouse or otherpointing device This is ideal for individuals whocannot use a regular keyboard but can use sometype of pointing deviceOPTICAL CHARACTER RECOGNITION(OCR) a process that utilizes special computersoftware to convert the scanned image of text intoactual text that may be edited by a word proces-sorOUTPUT computer-generated information for

the user This may be printed output from aprinter visual information from the screen orsounds from speakersSCANNER an electronic copier connected to acomputer Scanners are used to input drawingspictures or printed text into the computerSCANNING has nothing to do with the elec-tronic copier above It is another method for ac-cessing a computer or communication deviceusing one or more switches Scanning involvespresenting a group of choices cycling amongthem and making choices by activating a switchSCREEN READER software that reads text ona computer screen using a speech synthesizerThis allows individuals with visual impairmentsor other print disabilities to access text on thecomputer screenSIMULATION software that simulates real-world situations on a computer This may rangefrom a joystick trainer for driving an electricwheelchair to running citiesSPEECH SYNTHESIZER hardware or softwarefor producing electronic human speech on a com-puterSPELL CHECKER utility for checking the spell-ing in a documentSTICKY KEYS software or mechanical utility forallowing typing of multiple keystrokes with onefinger (using the shift or other modifier keys)SWITCH a device that is like a single button ofa keyboard or mouse Switches may be used byan individual with servere motor difficulties byany controllable muscle in their body (headhand toe eye breath etc) to operate any typeof computer communication or environmentalcontrol deviceSWITCH INTERFACE black box that connectsto a computer or other device that has plugs forswitchesTDD a text telephone used for communicatingin typed text over a phone line A TDD has akeyboard and text display or small printer Bothparties who are communicating over a phone linemust have TDDs

52

TOUCH WINDOW a computer input devicethat uses a touch-sensitive transparent windowplaced on the computer screen It performsmouse functions with a finger or stylus directlyon the screenTRACKBALL another replacement for themouse pointing device that uses a rolling ball toperform mouse movementsTUTORIAL teaches concepts presents informa-tion as opposed to simple drill and practiceVOICE RECOGNITION computer softwareand microphone that allows input and controlwith voice commandsWORD PREDICTION productivity softwarethat increases typing speed for one-finger typistsand others by predicting and choosing completewordsWORD PROCESSOR software for inputing andformatting textUSER person using a computerUTILITY software for adding function or per-forming housekeeping tasks on a computer

53

DocumentsSCHRAG LETTER ON ASSISTIVE TECHNOLOGY

August 10 1990

Dear Ms Goodman

This is in response to your recent letter to the Office of Special

Education Programs (OSEP) concerning the obligations of public

agencies under Part B of the Education of the Handicapped Act

(EHA-B) to provide assistive technology to children with handi-

caps

Specifically your letter asks

1 Can a school district presumptively deny assistive technol-

ogy to a handicapped student

2 Should the need for assistive technology be considered on

an individual case-by-case basis in the development of the

childs Individual Education Program

In brief it is impermissible under EHA-B for public agencies

(including school districts) to presumptively deny assistive tech-

nology to a child with handicaps before a determination is made

as to whether such technology is an element of a free appropriate

public education (FAPE) for that child Thus consideration of a

childs need for assistive technology must occur on a case-by-

case basis in connection with development of a childs individual-

ized education program (IEP)

We note that your inquiry does not define the term assistive

technology and that the term is not used either in the EHA-B

statute or regulations The technology Related Assistance for

Individuals with Disabilities Act of 1988 PL 100-407 contains

broad definitions of both the terms assistive technology device

and ldquoassistive technology service See Section 3 of PL 100-

407 codified as 29 USC 2201 2202 Our response will use

assistive technology to encompass assistive technology ser-

vices and ldquoassistive technology devices

Under EHA-B State and local educational agencies have re-

sponsibility to ensure that eligible children with handicaps receive

FAPE which includes the provision of special education and re-

lated services without charge in conformity with an IEP 20 USC

1401(18) 34 CFR S3004(a) and (d) The term special educa-

tion is defined as specially designed instruction at no cost to

the parent to meet the unique needs of a handicapped child 34

CFR S30014(a) Further related services is defined as includ-

ing transportation and such developmental corrective and other

supportive services as are required to assist a handicapped child

to benefit from special education 34 CFR ss33013 (a)

The EHA-B regulation includes as examples 13 services that

qualify as related services under EHA-B See 34 CFR S30013

(b)(1)-(13) We emphasize that this list is not exhaustive and

may include other developmental corrective or other supportive

servicesif they are required to assist a handicapped child to

benefit from special education 34 CFR S30013 and Comment

Thus under EHA-B assistive technology could qualify as spe-

cial education or related services

A determination of what is an appropriate educational program

for each child must be individualized and must be reflected in the

content of each childs IEP Each childs IEP must be developed

at a meeting which includes parents and school officials 34 CFR

S300343-300344 Thus if the participants on the IEP team de-

termine that child with handicaps requires assistive technology in

order to receive FAPE and designate such assistive technology

as either special education or a related service the childs IEP

must include a specific statement of such services including the

nature and amount of such services 34 CFR S300346(c) App

C to 34 CFR Part 3000 (Ques 51)

EHA-Bs least restrictive environment (LRE) provisions require

each agency to ensure (t)hat special classes separate school-

ing or other removal of handicapped children from their regular

educational environment occurs only when the nature or severity

of the handicap is such that education in regular classes with the

use of supplementary aids and services cannot be achieved sat-

isfactorily Part 121a 42FR 4251113 (August 23 1977)

Assistive technology can be a form of supplementary aid or ser-

vice utilized to facilitate a childs education in a regular educa-

tional environment Such supplementary aids and services or

modifications to the regular education program must be included

in a childs IEP Id Appendix C to 34 CF art 300 (Ques 48)

In sum a childs needs for assistive technology must be deter-

mined on a case-by-case basis and could be special education

related services or supplementary aids and services for children

with handicaps who are educated in regular classes

I hope the above information has been helpful If we may pro-

vide further assistance please let me know

Sincerely

Judy A Schrag EdD

Director Office of Special Education Programs

54

INDIVIDUALS WITH DISABILITIES EDUCATIONLAW REPORT

Cite as 18 IDELR 627

Digest of Inquiry

(Inquirerrsquos Name Not Provided)

(Date Not Provided)

bull Is a school district responsible to provide assistive

technology devices for home use

bull May a school board overrule a determination by an IEP

team that a child with a disability needs access to an

assistive technology device at home

bull What is the time limit on implementation of an IEP

Digest of Response

(November 27 1991)

Assistive Technology Devices May Be Required for Home Use

If an IEP team determines that a child with a disability needs

access to an assistive technology device at home as a matter of

FAPE then the school district must provide the device for home

use in order to implement the childrsquos IEP

School Board May Not Change IEP Teamrsquos Determination

Under Part B a school board has no authority to unilaterally

change any statement of special education or related services

contained in an IEP including a statement of a childrsquos need to

have access to an assistive technology device at home Without

reconvening the IEP team the school board may not change the

IEP and the school district is obligated to implement the IEP re-

quirements regardless of the school boardrsquos objections

IEPs Must Generally Be Implemented

Under Reg 300342(b) an IEP must be in effect before the

provision of special education or related services and must be

implemented as soon as possible following the conclusion of the

IEP meeting(s) In accordance with Appendix C to the Part 300

regulations an IEP should generally be implemented without de-

lay after being finalized although a reasonable delay may be per-

missible in limited circumstances

__________________

Text of Inquiry

I would like to have a copy of the policy classification on

Assistive Technology

I also have a question to ask regarding Assistive Technology

such as a closed circuit TV

My daughter uses a CCTV in school and it is on her IEP

program My daughter is visually impaired The initial request

was made by me the parent to the appropriate people involved

in her education and discussed and approved by the committee

on an individual basis

My question is I would like to make the request to the ap-

propriate officials for another CCTV for home use to accomplish

the same results at home as is done in school (For homework

reading books any assignments from school)

Another question is If the committee approves this request

it will go to School Board for approval I would like to know what

happens if the School Board doesnrsquot approve the proposal Is it

impartial hearing time

Thank you for your assistance in this matter

Any information regarding Assistive Technology Informative

for school and home use would be greatly appreciated

Is there a time limit on implementation of yearly updated

IEPs[] Every year I have long delays on implementation of board

approved IEPs[]

Text of Response

This is in response to your recent letter to the Office of Spe-

cial Education Programs (OSEP) requesting a copy of any OSEP

policy clarifications on assistive technology as well as asking spe-

cific questions concerning the assistive technology needs for your

daughter You also asked a question about the time limits for

implementation of an individualized education program (IEP)

In response to your request I am enclosing a copy of OSEPrsquos

August 10 1990 letter to Ms Susan Goodman concerning the

obligations of public agencies under Part B of the Individuals with

Disabilities Education Act (Part B) formerly cited as Part B of the

Education of the Handicapped Act to provide assistive technol-

55

ogy to children with disabilities along with some additional infor-

mation on assistive technology and a copy of the Part B regula-

tions I would also like to provide you with OSEPrsquos response to

each of your specific questions as stated below

I would like to make the request to the appropriate officials

for another CCTV for home use to accomplish the same

results as is done in school (For homework reading books

any assignment from school)

The IEP which must be developed at a meeting that includes

parents and school officials must contain among other things a

statement of the specific special education and related services

to be provided to the child See 34 CFR sectsect 300343-300346 As

stated in OSEPrsquos letter to Ms Goodman if the IEP team deter-

mines that a child with disabilities requires assistive technology in

order to receive a free appropriate public education (FAPE) and

designate such assistive technology as either special education

or a related service the childrsquos IEP must include a specific state-

ment of such services including the nature and amount of such

services See 34 CFR sect 300346(c) App C to 34 CFR Part 300

(Ques 51) The need for assistive technology is determined on a

case-by-case basis taking into consideration the unique need of

each individual child If the IEP team determines that a particular

assistive technology item is required for home use in order for a

particular child to be provided FAPE the technology must be pro-

vided to implement the IEP

If the committee approves this request it will go to the School

Board for approval I would like to know what happens if

the School Board doesnrsquot approve the proposal Is it im-

partial hearing time

As part of the public agencyrsquos part B obligation to provide

FAPE to an eligible child with disabilities the public agency must

ensure that special education and related services are provided

in conformity with an IEP which meets the requirements of 34

CFR sectsect 300340-300349 One requirement at 34 CFR sect

300343(a) is that the public agency conduct a meeting to de-

velop review and revise a childrsquos IEP The Regulations require

that certain participants attend the IEP meeting See 34 CFR sect

300344 The role of the participants at the IEP meeting is to

determine the specific special education and related services that

a child needs in order to receive FAPE Once the determination is

made at a meeting convened pursuant to 34 CFR sect 300343(a)

Part B does not recognize any authority on the part of a local

School Board to unilaterally change the statement of special edu-

cation and related services contained in the IEP After the IEP is

developed and the placement decision is made by a group of

persons knowledgeable about the child the meaning of the evalu-

ation data and placement options the public agency must imple-

ment the IEP See 34 CFR sect 300533(a)(3) Without reconven-

ing the IEP meeting the local school board could not change the

IEP

Is there a time limit on implementation of updated IEPrsquos[]

Every year I have long delays on implementation of Board

approved IEPrsquos[]

Part B imposes no specific time limits for the implementation

of IEPs The Part B regulations at 34 CFR sect 300342(b) require

that an IEP (1) must be in effect before special education and

related services are provided to a child and (2) must be imple-

mented as soon as possible following the meetings required to

develop review or revise a childrsquos IEP The answer to Question 4

in Appendix C to the Part 300 regulations states that no delay is

permissible between the time a childrsquos IEP is finalized and when

special education and related services is provided It is expected

that the special education and related services set out in the IEP

will be provided by the agency beginning immediately after the

IEP is finalized In certain circumstances such as when the IEP

meeting occurs during the summer or a vacation period or where

there are circumstances which require a short delay (eg work-

ing out transportation arrangements) the implementation may not

be immediate See Comment 34 CFR sect 300342

I hope that this information is helpful to you Please let us

know if you have any additional questions or concerns

Judy A Schrag

Director

Office of Special Education Programs

_______________________

Cite as 18 IDELR 628

56

Sample Letter Requesting an Assistive Tech-nology Evaluation

March 1997

Dear Sir

Our daughter Catherine an IDEA-eligiblestudent is currently receiving special educationand supportive therapies through the publicschool district As she is progressing through theelementary school grades the curriculum is de-manding more and more written work from herAt this point teachers or assistants are writingfor her but this method does not allow Catherinethe opportunity to compose written work on herown

As Catherinersquos parents we think the time hascome to consider assistive technology forCatherine to allow her to learn to do written workon her own so that she can learn the mechanicsof writing and can put her own thoughts downon paper for others to read

To this end we are requesting an assistivetechnology evaluation for Catherine to determinewhat kinds of technology are necessary to assisther with written expression We are assumingthat the assistive technology evaluation will beperformed at district expense by professionalswho are qualified to determine (a) what assistivetechnology may be necessary for Catherine (b)what assistive technology devices might be help-ful and (c) what occupational and physicaltherapy services may be necessary to support thetechnology

We would like to have this evaluation com-pleted so that information is available prior tothe convening of the IEP Team to writeCatherinersquos Individualized Education Programfor next year

We appreciate your assistance with this mat-ter and look forward to hearing from you

Yours truly

Assistive TechnologyIssues to Address

_____What are the individualrsquos current unmetneeds for access to communication writ-ing or educational materials

_____What are the short and long term educa-tional goals

_____What are the daily educational demandswhich require the use of assistive technol-ogy

_____Have the appropriate team members in-cluding parents been involved in the as-sessment process

_____What are the features of the technology thatwould assist the individual in meetingdaily classroom demands

_____Why is the selected equipment more appro-priate than other alternatives

_____Have all of the individualrsquos environmentsbeen considered

_____Does the selected equipment reflect the leastrestrictive intervention strategy

_____Is the equipment necessary to achieve edu-cationallife goals

_____How will the individual physically man-age the equipment in all environments

_____How will the equipment be integrated intothe individualrsquos daily life

_____How will the use of the assistive technol-ogy promote inclusion of the individualinto activities in the school and commu-nity

_____Which members of the education team willbe trained to use the equipment

_____How will the individual be trained to usethe equipment

_____How will the family be involved with theindividual and the equipment

57

ExamplesEDUCATIONAL SOFTWARE EVALUATION

A IDENTIFYING INFORMATION

Name of instructional program

Publisher

Cost ____________Computer platform(PCMac)

Other equipment needed to run program

Grade level of the program

Skill levels required of users

Special needs addressed by program

B DESCRIPTIVE INFORMATION

1 What is the purpose of the instructional program as stated by

its publisher

2 What curriculum area or areas does it address

3 What type of instructional program is it

tutorial drill and practice___ arcade game type___

drill and practice ____ simulation ___

problem solving___ educational game___

teacher utility___ other___

4 For what type of learner was the program designed

age level __________ grade level ____________

ability level ________ interest level ___________

5 What skills or information does the program attempt to teach

or review

6 How does the program present information

__text __graphics __animation __color __sound effects

__music __speech __other __________________________

7 Is the information presented clearly

Is text legible and readable

Are graphics comprehensible

Are sounds audible and intelligible

8 Are directions for using the program clearly stated and under-

standable Where do directions appear

_____ within the program

_____ in the programs documentation or manual

9 Is the program under user control that is can the user control

the programs movement from screen to screen

Review directions at any time

Exit the program at any time

10 What computer use demands are placed on the learner

_____ insert disk and turn on computer

_____ select from menu

other ______________________________

11 What academic demands are placed on the learner

reading level _______________________________

spelling level _______________________________

other _____________________________________

12 What physical demands are placed on the learner

_____ keyboard must be used to enter responses

_____ press any key

_____ press a key from one half or one quadrant of key-

board

_____ press on specific key

_____ press several keys in order

_____ other devices used to enter responses

13 What speed demands are placed on the learner

_____ presentation of information controlled by program (

moderate fast or slow)

_____ presentation of information under user control

_____ unlimited response time

_____ response time set by program (moderate fast slow)

_____ response time varied by user

58

14 What accuracy demands are placed on the learner

_____ user can correct typing errors

_____ program does not allow correction of typing errors

_____ program locates common errors

_____ program requires correct spelling of all responses

_____ program allows only one correct response for most

questions

15 Is feedback about response accuracy provided to learners

appropriately

_____ knowledge of results provided after each response

_____ correct responses confirmed

_____ learner informed if response incorrect

_____ another trial provided if response incorrect

_____ number of trials provided

_____ correct response demonstrated if learner fails to an-

swer correctly

_____ learner allowed opportunity to respond after demon-

stration of correct response

16 Does the program use any branching procedures besides

differential treatment of correct and incorrect responses

17 What techniques are used for reinforcement and motivation

_____ knowledge of results and confirmation of correct re-

sponses

_____ summary information about learner performance

_____ text message of praise for correct responses

_____ graphics display and or sound for correct responses

_____ competitive game in which correct response earn

points

_____ other _________________________________

Reinforcement is _____ continuous _____ intermittent

18 What user options are available to students and teachers

Students can select

_____ activity from menu difficulty

_____ number of questions type of questions

_____ other ____________________________

Teacher or parent can select

_____ sound on or off

_____ number of questions

_____ type of questions

_____ sequence of instruction

_____ number of trials

_____ speed of presentation

_____ speed demands for responses

_____ other_________________________________

Teacher or parent can

_____ enter own content into program

_____ review student records

_____ other________________________________

19 Is the programs documentation adequate

All program features fully and clearly explained

Rationale for program purpose and objectives included

Print materials provided for students

20 Other comments about the instructional program

C OVERALL EVALUATION

Rate the appropriateness of the instructional program in each of

the following areas using this scale

excellent adequate inadequate

1 2 3

1 2 3 Curricular content (program addresses important skills

1 2 3 Interest level

1 2 3 Ease of use for learners

1 2 3 Demands on learner (eg computer use academic)

1 2 3 Instructional procedures

1 2 3 Motivational value

1 2 3 Appropriate use of the medium

1 2 3 Important instructional variables under teacher control

1 2 3 Other _______________________________

59

Software Featuresbull Easy-to-Read Screensbull Consistency in Formatbull Intuitive Characteristicsbull Logical Labelsbull Instructional Choicesbull Graphicsbull Friendly Documentationbull On-Screen Instructionsbull Auditory Cuesbull Visual Cuesbull Built-in Access Methodsbull Alternatives to a Mousebull Optional Cursorsbull Creation of Custom Programs

Alternative Inputbull Switches and Switch Softwarebull Alternative Keyboardsbull Keyboard Additionsbull Access Utilitiesbull Interface Devicesbull Voice Recognitionbull Optical Character Recognition

and Scannersbull Electronic pointing Devicesbull Pointing and Typing Aidsbull Touch Screensbull Joysticksbull Trackballsbull Arm and Wrist Supports

Processing Aidsbull Abbreviation Expansion and

Macro Programsbull Word Predictionbull Talking and Large Print Word

Processorsbull Grammar and Spell Checkersbull Reading Comprehension Pro-

gramsbull Writing Composition Pro-

gramsbull Electronic Reference Toolsbull Menu Management Programs

Alternative Outputbull Braille Embossers and Transla-

torsbull Refreshable Braille Displaysbull Speech Synthesizersbull Screen Readersbull Screen Enlargement Programsbull Monitor Additions

Specialized Productsbull Closed Circuit Television

(CCTV)bull Environmental Control Units

(ECU)bull Notetakersbull Reading Machinesbull Text Telephone (TDD)

60

Next

Ste

p

Try

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ng C

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use

earp

hone

s w

hen

he is

wor

d pr

oces

sing

Curre

nt S

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ck is

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vel a

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nmen

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lite

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as a

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Loca

tions

Hom

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mun

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ion

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his

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leg

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g sh

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ft H

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ars

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t in

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shoe

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e C

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oes

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gra

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robl

ems

Chu

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con

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and

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has

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him

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olite

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wel

l-beh

aved

but

app

ears

tobe

imm

atur

e in

his

soc

ial r

elat

ions

hips

61

ASSI

STIV

E TE

CHN

OLO

GY

EVAL

UATI

ON

Func

tion

al A

naly

sis

Nam

e C

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Dat

eG

rade

Lev

el

Sixt

h

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rall

Des

crip

tion

Chu

ck is

a s

ixth

gra

de s

tude

nt w

ho re

ceiv

es a

ll of

his

inst

ruct

ion

inth

e re

gula

r cla

ssro

om

Chu

ck h

as ri

ght h

emip

legi

a H

is ri

ght u

pper

ext

rem

ity is

mor

eaf

fect

ed th

an h

is lo

wer

ext

rem

ity

He

has

diffi

culty

with

tota

l bod

y m

ovem

ents

requ

iring

Need

Fine

Mot

or Han

d W

ritin

g

Not

e Ta

king

Self

Hel

p

Curre

nt S

tatu

s

Chu

ck c

an u

se o

nly

one

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for f

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or ta

sks

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ping

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isan

exc

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ne-h

ande

dty

pist

bot

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term

s of

spee

d an

d ac

cura

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an w

rite

in c

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ve

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yla

bor i

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gfo

r him

H

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oduc

esm

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bette

r writ

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prod

ucts

usi

ng a

com

pute

rC

huck

can

not t

ake

note

san

d lis

ten

at th

e sa

me

time

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ck c

anno

t tie

his

ow

nsh

oes

and

he h

as d

iffic

ulty

zipp

ing

his

jack

et w

ith o

neha

nd

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Ste

p

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givi

ng C

huck

not

esbe

fore

the

clas

sroo

mpr

esen

tatio

n H

ave

him

hig

hlig

ht k

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ords

with

a h

ighl

ight

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pen

as h

e is

list

enin

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the

disc

ussi

on

Try

havi

ng a

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ddy

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with

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tera

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atio

n e

spec

ially

with

upp

er e

xtre

miti

es

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ck h

as a

leg

leng

thdi

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panc

y w

ith h

is ri

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eg b

eing

sho

rter t

han

his

left

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war

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lift i

n hi

s sh

oe to

com

pens

ate

for t

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ence

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huck

has

low

ave

rage

inte

lligen

ce a

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alsp

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at th

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l a

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mat

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gra

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vel

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rst

ory

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lem

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ery

conc

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in h

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inki

ng a

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as g

reat

diff

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nder

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ng fi

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a fu

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de in

the

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lar c

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mod

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ignm

ents

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ck is

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ell-b

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rs to

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imm

atur

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his

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ial r

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ions

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ria fo

r Suc

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ck w

ill be

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e to

prod

uce

writ

ten

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k at

abou

t the

sam

e pa

ce a

sot

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nts

in h

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lass

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ck w

ill be

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e to

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help

with

am

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f fus

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mun

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ork

Rec

reat

ion

62

ResourcesParent Trainingand InformationCenters

AlabamaSpecial Education ActionCommittee Inc (SEAC)600 Bel Air Blvd 210Mobile AL 36606-3501334-478-1208334-473-7877 FAX1-800-222-7322 AL onlyseacmob1junocomhttpwwwhsvtisnet~cja

AlaskaPARENTS ResourceCenter4743 E Northern Lights BlvdAnchorage AK 99508907-337-7678907-337-7671 FAX1-800-478-7678 in AKparentsalaskanethttpwwwalaskanet~parents

American SamoaAmerican Samoa ParentNetworkPO Box 3432Pago Pago AS 96799684-633-2407684-633-7707 (fax)

ArizonaPilot Parent Partnerships4750 N Black Canyon Hwy 101Phoenix AZ 85017-3621602-242-4366800-237-3007 (AZ only)602-242-4306 (fax)

ArkansasArkansas Disability Coalition2801 Lee Ave Suite BLittle Rock AR 72205501-614-7020501-614-9082 FAX1-800-223-1330 AR onlyadcceinet

FOCUS Inc305 W Jefferson AveJonesboro AR 72401870-935-2750870-931-3755 FAXfocusincipanet

CaliforniaDREDF2212 Sixth StreetBerkeley CA 94710510-644-2555510-841-8645 (fax)1-800-466-4232dredfdredforghttpwwwdredforg

Exceptional Parents Unlimited(EPU)4120 N First StreetFresno CA 93726209-229-2000209-229-2956 (fax)epu1cybergatecom

Matrix555 Northgate Dr Ste ASan Rafael CA 94903415-499-3877415-499-3854 (TDD)415-507-9457 (fax)1-800-578-2592matrixmatrixparentsorghttpwwwmatrixparentsorg

Parents Helping Parents - SanFrancisco594 Monterey BlvdSan Francisco CA 94127-2416415-841-8820415-841-8824 (fax)

Parents Helping Parents -Santa Clara3041 Olcott StSanta Clara CA 95054-3222408-727-5775408-727-7655 (TDD)408-727-0182 (fax)infophpcomhttpwwwphpco

Support for Families ofChildren with Disabilities2601 Mission 710San Francisco CA 94110-3111415-282-7494415-282-1226 (fax)sfcdmissaolcom

TASK100 W Cerritos AveAnaheim CA 92805-6546714-533-TASK (8275)714-533-2533 (fax)taskcaaolcom

TASK- San Diego3750 Convoy St Ste 303San Diego CA 92111-3741619-874-2386619-874-2375 (fax)

ColoradoPEAK Parent Center Inc6055 Lehman Drive Ste 101Colorado Springs CO 80918719-531-9400719-531-9403 (TDD)800-284-0251719-531-9452 (fax)PKPARENTaolcom

ConnecticutCPAC338 Main StreetNiantic CT 06357860-739-3089860-739-7460 (fax)1-800-445-2722 (in CT)cpacincaolcomhttpwwwmembersaolcomcpacinccpachtm

DelawareParent Information Center(PIC) of Delaware Inc700 Barksdale Road Ste 3Newark DE 19711302-366-0152302-366-0178 (TDD)302-366-0276 (fax)PEP700aolcom

FloridaFamily Network on Disabilitiesof Florida2735 Whitney RoadClearwater FL 24620813-523-1130800-285-5736 (FL only)813-523-8687 (fax)fndgatenethttpwwwgatenet~fnd

GeorgiaParents Educating Parentsand Professionals for AllChildren (PEPPAC)8318 Durelee Lane Ste 101Douglasville GA 30134770-577-7771770-577-7774 (fax)peppacbellsouthnet

HawaiiAWARELearning DisabilitiesAssociation of Hawaii200 N Vineyard Blvd Ste 310Honolulu HI 96817808-536-9684808-536-2280 (TTY)808-537-6780 (fax)ldahgtenet

IdahoIdaho Parents Unlimited Inc(IPUL)Parents Education amp ResourceCenter4696 Overland Rd Ste 478Boise ID 83705208-342-5884800-242-IPUL (4785)208-342-1408 (fax)ipulrmcinethttpwwwhomermcinetIPUL

IllinoisDesigns for Change6 N Michigan Ave Ste 1600Chicago IL 60602312-857-9292312-857-1013 (TDD)312-857-9299 (fax)1-800-851-8728DFC1aolcom

Family Resource Center onDisabilities (FRCD)20 East Jackson Blvd Rm 900Chicago IL 60604312-939-3513312-939-3519 (TDDTTY)312-939-7297 (fax)1-800-952-4199 (IL only)

Family TIES Network830 South Spring StreetSpringfield IL 62704800-865-7842217-544-6018 (fax)ftiesnaolcom

National Center for Latinoswith Disabilities1921 South Blue IslandChicago IL 60608312-666-3393312-666-1788 (TDD)312-666-1787 (fax)1-800-532-3393ncldinteraccesscom

1

A ssistive technology is redefining what ispossible for people with a wide range ofcognitive and physical disabilities In the

home classroom workplace and communityassistive technology is enabling individuals withdisabilities to be more independent self-confi-dent productive and better integrated into themainstream

Beginning early in life technology is makingit possible for children with disabilities to domore for themselves A child who cannot use herhands can operate a computer with a switch andan on-screen keyboard A child with speech prob-lems can communicate using a portable electronicdevice that ldquospeaksrdquo A child who is unable toget in and out of the bathtub can be safely andeasily lifted using a mechanical device Theseare just a few examples of the wide variety ofequipment called assistive technology that isavailable today

Assistive technology can mean anything fromsimple homemade devices to highly sophisti-cated environmental control systems It can beadapted toys computers powered mobility aug-mentative communication devices specialswitches and thousands of commercially avail-able or adapted tools to assist an individual withlearning working and interacting socially

As wonderful as assistive technology can beit is not always easy to acquire It takes expertiseand persistence to find the correct devices andfigure out ways to pay for them For examplechildren with disabilities who are eligible for spe-cial education have a legal right to technology toassist them with learning Both the Individual-ized Family Service Plan (IFSP) and the Individu-alized Education Program (IEP) which are re-quired by tthe Individuals with Disabilities Edu-cation Act (IDEA) are potentially powerful toolsfor incorporating assistive technology into theeducation of students with disabilities But

assistive technology does not become part of astudentrsquos special education plan unless parentsare knowledgeable about technology and knowwhat to do to ensure that assistive technologybecomes an integral part of their childrsquos program

This Guide is intended to help parents learnmore about assistive technology and how it canhelp their children The Guide includes tips forgetting started ideas about where to look formoney and suggestions for what to do whenapplying for funding Places to contact for moreinformation or to find software and equipmentare listed in the Appendix at the end of the Guide

Finding and paying for the right technologyrequires commitment and energy Professionalsin education and medicine can help but parentscannot rely on professionals to do everything thatis necessary to get the equipment As a parentyou have a much better chance of getting what isneeded if you and your child are involved in se-lecting the technology and planning for its useThis Guide should help you to understand theprocesses for acquiring assistive technology andprovide you with the tools to advocate for yourchildrsquos special technology needs

Introduction

2

Defining Assistive Technology

A ssistive technology devices are mechani-cal aids which substitute for or enhancethe function of some physical or mental

ability that is impaired Assistive technology canbe anything homemade purchased off the shelfmodified or commercially available which isused to help an individual perform some task ofdaily living The term assistive technology encom-passes a broad range of devices from ldquolow techrdquo(eg pencil grips splints paper stabilizers) toldquohigh techrdquo (eg computers voice synthesizersbraille readers) These devices include the entirerange of supportive tools and equipment fromadapted spoons to wheelchairs and computersystems for environmental control

The Individuals with Disabilities EducationAct (IDEA) the federal special education lawprovides the following legal definition of anassistive technology device ldquoany item piece ofequipment or product system that is used toincrease maintain or improve functional capa-bilities of individuals with disabilitiesrdquo UnderIDEA assistive technology devices can be usedin the educational setting to provide a variety ofaccommodations or adaptations for people withdisabilities

The IDEA also lists the services a school dis-trict may need to provide in order to ensure thatassistive technology is useful to a student in theschool setting The law defines assistive technol-ogy service as ldquoany service that directly assistsan individual with a disability in the selectionacquisition or use of an assistive technologydevicerdquo This service includes all of the follow-ing possibilities

bull evaluation of the technology needs of theindividual including a functional evalua-tion in the individualrsquos customary environ-ment

bull purchasing leasing or otherwise provid-

ing for the acquisition of assistive technol-ogy devices for individuals with disabili-ties

bull selecting designing fitting customizingadapting applying maintaining repair-ing or replacing of assistive technologydevices

bull coordinating and using other therapiesinterventions or services with assistivetechnology devices such as those associ-ated with existing education and rehabili-tation plans and programs

bull assistive technology training or technicalassistance with assistive technology for anindividual with a disability or where ap-propriate the family of an individual withdisabilities

bull training or technical assistance for profes-sionals employers or other individualswho provide services to employ or other-wise are substantially involved in the ma-jor life functions of individuals with dis-abilities

The intention of the special education law isthat if a student with disabilities needs technol-ogy in order to be able to learn the school dis-trict will (a) evaluate the studentrsquos technologyneeds (b) acquire the necessary technology (c)coordinate technology use with other therapiesand interventions and (d) provide training forthe individual the individualrsquos family and theschool staff in the effective use of the technology

During the time that students with disabili-ties are in school they can have the opportunityto learn to use technology at the same time thatthey are learning academic subjects and socialskills The efficient and effective use of assistivetechnology can be as basic a skill for students withdisabilities as reading writing and arithmeticsince the use of technology can go a long way

3

toward circumventing the limitations of disabil-ity and providing students with disabilities witha ldquolevel playing fieldrdquo in every area of life ac-complishment

What is an accommodation

Accommodations are reasonable modifica-tions that are made to compensate for skills orabilities that an individual lacks For example ifa person does not digest spicy foods well wemight accommodate this individual by adjustinghis or her diet so that the person was eating onlybland foods

When the word accommodation is used in con-nection with disability issues it refers to a wayof modifying a task or assignment so that a per-son with a disability can participate in spite ofwhatever challenges the disability may pose Forexample when a student who is unable to re-member math facts is allowed to do math prob-lems with a calculator the use of the calculator isan accommodation which allows the student towork around his or her disability With an ac-commodation the student can still perform mathproblems but the student does so using a differ-ent method

In the school setting sometimes it is neces-sary to make accommodations for individualswith disabilities in order to compensate for skillsor abilities that they do not have For examplefor some students with learning disabilities learn-ing to spell words correctly may be a skill theynever acquire or never acquire with a highenough degree of fluency to do them any goodin written expression To compensate for thisinability to spell such students may be encour-aged to use alternative methods for spelling likea spell check software program on the computeror a hand-held spelling device

What is an adaptation How does adaptationdiffer from accommodation

Adaptation means developing unique devicesor methods designed specifically to assist persons

with disabilities to perform daily tasks An ad-aptation is something specially designed whichis not normally used by other people An accom-modation on the other hand is simply a changein routine method or approach which may beused by people with or without disabilities Ex-amples of adaptations include special grips toturn stove knobs or specially designed keyboardsto operate computers

What are common types of assistive technol-ogy Does assistive technology just meancomputers

Assistive technology certainly includes com-puters but it also refers to a number of other typesof accommodations and adaptations which en-able individuals with disabilities to function moreindependently Computers are an important typeof assistive technology because they open up somany exciting possibilities for writing speakingfinding information or controlling anindividualrsquos environment But computers are notthe only avenues to solving problems throughtechnology There are many low tech (and lowcost) solutions for problems that disabilities poseExamples of inexpensive low tech solutions in-clude wrist splints clip boards for holding pa-pers steady or velcro tabs to keep positioningpads in place

The following is a list of common assistivetechnology applications

Positioning In the classroom individualswith physical disabilities may need assistancewith their positions for seating so that they canparticipate effectively in school work Generallytherapists try to achieve an upright forward fac-ing position by using padding structured chairsstraps supports or restraints to hold the body ina stable and comfortable manner Also consid-ered is the studentrsquos position in relation to peersand the teacher Often it is necessary to designpositioning systems for a variety of settings sothat the student can participate in multiple ac-tivities at school Examples of equipment used

4

for positioning are side lying frames walkerscrawling assists floor sitters chair inserts wheel-chairs straps trays standing aids bean bagchairs sand bags and so forth

Access In order to participate in school taskssome students require special devices that pro-vide access to computers or environmental con-trols The first step in providing access is to de-termine which body parts can be used to indi-cate the studentrsquos intentions Controllable ana-tomical sites like eye blinks head or neck move-ments mouth movements may be used to oper-ate equipment which provides access to the com-puter Once a controllable anatomical site hasbeen determined then decisions can be madeabout input devices selection techniques (directscanning) and acceleration strategies (codingprediction) Input devices include such thingsas switches alternative keyboards mousetrackball touch window speech recognition andhead pointers Once computer access has beenestablished it should be coordinated with othersystems that the student is using including pow-ered mobility communication or listening de-vices and environmental control systems

Access can also refer to physical entrance andexit of buildings or facilities This kind of assistivetechnology includes modifications to buildingsrooms and other facilities that let people with

physical impairments use ramps and door open-ers to enter allow people with visual disabilitiesto follow braille directions and move more freelywithin a facility and people of short stature orpeople who use wheelchairs to reach pay phonesor operate elevators Accessibility to shoppingcenters places of business schools recreationtransportation is possible because of assistivetechnology modifications

Environmental Control Independent useof equipment in the classroom can be achievedfor students with physical disabilities throughvarious types of environmental controls includ-ing remote control switches and special adapta-tions of onoff switches to make them accessible(eg velcro attachments pointer sticks)

Robotic arms and other environmental con-trol systems turn lights on and off open doorsoperate appliances Locational and orientationsystems give people with vision impairmentsinformation about where they are what theground nearby is like and whether or not thereis a curb close by

Augmentative Communication Every stu-dent in school needs some method of communi-cation in order to interact with others and learnfrom social contact Students who are nonverbalor whose speech is not fluent or understandableenough to communicate effectively may benefit

figure 1 Alternative and Pr ocessing Computer Access Methods

Inputbull Alternate keyboardsbull Interface devicesbull Joysticksbull Keyboard modificationsbull Keyboard additionsbull Optical pointing devicesbull Pointing and typing aidsbull Switches with scanningbull Scanners amp optical character recognitionbull Trackballsbull Touch screensbull Voice recognition

Processingbull Abbreviationexpansion and macro programsbull Access utilitiesbull Menu management programsbull Reading comprehension programsbull Writing composition programsbull Writing enhancement tools (ie grammar checkers)

Outputbull Braille displays and embossersbull Monitor additionsbull Screen enlargement programsbull Screen readersbull Speech synthesizersbull Talking and large print word processors

5

from using some type of communication deviceor devices Communication devices include suchthings as symbol systems communication boardsand wallets programmable switches electroniccommunication devices speech synthesizers re-corded speech devices communication enhance-ment software and voiced word processing

Assistive Listening Much of the time inschool students are expected to learn through lis-tening Students who have hearing impairmentsor auditory processing problems can be at a dis-tinct disadvantage unless they learn to use thehearing they have or they develop alternativemeans for getting information Hearing problemsmay be progressive permanent or intermittentAny of these impairments may interfere signifi-cantly with learning to speak read and followdirections Assistive devices to help with hear-ing and auditory processing problems includehearing aids personal FM units sound field FMsystems Phonic Ear TDDs or closed caption TV

Visual Aids Vision is also a major learningmode General methods for assisting with visionproblems include increasing contrast enlargingstimuli and making use of tactile and auditorymodels Devices that assist with vision includescreen readers screen enlargers magnifierslarge-type books taped books Braillers lightboxes high contrast materials thermoformgraphics synthesizers and scanners

Mobility Individuals whose physical impair-ments limit their mobility may need any of a num-ber of devices to help them get around in theschool building and participate in student activi-ties Mobility devices include such things as self-propelled walkers manual or powered wheel-chairs and powered recreational vehicles likebikes and scooters

Computer-Based Instruction Computer-based instruction can make possible independentparticipation in activities related to the curricu-lum Software can be selected which mirrors theconceptual framework of the regular curriculum

but offers an alternative way of responding to ex-ercises and learning activities Software can pro-vide the tools for written expression spelling cal-culation reading basic reasoning and higherlevel thinking skills The computer can also beused to access a wide variety of databases

Social Interaction and Recreation Studentswith disabilities want to have fun and interactsocially with their peers Assistive technologycan help them to participate in all sorts of recre-ational activities which can be interactive withfriends Some adapted recreational activities in-clude drawing software computer games com-puter simulations painting with a head or mouthwand interactive laser disks and adaptedpuzzles

Self Care In order to benefit from educa-tion some students require assistance with selfcare activities like feeding dressing and toiletingAssistive devices which assist with self care in-clude such things as robotics electric feedersadapted utensils specially designed toilet seatsand aids for tooth brushing washing dressingand grooming

What sort of students might use assistivetechnology

Students who require assistive technology arethose with mental or physical impairments thatinterfere with learning or other life functions Thetechnology helps the student to overcome or com-pensate for the impairment and be more inde-pendent in participating at school Students whobenefit from assistive technology may have mildlearning problems like learning disabilities orthey may have physical or cognitive disabilitiesthat range from mild to severe Assistive tech-nology is not necessary or helpful for every stu-dent in special education but it is an importantpart of the support system for many studentswith identified disabilities

Isnrsquot assistive technology appropriate only forstudents with more severe disabilities

Assistive technology is simply a set of tools

6

that can be used to compensate for some deficitthat a person may have For individuals with se-vere mental or physical disabilities the techno-logical solutions can help to solve multiple andcomplex problems But individuals with less in-volved problems also can benefit from assistivetechnology For example individuals with learn-ing disabilities who have difficulty with readingor writing can benefit educationally from usingthe word processing and voiced reading capa-bilities of computers

Isnrsquot assistive technology just a crutch Wonrsquotstudents become too dependent on technol-ogy and not learn to use the skills they have

Assistive technology should be used as sup-port for access learning and performing dailytasks In general assistive technology is appro-priate when it compensates for disabilities so thatthe individual can function as normally as pos-sible If assistive technology is necessary for astudent to have access to educational opportuni-ties or to benefit from education then it is not aldquocrutchrdquo but a legitimate support

Some skills are too laborious or taxing to ac-complish at a rate or with degree of proficiencyto allow for participation in the least restrictiveenvironment With assistive technology the stu-dent can participate more fully and more closelyapproximate the levels of achievement and in-teraction of his or her peers

The use of assistive technology enhancesfunction and increases skills and opportunitiesThough a student may be dependent upon a par-ticular device in order to perform skillfully de-nying the device denies the student an opportu-nity ever to achieve success at the level of his orher potential

When is using assistive technology appropri-ate

Assistive technology may be considered ap-propriate when it does any or all of the follow-ing things

bull Enables an individual to perform functions

that can be achieved by no other means

bull Enables an individual to approximate nor-mal fluency rate or standardsmdasha level ofaccomplishment which could not beachieved by any other means

bull Provides access for participation in pro-grams or activities which otherwise wouldbe closed to the individual

bull Increases endurance or ability to persevereand complete tasks that otherwise are toolaborious to be attempted on a routine ba-sis

bull Enables an individual to concentrate onlearning or employment tasks rather thanmechanical tasks

bull Provides greater access to information

bull Supports normal social interactions withpeers and adults

bull Supports participation in the least restric-tive educational environment

SummaryAssistive technology means any device which

helps an individual with an impairment to per-form tasks of daily living There is a wide rangeof types of devices in assistive technology fromlow tech homemade aids to computers and so-phisticated electronic equipment Assistive tech-nology is one of the services which can be pro-vided in a special education program under theIndividuals with Disabilities Education Act(IDEA) The requirements of IDEA say that stu-dents who need assistive technology are entitledto the aids and devices and the assistive technol-ogy services (eg evaluation for assistive tech-nology and modification and maintenance ofequipment) that are necessary for the student tobenefit from a free appropriate public education

Hints for Parents

It is never too soon to consider using assistive tech-nology Some infants with physical disabilities for ex-

7

ample really benefit from early interaction with toysthat operate by switch Here are suggestions for timesto evaluate a child for assistive technology

bull When disability limits interaction with the envi-ronment and interferes with experiential learn-ing

Assistive technology can be used to providephysical access to the environment (egswitch toys floor scooters touch window)

bull When a significant gap exists between receptiveand expressive abilities

Assistive technology can assist with expres-sion through the use of programmableswitches electronic communication devicesvoiced word processing braille embossingand so forth

bull When an individualrsquos performance falls behindthat of his or her peers

If an individualrsquos handwriting for exampleis very slow laborious and difficult to readuse of a word processing device can be sub-stituted for handwriting thus allowing theindividual to keep up with others in termsof written expression

bull When a physical disability is impeding the edu-cationalvocational potential of an individual

Assistive technology can provide access tothe workplace for example by allowing anindividual who is blind to learn to use ascreen reader and voiced word processingto do clerical tasks that would otherwise beimpossible

bull When a disability is impeding the independenceof an individual

Sometimes assistive technology can be usedto allow a person with a disability to func-tion more independently For example hav-ing a power wheelchair allows an individualto travel independently without the neces-sity of having someone to push the wheel-chair

SaraSara who has Down syndrome is eight

years-old Her language and speech skills arethree years delayed but she has age appropriatesocial skills Sara has spent part of her schoolday in a regular classroom ever since kindergar-ten but this year her third grade teacher is sug-gesting that Sara really cannot keep up with herclassmates The teacher thinks that Sara wouldbe better off in a self-contained class with stu-dents who work at her pace Sara has some finemotor coordination problems and she has haddifficulty learning to write in cursive Her oralreading is hampered by her speech difficultiesHowever Sara has learned to do addition andsubtraction problems well and has mastered add-ing with carrying and subtraction with borrow-ing She reads at about a second grade level withreasonably good comprehension Sararsquos parentswould like to see her continue in the regular class-room for as much time as possible but they rec-ognize that Sararsquos writing and speaking problemsare keeping her from doing her best work

What are Sararsquos needs

What kinds of technology should go in SararsquosIEP

How would you make a case for puttingassistive technology into her IEP

8

Sararsquos SolutionSararsquos IEP Team met to discuss her needs and

concluded that she is doing well in a regular class-room setting she is making adequate progressin academic skills and has learned how to inter-act socially with her peers It is to be expectedthat Sara will have difficulty keeping up with thepace in a third grade but as long as she is mak-ing progress toward her individual goals theregular classroom is a good setting for her How-ever some simple accommodations and technol-ogy may help Sara to work faster and more effi-ciently

At this point Sara may need some assistancewith handwriting and speaking but the solutionsto her problems in these areas need not be com-plex ones The team decided that Sara shouldcontinue to practice cursive until she has mas-tered all the letters and can be more facile in us-ing script However while she is still learningcursive she needs other means for respondingin writing For short written responses the teamagreed that Sara should be encouraged to usemanuscript printing When speed is importantor when writing assignments are longer Sarashould have access to a computer with an adap-tive keyboard (eg IntelliKeys) The adaptivekeyboard is helpful for Sara because the ldquokeysrdquoare larger and easier to see Using the keyboardrequires only a very light touch so Sara finds iteasier to use than a standard computer keyboard

In terms of oral reading the team decided tohave Sara practice reading into a tape recorderHer speech therapist will work with her on slow-ing down her rate of speech and reading withexpression When Sara has a good tape of heroral reading she will submit it to her teacher forreview

Solution SummaryPractice cursiveUse manuscript printing for short assign-

ments

Use computer with adaptive keyboard forlonger assignments

Practice oral reading using a tape recorder

9

Making Assistive Technology Decisions

W hen parents learn about assistive tech-nology and the wonderful opportuni-ties it can provide they want to jump

right in and get the latest in technology for theirchildren Who wouldnrsquot want an augmentativecommunication device for a child who cannottalk What parents wouldnrsquot want to buy a com-puter if it would help their child learn

When the world of assistive technology opensup for parents it can be like entering a great toystoremdasheverything looks so wonderful that itmakes it hard to know what to select Choosingthe right device to meet an individualrsquos needsrequires technical knowledge and indepth under-standing of the individualrsquos functional capabili-ties Not only is the selection of a device madedifficult by the complexity of the equipment andthe demands of the individualrsquos impairmentassistive technology devices can be very expen-sive Making such purchases is a major financialcommitment for most families one that takes agreat deal of soul searching and sometimes sig-nificant sacrifice

Families invest more than money in theirchildrenrsquos assistive technology Practical invest-ments of time and effort and emotional invest-ments of hope and enthusiasm are made withevery assistive technology purchase Because ofthe high level of financial personal and emotionalcommitment family disappointment is greatwhen equipment fails to perform as expected

Buying and then not using a device becauseof dissatisfaction can be a devastating experiencefor all concerned That is why it is so importantfor parents to proceed cautiously into the worldof assistive technology and make purchases onlyafter careful evaluation and trials with the newdevice Following is a summary of some sug-gestions for parents to consider before makingany assistive technology purchase be realisticabout your childrsquos capabilities and needs get a

multidisciplinary evaluation examine availabletechnology with a critical eye match the childrsquosneeds to specific equipment features do not makea purchase until you have used the device for atrial period identify next steps and determinewhat needs to be done for follow-up after pur-chase

Guidelines for Making Assistive TechnologyDecisions

bull Be realistic about your childrsquos capabilitiesand needs

Assistive technology can open up excitingnew opportunities for a child but it is not magicThere are certain basic requirements for any in-dividual to be successful with technology and itis important to face these requirements squarelyThere is nothing more disappointing or discour-aging than purchasing expensive equipment fora child which is beyond his or her capabilities touse

Prerequisites for Computer Use Physicalor sensory impairments do not limit access tocomputers but cognition is a factor in computeroperation The major prerequisite for using acomputer (with or without adaptations) is thecognitive ability to understand cause and effectThe child must be able to understand that thecomputer operates (eg changes does some-thing) because the child has activated the equip-ment through some volitional movement or ac-tivity (eg eyebeam speaking puffing into astraw hitting a switch) Some children enjoyplaying with switches by hitting them randomlybut may not be able to connect their own behav-ior to the response their movement activates Inorder to be successful in interacting with a com-puter the user must be able to control some voli-tional activity and to do so consistently For ex-ample the child would have to be able to acti-vate the computer in response to a visual tactileor auditory prompt

10

Another prerequisite to computer use is theability to make conscious meaningful choicesbetween alternatives like yes and no The choicescan be very simple ones but there has to be evi-dence that the child has made an actual decisionand not merely acted randomly

If a child does not have the concept of causeand effect or cannot make consistent choices us-ing a computer is probably not a worthwhile nextstep at this point in the childrsquos developmentOther types of activities may be more appropri-ate less expensive and just as rewarding devel-opmentally and personally

Prerequisites for Augmentative Communi-cation Augmentative communication devicescan literally give voice to the thoughts of indi-viduals who cannot speak or cannot speak clearlybutmdashagainmdashthese devices are not magic Elec-tronic communication devices are of no valueunless the user has some communicative intentThat is for a communication device to be help-ful the user has to have some basic understand-ing of the communication process and must beintentional in expressing choices desires orneeds

For example Maggie is a four-year-old whois nonverbal She communicates her wants andneeds by using eyeblinks as responses to yes orno questions When Maggiersquos dad asks her if shewould like another glass of milk she indicatesher choice by raising her eyes up vertically foryes or moving her eyes down for no Maggieclearly knows what she wants to communicateshe has a consistent method for making herwishes known and she expects that her dad willunderstand her communication and act on it

Dan who is also nonverbal communicatesin a different way He points to objects and makesgestures to show what he wants or needs Hisgestures are clear and used consistently so thatfamily members and even people who do notknow Dan well can understand most of the timewhat he is communicating

Shelley communicates very basic informationabout how she feels by crying when she is un-comfortable or wants attention and by laughingwhen she enjoys something like music brightlights or water running Shelley does not how-ever respond to yes or no questions She doesnot make choices even when objects are pre-sented to her individually or in pairs She can-not respond to a question like ldquoDo you want someice cream nowrdquo Or ldquoWould you like the teddybear or the dollrdquo

Maggie and Dan may benefit from usingsome communication device because they arealready using communication systems meaning-fully and consistently Shelley however mayneed to develop greater ability to communicatemeaningfully before moving on to electroniccommunication

Communication skills fall along a continuumAt one end of the continuum are very simplecommunications like expressing preferences byindicating yes or no pointing or gesturing towardobjects or pointing to pictures Use of sign is amore complex form of communication becauseit requires that the user understand that the signsare symbols for meaningful communicationsWhen an individual is able to string togethersigns or words into meaningful phrases this isan additional step toward more complex com-munication When a person understands syntaxand is aware of typical word order this is anotherstep forward Each of these advances along thecommunication continuum represents a step to-ward more complex and sophisticated commu-nication Whatever assistive communicationdevice is chosen should match or just slightlyexceed the place on the continuum where the in-dividual is functioning It makes no sense forexample to purchase an elaborate electronic com-munication device that requires understandingsymbols and syntax when the individual usingthe device is just at the point of learning how toexpress yes and no preferences

An electronic device does not teach commu-

11

nication it enhances communication by givingaudible expression to thoughts that already existin the mind of the user If the thoughts are notthere yet or are not completely formed they can-not be expressed by the device

Physical and Sensory Impairments Are NotBarriers Mastery of a few simple prerequisiteskills is necessary before computers or electroniccommunication devices should be consideredbut it is not necessary for a child to master everydevelopmental milestone before entering theworld of assistive technology Physical or sensoryimpairments can often be circumvented by thetechnology itself and typical developmentalmilestones can sometimes be bypassed so thatassistive technology can be used For examplesome educators assume that students cannot usecomputers until they have completely masteredkeyboarding skills This is a false assumptionMany students benefit from using computerseven though they operate the machine using aldquohunt and peckrdquo method or only one or two keysIn a similar fashion students with limited verbalability who have not mastered oral speech ben-efit from using augmentative communicationdevices while they continue to develop oral lan-guage

Overall the keys to knowing when to tryassistive technology are (a) being realistic aboutthe childrsquos cognitive abilities and potential and(b) being open to trying the level of technology

which meets the child where he or she is

bull Get a multidisciplinary evaluation

Evaluations for assistive technology are notalways easy to arrange In many parts of theUnited States there is no convenient center orldquoplacerdquo to go for an assessment The availablecenters may be far away in another city or evenanother state Since assistive technology is a newfield the systems for disseminating informationand providing assistance are in the process ofevolving Parents may have to be ldquoassistive tech-nology detectivesrdquo in order to put together theinformation needed for a complete AT evalua-tion for their child

The place to start the evaluation is by consid-ering the functions the child needs to performand cannot because of impairment The physi-cians teachers and therapists currently workingwith the child as well as family members andfriends who are around the child on a daily ba-sis can provide very valuable information aboutfunctional problems and potential solutions

Finding Functional Solutions The Alliancefor Technology Access (ATA) a national networkof assistive technology centers has developed aninformal method for using the functional infor-mation available from professionals family mem-bers and friends as a basis for analyzing assistivetechnology needs This process called a Solu-tion Circle is a means to bring people togetherin an informal session that allows for creative

figure 2 Factors to consider when selecting Assistive T echnology

Cognitive Factorsbull Diminished Cognitive Abilitiesbull Learning Disabilitiesbull Attention Deficitsbull SensoryPerceptual Deficitsbull Memory Deficitsbull Abstract Reasoning Deficitsbull Problem-Solving Deficits

Motor Factorsbull Voluntary Motor Deficitsbull Involuntary Motor Deficitsbull Fixed Posture amp Positioning Deficitsbull Recurring Purposeless Motionbull Motor Paralysisbull Low Muscle Tonebull Rigiditybull Spasticitybull Tremors

12

thinking and is not inhibited by what is ldquolegalrdquoldquocurrently availablerdquo or ldquowhat has been done be-forerdquo The individual with a disability and 4-10family members professionals and friends gettogether to brainstorm ideas about the technol-ogy which may help the individual perform func-tions that are hard or impossible to do becauseof disability The Circle usually includes a bal-ance between people who know the person whoneeds the technology and people who have spe-cialized knowledge about technology educationor work-related issues

Solution Circle for Tom To demonstratehow the Solution Circle works letrsquos take a lookat how this process was used in the case of Toma high school student with a learning disabilityFor Tom the print in textbooks is a significantbarrier to learning Tom is ldquoprint disabledrdquo thatis he cannot read the printed word with muchcomprehension Reading is a slow unproductiveprocess for him even though he is intelligent andeager to learn Tom and his parents were hopingthat there might be a way that new technologycould help Tom overcome or work around hisproblem with reading so that he could get moreout of school and perhaps go on to college

Tomrsquos Solution Circle included his parentsBetty and Bob his resource teacher a friendDarrell his soccer coach his 4-H leader and theowner of a local computer store This group mettogether to think about how Tom could partici-pate more fully in school and prepare himself forcollege even though he could not read with com-prehension past the second or third grade level

Solution Circles generally take 1 to 1 12 hoursto complete The steps include the following

1 Star Time The individual for whom theSolution Circle is being held is described in a ho-listic way The emphasis is on how the individualis functioning at home and in the communityWhat does he or she like and dislike What arehisher goals Interests If possible the indi-vidual with a disability speaks for himself or her-self or a video or pictures may be presented The

point of this part of the discussion is give a clearpicture of the individual as a whole person

At Tomrsquos Solution Circle he explained hisdream of going to college and becoming an agri-cultural botanist Tom loves plants he is inter-ested in breeding new strains of wheat and per-fecting various types of grain crops Tomrsquos 4-Hleader agreed that Tom had real gifts in under-standing plant growth and physiology and thathe already had sophisticated knowledge aboutbotany which would prepare him well for col-lege study

2 Strengths With a complete picture of theindividual in mind the group then makes an ex-haustive list of the individualrsquos strengths particu-larly noting any technological accommodationswhich the individual is already using What doesthe individual do well What are his or her un-impaired functions Often this discussion revealsan incredible number of adaptations that the in-dividual has already achieved

Tomrsquos Solution Circle discovered that he hadmany strengths including keen intelligence per-severance and thoroughness when approachinga task Tom already had some effective learningstrategies for remembering material that heheard He had also learned to use a small taperecorder for keeping track of information pro-vided in class

3 Obstacles With the individualrsquos strengthsin mind the group then turns its attention to aconsideration of the environment in which theindividual is functioning and the activities inwhich the individual wants to participate butcannot at this time The group considers whatthe obstacles and barriers might be for the indi-vidual in his or her environment and makes alist of these impediments

For Tom reading was a serious obstacle Hecould not keep up with homework assignmentsbecause it took him so long to read his textbooksIn addition he had difficulty reading directionson tests and often misread assignments on the

13

COGNITIVE FACTORSCognitive Ability

Documented below average abilityDocumented significant overall delayDoes not appear age appropriateLacks understanding of cause amp ef-

fectPaying Attention

Difficulty following prompts or direc-tions

Difficulty with multi-step proceduresDifficulty filtering informationDifficulty staying on task

PerceptionNeeds lengthened response timeRequires multi-sensory inputDifficulty with rapid changeSignificant visualperceptual problemsSlow visual-motor dexterity

MemoryDifficulty with recallRequires reteaching learned skillsRequires repeated practice

Abstract ReasoningDifficulty analyzing simple proceduresUnable to reproduce a sequenceUnable to analyze or synthesize in-

formationProblem Solving

Unable to use prompts or cues to ac-complish tasks

Unable to modify attempts and try an-other way

MOTOR FACTORSMobility

Needs help to be mobileNeeds motorized help to be indepen-

dentNeeds help boarding transportationUnable to transfer independentlyCannot climb stairsCannot open doors independentlyCannot carry materials in hands or

armsCannot lift weight

Voluntary MotorLimited control of head trunk or ex-

tremitiesVisual motor deficitsFixed position and posture

figure 3 ASSISTIVE TECHNOLOGY EVALUATIONIndividual Functional Analysis

Name Date

Needs support to sit or standNeeds adaptations in order to use

technologyMotor Paralysis

Changes in muscle tone interfere inmotor movements

Spastic movements result in poor con-trol

Limited movement of head arms orlegs

Difficulty balancing in sitting positionDifficulty maintaining good posture

Low Muscle ToneLimited use of arms or legsPoor posture controlFatigues quickly

RigidityInhibits arm and leg movementInhibits balance to sitInhibits good posture

SpasticityLimited upper range of motionLimited lower range of motionInterferes with accuracy and consis-

tency of motor movements on oneside

TremorsPresent all the timePresent when doing purposeful upper

extremity taskUnable to compensate for tremors

Extraneous MovementAthetoid (constant)Ataxia (poor coordination in move-

ment)FINE MOTOR

DexterityLimited fine motor controlHas limited hand movement

HandwritingWriting or copying ability is signifi-

cantly below peersSignificant legibility factor--written

work not readableCannot keep up with the pace of writ-

ten workIs frustrated by writingFatigue is a factorTyping appears to be potentially faster

than handwriting

SELF CARENeeds assistance with going to the

bathroomUnable to be toilet trainedNeeds assistance to eatCannot take in food orallyNeeds suctioning routinelyHas degenerative medical conditionIs medically fragileSeizures limit alertnessNeeds to rest frequentlyNeeds assistance to zip coat or tie

shoesCOMMUNICATION

Receptive LanguageReceptive language is significantly

lower than abilityReceptive language is significantly

higher than expressiveExpressive Language

Speech is unintelligibleExpressive language is significantly

lower than abilityMean Length of Utterance (MLU) is 3

words or lessSpontaneous or self initiated language

is significantly limitedDoes not make choices consistentlyDoes not respond appropriately with

yes or noDoes not have communicative intent

SENSORYVision

Requires corrective lensesRequires large print to readRequires mobility trainingHas blind spot

HearingRequires preferential seatingHearing limitations affect the language

thresholdsRequires assistance to receive lan-

guageRequires sign language to receive lan-

guageHas fluctuating hearing lossNeeds visual signals for safety pur-

poses

14

blackboard

4 The Enemy Within Physical and cogni-tive impairments may pose difficult obstacles foran individual but often the feelings that peoplehave about the individualrsquos disability or aboutassistive technology pose greater problems thanthe disabilities themselves The Solution Circleprocess recognizes that human fears concernsreservations and prejudices might stand in theway of a personrsquos success as much as other typesof limitations Getting these fears and concernsout on the table often helps the group to deal moreconstructively with what is possible and whatneeds to be done

One of the serious issues in Tomrsquos situationwas that his resource teacher felt he should con-tinue to try to read for himself instead of using aldquocrutchrdquo like assistive technology The teacherthought that if Tom did not have to read all thematerial he would lose what little reading skillhe had In some ways the teacherrsquos oppositionto considering assistive technology actually poseda greater barrier than the reading problem itself

5 Solutions The exciting part of a SolutionCircle occurs when the group takes each obstacleor concern and turns it into a possible solutionthrough the use of technology or some other typeof adaptation Not all solutions suggested even-tually prove to be feasible but the point of thediscussion is to produce many possible solutionsso that the individual and his or her family havean array of options from which to choose Withgood minds puzzling over the problems and aspirit of cooperation and collaboration seeminglyimpossible barriers can be removed or conqueredThe process recognizes the expertise and contri-butions of all participants including the indi-vidual with disabilities and his or her familymembers The freewheeling format of the dis-cussion promotes ingenuity and innovation Allinvolved come away from a Solution Circle ener-gized by the new possibilities

Tomrsquos Solution Circle became excited about

the possibility of solving his reading problem byusing computerized texts The computer storeoperator mentioned he had heard that Record-ings for the Blind (RFB) offered textbooks on diskTomrsquos parents got in touch with Recordings forthe Blind and ordered texts for Tom to try on hiscomputer at school Soon Tom found that hecould keep up with his classmates and study ex-actly the same material that they were coveringBecause Tom had good strategies for memoriz-ing information that he heard he learned quicklyfrom the texts that were read aloud to him by thecomputer When given oral tests by his classroomteachers he was able to recite appropriate an-swers which would have eluded him if he hadhad to read the tests for himself

Technology has made all the difference forTom he has every reason to think that he will beable to go to college and pursue his intellectualinterests His resource teacher is now completelysold on the idea of assistive technology and us-ing computerized books and wants to use thetechnique with other students More than thatTomrsquos teacher also appreciates the process of theSolution Circle which allowed professionals andnonprofessionals to work together to find prac-tical solutions without being too concerned aboutthe formalities of the special education processThe informal nature of the Solution Circle vali-dated the expertise of all the participants andgave everyone a chance to offer suggestions Thecombination of a new process for planning andnew technology made Tom a winner This samecombination holds potential for many studentslike Tom who benefit from technologies whicheliminate barriers and open up new possibilitiesfor learning

From Function to Technology Solution Ithappened that a participant in Tomrsquos SolutionCircle hit on a great idea for a solution to his func-tional problem with reading This was a fortu-nate connection to make At the suggestions ofhis Solution Circle Tom began to use computer-ized books which he ldquoreadsrdquo by having the com-

15

puter speak the words as he follows along withthe text For Tom computerized books proved tobe a successful solution to his reading problembecause they help him to get the information heneeds without struggling with the reading pro-cess

Not every Solution Circle will be like Tomrsquosand identify the exact technology that the indi-vidual needs But if a Solution Circle has workedwell the end result will be a clear analysis of thefunctions that need to be performed This func-tional information can then be brought to techni-cians who can make suggestions for possibleassistive technology solutions There are over 50assistive technology centers in the United Stateswhere knowledgeable individuals can assistpeople with disabilities and their families withmaking a match between functions that need tobe performed and the technology that is availableto perform those tasks A list of assistive technol-ogy centers is available in the Appendix to thisGuide

Formal Assessment Solution Circles are aneffective informal way to identify functionalneeds that can be met through technology How-ever in the school setting it is also necessary toestablish a studentrsquos needs for technology in amore formal way Formal evaluations for assistivetechnology must be multi-disciplinary involvingeducators and therapists who are knowledgeableabout the school curriculum and the particulartypes of impairments that the student being as-sessed may have For example for a student withcerebral palsy the assistive technology evaluationmight involve a teacher a physical therapist aspeech and language clinician and an occupa-tional therapist The teacher would assist thetherapists in determining what skills the studentneeded to learn and how technology might assistthe student in acquiring those skills Someassistive technology evaluations might require theadditional services of an A-V technician adap-tive physical education teacher a rehabilitationcounselor or speech and language pathologist

with specialized training in augmentative com-munication In school districts where there is nospecialized expertise in technology and its appli-cations it may be necessary to contract for evalu-ations with special education cooperatives medi-cal centers or centers that focus on technologyassessment

Individuals conducting an assistive technol-ogy evaluation should

bull Be knowledgeable of the studentrsquosstrengths and weaknesses medical needsmobility fine and gross motor skills cog-nitive ability communication abilities vo-cational potential self help needs sensoryabilities level of academic achievementand area(s) of disability

bull Have knowledge of and access to an arrayof assistive technology devices

bull Be familiar with the studentrsquos educationalsetting and educational needs

bull Be able to communicate effectively withparents and educators

Because the assistive technology field is sonew there are no particular licenses orcredentialing processes to identify a professionalas qualified to do assistive technology evalua-tions Generally speaking individuals with pro-fessional licenses as occupational or physicaltherapists special educators speech pathologistsor rehabilitative counselors may have the exper-tise to conduct an AT evaluation When consid-ering an evaluator it is wise to ask about theevaluatorrsquos specific experience with assistivetechnology It is also important to recognize thatno one person or discipline will know everythingabout assistive technology therefore access toknowledgeable people at the local level andthrough other agencies programs or services isessential

Conducting the AT Evaluation The assistivetechnology evaluation must be tailored to theunique needs of the student In some cases theevaluation may be conducted by at team of indi-

16

viduals in other cases the evaluation may beconducted by a single individual (eg the speechpathologist) Questions to be addressed duringthe assessment should be related to the specifictasks the student needs to be able to perform andwhat if any assistive technology would helpThe following questions may be considered dur-ing the assessment

bull What tasks does the student need to per-form that he or she cannot perform

bull Is there a low tech device which will ad-dress the studentrsquos needs satisfactorily

bull What types of high tech assistive devicesmay help the student in performing thetask

bull Will assistive technology help the studentto perform the task in the least restrictiveenvironment

bull Is the device being considered suited to thestudentrsquos educational needs and abilities

bull Will the assistive technology device remainsuitable over time How long lasting willthis solution potentially be

The above are only a few of the considerationswhich need to be addressed as part of the evalu-ation process There is no specific ldquotestrdquo forevaluating the need for assistive technologyTherefore prior to conducting the evaluation theindividuals doing the assessment need to have awell planned process in mind

The formal written assistive technologyevaluation report should address but not belimited to the following points

bull Procedures used to evaluate the student

bull Instruments employed in the evaluationassuring that a range of levels of technolo-gies has been considered

bull Results of evaluations including bothqualitative and quantitative measures

bull Recommendations for levels of technologyappropriate to the studentrsquos capabilitiesand potentials and

bull Implications for educational program-ming including discussion of both indi-vidual technology needs and recom-mended environmental and instructionalmodifications

In the end an assistive technology evaluationshould provide recommendations for accommo-dations adaptations devices and services basedon the individualrsquos strengths needs and pre-ferred lifestyle The evaluation should indicate(a) whether devices and services have potentialfor improving function and (b) what trainingmay be necessary in order to use the technologyequipment safely and effectively

bull Examine available technology with a criti-cal eye

It is easy to be dazzled by the possibilities innew assistive technology but it is important forparents to be wise consumers and ask probingquestions about the features and quality of anassistive technology device The following is alist of questions to consider when evaluating aparticular assistive technology device

Performance

Does it work efficiently and effectively

Is it easy to learn to use this device

Is it compatible with other devices

Does this device serve only one purposeor is it flexible

ldquoElegancerdquo

Does this device represent the simplestmost efficient way to accomplish the task

Or is this device too elaborate too com-plicated to be worthwhile

Ergonomics

Does it fit the individual

Is it convenient to use in the environment

Is the equipment portable enough to gowhere the user goes

Are different devices needed in differentenvironments

17

Reliability

What is the manufacturerrsquos reputation forreliability

Does it stand up well to normal use

Is it durable

Safety

Is it safe to use

What is the power source for the deviceIs it safe

Is a margin built in for foreseeable mis-use

Practicality

Do company sales people seem knowl-edgeable and helpful

Are the companyrsquos service people knowl-edgeable and helpful

Does the device have a warranty Howlong is the device guaranteed to function

How available are repair services Atwhat cost

Can this device be leased

Is this device available for a trial periodbefore purchase

Will this device soon be outdated Issomething better on the horizon

Will the company update the device

Does the manufacturer provide trainingin using the device

Aesthetics

Is this device attractive to the eye

Does the device fit well into the userrsquoslifestyle

Normalization

Does the device assist the user with morenormalized living

Can the user operate the device indepen-dently or with a minimum of assistance

Or does the device ldquostick outrdquo too muchand advertise the disability of the user

Does the equipment minimize differenceor exaggerate difference

Does the device have the potential to in-crease the quantity and quality of time spentwith nondisabled peers Or does the de-vice separate the user from others

Cost effectiveness

Do the benefits the device provides jus-tify the cost

Are there less expensive devices or mod-els that serve the purpose as well

Personal acceptance

Is this device the userrsquos own choice

Does the potential user like this deviceand want to use it

Does the potential user view this deviceas life-enhancing

Would the user have preferred some otherdevice or means to perform the task

Will using the device always be a choreor can using it become a habit

There are several ways that consumers canfind answers to their specific questions aboutassistive technology devices Most vendors willprovide good basic information about the prod-uct Call the vendor and ask for brochures prod-uct specifications price list and any other writ-ten information This is a place to start A sec-ond step is to read reviews of the product in trademagazines or Closing the Gap a widely respectedpublication that reviews new assistive technol-ogy products If possible it is very helpful totalk to other consumers who are already usingthe product Ask them about the pros and consof using the device Then visit a preview centerif there is one nearby and try out several typesof devices Ask for general recommendationsfrom the preview centerrsquos staff After identify-ing a device that appears to meet the potentialuserrsquos needs try the device out for a month tosix weeks to make sure that it performs as adver-tised and fits in well with the userrsquos lifestyle

18

During the trial period it will be possible to iden-tify training needs for the user family membersand school staff The trial period will also be atime for the user to test the device in several set-tings to determine its portability and flexibility

bull Match the Individualrsquos Needs to SpecificEquipment Features

When considering an assistive technologydevice it is very important to consider how adevice matches up with the particularindividualrsquos needs and habits In some ways anassistive device becomes an extension of theuserrsquos mind and body As such it is a highly per-sonal item A device may work as advertisedbut still not meet an individualrsquos needs becausethe individual just does not feel ldquocomfortablerdquo inusing it For example Cindy a fourteen-year-oldwho is totally blind and has mild cerebral palsyaffecting her hands and arms was being taughtMorse Code as a means to speed up her writingShe had difficulty using a Brailler because her armstrength was so limited so her teacher thoughtMorse Code would be an easier method of writ-ing for Cindy The only problem was that Cindydid not like using Morse Code To her it seemedlike she was having to learn another complicatedlanguage when she already knew braille andliked to use it Cindy admitted that writing inbraille was slow for her but she was more com-fortable with it Cindy and her teacher were atan impasse until a friend suggested to Cindy thatshe try writing on a voice-output computerCindy loved the computer With a headset at-tached to the sound system she could listen care-fully to the computer as it read aloud the lettersand words she was typing on a light touch tac-tile-marked keyboard This computer also had afeature of printing out text in either standard printor braille Cindy was delightedmdashshe could writecopy for herself to read in braille and for hersighted teachers to read in regular print Thissolution worked because it met Cindyrsquos learningneeds and responded to her own ideas about her-self She did not want to use Morse Code because

it was a separate type of communication knownonly to a few With her computer voiced soft-ware and dual printer she had the best of twoworldsmdashshe could ldquohearrdquo her writing as shetyped she could read it over in braille and hersighted teachers could read her finished prod-uct This solution helped Cindy to improve hercomposition skills speed up her writing timeand communicate more easily with sightedpeople

Cindy was fortunate because her assistivetechnology solution met her needs almost per-fectly Such a close match is not however al-ways possible Nonetheless every effort shouldbe made to have the match be as close as it canbe In general when assistive technology solu-tions are individualized simple to use and re-sponsive to the whole person they are more likelyto be used by the individual When the deviceperforms a task well but does not ldquofitrdquo the indi-vidual the technology is likely to be abandonedby the user in favor of something else whichmeets the need more exactly Too often devicesare purchased because of their technical poten-tial without thought to their relationship to theindividual and his or her lifestyle These mis-matched devices are the ones that end up lan-guishing in their packing boxesmdasha sad reminderof time and money spent to no avail

bull Try the Device Before Buying

It cannot be emphasized enough how vital itis to try out assistive technology devices andequipment before buying Trying out a devicefor several weeks provides the user with an op-portunity to learn how to use the device and howto adapt to its features while at the same timetesting the device in the various environmentswhere it will be used For example Mike triedout a communication device which attachednicely to his wheelchair tray and was compat-ible with his computer that he used for doingschool work Though the communication deviceworked well and was relatively easy to program

19

MOTORSELF CARE

manual wheelchairpower wheelchairbus liftsupportive classroom

chairstanderwalkerlift for transferspositioning devicecanes or crutchesadapted commodesuctioning devicebraces or supportsother ____________

________________

________________

________________

________________

________________

________________

________________

________________

________________

________________

________________

figure 4 ASSISTIVE TECHNOLOGY EVALUATION

Device or Equipment Features or Functions

Name Date

FINE MOTOR

word processorword processor with

predictionvoiced word proces-

sor with predictionadapted keyboardkeyguardalternative key

arrangementvoice activated

computer accessinfrared computer

accessmouse accesstrackballjoystickpower padswitch (eg mouth

lip chin)touch screenpointersdrag and click desk

accessorysticky keysonscreen keyboardprinter for written

work

adapted feedingutensils

braces or splintsother ____________

________________

________________

COGNITIVECOMMU-NICATION

communciationboard(s)

communication wallettotal communicationmanual signword processor with

voiceprogrammed voice

outputicon predictionelectronic communi-

cation deviceprogrammable switch

with voice output

no-reading-neces-sary word proces-sor

spell checkergrammar checkeroutlining programother ____________

________________

________________

________________

________________

________________

________________

________________

SENSORYPERCEP-TUAL

hearing aid(s)

classroom amplifica-tion

boosted signal tonoise ratio (egheadset to keepfocus during wordprocessing)

corrective lensesenlarged printtaped booksvoiced word process-

ingvoiced screen

directionsCCTVother ____________

________________

________________

________________

________________

________________

________________

________________

________________

________________

________________

20

Mike found out quickly that the device was justtoo bulky to be useful for him When he trav-eled around the school the communication de-vice blocked his view of the terrain and of peoplepassing by He found he missed opportunitiesto communicate because he could not see whowas coming his way Mike also discovered thatthe communication device did not serve him wellin crowds like at pep rallies or basketball gamesAfter a month of working with this communica-tion device Mike decided it was not for him andselected instead a device that was less compli-cated smaller and more portable The seconddevice was not as sophisticated as the first but itbetter met his needs for quick communicationwith friends in social settings If he had not hadthe opportunity to try out both devices for anextended period of time Mike might not haverealized the value of the second device and mayhave been stuck with a communication devicethat was too large and too sophisticated to matchhis lifestyle

Similarly Marilyn benefited from a trial pe-riod with her communication device She foundout the first week that the particular device shehad chosen would not work for her because itbroke too easily and it was difficult to get re-paired During the first week that Marilyn hadthe device for trial her teacher broke one of thebuttons during a programming session It tooktwo weeks to contact the manufacturer and thenthe device had to be mailed back to the factoryfor repairs The device was gone for over sixweeks and the manufacturer would not supplya ldquoloanerrdquo while Marilyn waited for repairs tothe first device This experience taught Marilynthe importance of having a responsive manufac-turer who is willing to repair devices quickly andto supply substitutes for the user while repairsare being made Marilyn decided on a differentdevice with similar features and a great helplineto provide assistance with the maintenance of themachine

The information that can be learned during a

trial period with a device is invaluable to the userIt is discouraging to find out during the trial thata device is not all it is purported to be or that itdoes not work as well as advertised but it is farbetter to learn before purchase that a device doesnot meet the userrsquos needs than to learn after pur-chase and be stuck with an expensive unusablemachine For the consumer it is daunting to thinkabout starting over again with the process of se-lecting a device Nonetheless it is worthwhileto seek more information and look again Hav-ing been through a trial even when the outcomeis not successful provides the user with greaterclarity about what an appropriate device willhave to be able to do The second time aroundthe search is likely to go faster and come out witha better result

bull Identify Next Steps

Once a device has been selected the con-sumer becomes impatient to have one and beginusing it right away But at this point importantwork still needs to be done Funding the deviceis a major consideration Sometimes families willpay for the device themselves but under othercircumstances the device will be purchased by aschool district through Medicaid or private in-surance or through some other means Parentsneed to become familiar with the various fund-ing options and determine which one will workfor them (See Funding Assistive Technology foradditional information about funding sources)

Also when considering funding familiesshould think about costs beyond the price of thedevice itself For example a computer set-upwith a keyboard monitor and printer might cost$3500 This equipment is basically useless un-less other equipment is purchased as well soft-ware adaptive devices paper manuals up-grades Prices for these additions can raise theactual cost of the device by hundreds of dollars

Devices often require training for the userfamily members and others to ensure effectiveand safe use How much does training cost Who

21

will provide it Repair and maintenance are othercosts usually additional to the price of the equip-ment Sometimes families will also want to insurethe assistive device so insurance payments be-come part of the overall cost

Since making an assistive technology pur-chase is such an important personal and finan-cial decision it is wise to have a realistic budgetin mind that includes all of the equipment andservices that are necessary to make the assistivetechnology work effectively With this budget inmind it becomes easier to plan the purchase seekout funding sources and make a compelling casefor financial assistance

bull Determine What Follow-up Is Needed

After the assistive technology device has beenpurchased and put to use there are additionalfollow-up activities that need to take place Theoriginal assistive technology evaluation shouldinclude a way to monitor the use of the devicePeriodic scheduled reviews the by evaluator fol-low-up calls to and from the family are some waysto help assure effective safe use Families whotravel great distances for evaluation need to becertain that services like maintenance repair andreplacement of devices are available within a rea-sonable distance from home

Assistive technology devices are used bestwhen all the people in the life of the individualwith disabilities understand the devices in thesame way At first devices may seem to exagger-ate differences between a person and the rest ofthe world Care should be taken to explain thatassistive equipment is a difference equalizer nota difference maker Classmates and friends needto understand that the adapted seating or adaptedkeyboard helps the individual do what other stu-dents do Adults in a childrsquos life need to under-stand that devices work to make life easier bet-ter and more functional People need to knowthat ramps help keep individuals with mobilitydisabilities from being separated from peers thatcommunication technology allows people to

ldquospeakrdquo their thoughts

Close communication between parents andtheir childrsquos helpersmdashteachers therapists daycare workers and othersmdashis essential to makesure devices and services are being used safelyand effectively If the device is working well butthe child is not being integrated into the class-room or other environments then there may bea need for additional training for the children andadults who interact with the child

Besides keeping track of how the device isworking and being used it is important to ob-serve progress in the areas of technology whichare useful to the individual with the assistivetechnology device As upgrades of equipmentoccur or more sophisticated models come on themarket the user may want to consider modify-ing or replacing the equipment that is currentlyin use Also as the individual becomes moreskilled at using technology the individual mayoutgrow the current device and need to look formore advanced equipment It can be assumedwith most high tech items that in three to fiveyears there will be a need for upgrade or replace-ment The wise consumer begins early to planfor the next step in technology including savingmoney for a new device and staying alert to thenew options that become available

What kinds of training are important to occurwhen a child has a new assistive technologydevice

Because assistive technology of the high techvariety is so new it is particularly important thattraining be provided to all those who may needit In the school setting it is helpful for all edu-cators and administrators to have some aware-ness training so that they have a general idea ofwhat assistive technology is Areas to be cov-ered in inservice training might include

bull legal issues related to assistive technology

bull awareness training concerning how toserve students with assistive technologyneeds

22

bull information on how assistive technologyrelates to the evaluation process

bull how to write IEPs for students who requireuse of assistive technology devices

bull the relationship between technology andstudent placement

bull the nature of common assistive technologydevices

bull resources to contact for information onassistive technology

Beyond these awareness activities thosemembers of the school staff who work directlywith a student who uses technology need to havetraining on the specifics of using the device andhow it is maintained and serviced Trainingshould include but not be limited to the follow-ing

bull review of the studentrsquos educational andassistive technology needs

bull review of goals and objectives supplemen-tary aids and services and related serviceson the IEP or IFSP

bull training on how to use and maintain thedevice

bull training on proper transport of the devicewithin the school building and from hometo school

bull training on how to program the device ifneeded

bull training on how to use the device effec-tively during instruction

bull training in trouble-shooting when the de-vice is not working properly

bull information about what to do when thedevice is not functioning or broken

bull information about how to coordinateassistive technology with all the activitiesin the studentrsquos day

bull training in methods to evaluate the effec-tiveness of assistive technology

Depending on the type of assistive technol-

ogy used by the student and the studentrsquos needsit may be advantageous for assistive technologyinformation to be shared with the studentrsquos peersSuch training will help fellow students to gainan understanding of the studentrsquos assistive de-vice foster acceptance in the social environmentand reduce fears other students may have aboutsocializing with the student who uses technol-ogy In some cases parents and the student maywant to be involved in the peer training

Parents may require training too in order forthe device to be used at home for the student tocomplete homework assignments or participatein extended school year services Once trainedthe parents can become a resource to the studentfor proper care and maintenance of the device

Most importantly the student himself or her-self will need training in how to use the deviceas independently as possible Training for thestudent may be written into the IEP as a separategoal or may be included as a related service thatsupports the studentrsquos special education pro-gram

SummaryPurchasing a high tech assistive technology

device is a major life decision because of the po-tential impact on the individual and because suchdevices can be costly When considering anassistive technology device it is important to dothe following be realistic about the consumerrsquoscapabilities and needs get a multidisciplinaryevaluation examine available technology with acritical eye match the individualrsquos needs to spe-cific equipment features test the device for a trialperiod identify next steps and determine whatneeds to be done for follow-up after purchaseEvaluations for assistive technology both infor-mal and formal should consider first of all thefunctions that the consumer wishes to performusing technology When evaluating a particularpiece of equipment consideration should begiven to the following features performance sim-

23

plicity of design ergonomics reliability safetypracticality aesthetics normalization cost effec-tiveness and personal acceptance Good sourcesof information about assistive devices are manu-facturers publications trade journals previewcenters and consumers who are already using thedevice Once a device is selected the consumerwill need to secure funding for the purchase andbe aware of additional costs for related equip-ment insurance and training

Hints for Parents

Donrsquot let the cost of assistive technology deter youfrom considering it for your child High tech assistivetechnology can be quite costly but it can also makethe difference for your child in terms of becoming welleducated employable and a fully-included member ofthe community Donrsquot leave any stone unturned whenlooking for funding sources Consider any or all ofthe following for funding or assistance

bull Early intervention programs

bull Schools

bull Transition programs

bull Vocational Rehabilitation

bull State Programs for Children with SpecialHealth Care Needs

bull Medicaid

bull Medicare

bull State Technology Resources

bull Used Equipment

bull Leasing

bull Equipment Loan Programs

bull Disability Organizations

SierraSierra wants to play with dolls like other chil-

dren her age but she has a muscle disease thathas caused her to lose muscle tone except in onehand What could be done to allow Sierra to dressand undress her dolls comb their hair and bathethem

Sierrarsquos SolutionThe assistive technology solution for Sierra

involved her whole family While vacationingin Mexico Sierrarsquos grandmother found her a fash-ion doll that was a bit larger than the typicalldquoBarbie dollrdquo The larger doll was easier for Si-erra to manipulate Sierrarsquos mother sewed sev-eral outfits for the doll using velcro instead ofsnaps or buttons as fasteners

Sierrarsquos dad bought doll stands at a toy storeand fastened several stands with clamps toSierrarsquos wheelchair tray He also fastened a plas-tic pouch to the tray Sierra puts the small dollaccessories in the pouch When Sierra wants todress her doll she puts the doll in one of thestands In this way the doll is held securely andSierra can dress and undress the doll with onehand

Sierrarsquos friends also use the doll stands fortheir dolls With this arrangement two or threegirls can play together

Solution SummaryLarger doll

Velcro fasteners

Plastic pouch

Doll stands

Clamps

24

Funding Assistive Technology

F unding for assistive technology is availablefrom a variety of public and privatesources To receive public or private fund-

ing the individual must meet eligibility criteriafor the specific program and provide sufficientdocumentation of the need for assistive technol-ogy

The following list includes some of the pro-grams which may pay for equipment if the indi-vidual needing the device meets their require-ments Many of these programs are run by dif-ferent agencies in different states making themhard to find In general the statersquos Tech Act of-fice can assist consumers and family members infinding and using these programs (See Appen-dix under Resources)

PUBLIC PROGRAMSEarly Intervention Programs (Individuals withDisabilities Education Act Part H)

Young children (0-3) and their families mayreceive help through early intervention programsin evaluating what the child needs in gettingassistive technology and in learning how to useit Equipment and services must be included ina written plan called an Individualized FamilyService Plan (IFSP) To find the program for aparticular state call National Early ChildhoodTechnical Assistance System (NECTAS) at 919-962-2001 or 919-966-4041 (TDD)

Head StartThis child development program provides

comprehensive educational and health servicesfor eligible children ages 3-5 Since 1982 federallaw has required that at least 10 percent of thetotal number of placements must be available tochildren who are disabled and require specialservices Head Start is a mainstream placementoption for children whose IEP calls for placementwith nondisabled children The January 1993Head Start regulations specifically require the

consideration of assistive technology services anddevices For more information contact NationalHead Start Association 201 N Union St Suite320 Alexandria VA 22314 703-739-0875

Schools (IDEA Part B)This program mandates a free appropriate

public education for preschoolers children andyouth with disabilities An Individualized Edu-cation Program (IEP) is required for all childrenwith a disability These children are entitled tospecial education related services or supplemen-tary aids If the IEP team determines that assistivetechnology is required for a free appropriatepublic education then it must be provided at nocost to the child The technology must be in-cluded in the childrsquos Individualized EducationProgram (IEP) Parents have a right to be in-volved and should help to develop the IEP goalswhich may include technology For help in get-ting assistive technology in the IEP call the TAPPFocus Center on Assistive Technology at 1-800-222-7585

State Operated and Supported Schools (Chap-ter I)

This program provides federal assistance tohelp educate children with disabilities who areenrolled in state-operated and state-supportedprograms Federal funds must be used to payfor services that supplement a childrsquos basic spe-cial education program such as construction andthe purchase of equipment For more informa-tion contact your State Department of Education

Section 504 of the Rehabilitation Act of 1973Section 504 provides a civil-rights mandate

that requires accommodations for students whohave disabilities such as orthopedic impairmentsbut who do not qualify for special education ser-vices It denies federal funds to any institutionincluding a school whose practices or policiesdiscriminate against individuals with disabilities

25

This legislation has resulted in a number of out-comes including various actions to remove physi-cal barriers to education which may incorporateassistive technology For more information con-tact the nearest regional Office of Civil Rights orthe State Vocational Rehabilitation Agency

State Programs for Children with SpecialHealth Care Needs

These programs provide and pay for servicesfor eligible children CSHCN programs varywidely from state to state in the services they of-fer the number of children served and the re-quirements for eligibility Some CSHCN pro-grams do pay for assistive technology deviceswhen no other funding source is available andthe equipment is necessary for health-related rea-sons Most CSHCN programs are run by the statehealth agency To contact CSHCN ask informa-tion for the telephone number of the state healthagency

School-to-Work Transition ProgramsTransition Programs are charged with assist-

ing students with disabilities to receive the jobrelated training and placement services to helpthem move from school to work Sometimesassistive technology may be necessary in orderfor a student to make a successful transition andbecome employable If technology is needed fortransition purposes it can be written into thestudentrsquos Individualized Transition Plan (ITP) Toreceive more information about transition andtechnology call the Parent Training and Informa-tion Center (PTI) in your state (See Appendix)

Vocational Rehabilitation ServicesState vocational rehabilitation agencies pro-

vide information evaluation services trainingand funding for technology and education to helpadults go to work or live more independently Iftechnology is necessary for an individual to workVocational Rehabilitation may pay for the equip-ment as part of an Individualized Work-RelatedPlan (IWRP) To locate the nearest Vocational Re-habilitation Agency look in the telephone book

under state government

Plan to Achieve Self-Support (PASS)One of many Social Security Administration

work incentive programs this program providesan income and resource exclusion that allows ablind or disabled person to set aside income andresources for a work goal such as educationequipment purchase vocational training andstarting a business It should be considered forall students with vocational goals who are receiv-ing social security benefits

This program provides a mechanism forpeople to set aside funds to purchase work-re-lated equipment such as assistive technologydevices and services In many cases if an indi-vidual is a recipient of SSI and writes a PASS topurchase education or equipment an additionalSSI check will be provided to cover other livingexpenses Sometimes if a person receives SocialSecurity Disability Insurance (SSDI) and designsa PASS it may make the individual eligible forSSI because the SSDI has been allocated for equip-ment and services

Impairment-Related Work Expense (IRWE)Impairment-Related Work Expense (IRWE)mdash

one of the Social Security Administrationrsquos workincentive programsmdashallows an employed indi-vidual with a disability who receives or is eligiblefor SSI or SSDI to deduct work-related expensesfrom gross reported income

This deduction allows the person to continuedrawing SSDI or SSI and associated benefits(Medicaid or Medicare) if the IRWE deductionreduces earning below the Substantial GainfulActivity (SGA) Test

Although this method does not provide fund-ing to pay for a device or service it is a way ofallowing the use of the individualrsquos own moneyto pay for assistive devices and services neces-sary to return to work The following is a list ofpossible work-related expenses special transpor-tation to and from work personal assistance onthe job structural modifications durable medi-

26

cal equipment prostheses medical supplies andservices work-related equipment non-medicalappliances and equipment routine drug andmedical costs and diagnostic procedure costs

MedicaidMedicaid is a joint federal and state program

which covers some equipment if it is consideredmedically necessary For more information aboutMedicaid and who and what is covered contactthe local Department of Human Services office

MedicareAlthough not a usual source of funds for

assistive technology Part B of Medicare providescoverage for some durable medical equipment ifit is considered medically necessary and is foruse in the personrsquos home For more informationabout Medicare benefits contact the Social Secu-rity Administration Regional Office

Technology-Related Assistance for Individualswith Disabilities Act of 1988

This federal competitive grants program pro-vides monies for states to establish a statewideconsumer-responsive service delivery system de-signed to effect systems change regardingassistive technology In most Tech Act states afunding specialist or policy analyst is availableto assist with accessing assistive technology Sev-eral states operate loan programs to help withthe purchase of devices and services For moreinformation contact RESNA Technology Assis-tance Project 1700 N Moore ST Suite 1540 Ar-lington VA 22209-1903 703-524-6686

PRIVATE PROGRAMS

Private InsuranceSome health insurance plans will buy equip-

ment but it depends on the specific wording ofthe policy Unless the policy says the equipmentis not covered it makes sense to ask the insur-ance company to pay for it The equipment mustbe considered medically necessary and thereforerequires a doctorrsquos prescription

Loans

There are several low or no interest loansavailable to help buy technology Call the stateTech Act program or the manufacturer of theequipment may know where to get this type ofloan

Non-Profit Disability AssociationsThere are many disability organizations

some of which may be able to loan equipment orprovide information about other funding sourcesor support groups These organizations includeNational Easter Seal Society March of DimesMuscular Dystrophy Association United WayUnited Cerebral Palsy Association and the BrailleInstitute

FoundationsSome private foundations have been set up

specifically to provide help to people with dis-abilities A listing of such foundations can befound at the library or may be available from thestate Tech Act program

Programs Providing Assistive TechnologyThe state Tech Act programs offer referrals

for evaluation and equipment recommendationsas well as assistance with identifying funding orequipment lending sources A therapy depart-ment in a local hospital or Disabled StudentsCenter at a local college or university may alsooffer to help locate technology programs in thearea Alliance for Technology Access Centers(ATA) sometimes have loan programs or infor-mation about purchasing used equipment orrenting equipment

Civic OrganizationsThere are many local civic and service orga-

nizations which may provide money to helpsomeone in their community Lists of these or-ganizations are available from the Chamber ofCommerce Examples of these organizations areLions Club Masons Grotto Veterans of ForeignWars (VFW) Elks Club Rotary Club KiwanisKnights of Columbus and Soroptomists Someof these organizations have a national focus on

27

disability or on a particular disability Others willfund devices for a particular child who is knownto the local club

Charities and Fund-RaisersLocal churches high school groups neighbor-

hood organizations labor unions or special in-terest groups (eg computer clubs ham opera-tors) may plan a fund-raiser to help purchaseassistive technology College student organiza-tions (fraternities and sororities) may give moneyor studentsrsquo time to help a special cause Even ifmoney is not available they may be willing tohelp organize a fund raiser

Local media (radio television newspapers)sometimes will sponsor fund-raising activities tofund devices They may not contribute moneybut will help with organizing the fund-raisingactivity and publicizing it to the community

OTHER OPTIONS

In addition to federal and private fundingsources there are a number of education-relatedgrants corporate technology donation programsand funding options that consumers should con-sider Information on these alternative options isavailable through a number of sources includ-ing the following

NewslettersEducation Grants Alert Capital Publications

Inc PO Box 1453 Alexandria VA 22313-2052800-655-5597

Education Technology News Business Publish-ers Inc 951 Pershing Dr Silver Spring MD 20910-4464 301-5878-6300

Financing Assistive Technology Smiling Inter-face PO Box 2792 Church St Station New YorkNY 10008-2792 415-864-2220

Special Education Report Capital PublicationsInc PO Box 1453 Alexandria VA 22313-2053800-655-5597

Technology and Learning Peter Li Inc Publish-ing 330 Progress Rd Dayton OH 45449 415-457-4333

Technology ManufacturersIf it is not possible financially to purchase

equipment consumers can sometimes rent orborrow equipment directly from the manufac-turer

Used EquipmentUsed equipment is often advertised for sale

in disability-related publications or the consumercan place a newspaper ad to see if used equip-ment can be purchased locally Several compa-nies refurbish old computers and sell them at lowprices Listings of used computer outlets can beobtained from ATA Centers or state Tech Act pro-grams

LeasingMany manufacturers of assistive technology

devices have equipment which is available forrent or lease Sometimes the rent or lease pay-ments can be applied toward purchase Checkwith the manufacturer to see if this is an option

Equipment Loan ProgramsMany states have equipment loan programs

as do some rehabilitation facilities and disabilityorganizations Information about loan programsis available from Tech Act programs

HOW TO APPLY FOR FUNDING

There is an art to applying for funding forassistive technology It is necessary to use justthe right words to suit the particular agency thatmight be the funding source It is also crucial todocument the need for and projected outcome ofassistive technology This documentation shouldinclude at minimum

bull A written statement of medical need fromdoctors or other health professionals If thechild had an evaluation by a rehabilitationprofession also include this report

bull A description of the childrsquos problems re-sulting from the disability This descrip-tion can come from the doctor or other pro-fessional who evaluated the child

28

bull Description of how the technology helpsthe child For example the equipment maymake the child safer or allow the child todo things more independently Be sure topoint out how money will be saved if useof the equipment allows attendant care tobe reduced

bull A clear statement based on assessmentthat the child is a good candidate who hasthe cognitive and physical capacities nec-essary for using the technology

In summary the documentation to supportan assistive technology funding request shouldinclude a physicianrsquos prescription the childrsquos as-sessment an explanation of projected benefitfrom use of the technology or service and anycorrespondence obtained from professionals thatwould support the childrsquos need for technology

The initial funding request should include notonly the cost of the device but also the cost ofongoing support and instruction in the use of thetechnology Assistive devices often have ldquohid-denrdquo expenses that are incurred with their pur-chase and these expenses are frequently costlyover time Battery-powered devices may requirefrequent charging or cleaning Upgrades for com-puter software may be necessary Special modi-fications of the home or school environment maybe necessary for the technology to be used Ineach of these examples costs associated with thetechnology may have to be assumed by the fam-ily if they are not considered in the initial appli-cation for funding

It is also helpful to include with the fundingrequest a picture or a descriptive brochure aboutthe device being requested This is importantbecause often persons who are reviewing theapplication do not know about the wide rangeof technologies that might be appropriate

Appropriate wording on the application isabsolutely necessary Key concepts for Medic-aid include ldquomedical necessityrdquo and ldquorestore thepatient to his or her best functional levelrdquo The

term medical necessity means that the device isincluded in the course of treatment being pro-vided to the child and that a professional suchas a physician or speech therapist is supervisingits use Medicaid and private insurers alike gen-erally pay for technologies that help restorepeople to ldquofunctioning levelsrdquo and take the placeof a body part that is not working Typically theseprograms do not pay for technologies or serviceswhose function is educational or life-enhancingrather than health related

The key for private insurance is ldquoterms of thepolicyrdquo It must be remembered that coverageby any insurance company does not set a prece-dent Just because one child receives needed tech-nology under a particular policy issued by a com-pany does not mean that all other covered chil-dren will also have technology paid for by thatcompany Each application stands on its ownbased on the expressed terms of the policy

It is usually under the major medical provi-sions of a health policy that assistive technologycan be provided as ldquoother medical services andsuppliesrdquo It may however be necessary to pur-chase additional insurance coverage or a ldquoriderrdquoin order for technology costs to be included inthe terms of the policy It is important to remem-ber that heath insurance policies are oriented to-ward health care and not toward changes in theenvironment or rehabilitation

Both private health insurance policies andMedicaid sometimes impose limits on the num-ber of assistive technology devices over a certaincost that can be purchased within a certain timeframe Sometimes the rule is that the fundingsource will purchase only one device in theindividualrsquos lifetime With these kinds of restric-tions it is all the more critical to be sure that thetechnology choice is the right one

TIPS THAT LEAD TO SUCCESS

bull Apply to several funding sources at thesame time Be sure to meet the require-

29

ments of each agency

bull Find out if agencies will share costs

bull Fill in the agencyrsquos forms correctly Manyapplications are denied because forms arenot filled out properly

bull In addition to the standard form includeany other information that describes orshows what the equipment does and howit benefits the child Assume no knowledgeon the part of the reviewers

bull Turn in all documentation at the same time

bull Avoid using jargon define all unfamiliarterms

bull Take the funding request package to theagency in person While there have itchecked to make sure everything requiredhas been included Get the name of theperson who reviewed the application

bull Call regularly to check on the funding re-quest each time try to talk to the same per-son

bull Be super politemdashand persistent

WHAT IF FUNDING IS DENIED

It is not at all unusual for an initial fundingrequest to be denied Even when family mem-bers and professionals have been meticulous inpreparing applications requesting funding forneeded technology denials should be anticipatedMaking an appeal is worth the effort since manydenials are reversed at the appeal level

To start the appeal process obtain any docu-mentation or information provided by the fund-ing agency (eg Medicaid or the private insur-ance company) relating to appeal proceduresforms to use timelines and filing procedures forinstance This information will help in the promptpreparation for appeal The kind of appeal to bemade depends on the reason for denial Whendeveloping an appeal find out the following

bull Why the request was denied Ask for thereason in writing Sometimes requests are

denied because a reviewer lacks under-standing of the technology or there maybe an error in the paperwork

bull If needed correct any mistakes or includemore information then resubmit the re-quest

Going to appeal makes sense because gener-ally the appeal places the application before moreexperienced persons in the decision-making hi-erarchy The technology requested is often newand the initial examiners in the process may beunaware of its usefulness Also insufficient docu-mentation may have been provided in the origi-nal application and the problem can be remediedon appeal

Donrsquot be daunted by the length of the appealprocess Follow it through to its completion Insome states families may be able to appeal a de-nial beyond the first level For example somestates have ldquounfair claims settlement practicesrdquoregulations which are administered through theinsurance commissionerrsquos office

Always make your appeal in person and takethe child and the equipment if possible If onlypart of the money is offered by one agency askanother agency to share costs If the appeal isdenied try again Submit the funding request toanother agency Being persistent will nearly al-ways result in success

When going through the appeal process turnto the state Protection and Advocacy Program (Pamp A) for guidance and support P amp A advocatescan help make sure that a childrsquos rights to tech-nology and related services are not denied

Who pays when assistive technology is neededat school

The party who is responsible for paying forassistive technology depends upon the circum-stances under which the technology is purchasedUnder the special education law students withdisabilities who are eligible for special educationare entitled to a free appropriate public educa-tion Parents do not have to pay for school ser-

30

vices including assistive technology if that ser-vice is part of the studentrsquos Individualized Edu-cation Program (IEP) If the student is eligible forMedicaid the school district can request thatMedicaid pay for the device If parents choose todo so they may agree to use private insurance topay for a device that is used at school Parentscannot however be forced to use their insurancein this way If the private insurance requires aco-payment the school district would have to paythis amount since parents should not have to payany special education related costs

Does Section 504 pay for assistive technologySection 504 part of the Rehabilitation Act of

1973 is basically a piece of civil rights legislationthat is intended to prevent discrimination againstindividuals with disabilities in any programwhich receives federal funding Students whohave disabilities but who do not qualify for spe-cial education may still be eligible for accommo-dations under Section 504 of the RehabilitationAct of 1973 Section 504 however does not pro-vide any funding for accommodations

Like the special education law Section 504requires public schools to provide students withdisabilities with a free appropriate public educa-tion and in addition ensures that students withdisabilities are afforded an equal opportunity toparticipate in school programs For students withdisabilities this means that schools may need tomake special arrangements so that these studentshave access to the full range of programs andactivities offered For example a student whoneeds a wheelchair lift on a school bus to get toschool must be provided with this technologyOther modifications which might be requiredunder Section 504 include installing ramps intobuildings and modifying bathrooms to provideaccess for individuals with physical disabilitiesEven though required by the law none of thesetypes of modifications would be funded by Sec-tion 504

Under what circumstances does private health

insurance pay for assistive technologySome private health insurance policies will

pay all or part of the cost for some assistive tech-nology devices The devices are unlikely to belisted specifically in the policy but may be in-cluded under some generic term like ldquotherapeu-tic aidsrdquo Usually the devices have to be pre-scribed by a physician in order to be covered bythe policy

When does Medicaid cover assistive technol-ogy

Medicaid (Title XIX) will pay for ldquoprostheticdevicesrdquondashthat is replacement corrective or sup-portive devices prescribed by a physician or otherlicensed person Each state has some flexibilityin determining which prosthetic devices it willinclude in its list of Medicaid covered expensesDevices that are frequently covered by Medicaidare canes crutches walkers manual wheelchairshospital beds and hearing aids or eyeglasses forchildren and youth

SummaryAssistive technology can be expensive to pur-

chase but there are a number of public and pri-vate sources for funding devices Common pub-lic funding sources include early childhood in-tervention programs schools Vocational Reha-bilitation and Medicaid Private sources mayinvolve health insurance personal loans chari-table donations or fundraising It is very impor-tant to provide proper documentation and usecorrect wording and procedures when request-ing funding Initial requests for funding are fre-quently turned down but appeals can be success-ful

31

TEDTed is an active four-year old who lives in a

small rural community with his parents andyounger sisters He was identified as speech im-paired and has been attending preschool specialeducation classes Ted has normal mental capa-bilities but his mild cerebral palsy impairs hisability to speak Because of the speech therapyhe has received Ted is able to make some speechsounds but he says no intelligible words Heuses sign to communicate with his special edu-cation teacher and his parents No one else inhis community uses sign so Ted is limited in hisability to communicate with others

As Tedrsquos IEP Team looks ahead to his entryinto elementary school the Team recognizes thathe will need better communication skills in or-der to participate successfully in the regular class-room His speech therapist has recommendedthat Ted begin to use an AlphaTalker

What funding sources might pay for theAlphaTalker

What case could you make for funding Arethere any obstacles to seeking funding

TEDrsquoS SOLUTIONAt this point Tedrsquos ability to communi-

cate is somewhat primitive Because of his cere-bral palsy he is not able to make conventionalsigns so the gestures he makes are understoodonly by those who know him well A simple elec-tronic communication device may work for Tedbut there are some prerequisite communicationskills he will have to master first Augmentativecommunication devices operate on the principleof choosing icons (abstract symbols) that repre-sent certain basic communications like a cup toindicate ldquoI want a drinkrdquo

In order to make a picturesymbol systemmeaningful and functional for Ted at his youngage his speech therapist began to work on point-to-object and point-to-picture activities WhenTed had mastered point-to-picture activities histherapist made a picture ring for him On thering were picture symbols (icons) for things thatTed might want to say Tedrsquos family his teacherand his classmates began to ask him to use hispictures to explain what he wanted Soon Tedwas using pictures to communicate simple wantsand needs effectively His word ring went withhim everywhere and helped him to ldquotalkrdquo topeople he did not know as well as to friends andfamily members

An unexpected bonus to the picture practiceis that Ted is verbalizing more and his speech hasbecome more intelligible He has even begun tosing An electronic communication device maybe in Tedrsquos future but for now he is learning tocommunicate well with his picture ring and somespoken words

Solution SummaryPoint-to-picture practice

Use of picture ring

32

GLORIAGloria an eighteen year-old with mild cog-

nitive delays and CP is about to finish highschool She has been using a laptop computerand switch access hardware and software in lieuof a pencil and paper to complete work in highschool The equipment and software were pro-vided by the school district through the IEP pro-cess Gloriarsquos current goal articulated in her In-dividual Transition Plan (ITP) as mandated byIDEA is to have a full-time job by the time she is22 She wants to work in an office and woulduse a computer system similar to her currentsetup As she moves into the transition periodthese questions must be addressed

Will the laptop computer she has been usingbe functional for her in the workplace

Will she need to consider new equipmentWhat would influence a decision to purchase newequipment

What funding sources might help Gloria topurchase new equipment

What case should Gloria make for funding

GLORIArsquoS SOLU-TION

Gloria is fortunate to have learned computerand word processing skills while she was inschool Now she must learn ways to transferthese skills into the work setting Laptop com-puters are not typical in offices instead whatGloria is more likely to encounter is a desktopworkstation with computer and printer In or-der to use a standard computer Gloria will needa switch access device and an onscreen keyboardto do word processing and data entry

Since single switch access is necessary forGloria to become employed in an office settingGloriarsquos Vocational Rehabilitation Counselor waswilling to make such a purchase for her Gloriaapplied to be a data processor with a temporaryemployment firm and got the job Gloriarsquos VRcounselor helped her to select switch access hard-ware compatible with most IBM compatible com-puters In her new job Gloria changes office set-tings frequently Each time she moves she takesher switch access device and onscreen keyboardsoftware with her With these portable items sheis able to adapt each new office setting to meether needs Having the right technology has madeGloria an adaptable and successful temporaryoffice employee

Solution SummarySwitch access

Onscreen keyboard software

33

Making Assistive Technology a Part ofChildrsquos Education

The ideal time for a child with a disabilityto learn to use assistive technology is whenthe child is learning all sorts of others skills

in early intervention services preschool and K-12 education Children who are eligible for earlyintervention services under Part C or special edu-cation under Part B of the Individuals with Dis-abilities Education Act (IDEA) are entitled to beevaluated for assistive technology needs and toreceive assistive technology devices and servicesif they are necessary to providing a free appro-priate public education In order for children toreceive the assistive technology to which they areentitled parents must be knowledgeable abouthow assistive technology fits into special educa-tion and the ways that AT can be included in achildrsquos Individualized Family Service Plan (IFSP)or Individualized Education Program (IEP)

ASSISTIVE TECHNOLOGY FOR YOUNG CHILDRENParents are often surprised to learn that

assistive technology can be appropriate for in-fants and toddlers Very young children whohave disabilities that limit their ability to inter-act with the environment by crawling touchingseeing or hearing can benefit from technologythat improves their interactions Federal educa-tion amendments require states to ldquopromote theuse of assistive technology devices and assistivetechnology services where appropriate to en-hance the development of infants and toddlerswith disabilitiesrdquo These amendments furtherrequire states to ldquofacilitate the transition of in-fants with disabilitiesfrom medical care to earlyintervention services and the transition fromearly intervention services to preschool specialeducation or regular education servicesrdquo

When Kayla was an infant her interactionswith the environment were very limited because

she has a genetic condition resulting in abnor-mally short arms and legs She could not turnover or crawl she had difficulty touching andgrasping objects As part of her early interven-tion program Kayla was introduced at the ageof six months to the use of switches When theswitches were positioned correctly she could ac-tivate switch-operated toys or noisemakers Theopportunity to interact with toys opened upKaylarsquos world She soon began to hunt for theswitches and to activate certain toys on com-mand She used the switches to make choicesbetween toys or sounds She became verballymore expressive and began to interact morereadily and more often with her parents and sib-lings

By the time that Kayla was three and readyfor preschool special education she was able tosit up and interact with a computer activated byswitches She could identify objects on the com-puter screen and match those objects to real ob-jects in the world around her At three Kaylacould identify and match some letters and shapeson the computer screen Though limited in hermobility Kayla became an active participant inclassroom activities She could interact withclassmates by playing computer games joiningin at circle time and participating in allpreacademic learning activities

Assistive technology was an integral and nec-essary part of Kaylarsquos early intervention servicesKaylarsquos parents were involved in writing the In-dividualized Family Service Plans (IFSPs) thatoutlined the services Kayla and their familyneeded From the beginning Kaylarsquos family hadthe opportunity to see how assistive technologycould be included in the IFSP and really make adifference in Kaylarsquos education and her life

Kaylarsquos story illustrates how assistive tech-

34

nology can be utilized from an early age and canbe part of the transition from medical treatmentto early intervention and from early interventioninto preschool special education or regular edu-cation Because of the availability of early inter-vention services there is no reason to wait untila child is of school age before trying assistive tech-nology Early use of the necessary technology willenhance a childrsquos development by increasingopportunities to interact with the environment

ASSISTIVE TECHNOLOGY AT SCHOOL AGE ANDBEYOND

When students enter kindergarten and begintheir regular public school years assistive tech-nology can continue to be a part of their specialeducation programs For students who are eli-gible for special education assistive technologymust be provided when it is necessary

(1) to support placement in the least restric-tive environment

(2) to ensure that a student benefits from hisor her education or

(3) to implement the goals and objectives inthe studentrsquos IEP

Needs for assistive technology should be oneof the considerations when a student is assessedto determine eligibility for special education Ifan assessment reveals that a student is eligiblefor special education then the multi-disciplinaryteam should consider assistive technology needswhen making recommendations for the Individu-alized Education Program (IEP) The team shouldanalyze what is required of nondisabled studentsof the same age and determine how many of theserequirements could be completely or partiallyfulfilled by the student being assessed if that stu-dent had access to appropriate assistive technol-ogy

In addition when information is being col-lected for the present level of performance sec-tion of the IEP part of that assessment should bea consideration of whether or not assistive tech-nology is necessary for the student to achieve

educational or social goals benefit from educa-tion or make reasonable progress in the least re-strictive educational setting Whoever is collect-ing the information might experiment withassistive technology applications to determinewhich ones might work for the particular student

Assistive technology should be considered asan option for every IEP Some students of coursewill not require technology but many studentswill benefit from technology that helps them tocompensate for their impairments School dis-tricts are not required to provide all of the pos-sible assistive devices that might be nice to haveor might provide the best possible arrangementsAssistive technology is required however whenits presence enables the student to make reason-able progress toward the goals the IEP Team iden-tifies

HOW TO INCLUDE ASSISTIVE TECHNOLOGY INTHE IEP

Assistive technology can be included in theIEP in a number of ways It may appear as partof the studentrsquos annual goals or short term objec-tives It may also appear in a list of specific ac-commodations which need to be made in orderfor the student to function in the least restrictiveenvironment For example the IEP might includesuch accommodations as the use of word pro-cessing use of a calculator use of a hand heldspell checker and so forth In addition the IEPmay specify that as a related service necessaryfor the student to benefit from his or her educa-tion the student will receive training in the useof assistive equipment like an electronic commu-nication device a power wheelchair or a personalcomputer

WHERE TO PUT ASSISTIVE TECHNOLOGY IN THEIEP

There are three places in the IEP whereassistive technology may appear (1) in the an-nual goals and short term objectives (2) in theenumeration of supplementary aids and servicesnecessary to maintain the student in the least re-

35

strictive educational setting and (3) in the list ofrelated services necessary for the student to ben-efit from his or her education

Assistive technology can be a part of the an-nual goals and short term objectives on an IEPbut there must be a certain degree of specificityin the goal in order for the role of assistive tech-nology to be clear An annual goal for the IEPshould express an estimate of what the studentcan accomplish in a particular domain during thecourse of one year under what conditions theskill is to be developed and what criteria will beused to indicate whether or not the skill has beenlearned

Many times IEP goals are broad vague andtotally nonspecific Such goals are impossible tomeasure and do not give any indication of whatis realistic to expect in terms of the studentrsquos be-havior or skill level in the course of a yearrsquos timeSuch broad goals are not useful in addressingassistive technology The inclusion of assistivetechnology in the IEP requires a degree of speci-ficity so that it is clear how and why the technol-ogy will be used to accomplish a particular goal

An annual goal which includes assistive tech-nology may indicate that the technology will bepart of the conditions under which some aca-demic or social skill will be acquired For ex-ample an IEP goal for a student with a learningdisability in written expression may look like this

10 Using a word processing program with spell-ing checker Shawn will compose three paragraphthemes composed of fifteen or more sentences with 80or better accuracy in the use of spelling punctuationand grammar

Objectives leading to this goal might includepreliminary exploration of the word processingprogram trials to learn effective use of the spell-ing checker drill and practice in writing singleparagraphs to the 80 level of accuracy in spell-ing punctuation and grammar increasing thelength of writing to two paragraphs and theneventually moving to three paragraphs with

gradually increasing degrees of accuracy

Another type of annual goal may address askill which is necessary for using assistive tech-nology Such a goal might appear this way

20 Using an adapted computer keyboard Rachelwill type 12 words per minute with no errors over 10or more consecutive trials

In this case Rachel would spend a year learn-ing keyboarding skills with the goal of achievingat least 12 words per minute with complete ac-curacy For a young student who experiencessome fine motor difficulties this goal would bechallenging but it might be achievable in a yearrsquostime Objectives leading to this goal might in-volve preliminary exploration of the keyboardgradual introduction of the letters and numberson the keyboard practice to build speed and ac-curacy and eventually timed trials until 10 con-secutive trials could be achieved with no errorsat a rate of 12 words per minute or better

Still another type of annual goal might ad-dress a social issue like communication withpeers

30 Using an electronic communication deviceSara will respond appropriately to social inquiries fromclassmates 5 times out of 5 opportunities over 5 con-secutive days

Objectives leading to this goal might includetraining in the use of particular words andphrases on the communication device drill andpractice in responding with the device in struc-tured settings increasing accuracy in respond-ing in structured settings practice in unstruc-tured conversational opportunities and gradualachievement of accuracy in unstructured conver-sational settings with peers

ASSISTIVE TECHNOLOGY AS A RELATED SERVICEAssistive technology can be a related service

just like audiology physical therapy or speech ifit is necessary for the student to benefit from hisor her education For a student to be successfulin using assistive technology he or she must be

36

trained in its use Training to use a computer anaugmentative communication device a PhonicEar or large type viewer or other similar devicescan occur as a related service which supports thestudentrsquos educational program Preparation forthe use of assistive technology can also be workedinto other related services like occupationaltherapy Occupational therapy may involve de-termining correct positioning to take advantageof assistive technology and exercises to preparethe student to use a computer keyboard or a com-munication board

Margo who has muscular dystrophy uses alaptop computer every day in her sixth gradeclass Margorsquos upper body strength is diminish-ing and she is gradually having greater andgreater difficulty using her hands for writing ordrawing Using a computer saves her energy andallows her to keep performing well in the class-room As a related service in her IEP Margo isreceiving occupational therapy designed to pre-pare her for even more adaptations which maybe necessary as she loses more strength Margoand her therapist are experimenting with com-puter access devices (eg switches trackball) andon screen keyboards to determine what methodMargo would like to use when her hands are nolonger strong enough to type on a standard key-board This special training for assistive technol-ogy is written into Margorsquos IEP as a related ser-vice because such training is necessary for her tocontinue to benefit from her education

ASSISTIVE TECHNOLOGY SUPPORT FOR PLACE-MENT IN THE LEAST RESTRICTIVE ENVIRON-MENT

One important feature of assistive technologyis the fact that it can make it easier for studentswith and without disabilities to learn togetherStudents with disabilities are guaranteed the rightto be with nondisabled peers and to receive theireducation in the setting which is the least restric-tive environment In order to be successful in theleast restrictive environment students are to be

afforded whatever supplementary aids and ser-vices are necessary Among the supplementaryaids which may allow a student to remain in aless restrictive environment are a variety ofassistive devices that compensate for disabilityand allow the student to perform educational andsocial tasks Assistive technology is necessary asa supplementary aid if its presence (along withother necessary aids) supports the student suffi-ciently to maintain the placement and its absencerequires the studentrsquos removal to a more restric-tive setting For example if a student with mul-tiple physical disabilities can make progress onhis or her IEP goals in the regular classroom withthe use of a computer and an augmentative com-munication device and cannot make suchprogress in that setting without the devices thenthose devices are necessary supplementary aids

Lyle a fourth grader with cerebral palsy is agood example of a student who thrives in theregular classroom if he has the use of appropri-ate technology Lyle is able to keep up academi-cally with his classmates if he has access to a com-puter with an adapted keyboard and word pre-diction software Lyle has learned to type welland is able to do written assignments in relativelythe same amount of time as other students in hisclass Without a computer Lyle could not keepup at all Handwriting is a laborious task for Lyleand his written product tends to be messy andbarely readable If he could not use a computerLyle would have to rely on others to do hand-writing for him or he would have to do alterna-tive assignments that require no writing

Lyle likes being a regular fourth grader Heis proud of his writing on the computer becausehe is using his own words and learning to editout his mistakes by himself With his computerhe does not need the services of an aide and canbe completely independent in doing his schoolwork

Assistive technology in the form of a com-puter with appropriate software and keyboard

37

adaptations is necessary for Lyle to remain in theregular classroom working independently Thisuse of the computer can be written into his IEPas a supplementary aid which is necessary tosupport Lylersquos placement in the least restrictiveenvironment

Does assistive technology include access toschool buildings

AT certainly can mean devices that provideaccess to school buildings and facilities Oneimportant part of a free appropriate public edu-cation is that students with disabilities are ableto get to school get into the school and use theschool building and facilities Assistive technol-ogy can be used to provide access to the schoolbus classroom playground gymnasium audi-torium lunchroom or the equipment in themAny or all of these needs can be addressed in theIEP

Bus modifications for improved access andappropriate seating can help with transportationto and from school and school activities Doorswalkways handles switches stairs steps can bemodified so that a student with disabilities canuse them as effectively as classmates Appropri-ate seating and playground modifications canhelp include students who have disabilities atclassroom lunchroom and recess times

When an individual graduates from publicschool is it still possible to have assistivetechnology

If individuals benefit from the use of assistivetechnology during their school years the likeli-hood is that assistive technology will be evenmore important for them in adult livingAssistive technology can certainly be part of anindividualrsquos future after high school but it is nec-essary to begin planning for the transition fromhigh school so that the technology and other nec-essary services are available when needed

The earlier a family can estimate their childrsquospost-high school needs including needs for tech-nology the earlier transition planning can begin

Federal legislation says that transition planningcan begin in school as early as ldquo14 or youngerrdquoEach student with a disability who has an Indi-vidualized Education Program (IEP) should havea ldquostatement of transition servicesbeginning nolater than age 16rdquo This means that as early asmiddle school but probably not later than fresh-man year in high school families should begintransition planning

Unlike school services services in the adultworld are not mandated An individual may beeligible for a disability service but not receive itbecause all of the slots are filled or funding is notavailable If an individual does not own his orher own assistive technology devices then partof transition planning will be looking into fund-ing sources that could help with technology pur-chases If technology is necessary for the indi-vidual to become employed it is possible thatVocational Rehabilitation will pay for the devicesas part of an Individual Work-Related Plan(IWRP) Students who go on to postsecondaryeducation at community college vocational-tech-nical schools or universities can expect to be ableto receive certain accommodations for their dis-abilities while on campus Most postsecondaryinstitutions have Student Support Services thathelp with assistive technology needs alternativetesting readers and notetakers

SummaryAssistive technology can be included as an

integral part of a studentrsquos education but par-ents have to be knowledgeable about how to goabout getting assistive technology into theirchildrenrsquos educational plans Assistive technol-ogy can be written into the Individualized Fam-ily Service Plan (IFSP) for infants and toddlers inearly intervention programs and into the Indi-vidualized Education Program (IEP) forpreschoolers and students in grades K through12 Assistive technology can appear in threeplaces in the IEP (a) as part of the goals and ob-jectives (b) as a supplementary aid to support

38

placement in the least restrictive environmentand (c) as a related service Assistive technologycan also be a part of studentsrsquo transition planningas they move from high school into adult pur-suits Assistive technology is available throughVocational Rehabilitation and other adult disabil-ity services but these services are not mandatedTo ensure continued use of assistive technologyit is important to plan ahead and secure fundingfor devices needed in the work or postsecondaryeducation environments

Hints for Parents

If your child is a successful assistive technologyuser begin to save money early in your childrsquos lifemdashjust as you might save for college Gradually accu-mulate enough funding to purchase the kinds of tech-nology your child will need as an adult Technologychanges so fast that it is impossible to predict whatwill be available fifteen years from now But a parentcan be certain that assistive technology of the futurewill be even better than what is available today

EmilyEmily is a seventh grade student who has

learning disabilities She is in regular classes allday in her neighborhood middle school A spe-cial education teacher monitors Emilyrsquos progressand provides the regular classroom teachers withassistance by modifying some of Emilyrsquos assign-ments giving her oral tests helping to organizeEmilyrsquos work and reteaching certain skills asnecessary In elementary school Emily did wellwith the limited amount of support she receivedin the regular classroom In middle school how-ever she is having trouble keeping up with as-signments Emilyrsquos spelling is inaccurate sheoften misspells the same word three or four dif-ferent ways on the same page Her handwritingis very slow and laborious so she spends manyhours each evening working on her homeworkShe has tried tape recording assignments but shefinds this process also to be laborious because itis so time consuming to correct mistakes

It has been recommended that Emily be re-moved from some of her academic classes andreceive instruction in the resource programEmily wants to remain in regular classes but shecanrsquot keep up with the pace

How could assistive technology help Emily

What are her needs

What case could be made for assistive tech-nology for her

39

Emilyrsquos SolutionEmily has reached the point in her educa-

tional career when she cannot keep pace with thedemands of the written work On observingEmily the occupational therapist noted that ittook Emily five times as long as the average stu-dent in her English class to complete written as-signments

Emilyrsquos IEP Team decided she was spendingfar too much time on the handwriting processTo help her with this problem the team agreedthat Emily should learn to use a computer with aword processing program and a voiced spellchecker One period per day Emily goes to theresource room to practice keyboarding and workon longer written assignments During her regu-lar classes Emily uses a portable word proces-sor (eg AlphaSmart) to take notes which shecan print out later in the resource room

These simple solutions allow Emily to speedup her writing time and produce written workthat is easy to correct and edit With technologyto aid her Emily is spending less time on thehandwriting process and more time on thinkingand processing information Her homework timehas been cut in half and Emily is much more re-laxed and confident at school

Solution SummaryKeyboarding training

Use of computer with word processingsoftware

Use of voiced spell checker

Use of portable word processor

BryanBryan is a seventh grader with a neuro-mus-

cular disease that has caused him to lose physi-cal function He is a bright student with excel-lent academic skills Bryan uses a laptop com-puter with a trackball and an onscreen keyboardto do all his written work He navigates skill-fully around the school building using a powerwheelchair Technology has really helped Bryanto fit in and do well at school However now asa young adolescent Bryan is beginning to feelleft out socially He requires so much help withhis physical needs that he has to spend lots oftime with adults Bryan wants to ldquohang outrdquo likethe other kids his age and escape adult scrutinyonce in a while

Bryan is nonverbal He uses a complex so-phisticated electronic communication device toparticipate in class The device is programmedwith phrases that Bryan frequently uses and healso can select icons to create sentences of hisown Bryanrsquos communication device works wellfor him in formal classroom settings but it isbulky and cumbersome to use in casual conver-sation with friends Bryan has come to believethat his communication device is actually a bar-rier to the kinds of informal interactions he wantsto have

Bryan knows that he has the best in technol-ogy and that the equipment he uses was very ex-pensive He doesnrsquot want to appear ldquogreedyrdquo ordemanding so he has not told his parents abouthis dissatisfaction with his ability to communi-cate One of Bryanrsquos friends Michael howevernoticed that Bryan was acting pensive and un-usually quiet Michael gently coaxed the truthout of Bryan and offered to help his friend thinkof a new way to ldquotalkrdquo that would provide himwith more flexibility and independence

40

Bryanrsquos SolutionWhen Bryan and Michael put their heads to-

gether they came up with lots of ideas The onethey settled on as the most feasible involved us-ing the laptop that Bryan already had The laptophad some advantages because it was small andportable and Bryan already knew how to use itvery well In a catalog of special needs softwarethe friends found communication software thatoperated on an icon system and the price wasright--around $100 With communication soft-ware installed on the laptop Bryan had asimplermore portable device for talking in ca-sual settings

Next Michael asked his father to help themmake a tray for Bryanrsquos wheelchair that wouldhold the laptop and fold down beside the chairout of the way when not in use Michaelrsquos dadcame up with a clever tray on hinges that foldedto the side The laptop fastened to the tray withwide rubber bands A handle on the tray allowedBryan to raise and lower the tray as needed

In addition to his laptop Bryan also neededa device for quick greetings and spontaneous re-torts Bryan and Michael chose a programmableswitch with the capacity to record up to 12 mes-sages Bryan could operate the switch quickly byhitting it with his elbow He and Michael had agreat time recording messages suitable for talk-ing to their friends or to girls

What Bryan found out was that he neededmultiple ways to communicate so that he couldcustomize his electronic speech to fit the settingand the occasion For a relatively small financialinvestment Bryan and Michael were able to ex-pand communication possibilities for Bryan andallow him greater control and personal choiceabout what he said how he said it and to whom

Solution SummaryCommunication softwareDrop-down wheelchair trayProgrammable switch

TracyTracy is a man in his mid-thirties who has

been blind from birth Since graduating fromcollege he has held a series of entry level jobs atminimum wage and without benefits Tracy isfrustrated by the lack of challenge in the jobs hehas had he would like to have a managerial po-sition with some opportunities for advancementbetter pay and benefits

Currently Tracy is working at a Pizza Hutrestaurant where he prepares pizzas for the ovenHe enjoys his co-workers and regular customersbut Tracy wants more A management traineeopening has been announced in the companynewsletter and Tracy decides to apply This newposition involves taking pizza orders over thetelephone and sending the order via computerand modem to the appropriate Pizza Hut outletwhere the pizzas will be made Having madeevery possible type and size of pizza Tracy isvery familiar with the options But how couldhe operate the computer and record orders asthey come in over the telephone Would he havea chance for this job which could be his first stepup

41

Tracyrsquos SolutionTracy and his Vocational Rehabilitation Coun-

selor filled out the job application for the posi-tion at Pizza Hutrsquos central ordering facility andTracy was called to set up an interview Prior tothe interview Tracy and his job counselor wentto the central ordering facility for Pizza Hut tostudy aspects of the job and to determine if tech-nology could assist Tracy to perform the essen-tial job functions The job involved the follow-ing steps (1) greeting the customer and takingdown customer information (2) asking a seriesof questions about the customerrsquos order (egtype size toppings) (3) simultaneous record-ing of the order via computer and (4) sendingthe order to the appropriate Pizza Hut outlet

After studying the process of taking ordersTracy and his counselor decided upon the follow-ing technology

(a) A computer compatible with the Pizza Hutnetwork

(b) Voiced software so that Tracy couldldquohearrdquo what he was typing

(c) A telephone headset to listen to the cus-tomer with one ear

(d) an ear piece to listen to the computer

At his interview for the job Tracy explainedhis qualifications for the position--college degreeexperience with Pizza Hut He also told the in-terview team about how technology would al-low him to do the job as efficiently and effectivelyas other workers

The interview team members were impressedby Tracyrsquos initiative and his work ethic Theychose him over several other qualified candi-dates Though it took some detective work toput together a computersoftware package com-patible with Pizza Hutrsquos system Tracy was ableto do it

From the first day on the job Tracy knew he

was going to like it better than anything he haddone before Listening to the computer and thecustomer simultaneously was challenging at firstbut soon Tracy had mastered the process Afterthree months in his new position Tracy wasasked to become the manager for his shift Nowhe hires and trains new order clerks schedulesworkers and evaluates their job performanceTracy has what he wanted--a managerial posi-tion better wages and a future with the com-pany

Solution SummaryCompatible computer terminal

Voiced software

Telephone headset

Ear piece for computer

42

Advocating forAssistive Technology

In the area of Assistive Technology mdash just as in so many areas of need mdash parents must betheir childrenrsquos best advocates Federal and

state laws support providing assistive technol-ogy to individuals with disabilities but theselaws are only meaningful when parents knowabout them and can use legal processes to securetheir childrenrsquos rights Here are just a few of thelaws on which parents can rely when advocat-ing for assistive technology for their children

THE AMERICANS WITH DISABILITIES ACT OF1990

The Americans with Disabilities Act (ADA)proposes to eliminate ldquodiscrimination againstindividuals with disabilitiesto address the ma-jor areas of discrimination faced day-to-day bypeople with disabilitiesrdquo The ADA applies spe-cifically to the areas of employment public ac-commodations and government functions Inthese areas the ADA requires that reasonable ac-commodations be made so that people with dis-abilities can have an equal opportunity to par-ticipate in employment opportunities public ac-commodations and government functions TheADArsquos definition of ldquoauxiliary aids and servicesrdquoits mandates for ldquoacquisition or modifications ofequipment and devicesrdquo and ldquoreasonable accom-modationsrdquo support the provision of assistivetechnology devices and services to individualswith disabilities

THE REHABILITATION ACT OF 1973Section 504 of the Rehabilitation Act requires

that any ldquoprogram or activity receiving Federalfinancial assistancerdquo comply with non-discrimi-nation rules Section 504 Regulations require thatpublic schools provide students who have dis-abilities an educational opportunity equal to theeducational opportunity provided to students

without disabilities Section 504 also uses theterm ldquoreasonable accommodationsrdquo which canmean the provision of assistive technology de-vices and services

THE INDIVIDUALS WITH DISABILITIES EDUCA-TION ACT (IDEA)

The Individuals with Disabilities EducationAct (IDEA) requires free appropriate public edu-cation (FAPE) for students with disabilities IDEAmandates education in the least restrictive envi-ronment requires schools to use supplementaryaids and services special and related services tohelp assure that students with disabilities par-ticipate in and benefit from public educationAssistive technology is specifically mentioned inIDEA as a service which school districts may haveto provide in order for a student with disabilitiesto benefit from special education

THE CARL PERKINS ACTThe Carl Perkins Act assures that Vocational

Education programs in public schools are madeaccessible to students with disabilities The lawassures supplementary services including class-room curriculum and equipment modificationssupportive personnel instructional aides and in-structional devices

PARENT RESPONSIBILITIESIn order to be effective advocates for their

children parents need to familiarize themselveswith all the laws that support the provision ofassistive technology Copies of the laws and theirregulations are available from the offices of mem-bers of the House of Representatives and the Sen-ate

Besides knowing the law parents must par-ticipate actively in developing plans for theirchildrenrsquos education that include assistive tech-nology when it is needed Parents must attend

43

IFSP and IEP meetings and be prepared to workcooperatively with other team members Whena parent questions an assistive technology evalu-ation or an IEP Team recommendation the par-ent must be prepared to follow-up on those ques-tions including using due process rights whennecessary

What should a parent do when an agencyrefuses to pay for assistive technology that achild needs

Agencies like early intervention programsand school districts are mandated to provideassistive technology if the need for technology isin the childrsquos written plan If one of these agen-cies refuses to pay for needed technology then aparent must consider using due process rightsIn early intervention services the parent wouldfollow the appeal process laid out by the leadagency for Part C When school district servicesare involved the parent can file a complaint ifservices in the IEP are not provided or can askfor a due process hearing if the parent and theschool district disagree about the need forassistive technology If a parent disagrees withthe results of an evaluation for assistive technol-ogy the parent can ask for an independent evalu-ation at school district expense

SummaryOverall getting the devices and services for

children with disabilities means that parents mustbe part of the planning team at every level of theirchildrenrsquos education It means talking with otherfamilies and users of assistive technology aboutdevices and services learning how they foundthe best technology and figuring out where togo when resources are few Getting assistive de-vices and services is not always an easy job Buthelp is available Working with professionalstalking with consumers and other families par-ents can find the best avenues for providing theirchildren with the assistive technology they needIn the end the effort is worth it because assistive

technology is not just a civil right guaranteed bylaw it is also a means to achieve human rights togrow up happy independent and self-sufficientas possible

Hints for Parents

When advocating for your child in the special edu-cation arena donrsquot forget the following facts aboutassistive technology and the IEP

bull Assistive technology needs must be con-sidered along with a studentrsquos other edu-cational needs

bull Needs for technology must be identifiedon an individual basis

bull Identification of technology needs mustinvolve parents the student when appro-priate and a multidisciplinary team

bull Parents or other IEP Team members can askfor additional evaluation or an indepen-dent evaluation to determine assistive tech-nology needs

bull When an evaluation is being conductedconsider mobility fine-motor skills com-munication and alternatives to traditionallearning approaches

bull Lack of availability of equipment or costalone cannot be used as an excuse for de-nying assistive technology services

bull If included in the IEP assistive technologyservices and devices must be provided atno cost to the family

bull Parents always have the right to appeal ifassistive technology services are denied

44

More Questions and Answers

A re schools required to pay forassistive technology devices andservices

It is the responsibility of the school dis-trict to provide for the equipment services orprograms identified in the IEP The school dis-trict may pay for the equipment service or pro-grams itself utilize other resources to provide orpay for the device or utilize private insurancefunds Medicaid or other sources of funds as longas the device or services identified in the IEP areprovided at no cost to the parent Private insur-ance or Medicaid may be used ony if the parentagrees

Can schools require the parents to payfor an assistive technology device orservice identified in the studentrsquos IEPor require the parents to use theirown private health insurance to payfor the device or service

No The ldquofreerdquo in FAPE means that parentsof students with disabilities who require assistivetechnology devices or services do not have to payfor these items As stated in IDEA and its regu-lations all special education and related servicesidentified in the studentrsquos IEP must be providedldquoat no cost to the parentrdquo The term ldquofreerdquo is in-terpreted broadly and goes far beyond the simplepaying of deductibles and co-payments Thecourts have interpreted ldquofreerdquo to apply to butnot be limited to future insurability depletionof maximum lifetime caps raised premiums dis-continuation of policies and preexisting condi-tion exclusions If the family agrees to allow theschool to access their Medicaid or private insur-ance this decision must be strictly voluntary onthe part of the family

How can school districts use Medicaidfunds to purchase assistive technologydevices

If Medicaid is capitated in any way concern-

ing its use for assistive devices school districtsmust request from parents the right to use Med-icaid funds However parents are not obligatedto use their Medicaid funds to purchase devicesor services used at school With permission aparentrsquos private insurance must be accessed be-fore Medicaid can be used for assistive technol-ogy devices Medicaid regulations vary some-what from state to state so it is wise to consultthe state Medicaid Service Bureau before mak-ing any assumptions about Medicaid and thepurchase of assistive technology

Are there other options for schools toconsider in lieu of purchasing theassistive technology device

Yes There are times when the outright pur-chase of equipment or devices is not necessaryor even advisable In such instances schoolsmight consider rental or long-term lease optionsThere are certain advantages to renting or leas-ing depending on the individual needs of thestudent For example renting equipment mightbe a reasonable strategy if the student is expectedto improve or deteriorate in a short period of timeor when it is necessary to try out the equipmentbefore purchase Long-term leasing or leasepurchase agreements also have potential benefitsfor schools which include no obligation on be-half of the school to purchase the device abilityto return leased equipment and thus reduce ob-solete inventory flexible leasing terms use ofequipment without a lump-sum purchase up-grading of equipment as more improved tech-nology becomes available and upgrading ofequipment as the studentrsquos needs change

Isnrsquot assistive technology just acrutch Wonrsquot students become toodependent on technology and notlearn to use the skills they have

Assistive technology should be used as sup-port for access learning and performing daily

45

tasks In general assistive technology is appro-priate when it compensates for disabilities so thatthe individual can function as normally as pos-sible If assistive technology is necessary for astudent to have access to educational opportuni-ties or to benefit from education then it is not aldquocrutchrdquo but a legitimate support Some skillsare too laborious or taxing to accomplish at a rateor with degree of proficiency to allow for partici-pation in the least restrictive environment Withassistive technology the student can participatemore fully and more closely approximate the lev-els of achievement and interaction of his or herpeers In general the use of assistive technologyenhances function and increases skills and op-portunities Though a student may be dependentupon a particular device in order to perform skill-fully denying the device denies the student anopportunity ever to achieve success at the levelof his or her potential

When is assistive technology appropri-ate

Assistive technology may be considered ap-propriate when it does any or all of the follow-ing things

bull Enables students to perform functions thatcan be achieved by no other means

bull Enables students to approximate normalfluency rate or standardsmdasha level of ac-complishment which could not beachieved by any other means

bull Provides access for participation in pro-grams or activities which otherwise wouldbe closed to the individual

bull Increases endurance or ability to persevereand complete tasks that otherwise are toolaborious to be attempted on a routine ba-sis

bull Enables students to concentrate on learn-ing tasks rather than mechanical tasks

bull Provides greater access to information

bull Supports normal social interactions with

peers and adults

bull Supports participation in the least restric-tive educational environment

Who owns the special equipment thatis purchased for students

If the school district purchases the equipmentthe equipment belongs to the district Someschool districts designate that a particular deviceis to be used by a specific student during the timewhen that device remains appropriate for thatstudent Other districts have ldquopoolsrdquo of assistivedevices and distribute them for use by a varietyof students The distribution and use of devicesis under the districtrsquos control as long as the needsdescribed in studentsrsquo IEPs are being met

If devices are purchased for a particular stu-dent using that studentrsquos Medicaid funds or pri-vate insurance then the device belongs to the stu-dent and is meant for the exclusive use of thatstudent

When a student moves from one levelof schooling to another like elemen-tary school to middle school does thedevice follow the student

If an assistive device is necessary in order tofulfill the requirements of a studentrsquos IEP such adevice must be provided in whatever school thestudent attends The same device may not nec-essarily follow the student from one school toanother but a comparable device which fulfillsthe IEP requirements would have to be providedin the new school that the student attends

If a family moves from one schooldistrict to another can a studentrsquosassistive technology go along

Devices bought by the school belong to theschool not the student who uses them When afamily moves from one school district to anotherthe equipment the student has been using doesnot automatically move to the new school

Assistive equipment can go with a studentto a new school if the sending school district

46

agrees to sell or give the device to the family orthe new school district

If the device was purchased by the familythrough the familyrsquos private health insurance orby Medicaid for this particular student then thedevice belongs to the student and can go withthe student to a new school district

What happens to assistive technologydevices when students leave the schoolsystem at graduation

If the school district purchased the device thedevice is the property of the school The schoolcould keep the device for use by other studentssell it or decide to transfer the device to anotherdistrict or loan program If the family or anotherfunding source purchased the device it is theproperty of the student and the family

If a piece of assistive technology is nolonger needed or relevant to a studentand the device was paid for by Medic-aid or private insurance can it bedonated for another studentrsquos benefit

Yes it is a parental decision The parentscould donate the device to the school for use byother students with disabilities or to some otherorganization which loans out equipment

Can assistive devices be insured

Many school district liability policies willcover devices purchased by the district for stu-dent use Devices purchased by other fundingsources may or may not be covered while onschool premises or involved in school activitiesIt is important for school staff to investigate thedistrictrsquos property insurance to determine whatthe policy currently covers and whether or notthe policy insures against loss or damage ofassistive devices

Parents who own assistive devices that areused at home and at school may also wish to pur-chase home owners or rentersrsquo insurance with aspecial rider that covers damage to or loss of thedevice

Who is responsible for the repair and

maintenance of assistive devices

In general the school district is responsiblefor repair and maintenance of assistive devicesused to support educational programs describedin the IEP or covered by Section 504

If a device is broken and is beyondrepair who replaces the broken de-vice

If an assistive device is necessary for thestudentrsquos IEP to be implemented then the schooldistrict will have to replace a broken lost or sto-len device

If a device is broken and sent off forrepairs must the school district sup-ply a substitute device until the origi-nal device is returned

If the assistive technology device is vital tothe studentrsquos daily special education program itis not reasonable for the student to be without adevice for long periods of time If a device isgoing to be unavailable for more than a day ortwo the district should provide a backup ma-chine which allows the student to continue work-ing on IEP goals

Is the school district obligated totrain substitute teachers and aides tooperate assistive technology devices

Again if the assistive technology device isvital to the studentrsquos daily special education pro-gram it is not reasonable for the student not tobe able to use the device for long periods of timebecause a substitute is teaching the class If thesubstitute is only going to be in the classroomfor a day or two it is probably not necessary toprovide elaborate training However if the sub-stitute is going to be in the classroom for an ex-tended time training should be provided

Must school districts allow students totake assistive devices home on schoolnights to do homework Over week-ends During school vacations Overthe summer

In many cases it is desirable for students to

47

have the opportunity to use the same assistivetechnology devices at home and in school Forexample when a student is completing home-work assignments assistive technology may benecessary to produce the type of product that isrequired Some school districts have policieswhich allow the devices to go home with the stu-dents overnight on weekends or during vaca-tion or summer periods In general these kindsof policies are a local district matter and may bedetermined according to local district needs Ifhowever a studentrsquos IEP includes a provisionwhich says the student is to have access to anassistive device both at school and at home thenthe school district would be obligated to allowthe student to take a device home or provide twodevices one for home use and one for school

What professionals are consideredqualified to assess a student in thearea of assistive technology

Because assistive technology is such a newfield there are no national standards and few lo-cal or state standards for licensing or certificationfor specialists in assistive technology Howeverschool districts often have professionals who havereceived training in conducting assistive technol-ogy evaluations and are able to provide the ser-vices identified in the IEP If a district does nothave personnel who are knowledgeable in con-ducting such evaluations the district can arrangefor such services from other knowledgeable pro-vidersndash such as Independent Living Projects Al-liance for Technology Access Centers or Tech ActProjects

How can one distinguish betweenassistive technology and personalitems (eg wheelchairs hearing aidseyeglasses crutches)

Currently IDEA does not make a clear dis-tinction between assistive technology devices andpersonal items This confusion stems in large partfrom IDEArsquos broad definition of assistive technol-ogy For example if a student with a disability

needs eye glasses in order to obtain FAPE thenthe school district is obligated to provide themat no cost to the parents In general howeverschool districts do not purchase personally pre-scribed devices such as hearing aids or glasses

Who determines how assistive tech-nology will be purchased and withwhat available funding resourcesmdashtheIEP Team or school administration

Once the IEP team makes the determinationthat assistive technology must be provided aspart of the studentrsquos IEP it is the responsibilityof school administration to determine how theassistive technology will be provided and withwhich funding sources

Is a school district responsible forproviding ldquostate of the artrdquo equip-ment for a student

No The school district need provide onlyappropriate technology in order to meet thestudentrsquos needs as described in the IEP The de-cision as to what type of assistive technology isappropriate should be based on the assistive tech-nology evaluation recommendations and IEPteam decision There may be ldquodevicesrdquo or fea-tures of equipment which may be nice for the stu-dent to have but if they are not necessary forFAPE the school district is not obligated to pro-vide them If a specific device is necessary toensure FAPE and no other device can meet thestudentrsquos needs then the district must providethe required device even though it is costly If aless expensive device would accomplish the samegoals the IEP team is under no obligation tochoose a more expensive option

If a student needs a computer can aschool owned computer be used in thelab or classroom

Yes a school owned computer can be used ifthe student has access to the equipment when heor she needs it If the student does not have thenecessary access then the appropriate equipmentshould be purchased for the studentrsquos use

48

Can school district administratorsinstruct personnel not to includecostly assistive technology devices inthe IEP

IEP teams are charged with the responsibil-ity for determining a studentrsquos need for assistivetechnology devices and services and for specify-ing those devices and services Therefore it isimportant that IEP teams are clearly informed oftheir responsibility to determine if a studentneeds a device and the need for an assistive tech-nology evaluation to assist in making the deter-mination A school district may not have a policywhich prevents IEP teams from identifying astudentrsquos need for assistive devices or services

How does assistive technology getintegrated into the curriculum

The IEP team needs to discuss how the de-vice will be used by the student and how it willbe integrated into the curriculum The IEP teamshould identify on the IEP how the device willbe used by the student in the classroom Thisinformation should be shared with the generalclassroom teachers so that they are aware of howit is to be used

How can assistive technology be pro-vided from year to year with a degreeof continuity

As part of the annual review of the IEP a pointshould be made to devise ways to communicatewith next yearrsquos teachers about the technologythe student uses and how it should be integratedinto the curriculum Teachers who are new toworking with the student who uses technologyshould be provided training if they are unfamil-iar with the device and its use Training for teach-ers and support staff should be written into theIEP as a related service

Can an assistive technology device beused by more than one student

Yes if the device is the property of the schooldistrict and if all of the students using the devicehave access to the equipment when they need it

Can an independent evaluation berequested to address assistive tech-nology

Yes The school district is required to evalu-ate a student in all areas of suspected disabilityincluding if appropriate evaluating the studentrsquosneed for assistive technology A parent has theright to an independent educational evaluationat public expense if the parent disagrees with anevaluation obtained by the school district How-ever the school district may initiate a due pro-cess hearing to show that its evaluation is appro-priate If the final decision is that the evaluationis appropriate the parent still has the right to anindependent educational evaluation but not atpublic expense If the parent obtains an inde-pendent educational evaluation at private ex-pense the results of the evaluation (a) must beconsidered by the school district in any decisionmade with respect to the provision of FAPE tothe child and (b) may be presented as evidenceat a due process hearing

What is a product system

A product system is more than one piece ofequipment working together to produce a resultFor example an FM system that works in con-junction with a studentrsquos hearing aid is a prod-uct system

Can the school district require a stu-dent to bring a personally ownedassistive device such as an augmenta-tive communication system or laptopcomputer to school in order to doschoolwork

No However the family may wish the childto use his or her equipment in school since thechild may be more familiar or comfortable withit The IEP team should decide who is respon-sible for repair and maintenance of family owneddevices

Is it sufficient for a school district tosupply access to a district-ownedcomputer but provide no software

49

that is appropriate for the student touse

Just providing access to a computer does notfulfill the districtrsquos obligation to provide assistivetechnology to support FAPE The educationalaspect of the computer is very much related tothe software that the student uses If no appro-priate software is available then the student can-not pursue the IEP goals

50

Appendix

GlossaryASSISTIVE TECHNOLOGY any sort of aidincluding computers switches calculators spell-ing devices communication devices and voicesynthesizers which is used to help an individualperform some task of daily livingALTERNATIVE KEYBOARD may include en-larged reduced varied key placement one-handed braille chordic or any other device forentering text on a computerAUGMENTATIVE COMMUNICATION anydevice (electronic or otherwise) to enhance com-munication for a person with limited speechBRAILLE EMBOSSER a printer for producingbraille output either manually or when connectedto a computer When printing standard text froma computer it must first be translated into brailleBRANCHING describes the process of choos-ing among a sequence of choices or actions toproduce another sequence of choices This pro-cess is used in the ldquoscanningrdquo method of accessCD-ROM ldquoCompact Disk Read-Only Memoryrdquorefers to the 4-inch silver disks that typically hold700 megabytes of digital information and theplayers that access the information on these disksCURSOR either the flashing vertical or horizon-tal line on a computer screen that indicates theinsertion point for text or the arrow or I-beamthat indicates the position of the mouse pointeron the computer screenDESK ACCESSARY a small utility program thatruns on a computer and may be accessed fromany program at any time (such as a calculator)DRILL AND PRACTICE presents questionsrepetetively but is not a tutorial Software thatis only drill and practise doesnrsquot necessarily teachthe concepts needed to answer the questions pre-sented

ENVIRONMENTAL CONTROL any type ofdevice that an individual may use to control theirenvironment (lights appliances TV telephoneetc) This may include anything from simplereachers or sticks to computers and voice-acti-vated electronic systemsFM SYSTEM a local wireless broadcast systemthat consists of a microphone and transmitter forthe speaker and ldquowalkman-likerdquo receivers withheadphones for listeners with hearingimpairements or attention disordersHIGH TECH use of electronics or computers asa solutionICON a small computer graphic that appears onthe computer screen and may represent differ-ent types of objects (files or applications) or ac-tions depending on the context Use the mousepointer to click on icons that open files or per-form other actionsINDIVIDUAL FAMILY SERVICE PLAN (IFSP)the written document which defines the earlyintervention services provided to the child andfamily The program is designed to meet theneeds of the child and the family and is based onfamily-identified prioritiesINDIVIDUALIZED EDUCATION PROGRAM(IEP) a written plan specifying instructionalgoals and any special education and related ser-vices a student may need which must be writ-ten and reviewed annually Included are (1) thepresent educational levels of the student (2) astatement of annual goals including short-termobjectives (3) a statement of specific services ifneeded (4) the programs (5) the date when spe-cial services are to begin and the expected dura-tion of these services and (6) the tests and otherrequirements or information used to guage thestudentrsquos progress to determine if the instruc-tional objectives are being metINPUT the information that is transmitted to acomputer from a keyboard mouse or other in-

51

put deviceKEYBOARD a device for inputing text and com-mands to a computerKEYGUARD a plexiglass or other cover for akeyboard with holes for the individual keys Itallows more precise selection of keys for an indi-vidual with fine motor difficultiesKEYPAD a small keyboard with a 10-key setupfor numeric input or it may also be used as a con-trol for a screen-reader programLAPTOP a portable battery-powered computerthat is typically the size of a 3-ring binder weighs5-10 pounds and consists of a screen keyboardand disk-drivesLASER DISCS large (12-inch) CD-ROMs thatnormally contain moviesLOW TECH indicates use of low cost non-elec-tronic solutionsMACRO a simple short program that performsan action on a computer They are usually cre-ated by recording the keyboard andor mouseinput and storing them as an icon or key combi-nationMEGABYTE 1000 X 210 bytes of informationwhich basically means over one million key-strokes of computer storage (about 10 novels)MORSE CODE a direct method for computerinput using one to three switches and coded in-put to replace the keyboard and mouseMOUSE the name given to the pointing deviceused to control graphical user interfaces (GUI) ofmodern personal computersONSCREEN KEYBOARD a software programthat places the keyboard on the screen of the com-puter and may be accessed using a mouse or otherpointing device This is ideal for individuals whocannot use a regular keyboard but can use sometype of pointing deviceOPTICAL CHARACTER RECOGNITION(OCR) a process that utilizes special computersoftware to convert the scanned image of text intoactual text that may be edited by a word proces-sorOUTPUT computer-generated information for

the user This may be printed output from aprinter visual information from the screen orsounds from speakersSCANNER an electronic copier connected to acomputer Scanners are used to input drawingspictures or printed text into the computerSCANNING has nothing to do with the elec-tronic copier above It is another method for ac-cessing a computer or communication deviceusing one or more switches Scanning involvespresenting a group of choices cycling amongthem and making choices by activating a switchSCREEN READER software that reads text ona computer screen using a speech synthesizerThis allows individuals with visual impairmentsor other print disabilities to access text on thecomputer screenSIMULATION software that simulates real-world situations on a computer This may rangefrom a joystick trainer for driving an electricwheelchair to running citiesSPEECH SYNTHESIZER hardware or softwarefor producing electronic human speech on a com-puterSPELL CHECKER utility for checking the spell-ing in a documentSTICKY KEYS software or mechanical utility forallowing typing of multiple keystrokes with onefinger (using the shift or other modifier keys)SWITCH a device that is like a single button ofa keyboard or mouse Switches may be used byan individual with servere motor difficulties byany controllable muscle in their body (headhand toe eye breath etc) to operate any typeof computer communication or environmentalcontrol deviceSWITCH INTERFACE black box that connectsto a computer or other device that has plugs forswitchesTDD a text telephone used for communicatingin typed text over a phone line A TDD has akeyboard and text display or small printer Bothparties who are communicating over a phone linemust have TDDs

52

TOUCH WINDOW a computer input devicethat uses a touch-sensitive transparent windowplaced on the computer screen It performsmouse functions with a finger or stylus directlyon the screenTRACKBALL another replacement for themouse pointing device that uses a rolling ball toperform mouse movementsTUTORIAL teaches concepts presents informa-tion as opposed to simple drill and practiceVOICE RECOGNITION computer softwareand microphone that allows input and controlwith voice commandsWORD PREDICTION productivity softwarethat increases typing speed for one-finger typistsand others by predicting and choosing completewordsWORD PROCESSOR software for inputing andformatting textUSER person using a computerUTILITY software for adding function or per-forming housekeeping tasks on a computer

53

DocumentsSCHRAG LETTER ON ASSISTIVE TECHNOLOGY

August 10 1990

Dear Ms Goodman

This is in response to your recent letter to the Office of Special

Education Programs (OSEP) concerning the obligations of public

agencies under Part B of the Education of the Handicapped Act

(EHA-B) to provide assistive technology to children with handi-

caps

Specifically your letter asks

1 Can a school district presumptively deny assistive technol-

ogy to a handicapped student

2 Should the need for assistive technology be considered on

an individual case-by-case basis in the development of the

childs Individual Education Program

In brief it is impermissible under EHA-B for public agencies

(including school districts) to presumptively deny assistive tech-

nology to a child with handicaps before a determination is made

as to whether such technology is an element of a free appropriate

public education (FAPE) for that child Thus consideration of a

childs need for assistive technology must occur on a case-by-

case basis in connection with development of a childs individual-

ized education program (IEP)

We note that your inquiry does not define the term assistive

technology and that the term is not used either in the EHA-B

statute or regulations The technology Related Assistance for

Individuals with Disabilities Act of 1988 PL 100-407 contains

broad definitions of both the terms assistive technology device

and ldquoassistive technology service See Section 3 of PL 100-

407 codified as 29 USC 2201 2202 Our response will use

assistive technology to encompass assistive technology ser-

vices and ldquoassistive technology devices

Under EHA-B State and local educational agencies have re-

sponsibility to ensure that eligible children with handicaps receive

FAPE which includes the provision of special education and re-

lated services without charge in conformity with an IEP 20 USC

1401(18) 34 CFR S3004(a) and (d) The term special educa-

tion is defined as specially designed instruction at no cost to

the parent to meet the unique needs of a handicapped child 34

CFR S30014(a) Further related services is defined as includ-

ing transportation and such developmental corrective and other

supportive services as are required to assist a handicapped child

to benefit from special education 34 CFR ss33013 (a)

The EHA-B regulation includes as examples 13 services that

qualify as related services under EHA-B See 34 CFR S30013

(b)(1)-(13) We emphasize that this list is not exhaustive and

may include other developmental corrective or other supportive

servicesif they are required to assist a handicapped child to

benefit from special education 34 CFR S30013 and Comment

Thus under EHA-B assistive technology could qualify as spe-

cial education or related services

A determination of what is an appropriate educational program

for each child must be individualized and must be reflected in the

content of each childs IEP Each childs IEP must be developed

at a meeting which includes parents and school officials 34 CFR

S300343-300344 Thus if the participants on the IEP team de-

termine that child with handicaps requires assistive technology in

order to receive FAPE and designate such assistive technology

as either special education or a related service the childs IEP

must include a specific statement of such services including the

nature and amount of such services 34 CFR S300346(c) App

C to 34 CFR Part 3000 (Ques 51)

EHA-Bs least restrictive environment (LRE) provisions require

each agency to ensure (t)hat special classes separate school-

ing or other removal of handicapped children from their regular

educational environment occurs only when the nature or severity

of the handicap is such that education in regular classes with the

use of supplementary aids and services cannot be achieved sat-

isfactorily Part 121a 42FR 4251113 (August 23 1977)

Assistive technology can be a form of supplementary aid or ser-

vice utilized to facilitate a childs education in a regular educa-

tional environment Such supplementary aids and services or

modifications to the regular education program must be included

in a childs IEP Id Appendix C to 34 CF art 300 (Ques 48)

In sum a childs needs for assistive technology must be deter-

mined on a case-by-case basis and could be special education

related services or supplementary aids and services for children

with handicaps who are educated in regular classes

I hope the above information has been helpful If we may pro-

vide further assistance please let me know

Sincerely

Judy A Schrag EdD

Director Office of Special Education Programs

54

INDIVIDUALS WITH DISABILITIES EDUCATIONLAW REPORT

Cite as 18 IDELR 627

Digest of Inquiry

(Inquirerrsquos Name Not Provided)

(Date Not Provided)

bull Is a school district responsible to provide assistive

technology devices for home use

bull May a school board overrule a determination by an IEP

team that a child with a disability needs access to an

assistive technology device at home

bull What is the time limit on implementation of an IEP

Digest of Response

(November 27 1991)

Assistive Technology Devices May Be Required for Home Use

If an IEP team determines that a child with a disability needs

access to an assistive technology device at home as a matter of

FAPE then the school district must provide the device for home

use in order to implement the childrsquos IEP

School Board May Not Change IEP Teamrsquos Determination

Under Part B a school board has no authority to unilaterally

change any statement of special education or related services

contained in an IEP including a statement of a childrsquos need to

have access to an assistive technology device at home Without

reconvening the IEP team the school board may not change the

IEP and the school district is obligated to implement the IEP re-

quirements regardless of the school boardrsquos objections

IEPs Must Generally Be Implemented

Under Reg 300342(b) an IEP must be in effect before the

provision of special education or related services and must be

implemented as soon as possible following the conclusion of the

IEP meeting(s) In accordance with Appendix C to the Part 300

regulations an IEP should generally be implemented without de-

lay after being finalized although a reasonable delay may be per-

missible in limited circumstances

__________________

Text of Inquiry

I would like to have a copy of the policy classification on

Assistive Technology

I also have a question to ask regarding Assistive Technology

such as a closed circuit TV

My daughter uses a CCTV in school and it is on her IEP

program My daughter is visually impaired The initial request

was made by me the parent to the appropriate people involved

in her education and discussed and approved by the committee

on an individual basis

My question is I would like to make the request to the ap-

propriate officials for another CCTV for home use to accomplish

the same results at home as is done in school (For homework

reading books any assignments from school)

Another question is If the committee approves this request

it will go to School Board for approval I would like to know what

happens if the School Board doesnrsquot approve the proposal Is it

impartial hearing time

Thank you for your assistance in this matter

Any information regarding Assistive Technology Informative

for school and home use would be greatly appreciated

Is there a time limit on implementation of yearly updated

IEPs[] Every year I have long delays on implementation of board

approved IEPs[]

Text of Response

This is in response to your recent letter to the Office of Spe-

cial Education Programs (OSEP) requesting a copy of any OSEP

policy clarifications on assistive technology as well as asking spe-

cific questions concerning the assistive technology needs for your

daughter You also asked a question about the time limits for

implementation of an individualized education program (IEP)

In response to your request I am enclosing a copy of OSEPrsquos

August 10 1990 letter to Ms Susan Goodman concerning the

obligations of public agencies under Part B of the Individuals with

Disabilities Education Act (Part B) formerly cited as Part B of the

Education of the Handicapped Act to provide assistive technol-

55

ogy to children with disabilities along with some additional infor-

mation on assistive technology and a copy of the Part B regula-

tions I would also like to provide you with OSEPrsquos response to

each of your specific questions as stated below

I would like to make the request to the appropriate officials

for another CCTV for home use to accomplish the same

results as is done in school (For homework reading books

any assignment from school)

The IEP which must be developed at a meeting that includes

parents and school officials must contain among other things a

statement of the specific special education and related services

to be provided to the child See 34 CFR sectsect 300343-300346 As

stated in OSEPrsquos letter to Ms Goodman if the IEP team deter-

mines that a child with disabilities requires assistive technology in

order to receive a free appropriate public education (FAPE) and

designate such assistive technology as either special education

or a related service the childrsquos IEP must include a specific state-

ment of such services including the nature and amount of such

services See 34 CFR sect 300346(c) App C to 34 CFR Part 300

(Ques 51) The need for assistive technology is determined on a

case-by-case basis taking into consideration the unique need of

each individual child If the IEP team determines that a particular

assistive technology item is required for home use in order for a

particular child to be provided FAPE the technology must be pro-

vided to implement the IEP

If the committee approves this request it will go to the School

Board for approval I would like to know what happens if

the School Board doesnrsquot approve the proposal Is it im-

partial hearing time

As part of the public agencyrsquos part B obligation to provide

FAPE to an eligible child with disabilities the public agency must

ensure that special education and related services are provided

in conformity with an IEP which meets the requirements of 34

CFR sectsect 300340-300349 One requirement at 34 CFR sect

300343(a) is that the public agency conduct a meeting to de-

velop review and revise a childrsquos IEP The Regulations require

that certain participants attend the IEP meeting See 34 CFR sect

300344 The role of the participants at the IEP meeting is to

determine the specific special education and related services that

a child needs in order to receive FAPE Once the determination is

made at a meeting convened pursuant to 34 CFR sect 300343(a)

Part B does not recognize any authority on the part of a local

School Board to unilaterally change the statement of special edu-

cation and related services contained in the IEP After the IEP is

developed and the placement decision is made by a group of

persons knowledgeable about the child the meaning of the evalu-

ation data and placement options the public agency must imple-

ment the IEP See 34 CFR sect 300533(a)(3) Without reconven-

ing the IEP meeting the local school board could not change the

IEP

Is there a time limit on implementation of updated IEPrsquos[]

Every year I have long delays on implementation of Board

approved IEPrsquos[]

Part B imposes no specific time limits for the implementation

of IEPs The Part B regulations at 34 CFR sect 300342(b) require

that an IEP (1) must be in effect before special education and

related services are provided to a child and (2) must be imple-

mented as soon as possible following the meetings required to

develop review or revise a childrsquos IEP The answer to Question 4

in Appendix C to the Part 300 regulations states that no delay is

permissible between the time a childrsquos IEP is finalized and when

special education and related services is provided It is expected

that the special education and related services set out in the IEP

will be provided by the agency beginning immediately after the

IEP is finalized In certain circumstances such as when the IEP

meeting occurs during the summer or a vacation period or where

there are circumstances which require a short delay (eg work-

ing out transportation arrangements) the implementation may not

be immediate See Comment 34 CFR sect 300342

I hope that this information is helpful to you Please let us

know if you have any additional questions or concerns

Judy A Schrag

Director

Office of Special Education Programs

_______________________

Cite as 18 IDELR 628

56

Sample Letter Requesting an Assistive Tech-nology Evaluation

March 1997

Dear Sir

Our daughter Catherine an IDEA-eligiblestudent is currently receiving special educationand supportive therapies through the publicschool district As she is progressing through theelementary school grades the curriculum is de-manding more and more written work from herAt this point teachers or assistants are writingfor her but this method does not allow Catherinethe opportunity to compose written work on herown

As Catherinersquos parents we think the time hascome to consider assistive technology forCatherine to allow her to learn to do written workon her own so that she can learn the mechanicsof writing and can put her own thoughts downon paper for others to read

To this end we are requesting an assistivetechnology evaluation for Catherine to determinewhat kinds of technology are necessary to assisther with written expression We are assumingthat the assistive technology evaluation will beperformed at district expense by professionalswho are qualified to determine (a) what assistivetechnology may be necessary for Catherine (b)what assistive technology devices might be help-ful and (c) what occupational and physicaltherapy services may be necessary to support thetechnology

We would like to have this evaluation com-pleted so that information is available prior tothe convening of the IEP Team to writeCatherinersquos Individualized Education Programfor next year

We appreciate your assistance with this mat-ter and look forward to hearing from you

Yours truly

Assistive TechnologyIssues to Address

_____What are the individualrsquos current unmetneeds for access to communication writ-ing or educational materials

_____What are the short and long term educa-tional goals

_____What are the daily educational demandswhich require the use of assistive technol-ogy

_____Have the appropriate team members in-cluding parents been involved in the as-sessment process

_____What are the features of the technology thatwould assist the individual in meetingdaily classroom demands

_____Why is the selected equipment more appro-priate than other alternatives

_____Have all of the individualrsquos environmentsbeen considered

_____Does the selected equipment reflect the leastrestrictive intervention strategy

_____Is the equipment necessary to achieve edu-cationallife goals

_____How will the individual physically man-age the equipment in all environments

_____How will the equipment be integrated intothe individualrsquos daily life

_____How will the use of the assistive technol-ogy promote inclusion of the individualinto activities in the school and commu-nity

_____Which members of the education team willbe trained to use the equipment

_____How will the individual be trained to usethe equipment

_____How will the family be involved with theindividual and the equipment

57

ExamplesEDUCATIONAL SOFTWARE EVALUATION

A IDENTIFYING INFORMATION

Name of instructional program

Publisher

Cost ____________Computer platform(PCMac)

Other equipment needed to run program

Grade level of the program

Skill levels required of users

Special needs addressed by program

B DESCRIPTIVE INFORMATION

1 What is the purpose of the instructional program as stated by

its publisher

2 What curriculum area or areas does it address

3 What type of instructional program is it

tutorial drill and practice___ arcade game type___

drill and practice ____ simulation ___

problem solving___ educational game___

teacher utility___ other___

4 For what type of learner was the program designed

age level __________ grade level ____________

ability level ________ interest level ___________

5 What skills or information does the program attempt to teach

or review

6 How does the program present information

__text __graphics __animation __color __sound effects

__music __speech __other __________________________

7 Is the information presented clearly

Is text legible and readable

Are graphics comprehensible

Are sounds audible and intelligible

8 Are directions for using the program clearly stated and under-

standable Where do directions appear

_____ within the program

_____ in the programs documentation or manual

9 Is the program under user control that is can the user control

the programs movement from screen to screen

Review directions at any time

Exit the program at any time

10 What computer use demands are placed on the learner

_____ insert disk and turn on computer

_____ select from menu

other ______________________________

11 What academic demands are placed on the learner

reading level _______________________________

spelling level _______________________________

other _____________________________________

12 What physical demands are placed on the learner

_____ keyboard must be used to enter responses

_____ press any key

_____ press a key from one half or one quadrant of key-

board

_____ press on specific key

_____ press several keys in order

_____ other devices used to enter responses

13 What speed demands are placed on the learner

_____ presentation of information controlled by program (

moderate fast or slow)

_____ presentation of information under user control

_____ unlimited response time

_____ response time set by program (moderate fast slow)

_____ response time varied by user

58

14 What accuracy demands are placed on the learner

_____ user can correct typing errors

_____ program does not allow correction of typing errors

_____ program locates common errors

_____ program requires correct spelling of all responses

_____ program allows only one correct response for most

questions

15 Is feedback about response accuracy provided to learners

appropriately

_____ knowledge of results provided after each response

_____ correct responses confirmed

_____ learner informed if response incorrect

_____ another trial provided if response incorrect

_____ number of trials provided

_____ correct response demonstrated if learner fails to an-

swer correctly

_____ learner allowed opportunity to respond after demon-

stration of correct response

16 Does the program use any branching procedures besides

differential treatment of correct and incorrect responses

17 What techniques are used for reinforcement and motivation

_____ knowledge of results and confirmation of correct re-

sponses

_____ summary information about learner performance

_____ text message of praise for correct responses

_____ graphics display and or sound for correct responses

_____ competitive game in which correct response earn

points

_____ other _________________________________

Reinforcement is _____ continuous _____ intermittent

18 What user options are available to students and teachers

Students can select

_____ activity from menu difficulty

_____ number of questions type of questions

_____ other ____________________________

Teacher or parent can select

_____ sound on or off

_____ number of questions

_____ type of questions

_____ sequence of instruction

_____ number of trials

_____ speed of presentation

_____ speed demands for responses

_____ other_________________________________

Teacher or parent can

_____ enter own content into program

_____ review student records

_____ other________________________________

19 Is the programs documentation adequate

All program features fully and clearly explained

Rationale for program purpose and objectives included

Print materials provided for students

20 Other comments about the instructional program

C OVERALL EVALUATION

Rate the appropriateness of the instructional program in each of

the following areas using this scale

excellent adequate inadequate

1 2 3

1 2 3 Curricular content (program addresses important skills

1 2 3 Interest level

1 2 3 Ease of use for learners

1 2 3 Demands on learner (eg computer use academic)

1 2 3 Instructional procedures

1 2 3 Motivational value

1 2 3 Appropriate use of the medium

1 2 3 Important instructional variables under teacher control

1 2 3 Other _______________________________

59

Software Featuresbull Easy-to-Read Screensbull Consistency in Formatbull Intuitive Characteristicsbull Logical Labelsbull Instructional Choicesbull Graphicsbull Friendly Documentationbull On-Screen Instructionsbull Auditory Cuesbull Visual Cuesbull Built-in Access Methodsbull Alternatives to a Mousebull Optional Cursorsbull Creation of Custom Programs

Alternative Inputbull Switches and Switch Softwarebull Alternative Keyboardsbull Keyboard Additionsbull Access Utilitiesbull Interface Devicesbull Voice Recognitionbull Optical Character Recognition

and Scannersbull Electronic pointing Devicesbull Pointing and Typing Aidsbull Touch Screensbull Joysticksbull Trackballsbull Arm and Wrist Supports

Processing Aidsbull Abbreviation Expansion and

Macro Programsbull Word Predictionbull Talking and Large Print Word

Processorsbull Grammar and Spell Checkersbull Reading Comprehension Pro-

gramsbull Writing Composition Pro-

gramsbull Electronic Reference Toolsbull Menu Management Programs

Alternative Outputbull Braille Embossers and Transla-

torsbull Refreshable Braille Displaysbull Speech Synthesizersbull Screen Readersbull Screen Enlargement Programsbull Monitor Additions

Specialized Productsbull Closed Circuit Television

(CCTV)bull Environmental Control Units

(ECU)bull Notetakersbull Reading Machinesbull Text Telephone (TDD)

60

Next

Ste

p

Try

havi

ng C

huck

use

earp

hone

s w

hen

he is

wor

d pr

oces

sing

Curre

nt S

tatu

s

Chu

ck is

abl

e to

do

grad

ele

vel a

ssig

nmen

ts b

ut h

e is

very

lite

ral i

n hi

s in

terp

reta

-tio

ns e

spec

ially

of a

bstra

ctco

ncep

ts

Chu

ck is

ver

y ea

sily

dis

-tra

cted

bot

h vi

sual

ly a

ndau

dito

rily

Chu

ck h

as a

blin

d sp

otw

hich

mak

es it

diff

icul

t for

him

to tr

ack

from

line

to lin

ew

hen

he is

read

ing

He

also

has

troub

le d

istin

guis

hing

the

figur

e fro

m t

he b

ack-

grou

nd

Bec

ause

of

per-

cept

ion

prob

lem

s C

huck

mus

t hav

e a

larg

e di

spla

ysc

reen

on

his

com

pute

r

Need

Cog

nitiv

e Ab

ility

Atte

ndin

g

Perc

eptio

n

ASSI

STIV

E TE

CHN

OLO

GY

EVAL

UATI

ON

Func

tion

al A

naly

sis

Nam

e C

huck

Dat

eG

rade

Lev

el

Sixt

h

Ove

rall D

escr

iptio

n C

huck

is a

six

th g

rade

stu

dent

who

rece

ives

all o

f his

inst

ruct

ion

in th

ere

gula

r cla

ssro

om

Chu

ck h

as ri

ght h

emip

legi

a H

is ri

ght u

pper

ext

rem

ity is

mor

e af

fect

edth

an h

is lo

wer

ext

rem

ity

He

has

diffi

culty

with

tota

l bod

y m

ovem

ents

requ

iring

bila

tera

lco

ordi

natio

n e

spec

ially

with

upp

er e

xtre

miti

es

Chu

ck h

as a

leg

leng

th d

iscr

epan

cy w

ith

Crite

ria fo

r Suc

cess

Com

plet

ion

of g

rade

leve

las

sign

men

ts w

ith e

vide

nce

of u

nder

stan

ding

of

mai

nco

ncep

ts

Chu

ck w

ill be

on

task

65-7

0 o

f tim

e du

ring

inde

-pe

nden

t wor

k pe

riods

Chu

ck w

ill co

mpl

ete

mod

ified

ass

ignm

ents

inde

-pe

nden

tly a

t leas

t 85

of t

hetim

e

Supp

ort R

equi

red

Lim

it re

quire

men

ts to

a fe

wco

ncre

te c

once

pts

in e

ach

acad

emic

uni

t

Dis

trac

tion

free

env

iron-

men

t st

udy

carre

l pr

oxim

-ity

to te

ache

r or a

ide

Enl

arge

wor

kshe

ets

and

read

ing

mat

eria

l H

ighl

ight

key

voca

bula

ry w

ords

U

sea

card

boar

d w

indo

w to

iso-

late

indi

vidu

al li

nes

whe

nre

adin

g E

nlar

ge o

n sc

reen

disp

lay

whe

n do

ing

wor

dpr

oces

sing

Loca

tions

Hom

eSc

hool

Com

mun

ityW

ork

Rec

reat

ion

Hom

eSc

hool

Com

mun

ityW

ork

Rec

reat

ion

Hom

eSc

hool

Com

mun

ityW

ork

Rec

reat

ion

his

right

leg

bein

g sh

orte

r tha

n hi

s le

ft H

e w

ars

a lif

t in

his

shoe

to c

ompe

nsat

e fo

r the

diffe

renc

e C

huck

has

low

ave

rage

inte

lligen

ce a

nd n

orm

al s

peec

h H

e re

ads

at th

eth

ird g

rade

leve

l a

nd d

oes

mat

h at

gra

de le

vel

exce

pt fo

r sto

ry p

robl

ems

Chu

ck is

very

con

cret

e in

his

thin

king

and

has

gre

at d

iffic

ulty

und

erst

andi

ng fi

gura

tive

lang

uage

C

huck

has

a fu

ll tim

e ai

de in

the

regu

lar

clas

sroo

m w

ho m

odifi

es a

ssig

nmen

ts a

ndhe

lps

to k

eep

him

on

task

So

cial

ly C

huck

is p

olite

and

wel

l-beh

aved

but

app

ears

tobe

imm

atur

e in

his

soc

ial r

elat

ions

hips

61

ASSI

STIV

E TE

CHN

OLO

GY

EVAL

UATI

ON

Func

tion

al A

naly

sis

Nam

e C

huck

Dat

eG

rade

Lev

el

Sixt

h

Ove

rall

Des

crip

tion

Chu

ck is

a s

ixth

gra

de s

tude

nt w

ho re

ceiv

es a

ll of

his

inst

ruct

ion

inth

e re

gula

r cla

ssro

om

Chu

ck h

as ri

ght h

emip

legi

a H

is ri

ght u

pper

ext

rem

ity is

mor

eaf

fect

ed th

an h

is lo

wer

ext

rem

ity

He

has

diffi

culty

with

tota

l bod

y m

ovem

ents

requ

iring

Need

Fine

Mot

or Han

d W

ritin

g

Not

e Ta

king

Self

Hel

p

Curre

nt S

tatu

s

Chu

ck c

an u

se o

nly

one

hand

for f

ine

mot

or ta

sks

incl

udin

g ty

ping

C

huck

isan

exc

elle

nt o

ne-h

ande

dty

pist

bot

h in

term

s of

spee

d an

d ac

cura

cy

Chu

ck c

an w

rite

in c

ursi

ve

but h

andw

ritin

g is

ver

yla

bor i

nten

sive

and

tirin

gfo

r him

H

e pr

oduc

esm

uch

bette

r writ

ten

prod

ucts

usi

ng a

com

pute

rC

huck

can

not t

ake

note

san

d lis

ten

at th

e sa

me

time

Chu

ck c

anno

t tie

his

ow

nsh

oes

and

he h

as d

iffic

ulty

zipp

ing

his

jack

et w

ith o

neha

nd

Next

Ste

p

Try

givi

ng C

huck

not

esbe

fore

the

clas

sroo

mpr

esen

tatio

n H

ave

him

hig

hlig

ht k

eyw

ords

with

a h

ighl

ight

ing

pen

as h

e is

list

enin

g to

the

disc

ussi

on

Try

havi

ng a

pee

rbu

ddy

assi

st C

huck

with

his

sho

es a

ndja

cket

bila

tera

l coo

rdin

atio

n e

spec

ially

with

upp

er e

xtre

miti

es

Chu

ck h

as a

leg

leng

thdi

scre

panc

y w

ith h

is ri

ght l

eg b

eing

sho

rter t

han

his

left

He

war

s a

lift i

n hi

s sh

oe to

com

pens

ate

for t

he d

iffer

ence

C

huck

has

low

ave

rage

inte

lligen

ce a

nd n

orm

alsp

eech

H

e re

ads

at th

e th

ird g

rade

leve

l a

nd d

oes

mat

h at

gra

de le

vel

exce

pt fo

rst

ory

prob

lem

s C

huck

is v

ery

conc

rete

in h

is th

inki

ng a

nd h

as g

reat

diff

icul

ty u

nder

-st

andi

ng fi

gura

tive

lang

uage

C

huck

has

a fu

ll tim

e ai

de in

the

regu

lar c

lass

room

who

mod

ifies

ass

ignm

ents

and

hel

ps to

kee

p hi

m o

n ta

sk

Soci

ally

Chu

ck is

pol

ite a

ndw

ell-b

ehav

ed b

ut a

ppea

rs to

be

imm

atur

e in

his

soc

ial r

elat

ions

hips

Crite

ria fo

r Suc

cess

Chu

ck w

ill be

abl

e to

prod

uce

writ

ten

wor

k at

abou

t the

sam

e pa

ce a

sot

her s

tude

nts

in h

is c

lass

Chu

ck w

ill be

abl

e to

rece

ive

help

with

am

inim

um o

f fus

s or

emba

rrass

men

t

Supp

ort R

equi

red

Lapt

op c

ompu

ter

Prin

ter

Enla

rged

scr

een

disp

lay

Co-

Writ

er w

ith W

rite-

Out

-Lo

ud fo

r wor

d pr

oces

sing

and

wor

d pr

edic

tion

Chu

ck n

eeds

to u

se w

ord

proc

essi

ng w

hene

ver

writ

ten

assi

gnm

ents

are

requ

ired

Whe

neve

rpo

ssib

le h

is w

ritte

nas

sign

men

ts s

houl

d be

shor

tene

d or

he

shou

ld b

eex

pect

ed to

resp

ond

usin

gm

ultip

le c

hoic

e or

one

wor

dan

swer

s

Teac

her s

uppo

rt of

the

peer

bud

dy re

latio

nshi

p

Loca

tions

Hom

eSc

hool

Com

mun

ityW

ork

Rec

reat

ion

Hom

eSc

hool

Com

mun

ityW

ork

Rec

reat

ion

62

ResourcesParent Trainingand InformationCenters

AlabamaSpecial Education ActionCommittee Inc (SEAC)600 Bel Air Blvd 210Mobile AL 36606-3501334-478-1208334-473-7877 FAX1-800-222-7322 AL onlyseacmob1junocomhttpwwwhsvtisnet~cja

AlaskaPARENTS ResourceCenter4743 E Northern Lights BlvdAnchorage AK 99508907-337-7678907-337-7671 FAX1-800-478-7678 in AKparentsalaskanethttpwwwalaskanet~parents

American SamoaAmerican Samoa ParentNetworkPO Box 3432Pago Pago AS 96799684-633-2407684-633-7707 (fax)

ArizonaPilot Parent Partnerships4750 N Black Canyon Hwy 101Phoenix AZ 85017-3621602-242-4366800-237-3007 (AZ only)602-242-4306 (fax)

ArkansasArkansas Disability Coalition2801 Lee Ave Suite BLittle Rock AR 72205501-614-7020501-614-9082 FAX1-800-223-1330 AR onlyadcceinet

FOCUS Inc305 W Jefferson AveJonesboro AR 72401870-935-2750870-931-3755 FAXfocusincipanet

CaliforniaDREDF2212 Sixth StreetBerkeley CA 94710510-644-2555510-841-8645 (fax)1-800-466-4232dredfdredforghttpwwwdredforg

Exceptional Parents Unlimited(EPU)4120 N First StreetFresno CA 93726209-229-2000209-229-2956 (fax)epu1cybergatecom

Matrix555 Northgate Dr Ste ASan Rafael CA 94903415-499-3877415-499-3854 (TDD)415-507-9457 (fax)1-800-578-2592matrixmatrixparentsorghttpwwwmatrixparentsorg

Parents Helping Parents - SanFrancisco594 Monterey BlvdSan Francisco CA 94127-2416415-841-8820415-841-8824 (fax)

Parents Helping Parents -Santa Clara3041 Olcott StSanta Clara CA 95054-3222408-727-5775408-727-7655 (TDD)408-727-0182 (fax)infophpcomhttpwwwphpco

Support for Families ofChildren with Disabilities2601 Mission 710San Francisco CA 94110-3111415-282-7494415-282-1226 (fax)sfcdmissaolcom

TASK100 W Cerritos AveAnaheim CA 92805-6546714-533-TASK (8275)714-533-2533 (fax)taskcaaolcom

TASK- San Diego3750 Convoy St Ste 303San Diego CA 92111-3741619-874-2386619-874-2375 (fax)

ColoradoPEAK Parent Center Inc6055 Lehman Drive Ste 101Colorado Springs CO 80918719-531-9400719-531-9403 (TDD)800-284-0251719-531-9452 (fax)PKPARENTaolcom

ConnecticutCPAC338 Main StreetNiantic CT 06357860-739-3089860-739-7460 (fax)1-800-445-2722 (in CT)cpacincaolcomhttpwwwmembersaolcomcpacinccpachtm

DelawareParent Information Center(PIC) of Delaware Inc700 Barksdale Road Ste 3Newark DE 19711302-366-0152302-366-0178 (TDD)302-366-0276 (fax)PEP700aolcom

FloridaFamily Network on Disabilitiesof Florida2735 Whitney RoadClearwater FL 24620813-523-1130800-285-5736 (FL only)813-523-8687 (fax)fndgatenethttpwwwgatenet~fnd

GeorgiaParents Educating Parentsand Professionals for AllChildren (PEPPAC)8318 Durelee Lane Ste 101Douglasville GA 30134770-577-7771770-577-7774 (fax)peppacbellsouthnet

HawaiiAWARELearning DisabilitiesAssociation of Hawaii200 N Vineyard Blvd Ste 310Honolulu HI 96817808-536-9684808-536-2280 (TTY)808-537-6780 (fax)ldahgtenet

IdahoIdaho Parents Unlimited Inc(IPUL)Parents Education amp ResourceCenter4696 Overland Rd Ste 478Boise ID 83705208-342-5884800-242-IPUL (4785)208-342-1408 (fax)ipulrmcinethttpwwwhomermcinetIPUL

IllinoisDesigns for Change6 N Michigan Ave Ste 1600Chicago IL 60602312-857-9292312-857-1013 (TDD)312-857-9299 (fax)1-800-851-8728DFC1aolcom

Family Resource Center onDisabilities (FRCD)20 East Jackson Blvd Rm 900Chicago IL 60604312-939-3513312-939-3519 (TDDTTY)312-939-7297 (fax)1-800-952-4199 (IL only)

Family TIES Network830 South Spring StreetSpringfield IL 62704800-865-7842217-544-6018 (fax)ftiesnaolcom

National Center for Latinoswith Disabilities1921 South Blue IslandChicago IL 60608312-666-3393312-666-1788 (TDD)312-666-1787 (fax)1-800-532-3393ncldinteraccesscom

2

Defining Assistive Technology

A ssistive technology devices are mechani-cal aids which substitute for or enhancethe function of some physical or mental

ability that is impaired Assistive technology canbe anything homemade purchased off the shelfmodified or commercially available which isused to help an individual perform some task ofdaily living The term assistive technology encom-passes a broad range of devices from ldquolow techrdquo(eg pencil grips splints paper stabilizers) toldquohigh techrdquo (eg computers voice synthesizersbraille readers) These devices include the entirerange of supportive tools and equipment fromadapted spoons to wheelchairs and computersystems for environmental control

The Individuals with Disabilities EducationAct (IDEA) the federal special education lawprovides the following legal definition of anassistive technology device ldquoany item piece ofequipment or product system that is used toincrease maintain or improve functional capa-bilities of individuals with disabilitiesrdquo UnderIDEA assistive technology devices can be usedin the educational setting to provide a variety ofaccommodations or adaptations for people withdisabilities

The IDEA also lists the services a school dis-trict may need to provide in order to ensure thatassistive technology is useful to a student in theschool setting The law defines assistive technol-ogy service as ldquoany service that directly assistsan individual with a disability in the selectionacquisition or use of an assistive technologydevicerdquo This service includes all of the follow-ing possibilities

bull evaluation of the technology needs of theindividual including a functional evalua-tion in the individualrsquos customary environ-ment

bull purchasing leasing or otherwise provid-

ing for the acquisition of assistive technol-ogy devices for individuals with disabili-ties

bull selecting designing fitting customizingadapting applying maintaining repair-ing or replacing of assistive technologydevices

bull coordinating and using other therapiesinterventions or services with assistivetechnology devices such as those associ-ated with existing education and rehabili-tation plans and programs

bull assistive technology training or technicalassistance with assistive technology for anindividual with a disability or where ap-propriate the family of an individual withdisabilities

bull training or technical assistance for profes-sionals employers or other individualswho provide services to employ or other-wise are substantially involved in the ma-jor life functions of individuals with dis-abilities

The intention of the special education law isthat if a student with disabilities needs technol-ogy in order to be able to learn the school dis-trict will (a) evaluate the studentrsquos technologyneeds (b) acquire the necessary technology (c)coordinate technology use with other therapiesand interventions and (d) provide training forthe individual the individualrsquos family and theschool staff in the effective use of the technology

During the time that students with disabili-ties are in school they can have the opportunityto learn to use technology at the same time thatthey are learning academic subjects and socialskills The efficient and effective use of assistivetechnology can be as basic a skill for students withdisabilities as reading writing and arithmeticsince the use of technology can go a long way

3

toward circumventing the limitations of disabil-ity and providing students with disabilities witha ldquolevel playing fieldrdquo in every area of life ac-complishment

What is an accommodation

Accommodations are reasonable modifica-tions that are made to compensate for skills orabilities that an individual lacks For example ifa person does not digest spicy foods well wemight accommodate this individual by adjustinghis or her diet so that the person was eating onlybland foods

When the word accommodation is used in con-nection with disability issues it refers to a wayof modifying a task or assignment so that a per-son with a disability can participate in spite ofwhatever challenges the disability may pose Forexample when a student who is unable to re-member math facts is allowed to do math prob-lems with a calculator the use of the calculator isan accommodation which allows the student towork around his or her disability With an ac-commodation the student can still perform mathproblems but the student does so using a differ-ent method

In the school setting sometimes it is neces-sary to make accommodations for individualswith disabilities in order to compensate for skillsor abilities that they do not have For examplefor some students with learning disabilities learn-ing to spell words correctly may be a skill theynever acquire or never acquire with a highenough degree of fluency to do them any goodin written expression To compensate for thisinability to spell such students may be encour-aged to use alternative methods for spelling likea spell check software program on the computeror a hand-held spelling device

What is an adaptation How does adaptationdiffer from accommodation

Adaptation means developing unique devicesor methods designed specifically to assist persons

with disabilities to perform daily tasks An ad-aptation is something specially designed whichis not normally used by other people An accom-modation on the other hand is simply a changein routine method or approach which may beused by people with or without disabilities Ex-amples of adaptations include special grips toturn stove knobs or specially designed keyboardsto operate computers

What are common types of assistive technol-ogy Does assistive technology just meancomputers

Assistive technology certainly includes com-puters but it also refers to a number of other typesof accommodations and adaptations which en-able individuals with disabilities to function moreindependently Computers are an important typeof assistive technology because they open up somany exciting possibilities for writing speakingfinding information or controlling anindividualrsquos environment But computers are notthe only avenues to solving problems throughtechnology There are many low tech (and lowcost) solutions for problems that disabilities poseExamples of inexpensive low tech solutions in-clude wrist splints clip boards for holding pa-pers steady or velcro tabs to keep positioningpads in place

The following is a list of common assistivetechnology applications

Positioning In the classroom individualswith physical disabilities may need assistancewith their positions for seating so that they canparticipate effectively in school work Generallytherapists try to achieve an upright forward fac-ing position by using padding structured chairsstraps supports or restraints to hold the body ina stable and comfortable manner Also consid-ered is the studentrsquos position in relation to peersand the teacher Often it is necessary to designpositioning systems for a variety of settings sothat the student can participate in multiple ac-tivities at school Examples of equipment used

4

for positioning are side lying frames walkerscrawling assists floor sitters chair inserts wheel-chairs straps trays standing aids bean bagchairs sand bags and so forth

Access In order to participate in school taskssome students require special devices that pro-vide access to computers or environmental con-trols The first step in providing access is to de-termine which body parts can be used to indi-cate the studentrsquos intentions Controllable ana-tomical sites like eye blinks head or neck move-ments mouth movements may be used to oper-ate equipment which provides access to the com-puter Once a controllable anatomical site hasbeen determined then decisions can be madeabout input devices selection techniques (directscanning) and acceleration strategies (codingprediction) Input devices include such thingsas switches alternative keyboards mousetrackball touch window speech recognition andhead pointers Once computer access has beenestablished it should be coordinated with othersystems that the student is using including pow-ered mobility communication or listening de-vices and environmental control systems

Access can also refer to physical entrance andexit of buildings or facilities This kind of assistivetechnology includes modifications to buildingsrooms and other facilities that let people with

physical impairments use ramps and door open-ers to enter allow people with visual disabilitiesto follow braille directions and move more freelywithin a facility and people of short stature orpeople who use wheelchairs to reach pay phonesor operate elevators Accessibility to shoppingcenters places of business schools recreationtransportation is possible because of assistivetechnology modifications

Environmental Control Independent useof equipment in the classroom can be achievedfor students with physical disabilities throughvarious types of environmental controls includ-ing remote control switches and special adapta-tions of onoff switches to make them accessible(eg velcro attachments pointer sticks)

Robotic arms and other environmental con-trol systems turn lights on and off open doorsoperate appliances Locational and orientationsystems give people with vision impairmentsinformation about where they are what theground nearby is like and whether or not thereis a curb close by

Augmentative Communication Every stu-dent in school needs some method of communi-cation in order to interact with others and learnfrom social contact Students who are nonverbalor whose speech is not fluent or understandableenough to communicate effectively may benefit

figure 1 Alternative and Pr ocessing Computer Access Methods

Inputbull Alternate keyboardsbull Interface devicesbull Joysticksbull Keyboard modificationsbull Keyboard additionsbull Optical pointing devicesbull Pointing and typing aidsbull Switches with scanningbull Scanners amp optical character recognitionbull Trackballsbull Touch screensbull Voice recognition

Processingbull Abbreviationexpansion and macro programsbull Access utilitiesbull Menu management programsbull Reading comprehension programsbull Writing composition programsbull Writing enhancement tools (ie grammar checkers)

Outputbull Braille displays and embossersbull Monitor additionsbull Screen enlargement programsbull Screen readersbull Speech synthesizersbull Talking and large print word processors

5

from using some type of communication deviceor devices Communication devices include suchthings as symbol systems communication boardsand wallets programmable switches electroniccommunication devices speech synthesizers re-corded speech devices communication enhance-ment software and voiced word processing

Assistive Listening Much of the time inschool students are expected to learn through lis-tening Students who have hearing impairmentsor auditory processing problems can be at a dis-tinct disadvantage unless they learn to use thehearing they have or they develop alternativemeans for getting information Hearing problemsmay be progressive permanent or intermittentAny of these impairments may interfere signifi-cantly with learning to speak read and followdirections Assistive devices to help with hear-ing and auditory processing problems includehearing aids personal FM units sound field FMsystems Phonic Ear TDDs or closed caption TV

Visual Aids Vision is also a major learningmode General methods for assisting with visionproblems include increasing contrast enlargingstimuli and making use of tactile and auditorymodels Devices that assist with vision includescreen readers screen enlargers magnifierslarge-type books taped books Braillers lightboxes high contrast materials thermoformgraphics synthesizers and scanners

Mobility Individuals whose physical impair-ments limit their mobility may need any of a num-ber of devices to help them get around in theschool building and participate in student activi-ties Mobility devices include such things as self-propelled walkers manual or powered wheel-chairs and powered recreational vehicles likebikes and scooters

Computer-Based Instruction Computer-based instruction can make possible independentparticipation in activities related to the curricu-lum Software can be selected which mirrors theconceptual framework of the regular curriculum

but offers an alternative way of responding to ex-ercises and learning activities Software can pro-vide the tools for written expression spelling cal-culation reading basic reasoning and higherlevel thinking skills The computer can also beused to access a wide variety of databases

Social Interaction and Recreation Studentswith disabilities want to have fun and interactsocially with their peers Assistive technologycan help them to participate in all sorts of recre-ational activities which can be interactive withfriends Some adapted recreational activities in-clude drawing software computer games com-puter simulations painting with a head or mouthwand interactive laser disks and adaptedpuzzles

Self Care In order to benefit from educa-tion some students require assistance with selfcare activities like feeding dressing and toiletingAssistive devices which assist with self care in-clude such things as robotics electric feedersadapted utensils specially designed toilet seatsand aids for tooth brushing washing dressingand grooming

What sort of students might use assistivetechnology

Students who require assistive technology arethose with mental or physical impairments thatinterfere with learning or other life functions Thetechnology helps the student to overcome or com-pensate for the impairment and be more inde-pendent in participating at school Students whobenefit from assistive technology may have mildlearning problems like learning disabilities orthey may have physical or cognitive disabilitiesthat range from mild to severe Assistive tech-nology is not necessary or helpful for every stu-dent in special education but it is an importantpart of the support system for many studentswith identified disabilities

Isnrsquot assistive technology appropriate only forstudents with more severe disabilities

Assistive technology is simply a set of tools

6

that can be used to compensate for some deficitthat a person may have For individuals with se-vere mental or physical disabilities the techno-logical solutions can help to solve multiple andcomplex problems But individuals with less in-volved problems also can benefit from assistivetechnology For example individuals with learn-ing disabilities who have difficulty with readingor writing can benefit educationally from usingthe word processing and voiced reading capa-bilities of computers

Isnrsquot assistive technology just a crutch Wonrsquotstudents become too dependent on technol-ogy and not learn to use the skills they have

Assistive technology should be used as sup-port for access learning and performing dailytasks In general assistive technology is appro-priate when it compensates for disabilities so thatthe individual can function as normally as pos-sible If assistive technology is necessary for astudent to have access to educational opportuni-ties or to benefit from education then it is not aldquocrutchrdquo but a legitimate support

Some skills are too laborious or taxing to ac-complish at a rate or with degree of proficiencyto allow for participation in the least restrictiveenvironment With assistive technology the stu-dent can participate more fully and more closelyapproximate the levels of achievement and in-teraction of his or her peers

The use of assistive technology enhancesfunction and increases skills and opportunitiesThough a student may be dependent upon a par-ticular device in order to perform skillfully de-nying the device denies the student an opportu-nity ever to achieve success at the level of his orher potential

When is using assistive technology appropri-ate

Assistive technology may be considered ap-propriate when it does any or all of the follow-ing things

bull Enables an individual to perform functions

that can be achieved by no other means

bull Enables an individual to approximate nor-mal fluency rate or standardsmdasha level ofaccomplishment which could not beachieved by any other means

bull Provides access for participation in pro-grams or activities which otherwise wouldbe closed to the individual

bull Increases endurance or ability to persevereand complete tasks that otherwise are toolaborious to be attempted on a routine ba-sis

bull Enables an individual to concentrate onlearning or employment tasks rather thanmechanical tasks

bull Provides greater access to information

bull Supports normal social interactions withpeers and adults

bull Supports participation in the least restric-tive educational environment

SummaryAssistive technology means any device which

helps an individual with an impairment to per-form tasks of daily living There is a wide rangeof types of devices in assistive technology fromlow tech homemade aids to computers and so-phisticated electronic equipment Assistive tech-nology is one of the services which can be pro-vided in a special education program under theIndividuals with Disabilities Education Act(IDEA) The requirements of IDEA say that stu-dents who need assistive technology are entitledto the aids and devices and the assistive technol-ogy services (eg evaluation for assistive tech-nology and modification and maintenance ofequipment) that are necessary for the student tobenefit from a free appropriate public education

Hints for Parents

It is never too soon to consider using assistive tech-nology Some infants with physical disabilities for ex-

7

ample really benefit from early interaction with toysthat operate by switch Here are suggestions for timesto evaluate a child for assistive technology

bull When disability limits interaction with the envi-ronment and interferes with experiential learn-ing

Assistive technology can be used to providephysical access to the environment (egswitch toys floor scooters touch window)

bull When a significant gap exists between receptiveand expressive abilities

Assistive technology can assist with expres-sion through the use of programmableswitches electronic communication devicesvoiced word processing braille embossingand so forth

bull When an individualrsquos performance falls behindthat of his or her peers

If an individualrsquos handwriting for exampleis very slow laborious and difficult to readuse of a word processing device can be sub-stituted for handwriting thus allowing theindividual to keep up with others in termsof written expression

bull When a physical disability is impeding the edu-cationalvocational potential of an individual

Assistive technology can provide access tothe workplace for example by allowing anindividual who is blind to learn to use ascreen reader and voiced word processingto do clerical tasks that would otherwise beimpossible

bull When a disability is impeding the independenceof an individual

Sometimes assistive technology can be usedto allow a person with a disability to func-tion more independently For example hav-ing a power wheelchair allows an individualto travel independently without the neces-sity of having someone to push the wheel-chair

SaraSara who has Down syndrome is eight

years-old Her language and speech skills arethree years delayed but she has age appropriatesocial skills Sara has spent part of her schoolday in a regular classroom ever since kindergar-ten but this year her third grade teacher is sug-gesting that Sara really cannot keep up with herclassmates The teacher thinks that Sara wouldbe better off in a self-contained class with stu-dents who work at her pace Sara has some finemotor coordination problems and she has haddifficulty learning to write in cursive Her oralreading is hampered by her speech difficultiesHowever Sara has learned to do addition andsubtraction problems well and has mastered add-ing with carrying and subtraction with borrow-ing She reads at about a second grade level withreasonably good comprehension Sararsquos parentswould like to see her continue in the regular class-room for as much time as possible but they rec-ognize that Sararsquos writing and speaking problemsare keeping her from doing her best work

What are Sararsquos needs

What kinds of technology should go in SararsquosIEP

How would you make a case for puttingassistive technology into her IEP

8

Sararsquos SolutionSararsquos IEP Team met to discuss her needs and

concluded that she is doing well in a regular class-room setting she is making adequate progressin academic skills and has learned how to inter-act socially with her peers It is to be expectedthat Sara will have difficulty keeping up with thepace in a third grade but as long as she is mak-ing progress toward her individual goals theregular classroom is a good setting for her How-ever some simple accommodations and technol-ogy may help Sara to work faster and more effi-ciently

At this point Sara may need some assistancewith handwriting and speaking but the solutionsto her problems in these areas need not be com-plex ones The team decided that Sara shouldcontinue to practice cursive until she has mas-tered all the letters and can be more facile in us-ing script However while she is still learningcursive she needs other means for respondingin writing For short written responses the teamagreed that Sara should be encouraged to usemanuscript printing When speed is importantor when writing assignments are longer Sarashould have access to a computer with an adap-tive keyboard (eg IntelliKeys) The adaptivekeyboard is helpful for Sara because the ldquokeysrdquoare larger and easier to see Using the keyboardrequires only a very light touch so Sara finds iteasier to use than a standard computer keyboard

In terms of oral reading the team decided tohave Sara practice reading into a tape recorderHer speech therapist will work with her on slow-ing down her rate of speech and reading withexpression When Sara has a good tape of heroral reading she will submit it to her teacher forreview

Solution SummaryPractice cursiveUse manuscript printing for short assign-

ments

Use computer with adaptive keyboard forlonger assignments

Practice oral reading using a tape recorder

9

Making Assistive Technology Decisions

W hen parents learn about assistive tech-nology and the wonderful opportuni-ties it can provide they want to jump

right in and get the latest in technology for theirchildren Who wouldnrsquot want an augmentativecommunication device for a child who cannottalk What parents wouldnrsquot want to buy a com-puter if it would help their child learn

When the world of assistive technology opensup for parents it can be like entering a great toystoremdasheverything looks so wonderful that itmakes it hard to know what to select Choosingthe right device to meet an individualrsquos needsrequires technical knowledge and indepth under-standing of the individualrsquos functional capabili-ties Not only is the selection of a device madedifficult by the complexity of the equipment andthe demands of the individualrsquos impairmentassistive technology devices can be very expen-sive Making such purchases is a major financialcommitment for most families one that takes agreat deal of soul searching and sometimes sig-nificant sacrifice

Families invest more than money in theirchildrenrsquos assistive technology Practical invest-ments of time and effort and emotional invest-ments of hope and enthusiasm are made withevery assistive technology purchase Because ofthe high level of financial personal and emotionalcommitment family disappointment is greatwhen equipment fails to perform as expected

Buying and then not using a device becauseof dissatisfaction can be a devastating experiencefor all concerned That is why it is so importantfor parents to proceed cautiously into the worldof assistive technology and make purchases onlyafter careful evaluation and trials with the newdevice Following is a summary of some sug-gestions for parents to consider before makingany assistive technology purchase be realisticabout your childrsquos capabilities and needs get a

multidisciplinary evaluation examine availabletechnology with a critical eye match the childrsquosneeds to specific equipment features do not makea purchase until you have used the device for atrial period identify next steps and determinewhat needs to be done for follow-up after pur-chase

Guidelines for Making Assistive TechnologyDecisions

bull Be realistic about your childrsquos capabilitiesand needs

Assistive technology can open up excitingnew opportunities for a child but it is not magicThere are certain basic requirements for any in-dividual to be successful with technology and itis important to face these requirements squarelyThere is nothing more disappointing or discour-aging than purchasing expensive equipment fora child which is beyond his or her capabilities touse

Prerequisites for Computer Use Physicalor sensory impairments do not limit access tocomputers but cognition is a factor in computeroperation The major prerequisite for using acomputer (with or without adaptations) is thecognitive ability to understand cause and effectThe child must be able to understand that thecomputer operates (eg changes does some-thing) because the child has activated the equip-ment through some volitional movement or ac-tivity (eg eyebeam speaking puffing into astraw hitting a switch) Some children enjoyplaying with switches by hitting them randomlybut may not be able to connect their own behav-ior to the response their movement activates Inorder to be successful in interacting with a com-puter the user must be able to control some voli-tional activity and to do so consistently For ex-ample the child would have to be able to acti-vate the computer in response to a visual tactileor auditory prompt

10

Another prerequisite to computer use is theability to make conscious meaningful choicesbetween alternatives like yes and no The choicescan be very simple ones but there has to be evi-dence that the child has made an actual decisionand not merely acted randomly

If a child does not have the concept of causeand effect or cannot make consistent choices us-ing a computer is probably not a worthwhile nextstep at this point in the childrsquos developmentOther types of activities may be more appropri-ate less expensive and just as rewarding devel-opmentally and personally

Prerequisites for Augmentative Communi-cation Augmentative communication devicescan literally give voice to the thoughts of indi-viduals who cannot speak or cannot speak clearlybutmdashagainmdashthese devices are not magic Elec-tronic communication devices are of no valueunless the user has some communicative intentThat is for a communication device to be help-ful the user has to have some basic understand-ing of the communication process and must beintentional in expressing choices desires orneeds

For example Maggie is a four-year-old whois nonverbal She communicates her wants andneeds by using eyeblinks as responses to yes orno questions When Maggiersquos dad asks her if shewould like another glass of milk she indicatesher choice by raising her eyes up vertically foryes or moving her eyes down for no Maggieclearly knows what she wants to communicateshe has a consistent method for making herwishes known and she expects that her dad willunderstand her communication and act on it

Dan who is also nonverbal communicatesin a different way He points to objects and makesgestures to show what he wants or needs Hisgestures are clear and used consistently so thatfamily members and even people who do notknow Dan well can understand most of the timewhat he is communicating

Shelley communicates very basic informationabout how she feels by crying when she is un-comfortable or wants attention and by laughingwhen she enjoys something like music brightlights or water running Shelley does not how-ever respond to yes or no questions She doesnot make choices even when objects are pre-sented to her individually or in pairs She can-not respond to a question like ldquoDo you want someice cream nowrdquo Or ldquoWould you like the teddybear or the dollrdquo

Maggie and Dan may benefit from usingsome communication device because they arealready using communication systems meaning-fully and consistently Shelley however mayneed to develop greater ability to communicatemeaningfully before moving on to electroniccommunication

Communication skills fall along a continuumAt one end of the continuum are very simplecommunications like expressing preferences byindicating yes or no pointing or gesturing towardobjects or pointing to pictures Use of sign is amore complex form of communication becauseit requires that the user understand that the signsare symbols for meaningful communicationsWhen an individual is able to string togethersigns or words into meaningful phrases this isan additional step toward more complex com-munication When a person understands syntaxand is aware of typical word order this is anotherstep forward Each of these advances along thecommunication continuum represents a step to-ward more complex and sophisticated commu-nication Whatever assistive communicationdevice is chosen should match or just slightlyexceed the place on the continuum where the in-dividual is functioning It makes no sense forexample to purchase an elaborate electronic com-munication device that requires understandingsymbols and syntax when the individual usingthe device is just at the point of learning how toexpress yes and no preferences

An electronic device does not teach commu-

11

nication it enhances communication by givingaudible expression to thoughts that already existin the mind of the user If the thoughts are notthere yet or are not completely formed they can-not be expressed by the device

Physical and Sensory Impairments Are NotBarriers Mastery of a few simple prerequisiteskills is necessary before computers or electroniccommunication devices should be consideredbut it is not necessary for a child to master everydevelopmental milestone before entering theworld of assistive technology Physical or sensoryimpairments can often be circumvented by thetechnology itself and typical developmentalmilestones can sometimes be bypassed so thatassistive technology can be used For examplesome educators assume that students cannot usecomputers until they have completely masteredkeyboarding skills This is a false assumptionMany students benefit from using computerseven though they operate the machine using aldquohunt and peckrdquo method or only one or two keysIn a similar fashion students with limited verbalability who have not mastered oral speech ben-efit from using augmentative communicationdevices while they continue to develop oral lan-guage

Overall the keys to knowing when to tryassistive technology are (a) being realistic aboutthe childrsquos cognitive abilities and potential and(b) being open to trying the level of technology

which meets the child where he or she is

bull Get a multidisciplinary evaluation

Evaluations for assistive technology are notalways easy to arrange In many parts of theUnited States there is no convenient center orldquoplacerdquo to go for an assessment The availablecenters may be far away in another city or evenanother state Since assistive technology is a newfield the systems for disseminating informationand providing assistance are in the process ofevolving Parents may have to be ldquoassistive tech-nology detectivesrdquo in order to put together theinformation needed for a complete AT evalua-tion for their child

The place to start the evaluation is by consid-ering the functions the child needs to performand cannot because of impairment The physi-cians teachers and therapists currently workingwith the child as well as family members andfriends who are around the child on a daily ba-sis can provide very valuable information aboutfunctional problems and potential solutions

Finding Functional Solutions The Alliancefor Technology Access (ATA) a national networkof assistive technology centers has developed aninformal method for using the functional infor-mation available from professionals family mem-bers and friends as a basis for analyzing assistivetechnology needs This process called a Solu-tion Circle is a means to bring people togetherin an informal session that allows for creative

figure 2 Factors to consider when selecting Assistive T echnology

Cognitive Factorsbull Diminished Cognitive Abilitiesbull Learning Disabilitiesbull Attention Deficitsbull SensoryPerceptual Deficitsbull Memory Deficitsbull Abstract Reasoning Deficitsbull Problem-Solving Deficits

Motor Factorsbull Voluntary Motor Deficitsbull Involuntary Motor Deficitsbull Fixed Posture amp Positioning Deficitsbull Recurring Purposeless Motionbull Motor Paralysisbull Low Muscle Tonebull Rigiditybull Spasticitybull Tremors

12

thinking and is not inhibited by what is ldquolegalrdquoldquocurrently availablerdquo or ldquowhat has been done be-forerdquo The individual with a disability and 4-10family members professionals and friends gettogether to brainstorm ideas about the technol-ogy which may help the individual perform func-tions that are hard or impossible to do becauseof disability The Circle usually includes a bal-ance between people who know the person whoneeds the technology and people who have spe-cialized knowledge about technology educationor work-related issues

Solution Circle for Tom To demonstratehow the Solution Circle works letrsquos take a lookat how this process was used in the case of Toma high school student with a learning disabilityFor Tom the print in textbooks is a significantbarrier to learning Tom is ldquoprint disabledrdquo thatis he cannot read the printed word with muchcomprehension Reading is a slow unproductiveprocess for him even though he is intelligent andeager to learn Tom and his parents were hopingthat there might be a way that new technologycould help Tom overcome or work around hisproblem with reading so that he could get moreout of school and perhaps go on to college

Tomrsquos Solution Circle included his parentsBetty and Bob his resource teacher a friendDarrell his soccer coach his 4-H leader and theowner of a local computer store This group mettogether to think about how Tom could partici-pate more fully in school and prepare himself forcollege even though he could not read with com-prehension past the second or third grade level

Solution Circles generally take 1 to 1 12 hoursto complete The steps include the following

1 Star Time The individual for whom theSolution Circle is being held is described in a ho-listic way The emphasis is on how the individualis functioning at home and in the communityWhat does he or she like and dislike What arehisher goals Interests If possible the indi-vidual with a disability speaks for himself or her-self or a video or pictures may be presented The

point of this part of the discussion is give a clearpicture of the individual as a whole person

At Tomrsquos Solution Circle he explained hisdream of going to college and becoming an agri-cultural botanist Tom loves plants he is inter-ested in breeding new strains of wheat and per-fecting various types of grain crops Tomrsquos 4-Hleader agreed that Tom had real gifts in under-standing plant growth and physiology and thathe already had sophisticated knowledge aboutbotany which would prepare him well for col-lege study

2 Strengths With a complete picture of theindividual in mind the group then makes an ex-haustive list of the individualrsquos strengths particu-larly noting any technological accommodationswhich the individual is already using What doesthe individual do well What are his or her un-impaired functions Often this discussion revealsan incredible number of adaptations that the in-dividual has already achieved

Tomrsquos Solution Circle discovered that he hadmany strengths including keen intelligence per-severance and thoroughness when approachinga task Tom already had some effective learningstrategies for remembering material that heheard He had also learned to use a small taperecorder for keeping track of information pro-vided in class

3 Obstacles With the individualrsquos strengthsin mind the group then turns its attention to aconsideration of the environment in which theindividual is functioning and the activities inwhich the individual wants to participate butcannot at this time The group considers whatthe obstacles and barriers might be for the indi-vidual in his or her environment and makes alist of these impediments

For Tom reading was a serious obstacle Hecould not keep up with homework assignmentsbecause it took him so long to read his textbooksIn addition he had difficulty reading directionson tests and often misread assignments on the

13

COGNITIVE FACTORSCognitive Ability

Documented below average abilityDocumented significant overall delayDoes not appear age appropriateLacks understanding of cause amp ef-

fectPaying Attention

Difficulty following prompts or direc-tions

Difficulty with multi-step proceduresDifficulty filtering informationDifficulty staying on task

PerceptionNeeds lengthened response timeRequires multi-sensory inputDifficulty with rapid changeSignificant visualperceptual problemsSlow visual-motor dexterity

MemoryDifficulty with recallRequires reteaching learned skillsRequires repeated practice

Abstract ReasoningDifficulty analyzing simple proceduresUnable to reproduce a sequenceUnable to analyze or synthesize in-

formationProblem Solving

Unable to use prompts or cues to ac-complish tasks

Unable to modify attempts and try an-other way

MOTOR FACTORSMobility

Needs help to be mobileNeeds motorized help to be indepen-

dentNeeds help boarding transportationUnable to transfer independentlyCannot climb stairsCannot open doors independentlyCannot carry materials in hands or

armsCannot lift weight

Voluntary MotorLimited control of head trunk or ex-

tremitiesVisual motor deficitsFixed position and posture

figure 3 ASSISTIVE TECHNOLOGY EVALUATIONIndividual Functional Analysis

Name Date

Needs support to sit or standNeeds adaptations in order to use

technologyMotor Paralysis

Changes in muscle tone interfere inmotor movements

Spastic movements result in poor con-trol

Limited movement of head arms orlegs

Difficulty balancing in sitting positionDifficulty maintaining good posture

Low Muscle ToneLimited use of arms or legsPoor posture controlFatigues quickly

RigidityInhibits arm and leg movementInhibits balance to sitInhibits good posture

SpasticityLimited upper range of motionLimited lower range of motionInterferes with accuracy and consis-

tency of motor movements on oneside

TremorsPresent all the timePresent when doing purposeful upper

extremity taskUnable to compensate for tremors

Extraneous MovementAthetoid (constant)Ataxia (poor coordination in move-

ment)FINE MOTOR

DexterityLimited fine motor controlHas limited hand movement

HandwritingWriting or copying ability is signifi-

cantly below peersSignificant legibility factor--written

work not readableCannot keep up with the pace of writ-

ten workIs frustrated by writingFatigue is a factorTyping appears to be potentially faster

than handwriting

SELF CARENeeds assistance with going to the

bathroomUnable to be toilet trainedNeeds assistance to eatCannot take in food orallyNeeds suctioning routinelyHas degenerative medical conditionIs medically fragileSeizures limit alertnessNeeds to rest frequentlyNeeds assistance to zip coat or tie

shoesCOMMUNICATION

Receptive LanguageReceptive language is significantly

lower than abilityReceptive language is significantly

higher than expressiveExpressive Language

Speech is unintelligibleExpressive language is significantly

lower than abilityMean Length of Utterance (MLU) is 3

words or lessSpontaneous or self initiated language

is significantly limitedDoes not make choices consistentlyDoes not respond appropriately with

yes or noDoes not have communicative intent

SENSORYVision

Requires corrective lensesRequires large print to readRequires mobility trainingHas blind spot

HearingRequires preferential seatingHearing limitations affect the language

thresholdsRequires assistance to receive lan-

guageRequires sign language to receive lan-

guageHas fluctuating hearing lossNeeds visual signals for safety pur-

poses

14

blackboard

4 The Enemy Within Physical and cogni-tive impairments may pose difficult obstacles foran individual but often the feelings that peoplehave about the individualrsquos disability or aboutassistive technology pose greater problems thanthe disabilities themselves The Solution Circleprocess recognizes that human fears concernsreservations and prejudices might stand in theway of a personrsquos success as much as other typesof limitations Getting these fears and concernsout on the table often helps the group to deal moreconstructively with what is possible and whatneeds to be done

One of the serious issues in Tomrsquos situationwas that his resource teacher felt he should con-tinue to try to read for himself instead of using aldquocrutchrdquo like assistive technology The teacherthought that if Tom did not have to read all thematerial he would lose what little reading skillhe had In some ways the teacherrsquos oppositionto considering assistive technology actually poseda greater barrier than the reading problem itself

5 Solutions The exciting part of a SolutionCircle occurs when the group takes each obstacleor concern and turns it into a possible solutionthrough the use of technology or some other typeof adaptation Not all solutions suggested even-tually prove to be feasible but the point of thediscussion is to produce many possible solutionsso that the individual and his or her family havean array of options from which to choose Withgood minds puzzling over the problems and aspirit of cooperation and collaboration seeminglyimpossible barriers can be removed or conqueredThe process recognizes the expertise and contri-butions of all participants including the indi-vidual with disabilities and his or her familymembers The freewheeling format of the dis-cussion promotes ingenuity and innovation Allinvolved come away from a Solution Circle ener-gized by the new possibilities

Tomrsquos Solution Circle became excited about

the possibility of solving his reading problem byusing computerized texts The computer storeoperator mentioned he had heard that Record-ings for the Blind (RFB) offered textbooks on diskTomrsquos parents got in touch with Recordings forthe Blind and ordered texts for Tom to try on hiscomputer at school Soon Tom found that hecould keep up with his classmates and study ex-actly the same material that they were coveringBecause Tom had good strategies for memoriz-ing information that he heard he learned quicklyfrom the texts that were read aloud to him by thecomputer When given oral tests by his classroomteachers he was able to recite appropriate an-swers which would have eluded him if he hadhad to read the tests for himself

Technology has made all the difference forTom he has every reason to think that he will beable to go to college and pursue his intellectualinterests His resource teacher is now completelysold on the idea of assistive technology and us-ing computerized books and wants to use thetechnique with other students More than thatTomrsquos teacher also appreciates the process of theSolution Circle which allowed professionals andnonprofessionals to work together to find prac-tical solutions without being too concerned aboutthe formalities of the special education processThe informal nature of the Solution Circle vali-dated the expertise of all the participants andgave everyone a chance to offer suggestions Thecombination of a new process for planning andnew technology made Tom a winner This samecombination holds potential for many studentslike Tom who benefit from technologies whicheliminate barriers and open up new possibilitiesfor learning

From Function to Technology Solution Ithappened that a participant in Tomrsquos SolutionCircle hit on a great idea for a solution to his func-tional problem with reading This was a fortu-nate connection to make At the suggestions ofhis Solution Circle Tom began to use computer-ized books which he ldquoreadsrdquo by having the com-

15

puter speak the words as he follows along withthe text For Tom computerized books proved tobe a successful solution to his reading problembecause they help him to get the information heneeds without struggling with the reading pro-cess

Not every Solution Circle will be like Tomrsquosand identify the exact technology that the indi-vidual needs But if a Solution Circle has workedwell the end result will be a clear analysis of thefunctions that need to be performed This func-tional information can then be brought to techni-cians who can make suggestions for possibleassistive technology solutions There are over 50assistive technology centers in the United Stateswhere knowledgeable individuals can assistpeople with disabilities and their families withmaking a match between functions that need tobe performed and the technology that is availableto perform those tasks A list of assistive technol-ogy centers is available in the Appendix to thisGuide

Formal Assessment Solution Circles are aneffective informal way to identify functionalneeds that can be met through technology How-ever in the school setting it is also necessary toestablish a studentrsquos needs for technology in amore formal way Formal evaluations for assistivetechnology must be multi-disciplinary involvingeducators and therapists who are knowledgeableabout the school curriculum and the particulartypes of impairments that the student being as-sessed may have For example for a student withcerebral palsy the assistive technology evaluationmight involve a teacher a physical therapist aspeech and language clinician and an occupa-tional therapist The teacher would assist thetherapists in determining what skills the studentneeded to learn and how technology might assistthe student in acquiring those skills Someassistive technology evaluations might require theadditional services of an A-V technician adap-tive physical education teacher a rehabilitationcounselor or speech and language pathologist

with specialized training in augmentative com-munication In school districts where there is nospecialized expertise in technology and its appli-cations it may be necessary to contract for evalu-ations with special education cooperatives medi-cal centers or centers that focus on technologyassessment

Individuals conducting an assistive technol-ogy evaluation should

bull Be knowledgeable of the studentrsquosstrengths and weaknesses medical needsmobility fine and gross motor skills cog-nitive ability communication abilities vo-cational potential self help needs sensoryabilities level of academic achievementand area(s) of disability

bull Have knowledge of and access to an arrayof assistive technology devices

bull Be familiar with the studentrsquos educationalsetting and educational needs

bull Be able to communicate effectively withparents and educators

Because the assistive technology field is sonew there are no particular licenses orcredentialing processes to identify a professionalas qualified to do assistive technology evalua-tions Generally speaking individuals with pro-fessional licenses as occupational or physicaltherapists special educators speech pathologistsor rehabilitative counselors may have the exper-tise to conduct an AT evaluation When consid-ering an evaluator it is wise to ask about theevaluatorrsquos specific experience with assistivetechnology It is also important to recognize thatno one person or discipline will know everythingabout assistive technology therefore access toknowledgeable people at the local level andthrough other agencies programs or services isessential

Conducting the AT Evaluation The assistivetechnology evaluation must be tailored to theunique needs of the student In some cases theevaluation may be conducted by at team of indi-

16

viduals in other cases the evaluation may beconducted by a single individual (eg the speechpathologist) Questions to be addressed duringthe assessment should be related to the specifictasks the student needs to be able to perform andwhat if any assistive technology would helpThe following questions may be considered dur-ing the assessment

bull What tasks does the student need to per-form that he or she cannot perform

bull Is there a low tech device which will ad-dress the studentrsquos needs satisfactorily

bull What types of high tech assistive devicesmay help the student in performing thetask

bull Will assistive technology help the studentto perform the task in the least restrictiveenvironment

bull Is the device being considered suited to thestudentrsquos educational needs and abilities

bull Will the assistive technology device remainsuitable over time How long lasting willthis solution potentially be

The above are only a few of the considerationswhich need to be addressed as part of the evalu-ation process There is no specific ldquotestrdquo forevaluating the need for assistive technologyTherefore prior to conducting the evaluation theindividuals doing the assessment need to have awell planned process in mind

The formal written assistive technologyevaluation report should address but not belimited to the following points

bull Procedures used to evaluate the student

bull Instruments employed in the evaluationassuring that a range of levels of technolo-gies has been considered

bull Results of evaluations including bothqualitative and quantitative measures

bull Recommendations for levels of technologyappropriate to the studentrsquos capabilitiesand potentials and

bull Implications for educational program-ming including discussion of both indi-vidual technology needs and recom-mended environmental and instructionalmodifications

In the end an assistive technology evaluationshould provide recommendations for accommo-dations adaptations devices and services basedon the individualrsquos strengths needs and pre-ferred lifestyle The evaluation should indicate(a) whether devices and services have potentialfor improving function and (b) what trainingmay be necessary in order to use the technologyequipment safely and effectively

bull Examine available technology with a criti-cal eye

It is easy to be dazzled by the possibilities innew assistive technology but it is important forparents to be wise consumers and ask probingquestions about the features and quality of anassistive technology device The following is alist of questions to consider when evaluating aparticular assistive technology device

Performance

Does it work efficiently and effectively

Is it easy to learn to use this device

Is it compatible with other devices

Does this device serve only one purposeor is it flexible

ldquoElegancerdquo

Does this device represent the simplestmost efficient way to accomplish the task

Or is this device too elaborate too com-plicated to be worthwhile

Ergonomics

Does it fit the individual

Is it convenient to use in the environment

Is the equipment portable enough to gowhere the user goes

Are different devices needed in differentenvironments

17

Reliability

What is the manufacturerrsquos reputation forreliability

Does it stand up well to normal use

Is it durable

Safety

Is it safe to use

What is the power source for the deviceIs it safe

Is a margin built in for foreseeable mis-use

Practicality

Do company sales people seem knowl-edgeable and helpful

Are the companyrsquos service people knowl-edgeable and helpful

Does the device have a warranty Howlong is the device guaranteed to function

How available are repair services Atwhat cost

Can this device be leased

Is this device available for a trial periodbefore purchase

Will this device soon be outdated Issomething better on the horizon

Will the company update the device

Does the manufacturer provide trainingin using the device

Aesthetics

Is this device attractive to the eye

Does the device fit well into the userrsquoslifestyle

Normalization

Does the device assist the user with morenormalized living

Can the user operate the device indepen-dently or with a minimum of assistance

Or does the device ldquostick outrdquo too muchand advertise the disability of the user

Does the equipment minimize differenceor exaggerate difference

Does the device have the potential to in-crease the quantity and quality of time spentwith nondisabled peers Or does the de-vice separate the user from others

Cost effectiveness

Do the benefits the device provides jus-tify the cost

Are there less expensive devices or mod-els that serve the purpose as well

Personal acceptance

Is this device the userrsquos own choice

Does the potential user like this deviceand want to use it

Does the potential user view this deviceas life-enhancing

Would the user have preferred some otherdevice or means to perform the task

Will using the device always be a choreor can using it become a habit

There are several ways that consumers canfind answers to their specific questions aboutassistive technology devices Most vendors willprovide good basic information about the prod-uct Call the vendor and ask for brochures prod-uct specifications price list and any other writ-ten information This is a place to start A sec-ond step is to read reviews of the product in trademagazines or Closing the Gap a widely respectedpublication that reviews new assistive technol-ogy products If possible it is very helpful totalk to other consumers who are already usingthe product Ask them about the pros and consof using the device Then visit a preview centerif there is one nearby and try out several typesof devices Ask for general recommendationsfrom the preview centerrsquos staff After identify-ing a device that appears to meet the potentialuserrsquos needs try the device out for a month tosix weeks to make sure that it performs as adver-tised and fits in well with the userrsquos lifestyle

18

During the trial period it will be possible to iden-tify training needs for the user family membersand school staff The trial period will also be atime for the user to test the device in several set-tings to determine its portability and flexibility

bull Match the Individualrsquos Needs to SpecificEquipment Features

When considering an assistive technologydevice it is very important to consider how adevice matches up with the particularindividualrsquos needs and habits In some ways anassistive device becomes an extension of theuserrsquos mind and body As such it is a highly per-sonal item A device may work as advertisedbut still not meet an individualrsquos needs becausethe individual just does not feel ldquocomfortablerdquo inusing it For example Cindy a fourteen-year-oldwho is totally blind and has mild cerebral palsyaffecting her hands and arms was being taughtMorse Code as a means to speed up her writingShe had difficulty using a Brailler because her armstrength was so limited so her teacher thoughtMorse Code would be an easier method of writ-ing for Cindy The only problem was that Cindydid not like using Morse Code To her it seemedlike she was having to learn another complicatedlanguage when she already knew braille andliked to use it Cindy admitted that writing inbraille was slow for her but she was more com-fortable with it Cindy and her teacher were atan impasse until a friend suggested to Cindy thatshe try writing on a voice-output computerCindy loved the computer With a headset at-tached to the sound system she could listen care-fully to the computer as it read aloud the lettersand words she was typing on a light touch tac-tile-marked keyboard This computer also had afeature of printing out text in either standard printor braille Cindy was delightedmdashshe could writecopy for herself to read in braille and for hersighted teachers to read in regular print Thissolution worked because it met Cindyrsquos learningneeds and responded to her own ideas about her-self She did not want to use Morse Code because

it was a separate type of communication knownonly to a few With her computer voiced soft-ware and dual printer she had the best of twoworldsmdashshe could ldquohearrdquo her writing as shetyped she could read it over in braille and hersighted teachers could read her finished prod-uct This solution helped Cindy to improve hercomposition skills speed up her writing timeand communicate more easily with sightedpeople

Cindy was fortunate because her assistivetechnology solution met her needs almost per-fectly Such a close match is not however al-ways possible Nonetheless every effort shouldbe made to have the match be as close as it canbe In general when assistive technology solu-tions are individualized simple to use and re-sponsive to the whole person they are more likelyto be used by the individual When the deviceperforms a task well but does not ldquofitrdquo the indi-vidual the technology is likely to be abandonedby the user in favor of something else whichmeets the need more exactly Too often devicesare purchased because of their technical poten-tial without thought to their relationship to theindividual and his or her lifestyle These mis-matched devices are the ones that end up lan-guishing in their packing boxesmdasha sad reminderof time and money spent to no avail

bull Try the Device Before Buying

It cannot be emphasized enough how vital itis to try out assistive technology devices andequipment before buying Trying out a devicefor several weeks provides the user with an op-portunity to learn how to use the device and howto adapt to its features while at the same timetesting the device in the various environmentswhere it will be used For example Mike triedout a communication device which attachednicely to his wheelchair tray and was compat-ible with his computer that he used for doingschool work Though the communication deviceworked well and was relatively easy to program

19

MOTORSELF CARE

manual wheelchairpower wheelchairbus liftsupportive classroom

chairstanderwalkerlift for transferspositioning devicecanes or crutchesadapted commodesuctioning devicebraces or supportsother ____________

________________

________________

________________

________________

________________

________________

________________

________________

________________

________________

________________

figure 4 ASSISTIVE TECHNOLOGY EVALUATION

Device or Equipment Features or Functions

Name Date

FINE MOTOR

word processorword processor with

predictionvoiced word proces-

sor with predictionadapted keyboardkeyguardalternative key

arrangementvoice activated

computer accessinfrared computer

accessmouse accesstrackballjoystickpower padswitch (eg mouth

lip chin)touch screenpointersdrag and click desk

accessorysticky keysonscreen keyboardprinter for written

work

adapted feedingutensils

braces or splintsother ____________

________________

________________

COGNITIVECOMMU-NICATION

communciationboard(s)

communication wallettotal communicationmanual signword processor with

voiceprogrammed voice

outputicon predictionelectronic communi-

cation deviceprogrammable switch

with voice output

no-reading-neces-sary word proces-sor

spell checkergrammar checkeroutlining programother ____________

________________

________________

________________

________________

________________

________________

________________

SENSORYPERCEP-TUAL

hearing aid(s)

classroom amplifica-tion

boosted signal tonoise ratio (egheadset to keepfocus during wordprocessing)

corrective lensesenlarged printtaped booksvoiced word process-

ingvoiced screen

directionsCCTVother ____________

________________

________________

________________

________________

________________

________________

________________

________________

________________

________________

20

Mike found out quickly that the device was justtoo bulky to be useful for him When he trav-eled around the school the communication de-vice blocked his view of the terrain and of peoplepassing by He found he missed opportunitiesto communicate because he could not see whowas coming his way Mike also discovered thatthe communication device did not serve him wellin crowds like at pep rallies or basketball gamesAfter a month of working with this communica-tion device Mike decided it was not for him andselected instead a device that was less compli-cated smaller and more portable The seconddevice was not as sophisticated as the first but itbetter met his needs for quick communicationwith friends in social settings If he had not hadthe opportunity to try out both devices for anextended period of time Mike might not haverealized the value of the second device and mayhave been stuck with a communication devicethat was too large and too sophisticated to matchhis lifestyle

Similarly Marilyn benefited from a trial pe-riod with her communication device She foundout the first week that the particular device shehad chosen would not work for her because itbroke too easily and it was difficult to get re-paired During the first week that Marilyn hadthe device for trial her teacher broke one of thebuttons during a programming session It tooktwo weeks to contact the manufacturer and thenthe device had to be mailed back to the factoryfor repairs The device was gone for over sixweeks and the manufacturer would not supplya ldquoloanerrdquo while Marilyn waited for repairs tothe first device This experience taught Marilynthe importance of having a responsive manufac-turer who is willing to repair devices quickly andto supply substitutes for the user while repairsare being made Marilyn decided on a differentdevice with similar features and a great helplineto provide assistance with the maintenance of themachine

The information that can be learned during a

trial period with a device is invaluable to the userIt is discouraging to find out during the trial thata device is not all it is purported to be or that itdoes not work as well as advertised but it is farbetter to learn before purchase that a device doesnot meet the userrsquos needs than to learn after pur-chase and be stuck with an expensive unusablemachine For the consumer it is daunting to thinkabout starting over again with the process of se-lecting a device Nonetheless it is worthwhileto seek more information and look again Hav-ing been through a trial even when the outcomeis not successful provides the user with greaterclarity about what an appropriate device willhave to be able to do The second time aroundthe search is likely to go faster and come out witha better result

bull Identify Next Steps

Once a device has been selected the con-sumer becomes impatient to have one and beginusing it right away But at this point importantwork still needs to be done Funding the deviceis a major consideration Sometimes families willpay for the device themselves but under othercircumstances the device will be purchased by aschool district through Medicaid or private in-surance or through some other means Parentsneed to become familiar with the various fund-ing options and determine which one will workfor them (See Funding Assistive Technology foradditional information about funding sources)

Also when considering funding familiesshould think about costs beyond the price of thedevice itself For example a computer set-upwith a keyboard monitor and printer might cost$3500 This equipment is basically useless un-less other equipment is purchased as well soft-ware adaptive devices paper manuals up-grades Prices for these additions can raise theactual cost of the device by hundreds of dollars

Devices often require training for the userfamily members and others to ensure effectiveand safe use How much does training cost Who

21

will provide it Repair and maintenance are othercosts usually additional to the price of the equip-ment Sometimes families will also want to insurethe assistive device so insurance payments be-come part of the overall cost

Since making an assistive technology pur-chase is such an important personal and finan-cial decision it is wise to have a realistic budgetin mind that includes all of the equipment andservices that are necessary to make the assistivetechnology work effectively With this budget inmind it becomes easier to plan the purchase seekout funding sources and make a compelling casefor financial assistance

bull Determine What Follow-up Is Needed

After the assistive technology device has beenpurchased and put to use there are additionalfollow-up activities that need to take place Theoriginal assistive technology evaluation shouldinclude a way to monitor the use of the devicePeriodic scheduled reviews the by evaluator fol-low-up calls to and from the family are some waysto help assure effective safe use Families whotravel great distances for evaluation need to becertain that services like maintenance repair andreplacement of devices are available within a rea-sonable distance from home

Assistive technology devices are used bestwhen all the people in the life of the individualwith disabilities understand the devices in thesame way At first devices may seem to exagger-ate differences between a person and the rest ofthe world Care should be taken to explain thatassistive equipment is a difference equalizer nota difference maker Classmates and friends needto understand that the adapted seating or adaptedkeyboard helps the individual do what other stu-dents do Adults in a childrsquos life need to under-stand that devices work to make life easier bet-ter and more functional People need to knowthat ramps help keep individuals with mobilitydisabilities from being separated from peers thatcommunication technology allows people to

ldquospeakrdquo their thoughts

Close communication between parents andtheir childrsquos helpersmdashteachers therapists daycare workers and othersmdashis essential to makesure devices and services are being used safelyand effectively If the device is working well butthe child is not being integrated into the class-room or other environments then there may bea need for additional training for the children andadults who interact with the child

Besides keeping track of how the device isworking and being used it is important to ob-serve progress in the areas of technology whichare useful to the individual with the assistivetechnology device As upgrades of equipmentoccur or more sophisticated models come on themarket the user may want to consider modify-ing or replacing the equipment that is currentlyin use Also as the individual becomes moreskilled at using technology the individual mayoutgrow the current device and need to look formore advanced equipment It can be assumedwith most high tech items that in three to fiveyears there will be a need for upgrade or replace-ment The wise consumer begins early to planfor the next step in technology including savingmoney for a new device and staying alert to thenew options that become available

What kinds of training are important to occurwhen a child has a new assistive technologydevice

Because assistive technology of the high techvariety is so new it is particularly important thattraining be provided to all those who may needit In the school setting it is helpful for all edu-cators and administrators to have some aware-ness training so that they have a general idea ofwhat assistive technology is Areas to be cov-ered in inservice training might include

bull legal issues related to assistive technology

bull awareness training concerning how toserve students with assistive technologyneeds

22

bull information on how assistive technologyrelates to the evaluation process

bull how to write IEPs for students who requireuse of assistive technology devices

bull the relationship between technology andstudent placement

bull the nature of common assistive technologydevices

bull resources to contact for information onassistive technology

Beyond these awareness activities thosemembers of the school staff who work directlywith a student who uses technology need to havetraining on the specifics of using the device andhow it is maintained and serviced Trainingshould include but not be limited to the follow-ing

bull review of the studentrsquos educational andassistive technology needs

bull review of goals and objectives supplemen-tary aids and services and related serviceson the IEP or IFSP

bull training on how to use and maintain thedevice

bull training on proper transport of the devicewithin the school building and from hometo school

bull training on how to program the device ifneeded

bull training on how to use the device effec-tively during instruction

bull training in trouble-shooting when the de-vice is not working properly

bull information about what to do when thedevice is not functioning or broken

bull information about how to coordinateassistive technology with all the activitiesin the studentrsquos day

bull training in methods to evaluate the effec-tiveness of assistive technology

Depending on the type of assistive technol-

ogy used by the student and the studentrsquos needsit may be advantageous for assistive technologyinformation to be shared with the studentrsquos peersSuch training will help fellow students to gainan understanding of the studentrsquos assistive de-vice foster acceptance in the social environmentand reduce fears other students may have aboutsocializing with the student who uses technol-ogy In some cases parents and the student maywant to be involved in the peer training

Parents may require training too in order forthe device to be used at home for the student tocomplete homework assignments or participatein extended school year services Once trainedthe parents can become a resource to the studentfor proper care and maintenance of the device

Most importantly the student himself or her-self will need training in how to use the deviceas independently as possible Training for thestudent may be written into the IEP as a separategoal or may be included as a related service thatsupports the studentrsquos special education pro-gram

SummaryPurchasing a high tech assistive technology

device is a major life decision because of the po-tential impact on the individual and because suchdevices can be costly When considering anassistive technology device it is important to dothe following be realistic about the consumerrsquoscapabilities and needs get a multidisciplinaryevaluation examine available technology with acritical eye match the individualrsquos needs to spe-cific equipment features test the device for a trialperiod identify next steps and determine whatneeds to be done for follow-up after purchaseEvaluations for assistive technology both infor-mal and formal should consider first of all thefunctions that the consumer wishes to performusing technology When evaluating a particularpiece of equipment consideration should begiven to the following features performance sim-

23

plicity of design ergonomics reliability safetypracticality aesthetics normalization cost effec-tiveness and personal acceptance Good sourcesof information about assistive devices are manu-facturers publications trade journals previewcenters and consumers who are already using thedevice Once a device is selected the consumerwill need to secure funding for the purchase andbe aware of additional costs for related equip-ment insurance and training

Hints for Parents

Donrsquot let the cost of assistive technology deter youfrom considering it for your child High tech assistivetechnology can be quite costly but it can also makethe difference for your child in terms of becoming welleducated employable and a fully-included member ofthe community Donrsquot leave any stone unturned whenlooking for funding sources Consider any or all ofthe following for funding or assistance

bull Early intervention programs

bull Schools

bull Transition programs

bull Vocational Rehabilitation

bull State Programs for Children with SpecialHealth Care Needs

bull Medicaid

bull Medicare

bull State Technology Resources

bull Used Equipment

bull Leasing

bull Equipment Loan Programs

bull Disability Organizations

SierraSierra wants to play with dolls like other chil-

dren her age but she has a muscle disease thathas caused her to lose muscle tone except in onehand What could be done to allow Sierra to dressand undress her dolls comb their hair and bathethem

Sierrarsquos SolutionThe assistive technology solution for Sierra

involved her whole family While vacationingin Mexico Sierrarsquos grandmother found her a fash-ion doll that was a bit larger than the typicalldquoBarbie dollrdquo The larger doll was easier for Si-erra to manipulate Sierrarsquos mother sewed sev-eral outfits for the doll using velcro instead ofsnaps or buttons as fasteners

Sierrarsquos dad bought doll stands at a toy storeand fastened several stands with clamps toSierrarsquos wheelchair tray He also fastened a plas-tic pouch to the tray Sierra puts the small dollaccessories in the pouch When Sierra wants todress her doll she puts the doll in one of thestands In this way the doll is held securely andSierra can dress and undress the doll with onehand

Sierrarsquos friends also use the doll stands fortheir dolls With this arrangement two or threegirls can play together

Solution SummaryLarger doll

Velcro fasteners

Plastic pouch

Doll stands

Clamps

24

Funding Assistive Technology

F unding for assistive technology is availablefrom a variety of public and privatesources To receive public or private fund-

ing the individual must meet eligibility criteriafor the specific program and provide sufficientdocumentation of the need for assistive technol-ogy

The following list includes some of the pro-grams which may pay for equipment if the indi-vidual needing the device meets their require-ments Many of these programs are run by dif-ferent agencies in different states making themhard to find In general the statersquos Tech Act of-fice can assist consumers and family members infinding and using these programs (See Appen-dix under Resources)

PUBLIC PROGRAMSEarly Intervention Programs (Individuals withDisabilities Education Act Part H)

Young children (0-3) and their families mayreceive help through early intervention programsin evaluating what the child needs in gettingassistive technology and in learning how to useit Equipment and services must be included ina written plan called an Individualized FamilyService Plan (IFSP) To find the program for aparticular state call National Early ChildhoodTechnical Assistance System (NECTAS) at 919-962-2001 or 919-966-4041 (TDD)

Head StartThis child development program provides

comprehensive educational and health servicesfor eligible children ages 3-5 Since 1982 federallaw has required that at least 10 percent of thetotal number of placements must be available tochildren who are disabled and require specialservices Head Start is a mainstream placementoption for children whose IEP calls for placementwith nondisabled children The January 1993Head Start regulations specifically require the

consideration of assistive technology services anddevices For more information contact NationalHead Start Association 201 N Union St Suite320 Alexandria VA 22314 703-739-0875

Schools (IDEA Part B)This program mandates a free appropriate

public education for preschoolers children andyouth with disabilities An Individualized Edu-cation Program (IEP) is required for all childrenwith a disability These children are entitled tospecial education related services or supplemen-tary aids If the IEP team determines that assistivetechnology is required for a free appropriatepublic education then it must be provided at nocost to the child The technology must be in-cluded in the childrsquos Individualized EducationProgram (IEP) Parents have a right to be in-volved and should help to develop the IEP goalswhich may include technology For help in get-ting assistive technology in the IEP call the TAPPFocus Center on Assistive Technology at 1-800-222-7585

State Operated and Supported Schools (Chap-ter I)

This program provides federal assistance tohelp educate children with disabilities who areenrolled in state-operated and state-supportedprograms Federal funds must be used to payfor services that supplement a childrsquos basic spe-cial education program such as construction andthe purchase of equipment For more informa-tion contact your State Department of Education

Section 504 of the Rehabilitation Act of 1973Section 504 provides a civil-rights mandate

that requires accommodations for students whohave disabilities such as orthopedic impairmentsbut who do not qualify for special education ser-vices It denies federal funds to any institutionincluding a school whose practices or policiesdiscriminate against individuals with disabilities

25

This legislation has resulted in a number of out-comes including various actions to remove physi-cal barriers to education which may incorporateassistive technology For more information con-tact the nearest regional Office of Civil Rights orthe State Vocational Rehabilitation Agency

State Programs for Children with SpecialHealth Care Needs

These programs provide and pay for servicesfor eligible children CSHCN programs varywidely from state to state in the services they of-fer the number of children served and the re-quirements for eligibility Some CSHCN pro-grams do pay for assistive technology deviceswhen no other funding source is available andthe equipment is necessary for health-related rea-sons Most CSHCN programs are run by the statehealth agency To contact CSHCN ask informa-tion for the telephone number of the state healthagency

School-to-Work Transition ProgramsTransition Programs are charged with assist-

ing students with disabilities to receive the jobrelated training and placement services to helpthem move from school to work Sometimesassistive technology may be necessary in orderfor a student to make a successful transition andbecome employable If technology is needed fortransition purposes it can be written into thestudentrsquos Individualized Transition Plan (ITP) Toreceive more information about transition andtechnology call the Parent Training and Informa-tion Center (PTI) in your state (See Appendix)

Vocational Rehabilitation ServicesState vocational rehabilitation agencies pro-

vide information evaluation services trainingand funding for technology and education to helpadults go to work or live more independently Iftechnology is necessary for an individual to workVocational Rehabilitation may pay for the equip-ment as part of an Individualized Work-RelatedPlan (IWRP) To locate the nearest Vocational Re-habilitation Agency look in the telephone book

under state government

Plan to Achieve Self-Support (PASS)One of many Social Security Administration

work incentive programs this program providesan income and resource exclusion that allows ablind or disabled person to set aside income andresources for a work goal such as educationequipment purchase vocational training andstarting a business It should be considered forall students with vocational goals who are receiv-ing social security benefits

This program provides a mechanism forpeople to set aside funds to purchase work-re-lated equipment such as assistive technologydevices and services In many cases if an indi-vidual is a recipient of SSI and writes a PASS topurchase education or equipment an additionalSSI check will be provided to cover other livingexpenses Sometimes if a person receives SocialSecurity Disability Insurance (SSDI) and designsa PASS it may make the individual eligible forSSI because the SSDI has been allocated for equip-ment and services

Impairment-Related Work Expense (IRWE)Impairment-Related Work Expense (IRWE)mdash

one of the Social Security Administrationrsquos workincentive programsmdashallows an employed indi-vidual with a disability who receives or is eligiblefor SSI or SSDI to deduct work-related expensesfrom gross reported income

This deduction allows the person to continuedrawing SSDI or SSI and associated benefits(Medicaid or Medicare) if the IRWE deductionreduces earning below the Substantial GainfulActivity (SGA) Test

Although this method does not provide fund-ing to pay for a device or service it is a way ofallowing the use of the individualrsquos own moneyto pay for assistive devices and services neces-sary to return to work The following is a list ofpossible work-related expenses special transpor-tation to and from work personal assistance onthe job structural modifications durable medi-

26

cal equipment prostheses medical supplies andservices work-related equipment non-medicalappliances and equipment routine drug andmedical costs and diagnostic procedure costs

MedicaidMedicaid is a joint federal and state program

which covers some equipment if it is consideredmedically necessary For more information aboutMedicaid and who and what is covered contactthe local Department of Human Services office

MedicareAlthough not a usual source of funds for

assistive technology Part B of Medicare providescoverage for some durable medical equipment ifit is considered medically necessary and is foruse in the personrsquos home For more informationabout Medicare benefits contact the Social Secu-rity Administration Regional Office

Technology-Related Assistance for Individualswith Disabilities Act of 1988

This federal competitive grants program pro-vides monies for states to establish a statewideconsumer-responsive service delivery system de-signed to effect systems change regardingassistive technology In most Tech Act states afunding specialist or policy analyst is availableto assist with accessing assistive technology Sev-eral states operate loan programs to help withthe purchase of devices and services For moreinformation contact RESNA Technology Assis-tance Project 1700 N Moore ST Suite 1540 Ar-lington VA 22209-1903 703-524-6686

PRIVATE PROGRAMS

Private InsuranceSome health insurance plans will buy equip-

ment but it depends on the specific wording ofthe policy Unless the policy says the equipmentis not covered it makes sense to ask the insur-ance company to pay for it The equipment mustbe considered medically necessary and thereforerequires a doctorrsquos prescription

Loans

There are several low or no interest loansavailable to help buy technology Call the stateTech Act program or the manufacturer of theequipment may know where to get this type ofloan

Non-Profit Disability AssociationsThere are many disability organizations

some of which may be able to loan equipment orprovide information about other funding sourcesor support groups These organizations includeNational Easter Seal Society March of DimesMuscular Dystrophy Association United WayUnited Cerebral Palsy Association and the BrailleInstitute

FoundationsSome private foundations have been set up

specifically to provide help to people with dis-abilities A listing of such foundations can befound at the library or may be available from thestate Tech Act program

Programs Providing Assistive TechnologyThe state Tech Act programs offer referrals

for evaluation and equipment recommendationsas well as assistance with identifying funding orequipment lending sources A therapy depart-ment in a local hospital or Disabled StudentsCenter at a local college or university may alsooffer to help locate technology programs in thearea Alliance for Technology Access Centers(ATA) sometimes have loan programs or infor-mation about purchasing used equipment orrenting equipment

Civic OrganizationsThere are many local civic and service orga-

nizations which may provide money to helpsomeone in their community Lists of these or-ganizations are available from the Chamber ofCommerce Examples of these organizations areLions Club Masons Grotto Veterans of ForeignWars (VFW) Elks Club Rotary Club KiwanisKnights of Columbus and Soroptomists Someof these organizations have a national focus on

27

disability or on a particular disability Others willfund devices for a particular child who is knownto the local club

Charities and Fund-RaisersLocal churches high school groups neighbor-

hood organizations labor unions or special in-terest groups (eg computer clubs ham opera-tors) may plan a fund-raiser to help purchaseassistive technology College student organiza-tions (fraternities and sororities) may give moneyor studentsrsquo time to help a special cause Even ifmoney is not available they may be willing tohelp organize a fund raiser

Local media (radio television newspapers)sometimes will sponsor fund-raising activities tofund devices They may not contribute moneybut will help with organizing the fund-raisingactivity and publicizing it to the community

OTHER OPTIONS

In addition to federal and private fundingsources there are a number of education-relatedgrants corporate technology donation programsand funding options that consumers should con-sider Information on these alternative options isavailable through a number of sources includ-ing the following

NewslettersEducation Grants Alert Capital Publications

Inc PO Box 1453 Alexandria VA 22313-2052800-655-5597

Education Technology News Business Publish-ers Inc 951 Pershing Dr Silver Spring MD 20910-4464 301-5878-6300

Financing Assistive Technology Smiling Inter-face PO Box 2792 Church St Station New YorkNY 10008-2792 415-864-2220

Special Education Report Capital PublicationsInc PO Box 1453 Alexandria VA 22313-2053800-655-5597

Technology and Learning Peter Li Inc Publish-ing 330 Progress Rd Dayton OH 45449 415-457-4333

Technology ManufacturersIf it is not possible financially to purchase

equipment consumers can sometimes rent orborrow equipment directly from the manufac-turer

Used EquipmentUsed equipment is often advertised for sale

in disability-related publications or the consumercan place a newspaper ad to see if used equip-ment can be purchased locally Several compa-nies refurbish old computers and sell them at lowprices Listings of used computer outlets can beobtained from ATA Centers or state Tech Act pro-grams

LeasingMany manufacturers of assistive technology

devices have equipment which is available forrent or lease Sometimes the rent or lease pay-ments can be applied toward purchase Checkwith the manufacturer to see if this is an option

Equipment Loan ProgramsMany states have equipment loan programs

as do some rehabilitation facilities and disabilityorganizations Information about loan programsis available from Tech Act programs

HOW TO APPLY FOR FUNDING

There is an art to applying for funding forassistive technology It is necessary to use justthe right words to suit the particular agency thatmight be the funding source It is also crucial todocument the need for and projected outcome ofassistive technology This documentation shouldinclude at minimum

bull A written statement of medical need fromdoctors or other health professionals If thechild had an evaluation by a rehabilitationprofession also include this report

bull A description of the childrsquos problems re-sulting from the disability This descrip-tion can come from the doctor or other pro-fessional who evaluated the child

28

bull Description of how the technology helpsthe child For example the equipment maymake the child safer or allow the child todo things more independently Be sure topoint out how money will be saved if useof the equipment allows attendant care tobe reduced

bull A clear statement based on assessmentthat the child is a good candidate who hasthe cognitive and physical capacities nec-essary for using the technology

In summary the documentation to supportan assistive technology funding request shouldinclude a physicianrsquos prescription the childrsquos as-sessment an explanation of projected benefitfrom use of the technology or service and anycorrespondence obtained from professionals thatwould support the childrsquos need for technology

The initial funding request should include notonly the cost of the device but also the cost ofongoing support and instruction in the use of thetechnology Assistive devices often have ldquohid-denrdquo expenses that are incurred with their pur-chase and these expenses are frequently costlyover time Battery-powered devices may requirefrequent charging or cleaning Upgrades for com-puter software may be necessary Special modi-fications of the home or school environment maybe necessary for the technology to be used Ineach of these examples costs associated with thetechnology may have to be assumed by the fam-ily if they are not considered in the initial appli-cation for funding

It is also helpful to include with the fundingrequest a picture or a descriptive brochure aboutthe device being requested This is importantbecause often persons who are reviewing theapplication do not know about the wide rangeof technologies that might be appropriate

Appropriate wording on the application isabsolutely necessary Key concepts for Medic-aid include ldquomedical necessityrdquo and ldquorestore thepatient to his or her best functional levelrdquo The

term medical necessity means that the device isincluded in the course of treatment being pro-vided to the child and that a professional suchas a physician or speech therapist is supervisingits use Medicaid and private insurers alike gen-erally pay for technologies that help restorepeople to ldquofunctioning levelsrdquo and take the placeof a body part that is not working Typically theseprograms do not pay for technologies or serviceswhose function is educational or life-enhancingrather than health related

The key for private insurance is ldquoterms of thepolicyrdquo It must be remembered that coverageby any insurance company does not set a prece-dent Just because one child receives needed tech-nology under a particular policy issued by a com-pany does not mean that all other covered chil-dren will also have technology paid for by thatcompany Each application stands on its ownbased on the expressed terms of the policy

It is usually under the major medical provi-sions of a health policy that assistive technologycan be provided as ldquoother medical services andsuppliesrdquo It may however be necessary to pur-chase additional insurance coverage or a ldquoriderrdquoin order for technology costs to be included inthe terms of the policy It is important to remem-ber that heath insurance policies are oriented to-ward health care and not toward changes in theenvironment or rehabilitation

Both private health insurance policies andMedicaid sometimes impose limits on the num-ber of assistive technology devices over a certaincost that can be purchased within a certain timeframe Sometimes the rule is that the fundingsource will purchase only one device in theindividualrsquos lifetime With these kinds of restric-tions it is all the more critical to be sure that thetechnology choice is the right one

TIPS THAT LEAD TO SUCCESS

bull Apply to several funding sources at thesame time Be sure to meet the require-

29

ments of each agency

bull Find out if agencies will share costs

bull Fill in the agencyrsquos forms correctly Manyapplications are denied because forms arenot filled out properly

bull In addition to the standard form includeany other information that describes orshows what the equipment does and howit benefits the child Assume no knowledgeon the part of the reviewers

bull Turn in all documentation at the same time

bull Avoid using jargon define all unfamiliarterms

bull Take the funding request package to theagency in person While there have itchecked to make sure everything requiredhas been included Get the name of theperson who reviewed the application

bull Call regularly to check on the funding re-quest each time try to talk to the same per-son

bull Be super politemdashand persistent

WHAT IF FUNDING IS DENIED

It is not at all unusual for an initial fundingrequest to be denied Even when family mem-bers and professionals have been meticulous inpreparing applications requesting funding forneeded technology denials should be anticipatedMaking an appeal is worth the effort since manydenials are reversed at the appeal level

To start the appeal process obtain any docu-mentation or information provided by the fund-ing agency (eg Medicaid or the private insur-ance company) relating to appeal proceduresforms to use timelines and filing procedures forinstance This information will help in the promptpreparation for appeal The kind of appeal to bemade depends on the reason for denial Whendeveloping an appeal find out the following

bull Why the request was denied Ask for thereason in writing Sometimes requests are

denied because a reviewer lacks under-standing of the technology or there maybe an error in the paperwork

bull If needed correct any mistakes or includemore information then resubmit the re-quest

Going to appeal makes sense because gener-ally the appeal places the application before moreexperienced persons in the decision-making hi-erarchy The technology requested is often newand the initial examiners in the process may beunaware of its usefulness Also insufficient docu-mentation may have been provided in the origi-nal application and the problem can be remediedon appeal

Donrsquot be daunted by the length of the appealprocess Follow it through to its completion Insome states families may be able to appeal a de-nial beyond the first level For example somestates have ldquounfair claims settlement practicesrdquoregulations which are administered through theinsurance commissionerrsquos office

Always make your appeal in person and takethe child and the equipment if possible If onlypart of the money is offered by one agency askanother agency to share costs If the appeal isdenied try again Submit the funding request toanother agency Being persistent will nearly al-ways result in success

When going through the appeal process turnto the state Protection and Advocacy Program (Pamp A) for guidance and support P amp A advocatescan help make sure that a childrsquos rights to tech-nology and related services are not denied

Who pays when assistive technology is neededat school

The party who is responsible for paying forassistive technology depends upon the circum-stances under which the technology is purchasedUnder the special education law students withdisabilities who are eligible for special educationare entitled to a free appropriate public educa-tion Parents do not have to pay for school ser-

30

vices including assistive technology if that ser-vice is part of the studentrsquos Individualized Edu-cation Program (IEP) If the student is eligible forMedicaid the school district can request thatMedicaid pay for the device If parents choose todo so they may agree to use private insurance topay for a device that is used at school Parentscannot however be forced to use their insurancein this way If the private insurance requires aco-payment the school district would have to paythis amount since parents should not have to payany special education related costs

Does Section 504 pay for assistive technologySection 504 part of the Rehabilitation Act of

1973 is basically a piece of civil rights legislationthat is intended to prevent discrimination againstindividuals with disabilities in any programwhich receives federal funding Students whohave disabilities but who do not qualify for spe-cial education may still be eligible for accommo-dations under Section 504 of the RehabilitationAct of 1973 Section 504 however does not pro-vide any funding for accommodations

Like the special education law Section 504requires public schools to provide students withdisabilities with a free appropriate public educa-tion and in addition ensures that students withdisabilities are afforded an equal opportunity toparticipate in school programs For students withdisabilities this means that schools may need tomake special arrangements so that these studentshave access to the full range of programs andactivities offered For example a student whoneeds a wheelchair lift on a school bus to get toschool must be provided with this technologyOther modifications which might be requiredunder Section 504 include installing ramps intobuildings and modifying bathrooms to provideaccess for individuals with physical disabilitiesEven though required by the law none of thesetypes of modifications would be funded by Sec-tion 504

Under what circumstances does private health

insurance pay for assistive technologySome private health insurance policies will

pay all or part of the cost for some assistive tech-nology devices The devices are unlikely to belisted specifically in the policy but may be in-cluded under some generic term like ldquotherapeu-tic aidsrdquo Usually the devices have to be pre-scribed by a physician in order to be covered bythe policy

When does Medicaid cover assistive technol-ogy

Medicaid (Title XIX) will pay for ldquoprostheticdevicesrdquondashthat is replacement corrective or sup-portive devices prescribed by a physician or otherlicensed person Each state has some flexibilityin determining which prosthetic devices it willinclude in its list of Medicaid covered expensesDevices that are frequently covered by Medicaidare canes crutches walkers manual wheelchairshospital beds and hearing aids or eyeglasses forchildren and youth

SummaryAssistive technology can be expensive to pur-

chase but there are a number of public and pri-vate sources for funding devices Common pub-lic funding sources include early childhood in-tervention programs schools Vocational Reha-bilitation and Medicaid Private sources mayinvolve health insurance personal loans chari-table donations or fundraising It is very impor-tant to provide proper documentation and usecorrect wording and procedures when request-ing funding Initial requests for funding are fre-quently turned down but appeals can be success-ful

31

TEDTed is an active four-year old who lives in a

small rural community with his parents andyounger sisters He was identified as speech im-paired and has been attending preschool specialeducation classes Ted has normal mental capa-bilities but his mild cerebral palsy impairs hisability to speak Because of the speech therapyhe has received Ted is able to make some speechsounds but he says no intelligible words Heuses sign to communicate with his special edu-cation teacher and his parents No one else inhis community uses sign so Ted is limited in hisability to communicate with others

As Tedrsquos IEP Team looks ahead to his entryinto elementary school the Team recognizes thathe will need better communication skills in or-der to participate successfully in the regular class-room His speech therapist has recommendedthat Ted begin to use an AlphaTalker

What funding sources might pay for theAlphaTalker

What case could you make for funding Arethere any obstacles to seeking funding

TEDrsquoS SOLUTIONAt this point Tedrsquos ability to communi-

cate is somewhat primitive Because of his cere-bral palsy he is not able to make conventionalsigns so the gestures he makes are understoodonly by those who know him well A simple elec-tronic communication device may work for Tedbut there are some prerequisite communicationskills he will have to master first Augmentativecommunication devices operate on the principleof choosing icons (abstract symbols) that repre-sent certain basic communications like a cup toindicate ldquoI want a drinkrdquo

In order to make a picturesymbol systemmeaningful and functional for Ted at his youngage his speech therapist began to work on point-to-object and point-to-picture activities WhenTed had mastered point-to-picture activities histherapist made a picture ring for him On thering were picture symbols (icons) for things thatTed might want to say Tedrsquos family his teacherand his classmates began to ask him to use hispictures to explain what he wanted Soon Tedwas using pictures to communicate simple wantsand needs effectively His word ring went withhim everywhere and helped him to ldquotalkrdquo topeople he did not know as well as to friends andfamily members

An unexpected bonus to the picture practiceis that Ted is verbalizing more and his speech hasbecome more intelligible He has even begun tosing An electronic communication device maybe in Tedrsquos future but for now he is learning tocommunicate well with his picture ring and somespoken words

Solution SummaryPoint-to-picture practice

Use of picture ring

32

GLORIAGloria an eighteen year-old with mild cog-

nitive delays and CP is about to finish highschool She has been using a laptop computerand switch access hardware and software in lieuof a pencil and paper to complete work in highschool The equipment and software were pro-vided by the school district through the IEP pro-cess Gloriarsquos current goal articulated in her In-dividual Transition Plan (ITP) as mandated byIDEA is to have a full-time job by the time she is22 She wants to work in an office and woulduse a computer system similar to her currentsetup As she moves into the transition periodthese questions must be addressed

Will the laptop computer she has been usingbe functional for her in the workplace

Will she need to consider new equipmentWhat would influence a decision to purchase newequipment

What funding sources might help Gloria topurchase new equipment

What case should Gloria make for funding

GLORIArsquoS SOLU-TION

Gloria is fortunate to have learned computerand word processing skills while she was inschool Now she must learn ways to transferthese skills into the work setting Laptop com-puters are not typical in offices instead whatGloria is more likely to encounter is a desktopworkstation with computer and printer In or-der to use a standard computer Gloria will needa switch access device and an onscreen keyboardto do word processing and data entry

Since single switch access is necessary forGloria to become employed in an office settingGloriarsquos Vocational Rehabilitation Counselor waswilling to make such a purchase for her Gloriaapplied to be a data processor with a temporaryemployment firm and got the job Gloriarsquos VRcounselor helped her to select switch access hard-ware compatible with most IBM compatible com-puters In her new job Gloria changes office set-tings frequently Each time she moves she takesher switch access device and onscreen keyboardsoftware with her With these portable items sheis able to adapt each new office setting to meether needs Having the right technology has madeGloria an adaptable and successful temporaryoffice employee

Solution SummarySwitch access

Onscreen keyboard software

33

Making Assistive Technology a Part ofChildrsquos Education

The ideal time for a child with a disabilityto learn to use assistive technology is whenthe child is learning all sorts of others skills

in early intervention services preschool and K-12 education Children who are eligible for earlyintervention services under Part C or special edu-cation under Part B of the Individuals with Dis-abilities Education Act (IDEA) are entitled to beevaluated for assistive technology needs and toreceive assistive technology devices and servicesif they are necessary to providing a free appro-priate public education In order for children toreceive the assistive technology to which they areentitled parents must be knowledgeable abouthow assistive technology fits into special educa-tion and the ways that AT can be included in achildrsquos Individualized Family Service Plan (IFSP)or Individualized Education Program (IEP)

ASSISTIVE TECHNOLOGY FOR YOUNG CHILDRENParents are often surprised to learn that

assistive technology can be appropriate for in-fants and toddlers Very young children whohave disabilities that limit their ability to inter-act with the environment by crawling touchingseeing or hearing can benefit from technologythat improves their interactions Federal educa-tion amendments require states to ldquopromote theuse of assistive technology devices and assistivetechnology services where appropriate to en-hance the development of infants and toddlerswith disabilitiesrdquo These amendments furtherrequire states to ldquofacilitate the transition of in-fants with disabilitiesfrom medical care to earlyintervention services and the transition fromearly intervention services to preschool specialeducation or regular education servicesrdquo

When Kayla was an infant her interactionswith the environment were very limited because

she has a genetic condition resulting in abnor-mally short arms and legs She could not turnover or crawl she had difficulty touching andgrasping objects As part of her early interven-tion program Kayla was introduced at the ageof six months to the use of switches When theswitches were positioned correctly she could ac-tivate switch-operated toys or noisemakers Theopportunity to interact with toys opened upKaylarsquos world She soon began to hunt for theswitches and to activate certain toys on com-mand She used the switches to make choicesbetween toys or sounds She became verballymore expressive and began to interact morereadily and more often with her parents and sib-lings

By the time that Kayla was three and readyfor preschool special education she was able tosit up and interact with a computer activated byswitches She could identify objects on the com-puter screen and match those objects to real ob-jects in the world around her At three Kaylacould identify and match some letters and shapeson the computer screen Though limited in hermobility Kayla became an active participant inclassroom activities She could interact withclassmates by playing computer games joiningin at circle time and participating in allpreacademic learning activities

Assistive technology was an integral and nec-essary part of Kaylarsquos early intervention servicesKaylarsquos parents were involved in writing the In-dividualized Family Service Plans (IFSPs) thatoutlined the services Kayla and their familyneeded From the beginning Kaylarsquos family hadthe opportunity to see how assistive technologycould be included in the IFSP and really make adifference in Kaylarsquos education and her life

Kaylarsquos story illustrates how assistive tech-

34

nology can be utilized from an early age and canbe part of the transition from medical treatmentto early intervention and from early interventioninto preschool special education or regular edu-cation Because of the availability of early inter-vention services there is no reason to wait untila child is of school age before trying assistive tech-nology Early use of the necessary technology willenhance a childrsquos development by increasingopportunities to interact with the environment

ASSISTIVE TECHNOLOGY AT SCHOOL AGE ANDBEYOND

When students enter kindergarten and begintheir regular public school years assistive tech-nology can continue to be a part of their specialeducation programs For students who are eli-gible for special education assistive technologymust be provided when it is necessary

(1) to support placement in the least restric-tive environment

(2) to ensure that a student benefits from hisor her education or

(3) to implement the goals and objectives inthe studentrsquos IEP

Needs for assistive technology should be oneof the considerations when a student is assessedto determine eligibility for special education Ifan assessment reveals that a student is eligiblefor special education then the multi-disciplinaryteam should consider assistive technology needswhen making recommendations for the Individu-alized Education Program (IEP) The team shouldanalyze what is required of nondisabled studentsof the same age and determine how many of theserequirements could be completely or partiallyfulfilled by the student being assessed if that stu-dent had access to appropriate assistive technol-ogy

In addition when information is being col-lected for the present level of performance sec-tion of the IEP part of that assessment should bea consideration of whether or not assistive tech-nology is necessary for the student to achieve

educational or social goals benefit from educa-tion or make reasonable progress in the least re-strictive educational setting Whoever is collect-ing the information might experiment withassistive technology applications to determinewhich ones might work for the particular student

Assistive technology should be considered asan option for every IEP Some students of coursewill not require technology but many studentswill benefit from technology that helps them tocompensate for their impairments School dis-tricts are not required to provide all of the pos-sible assistive devices that might be nice to haveor might provide the best possible arrangementsAssistive technology is required however whenits presence enables the student to make reason-able progress toward the goals the IEP Team iden-tifies

HOW TO INCLUDE ASSISTIVE TECHNOLOGY INTHE IEP

Assistive technology can be included in theIEP in a number of ways It may appear as partof the studentrsquos annual goals or short term objec-tives It may also appear in a list of specific ac-commodations which need to be made in orderfor the student to function in the least restrictiveenvironment For example the IEP might includesuch accommodations as the use of word pro-cessing use of a calculator use of a hand heldspell checker and so forth In addition the IEPmay specify that as a related service necessaryfor the student to benefit from his or her educa-tion the student will receive training in the useof assistive equipment like an electronic commu-nication device a power wheelchair or a personalcomputer

WHERE TO PUT ASSISTIVE TECHNOLOGY IN THEIEP

There are three places in the IEP whereassistive technology may appear (1) in the an-nual goals and short term objectives (2) in theenumeration of supplementary aids and servicesnecessary to maintain the student in the least re-

35

strictive educational setting and (3) in the list ofrelated services necessary for the student to ben-efit from his or her education

Assistive technology can be a part of the an-nual goals and short term objectives on an IEPbut there must be a certain degree of specificityin the goal in order for the role of assistive tech-nology to be clear An annual goal for the IEPshould express an estimate of what the studentcan accomplish in a particular domain during thecourse of one year under what conditions theskill is to be developed and what criteria will beused to indicate whether or not the skill has beenlearned

Many times IEP goals are broad vague andtotally nonspecific Such goals are impossible tomeasure and do not give any indication of whatis realistic to expect in terms of the studentrsquos be-havior or skill level in the course of a yearrsquos timeSuch broad goals are not useful in addressingassistive technology The inclusion of assistivetechnology in the IEP requires a degree of speci-ficity so that it is clear how and why the technol-ogy will be used to accomplish a particular goal

An annual goal which includes assistive tech-nology may indicate that the technology will bepart of the conditions under which some aca-demic or social skill will be acquired For ex-ample an IEP goal for a student with a learningdisability in written expression may look like this

10 Using a word processing program with spell-ing checker Shawn will compose three paragraphthemes composed of fifteen or more sentences with 80or better accuracy in the use of spelling punctuationand grammar

Objectives leading to this goal might includepreliminary exploration of the word processingprogram trials to learn effective use of the spell-ing checker drill and practice in writing singleparagraphs to the 80 level of accuracy in spell-ing punctuation and grammar increasing thelength of writing to two paragraphs and theneventually moving to three paragraphs with

gradually increasing degrees of accuracy

Another type of annual goal may address askill which is necessary for using assistive tech-nology Such a goal might appear this way

20 Using an adapted computer keyboard Rachelwill type 12 words per minute with no errors over 10or more consecutive trials

In this case Rachel would spend a year learn-ing keyboarding skills with the goal of achievingat least 12 words per minute with complete ac-curacy For a young student who experiencessome fine motor difficulties this goal would bechallenging but it might be achievable in a yearrsquostime Objectives leading to this goal might in-volve preliminary exploration of the keyboardgradual introduction of the letters and numberson the keyboard practice to build speed and ac-curacy and eventually timed trials until 10 con-secutive trials could be achieved with no errorsat a rate of 12 words per minute or better

Still another type of annual goal might ad-dress a social issue like communication withpeers

30 Using an electronic communication deviceSara will respond appropriately to social inquiries fromclassmates 5 times out of 5 opportunities over 5 con-secutive days

Objectives leading to this goal might includetraining in the use of particular words andphrases on the communication device drill andpractice in responding with the device in struc-tured settings increasing accuracy in respond-ing in structured settings practice in unstruc-tured conversational opportunities and gradualachievement of accuracy in unstructured conver-sational settings with peers

ASSISTIVE TECHNOLOGY AS A RELATED SERVICEAssistive technology can be a related service

just like audiology physical therapy or speech ifit is necessary for the student to benefit from hisor her education For a student to be successfulin using assistive technology he or she must be

36

trained in its use Training to use a computer anaugmentative communication device a PhonicEar or large type viewer or other similar devicescan occur as a related service which supports thestudentrsquos educational program Preparation forthe use of assistive technology can also be workedinto other related services like occupationaltherapy Occupational therapy may involve de-termining correct positioning to take advantageof assistive technology and exercises to preparethe student to use a computer keyboard or a com-munication board

Margo who has muscular dystrophy uses alaptop computer every day in her sixth gradeclass Margorsquos upper body strength is diminish-ing and she is gradually having greater andgreater difficulty using her hands for writing ordrawing Using a computer saves her energy andallows her to keep performing well in the class-room As a related service in her IEP Margo isreceiving occupational therapy designed to pre-pare her for even more adaptations which maybe necessary as she loses more strength Margoand her therapist are experimenting with com-puter access devices (eg switches trackball) andon screen keyboards to determine what methodMargo would like to use when her hands are nolonger strong enough to type on a standard key-board This special training for assistive technol-ogy is written into Margorsquos IEP as a related ser-vice because such training is necessary for her tocontinue to benefit from her education

ASSISTIVE TECHNOLOGY SUPPORT FOR PLACE-MENT IN THE LEAST RESTRICTIVE ENVIRON-MENT

One important feature of assistive technologyis the fact that it can make it easier for studentswith and without disabilities to learn togetherStudents with disabilities are guaranteed the rightto be with nondisabled peers and to receive theireducation in the setting which is the least restric-tive environment In order to be successful in theleast restrictive environment students are to be

afforded whatever supplementary aids and ser-vices are necessary Among the supplementaryaids which may allow a student to remain in aless restrictive environment are a variety ofassistive devices that compensate for disabilityand allow the student to perform educational andsocial tasks Assistive technology is necessary asa supplementary aid if its presence (along withother necessary aids) supports the student suffi-ciently to maintain the placement and its absencerequires the studentrsquos removal to a more restric-tive setting For example if a student with mul-tiple physical disabilities can make progress onhis or her IEP goals in the regular classroom withthe use of a computer and an augmentative com-munication device and cannot make suchprogress in that setting without the devices thenthose devices are necessary supplementary aids

Lyle a fourth grader with cerebral palsy is agood example of a student who thrives in theregular classroom if he has the use of appropri-ate technology Lyle is able to keep up academi-cally with his classmates if he has access to a com-puter with an adapted keyboard and word pre-diction software Lyle has learned to type welland is able to do written assignments in relativelythe same amount of time as other students in hisclass Without a computer Lyle could not keepup at all Handwriting is a laborious task for Lyleand his written product tends to be messy andbarely readable If he could not use a computerLyle would have to rely on others to do hand-writing for him or he would have to do alterna-tive assignments that require no writing

Lyle likes being a regular fourth grader Heis proud of his writing on the computer becausehe is using his own words and learning to editout his mistakes by himself With his computerhe does not need the services of an aide and canbe completely independent in doing his schoolwork

Assistive technology in the form of a com-puter with appropriate software and keyboard

37

adaptations is necessary for Lyle to remain in theregular classroom working independently Thisuse of the computer can be written into his IEPas a supplementary aid which is necessary tosupport Lylersquos placement in the least restrictiveenvironment

Does assistive technology include access toschool buildings

AT certainly can mean devices that provideaccess to school buildings and facilities Oneimportant part of a free appropriate public edu-cation is that students with disabilities are ableto get to school get into the school and use theschool building and facilities Assistive technol-ogy can be used to provide access to the schoolbus classroom playground gymnasium audi-torium lunchroom or the equipment in themAny or all of these needs can be addressed in theIEP

Bus modifications for improved access andappropriate seating can help with transportationto and from school and school activities Doorswalkways handles switches stairs steps can bemodified so that a student with disabilities canuse them as effectively as classmates Appropri-ate seating and playground modifications canhelp include students who have disabilities atclassroom lunchroom and recess times

When an individual graduates from publicschool is it still possible to have assistivetechnology

If individuals benefit from the use of assistivetechnology during their school years the likeli-hood is that assistive technology will be evenmore important for them in adult livingAssistive technology can certainly be part of anindividualrsquos future after high school but it is nec-essary to begin planning for the transition fromhigh school so that the technology and other nec-essary services are available when needed

The earlier a family can estimate their childrsquospost-high school needs including needs for tech-nology the earlier transition planning can begin

Federal legislation says that transition planningcan begin in school as early as ldquo14 or youngerrdquoEach student with a disability who has an Indi-vidualized Education Program (IEP) should havea ldquostatement of transition servicesbeginning nolater than age 16rdquo This means that as early asmiddle school but probably not later than fresh-man year in high school families should begintransition planning

Unlike school services services in the adultworld are not mandated An individual may beeligible for a disability service but not receive itbecause all of the slots are filled or funding is notavailable If an individual does not own his orher own assistive technology devices then partof transition planning will be looking into fund-ing sources that could help with technology pur-chases If technology is necessary for the indi-vidual to become employed it is possible thatVocational Rehabilitation will pay for the devicesas part of an Individual Work-Related Plan(IWRP) Students who go on to postsecondaryeducation at community college vocational-tech-nical schools or universities can expect to be ableto receive certain accommodations for their dis-abilities while on campus Most postsecondaryinstitutions have Student Support Services thathelp with assistive technology needs alternativetesting readers and notetakers

SummaryAssistive technology can be included as an

integral part of a studentrsquos education but par-ents have to be knowledgeable about how to goabout getting assistive technology into theirchildrenrsquos educational plans Assistive technol-ogy can be written into the Individualized Fam-ily Service Plan (IFSP) for infants and toddlers inearly intervention programs and into the Indi-vidualized Education Program (IEP) forpreschoolers and students in grades K through12 Assistive technology can appear in threeplaces in the IEP (a) as part of the goals and ob-jectives (b) as a supplementary aid to support

38

placement in the least restrictive environmentand (c) as a related service Assistive technologycan also be a part of studentsrsquo transition planningas they move from high school into adult pur-suits Assistive technology is available throughVocational Rehabilitation and other adult disabil-ity services but these services are not mandatedTo ensure continued use of assistive technologyit is important to plan ahead and secure fundingfor devices needed in the work or postsecondaryeducation environments

Hints for Parents

If your child is a successful assistive technologyuser begin to save money early in your childrsquos lifemdashjust as you might save for college Gradually accu-mulate enough funding to purchase the kinds of tech-nology your child will need as an adult Technologychanges so fast that it is impossible to predict whatwill be available fifteen years from now But a parentcan be certain that assistive technology of the futurewill be even better than what is available today

EmilyEmily is a seventh grade student who has

learning disabilities She is in regular classes allday in her neighborhood middle school A spe-cial education teacher monitors Emilyrsquos progressand provides the regular classroom teachers withassistance by modifying some of Emilyrsquos assign-ments giving her oral tests helping to organizeEmilyrsquos work and reteaching certain skills asnecessary In elementary school Emily did wellwith the limited amount of support she receivedin the regular classroom In middle school how-ever she is having trouble keeping up with as-signments Emilyrsquos spelling is inaccurate sheoften misspells the same word three or four dif-ferent ways on the same page Her handwritingis very slow and laborious so she spends manyhours each evening working on her homeworkShe has tried tape recording assignments but shefinds this process also to be laborious because itis so time consuming to correct mistakes

It has been recommended that Emily be re-moved from some of her academic classes andreceive instruction in the resource programEmily wants to remain in regular classes but shecanrsquot keep up with the pace

How could assistive technology help Emily

What are her needs

What case could be made for assistive tech-nology for her

39

Emilyrsquos SolutionEmily has reached the point in her educa-

tional career when she cannot keep pace with thedemands of the written work On observingEmily the occupational therapist noted that ittook Emily five times as long as the average stu-dent in her English class to complete written as-signments

Emilyrsquos IEP Team decided she was spendingfar too much time on the handwriting processTo help her with this problem the team agreedthat Emily should learn to use a computer with aword processing program and a voiced spellchecker One period per day Emily goes to theresource room to practice keyboarding and workon longer written assignments During her regu-lar classes Emily uses a portable word proces-sor (eg AlphaSmart) to take notes which shecan print out later in the resource room

These simple solutions allow Emily to speedup her writing time and produce written workthat is easy to correct and edit With technologyto aid her Emily is spending less time on thehandwriting process and more time on thinkingand processing information Her homework timehas been cut in half and Emily is much more re-laxed and confident at school

Solution SummaryKeyboarding training

Use of computer with word processingsoftware

Use of voiced spell checker

Use of portable word processor

BryanBryan is a seventh grader with a neuro-mus-

cular disease that has caused him to lose physi-cal function He is a bright student with excel-lent academic skills Bryan uses a laptop com-puter with a trackball and an onscreen keyboardto do all his written work He navigates skill-fully around the school building using a powerwheelchair Technology has really helped Bryanto fit in and do well at school However now asa young adolescent Bryan is beginning to feelleft out socially He requires so much help withhis physical needs that he has to spend lots oftime with adults Bryan wants to ldquohang outrdquo likethe other kids his age and escape adult scrutinyonce in a while

Bryan is nonverbal He uses a complex so-phisticated electronic communication device toparticipate in class The device is programmedwith phrases that Bryan frequently uses and healso can select icons to create sentences of hisown Bryanrsquos communication device works wellfor him in formal classroom settings but it isbulky and cumbersome to use in casual conver-sation with friends Bryan has come to believethat his communication device is actually a bar-rier to the kinds of informal interactions he wantsto have

Bryan knows that he has the best in technol-ogy and that the equipment he uses was very ex-pensive He doesnrsquot want to appear ldquogreedyrdquo ordemanding so he has not told his parents abouthis dissatisfaction with his ability to communi-cate One of Bryanrsquos friends Michael howevernoticed that Bryan was acting pensive and un-usually quiet Michael gently coaxed the truthout of Bryan and offered to help his friend thinkof a new way to ldquotalkrdquo that would provide himwith more flexibility and independence

40

Bryanrsquos SolutionWhen Bryan and Michael put their heads to-

gether they came up with lots of ideas The onethey settled on as the most feasible involved us-ing the laptop that Bryan already had The laptophad some advantages because it was small andportable and Bryan already knew how to use itvery well In a catalog of special needs softwarethe friends found communication software thatoperated on an icon system and the price wasright--around $100 With communication soft-ware installed on the laptop Bryan had asimplermore portable device for talking in ca-sual settings

Next Michael asked his father to help themmake a tray for Bryanrsquos wheelchair that wouldhold the laptop and fold down beside the chairout of the way when not in use Michaelrsquos dadcame up with a clever tray on hinges that foldedto the side The laptop fastened to the tray withwide rubber bands A handle on the tray allowedBryan to raise and lower the tray as needed

In addition to his laptop Bryan also neededa device for quick greetings and spontaneous re-torts Bryan and Michael chose a programmableswitch with the capacity to record up to 12 mes-sages Bryan could operate the switch quickly byhitting it with his elbow He and Michael had agreat time recording messages suitable for talk-ing to their friends or to girls

What Bryan found out was that he neededmultiple ways to communicate so that he couldcustomize his electronic speech to fit the settingand the occasion For a relatively small financialinvestment Bryan and Michael were able to ex-pand communication possibilities for Bryan andallow him greater control and personal choiceabout what he said how he said it and to whom

Solution SummaryCommunication softwareDrop-down wheelchair trayProgrammable switch

TracyTracy is a man in his mid-thirties who has

been blind from birth Since graduating fromcollege he has held a series of entry level jobs atminimum wage and without benefits Tracy isfrustrated by the lack of challenge in the jobs hehas had he would like to have a managerial po-sition with some opportunities for advancementbetter pay and benefits

Currently Tracy is working at a Pizza Hutrestaurant where he prepares pizzas for the ovenHe enjoys his co-workers and regular customersbut Tracy wants more A management traineeopening has been announced in the companynewsletter and Tracy decides to apply This newposition involves taking pizza orders over thetelephone and sending the order via computerand modem to the appropriate Pizza Hut outletwhere the pizzas will be made Having madeevery possible type and size of pizza Tracy isvery familiar with the options But how couldhe operate the computer and record orders asthey come in over the telephone Would he havea chance for this job which could be his first stepup

41

Tracyrsquos SolutionTracy and his Vocational Rehabilitation Coun-

selor filled out the job application for the posi-tion at Pizza Hutrsquos central ordering facility andTracy was called to set up an interview Prior tothe interview Tracy and his job counselor wentto the central ordering facility for Pizza Hut tostudy aspects of the job and to determine if tech-nology could assist Tracy to perform the essen-tial job functions The job involved the follow-ing steps (1) greeting the customer and takingdown customer information (2) asking a seriesof questions about the customerrsquos order (egtype size toppings) (3) simultaneous record-ing of the order via computer and (4) sendingthe order to the appropriate Pizza Hut outlet

After studying the process of taking ordersTracy and his counselor decided upon the follow-ing technology

(a) A computer compatible with the Pizza Hutnetwork

(b) Voiced software so that Tracy couldldquohearrdquo what he was typing

(c) A telephone headset to listen to the cus-tomer with one ear

(d) an ear piece to listen to the computer

At his interview for the job Tracy explainedhis qualifications for the position--college degreeexperience with Pizza Hut He also told the in-terview team about how technology would al-low him to do the job as efficiently and effectivelyas other workers

The interview team members were impressedby Tracyrsquos initiative and his work ethic Theychose him over several other qualified candi-dates Though it took some detective work toput together a computersoftware package com-patible with Pizza Hutrsquos system Tracy was ableto do it

From the first day on the job Tracy knew he

was going to like it better than anything he haddone before Listening to the computer and thecustomer simultaneously was challenging at firstbut soon Tracy had mastered the process Afterthree months in his new position Tracy wasasked to become the manager for his shift Nowhe hires and trains new order clerks schedulesworkers and evaluates their job performanceTracy has what he wanted--a managerial posi-tion better wages and a future with the com-pany

Solution SummaryCompatible computer terminal

Voiced software

Telephone headset

Ear piece for computer

42

Advocating forAssistive Technology

In the area of Assistive Technology mdash just as in so many areas of need mdash parents must betheir childrenrsquos best advocates Federal and

state laws support providing assistive technol-ogy to individuals with disabilities but theselaws are only meaningful when parents knowabout them and can use legal processes to securetheir childrenrsquos rights Here are just a few of thelaws on which parents can rely when advocat-ing for assistive technology for their children

THE AMERICANS WITH DISABILITIES ACT OF1990

The Americans with Disabilities Act (ADA)proposes to eliminate ldquodiscrimination againstindividuals with disabilitiesto address the ma-jor areas of discrimination faced day-to-day bypeople with disabilitiesrdquo The ADA applies spe-cifically to the areas of employment public ac-commodations and government functions Inthese areas the ADA requires that reasonable ac-commodations be made so that people with dis-abilities can have an equal opportunity to par-ticipate in employment opportunities public ac-commodations and government functions TheADArsquos definition of ldquoauxiliary aids and servicesrdquoits mandates for ldquoacquisition or modifications ofequipment and devicesrdquo and ldquoreasonable accom-modationsrdquo support the provision of assistivetechnology devices and services to individualswith disabilities

THE REHABILITATION ACT OF 1973Section 504 of the Rehabilitation Act requires

that any ldquoprogram or activity receiving Federalfinancial assistancerdquo comply with non-discrimi-nation rules Section 504 Regulations require thatpublic schools provide students who have dis-abilities an educational opportunity equal to theeducational opportunity provided to students

without disabilities Section 504 also uses theterm ldquoreasonable accommodationsrdquo which canmean the provision of assistive technology de-vices and services

THE INDIVIDUALS WITH DISABILITIES EDUCA-TION ACT (IDEA)

The Individuals with Disabilities EducationAct (IDEA) requires free appropriate public edu-cation (FAPE) for students with disabilities IDEAmandates education in the least restrictive envi-ronment requires schools to use supplementaryaids and services special and related services tohelp assure that students with disabilities par-ticipate in and benefit from public educationAssistive technology is specifically mentioned inIDEA as a service which school districts may haveto provide in order for a student with disabilitiesto benefit from special education

THE CARL PERKINS ACTThe Carl Perkins Act assures that Vocational

Education programs in public schools are madeaccessible to students with disabilities The lawassures supplementary services including class-room curriculum and equipment modificationssupportive personnel instructional aides and in-structional devices

PARENT RESPONSIBILITIESIn order to be effective advocates for their

children parents need to familiarize themselveswith all the laws that support the provision ofassistive technology Copies of the laws and theirregulations are available from the offices of mem-bers of the House of Representatives and the Sen-ate

Besides knowing the law parents must par-ticipate actively in developing plans for theirchildrenrsquos education that include assistive tech-nology when it is needed Parents must attend

43

IFSP and IEP meetings and be prepared to workcooperatively with other team members Whena parent questions an assistive technology evalu-ation or an IEP Team recommendation the par-ent must be prepared to follow-up on those ques-tions including using due process rights whennecessary

What should a parent do when an agencyrefuses to pay for assistive technology that achild needs

Agencies like early intervention programsand school districts are mandated to provideassistive technology if the need for technology isin the childrsquos written plan If one of these agen-cies refuses to pay for needed technology then aparent must consider using due process rightsIn early intervention services the parent wouldfollow the appeal process laid out by the leadagency for Part C When school district servicesare involved the parent can file a complaint ifservices in the IEP are not provided or can askfor a due process hearing if the parent and theschool district disagree about the need forassistive technology If a parent disagrees withthe results of an evaluation for assistive technol-ogy the parent can ask for an independent evalu-ation at school district expense

SummaryOverall getting the devices and services for

children with disabilities means that parents mustbe part of the planning team at every level of theirchildrenrsquos education It means talking with otherfamilies and users of assistive technology aboutdevices and services learning how they foundthe best technology and figuring out where togo when resources are few Getting assistive de-vices and services is not always an easy job Buthelp is available Working with professionalstalking with consumers and other families par-ents can find the best avenues for providing theirchildren with the assistive technology they needIn the end the effort is worth it because assistive

technology is not just a civil right guaranteed bylaw it is also a means to achieve human rights togrow up happy independent and self-sufficientas possible

Hints for Parents

When advocating for your child in the special edu-cation arena donrsquot forget the following facts aboutassistive technology and the IEP

bull Assistive technology needs must be con-sidered along with a studentrsquos other edu-cational needs

bull Needs for technology must be identifiedon an individual basis

bull Identification of technology needs mustinvolve parents the student when appro-priate and a multidisciplinary team

bull Parents or other IEP Team members can askfor additional evaluation or an indepen-dent evaluation to determine assistive tech-nology needs

bull When an evaluation is being conductedconsider mobility fine-motor skills com-munication and alternatives to traditionallearning approaches

bull Lack of availability of equipment or costalone cannot be used as an excuse for de-nying assistive technology services

bull If included in the IEP assistive technologyservices and devices must be provided atno cost to the family

bull Parents always have the right to appeal ifassistive technology services are denied

44

More Questions and Answers

A re schools required to pay forassistive technology devices andservices

It is the responsibility of the school dis-trict to provide for the equipment services orprograms identified in the IEP The school dis-trict may pay for the equipment service or pro-grams itself utilize other resources to provide orpay for the device or utilize private insurancefunds Medicaid or other sources of funds as longas the device or services identified in the IEP areprovided at no cost to the parent Private insur-ance or Medicaid may be used ony if the parentagrees

Can schools require the parents to payfor an assistive technology device orservice identified in the studentrsquos IEPor require the parents to use theirown private health insurance to payfor the device or service

No The ldquofreerdquo in FAPE means that parentsof students with disabilities who require assistivetechnology devices or services do not have to payfor these items As stated in IDEA and its regu-lations all special education and related servicesidentified in the studentrsquos IEP must be providedldquoat no cost to the parentrdquo The term ldquofreerdquo is in-terpreted broadly and goes far beyond the simplepaying of deductibles and co-payments Thecourts have interpreted ldquofreerdquo to apply to butnot be limited to future insurability depletionof maximum lifetime caps raised premiums dis-continuation of policies and preexisting condi-tion exclusions If the family agrees to allow theschool to access their Medicaid or private insur-ance this decision must be strictly voluntary onthe part of the family

How can school districts use Medicaidfunds to purchase assistive technologydevices

If Medicaid is capitated in any way concern-

ing its use for assistive devices school districtsmust request from parents the right to use Med-icaid funds However parents are not obligatedto use their Medicaid funds to purchase devicesor services used at school With permission aparentrsquos private insurance must be accessed be-fore Medicaid can be used for assistive technol-ogy devices Medicaid regulations vary some-what from state to state so it is wise to consultthe state Medicaid Service Bureau before mak-ing any assumptions about Medicaid and thepurchase of assistive technology

Are there other options for schools toconsider in lieu of purchasing theassistive technology device

Yes There are times when the outright pur-chase of equipment or devices is not necessaryor even advisable In such instances schoolsmight consider rental or long-term lease optionsThere are certain advantages to renting or leas-ing depending on the individual needs of thestudent For example renting equipment mightbe a reasonable strategy if the student is expectedto improve or deteriorate in a short period of timeor when it is necessary to try out the equipmentbefore purchase Long-term leasing or leasepurchase agreements also have potential benefitsfor schools which include no obligation on be-half of the school to purchase the device abilityto return leased equipment and thus reduce ob-solete inventory flexible leasing terms use ofequipment without a lump-sum purchase up-grading of equipment as more improved tech-nology becomes available and upgrading ofequipment as the studentrsquos needs change

Isnrsquot assistive technology just acrutch Wonrsquot students become toodependent on technology and notlearn to use the skills they have

Assistive technology should be used as sup-port for access learning and performing daily

45

tasks In general assistive technology is appro-priate when it compensates for disabilities so thatthe individual can function as normally as pos-sible If assistive technology is necessary for astudent to have access to educational opportuni-ties or to benefit from education then it is not aldquocrutchrdquo but a legitimate support Some skillsare too laborious or taxing to accomplish at a rateor with degree of proficiency to allow for partici-pation in the least restrictive environment Withassistive technology the student can participatemore fully and more closely approximate the lev-els of achievement and interaction of his or herpeers In general the use of assistive technologyenhances function and increases skills and op-portunities Though a student may be dependentupon a particular device in order to perform skill-fully denying the device denies the student anopportunity ever to achieve success at the levelof his or her potential

When is assistive technology appropri-ate

Assistive technology may be considered ap-propriate when it does any or all of the follow-ing things

bull Enables students to perform functions thatcan be achieved by no other means

bull Enables students to approximate normalfluency rate or standardsmdasha level of ac-complishment which could not beachieved by any other means

bull Provides access for participation in pro-grams or activities which otherwise wouldbe closed to the individual

bull Increases endurance or ability to persevereand complete tasks that otherwise are toolaborious to be attempted on a routine ba-sis

bull Enables students to concentrate on learn-ing tasks rather than mechanical tasks

bull Provides greater access to information

bull Supports normal social interactions with

peers and adults

bull Supports participation in the least restric-tive educational environment

Who owns the special equipment thatis purchased for students

If the school district purchases the equipmentthe equipment belongs to the district Someschool districts designate that a particular deviceis to be used by a specific student during the timewhen that device remains appropriate for thatstudent Other districts have ldquopoolsrdquo of assistivedevices and distribute them for use by a varietyof students The distribution and use of devicesis under the districtrsquos control as long as the needsdescribed in studentsrsquo IEPs are being met

If devices are purchased for a particular stu-dent using that studentrsquos Medicaid funds or pri-vate insurance then the device belongs to the stu-dent and is meant for the exclusive use of thatstudent

When a student moves from one levelof schooling to another like elemen-tary school to middle school does thedevice follow the student

If an assistive device is necessary in order tofulfill the requirements of a studentrsquos IEP such adevice must be provided in whatever school thestudent attends The same device may not nec-essarily follow the student from one school toanother but a comparable device which fulfillsthe IEP requirements would have to be providedin the new school that the student attends

If a family moves from one schooldistrict to another can a studentrsquosassistive technology go along

Devices bought by the school belong to theschool not the student who uses them When afamily moves from one school district to anotherthe equipment the student has been using doesnot automatically move to the new school

Assistive equipment can go with a studentto a new school if the sending school district

46

agrees to sell or give the device to the family orthe new school district

If the device was purchased by the familythrough the familyrsquos private health insurance orby Medicaid for this particular student then thedevice belongs to the student and can go withthe student to a new school district

What happens to assistive technologydevices when students leave the schoolsystem at graduation

If the school district purchased the device thedevice is the property of the school The schoolcould keep the device for use by other studentssell it or decide to transfer the device to anotherdistrict or loan program If the family or anotherfunding source purchased the device it is theproperty of the student and the family

If a piece of assistive technology is nolonger needed or relevant to a studentand the device was paid for by Medic-aid or private insurance can it bedonated for another studentrsquos benefit

Yes it is a parental decision The parentscould donate the device to the school for use byother students with disabilities or to some otherorganization which loans out equipment

Can assistive devices be insured

Many school district liability policies willcover devices purchased by the district for stu-dent use Devices purchased by other fundingsources may or may not be covered while onschool premises or involved in school activitiesIt is important for school staff to investigate thedistrictrsquos property insurance to determine whatthe policy currently covers and whether or notthe policy insures against loss or damage ofassistive devices

Parents who own assistive devices that areused at home and at school may also wish to pur-chase home owners or rentersrsquo insurance with aspecial rider that covers damage to or loss of thedevice

Who is responsible for the repair and

maintenance of assistive devices

In general the school district is responsiblefor repair and maintenance of assistive devicesused to support educational programs describedin the IEP or covered by Section 504

If a device is broken and is beyondrepair who replaces the broken de-vice

If an assistive device is necessary for thestudentrsquos IEP to be implemented then the schooldistrict will have to replace a broken lost or sto-len device

If a device is broken and sent off forrepairs must the school district sup-ply a substitute device until the origi-nal device is returned

If the assistive technology device is vital tothe studentrsquos daily special education program itis not reasonable for the student to be without adevice for long periods of time If a device isgoing to be unavailable for more than a day ortwo the district should provide a backup ma-chine which allows the student to continue work-ing on IEP goals

Is the school district obligated totrain substitute teachers and aides tooperate assistive technology devices

Again if the assistive technology device isvital to the studentrsquos daily special education pro-gram it is not reasonable for the student not tobe able to use the device for long periods of timebecause a substitute is teaching the class If thesubstitute is only going to be in the classroomfor a day or two it is probably not necessary toprovide elaborate training However if the sub-stitute is going to be in the classroom for an ex-tended time training should be provided

Must school districts allow students totake assistive devices home on schoolnights to do homework Over week-ends During school vacations Overthe summer

In many cases it is desirable for students to

47

have the opportunity to use the same assistivetechnology devices at home and in school Forexample when a student is completing home-work assignments assistive technology may benecessary to produce the type of product that isrequired Some school districts have policieswhich allow the devices to go home with the stu-dents overnight on weekends or during vaca-tion or summer periods In general these kindsof policies are a local district matter and may bedetermined according to local district needs Ifhowever a studentrsquos IEP includes a provisionwhich says the student is to have access to anassistive device both at school and at home thenthe school district would be obligated to allowthe student to take a device home or provide twodevices one for home use and one for school

What professionals are consideredqualified to assess a student in thearea of assistive technology

Because assistive technology is such a newfield there are no national standards and few lo-cal or state standards for licensing or certificationfor specialists in assistive technology Howeverschool districts often have professionals who havereceived training in conducting assistive technol-ogy evaluations and are able to provide the ser-vices identified in the IEP If a district does nothave personnel who are knowledgeable in con-ducting such evaluations the district can arrangefor such services from other knowledgeable pro-vidersndash such as Independent Living Projects Al-liance for Technology Access Centers or Tech ActProjects

How can one distinguish betweenassistive technology and personalitems (eg wheelchairs hearing aidseyeglasses crutches)

Currently IDEA does not make a clear dis-tinction between assistive technology devices andpersonal items This confusion stems in large partfrom IDEArsquos broad definition of assistive technol-ogy For example if a student with a disability

needs eye glasses in order to obtain FAPE thenthe school district is obligated to provide themat no cost to the parents In general howeverschool districts do not purchase personally pre-scribed devices such as hearing aids or glasses

Who determines how assistive tech-nology will be purchased and withwhat available funding resourcesmdashtheIEP Team or school administration

Once the IEP team makes the determinationthat assistive technology must be provided aspart of the studentrsquos IEP it is the responsibilityof school administration to determine how theassistive technology will be provided and withwhich funding sources

Is a school district responsible forproviding ldquostate of the artrdquo equip-ment for a student

No The school district need provide onlyappropriate technology in order to meet thestudentrsquos needs as described in the IEP The de-cision as to what type of assistive technology isappropriate should be based on the assistive tech-nology evaluation recommendations and IEPteam decision There may be ldquodevicesrdquo or fea-tures of equipment which may be nice for the stu-dent to have but if they are not necessary forFAPE the school district is not obligated to pro-vide them If a specific device is necessary toensure FAPE and no other device can meet thestudentrsquos needs then the district must providethe required device even though it is costly If aless expensive device would accomplish the samegoals the IEP team is under no obligation tochoose a more expensive option

If a student needs a computer can aschool owned computer be used in thelab or classroom

Yes a school owned computer can be used ifthe student has access to the equipment when heor she needs it If the student does not have thenecessary access then the appropriate equipmentshould be purchased for the studentrsquos use

48

Can school district administratorsinstruct personnel not to includecostly assistive technology devices inthe IEP

IEP teams are charged with the responsibil-ity for determining a studentrsquos need for assistivetechnology devices and services and for specify-ing those devices and services Therefore it isimportant that IEP teams are clearly informed oftheir responsibility to determine if a studentneeds a device and the need for an assistive tech-nology evaluation to assist in making the deter-mination A school district may not have a policywhich prevents IEP teams from identifying astudentrsquos need for assistive devices or services

How does assistive technology getintegrated into the curriculum

The IEP team needs to discuss how the de-vice will be used by the student and how it willbe integrated into the curriculum The IEP teamshould identify on the IEP how the device willbe used by the student in the classroom Thisinformation should be shared with the generalclassroom teachers so that they are aware of howit is to be used

How can assistive technology be pro-vided from year to year with a degreeof continuity

As part of the annual review of the IEP a pointshould be made to devise ways to communicatewith next yearrsquos teachers about the technologythe student uses and how it should be integratedinto the curriculum Teachers who are new toworking with the student who uses technologyshould be provided training if they are unfamil-iar with the device and its use Training for teach-ers and support staff should be written into theIEP as a related service

Can an assistive technology device beused by more than one student

Yes if the device is the property of the schooldistrict and if all of the students using the devicehave access to the equipment when they need it

Can an independent evaluation berequested to address assistive tech-nology

Yes The school district is required to evalu-ate a student in all areas of suspected disabilityincluding if appropriate evaluating the studentrsquosneed for assistive technology A parent has theright to an independent educational evaluationat public expense if the parent disagrees with anevaluation obtained by the school district How-ever the school district may initiate a due pro-cess hearing to show that its evaluation is appro-priate If the final decision is that the evaluationis appropriate the parent still has the right to anindependent educational evaluation but not atpublic expense If the parent obtains an inde-pendent educational evaluation at private ex-pense the results of the evaluation (a) must beconsidered by the school district in any decisionmade with respect to the provision of FAPE tothe child and (b) may be presented as evidenceat a due process hearing

What is a product system

A product system is more than one piece ofequipment working together to produce a resultFor example an FM system that works in con-junction with a studentrsquos hearing aid is a prod-uct system

Can the school district require a stu-dent to bring a personally ownedassistive device such as an augmenta-tive communication system or laptopcomputer to school in order to doschoolwork

No However the family may wish the childto use his or her equipment in school since thechild may be more familiar or comfortable withit The IEP team should decide who is respon-sible for repair and maintenance of family owneddevices

Is it sufficient for a school district tosupply access to a district-ownedcomputer but provide no software

49

that is appropriate for the student touse

Just providing access to a computer does notfulfill the districtrsquos obligation to provide assistivetechnology to support FAPE The educationalaspect of the computer is very much related tothe software that the student uses If no appro-priate software is available then the student can-not pursue the IEP goals

50

Appendix

GlossaryASSISTIVE TECHNOLOGY any sort of aidincluding computers switches calculators spell-ing devices communication devices and voicesynthesizers which is used to help an individualperform some task of daily livingALTERNATIVE KEYBOARD may include en-larged reduced varied key placement one-handed braille chordic or any other device forentering text on a computerAUGMENTATIVE COMMUNICATION anydevice (electronic or otherwise) to enhance com-munication for a person with limited speechBRAILLE EMBOSSER a printer for producingbraille output either manually or when connectedto a computer When printing standard text froma computer it must first be translated into brailleBRANCHING describes the process of choos-ing among a sequence of choices or actions toproduce another sequence of choices This pro-cess is used in the ldquoscanningrdquo method of accessCD-ROM ldquoCompact Disk Read-Only Memoryrdquorefers to the 4-inch silver disks that typically hold700 megabytes of digital information and theplayers that access the information on these disksCURSOR either the flashing vertical or horizon-tal line on a computer screen that indicates theinsertion point for text or the arrow or I-beamthat indicates the position of the mouse pointeron the computer screenDESK ACCESSARY a small utility program thatruns on a computer and may be accessed fromany program at any time (such as a calculator)DRILL AND PRACTICE presents questionsrepetetively but is not a tutorial Software thatis only drill and practise doesnrsquot necessarily teachthe concepts needed to answer the questions pre-sented

ENVIRONMENTAL CONTROL any type ofdevice that an individual may use to control theirenvironment (lights appliances TV telephoneetc) This may include anything from simplereachers or sticks to computers and voice-acti-vated electronic systemsFM SYSTEM a local wireless broadcast systemthat consists of a microphone and transmitter forthe speaker and ldquowalkman-likerdquo receivers withheadphones for listeners with hearingimpairements or attention disordersHIGH TECH use of electronics or computers asa solutionICON a small computer graphic that appears onthe computer screen and may represent differ-ent types of objects (files or applications) or ac-tions depending on the context Use the mousepointer to click on icons that open files or per-form other actionsINDIVIDUAL FAMILY SERVICE PLAN (IFSP)the written document which defines the earlyintervention services provided to the child andfamily The program is designed to meet theneeds of the child and the family and is based onfamily-identified prioritiesINDIVIDUALIZED EDUCATION PROGRAM(IEP) a written plan specifying instructionalgoals and any special education and related ser-vices a student may need which must be writ-ten and reviewed annually Included are (1) thepresent educational levels of the student (2) astatement of annual goals including short-termobjectives (3) a statement of specific services ifneeded (4) the programs (5) the date when spe-cial services are to begin and the expected dura-tion of these services and (6) the tests and otherrequirements or information used to guage thestudentrsquos progress to determine if the instruc-tional objectives are being metINPUT the information that is transmitted to acomputer from a keyboard mouse or other in-

51

put deviceKEYBOARD a device for inputing text and com-mands to a computerKEYGUARD a plexiglass or other cover for akeyboard with holes for the individual keys Itallows more precise selection of keys for an indi-vidual with fine motor difficultiesKEYPAD a small keyboard with a 10-key setupfor numeric input or it may also be used as a con-trol for a screen-reader programLAPTOP a portable battery-powered computerthat is typically the size of a 3-ring binder weighs5-10 pounds and consists of a screen keyboardand disk-drivesLASER DISCS large (12-inch) CD-ROMs thatnormally contain moviesLOW TECH indicates use of low cost non-elec-tronic solutionsMACRO a simple short program that performsan action on a computer They are usually cre-ated by recording the keyboard andor mouseinput and storing them as an icon or key combi-nationMEGABYTE 1000 X 210 bytes of informationwhich basically means over one million key-strokes of computer storage (about 10 novels)MORSE CODE a direct method for computerinput using one to three switches and coded in-put to replace the keyboard and mouseMOUSE the name given to the pointing deviceused to control graphical user interfaces (GUI) ofmodern personal computersONSCREEN KEYBOARD a software programthat places the keyboard on the screen of the com-puter and may be accessed using a mouse or otherpointing device This is ideal for individuals whocannot use a regular keyboard but can use sometype of pointing deviceOPTICAL CHARACTER RECOGNITION(OCR) a process that utilizes special computersoftware to convert the scanned image of text intoactual text that may be edited by a word proces-sorOUTPUT computer-generated information for

the user This may be printed output from aprinter visual information from the screen orsounds from speakersSCANNER an electronic copier connected to acomputer Scanners are used to input drawingspictures or printed text into the computerSCANNING has nothing to do with the elec-tronic copier above It is another method for ac-cessing a computer or communication deviceusing one or more switches Scanning involvespresenting a group of choices cycling amongthem and making choices by activating a switchSCREEN READER software that reads text ona computer screen using a speech synthesizerThis allows individuals with visual impairmentsor other print disabilities to access text on thecomputer screenSIMULATION software that simulates real-world situations on a computer This may rangefrom a joystick trainer for driving an electricwheelchair to running citiesSPEECH SYNTHESIZER hardware or softwarefor producing electronic human speech on a com-puterSPELL CHECKER utility for checking the spell-ing in a documentSTICKY KEYS software or mechanical utility forallowing typing of multiple keystrokes with onefinger (using the shift or other modifier keys)SWITCH a device that is like a single button ofa keyboard or mouse Switches may be used byan individual with servere motor difficulties byany controllable muscle in their body (headhand toe eye breath etc) to operate any typeof computer communication or environmentalcontrol deviceSWITCH INTERFACE black box that connectsto a computer or other device that has plugs forswitchesTDD a text telephone used for communicatingin typed text over a phone line A TDD has akeyboard and text display or small printer Bothparties who are communicating over a phone linemust have TDDs

52

TOUCH WINDOW a computer input devicethat uses a touch-sensitive transparent windowplaced on the computer screen It performsmouse functions with a finger or stylus directlyon the screenTRACKBALL another replacement for themouse pointing device that uses a rolling ball toperform mouse movementsTUTORIAL teaches concepts presents informa-tion as opposed to simple drill and practiceVOICE RECOGNITION computer softwareand microphone that allows input and controlwith voice commandsWORD PREDICTION productivity softwarethat increases typing speed for one-finger typistsand others by predicting and choosing completewordsWORD PROCESSOR software for inputing andformatting textUSER person using a computerUTILITY software for adding function or per-forming housekeeping tasks on a computer

53

DocumentsSCHRAG LETTER ON ASSISTIVE TECHNOLOGY

August 10 1990

Dear Ms Goodman

This is in response to your recent letter to the Office of Special

Education Programs (OSEP) concerning the obligations of public

agencies under Part B of the Education of the Handicapped Act

(EHA-B) to provide assistive technology to children with handi-

caps

Specifically your letter asks

1 Can a school district presumptively deny assistive technol-

ogy to a handicapped student

2 Should the need for assistive technology be considered on

an individual case-by-case basis in the development of the

childs Individual Education Program

In brief it is impermissible under EHA-B for public agencies

(including school districts) to presumptively deny assistive tech-

nology to a child with handicaps before a determination is made

as to whether such technology is an element of a free appropriate

public education (FAPE) for that child Thus consideration of a

childs need for assistive technology must occur on a case-by-

case basis in connection with development of a childs individual-

ized education program (IEP)

We note that your inquiry does not define the term assistive

technology and that the term is not used either in the EHA-B

statute or regulations The technology Related Assistance for

Individuals with Disabilities Act of 1988 PL 100-407 contains

broad definitions of both the terms assistive technology device

and ldquoassistive technology service See Section 3 of PL 100-

407 codified as 29 USC 2201 2202 Our response will use

assistive technology to encompass assistive technology ser-

vices and ldquoassistive technology devices

Under EHA-B State and local educational agencies have re-

sponsibility to ensure that eligible children with handicaps receive

FAPE which includes the provision of special education and re-

lated services without charge in conformity with an IEP 20 USC

1401(18) 34 CFR S3004(a) and (d) The term special educa-

tion is defined as specially designed instruction at no cost to

the parent to meet the unique needs of a handicapped child 34

CFR S30014(a) Further related services is defined as includ-

ing transportation and such developmental corrective and other

supportive services as are required to assist a handicapped child

to benefit from special education 34 CFR ss33013 (a)

The EHA-B regulation includes as examples 13 services that

qualify as related services under EHA-B See 34 CFR S30013

(b)(1)-(13) We emphasize that this list is not exhaustive and

may include other developmental corrective or other supportive

servicesif they are required to assist a handicapped child to

benefit from special education 34 CFR S30013 and Comment

Thus under EHA-B assistive technology could qualify as spe-

cial education or related services

A determination of what is an appropriate educational program

for each child must be individualized and must be reflected in the

content of each childs IEP Each childs IEP must be developed

at a meeting which includes parents and school officials 34 CFR

S300343-300344 Thus if the participants on the IEP team de-

termine that child with handicaps requires assistive technology in

order to receive FAPE and designate such assistive technology

as either special education or a related service the childs IEP

must include a specific statement of such services including the

nature and amount of such services 34 CFR S300346(c) App

C to 34 CFR Part 3000 (Ques 51)

EHA-Bs least restrictive environment (LRE) provisions require

each agency to ensure (t)hat special classes separate school-

ing or other removal of handicapped children from their regular

educational environment occurs only when the nature or severity

of the handicap is such that education in regular classes with the

use of supplementary aids and services cannot be achieved sat-

isfactorily Part 121a 42FR 4251113 (August 23 1977)

Assistive technology can be a form of supplementary aid or ser-

vice utilized to facilitate a childs education in a regular educa-

tional environment Such supplementary aids and services or

modifications to the regular education program must be included

in a childs IEP Id Appendix C to 34 CF art 300 (Ques 48)

In sum a childs needs for assistive technology must be deter-

mined on a case-by-case basis and could be special education

related services or supplementary aids and services for children

with handicaps who are educated in regular classes

I hope the above information has been helpful If we may pro-

vide further assistance please let me know

Sincerely

Judy A Schrag EdD

Director Office of Special Education Programs

54

INDIVIDUALS WITH DISABILITIES EDUCATIONLAW REPORT

Cite as 18 IDELR 627

Digest of Inquiry

(Inquirerrsquos Name Not Provided)

(Date Not Provided)

bull Is a school district responsible to provide assistive

technology devices for home use

bull May a school board overrule a determination by an IEP

team that a child with a disability needs access to an

assistive technology device at home

bull What is the time limit on implementation of an IEP

Digest of Response

(November 27 1991)

Assistive Technology Devices May Be Required for Home Use

If an IEP team determines that a child with a disability needs

access to an assistive technology device at home as a matter of

FAPE then the school district must provide the device for home

use in order to implement the childrsquos IEP

School Board May Not Change IEP Teamrsquos Determination

Under Part B a school board has no authority to unilaterally

change any statement of special education or related services

contained in an IEP including a statement of a childrsquos need to

have access to an assistive technology device at home Without

reconvening the IEP team the school board may not change the

IEP and the school district is obligated to implement the IEP re-

quirements regardless of the school boardrsquos objections

IEPs Must Generally Be Implemented

Under Reg 300342(b) an IEP must be in effect before the

provision of special education or related services and must be

implemented as soon as possible following the conclusion of the

IEP meeting(s) In accordance with Appendix C to the Part 300

regulations an IEP should generally be implemented without de-

lay after being finalized although a reasonable delay may be per-

missible in limited circumstances

__________________

Text of Inquiry

I would like to have a copy of the policy classification on

Assistive Technology

I also have a question to ask regarding Assistive Technology

such as a closed circuit TV

My daughter uses a CCTV in school and it is on her IEP

program My daughter is visually impaired The initial request

was made by me the parent to the appropriate people involved

in her education and discussed and approved by the committee

on an individual basis

My question is I would like to make the request to the ap-

propriate officials for another CCTV for home use to accomplish

the same results at home as is done in school (For homework

reading books any assignments from school)

Another question is If the committee approves this request

it will go to School Board for approval I would like to know what

happens if the School Board doesnrsquot approve the proposal Is it

impartial hearing time

Thank you for your assistance in this matter

Any information regarding Assistive Technology Informative

for school and home use would be greatly appreciated

Is there a time limit on implementation of yearly updated

IEPs[] Every year I have long delays on implementation of board

approved IEPs[]

Text of Response

This is in response to your recent letter to the Office of Spe-

cial Education Programs (OSEP) requesting a copy of any OSEP

policy clarifications on assistive technology as well as asking spe-

cific questions concerning the assistive technology needs for your

daughter You also asked a question about the time limits for

implementation of an individualized education program (IEP)

In response to your request I am enclosing a copy of OSEPrsquos

August 10 1990 letter to Ms Susan Goodman concerning the

obligations of public agencies under Part B of the Individuals with

Disabilities Education Act (Part B) formerly cited as Part B of the

Education of the Handicapped Act to provide assistive technol-

55

ogy to children with disabilities along with some additional infor-

mation on assistive technology and a copy of the Part B regula-

tions I would also like to provide you with OSEPrsquos response to

each of your specific questions as stated below

I would like to make the request to the appropriate officials

for another CCTV for home use to accomplish the same

results as is done in school (For homework reading books

any assignment from school)

The IEP which must be developed at a meeting that includes

parents and school officials must contain among other things a

statement of the specific special education and related services

to be provided to the child See 34 CFR sectsect 300343-300346 As

stated in OSEPrsquos letter to Ms Goodman if the IEP team deter-

mines that a child with disabilities requires assistive technology in

order to receive a free appropriate public education (FAPE) and

designate such assistive technology as either special education

or a related service the childrsquos IEP must include a specific state-

ment of such services including the nature and amount of such

services See 34 CFR sect 300346(c) App C to 34 CFR Part 300

(Ques 51) The need for assistive technology is determined on a

case-by-case basis taking into consideration the unique need of

each individual child If the IEP team determines that a particular

assistive technology item is required for home use in order for a

particular child to be provided FAPE the technology must be pro-

vided to implement the IEP

If the committee approves this request it will go to the School

Board for approval I would like to know what happens if

the School Board doesnrsquot approve the proposal Is it im-

partial hearing time

As part of the public agencyrsquos part B obligation to provide

FAPE to an eligible child with disabilities the public agency must

ensure that special education and related services are provided

in conformity with an IEP which meets the requirements of 34

CFR sectsect 300340-300349 One requirement at 34 CFR sect

300343(a) is that the public agency conduct a meeting to de-

velop review and revise a childrsquos IEP The Regulations require

that certain participants attend the IEP meeting See 34 CFR sect

300344 The role of the participants at the IEP meeting is to

determine the specific special education and related services that

a child needs in order to receive FAPE Once the determination is

made at a meeting convened pursuant to 34 CFR sect 300343(a)

Part B does not recognize any authority on the part of a local

School Board to unilaterally change the statement of special edu-

cation and related services contained in the IEP After the IEP is

developed and the placement decision is made by a group of

persons knowledgeable about the child the meaning of the evalu-

ation data and placement options the public agency must imple-

ment the IEP See 34 CFR sect 300533(a)(3) Without reconven-

ing the IEP meeting the local school board could not change the

IEP

Is there a time limit on implementation of updated IEPrsquos[]

Every year I have long delays on implementation of Board

approved IEPrsquos[]

Part B imposes no specific time limits for the implementation

of IEPs The Part B regulations at 34 CFR sect 300342(b) require

that an IEP (1) must be in effect before special education and

related services are provided to a child and (2) must be imple-

mented as soon as possible following the meetings required to

develop review or revise a childrsquos IEP The answer to Question 4

in Appendix C to the Part 300 regulations states that no delay is

permissible between the time a childrsquos IEP is finalized and when

special education and related services is provided It is expected

that the special education and related services set out in the IEP

will be provided by the agency beginning immediately after the

IEP is finalized In certain circumstances such as when the IEP

meeting occurs during the summer or a vacation period or where

there are circumstances which require a short delay (eg work-

ing out transportation arrangements) the implementation may not

be immediate See Comment 34 CFR sect 300342

I hope that this information is helpful to you Please let us

know if you have any additional questions or concerns

Judy A Schrag

Director

Office of Special Education Programs

_______________________

Cite as 18 IDELR 628

56

Sample Letter Requesting an Assistive Tech-nology Evaluation

March 1997

Dear Sir

Our daughter Catherine an IDEA-eligiblestudent is currently receiving special educationand supportive therapies through the publicschool district As she is progressing through theelementary school grades the curriculum is de-manding more and more written work from herAt this point teachers or assistants are writingfor her but this method does not allow Catherinethe opportunity to compose written work on herown

As Catherinersquos parents we think the time hascome to consider assistive technology forCatherine to allow her to learn to do written workon her own so that she can learn the mechanicsof writing and can put her own thoughts downon paper for others to read

To this end we are requesting an assistivetechnology evaluation for Catherine to determinewhat kinds of technology are necessary to assisther with written expression We are assumingthat the assistive technology evaluation will beperformed at district expense by professionalswho are qualified to determine (a) what assistivetechnology may be necessary for Catherine (b)what assistive technology devices might be help-ful and (c) what occupational and physicaltherapy services may be necessary to support thetechnology

We would like to have this evaluation com-pleted so that information is available prior tothe convening of the IEP Team to writeCatherinersquos Individualized Education Programfor next year

We appreciate your assistance with this mat-ter and look forward to hearing from you

Yours truly

Assistive TechnologyIssues to Address

_____What are the individualrsquos current unmetneeds for access to communication writ-ing or educational materials

_____What are the short and long term educa-tional goals

_____What are the daily educational demandswhich require the use of assistive technol-ogy

_____Have the appropriate team members in-cluding parents been involved in the as-sessment process

_____What are the features of the technology thatwould assist the individual in meetingdaily classroom demands

_____Why is the selected equipment more appro-priate than other alternatives

_____Have all of the individualrsquos environmentsbeen considered

_____Does the selected equipment reflect the leastrestrictive intervention strategy

_____Is the equipment necessary to achieve edu-cationallife goals

_____How will the individual physically man-age the equipment in all environments

_____How will the equipment be integrated intothe individualrsquos daily life

_____How will the use of the assistive technol-ogy promote inclusion of the individualinto activities in the school and commu-nity

_____Which members of the education team willbe trained to use the equipment

_____How will the individual be trained to usethe equipment

_____How will the family be involved with theindividual and the equipment

57

ExamplesEDUCATIONAL SOFTWARE EVALUATION

A IDENTIFYING INFORMATION

Name of instructional program

Publisher

Cost ____________Computer platform(PCMac)

Other equipment needed to run program

Grade level of the program

Skill levels required of users

Special needs addressed by program

B DESCRIPTIVE INFORMATION

1 What is the purpose of the instructional program as stated by

its publisher

2 What curriculum area or areas does it address

3 What type of instructional program is it

tutorial drill and practice___ arcade game type___

drill and practice ____ simulation ___

problem solving___ educational game___

teacher utility___ other___

4 For what type of learner was the program designed

age level __________ grade level ____________

ability level ________ interest level ___________

5 What skills or information does the program attempt to teach

or review

6 How does the program present information

__text __graphics __animation __color __sound effects

__music __speech __other __________________________

7 Is the information presented clearly

Is text legible and readable

Are graphics comprehensible

Are sounds audible and intelligible

8 Are directions for using the program clearly stated and under-

standable Where do directions appear

_____ within the program

_____ in the programs documentation or manual

9 Is the program under user control that is can the user control

the programs movement from screen to screen

Review directions at any time

Exit the program at any time

10 What computer use demands are placed on the learner

_____ insert disk and turn on computer

_____ select from menu

other ______________________________

11 What academic demands are placed on the learner

reading level _______________________________

spelling level _______________________________

other _____________________________________

12 What physical demands are placed on the learner

_____ keyboard must be used to enter responses

_____ press any key

_____ press a key from one half or one quadrant of key-

board

_____ press on specific key

_____ press several keys in order

_____ other devices used to enter responses

13 What speed demands are placed on the learner

_____ presentation of information controlled by program (

moderate fast or slow)

_____ presentation of information under user control

_____ unlimited response time

_____ response time set by program (moderate fast slow)

_____ response time varied by user

58

14 What accuracy demands are placed on the learner

_____ user can correct typing errors

_____ program does not allow correction of typing errors

_____ program locates common errors

_____ program requires correct spelling of all responses

_____ program allows only one correct response for most

questions

15 Is feedback about response accuracy provided to learners

appropriately

_____ knowledge of results provided after each response

_____ correct responses confirmed

_____ learner informed if response incorrect

_____ another trial provided if response incorrect

_____ number of trials provided

_____ correct response demonstrated if learner fails to an-

swer correctly

_____ learner allowed opportunity to respond after demon-

stration of correct response

16 Does the program use any branching procedures besides

differential treatment of correct and incorrect responses

17 What techniques are used for reinforcement and motivation

_____ knowledge of results and confirmation of correct re-

sponses

_____ summary information about learner performance

_____ text message of praise for correct responses

_____ graphics display and or sound for correct responses

_____ competitive game in which correct response earn

points

_____ other _________________________________

Reinforcement is _____ continuous _____ intermittent

18 What user options are available to students and teachers

Students can select

_____ activity from menu difficulty

_____ number of questions type of questions

_____ other ____________________________

Teacher or parent can select

_____ sound on or off

_____ number of questions

_____ type of questions

_____ sequence of instruction

_____ number of trials

_____ speed of presentation

_____ speed demands for responses

_____ other_________________________________

Teacher or parent can

_____ enter own content into program

_____ review student records

_____ other________________________________

19 Is the programs documentation adequate

All program features fully and clearly explained

Rationale for program purpose and objectives included

Print materials provided for students

20 Other comments about the instructional program

C OVERALL EVALUATION

Rate the appropriateness of the instructional program in each of

the following areas using this scale

excellent adequate inadequate

1 2 3

1 2 3 Curricular content (program addresses important skills

1 2 3 Interest level

1 2 3 Ease of use for learners

1 2 3 Demands on learner (eg computer use academic)

1 2 3 Instructional procedures

1 2 3 Motivational value

1 2 3 Appropriate use of the medium

1 2 3 Important instructional variables under teacher control

1 2 3 Other _______________________________

59

Software Featuresbull Easy-to-Read Screensbull Consistency in Formatbull Intuitive Characteristicsbull Logical Labelsbull Instructional Choicesbull Graphicsbull Friendly Documentationbull On-Screen Instructionsbull Auditory Cuesbull Visual Cuesbull Built-in Access Methodsbull Alternatives to a Mousebull Optional Cursorsbull Creation of Custom Programs

Alternative Inputbull Switches and Switch Softwarebull Alternative Keyboardsbull Keyboard Additionsbull Access Utilitiesbull Interface Devicesbull Voice Recognitionbull Optical Character Recognition

and Scannersbull Electronic pointing Devicesbull Pointing and Typing Aidsbull Touch Screensbull Joysticksbull Trackballsbull Arm and Wrist Supports

Processing Aidsbull Abbreviation Expansion and

Macro Programsbull Word Predictionbull Talking and Large Print Word

Processorsbull Grammar and Spell Checkersbull Reading Comprehension Pro-

gramsbull Writing Composition Pro-

gramsbull Electronic Reference Toolsbull Menu Management Programs

Alternative Outputbull Braille Embossers and Transla-

torsbull Refreshable Braille Displaysbull Speech Synthesizersbull Screen Readersbull Screen Enlargement Programsbull Monitor Additions

Specialized Productsbull Closed Circuit Television

(CCTV)bull Environmental Control Units

(ECU)bull Notetakersbull Reading Machinesbull Text Telephone (TDD)

60

Next

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ng C

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oces

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61

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mun

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62

ResourcesParent Trainingand InformationCenters

AlabamaSpecial Education ActionCommittee Inc (SEAC)600 Bel Air Blvd 210Mobile AL 36606-3501334-478-1208334-473-7877 FAX1-800-222-7322 AL onlyseacmob1junocomhttpwwwhsvtisnet~cja

AlaskaPARENTS ResourceCenter4743 E Northern Lights BlvdAnchorage AK 99508907-337-7678907-337-7671 FAX1-800-478-7678 in AKparentsalaskanethttpwwwalaskanet~parents

American SamoaAmerican Samoa ParentNetworkPO Box 3432Pago Pago AS 96799684-633-2407684-633-7707 (fax)

ArizonaPilot Parent Partnerships4750 N Black Canyon Hwy 101Phoenix AZ 85017-3621602-242-4366800-237-3007 (AZ only)602-242-4306 (fax)

ArkansasArkansas Disability Coalition2801 Lee Ave Suite BLittle Rock AR 72205501-614-7020501-614-9082 FAX1-800-223-1330 AR onlyadcceinet

FOCUS Inc305 W Jefferson AveJonesboro AR 72401870-935-2750870-931-3755 FAXfocusincipanet

CaliforniaDREDF2212 Sixth StreetBerkeley CA 94710510-644-2555510-841-8645 (fax)1-800-466-4232dredfdredforghttpwwwdredforg

Exceptional Parents Unlimited(EPU)4120 N First StreetFresno CA 93726209-229-2000209-229-2956 (fax)epu1cybergatecom

Matrix555 Northgate Dr Ste ASan Rafael CA 94903415-499-3877415-499-3854 (TDD)415-507-9457 (fax)1-800-578-2592matrixmatrixparentsorghttpwwwmatrixparentsorg

Parents Helping Parents - SanFrancisco594 Monterey BlvdSan Francisco CA 94127-2416415-841-8820415-841-8824 (fax)

Parents Helping Parents -Santa Clara3041 Olcott StSanta Clara CA 95054-3222408-727-5775408-727-7655 (TDD)408-727-0182 (fax)infophpcomhttpwwwphpco

Support for Families ofChildren with Disabilities2601 Mission 710San Francisco CA 94110-3111415-282-7494415-282-1226 (fax)sfcdmissaolcom

TASK100 W Cerritos AveAnaheim CA 92805-6546714-533-TASK (8275)714-533-2533 (fax)taskcaaolcom

TASK- San Diego3750 Convoy St Ste 303San Diego CA 92111-3741619-874-2386619-874-2375 (fax)

ColoradoPEAK Parent Center Inc6055 Lehman Drive Ste 101Colorado Springs CO 80918719-531-9400719-531-9403 (TDD)800-284-0251719-531-9452 (fax)PKPARENTaolcom

ConnecticutCPAC338 Main StreetNiantic CT 06357860-739-3089860-739-7460 (fax)1-800-445-2722 (in CT)cpacincaolcomhttpwwwmembersaolcomcpacinccpachtm

DelawareParent Information Center(PIC) of Delaware Inc700 Barksdale Road Ste 3Newark DE 19711302-366-0152302-366-0178 (TDD)302-366-0276 (fax)PEP700aolcom

FloridaFamily Network on Disabilitiesof Florida2735 Whitney RoadClearwater FL 24620813-523-1130800-285-5736 (FL only)813-523-8687 (fax)fndgatenethttpwwwgatenet~fnd

GeorgiaParents Educating Parentsand Professionals for AllChildren (PEPPAC)8318 Durelee Lane Ste 101Douglasville GA 30134770-577-7771770-577-7774 (fax)peppacbellsouthnet

HawaiiAWARELearning DisabilitiesAssociation of Hawaii200 N Vineyard Blvd Ste 310Honolulu HI 96817808-536-9684808-536-2280 (TTY)808-537-6780 (fax)ldahgtenet

IdahoIdaho Parents Unlimited Inc(IPUL)Parents Education amp ResourceCenter4696 Overland Rd Ste 478Boise ID 83705208-342-5884800-242-IPUL (4785)208-342-1408 (fax)ipulrmcinethttpwwwhomermcinetIPUL

IllinoisDesigns for Change6 N Michigan Ave Ste 1600Chicago IL 60602312-857-9292312-857-1013 (TDD)312-857-9299 (fax)1-800-851-8728DFC1aolcom

Family Resource Center onDisabilities (FRCD)20 East Jackson Blvd Rm 900Chicago IL 60604312-939-3513312-939-3519 (TDDTTY)312-939-7297 (fax)1-800-952-4199 (IL only)

Family TIES Network830 South Spring StreetSpringfield IL 62704800-865-7842217-544-6018 (fax)ftiesnaolcom

National Center for Latinoswith Disabilities1921 South Blue IslandChicago IL 60608312-666-3393312-666-1788 (TDD)312-666-1787 (fax)1-800-532-3393ncldinteraccesscom

3

toward circumventing the limitations of disabil-ity and providing students with disabilities witha ldquolevel playing fieldrdquo in every area of life ac-complishment

What is an accommodation

Accommodations are reasonable modifica-tions that are made to compensate for skills orabilities that an individual lacks For example ifa person does not digest spicy foods well wemight accommodate this individual by adjustinghis or her diet so that the person was eating onlybland foods

When the word accommodation is used in con-nection with disability issues it refers to a wayof modifying a task or assignment so that a per-son with a disability can participate in spite ofwhatever challenges the disability may pose Forexample when a student who is unable to re-member math facts is allowed to do math prob-lems with a calculator the use of the calculator isan accommodation which allows the student towork around his or her disability With an ac-commodation the student can still perform mathproblems but the student does so using a differ-ent method

In the school setting sometimes it is neces-sary to make accommodations for individualswith disabilities in order to compensate for skillsor abilities that they do not have For examplefor some students with learning disabilities learn-ing to spell words correctly may be a skill theynever acquire or never acquire with a highenough degree of fluency to do them any goodin written expression To compensate for thisinability to spell such students may be encour-aged to use alternative methods for spelling likea spell check software program on the computeror a hand-held spelling device

What is an adaptation How does adaptationdiffer from accommodation

Adaptation means developing unique devicesor methods designed specifically to assist persons

with disabilities to perform daily tasks An ad-aptation is something specially designed whichis not normally used by other people An accom-modation on the other hand is simply a changein routine method or approach which may beused by people with or without disabilities Ex-amples of adaptations include special grips toturn stove knobs or specially designed keyboardsto operate computers

What are common types of assistive technol-ogy Does assistive technology just meancomputers

Assistive technology certainly includes com-puters but it also refers to a number of other typesof accommodations and adaptations which en-able individuals with disabilities to function moreindependently Computers are an important typeof assistive technology because they open up somany exciting possibilities for writing speakingfinding information or controlling anindividualrsquos environment But computers are notthe only avenues to solving problems throughtechnology There are many low tech (and lowcost) solutions for problems that disabilities poseExamples of inexpensive low tech solutions in-clude wrist splints clip boards for holding pa-pers steady or velcro tabs to keep positioningpads in place

The following is a list of common assistivetechnology applications

Positioning In the classroom individualswith physical disabilities may need assistancewith their positions for seating so that they canparticipate effectively in school work Generallytherapists try to achieve an upright forward fac-ing position by using padding structured chairsstraps supports or restraints to hold the body ina stable and comfortable manner Also consid-ered is the studentrsquos position in relation to peersand the teacher Often it is necessary to designpositioning systems for a variety of settings sothat the student can participate in multiple ac-tivities at school Examples of equipment used

4

for positioning are side lying frames walkerscrawling assists floor sitters chair inserts wheel-chairs straps trays standing aids bean bagchairs sand bags and so forth

Access In order to participate in school taskssome students require special devices that pro-vide access to computers or environmental con-trols The first step in providing access is to de-termine which body parts can be used to indi-cate the studentrsquos intentions Controllable ana-tomical sites like eye blinks head or neck move-ments mouth movements may be used to oper-ate equipment which provides access to the com-puter Once a controllable anatomical site hasbeen determined then decisions can be madeabout input devices selection techniques (directscanning) and acceleration strategies (codingprediction) Input devices include such thingsas switches alternative keyboards mousetrackball touch window speech recognition andhead pointers Once computer access has beenestablished it should be coordinated with othersystems that the student is using including pow-ered mobility communication or listening de-vices and environmental control systems

Access can also refer to physical entrance andexit of buildings or facilities This kind of assistivetechnology includes modifications to buildingsrooms and other facilities that let people with

physical impairments use ramps and door open-ers to enter allow people with visual disabilitiesto follow braille directions and move more freelywithin a facility and people of short stature orpeople who use wheelchairs to reach pay phonesor operate elevators Accessibility to shoppingcenters places of business schools recreationtransportation is possible because of assistivetechnology modifications

Environmental Control Independent useof equipment in the classroom can be achievedfor students with physical disabilities throughvarious types of environmental controls includ-ing remote control switches and special adapta-tions of onoff switches to make them accessible(eg velcro attachments pointer sticks)

Robotic arms and other environmental con-trol systems turn lights on and off open doorsoperate appliances Locational and orientationsystems give people with vision impairmentsinformation about where they are what theground nearby is like and whether or not thereis a curb close by

Augmentative Communication Every stu-dent in school needs some method of communi-cation in order to interact with others and learnfrom social contact Students who are nonverbalor whose speech is not fluent or understandableenough to communicate effectively may benefit

figure 1 Alternative and Pr ocessing Computer Access Methods

Inputbull Alternate keyboardsbull Interface devicesbull Joysticksbull Keyboard modificationsbull Keyboard additionsbull Optical pointing devicesbull Pointing and typing aidsbull Switches with scanningbull Scanners amp optical character recognitionbull Trackballsbull Touch screensbull Voice recognition

Processingbull Abbreviationexpansion and macro programsbull Access utilitiesbull Menu management programsbull Reading comprehension programsbull Writing composition programsbull Writing enhancement tools (ie grammar checkers)

Outputbull Braille displays and embossersbull Monitor additionsbull Screen enlargement programsbull Screen readersbull Speech synthesizersbull Talking and large print word processors

5

from using some type of communication deviceor devices Communication devices include suchthings as symbol systems communication boardsand wallets programmable switches electroniccommunication devices speech synthesizers re-corded speech devices communication enhance-ment software and voiced word processing

Assistive Listening Much of the time inschool students are expected to learn through lis-tening Students who have hearing impairmentsor auditory processing problems can be at a dis-tinct disadvantage unless they learn to use thehearing they have or they develop alternativemeans for getting information Hearing problemsmay be progressive permanent or intermittentAny of these impairments may interfere signifi-cantly with learning to speak read and followdirections Assistive devices to help with hear-ing and auditory processing problems includehearing aids personal FM units sound field FMsystems Phonic Ear TDDs or closed caption TV

Visual Aids Vision is also a major learningmode General methods for assisting with visionproblems include increasing contrast enlargingstimuli and making use of tactile and auditorymodels Devices that assist with vision includescreen readers screen enlargers magnifierslarge-type books taped books Braillers lightboxes high contrast materials thermoformgraphics synthesizers and scanners

Mobility Individuals whose physical impair-ments limit their mobility may need any of a num-ber of devices to help them get around in theschool building and participate in student activi-ties Mobility devices include such things as self-propelled walkers manual or powered wheel-chairs and powered recreational vehicles likebikes and scooters

Computer-Based Instruction Computer-based instruction can make possible independentparticipation in activities related to the curricu-lum Software can be selected which mirrors theconceptual framework of the regular curriculum

but offers an alternative way of responding to ex-ercises and learning activities Software can pro-vide the tools for written expression spelling cal-culation reading basic reasoning and higherlevel thinking skills The computer can also beused to access a wide variety of databases

Social Interaction and Recreation Studentswith disabilities want to have fun and interactsocially with their peers Assistive technologycan help them to participate in all sorts of recre-ational activities which can be interactive withfriends Some adapted recreational activities in-clude drawing software computer games com-puter simulations painting with a head or mouthwand interactive laser disks and adaptedpuzzles

Self Care In order to benefit from educa-tion some students require assistance with selfcare activities like feeding dressing and toiletingAssistive devices which assist with self care in-clude such things as robotics electric feedersadapted utensils specially designed toilet seatsand aids for tooth brushing washing dressingand grooming

What sort of students might use assistivetechnology

Students who require assistive technology arethose with mental or physical impairments thatinterfere with learning or other life functions Thetechnology helps the student to overcome or com-pensate for the impairment and be more inde-pendent in participating at school Students whobenefit from assistive technology may have mildlearning problems like learning disabilities orthey may have physical or cognitive disabilitiesthat range from mild to severe Assistive tech-nology is not necessary or helpful for every stu-dent in special education but it is an importantpart of the support system for many studentswith identified disabilities

Isnrsquot assistive technology appropriate only forstudents with more severe disabilities

Assistive technology is simply a set of tools

6

that can be used to compensate for some deficitthat a person may have For individuals with se-vere mental or physical disabilities the techno-logical solutions can help to solve multiple andcomplex problems But individuals with less in-volved problems also can benefit from assistivetechnology For example individuals with learn-ing disabilities who have difficulty with readingor writing can benefit educationally from usingthe word processing and voiced reading capa-bilities of computers

Isnrsquot assistive technology just a crutch Wonrsquotstudents become too dependent on technol-ogy and not learn to use the skills they have

Assistive technology should be used as sup-port for access learning and performing dailytasks In general assistive technology is appro-priate when it compensates for disabilities so thatthe individual can function as normally as pos-sible If assistive technology is necessary for astudent to have access to educational opportuni-ties or to benefit from education then it is not aldquocrutchrdquo but a legitimate support

Some skills are too laborious or taxing to ac-complish at a rate or with degree of proficiencyto allow for participation in the least restrictiveenvironment With assistive technology the stu-dent can participate more fully and more closelyapproximate the levels of achievement and in-teraction of his or her peers

The use of assistive technology enhancesfunction and increases skills and opportunitiesThough a student may be dependent upon a par-ticular device in order to perform skillfully de-nying the device denies the student an opportu-nity ever to achieve success at the level of his orher potential

When is using assistive technology appropri-ate

Assistive technology may be considered ap-propriate when it does any or all of the follow-ing things

bull Enables an individual to perform functions

that can be achieved by no other means

bull Enables an individual to approximate nor-mal fluency rate or standardsmdasha level ofaccomplishment which could not beachieved by any other means

bull Provides access for participation in pro-grams or activities which otherwise wouldbe closed to the individual

bull Increases endurance or ability to persevereand complete tasks that otherwise are toolaborious to be attempted on a routine ba-sis

bull Enables an individual to concentrate onlearning or employment tasks rather thanmechanical tasks

bull Provides greater access to information

bull Supports normal social interactions withpeers and adults

bull Supports participation in the least restric-tive educational environment

SummaryAssistive technology means any device which

helps an individual with an impairment to per-form tasks of daily living There is a wide rangeof types of devices in assistive technology fromlow tech homemade aids to computers and so-phisticated electronic equipment Assistive tech-nology is one of the services which can be pro-vided in a special education program under theIndividuals with Disabilities Education Act(IDEA) The requirements of IDEA say that stu-dents who need assistive technology are entitledto the aids and devices and the assistive technol-ogy services (eg evaluation for assistive tech-nology and modification and maintenance ofequipment) that are necessary for the student tobenefit from a free appropriate public education

Hints for Parents

It is never too soon to consider using assistive tech-nology Some infants with physical disabilities for ex-

7

ample really benefit from early interaction with toysthat operate by switch Here are suggestions for timesto evaluate a child for assistive technology

bull When disability limits interaction with the envi-ronment and interferes with experiential learn-ing

Assistive technology can be used to providephysical access to the environment (egswitch toys floor scooters touch window)

bull When a significant gap exists between receptiveand expressive abilities

Assistive technology can assist with expres-sion through the use of programmableswitches electronic communication devicesvoiced word processing braille embossingand so forth

bull When an individualrsquos performance falls behindthat of his or her peers

If an individualrsquos handwriting for exampleis very slow laborious and difficult to readuse of a word processing device can be sub-stituted for handwriting thus allowing theindividual to keep up with others in termsof written expression

bull When a physical disability is impeding the edu-cationalvocational potential of an individual

Assistive technology can provide access tothe workplace for example by allowing anindividual who is blind to learn to use ascreen reader and voiced word processingto do clerical tasks that would otherwise beimpossible

bull When a disability is impeding the independenceof an individual

Sometimes assistive technology can be usedto allow a person with a disability to func-tion more independently For example hav-ing a power wheelchair allows an individualto travel independently without the neces-sity of having someone to push the wheel-chair

SaraSara who has Down syndrome is eight

years-old Her language and speech skills arethree years delayed but she has age appropriatesocial skills Sara has spent part of her schoolday in a regular classroom ever since kindergar-ten but this year her third grade teacher is sug-gesting that Sara really cannot keep up with herclassmates The teacher thinks that Sara wouldbe better off in a self-contained class with stu-dents who work at her pace Sara has some finemotor coordination problems and she has haddifficulty learning to write in cursive Her oralreading is hampered by her speech difficultiesHowever Sara has learned to do addition andsubtraction problems well and has mastered add-ing with carrying and subtraction with borrow-ing She reads at about a second grade level withreasonably good comprehension Sararsquos parentswould like to see her continue in the regular class-room for as much time as possible but they rec-ognize that Sararsquos writing and speaking problemsare keeping her from doing her best work

What are Sararsquos needs

What kinds of technology should go in SararsquosIEP

How would you make a case for puttingassistive technology into her IEP

8

Sararsquos SolutionSararsquos IEP Team met to discuss her needs and

concluded that she is doing well in a regular class-room setting she is making adequate progressin academic skills and has learned how to inter-act socially with her peers It is to be expectedthat Sara will have difficulty keeping up with thepace in a third grade but as long as she is mak-ing progress toward her individual goals theregular classroom is a good setting for her How-ever some simple accommodations and technol-ogy may help Sara to work faster and more effi-ciently

At this point Sara may need some assistancewith handwriting and speaking but the solutionsto her problems in these areas need not be com-plex ones The team decided that Sara shouldcontinue to practice cursive until she has mas-tered all the letters and can be more facile in us-ing script However while she is still learningcursive she needs other means for respondingin writing For short written responses the teamagreed that Sara should be encouraged to usemanuscript printing When speed is importantor when writing assignments are longer Sarashould have access to a computer with an adap-tive keyboard (eg IntelliKeys) The adaptivekeyboard is helpful for Sara because the ldquokeysrdquoare larger and easier to see Using the keyboardrequires only a very light touch so Sara finds iteasier to use than a standard computer keyboard

In terms of oral reading the team decided tohave Sara practice reading into a tape recorderHer speech therapist will work with her on slow-ing down her rate of speech and reading withexpression When Sara has a good tape of heroral reading she will submit it to her teacher forreview

Solution SummaryPractice cursiveUse manuscript printing for short assign-

ments

Use computer with adaptive keyboard forlonger assignments

Practice oral reading using a tape recorder

9

Making Assistive Technology Decisions

W hen parents learn about assistive tech-nology and the wonderful opportuni-ties it can provide they want to jump

right in and get the latest in technology for theirchildren Who wouldnrsquot want an augmentativecommunication device for a child who cannottalk What parents wouldnrsquot want to buy a com-puter if it would help their child learn

When the world of assistive technology opensup for parents it can be like entering a great toystoremdasheverything looks so wonderful that itmakes it hard to know what to select Choosingthe right device to meet an individualrsquos needsrequires technical knowledge and indepth under-standing of the individualrsquos functional capabili-ties Not only is the selection of a device madedifficult by the complexity of the equipment andthe demands of the individualrsquos impairmentassistive technology devices can be very expen-sive Making such purchases is a major financialcommitment for most families one that takes agreat deal of soul searching and sometimes sig-nificant sacrifice

Families invest more than money in theirchildrenrsquos assistive technology Practical invest-ments of time and effort and emotional invest-ments of hope and enthusiasm are made withevery assistive technology purchase Because ofthe high level of financial personal and emotionalcommitment family disappointment is greatwhen equipment fails to perform as expected

Buying and then not using a device becauseof dissatisfaction can be a devastating experiencefor all concerned That is why it is so importantfor parents to proceed cautiously into the worldof assistive technology and make purchases onlyafter careful evaluation and trials with the newdevice Following is a summary of some sug-gestions for parents to consider before makingany assistive technology purchase be realisticabout your childrsquos capabilities and needs get a

multidisciplinary evaluation examine availabletechnology with a critical eye match the childrsquosneeds to specific equipment features do not makea purchase until you have used the device for atrial period identify next steps and determinewhat needs to be done for follow-up after pur-chase

Guidelines for Making Assistive TechnologyDecisions

bull Be realistic about your childrsquos capabilitiesand needs

Assistive technology can open up excitingnew opportunities for a child but it is not magicThere are certain basic requirements for any in-dividual to be successful with technology and itis important to face these requirements squarelyThere is nothing more disappointing or discour-aging than purchasing expensive equipment fora child which is beyond his or her capabilities touse

Prerequisites for Computer Use Physicalor sensory impairments do not limit access tocomputers but cognition is a factor in computeroperation The major prerequisite for using acomputer (with or without adaptations) is thecognitive ability to understand cause and effectThe child must be able to understand that thecomputer operates (eg changes does some-thing) because the child has activated the equip-ment through some volitional movement or ac-tivity (eg eyebeam speaking puffing into astraw hitting a switch) Some children enjoyplaying with switches by hitting them randomlybut may not be able to connect their own behav-ior to the response their movement activates Inorder to be successful in interacting with a com-puter the user must be able to control some voli-tional activity and to do so consistently For ex-ample the child would have to be able to acti-vate the computer in response to a visual tactileor auditory prompt

10

Another prerequisite to computer use is theability to make conscious meaningful choicesbetween alternatives like yes and no The choicescan be very simple ones but there has to be evi-dence that the child has made an actual decisionand not merely acted randomly

If a child does not have the concept of causeand effect or cannot make consistent choices us-ing a computer is probably not a worthwhile nextstep at this point in the childrsquos developmentOther types of activities may be more appropri-ate less expensive and just as rewarding devel-opmentally and personally

Prerequisites for Augmentative Communi-cation Augmentative communication devicescan literally give voice to the thoughts of indi-viduals who cannot speak or cannot speak clearlybutmdashagainmdashthese devices are not magic Elec-tronic communication devices are of no valueunless the user has some communicative intentThat is for a communication device to be help-ful the user has to have some basic understand-ing of the communication process and must beintentional in expressing choices desires orneeds

For example Maggie is a four-year-old whois nonverbal She communicates her wants andneeds by using eyeblinks as responses to yes orno questions When Maggiersquos dad asks her if shewould like another glass of milk she indicatesher choice by raising her eyes up vertically foryes or moving her eyes down for no Maggieclearly knows what she wants to communicateshe has a consistent method for making herwishes known and she expects that her dad willunderstand her communication and act on it

Dan who is also nonverbal communicatesin a different way He points to objects and makesgestures to show what he wants or needs Hisgestures are clear and used consistently so thatfamily members and even people who do notknow Dan well can understand most of the timewhat he is communicating

Shelley communicates very basic informationabout how she feels by crying when she is un-comfortable or wants attention and by laughingwhen she enjoys something like music brightlights or water running Shelley does not how-ever respond to yes or no questions She doesnot make choices even when objects are pre-sented to her individually or in pairs She can-not respond to a question like ldquoDo you want someice cream nowrdquo Or ldquoWould you like the teddybear or the dollrdquo

Maggie and Dan may benefit from usingsome communication device because they arealready using communication systems meaning-fully and consistently Shelley however mayneed to develop greater ability to communicatemeaningfully before moving on to electroniccommunication

Communication skills fall along a continuumAt one end of the continuum are very simplecommunications like expressing preferences byindicating yes or no pointing or gesturing towardobjects or pointing to pictures Use of sign is amore complex form of communication becauseit requires that the user understand that the signsare symbols for meaningful communicationsWhen an individual is able to string togethersigns or words into meaningful phrases this isan additional step toward more complex com-munication When a person understands syntaxand is aware of typical word order this is anotherstep forward Each of these advances along thecommunication continuum represents a step to-ward more complex and sophisticated commu-nication Whatever assistive communicationdevice is chosen should match or just slightlyexceed the place on the continuum where the in-dividual is functioning It makes no sense forexample to purchase an elaborate electronic com-munication device that requires understandingsymbols and syntax when the individual usingthe device is just at the point of learning how toexpress yes and no preferences

An electronic device does not teach commu-

11

nication it enhances communication by givingaudible expression to thoughts that already existin the mind of the user If the thoughts are notthere yet or are not completely formed they can-not be expressed by the device

Physical and Sensory Impairments Are NotBarriers Mastery of a few simple prerequisiteskills is necessary before computers or electroniccommunication devices should be consideredbut it is not necessary for a child to master everydevelopmental milestone before entering theworld of assistive technology Physical or sensoryimpairments can often be circumvented by thetechnology itself and typical developmentalmilestones can sometimes be bypassed so thatassistive technology can be used For examplesome educators assume that students cannot usecomputers until they have completely masteredkeyboarding skills This is a false assumptionMany students benefit from using computerseven though they operate the machine using aldquohunt and peckrdquo method or only one or two keysIn a similar fashion students with limited verbalability who have not mastered oral speech ben-efit from using augmentative communicationdevices while they continue to develop oral lan-guage

Overall the keys to knowing when to tryassistive technology are (a) being realistic aboutthe childrsquos cognitive abilities and potential and(b) being open to trying the level of technology

which meets the child where he or she is

bull Get a multidisciplinary evaluation

Evaluations for assistive technology are notalways easy to arrange In many parts of theUnited States there is no convenient center orldquoplacerdquo to go for an assessment The availablecenters may be far away in another city or evenanother state Since assistive technology is a newfield the systems for disseminating informationand providing assistance are in the process ofevolving Parents may have to be ldquoassistive tech-nology detectivesrdquo in order to put together theinformation needed for a complete AT evalua-tion for their child

The place to start the evaluation is by consid-ering the functions the child needs to performand cannot because of impairment The physi-cians teachers and therapists currently workingwith the child as well as family members andfriends who are around the child on a daily ba-sis can provide very valuable information aboutfunctional problems and potential solutions

Finding Functional Solutions The Alliancefor Technology Access (ATA) a national networkof assistive technology centers has developed aninformal method for using the functional infor-mation available from professionals family mem-bers and friends as a basis for analyzing assistivetechnology needs This process called a Solu-tion Circle is a means to bring people togetherin an informal session that allows for creative

figure 2 Factors to consider when selecting Assistive T echnology

Cognitive Factorsbull Diminished Cognitive Abilitiesbull Learning Disabilitiesbull Attention Deficitsbull SensoryPerceptual Deficitsbull Memory Deficitsbull Abstract Reasoning Deficitsbull Problem-Solving Deficits

Motor Factorsbull Voluntary Motor Deficitsbull Involuntary Motor Deficitsbull Fixed Posture amp Positioning Deficitsbull Recurring Purposeless Motionbull Motor Paralysisbull Low Muscle Tonebull Rigiditybull Spasticitybull Tremors

12

thinking and is not inhibited by what is ldquolegalrdquoldquocurrently availablerdquo or ldquowhat has been done be-forerdquo The individual with a disability and 4-10family members professionals and friends gettogether to brainstorm ideas about the technol-ogy which may help the individual perform func-tions that are hard or impossible to do becauseof disability The Circle usually includes a bal-ance between people who know the person whoneeds the technology and people who have spe-cialized knowledge about technology educationor work-related issues

Solution Circle for Tom To demonstratehow the Solution Circle works letrsquos take a lookat how this process was used in the case of Toma high school student with a learning disabilityFor Tom the print in textbooks is a significantbarrier to learning Tom is ldquoprint disabledrdquo thatis he cannot read the printed word with muchcomprehension Reading is a slow unproductiveprocess for him even though he is intelligent andeager to learn Tom and his parents were hopingthat there might be a way that new technologycould help Tom overcome or work around hisproblem with reading so that he could get moreout of school and perhaps go on to college

Tomrsquos Solution Circle included his parentsBetty and Bob his resource teacher a friendDarrell his soccer coach his 4-H leader and theowner of a local computer store This group mettogether to think about how Tom could partici-pate more fully in school and prepare himself forcollege even though he could not read with com-prehension past the second or third grade level

Solution Circles generally take 1 to 1 12 hoursto complete The steps include the following

1 Star Time The individual for whom theSolution Circle is being held is described in a ho-listic way The emphasis is on how the individualis functioning at home and in the communityWhat does he or she like and dislike What arehisher goals Interests If possible the indi-vidual with a disability speaks for himself or her-self or a video or pictures may be presented The

point of this part of the discussion is give a clearpicture of the individual as a whole person

At Tomrsquos Solution Circle he explained hisdream of going to college and becoming an agri-cultural botanist Tom loves plants he is inter-ested in breeding new strains of wheat and per-fecting various types of grain crops Tomrsquos 4-Hleader agreed that Tom had real gifts in under-standing plant growth and physiology and thathe already had sophisticated knowledge aboutbotany which would prepare him well for col-lege study

2 Strengths With a complete picture of theindividual in mind the group then makes an ex-haustive list of the individualrsquos strengths particu-larly noting any technological accommodationswhich the individual is already using What doesthe individual do well What are his or her un-impaired functions Often this discussion revealsan incredible number of adaptations that the in-dividual has already achieved

Tomrsquos Solution Circle discovered that he hadmany strengths including keen intelligence per-severance and thoroughness when approachinga task Tom already had some effective learningstrategies for remembering material that heheard He had also learned to use a small taperecorder for keeping track of information pro-vided in class

3 Obstacles With the individualrsquos strengthsin mind the group then turns its attention to aconsideration of the environment in which theindividual is functioning and the activities inwhich the individual wants to participate butcannot at this time The group considers whatthe obstacles and barriers might be for the indi-vidual in his or her environment and makes alist of these impediments

For Tom reading was a serious obstacle Hecould not keep up with homework assignmentsbecause it took him so long to read his textbooksIn addition he had difficulty reading directionson tests and often misread assignments on the

13

COGNITIVE FACTORSCognitive Ability

Documented below average abilityDocumented significant overall delayDoes not appear age appropriateLacks understanding of cause amp ef-

fectPaying Attention

Difficulty following prompts or direc-tions

Difficulty with multi-step proceduresDifficulty filtering informationDifficulty staying on task

PerceptionNeeds lengthened response timeRequires multi-sensory inputDifficulty with rapid changeSignificant visualperceptual problemsSlow visual-motor dexterity

MemoryDifficulty with recallRequires reteaching learned skillsRequires repeated practice

Abstract ReasoningDifficulty analyzing simple proceduresUnable to reproduce a sequenceUnable to analyze or synthesize in-

formationProblem Solving

Unable to use prompts or cues to ac-complish tasks

Unable to modify attempts and try an-other way

MOTOR FACTORSMobility

Needs help to be mobileNeeds motorized help to be indepen-

dentNeeds help boarding transportationUnable to transfer independentlyCannot climb stairsCannot open doors independentlyCannot carry materials in hands or

armsCannot lift weight

Voluntary MotorLimited control of head trunk or ex-

tremitiesVisual motor deficitsFixed position and posture

figure 3 ASSISTIVE TECHNOLOGY EVALUATIONIndividual Functional Analysis

Name Date

Needs support to sit or standNeeds adaptations in order to use

technologyMotor Paralysis

Changes in muscle tone interfere inmotor movements

Spastic movements result in poor con-trol

Limited movement of head arms orlegs

Difficulty balancing in sitting positionDifficulty maintaining good posture

Low Muscle ToneLimited use of arms or legsPoor posture controlFatigues quickly

RigidityInhibits arm and leg movementInhibits balance to sitInhibits good posture

SpasticityLimited upper range of motionLimited lower range of motionInterferes with accuracy and consis-

tency of motor movements on oneside

TremorsPresent all the timePresent when doing purposeful upper

extremity taskUnable to compensate for tremors

Extraneous MovementAthetoid (constant)Ataxia (poor coordination in move-

ment)FINE MOTOR

DexterityLimited fine motor controlHas limited hand movement

HandwritingWriting or copying ability is signifi-

cantly below peersSignificant legibility factor--written

work not readableCannot keep up with the pace of writ-

ten workIs frustrated by writingFatigue is a factorTyping appears to be potentially faster

than handwriting

SELF CARENeeds assistance with going to the

bathroomUnable to be toilet trainedNeeds assistance to eatCannot take in food orallyNeeds suctioning routinelyHas degenerative medical conditionIs medically fragileSeizures limit alertnessNeeds to rest frequentlyNeeds assistance to zip coat or tie

shoesCOMMUNICATION

Receptive LanguageReceptive language is significantly

lower than abilityReceptive language is significantly

higher than expressiveExpressive Language

Speech is unintelligibleExpressive language is significantly

lower than abilityMean Length of Utterance (MLU) is 3

words or lessSpontaneous or self initiated language

is significantly limitedDoes not make choices consistentlyDoes not respond appropriately with

yes or noDoes not have communicative intent

SENSORYVision

Requires corrective lensesRequires large print to readRequires mobility trainingHas blind spot

HearingRequires preferential seatingHearing limitations affect the language

thresholdsRequires assistance to receive lan-

guageRequires sign language to receive lan-

guageHas fluctuating hearing lossNeeds visual signals for safety pur-

poses

14

blackboard

4 The Enemy Within Physical and cogni-tive impairments may pose difficult obstacles foran individual but often the feelings that peoplehave about the individualrsquos disability or aboutassistive technology pose greater problems thanthe disabilities themselves The Solution Circleprocess recognizes that human fears concernsreservations and prejudices might stand in theway of a personrsquos success as much as other typesof limitations Getting these fears and concernsout on the table often helps the group to deal moreconstructively with what is possible and whatneeds to be done

One of the serious issues in Tomrsquos situationwas that his resource teacher felt he should con-tinue to try to read for himself instead of using aldquocrutchrdquo like assistive technology The teacherthought that if Tom did not have to read all thematerial he would lose what little reading skillhe had In some ways the teacherrsquos oppositionto considering assistive technology actually poseda greater barrier than the reading problem itself

5 Solutions The exciting part of a SolutionCircle occurs when the group takes each obstacleor concern and turns it into a possible solutionthrough the use of technology or some other typeof adaptation Not all solutions suggested even-tually prove to be feasible but the point of thediscussion is to produce many possible solutionsso that the individual and his or her family havean array of options from which to choose Withgood minds puzzling over the problems and aspirit of cooperation and collaboration seeminglyimpossible barriers can be removed or conqueredThe process recognizes the expertise and contri-butions of all participants including the indi-vidual with disabilities and his or her familymembers The freewheeling format of the dis-cussion promotes ingenuity and innovation Allinvolved come away from a Solution Circle ener-gized by the new possibilities

Tomrsquos Solution Circle became excited about

the possibility of solving his reading problem byusing computerized texts The computer storeoperator mentioned he had heard that Record-ings for the Blind (RFB) offered textbooks on diskTomrsquos parents got in touch with Recordings forthe Blind and ordered texts for Tom to try on hiscomputer at school Soon Tom found that hecould keep up with his classmates and study ex-actly the same material that they were coveringBecause Tom had good strategies for memoriz-ing information that he heard he learned quicklyfrom the texts that were read aloud to him by thecomputer When given oral tests by his classroomteachers he was able to recite appropriate an-swers which would have eluded him if he hadhad to read the tests for himself

Technology has made all the difference forTom he has every reason to think that he will beable to go to college and pursue his intellectualinterests His resource teacher is now completelysold on the idea of assistive technology and us-ing computerized books and wants to use thetechnique with other students More than thatTomrsquos teacher also appreciates the process of theSolution Circle which allowed professionals andnonprofessionals to work together to find prac-tical solutions without being too concerned aboutthe formalities of the special education processThe informal nature of the Solution Circle vali-dated the expertise of all the participants andgave everyone a chance to offer suggestions Thecombination of a new process for planning andnew technology made Tom a winner This samecombination holds potential for many studentslike Tom who benefit from technologies whicheliminate barriers and open up new possibilitiesfor learning

From Function to Technology Solution Ithappened that a participant in Tomrsquos SolutionCircle hit on a great idea for a solution to his func-tional problem with reading This was a fortu-nate connection to make At the suggestions ofhis Solution Circle Tom began to use computer-ized books which he ldquoreadsrdquo by having the com-

15

puter speak the words as he follows along withthe text For Tom computerized books proved tobe a successful solution to his reading problembecause they help him to get the information heneeds without struggling with the reading pro-cess

Not every Solution Circle will be like Tomrsquosand identify the exact technology that the indi-vidual needs But if a Solution Circle has workedwell the end result will be a clear analysis of thefunctions that need to be performed This func-tional information can then be brought to techni-cians who can make suggestions for possibleassistive technology solutions There are over 50assistive technology centers in the United Stateswhere knowledgeable individuals can assistpeople with disabilities and their families withmaking a match between functions that need tobe performed and the technology that is availableto perform those tasks A list of assistive technol-ogy centers is available in the Appendix to thisGuide

Formal Assessment Solution Circles are aneffective informal way to identify functionalneeds that can be met through technology How-ever in the school setting it is also necessary toestablish a studentrsquos needs for technology in amore formal way Formal evaluations for assistivetechnology must be multi-disciplinary involvingeducators and therapists who are knowledgeableabout the school curriculum and the particulartypes of impairments that the student being as-sessed may have For example for a student withcerebral palsy the assistive technology evaluationmight involve a teacher a physical therapist aspeech and language clinician and an occupa-tional therapist The teacher would assist thetherapists in determining what skills the studentneeded to learn and how technology might assistthe student in acquiring those skills Someassistive technology evaluations might require theadditional services of an A-V technician adap-tive physical education teacher a rehabilitationcounselor or speech and language pathologist

with specialized training in augmentative com-munication In school districts where there is nospecialized expertise in technology and its appli-cations it may be necessary to contract for evalu-ations with special education cooperatives medi-cal centers or centers that focus on technologyassessment

Individuals conducting an assistive technol-ogy evaluation should

bull Be knowledgeable of the studentrsquosstrengths and weaknesses medical needsmobility fine and gross motor skills cog-nitive ability communication abilities vo-cational potential self help needs sensoryabilities level of academic achievementand area(s) of disability

bull Have knowledge of and access to an arrayof assistive technology devices

bull Be familiar with the studentrsquos educationalsetting and educational needs

bull Be able to communicate effectively withparents and educators

Because the assistive technology field is sonew there are no particular licenses orcredentialing processes to identify a professionalas qualified to do assistive technology evalua-tions Generally speaking individuals with pro-fessional licenses as occupational or physicaltherapists special educators speech pathologistsor rehabilitative counselors may have the exper-tise to conduct an AT evaluation When consid-ering an evaluator it is wise to ask about theevaluatorrsquos specific experience with assistivetechnology It is also important to recognize thatno one person or discipline will know everythingabout assistive technology therefore access toknowledgeable people at the local level andthrough other agencies programs or services isessential

Conducting the AT Evaluation The assistivetechnology evaluation must be tailored to theunique needs of the student In some cases theevaluation may be conducted by at team of indi-

16

viduals in other cases the evaluation may beconducted by a single individual (eg the speechpathologist) Questions to be addressed duringthe assessment should be related to the specifictasks the student needs to be able to perform andwhat if any assistive technology would helpThe following questions may be considered dur-ing the assessment

bull What tasks does the student need to per-form that he or she cannot perform

bull Is there a low tech device which will ad-dress the studentrsquos needs satisfactorily

bull What types of high tech assistive devicesmay help the student in performing thetask

bull Will assistive technology help the studentto perform the task in the least restrictiveenvironment

bull Is the device being considered suited to thestudentrsquos educational needs and abilities

bull Will the assistive technology device remainsuitable over time How long lasting willthis solution potentially be

The above are only a few of the considerationswhich need to be addressed as part of the evalu-ation process There is no specific ldquotestrdquo forevaluating the need for assistive technologyTherefore prior to conducting the evaluation theindividuals doing the assessment need to have awell planned process in mind

The formal written assistive technologyevaluation report should address but not belimited to the following points

bull Procedures used to evaluate the student

bull Instruments employed in the evaluationassuring that a range of levels of technolo-gies has been considered

bull Results of evaluations including bothqualitative and quantitative measures

bull Recommendations for levels of technologyappropriate to the studentrsquos capabilitiesand potentials and

bull Implications for educational program-ming including discussion of both indi-vidual technology needs and recom-mended environmental and instructionalmodifications

In the end an assistive technology evaluationshould provide recommendations for accommo-dations adaptations devices and services basedon the individualrsquos strengths needs and pre-ferred lifestyle The evaluation should indicate(a) whether devices and services have potentialfor improving function and (b) what trainingmay be necessary in order to use the technologyequipment safely and effectively

bull Examine available technology with a criti-cal eye

It is easy to be dazzled by the possibilities innew assistive technology but it is important forparents to be wise consumers and ask probingquestions about the features and quality of anassistive technology device The following is alist of questions to consider when evaluating aparticular assistive technology device

Performance

Does it work efficiently and effectively

Is it easy to learn to use this device

Is it compatible with other devices

Does this device serve only one purposeor is it flexible

ldquoElegancerdquo

Does this device represent the simplestmost efficient way to accomplish the task

Or is this device too elaborate too com-plicated to be worthwhile

Ergonomics

Does it fit the individual

Is it convenient to use in the environment

Is the equipment portable enough to gowhere the user goes

Are different devices needed in differentenvironments

17

Reliability

What is the manufacturerrsquos reputation forreliability

Does it stand up well to normal use

Is it durable

Safety

Is it safe to use

What is the power source for the deviceIs it safe

Is a margin built in for foreseeable mis-use

Practicality

Do company sales people seem knowl-edgeable and helpful

Are the companyrsquos service people knowl-edgeable and helpful

Does the device have a warranty Howlong is the device guaranteed to function

How available are repair services Atwhat cost

Can this device be leased

Is this device available for a trial periodbefore purchase

Will this device soon be outdated Issomething better on the horizon

Will the company update the device

Does the manufacturer provide trainingin using the device

Aesthetics

Is this device attractive to the eye

Does the device fit well into the userrsquoslifestyle

Normalization

Does the device assist the user with morenormalized living

Can the user operate the device indepen-dently or with a minimum of assistance

Or does the device ldquostick outrdquo too muchand advertise the disability of the user

Does the equipment minimize differenceor exaggerate difference

Does the device have the potential to in-crease the quantity and quality of time spentwith nondisabled peers Or does the de-vice separate the user from others

Cost effectiveness

Do the benefits the device provides jus-tify the cost

Are there less expensive devices or mod-els that serve the purpose as well

Personal acceptance

Is this device the userrsquos own choice

Does the potential user like this deviceand want to use it

Does the potential user view this deviceas life-enhancing

Would the user have preferred some otherdevice or means to perform the task

Will using the device always be a choreor can using it become a habit

There are several ways that consumers canfind answers to their specific questions aboutassistive technology devices Most vendors willprovide good basic information about the prod-uct Call the vendor and ask for brochures prod-uct specifications price list and any other writ-ten information This is a place to start A sec-ond step is to read reviews of the product in trademagazines or Closing the Gap a widely respectedpublication that reviews new assistive technol-ogy products If possible it is very helpful totalk to other consumers who are already usingthe product Ask them about the pros and consof using the device Then visit a preview centerif there is one nearby and try out several typesof devices Ask for general recommendationsfrom the preview centerrsquos staff After identify-ing a device that appears to meet the potentialuserrsquos needs try the device out for a month tosix weeks to make sure that it performs as adver-tised and fits in well with the userrsquos lifestyle

18

During the trial period it will be possible to iden-tify training needs for the user family membersand school staff The trial period will also be atime for the user to test the device in several set-tings to determine its portability and flexibility

bull Match the Individualrsquos Needs to SpecificEquipment Features

When considering an assistive technologydevice it is very important to consider how adevice matches up with the particularindividualrsquos needs and habits In some ways anassistive device becomes an extension of theuserrsquos mind and body As such it is a highly per-sonal item A device may work as advertisedbut still not meet an individualrsquos needs becausethe individual just does not feel ldquocomfortablerdquo inusing it For example Cindy a fourteen-year-oldwho is totally blind and has mild cerebral palsyaffecting her hands and arms was being taughtMorse Code as a means to speed up her writingShe had difficulty using a Brailler because her armstrength was so limited so her teacher thoughtMorse Code would be an easier method of writ-ing for Cindy The only problem was that Cindydid not like using Morse Code To her it seemedlike she was having to learn another complicatedlanguage when she already knew braille andliked to use it Cindy admitted that writing inbraille was slow for her but she was more com-fortable with it Cindy and her teacher were atan impasse until a friend suggested to Cindy thatshe try writing on a voice-output computerCindy loved the computer With a headset at-tached to the sound system she could listen care-fully to the computer as it read aloud the lettersand words she was typing on a light touch tac-tile-marked keyboard This computer also had afeature of printing out text in either standard printor braille Cindy was delightedmdashshe could writecopy for herself to read in braille and for hersighted teachers to read in regular print Thissolution worked because it met Cindyrsquos learningneeds and responded to her own ideas about her-self She did not want to use Morse Code because

it was a separate type of communication knownonly to a few With her computer voiced soft-ware and dual printer she had the best of twoworldsmdashshe could ldquohearrdquo her writing as shetyped she could read it over in braille and hersighted teachers could read her finished prod-uct This solution helped Cindy to improve hercomposition skills speed up her writing timeand communicate more easily with sightedpeople

Cindy was fortunate because her assistivetechnology solution met her needs almost per-fectly Such a close match is not however al-ways possible Nonetheless every effort shouldbe made to have the match be as close as it canbe In general when assistive technology solu-tions are individualized simple to use and re-sponsive to the whole person they are more likelyto be used by the individual When the deviceperforms a task well but does not ldquofitrdquo the indi-vidual the technology is likely to be abandonedby the user in favor of something else whichmeets the need more exactly Too often devicesare purchased because of their technical poten-tial without thought to their relationship to theindividual and his or her lifestyle These mis-matched devices are the ones that end up lan-guishing in their packing boxesmdasha sad reminderof time and money spent to no avail

bull Try the Device Before Buying

It cannot be emphasized enough how vital itis to try out assistive technology devices andequipment before buying Trying out a devicefor several weeks provides the user with an op-portunity to learn how to use the device and howto adapt to its features while at the same timetesting the device in the various environmentswhere it will be used For example Mike triedout a communication device which attachednicely to his wheelchair tray and was compat-ible with his computer that he used for doingschool work Though the communication deviceworked well and was relatively easy to program

19

MOTORSELF CARE

manual wheelchairpower wheelchairbus liftsupportive classroom

chairstanderwalkerlift for transferspositioning devicecanes or crutchesadapted commodesuctioning devicebraces or supportsother ____________

________________

________________

________________

________________

________________

________________

________________

________________

________________

________________

________________

figure 4 ASSISTIVE TECHNOLOGY EVALUATION

Device or Equipment Features or Functions

Name Date

FINE MOTOR

word processorword processor with

predictionvoiced word proces-

sor with predictionadapted keyboardkeyguardalternative key

arrangementvoice activated

computer accessinfrared computer

accessmouse accesstrackballjoystickpower padswitch (eg mouth

lip chin)touch screenpointersdrag and click desk

accessorysticky keysonscreen keyboardprinter for written

work

adapted feedingutensils

braces or splintsother ____________

________________

________________

COGNITIVECOMMU-NICATION

communciationboard(s)

communication wallettotal communicationmanual signword processor with

voiceprogrammed voice

outputicon predictionelectronic communi-

cation deviceprogrammable switch

with voice output

no-reading-neces-sary word proces-sor

spell checkergrammar checkeroutlining programother ____________

________________

________________

________________

________________

________________

________________

________________

SENSORYPERCEP-TUAL

hearing aid(s)

classroom amplifica-tion

boosted signal tonoise ratio (egheadset to keepfocus during wordprocessing)

corrective lensesenlarged printtaped booksvoiced word process-

ingvoiced screen

directionsCCTVother ____________

________________

________________

________________

________________

________________

________________

________________

________________

________________

________________

20

Mike found out quickly that the device was justtoo bulky to be useful for him When he trav-eled around the school the communication de-vice blocked his view of the terrain and of peoplepassing by He found he missed opportunitiesto communicate because he could not see whowas coming his way Mike also discovered thatthe communication device did not serve him wellin crowds like at pep rallies or basketball gamesAfter a month of working with this communica-tion device Mike decided it was not for him andselected instead a device that was less compli-cated smaller and more portable The seconddevice was not as sophisticated as the first but itbetter met his needs for quick communicationwith friends in social settings If he had not hadthe opportunity to try out both devices for anextended period of time Mike might not haverealized the value of the second device and mayhave been stuck with a communication devicethat was too large and too sophisticated to matchhis lifestyle

Similarly Marilyn benefited from a trial pe-riod with her communication device She foundout the first week that the particular device shehad chosen would not work for her because itbroke too easily and it was difficult to get re-paired During the first week that Marilyn hadthe device for trial her teacher broke one of thebuttons during a programming session It tooktwo weeks to contact the manufacturer and thenthe device had to be mailed back to the factoryfor repairs The device was gone for over sixweeks and the manufacturer would not supplya ldquoloanerrdquo while Marilyn waited for repairs tothe first device This experience taught Marilynthe importance of having a responsive manufac-turer who is willing to repair devices quickly andto supply substitutes for the user while repairsare being made Marilyn decided on a differentdevice with similar features and a great helplineto provide assistance with the maintenance of themachine

The information that can be learned during a

trial period with a device is invaluable to the userIt is discouraging to find out during the trial thata device is not all it is purported to be or that itdoes not work as well as advertised but it is farbetter to learn before purchase that a device doesnot meet the userrsquos needs than to learn after pur-chase and be stuck with an expensive unusablemachine For the consumer it is daunting to thinkabout starting over again with the process of se-lecting a device Nonetheless it is worthwhileto seek more information and look again Hav-ing been through a trial even when the outcomeis not successful provides the user with greaterclarity about what an appropriate device willhave to be able to do The second time aroundthe search is likely to go faster and come out witha better result

bull Identify Next Steps

Once a device has been selected the con-sumer becomes impatient to have one and beginusing it right away But at this point importantwork still needs to be done Funding the deviceis a major consideration Sometimes families willpay for the device themselves but under othercircumstances the device will be purchased by aschool district through Medicaid or private in-surance or through some other means Parentsneed to become familiar with the various fund-ing options and determine which one will workfor them (See Funding Assistive Technology foradditional information about funding sources)

Also when considering funding familiesshould think about costs beyond the price of thedevice itself For example a computer set-upwith a keyboard monitor and printer might cost$3500 This equipment is basically useless un-less other equipment is purchased as well soft-ware adaptive devices paper manuals up-grades Prices for these additions can raise theactual cost of the device by hundreds of dollars

Devices often require training for the userfamily members and others to ensure effectiveand safe use How much does training cost Who

21

will provide it Repair and maintenance are othercosts usually additional to the price of the equip-ment Sometimes families will also want to insurethe assistive device so insurance payments be-come part of the overall cost

Since making an assistive technology pur-chase is such an important personal and finan-cial decision it is wise to have a realistic budgetin mind that includes all of the equipment andservices that are necessary to make the assistivetechnology work effectively With this budget inmind it becomes easier to plan the purchase seekout funding sources and make a compelling casefor financial assistance

bull Determine What Follow-up Is Needed

After the assistive technology device has beenpurchased and put to use there are additionalfollow-up activities that need to take place Theoriginal assistive technology evaluation shouldinclude a way to monitor the use of the devicePeriodic scheduled reviews the by evaluator fol-low-up calls to and from the family are some waysto help assure effective safe use Families whotravel great distances for evaluation need to becertain that services like maintenance repair andreplacement of devices are available within a rea-sonable distance from home

Assistive technology devices are used bestwhen all the people in the life of the individualwith disabilities understand the devices in thesame way At first devices may seem to exagger-ate differences between a person and the rest ofthe world Care should be taken to explain thatassistive equipment is a difference equalizer nota difference maker Classmates and friends needto understand that the adapted seating or adaptedkeyboard helps the individual do what other stu-dents do Adults in a childrsquos life need to under-stand that devices work to make life easier bet-ter and more functional People need to knowthat ramps help keep individuals with mobilitydisabilities from being separated from peers thatcommunication technology allows people to

ldquospeakrdquo their thoughts

Close communication between parents andtheir childrsquos helpersmdashteachers therapists daycare workers and othersmdashis essential to makesure devices and services are being used safelyand effectively If the device is working well butthe child is not being integrated into the class-room or other environments then there may bea need for additional training for the children andadults who interact with the child

Besides keeping track of how the device isworking and being used it is important to ob-serve progress in the areas of technology whichare useful to the individual with the assistivetechnology device As upgrades of equipmentoccur or more sophisticated models come on themarket the user may want to consider modify-ing or replacing the equipment that is currentlyin use Also as the individual becomes moreskilled at using technology the individual mayoutgrow the current device and need to look formore advanced equipment It can be assumedwith most high tech items that in three to fiveyears there will be a need for upgrade or replace-ment The wise consumer begins early to planfor the next step in technology including savingmoney for a new device and staying alert to thenew options that become available

What kinds of training are important to occurwhen a child has a new assistive technologydevice

Because assistive technology of the high techvariety is so new it is particularly important thattraining be provided to all those who may needit In the school setting it is helpful for all edu-cators and administrators to have some aware-ness training so that they have a general idea ofwhat assistive technology is Areas to be cov-ered in inservice training might include

bull legal issues related to assistive technology

bull awareness training concerning how toserve students with assistive technologyneeds

22

bull information on how assistive technologyrelates to the evaluation process

bull how to write IEPs for students who requireuse of assistive technology devices

bull the relationship between technology andstudent placement

bull the nature of common assistive technologydevices

bull resources to contact for information onassistive technology

Beyond these awareness activities thosemembers of the school staff who work directlywith a student who uses technology need to havetraining on the specifics of using the device andhow it is maintained and serviced Trainingshould include but not be limited to the follow-ing

bull review of the studentrsquos educational andassistive technology needs

bull review of goals and objectives supplemen-tary aids and services and related serviceson the IEP or IFSP

bull training on how to use and maintain thedevice

bull training on proper transport of the devicewithin the school building and from hometo school

bull training on how to program the device ifneeded

bull training on how to use the device effec-tively during instruction

bull training in trouble-shooting when the de-vice is not working properly

bull information about what to do when thedevice is not functioning or broken

bull information about how to coordinateassistive technology with all the activitiesin the studentrsquos day

bull training in methods to evaluate the effec-tiveness of assistive technology

Depending on the type of assistive technol-

ogy used by the student and the studentrsquos needsit may be advantageous for assistive technologyinformation to be shared with the studentrsquos peersSuch training will help fellow students to gainan understanding of the studentrsquos assistive de-vice foster acceptance in the social environmentand reduce fears other students may have aboutsocializing with the student who uses technol-ogy In some cases parents and the student maywant to be involved in the peer training

Parents may require training too in order forthe device to be used at home for the student tocomplete homework assignments or participatein extended school year services Once trainedthe parents can become a resource to the studentfor proper care and maintenance of the device

Most importantly the student himself or her-self will need training in how to use the deviceas independently as possible Training for thestudent may be written into the IEP as a separategoal or may be included as a related service thatsupports the studentrsquos special education pro-gram

SummaryPurchasing a high tech assistive technology

device is a major life decision because of the po-tential impact on the individual and because suchdevices can be costly When considering anassistive technology device it is important to dothe following be realistic about the consumerrsquoscapabilities and needs get a multidisciplinaryevaluation examine available technology with acritical eye match the individualrsquos needs to spe-cific equipment features test the device for a trialperiod identify next steps and determine whatneeds to be done for follow-up after purchaseEvaluations for assistive technology both infor-mal and formal should consider first of all thefunctions that the consumer wishes to performusing technology When evaluating a particularpiece of equipment consideration should begiven to the following features performance sim-

23

plicity of design ergonomics reliability safetypracticality aesthetics normalization cost effec-tiveness and personal acceptance Good sourcesof information about assistive devices are manu-facturers publications trade journals previewcenters and consumers who are already using thedevice Once a device is selected the consumerwill need to secure funding for the purchase andbe aware of additional costs for related equip-ment insurance and training

Hints for Parents

Donrsquot let the cost of assistive technology deter youfrom considering it for your child High tech assistivetechnology can be quite costly but it can also makethe difference for your child in terms of becoming welleducated employable and a fully-included member ofthe community Donrsquot leave any stone unturned whenlooking for funding sources Consider any or all ofthe following for funding or assistance

bull Early intervention programs

bull Schools

bull Transition programs

bull Vocational Rehabilitation

bull State Programs for Children with SpecialHealth Care Needs

bull Medicaid

bull Medicare

bull State Technology Resources

bull Used Equipment

bull Leasing

bull Equipment Loan Programs

bull Disability Organizations

SierraSierra wants to play with dolls like other chil-

dren her age but she has a muscle disease thathas caused her to lose muscle tone except in onehand What could be done to allow Sierra to dressand undress her dolls comb their hair and bathethem

Sierrarsquos SolutionThe assistive technology solution for Sierra

involved her whole family While vacationingin Mexico Sierrarsquos grandmother found her a fash-ion doll that was a bit larger than the typicalldquoBarbie dollrdquo The larger doll was easier for Si-erra to manipulate Sierrarsquos mother sewed sev-eral outfits for the doll using velcro instead ofsnaps or buttons as fasteners

Sierrarsquos dad bought doll stands at a toy storeand fastened several stands with clamps toSierrarsquos wheelchair tray He also fastened a plas-tic pouch to the tray Sierra puts the small dollaccessories in the pouch When Sierra wants todress her doll she puts the doll in one of thestands In this way the doll is held securely andSierra can dress and undress the doll with onehand

Sierrarsquos friends also use the doll stands fortheir dolls With this arrangement two or threegirls can play together

Solution SummaryLarger doll

Velcro fasteners

Plastic pouch

Doll stands

Clamps

24

Funding Assistive Technology

F unding for assistive technology is availablefrom a variety of public and privatesources To receive public or private fund-

ing the individual must meet eligibility criteriafor the specific program and provide sufficientdocumentation of the need for assistive technol-ogy

The following list includes some of the pro-grams which may pay for equipment if the indi-vidual needing the device meets their require-ments Many of these programs are run by dif-ferent agencies in different states making themhard to find In general the statersquos Tech Act of-fice can assist consumers and family members infinding and using these programs (See Appen-dix under Resources)

PUBLIC PROGRAMSEarly Intervention Programs (Individuals withDisabilities Education Act Part H)

Young children (0-3) and their families mayreceive help through early intervention programsin evaluating what the child needs in gettingassistive technology and in learning how to useit Equipment and services must be included ina written plan called an Individualized FamilyService Plan (IFSP) To find the program for aparticular state call National Early ChildhoodTechnical Assistance System (NECTAS) at 919-962-2001 or 919-966-4041 (TDD)

Head StartThis child development program provides

comprehensive educational and health servicesfor eligible children ages 3-5 Since 1982 federallaw has required that at least 10 percent of thetotal number of placements must be available tochildren who are disabled and require specialservices Head Start is a mainstream placementoption for children whose IEP calls for placementwith nondisabled children The January 1993Head Start regulations specifically require the

consideration of assistive technology services anddevices For more information contact NationalHead Start Association 201 N Union St Suite320 Alexandria VA 22314 703-739-0875

Schools (IDEA Part B)This program mandates a free appropriate

public education for preschoolers children andyouth with disabilities An Individualized Edu-cation Program (IEP) is required for all childrenwith a disability These children are entitled tospecial education related services or supplemen-tary aids If the IEP team determines that assistivetechnology is required for a free appropriatepublic education then it must be provided at nocost to the child The technology must be in-cluded in the childrsquos Individualized EducationProgram (IEP) Parents have a right to be in-volved and should help to develop the IEP goalswhich may include technology For help in get-ting assistive technology in the IEP call the TAPPFocus Center on Assistive Technology at 1-800-222-7585

State Operated and Supported Schools (Chap-ter I)

This program provides federal assistance tohelp educate children with disabilities who areenrolled in state-operated and state-supportedprograms Federal funds must be used to payfor services that supplement a childrsquos basic spe-cial education program such as construction andthe purchase of equipment For more informa-tion contact your State Department of Education

Section 504 of the Rehabilitation Act of 1973Section 504 provides a civil-rights mandate

that requires accommodations for students whohave disabilities such as orthopedic impairmentsbut who do not qualify for special education ser-vices It denies federal funds to any institutionincluding a school whose practices or policiesdiscriminate against individuals with disabilities

25

This legislation has resulted in a number of out-comes including various actions to remove physi-cal barriers to education which may incorporateassistive technology For more information con-tact the nearest regional Office of Civil Rights orthe State Vocational Rehabilitation Agency

State Programs for Children with SpecialHealth Care Needs

These programs provide and pay for servicesfor eligible children CSHCN programs varywidely from state to state in the services they of-fer the number of children served and the re-quirements for eligibility Some CSHCN pro-grams do pay for assistive technology deviceswhen no other funding source is available andthe equipment is necessary for health-related rea-sons Most CSHCN programs are run by the statehealth agency To contact CSHCN ask informa-tion for the telephone number of the state healthagency

School-to-Work Transition ProgramsTransition Programs are charged with assist-

ing students with disabilities to receive the jobrelated training and placement services to helpthem move from school to work Sometimesassistive technology may be necessary in orderfor a student to make a successful transition andbecome employable If technology is needed fortransition purposes it can be written into thestudentrsquos Individualized Transition Plan (ITP) Toreceive more information about transition andtechnology call the Parent Training and Informa-tion Center (PTI) in your state (See Appendix)

Vocational Rehabilitation ServicesState vocational rehabilitation agencies pro-

vide information evaluation services trainingand funding for technology and education to helpadults go to work or live more independently Iftechnology is necessary for an individual to workVocational Rehabilitation may pay for the equip-ment as part of an Individualized Work-RelatedPlan (IWRP) To locate the nearest Vocational Re-habilitation Agency look in the telephone book

under state government

Plan to Achieve Self-Support (PASS)One of many Social Security Administration

work incentive programs this program providesan income and resource exclusion that allows ablind or disabled person to set aside income andresources for a work goal such as educationequipment purchase vocational training andstarting a business It should be considered forall students with vocational goals who are receiv-ing social security benefits

This program provides a mechanism forpeople to set aside funds to purchase work-re-lated equipment such as assistive technologydevices and services In many cases if an indi-vidual is a recipient of SSI and writes a PASS topurchase education or equipment an additionalSSI check will be provided to cover other livingexpenses Sometimes if a person receives SocialSecurity Disability Insurance (SSDI) and designsa PASS it may make the individual eligible forSSI because the SSDI has been allocated for equip-ment and services

Impairment-Related Work Expense (IRWE)Impairment-Related Work Expense (IRWE)mdash

one of the Social Security Administrationrsquos workincentive programsmdashallows an employed indi-vidual with a disability who receives or is eligiblefor SSI or SSDI to deduct work-related expensesfrom gross reported income

This deduction allows the person to continuedrawing SSDI or SSI and associated benefits(Medicaid or Medicare) if the IRWE deductionreduces earning below the Substantial GainfulActivity (SGA) Test

Although this method does not provide fund-ing to pay for a device or service it is a way ofallowing the use of the individualrsquos own moneyto pay for assistive devices and services neces-sary to return to work The following is a list ofpossible work-related expenses special transpor-tation to and from work personal assistance onthe job structural modifications durable medi-

26

cal equipment prostheses medical supplies andservices work-related equipment non-medicalappliances and equipment routine drug andmedical costs and diagnostic procedure costs

MedicaidMedicaid is a joint federal and state program

which covers some equipment if it is consideredmedically necessary For more information aboutMedicaid and who and what is covered contactthe local Department of Human Services office

MedicareAlthough not a usual source of funds for

assistive technology Part B of Medicare providescoverage for some durable medical equipment ifit is considered medically necessary and is foruse in the personrsquos home For more informationabout Medicare benefits contact the Social Secu-rity Administration Regional Office

Technology-Related Assistance for Individualswith Disabilities Act of 1988

This federal competitive grants program pro-vides monies for states to establish a statewideconsumer-responsive service delivery system de-signed to effect systems change regardingassistive technology In most Tech Act states afunding specialist or policy analyst is availableto assist with accessing assistive technology Sev-eral states operate loan programs to help withthe purchase of devices and services For moreinformation contact RESNA Technology Assis-tance Project 1700 N Moore ST Suite 1540 Ar-lington VA 22209-1903 703-524-6686

PRIVATE PROGRAMS

Private InsuranceSome health insurance plans will buy equip-

ment but it depends on the specific wording ofthe policy Unless the policy says the equipmentis not covered it makes sense to ask the insur-ance company to pay for it The equipment mustbe considered medically necessary and thereforerequires a doctorrsquos prescription

Loans

There are several low or no interest loansavailable to help buy technology Call the stateTech Act program or the manufacturer of theequipment may know where to get this type ofloan

Non-Profit Disability AssociationsThere are many disability organizations

some of which may be able to loan equipment orprovide information about other funding sourcesor support groups These organizations includeNational Easter Seal Society March of DimesMuscular Dystrophy Association United WayUnited Cerebral Palsy Association and the BrailleInstitute

FoundationsSome private foundations have been set up

specifically to provide help to people with dis-abilities A listing of such foundations can befound at the library or may be available from thestate Tech Act program

Programs Providing Assistive TechnologyThe state Tech Act programs offer referrals

for evaluation and equipment recommendationsas well as assistance with identifying funding orequipment lending sources A therapy depart-ment in a local hospital or Disabled StudentsCenter at a local college or university may alsooffer to help locate technology programs in thearea Alliance for Technology Access Centers(ATA) sometimes have loan programs or infor-mation about purchasing used equipment orrenting equipment

Civic OrganizationsThere are many local civic and service orga-

nizations which may provide money to helpsomeone in their community Lists of these or-ganizations are available from the Chamber ofCommerce Examples of these organizations areLions Club Masons Grotto Veterans of ForeignWars (VFW) Elks Club Rotary Club KiwanisKnights of Columbus and Soroptomists Someof these organizations have a national focus on

27

disability or on a particular disability Others willfund devices for a particular child who is knownto the local club

Charities and Fund-RaisersLocal churches high school groups neighbor-

hood organizations labor unions or special in-terest groups (eg computer clubs ham opera-tors) may plan a fund-raiser to help purchaseassistive technology College student organiza-tions (fraternities and sororities) may give moneyor studentsrsquo time to help a special cause Even ifmoney is not available they may be willing tohelp organize a fund raiser

Local media (radio television newspapers)sometimes will sponsor fund-raising activities tofund devices They may not contribute moneybut will help with organizing the fund-raisingactivity and publicizing it to the community

OTHER OPTIONS

In addition to federal and private fundingsources there are a number of education-relatedgrants corporate technology donation programsand funding options that consumers should con-sider Information on these alternative options isavailable through a number of sources includ-ing the following

NewslettersEducation Grants Alert Capital Publications

Inc PO Box 1453 Alexandria VA 22313-2052800-655-5597

Education Technology News Business Publish-ers Inc 951 Pershing Dr Silver Spring MD 20910-4464 301-5878-6300

Financing Assistive Technology Smiling Inter-face PO Box 2792 Church St Station New YorkNY 10008-2792 415-864-2220

Special Education Report Capital PublicationsInc PO Box 1453 Alexandria VA 22313-2053800-655-5597

Technology and Learning Peter Li Inc Publish-ing 330 Progress Rd Dayton OH 45449 415-457-4333

Technology ManufacturersIf it is not possible financially to purchase

equipment consumers can sometimes rent orborrow equipment directly from the manufac-turer

Used EquipmentUsed equipment is often advertised for sale

in disability-related publications or the consumercan place a newspaper ad to see if used equip-ment can be purchased locally Several compa-nies refurbish old computers and sell them at lowprices Listings of used computer outlets can beobtained from ATA Centers or state Tech Act pro-grams

LeasingMany manufacturers of assistive technology

devices have equipment which is available forrent or lease Sometimes the rent or lease pay-ments can be applied toward purchase Checkwith the manufacturer to see if this is an option

Equipment Loan ProgramsMany states have equipment loan programs

as do some rehabilitation facilities and disabilityorganizations Information about loan programsis available from Tech Act programs

HOW TO APPLY FOR FUNDING

There is an art to applying for funding forassistive technology It is necessary to use justthe right words to suit the particular agency thatmight be the funding source It is also crucial todocument the need for and projected outcome ofassistive technology This documentation shouldinclude at minimum

bull A written statement of medical need fromdoctors or other health professionals If thechild had an evaluation by a rehabilitationprofession also include this report

bull A description of the childrsquos problems re-sulting from the disability This descrip-tion can come from the doctor or other pro-fessional who evaluated the child

28

bull Description of how the technology helpsthe child For example the equipment maymake the child safer or allow the child todo things more independently Be sure topoint out how money will be saved if useof the equipment allows attendant care tobe reduced

bull A clear statement based on assessmentthat the child is a good candidate who hasthe cognitive and physical capacities nec-essary for using the technology

In summary the documentation to supportan assistive technology funding request shouldinclude a physicianrsquos prescription the childrsquos as-sessment an explanation of projected benefitfrom use of the technology or service and anycorrespondence obtained from professionals thatwould support the childrsquos need for technology

The initial funding request should include notonly the cost of the device but also the cost ofongoing support and instruction in the use of thetechnology Assistive devices often have ldquohid-denrdquo expenses that are incurred with their pur-chase and these expenses are frequently costlyover time Battery-powered devices may requirefrequent charging or cleaning Upgrades for com-puter software may be necessary Special modi-fications of the home or school environment maybe necessary for the technology to be used Ineach of these examples costs associated with thetechnology may have to be assumed by the fam-ily if they are not considered in the initial appli-cation for funding

It is also helpful to include with the fundingrequest a picture or a descriptive brochure aboutthe device being requested This is importantbecause often persons who are reviewing theapplication do not know about the wide rangeof technologies that might be appropriate

Appropriate wording on the application isabsolutely necessary Key concepts for Medic-aid include ldquomedical necessityrdquo and ldquorestore thepatient to his or her best functional levelrdquo The

term medical necessity means that the device isincluded in the course of treatment being pro-vided to the child and that a professional suchas a physician or speech therapist is supervisingits use Medicaid and private insurers alike gen-erally pay for technologies that help restorepeople to ldquofunctioning levelsrdquo and take the placeof a body part that is not working Typically theseprograms do not pay for technologies or serviceswhose function is educational or life-enhancingrather than health related

The key for private insurance is ldquoterms of thepolicyrdquo It must be remembered that coverageby any insurance company does not set a prece-dent Just because one child receives needed tech-nology under a particular policy issued by a com-pany does not mean that all other covered chil-dren will also have technology paid for by thatcompany Each application stands on its ownbased on the expressed terms of the policy

It is usually under the major medical provi-sions of a health policy that assistive technologycan be provided as ldquoother medical services andsuppliesrdquo It may however be necessary to pur-chase additional insurance coverage or a ldquoriderrdquoin order for technology costs to be included inthe terms of the policy It is important to remem-ber that heath insurance policies are oriented to-ward health care and not toward changes in theenvironment or rehabilitation

Both private health insurance policies andMedicaid sometimes impose limits on the num-ber of assistive technology devices over a certaincost that can be purchased within a certain timeframe Sometimes the rule is that the fundingsource will purchase only one device in theindividualrsquos lifetime With these kinds of restric-tions it is all the more critical to be sure that thetechnology choice is the right one

TIPS THAT LEAD TO SUCCESS

bull Apply to several funding sources at thesame time Be sure to meet the require-

29

ments of each agency

bull Find out if agencies will share costs

bull Fill in the agencyrsquos forms correctly Manyapplications are denied because forms arenot filled out properly

bull In addition to the standard form includeany other information that describes orshows what the equipment does and howit benefits the child Assume no knowledgeon the part of the reviewers

bull Turn in all documentation at the same time

bull Avoid using jargon define all unfamiliarterms

bull Take the funding request package to theagency in person While there have itchecked to make sure everything requiredhas been included Get the name of theperson who reviewed the application

bull Call regularly to check on the funding re-quest each time try to talk to the same per-son

bull Be super politemdashand persistent

WHAT IF FUNDING IS DENIED

It is not at all unusual for an initial fundingrequest to be denied Even when family mem-bers and professionals have been meticulous inpreparing applications requesting funding forneeded technology denials should be anticipatedMaking an appeal is worth the effort since manydenials are reversed at the appeal level

To start the appeal process obtain any docu-mentation or information provided by the fund-ing agency (eg Medicaid or the private insur-ance company) relating to appeal proceduresforms to use timelines and filing procedures forinstance This information will help in the promptpreparation for appeal The kind of appeal to bemade depends on the reason for denial Whendeveloping an appeal find out the following

bull Why the request was denied Ask for thereason in writing Sometimes requests are

denied because a reviewer lacks under-standing of the technology or there maybe an error in the paperwork

bull If needed correct any mistakes or includemore information then resubmit the re-quest

Going to appeal makes sense because gener-ally the appeal places the application before moreexperienced persons in the decision-making hi-erarchy The technology requested is often newand the initial examiners in the process may beunaware of its usefulness Also insufficient docu-mentation may have been provided in the origi-nal application and the problem can be remediedon appeal

Donrsquot be daunted by the length of the appealprocess Follow it through to its completion Insome states families may be able to appeal a de-nial beyond the first level For example somestates have ldquounfair claims settlement practicesrdquoregulations which are administered through theinsurance commissionerrsquos office

Always make your appeal in person and takethe child and the equipment if possible If onlypart of the money is offered by one agency askanother agency to share costs If the appeal isdenied try again Submit the funding request toanother agency Being persistent will nearly al-ways result in success

When going through the appeal process turnto the state Protection and Advocacy Program (Pamp A) for guidance and support P amp A advocatescan help make sure that a childrsquos rights to tech-nology and related services are not denied

Who pays when assistive technology is neededat school

The party who is responsible for paying forassistive technology depends upon the circum-stances under which the technology is purchasedUnder the special education law students withdisabilities who are eligible for special educationare entitled to a free appropriate public educa-tion Parents do not have to pay for school ser-

30

vices including assistive technology if that ser-vice is part of the studentrsquos Individualized Edu-cation Program (IEP) If the student is eligible forMedicaid the school district can request thatMedicaid pay for the device If parents choose todo so they may agree to use private insurance topay for a device that is used at school Parentscannot however be forced to use their insurancein this way If the private insurance requires aco-payment the school district would have to paythis amount since parents should not have to payany special education related costs

Does Section 504 pay for assistive technologySection 504 part of the Rehabilitation Act of

1973 is basically a piece of civil rights legislationthat is intended to prevent discrimination againstindividuals with disabilities in any programwhich receives federal funding Students whohave disabilities but who do not qualify for spe-cial education may still be eligible for accommo-dations under Section 504 of the RehabilitationAct of 1973 Section 504 however does not pro-vide any funding for accommodations

Like the special education law Section 504requires public schools to provide students withdisabilities with a free appropriate public educa-tion and in addition ensures that students withdisabilities are afforded an equal opportunity toparticipate in school programs For students withdisabilities this means that schools may need tomake special arrangements so that these studentshave access to the full range of programs andactivities offered For example a student whoneeds a wheelchair lift on a school bus to get toschool must be provided with this technologyOther modifications which might be requiredunder Section 504 include installing ramps intobuildings and modifying bathrooms to provideaccess for individuals with physical disabilitiesEven though required by the law none of thesetypes of modifications would be funded by Sec-tion 504

Under what circumstances does private health

insurance pay for assistive technologySome private health insurance policies will

pay all or part of the cost for some assistive tech-nology devices The devices are unlikely to belisted specifically in the policy but may be in-cluded under some generic term like ldquotherapeu-tic aidsrdquo Usually the devices have to be pre-scribed by a physician in order to be covered bythe policy

When does Medicaid cover assistive technol-ogy

Medicaid (Title XIX) will pay for ldquoprostheticdevicesrdquondashthat is replacement corrective or sup-portive devices prescribed by a physician or otherlicensed person Each state has some flexibilityin determining which prosthetic devices it willinclude in its list of Medicaid covered expensesDevices that are frequently covered by Medicaidare canes crutches walkers manual wheelchairshospital beds and hearing aids or eyeglasses forchildren and youth

SummaryAssistive technology can be expensive to pur-

chase but there are a number of public and pri-vate sources for funding devices Common pub-lic funding sources include early childhood in-tervention programs schools Vocational Reha-bilitation and Medicaid Private sources mayinvolve health insurance personal loans chari-table donations or fundraising It is very impor-tant to provide proper documentation and usecorrect wording and procedures when request-ing funding Initial requests for funding are fre-quently turned down but appeals can be success-ful

31

TEDTed is an active four-year old who lives in a

small rural community with his parents andyounger sisters He was identified as speech im-paired and has been attending preschool specialeducation classes Ted has normal mental capa-bilities but his mild cerebral palsy impairs hisability to speak Because of the speech therapyhe has received Ted is able to make some speechsounds but he says no intelligible words Heuses sign to communicate with his special edu-cation teacher and his parents No one else inhis community uses sign so Ted is limited in hisability to communicate with others

As Tedrsquos IEP Team looks ahead to his entryinto elementary school the Team recognizes thathe will need better communication skills in or-der to participate successfully in the regular class-room His speech therapist has recommendedthat Ted begin to use an AlphaTalker

What funding sources might pay for theAlphaTalker

What case could you make for funding Arethere any obstacles to seeking funding

TEDrsquoS SOLUTIONAt this point Tedrsquos ability to communi-

cate is somewhat primitive Because of his cere-bral palsy he is not able to make conventionalsigns so the gestures he makes are understoodonly by those who know him well A simple elec-tronic communication device may work for Tedbut there are some prerequisite communicationskills he will have to master first Augmentativecommunication devices operate on the principleof choosing icons (abstract symbols) that repre-sent certain basic communications like a cup toindicate ldquoI want a drinkrdquo

In order to make a picturesymbol systemmeaningful and functional for Ted at his youngage his speech therapist began to work on point-to-object and point-to-picture activities WhenTed had mastered point-to-picture activities histherapist made a picture ring for him On thering were picture symbols (icons) for things thatTed might want to say Tedrsquos family his teacherand his classmates began to ask him to use hispictures to explain what he wanted Soon Tedwas using pictures to communicate simple wantsand needs effectively His word ring went withhim everywhere and helped him to ldquotalkrdquo topeople he did not know as well as to friends andfamily members

An unexpected bonus to the picture practiceis that Ted is verbalizing more and his speech hasbecome more intelligible He has even begun tosing An electronic communication device maybe in Tedrsquos future but for now he is learning tocommunicate well with his picture ring and somespoken words

Solution SummaryPoint-to-picture practice

Use of picture ring

32

GLORIAGloria an eighteen year-old with mild cog-

nitive delays and CP is about to finish highschool She has been using a laptop computerand switch access hardware and software in lieuof a pencil and paper to complete work in highschool The equipment and software were pro-vided by the school district through the IEP pro-cess Gloriarsquos current goal articulated in her In-dividual Transition Plan (ITP) as mandated byIDEA is to have a full-time job by the time she is22 She wants to work in an office and woulduse a computer system similar to her currentsetup As she moves into the transition periodthese questions must be addressed

Will the laptop computer she has been usingbe functional for her in the workplace

Will she need to consider new equipmentWhat would influence a decision to purchase newequipment

What funding sources might help Gloria topurchase new equipment

What case should Gloria make for funding

GLORIArsquoS SOLU-TION

Gloria is fortunate to have learned computerand word processing skills while she was inschool Now she must learn ways to transferthese skills into the work setting Laptop com-puters are not typical in offices instead whatGloria is more likely to encounter is a desktopworkstation with computer and printer In or-der to use a standard computer Gloria will needa switch access device and an onscreen keyboardto do word processing and data entry

Since single switch access is necessary forGloria to become employed in an office settingGloriarsquos Vocational Rehabilitation Counselor waswilling to make such a purchase for her Gloriaapplied to be a data processor with a temporaryemployment firm and got the job Gloriarsquos VRcounselor helped her to select switch access hard-ware compatible with most IBM compatible com-puters In her new job Gloria changes office set-tings frequently Each time she moves she takesher switch access device and onscreen keyboardsoftware with her With these portable items sheis able to adapt each new office setting to meether needs Having the right technology has madeGloria an adaptable and successful temporaryoffice employee

Solution SummarySwitch access

Onscreen keyboard software

33

Making Assistive Technology a Part ofChildrsquos Education

The ideal time for a child with a disabilityto learn to use assistive technology is whenthe child is learning all sorts of others skills

in early intervention services preschool and K-12 education Children who are eligible for earlyintervention services under Part C or special edu-cation under Part B of the Individuals with Dis-abilities Education Act (IDEA) are entitled to beevaluated for assistive technology needs and toreceive assistive technology devices and servicesif they are necessary to providing a free appro-priate public education In order for children toreceive the assistive technology to which they areentitled parents must be knowledgeable abouthow assistive technology fits into special educa-tion and the ways that AT can be included in achildrsquos Individualized Family Service Plan (IFSP)or Individualized Education Program (IEP)

ASSISTIVE TECHNOLOGY FOR YOUNG CHILDRENParents are often surprised to learn that

assistive technology can be appropriate for in-fants and toddlers Very young children whohave disabilities that limit their ability to inter-act with the environment by crawling touchingseeing or hearing can benefit from technologythat improves their interactions Federal educa-tion amendments require states to ldquopromote theuse of assistive technology devices and assistivetechnology services where appropriate to en-hance the development of infants and toddlerswith disabilitiesrdquo These amendments furtherrequire states to ldquofacilitate the transition of in-fants with disabilitiesfrom medical care to earlyintervention services and the transition fromearly intervention services to preschool specialeducation or regular education servicesrdquo

When Kayla was an infant her interactionswith the environment were very limited because

she has a genetic condition resulting in abnor-mally short arms and legs She could not turnover or crawl she had difficulty touching andgrasping objects As part of her early interven-tion program Kayla was introduced at the ageof six months to the use of switches When theswitches were positioned correctly she could ac-tivate switch-operated toys or noisemakers Theopportunity to interact with toys opened upKaylarsquos world She soon began to hunt for theswitches and to activate certain toys on com-mand She used the switches to make choicesbetween toys or sounds She became verballymore expressive and began to interact morereadily and more often with her parents and sib-lings

By the time that Kayla was three and readyfor preschool special education she was able tosit up and interact with a computer activated byswitches She could identify objects on the com-puter screen and match those objects to real ob-jects in the world around her At three Kaylacould identify and match some letters and shapeson the computer screen Though limited in hermobility Kayla became an active participant inclassroom activities She could interact withclassmates by playing computer games joiningin at circle time and participating in allpreacademic learning activities

Assistive technology was an integral and nec-essary part of Kaylarsquos early intervention servicesKaylarsquos parents were involved in writing the In-dividualized Family Service Plans (IFSPs) thatoutlined the services Kayla and their familyneeded From the beginning Kaylarsquos family hadthe opportunity to see how assistive technologycould be included in the IFSP and really make adifference in Kaylarsquos education and her life

Kaylarsquos story illustrates how assistive tech-

34

nology can be utilized from an early age and canbe part of the transition from medical treatmentto early intervention and from early interventioninto preschool special education or regular edu-cation Because of the availability of early inter-vention services there is no reason to wait untila child is of school age before trying assistive tech-nology Early use of the necessary technology willenhance a childrsquos development by increasingopportunities to interact with the environment

ASSISTIVE TECHNOLOGY AT SCHOOL AGE ANDBEYOND

When students enter kindergarten and begintheir regular public school years assistive tech-nology can continue to be a part of their specialeducation programs For students who are eli-gible for special education assistive technologymust be provided when it is necessary

(1) to support placement in the least restric-tive environment

(2) to ensure that a student benefits from hisor her education or

(3) to implement the goals and objectives inthe studentrsquos IEP

Needs for assistive technology should be oneof the considerations when a student is assessedto determine eligibility for special education Ifan assessment reveals that a student is eligiblefor special education then the multi-disciplinaryteam should consider assistive technology needswhen making recommendations for the Individu-alized Education Program (IEP) The team shouldanalyze what is required of nondisabled studentsof the same age and determine how many of theserequirements could be completely or partiallyfulfilled by the student being assessed if that stu-dent had access to appropriate assistive technol-ogy

In addition when information is being col-lected for the present level of performance sec-tion of the IEP part of that assessment should bea consideration of whether or not assistive tech-nology is necessary for the student to achieve

educational or social goals benefit from educa-tion or make reasonable progress in the least re-strictive educational setting Whoever is collect-ing the information might experiment withassistive technology applications to determinewhich ones might work for the particular student

Assistive technology should be considered asan option for every IEP Some students of coursewill not require technology but many studentswill benefit from technology that helps them tocompensate for their impairments School dis-tricts are not required to provide all of the pos-sible assistive devices that might be nice to haveor might provide the best possible arrangementsAssistive technology is required however whenits presence enables the student to make reason-able progress toward the goals the IEP Team iden-tifies

HOW TO INCLUDE ASSISTIVE TECHNOLOGY INTHE IEP

Assistive technology can be included in theIEP in a number of ways It may appear as partof the studentrsquos annual goals or short term objec-tives It may also appear in a list of specific ac-commodations which need to be made in orderfor the student to function in the least restrictiveenvironment For example the IEP might includesuch accommodations as the use of word pro-cessing use of a calculator use of a hand heldspell checker and so forth In addition the IEPmay specify that as a related service necessaryfor the student to benefit from his or her educa-tion the student will receive training in the useof assistive equipment like an electronic commu-nication device a power wheelchair or a personalcomputer

WHERE TO PUT ASSISTIVE TECHNOLOGY IN THEIEP

There are three places in the IEP whereassistive technology may appear (1) in the an-nual goals and short term objectives (2) in theenumeration of supplementary aids and servicesnecessary to maintain the student in the least re-

35

strictive educational setting and (3) in the list ofrelated services necessary for the student to ben-efit from his or her education

Assistive technology can be a part of the an-nual goals and short term objectives on an IEPbut there must be a certain degree of specificityin the goal in order for the role of assistive tech-nology to be clear An annual goal for the IEPshould express an estimate of what the studentcan accomplish in a particular domain during thecourse of one year under what conditions theskill is to be developed and what criteria will beused to indicate whether or not the skill has beenlearned

Many times IEP goals are broad vague andtotally nonspecific Such goals are impossible tomeasure and do not give any indication of whatis realistic to expect in terms of the studentrsquos be-havior or skill level in the course of a yearrsquos timeSuch broad goals are not useful in addressingassistive technology The inclusion of assistivetechnology in the IEP requires a degree of speci-ficity so that it is clear how and why the technol-ogy will be used to accomplish a particular goal

An annual goal which includes assistive tech-nology may indicate that the technology will bepart of the conditions under which some aca-demic or social skill will be acquired For ex-ample an IEP goal for a student with a learningdisability in written expression may look like this

10 Using a word processing program with spell-ing checker Shawn will compose three paragraphthemes composed of fifteen or more sentences with 80or better accuracy in the use of spelling punctuationand grammar

Objectives leading to this goal might includepreliminary exploration of the word processingprogram trials to learn effective use of the spell-ing checker drill and practice in writing singleparagraphs to the 80 level of accuracy in spell-ing punctuation and grammar increasing thelength of writing to two paragraphs and theneventually moving to three paragraphs with

gradually increasing degrees of accuracy

Another type of annual goal may address askill which is necessary for using assistive tech-nology Such a goal might appear this way

20 Using an adapted computer keyboard Rachelwill type 12 words per minute with no errors over 10or more consecutive trials

In this case Rachel would spend a year learn-ing keyboarding skills with the goal of achievingat least 12 words per minute with complete ac-curacy For a young student who experiencessome fine motor difficulties this goal would bechallenging but it might be achievable in a yearrsquostime Objectives leading to this goal might in-volve preliminary exploration of the keyboardgradual introduction of the letters and numberson the keyboard practice to build speed and ac-curacy and eventually timed trials until 10 con-secutive trials could be achieved with no errorsat a rate of 12 words per minute or better

Still another type of annual goal might ad-dress a social issue like communication withpeers

30 Using an electronic communication deviceSara will respond appropriately to social inquiries fromclassmates 5 times out of 5 opportunities over 5 con-secutive days

Objectives leading to this goal might includetraining in the use of particular words andphrases on the communication device drill andpractice in responding with the device in struc-tured settings increasing accuracy in respond-ing in structured settings practice in unstruc-tured conversational opportunities and gradualachievement of accuracy in unstructured conver-sational settings with peers

ASSISTIVE TECHNOLOGY AS A RELATED SERVICEAssistive technology can be a related service

just like audiology physical therapy or speech ifit is necessary for the student to benefit from hisor her education For a student to be successfulin using assistive technology he or she must be

36

trained in its use Training to use a computer anaugmentative communication device a PhonicEar or large type viewer or other similar devicescan occur as a related service which supports thestudentrsquos educational program Preparation forthe use of assistive technology can also be workedinto other related services like occupationaltherapy Occupational therapy may involve de-termining correct positioning to take advantageof assistive technology and exercises to preparethe student to use a computer keyboard or a com-munication board

Margo who has muscular dystrophy uses alaptop computer every day in her sixth gradeclass Margorsquos upper body strength is diminish-ing and she is gradually having greater andgreater difficulty using her hands for writing ordrawing Using a computer saves her energy andallows her to keep performing well in the class-room As a related service in her IEP Margo isreceiving occupational therapy designed to pre-pare her for even more adaptations which maybe necessary as she loses more strength Margoand her therapist are experimenting with com-puter access devices (eg switches trackball) andon screen keyboards to determine what methodMargo would like to use when her hands are nolonger strong enough to type on a standard key-board This special training for assistive technol-ogy is written into Margorsquos IEP as a related ser-vice because such training is necessary for her tocontinue to benefit from her education

ASSISTIVE TECHNOLOGY SUPPORT FOR PLACE-MENT IN THE LEAST RESTRICTIVE ENVIRON-MENT

One important feature of assistive technologyis the fact that it can make it easier for studentswith and without disabilities to learn togetherStudents with disabilities are guaranteed the rightto be with nondisabled peers and to receive theireducation in the setting which is the least restric-tive environment In order to be successful in theleast restrictive environment students are to be

afforded whatever supplementary aids and ser-vices are necessary Among the supplementaryaids which may allow a student to remain in aless restrictive environment are a variety ofassistive devices that compensate for disabilityand allow the student to perform educational andsocial tasks Assistive technology is necessary asa supplementary aid if its presence (along withother necessary aids) supports the student suffi-ciently to maintain the placement and its absencerequires the studentrsquos removal to a more restric-tive setting For example if a student with mul-tiple physical disabilities can make progress onhis or her IEP goals in the regular classroom withthe use of a computer and an augmentative com-munication device and cannot make suchprogress in that setting without the devices thenthose devices are necessary supplementary aids

Lyle a fourth grader with cerebral palsy is agood example of a student who thrives in theregular classroom if he has the use of appropri-ate technology Lyle is able to keep up academi-cally with his classmates if he has access to a com-puter with an adapted keyboard and word pre-diction software Lyle has learned to type welland is able to do written assignments in relativelythe same amount of time as other students in hisclass Without a computer Lyle could not keepup at all Handwriting is a laborious task for Lyleand his written product tends to be messy andbarely readable If he could not use a computerLyle would have to rely on others to do hand-writing for him or he would have to do alterna-tive assignments that require no writing

Lyle likes being a regular fourth grader Heis proud of his writing on the computer becausehe is using his own words and learning to editout his mistakes by himself With his computerhe does not need the services of an aide and canbe completely independent in doing his schoolwork

Assistive technology in the form of a com-puter with appropriate software and keyboard

37

adaptations is necessary for Lyle to remain in theregular classroom working independently Thisuse of the computer can be written into his IEPas a supplementary aid which is necessary tosupport Lylersquos placement in the least restrictiveenvironment

Does assistive technology include access toschool buildings

AT certainly can mean devices that provideaccess to school buildings and facilities Oneimportant part of a free appropriate public edu-cation is that students with disabilities are ableto get to school get into the school and use theschool building and facilities Assistive technol-ogy can be used to provide access to the schoolbus classroom playground gymnasium audi-torium lunchroom or the equipment in themAny or all of these needs can be addressed in theIEP

Bus modifications for improved access andappropriate seating can help with transportationto and from school and school activities Doorswalkways handles switches stairs steps can bemodified so that a student with disabilities canuse them as effectively as classmates Appropri-ate seating and playground modifications canhelp include students who have disabilities atclassroom lunchroom and recess times

When an individual graduates from publicschool is it still possible to have assistivetechnology

If individuals benefit from the use of assistivetechnology during their school years the likeli-hood is that assistive technology will be evenmore important for them in adult livingAssistive technology can certainly be part of anindividualrsquos future after high school but it is nec-essary to begin planning for the transition fromhigh school so that the technology and other nec-essary services are available when needed

The earlier a family can estimate their childrsquospost-high school needs including needs for tech-nology the earlier transition planning can begin

Federal legislation says that transition planningcan begin in school as early as ldquo14 or youngerrdquoEach student with a disability who has an Indi-vidualized Education Program (IEP) should havea ldquostatement of transition servicesbeginning nolater than age 16rdquo This means that as early asmiddle school but probably not later than fresh-man year in high school families should begintransition planning

Unlike school services services in the adultworld are not mandated An individual may beeligible for a disability service but not receive itbecause all of the slots are filled or funding is notavailable If an individual does not own his orher own assistive technology devices then partof transition planning will be looking into fund-ing sources that could help with technology pur-chases If technology is necessary for the indi-vidual to become employed it is possible thatVocational Rehabilitation will pay for the devicesas part of an Individual Work-Related Plan(IWRP) Students who go on to postsecondaryeducation at community college vocational-tech-nical schools or universities can expect to be ableto receive certain accommodations for their dis-abilities while on campus Most postsecondaryinstitutions have Student Support Services thathelp with assistive technology needs alternativetesting readers and notetakers

SummaryAssistive technology can be included as an

integral part of a studentrsquos education but par-ents have to be knowledgeable about how to goabout getting assistive technology into theirchildrenrsquos educational plans Assistive technol-ogy can be written into the Individualized Fam-ily Service Plan (IFSP) for infants and toddlers inearly intervention programs and into the Indi-vidualized Education Program (IEP) forpreschoolers and students in grades K through12 Assistive technology can appear in threeplaces in the IEP (a) as part of the goals and ob-jectives (b) as a supplementary aid to support

38

placement in the least restrictive environmentand (c) as a related service Assistive technologycan also be a part of studentsrsquo transition planningas they move from high school into adult pur-suits Assistive technology is available throughVocational Rehabilitation and other adult disabil-ity services but these services are not mandatedTo ensure continued use of assistive technologyit is important to plan ahead and secure fundingfor devices needed in the work or postsecondaryeducation environments

Hints for Parents

If your child is a successful assistive technologyuser begin to save money early in your childrsquos lifemdashjust as you might save for college Gradually accu-mulate enough funding to purchase the kinds of tech-nology your child will need as an adult Technologychanges so fast that it is impossible to predict whatwill be available fifteen years from now But a parentcan be certain that assistive technology of the futurewill be even better than what is available today

EmilyEmily is a seventh grade student who has

learning disabilities She is in regular classes allday in her neighborhood middle school A spe-cial education teacher monitors Emilyrsquos progressand provides the regular classroom teachers withassistance by modifying some of Emilyrsquos assign-ments giving her oral tests helping to organizeEmilyrsquos work and reteaching certain skills asnecessary In elementary school Emily did wellwith the limited amount of support she receivedin the regular classroom In middle school how-ever she is having trouble keeping up with as-signments Emilyrsquos spelling is inaccurate sheoften misspells the same word three or four dif-ferent ways on the same page Her handwritingis very slow and laborious so she spends manyhours each evening working on her homeworkShe has tried tape recording assignments but shefinds this process also to be laborious because itis so time consuming to correct mistakes

It has been recommended that Emily be re-moved from some of her academic classes andreceive instruction in the resource programEmily wants to remain in regular classes but shecanrsquot keep up with the pace

How could assistive technology help Emily

What are her needs

What case could be made for assistive tech-nology for her

39

Emilyrsquos SolutionEmily has reached the point in her educa-

tional career when she cannot keep pace with thedemands of the written work On observingEmily the occupational therapist noted that ittook Emily five times as long as the average stu-dent in her English class to complete written as-signments

Emilyrsquos IEP Team decided she was spendingfar too much time on the handwriting processTo help her with this problem the team agreedthat Emily should learn to use a computer with aword processing program and a voiced spellchecker One period per day Emily goes to theresource room to practice keyboarding and workon longer written assignments During her regu-lar classes Emily uses a portable word proces-sor (eg AlphaSmart) to take notes which shecan print out later in the resource room

These simple solutions allow Emily to speedup her writing time and produce written workthat is easy to correct and edit With technologyto aid her Emily is spending less time on thehandwriting process and more time on thinkingand processing information Her homework timehas been cut in half and Emily is much more re-laxed and confident at school

Solution SummaryKeyboarding training

Use of computer with word processingsoftware

Use of voiced spell checker

Use of portable word processor

BryanBryan is a seventh grader with a neuro-mus-

cular disease that has caused him to lose physi-cal function He is a bright student with excel-lent academic skills Bryan uses a laptop com-puter with a trackball and an onscreen keyboardto do all his written work He navigates skill-fully around the school building using a powerwheelchair Technology has really helped Bryanto fit in and do well at school However now asa young adolescent Bryan is beginning to feelleft out socially He requires so much help withhis physical needs that he has to spend lots oftime with adults Bryan wants to ldquohang outrdquo likethe other kids his age and escape adult scrutinyonce in a while

Bryan is nonverbal He uses a complex so-phisticated electronic communication device toparticipate in class The device is programmedwith phrases that Bryan frequently uses and healso can select icons to create sentences of hisown Bryanrsquos communication device works wellfor him in formal classroom settings but it isbulky and cumbersome to use in casual conver-sation with friends Bryan has come to believethat his communication device is actually a bar-rier to the kinds of informal interactions he wantsto have

Bryan knows that he has the best in technol-ogy and that the equipment he uses was very ex-pensive He doesnrsquot want to appear ldquogreedyrdquo ordemanding so he has not told his parents abouthis dissatisfaction with his ability to communi-cate One of Bryanrsquos friends Michael howevernoticed that Bryan was acting pensive and un-usually quiet Michael gently coaxed the truthout of Bryan and offered to help his friend thinkof a new way to ldquotalkrdquo that would provide himwith more flexibility and independence

40

Bryanrsquos SolutionWhen Bryan and Michael put their heads to-

gether they came up with lots of ideas The onethey settled on as the most feasible involved us-ing the laptop that Bryan already had The laptophad some advantages because it was small andportable and Bryan already knew how to use itvery well In a catalog of special needs softwarethe friends found communication software thatoperated on an icon system and the price wasright--around $100 With communication soft-ware installed on the laptop Bryan had asimplermore portable device for talking in ca-sual settings

Next Michael asked his father to help themmake a tray for Bryanrsquos wheelchair that wouldhold the laptop and fold down beside the chairout of the way when not in use Michaelrsquos dadcame up with a clever tray on hinges that foldedto the side The laptop fastened to the tray withwide rubber bands A handle on the tray allowedBryan to raise and lower the tray as needed

In addition to his laptop Bryan also neededa device for quick greetings and spontaneous re-torts Bryan and Michael chose a programmableswitch with the capacity to record up to 12 mes-sages Bryan could operate the switch quickly byhitting it with his elbow He and Michael had agreat time recording messages suitable for talk-ing to their friends or to girls

What Bryan found out was that he neededmultiple ways to communicate so that he couldcustomize his electronic speech to fit the settingand the occasion For a relatively small financialinvestment Bryan and Michael were able to ex-pand communication possibilities for Bryan andallow him greater control and personal choiceabout what he said how he said it and to whom

Solution SummaryCommunication softwareDrop-down wheelchair trayProgrammable switch

TracyTracy is a man in his mid-thirties who has

been blind from birth Since graduating fromcollege he has held a series of entry level jobs atminimum wage and without benefits Tracy isfrustrated by the lack of challenge in the jobs hehas had he would like to have a managerial po-sition with some opportunities for advancementbetter pay and benefits

Currently Tracy is working at a Pizza Hutrestaurant where he prepares pizzas for the ovenHe enjoys his co-workers and regular customersbut Tracy wants more A management traineeopening has been announced in the companynewsletter and Tracy decides to apply This newposition involves taking pizza orders over thetelephone and sending the order via computerand modem to the appropriate Pizza Hut outletwhere the pizzas will be made Having madeevery possible type and size of pizza Tracy isvery familiar with the options But how couldhe operate the computer and record orders asthey come in over the telephone Would he havea chance for this job which could be his first stepup

41

Tracyrsquos SolutionTracy and his Vocational Rehabilitation Coun-

selor filled out the job application for the posi-tion at Pizza Hutrsquos central ordering facility andTracy was called to set up an interview Prior tothe interview Tracy and his job counselor wentto the central ordering facility for Pizza Hut tostudy aspects of the job and to determine if tech-nology could assist Tracy to perform the essen-tial job functions The job involved the follow-ing steps (1) greeting the customer and takingdown customer information (2) asking a seriesof questions about the customerrsquos order (egtype size toppings) (3) simultaneous record-ing of the order via computer and (4) sendingthe order to the appropriate Pizza Hut outlet

After studying the process of taking ordersTracy and his counselor decided upon the follow-ing technology

(a) A computer compatible with the Pizza Hutnetwork

(b) Voiced software so that Tracy couldldquohearrdquo what he was typing

(c) A telephone headset to listen to the cus-tomer with one ear

(d) an ear piece to listen to the computer

At his interview for the job Tracy explainedhis qualifications for the position--college degreeexperience with Pizza Hut He also told the in-terview team about how technology would al-low him to do the job as efficiently and effectivelyas other workers

The interview team members were impressedby Tracyrsquos initiative and his work ethic Theychose him over several other qualified candi-dates Though it took some detective work toput together a computersoftware package com-patible with Pizza Hutrsquos system Tracy was ableto do it

From the first day on the job Tracy knew he

was going to like it better than anything he haddone before Listening to the computer and thecustomer simultaneously was challenging at firstbut soon Tracy had mastered the process Afterthree months in his new position Tracy wasasked to become the manager for his shift Nowhe hires and trains new order clerks schedulesworkers and evaluates their job performanceTracy has what he wanted--a managerial posi-tion better wages and a future with the com-pany

Solution SummaryCompatible computer terminal

Voiced software

Telephone headset

Ear piece for computer

42

Advocating forAssistive Technology

In the area of Assistive Technology mdash just as in so many areas of need mdash parents must betheir childrenrsquos best advocates Federal and

state laws support providing assistive technol-ogy to individuals with disabilities but theselaws are only meaningful when parents knowabout them and can use legal processes to securetheir childrenrsquos rights Here are just a few of thelaws on which parents can rely when advocat-ing for assistive technology for their children

THE AMERICANS WITH DISABILITIES ACT OF1990

The Americans with Disabilities Act (ADA)proposes to eliminate ldquodiscrimination againstindividuals with disabilitiesto address the ma-jor areas of discrimination faced day-to-day bypeople with disabilitiesrdquo The ADA applies spe-cifically to the areas of employment public ac-commodations and government functions Inthese areas the ADA requires that reasonable ac-commodations be made so that people with dis-abilities can have an equal opportunity to par-ticipate in employment opportunities public ac-commodations and government functions TheADArsquos definition of ldquoauxiliary aids and servicesrdquoits mandates for ldquoacquisition or modifications ofequipment and devicesrdquo and ldquoreasonable accom-modationsrdquo support the provision of assistivetechnology devices and services to individualswith disabilities

THE REHABILITATION ACT OF 1973Section 504 of the Rehabilitation Act requires

that any ldquoprogram or activity receiving Federalfinancial assistancerdquo comply with non-discrimi-nation rules Section 504 Regulations require thatpublic schools provide students who have dis-abilities an educational opportunity equal to theeducational opportunity provided to students

without disabilities Section 504 also uses theterm ldquoreasonable accommodationsrdquo which canmean the provision of assistive technology de-vices and services

THE INDIVIDUALS WITH DISABILITIES EDUCA-TION ACT (IDEA)

The Individuals with Disabilities EducationAct (IDEA) requires free appropriate public edu-cation (FAPE) for students with disabilities IDEAmandates education in the least restrictive envi-ronment requires schools to use supplementaryaids and services special and related services tohelp assure that students with disabilities par-ticipate in and benefit from public educationAssistive technology is specifically mentioned inIDEA as a service which school districts may haveto provide in order for a student with disabilitiesto benefit from special education

THE CARL PERKINS ACTThe Carl Perkins Act assures that Vocational

Education programs in public schools are madeaccessible to students with disabilities The lawassures supplementary services including class-room curriculum and equipment modificationssupportive personnel instructional aides and in-structional devices

PARENT RESPONSIBILITIESIn order to be effective advocates for their

children parents need to familiarize themselveswith all the laws that support the provision ofassistive technology Copies of the laws and theirregulations are available from the offices of mem-bers of the House of Representatives and the Sen-ate

Besides knowing the law parents must par-ticipate actively in developing plans for theirchildrenrsquos education that include assistive tech-nology when it is needed Parents must attend

43

IFSP and IEP meetings and be prepared to workcooperatively with other team members Whena parent questions an assistive technology evalu-ation or an IEP Team recommendation the par-ent must be prepared to follow-up on those ques-tions including using due process rights whennecessary

What should a parent do when an agencyrefuses to pay for assistive technology that achild needs

Agencies like early intervention programsand school districts are mandated to provideassistive technology if the need for technology isin the childrsquos written plan If one of these agen-cies refuses to pay for needed technology then aparent must consider using due process rightsIn early intervention services the parent wouldfollow the appeal process laid out by the leadagency for Part C When school district servicesare involved the parent can file a complaint ifservices in the IEP are not provided or can askfor a due process hearing if the parent and theschool district disagree about the need forassistive technology If a parent disagrees withthe results of an evaluation for assistive technol-ogy the parent can ask for an independent evalu-ation at school district expense

SummaryOverall getting the devices and services for

children with disabilities means that parents mustbe part of the planning team at every level of theirchildrenrsquos education It means talking with otherfamilies and users of assistive technology aboutdevices and services learning how they foundthe best technology and figuring out where togo when resources are few Getting assistive de-vices and services is not always an easy job Buthelp is available Working with professionalstalking with consumers and other families par-ents can find the best avenues for providing theirchildren with the assistive technology they needIn the end the effort is worth it because assistive

technology is not just a civil right guaranteed bylaw it is also a means to achieve human rights togrow up happy independent and self-sufficientas possible

Hints for Parents

When advocating for your child in the special edu-cation arena donrsquot forget the following facts aboutassistive technology and the IEP

bull Assistive technology needs must be con-sidered along with a studentrsquos other edu-cational needs

bull Needs for technology must be identifiedon an individual basis

bull Identification of technology needs mustinvolve parents the student when appro-priate and a multidisciplinary team

bull Parents or other IEP Team members can askfor additional evaluation or an indepen-dent evaluation to determine assistive tech-nology needs

bull When an evaluation is being conductedconsider mobility fine-motor skills com-munication and alternatives to traditionallearning approaches

bull Lack of availability of equipment or costalone cannot be used as an excuse for de-nying assistive technology services

bull If included in the IEP assistive technologyservices and devices must be provided atno cost to the family

bull Parents always have the right to appeal ifassistive technology services are denied

44

More Questions and Answers

A re schools required to pay forassistive technology devices andservices

It is the responsibility of the school dis-trict to provide for the equipment services orprograms identified in the IEP The school dis-trict may pay for the equipment service or pro-grams itself utilize other resources to provide orpay for the device or utilize private insurancefunds Medicaid or other sources of funds as longas the device or services identified in the IEP areprovided at no cost to the parent Private insur-ance or Medicaid may be used ony if the parentagrees

Can schools require the parents to payfor an assistive technology device orservice identified in the studentrsquos IEPor require the parents to use theirown private health insurance to payfor the device or service

No The ldquofreerdquo in FAPE means that parentsof students with disabilities who require assistivetechnology devices or services do not have to payfor these items As stated in IDEA and its regu-lations all special education and related servicesidentified in the studentrsquos IEP must be providedldquoat no cost to the parentrdquo The term ldquofreerdquo is in-terpreted broadly and goes far beyond the simplepaying of deductibles and co-payments Thecourts have interpreted ldquofreerdquo to apply to butnot be limited to future insurability depletionof maximum lifetime caps raised premiums dis-continuation of policies and preexisting condi-tion exclusions If the family agrees to allow theschool to access their Medicaid or private insur-ance this decision must be strictly voluntary onthe part of the family

How can school districts use Medicaidfunds to purchase assistive technologydevices

If Medicaid is capitated in any way concern-

ing its use for assistive devices school districtsmust request from parents the right to use Med-icaid funds However parents are not obligatedto use their Medicaid funds to purchase devicesor services used at school With permission aparentrsquos private insurance must be accessed be-fore Medicaid can be used for assistive technol-ogy devices Medicaid regulations vary some-what from state to state so it is wise to consultthe state Medicaid Service Bureau before mak-ing any assumptions about Medicaid and thepurchase of assistive technology

Are there other options for schools toconsider in lieu of purchasing theassistive technology device

Yes There are times when the outright pur-chase of equipment or devices is not necessaryor even advisable In such instances schoolsmight consider rental or long-term lease optionsThere are certain advantages to renting or leas-ing depending on the individual needs of thestudent For example renting equipment mightbe a reasonable strategy if the student is expectedto improve or deteriorate in a short period of timeor when it is necessary to try out the equipmentbefore purchase Long-term leasing or leasepurchase agreements also have potential benefitsfor schools which include no obligation on be-half of the school to purchase the device abilityto return leased equipment and thus reduce ob-solete inventory flexible leasing terms use ofequipment without a lump-sum purchase up-grading of equipment as more improved tech-nology becomes available and upgrading ofequipment as the studentrsquos needs change

Isnrsquot assistive technology just acrutch Wonrsquot students become toodependent on technology and notlearn to use the skills they have

Assistive technology should be used as sup-port for access learning and performing daily

45

tasks In general assistive technology is appro-priate when it compensates for disabilities so thatthe individual can function as normally as pos-sible If assistive technology is necessary for astudent to have access to educational opportuni-ties or to benefit from education then it is not aldquocrutchrdquo but a legitimate support Some skillsare too laborious or taxing to accomplish at a rateor with degree of proficiency to allow for partici-pation in the least restrictive environment Withassistive technology the student can participatemore fully and more closely approximate the lev-els of achievement and interaction of his or herpeers In general the use of assistive technologyenhances function and increases skills and op-portunities Though a student may be dependentupon a particular device in order to perform skill-fully denying the device denies the student anopportunity ever to achieve success at the levelof his or her potential

When is assistive technology appropri-ate

Assistive technology may be considered ap-propriate when it does any or all of the follow-ing things

bull Enables students to perform functions thatcan be achieved by no other means

bull Enables students to approximate normalfluency rate or standardsmdasha level of ac-complishment which could not beachieved by any other means

bull Provides access for participation in pro-grams or activities which otherwise wouldbe closed to the individual

bull Increases endurance or ability to persevereand complete tasks that otherwise are toolaborious to be attempted on a routine ba-sis

bull Enables students to concentrate on learn-ing tasks rather than mechanical tasks

bull Provides greater access to information

bull Supports normal social interactions with

peers and adults

bull Supports participation in the least restric-tive educational environment

Who owns the special equipment thatis purchased for students

If the school district purchases the equipmentthe equipment belongs to the district Someschool districts designate that a particular deviceis to be used by a specific student during the timewhen that device remains appropriate for thatstudent Other districts have ldquopoolsrdquo of assistivedevices and distribute them for use by a varietyof students The distribution and use of devicesis under the districtrsquos control as long as the needsdescribed in studentsrsquo IEPs are being met

If devices are purchased for a particular stu-dent using that studentrsquos Medicaid funds or pri-vate insurance then the device belongs to the stu-dent and is meant for the exclusive use of thatstudent

When a student moves from one levelof schooling to another like elemen-tary school to middle school does thedevice follow the student

If an assistive device is necessary in order tofulfill the requirements of a studentrsquos IEP such adevice must be provided in whatever school thestudent attends The same device may not nec-essarily follow the student from one school toanother but a comparable device which fulfillsthe IEP requirements would have to be providedin the new school that the student attends

If a family moves from one schooldistrict to another can a studentrsquosassistive technology go along

Devices bought by the school belong to theschool not the student who uses them When afamily moves from one school district to anotherthe equipment the student has been using doesnot automatically move to the new school

Assistive equipment can go with a studentto a new school if the sending school district

46

agrees to sell or give the device to the family orthe new school district

If the device was purchased by the familythrough the familyrsquos private health insurance orby Medicaid for this particular student then thedevice belongs to the student and can go withthe student to a new school district

What happens to assistive technologydevices when students leave the schoolsystem at graduation

If the school district purchased the device thedevice is the property of the school The schoolcould keep the device for use by other studentssell it or decide to transfer the device to anotherdistrict or loan program If the family or anotherfunding source purchased the device it is theproperty of the student and the family

If a piece of assistive technology is nolonger needed or relevant to a studentand the device was paid for by Medic-aid or private insurance can it bedonated for another studentrsquos benefit

Yes it is a parental decision The parentscould donate the device to the school for use byother students with disabilities or to some otherorganization which loans out equipment

Can assistive devices be insured

Many school district liability policies willcover devices purchased by the district for stu-dent use Devices purchased by other fundingsources may or may not be covered while onschool premises or involved in school activitiesIt is important for school staff to investigate thedistrictrsquos property insurance to determine whatthe policy currently covers and whether or notthe policy insures against loss or damage ofassistive devices

Parents who own assistive devices that areused at home and at school may also wish to pur-chase home owners or rentersrsquo insurance with aspecial rider that covers damage to or loss of thedevice

Who is responsible for the repair and

maintenance of assistive devices

In general the school district is responsiblefor repair and maintenance of assistive devicesused to support educational programs describedin the IEP or covered by Section 504

If a device is broken and is beyondrepair who replaces the broken de-vice

If an assistive device is necessary for thestudentrsquos IEP to be implemented then the schooldistrict will have to replace a broken lost or sto-len device

If a device is broken and sent off forrepairs must the school district sup-ply a substitute device until the origi-nal device is returned

If the assistive technology device is vital tothe studentrsquos daily special education program itis not reasonable for the student to be without adevice for long periods of time If a device isgoing to be unavailable for more than a day ortwo the district should provide a backup ma-chine which allows the student to continue work-ing on IEP goals

Is the school district obligated totrain substitute teachers and aides tooperate assistive technology devices

Again if the assistive technology device isvital to the studentrsquos daily special education pro-gram it is not reasonable for the student not tobe able to use the device for long periods of timebecause a substitute is teaching the class If thesubstitute is only going to be in the classroomfor a day or two it is probably not necessary toprovide elaborate training However if the sub-stitute is going to be in the classroom for an ex-tended time training should be provided

Must school districts allow students totake assistive devices home on schoolnights to do homework Over week-ends During school vacations Overthe summer

In many cases it is desirable for students to

47

have the opportunity to use the same assistivetechnology devices at home and in school Forexample when a student is completing home-work assignments assistive technology may benecessary to produce the type of product that isrequired Some school districts have policieswhich allow the devices to go home with the stu-dents overnight on weekends or during vaca-tion or summer periods In general these kindsof policies are a local district matter and may bedetermined according to local district needs Ifhowever a studentrsquos IEP includes a provisionwhich says the student is to have access to anassistive device both at school and at home thenthe school district would be obligated to allowthe student to take a device home or provide twodevices one for home use and one for school

What professionals are consideredqualified to assess a student in thearea of assistive technology

Because assistive technology is such a newfield there are no national standards and few lo-cal or state standards for licensing or certificationfor specialists in assistive technology Howeverschool districts often have professionals who havereceived training in conducting assistive technol-ogy evaluations and are able to provide the ser-vices identified in the IEP If a district does nothave personnel who are knowledgeable in con-ducting such evaluations the district can arrangefor such services from other knowledgeable pro-vidersndash such as Independent Living Projects Al-liance for Technology Access Centers or Tech ActProjects

How can one distinguish betweenassistive technology and personalitems (eg wheelchairs hearing aidseyeglasses crutches)

Currently IDEA does not make a clear dis-tinction between assistive technology devices andpersonal items This confusion stems in large partfrom IDEArsquos broad definition of assistive technol-ogy For example if a student with a disability

needs eye glasses in order to obtain FAPE thenthe school district is obligated to provide themat no cost to the parents In general howeverschool districts do not purchase personally pre-scribed devices such as hearing aids or glasses

Who determines how assistive tech-nology will be purchased and withwhat available funding resourcesmdashtheIEP Team or school administration

Once the IEP team makes the determinationthat assistive technology must be provided aspart of the studentrsquos IEP it is the responsibilityof school administration to determine how theassistive technology will be provided and withwhich funding sources

Is a school district responsible forproviding ldquostate of the artrdquo equip-ment for a student

No The school district need provide onlyappropriate technology in order to meet thestudentrsquos needs as described in the IEP The de-cision as to what type of assistive technology isappropriate should be based on the assistive tech-nology evaluation recommendations and IEPteam decision There may be ldquodevicesrdquo or fea-tures of equipment which may be nice for the stu-dent to have but if they are not necessary forFAPE the school district is not obligated to pro-vide them If a specific device is necessary toensure FAPE and no other device can meet thestudentrsquos needs then the district must providethe required device even though it is costly If aless expensive device would accomplish the samegoals the IEP team is under no obligation tochoose a more expensive option

If a student needs a computer can aschool owned computer be used in thelab or classroom

Yes a school owned computer can be used ifthe student has access to the equipment when heor she needs it If the student does not have thenecessary access then the appropriate equipmentshould be purchased for the studentrsquos use

48

Can school district administratorsinstruct personnel not to includecostly assistive technology devices inthe IEP

IEP teams are charged with the responsibil-ity for determining a studentrsquos need for assistivetechnology devices and services and for specify-ing those devices and services Therefore it isimportant that IEP teams are clearly informed oftheir responsibility to determine if a studentneeds a device and the need for an assistive tech-nology evaluation to assist in making the deter-mination A school district may not have a policywhich prevents IEP teams from identifying astudentrsquos need for assistive devices or services

How does assistive technology getintegrated into the curriculum

The IEP team needs to discuss how the de-vice will be used by the student and how it willbe integrated into the curriculum The IEP teamshould identify on the IEP how the device willbe used by the student in the classroom Thisinformation should be shared with the generalclassroom teachers so that they are aware of howit is to be used

How can assistive technology be pro-vided from year to year with a degreeof continuity

As part of the annual review of the IEP a pointshould be made to devise ways to communicatewith next yearrsquos teachers about the technologythe student uses and how it should be integratedinto the curriculum Teachers who are new toworking with the student who uses technologyshould be provided training if they are unfamil-iar with the device and its use Training for teach-ers and support staff should be written into theIEP as a related service

Can an assistive technology device beused by more than one student

Yes if the device is the property of the schooldistrict and if all of the students using the devicehave access to the equipment when they need it

Can an independent evaluation berequested to address assistive tech-nology

Yes The school district is required to evalu-ate a student in all areas of suspected disabilityincluding if appropriate evaluating the studentrsquosneed for assistive technology A parent has theright to an independent educational evaluationat public expense if the parent disagrees with anevaluation obtained by the school district How-ever the school district may initiate a due pro-cess hearing to show that its evaluation is appro-priate If the final decision is that the evaluationis appropriate the parent still has the right to anindependent educational evaluation but not atpublic expense If the parent obtains an inde-pendent educational evaluation at private ex-pense the results of the evaluation (a) must beconsidered by the school district in any decisionmade with respect to the provision of FAPE tothe child and (b) may be presented as evidenceat a due process hearing

What is a product system

A product system is more than one piece ofequipment working together to produce a resultFor example an FM system that works in con-junction with a studentrsquos hearing aid is a prod-uct system

Can the school district require a stu-dent to bring a personally ownedassistive device such as an augmenta-tive communication system or laptopcomputer to school in order to doschoolwork

No However the family may wish the childto use his or her equipment in school since thechild may be more familiar or comfortable withit The IEP team should decide who is respon-sible for repair and maintenance of family owneddevices

Is it sufficient for a school district tosupply access to a district-ownedcomputer but provide no software

49

that is appropriate for the student touse

Just providing access to a computer does notfulfill the districtrsquos obligation to provide assistivetechnology to support FAPE The educationalaspect of the computer is very much related tothe software that the student uses If no appro-priate software is available then the student can-not pursue the IEP goals

50

Appendix

GlossaryASSISTIVE TECHNOLOGY any sort of aidincluding computers switches calculators spell-ing devices communication devices and voicesynthesizers which is used to help an individualperform some task of daily livingALTERNATIVE KEYBOARD may include en-larged reduced varied key placement one-handed braille chordic or any other device forentering text on a computerAUGMENTATIVE COMMUNICATION anydevice (electronic or otherwise) to enhance com-munication for a person with limited speechBRAILLE EMBOSSER a printer for producingbraille output either manually or when connectedto a computer When printing standard text froma computer it must first be translated into brailleBRANCHING describes the process of choos-ing among a sequence of choices or actions toproduce another sequence of choices This pro-cess is used in the ldquoscanningrdquo method of accessCD-ROM ldquoCompact Disk Read-Only Memoryrdquorefers to the 4-inch silver disks that typically hold700 megabytes of digital information and theplayers that access the information on these disksCURSOR either the flashing vertical or horizon-tal line on a computer screen that indicates theinsertion point for text or the arrow or I-beamthat indicates the position of the mouse pointeron the computer screenDESK ACCESSARY a small utility program thatruns on a computer and may be accessed fromany program at any time (such as a calculator)DRILL AND PRACTICE presents questionsrepetetively but is not a tutorial Software thatis only drill and practise doesnrsquot necessarily teachthe concepts needed to answer the questions pre-sented

ENVIRONMENTAL CONTROL any type ofdevice that an individual may use to control theirenvironment (lights appliances TV telephoneetc) This may include anything from simplereachers or sticks to computers and voice-acti-vated electronic systemsFM SYSTEM a local wireless broadcast systemthat consists of a microphone and transmitter forthe speaker and ldquowalkman-likerdquo receivers withheadphones for listeners with hearingimpairements or attention disordersHIGH TECH use of electronics or computers asa solutionICON a small computer graphic that appears onthe computer screen and may represent differ-ent types of objects (files or applications) or ac-tions depending on the context Use the mousepointer to click on icons that open files or per-form other actionsINDIVIDUAL FAMILY SERVICE PLAN (IFSP)the written document which defines the earlyintervention services provided to the child andfamily The program is designed to meet theneeds of the child and the family and is based onfamily-identified prioritiesINDIVIDUALIZED EDUCATION PROGRAM(IEP) a written plan specifying instructionalgoals and any special education and related ser-vices a student may need which must be writ-ten and reviewed annually Included are (1) thepresent educational levels of the student (2) astatement of annual goals including short-termobjectives (3) a statement of specific services ifneeded (4) the programs (5) the date when spe-cial services are to begin and the expected dura-tion of these services and (6) the tests and otherrequirements or information used to guage thestudentrsquos progress to determine if the instruc-tional objectives are being metINPUT the information that is transmitted to acomputer from a keyboard mouse or other in-

51

put deviceKEYBOARD a device for inputing text and com-mands to a computerKEYGUARD a plexiglass or other cover for akeyboard with holes for the individual keys Itallows more precise selection of keys for an indi-vidual with fine motor difficultiesKEYPAD a small keyboard with a 10-key setupfor numeric input or it may also be used as a con-trol for a screen-reader programLAPTOP a portable battery-powered computerthat is typically the size of a 3-ring binder weighs5-10 pounds and consists of a screen keyboardand disk-drivesLASER DISCS large (12-inch) CD-ROMs thatnormally contain moviesLOW TECH indicates use of low cost non-elec-tronic solutionsMACRO a simple short program that performsan action on a computer They are usually cre-ated by recording the keyboard andor mouseinput and storing them as an icon or key combi-nationMEGABYTE 1000 X 210 bytes of informationwhich basically means over one million key-strokes of computer storage (about 10 novels)MORSE CODE a direct method for computerinput using one to three switches and coded in-put to replace the keyboard and mouseMOUSE the name given to the pointing deviceused to control graphical user interfaces (GUI) ofmodern personal computersONSCREEN KEYBOARD a software programthat places the keyboard on the screen of the com-puter and may be accessed using a mouse or otherpointing device This is ideal for individuals whocannot use a regular keyboard but can use sometype of pointing deviceOPTICAL CHARACTER RECOGNITION(OCR) a process that utilizes special computersoftware to convert the scanned image of text intoactual text that may be edited by a word proces-sorOUTPUT computer-generated information for

the user This may be printed output from aprinter visual information from the screen orsounds from speakersSCANNER an electronic copier connected to acomputer Scanners are used to input drawingspictures or printed text into the computerSCANNING has nothing to do with the elec-tronic copier above It is another method for ac-cessing a computer or communication deviceusing one or more switches Scanning involvespresenting a group of choices cycling amongthem and making choices by activating a switchSCREEN READER software that reads text ona computer screen using a speech synthesizerThis allows individuals with visual impairmentsor other print disabilities to access text on thecomputer screenSIMULATION software that simulates real-world situations on a computer This may rangefrom a joystick trainer for driving an electricwheelchair to running citiesSPEECH SYNTHESIZER hardware or softwarefor producing electronic human speech on a com-puterSPELL CHECKER utility for checking the spell-ing in a documentSTICKY KEYS software or mechanical utility forallowing typing of multiple keystrokes with onefinger (using the shift or other modifier keys)SWITCH a device that is like a single button ofa keyboard or mouse Switches may be used byan individual with servere motor difficulties byany controllable muscle in their body (headhand toe eye breath etc) to operate any typeof computer communication or environmentalcontrol deviceSWITCH INTERFACE black box that connectsto a computer or other device that has plugs forswitchesTDD a text telephone used for communicatingin typed text over a phone line A TDD has akeyboard and text display or small printer Bothparties who are communicating over a phone linemust have TDDs

52

TOUCH WINDOW a computer input devicethat uses a touch-sensitive transparent windowplaced on the computer screen It performsmouse functions with a finger or stylus directlyon the screenTRACKBALL another replacement for themouse pointing device that uses a rolling ball toperform mouse movementsTUTORIAL teaches concepts presents informa-tion as opposed to simple drill and practiceVOICE RECOGNITION computer softwareand microphone that allows input and controlwith voice commandsWORD PREDICTION productivity softwarethat increases typing speed for one-finger typistsand others by predicting and choosing completewordsWORD PROCESSOR software for inputing andformatting textUSER person using a computerUTILITY software for adding function or per-forming housekeeping tasks on a computer

53

DocumentsSCHRAG LETTER ON ASSISTIVE TECHNOLOGY

August 10 1990

Dear Ms Goodman

This is in response to your recent letter to the Office of Special

Education Programs (OSEP) concerning the obligations of public

agencies under Part B of the Education of the Handicapped Act

(EHA-B) to provide assistive technology to children with handi-

caps

Specifically your letter asks

1 Can a school district presumptively deny assistive technol-

ogy to a handicapped student

2 Should the need for assistive technology be considered on

an individual case-by-case basis in the development of the

childs Individual Education Program

In brief it is impermissible under EHA-B for public agencies

(including school districts) to presumptively deny assistive tech-

nology to a child with handicaps before a determination is made

as to whether such technology is an element of a free appropriate

public education (FAPE) for that child Thus consideration of a

childs need for assistive technology must occur on a case-by-

case basis in connection with development of a childs individual-

ized education program (IEP)

We note that your inquiry does not define the term assistive

technology and that the term is not used either in the EHA-B

statute or regulations The technology Related Assistance for

Individuals with Disabilities Act of 1988 PL 100-407 contains

broad definitions of both the terms assistive technology device

and ldquoassistive technology service See Section 3 of PL 100-

407 codified as 29 USC 2201 2202 Our response will use

assistive technology to encompass assistive technology ser-

vices and ldquoassistive technology devices

Under EHA-B State and local educational agencies have re-

sponsibility to ensure that eligible children with handicaps receive

FAPE which includes the provision of special education and re-

lated services without charge in conformity with an IEP 20 USC

1401(18) 34 CFR S3004(a) and (d) The term special educa-

tion is defined as specially designed instruction at no cost to

the parent to meet the unique needs of a handicapped child 34

CFR S30014(a) Further related services is defined as includ-

ing transportation and such developmental corrective and other

supportive services as are required to assist a handicapped child

to benefit from special education 34 CFR ss33013 (a)

The EHA-B regulation includes as examples 13 services that

qualify as related services under EHA-B See 34 CFR S30013

(b)(1)-(13) We emphasize that this list is not exhaustive and

may include other developmental corrective or other supportive

servicesif they are required to assist a handicapped child to

benefit from special education 34 CFR S30013 and Comment

Thus under EHA-B assistive technology could qualify as spe-

cial education or related services

A determination of what is an appropriate educational program

for each child must be individualized and must be reflected in the

content of each childs IEP Each childs IEP must be developed

at a meeting which includes parents and school officials 34 CFR

S300343-300344 Thus if the participants on the IEP team de-

termine that child with handicaps requires assistive technology in

order to receive FAPE and designate such assistive technology

as either special education or a related service the childs IEP

must include a specific statement of such services including the

nature and amount of such services 34 CFR S300346(c) App

C to 34 CFR Part 3000 (Ques 51)

EHA-Bs least restrictive environment (LRE) provisions require

each agency to ensure (t)hat special classes separate school-

ing or other removal of handicapped children from their regular

educational environment occurs only when the nature or severity

of the handicap is such that education in regular classes with the

use of supplementary aids and services cannot be achieved sat-

isfactorily Part 121a 42FR 4251113 (August 23 1977)

Assistive technology can be a form of supplementary aid or ser-

vice utilized to facilitate a childs education in a regular educa-

tional environment Such supplementary aids and services or

modifications to the regular education program must be included

in a childs IEP Id Appendix C to 34 CF art 300 (Ques 48)

In sum a childs needs for assistive technology must be deter-

mined on a case-by-case basis and could be special education

related services or supplementary aids and services for children

with handicaps who are educated in regular classes

I hope the above information has been helpful If we may pro-

vide further assistance please let me know

Sincerely

Judy A Schrag EdD

Director Office of Special Education Programs

54

INDIVIDUALS WITH DISABILITIES EDUCATIONLAW REPORT

Cite as 18 IDELR 627

Digest of Inquiry

(Inquirerrsquos Name Not Provided)

(Date Not Provided)

bull Is a school district responsible to provide assistive

technology devices for home use

bull May a school board overrule a determination by an IEP

team that a child with a disability needs access to an

assistive technology device at home

bull What is the time limit on implementation of an IEP

Digest of Response

(November 27 1991)

Assistive Technology Devices May Be Required for Home Use

If an IEP team determines that a child with a disability needs

access to an assistive technology device at home as a matter of

FAPE then the school district must provide the device for home

use in order to implement the childrsquos IEP

School Board May Not Change IEP Teamrsquos Determination

Under Part B a school board has no authority to unilaterally

change any statement of special education or related services

contained in an IEP including a statement of a childrsquos need to

have access to an assistive technology device at home Without

reconvening the IEP team the school board may not change the

IEP and the school district is obligated to implement the IEP re-

quirements regardless of the school boardrsquos objections

IEPs Must Generally Be Implemented

Under Reg 300342(b) an IEP must be in effect before the

provision of special education or related services and must be

implemented as soon as possible following the conclusion of the

IEP meeting(s) In accordance with Appendix C to the Part 300

regulations an IEP should generally be implemented without de-

lay after being finalized although a reasonable delay may be per-

missible in limited circumstances

__________________

Text of Inquiry

I would like to have a copy of the policy classification on

Assistive Technology

I also have a question to ask regarding Assistive Technology

such as a closed circuit TV

My daughter uses a CCTV in school and it is on her IEP

program My daughter is visually impaired The initial request

was made by me the parent to the appropriate people involved

in her education and discussed and approved by the committee

on an individual basis

My question is I would like to make the request to the ap-

propriate officials for another CCTV for home use to accomplish

the same results at home as is done in school (For homework

reading books any assignments from school)

Another question is If the committee approves this request

it will go to School Board for approval I would like to know what

happens if the School Board doesnrsquot approve the proposal Is it

impartial hearing time

Thank you for your assistance in this matter

Any information regarding Assistive Technology Informative

for school and home use would be greatly appreciated

Is there a time limit on implementation of yearly updated

IEPs[] Every year I have long delays on implementation of board

approved IEPs[]

Text of Response

This is in response to your recent letter to the Office of Spe-

cial Education Programs (OSEP) requesting a copy of any OSEP

policy clarifications on assistive technology as well as asking spe-

cific questions concerning the assistive technology needs for your

daughter You also asked a question about the time limits for

implementation of an individualized education program (IEP)

In response to your request I am enclosing a copy of OSEPrsquos

August 10 1990 letter to Ms Susan Goodman concerning the

obligations of public agencies under Part B of the Individuals with

Disabilities Education Act (Part B) formerly cited as Part B of the

Education of the Handicapped Act to provide assistive technol-

55

ogy to children with disabilities along with some additional infor-

mation on assistive technology and a copy of the Part B regula-

tions I would also like to provide you with OSEPrsquos response to

each of your specific questions as stated below

I would like to make the request to the appropriate officials

for another CCTV for home use to accomplish the same

results as is done in school (For homework reading books

any assignment from school)

The IEP which must be developed at a meeting that includes

parents and school officials must contain among other things a

statement of the specific special education and related services

to be provided to the child See 34 CFR sectsect 300343-300346 As

stated in OSEPrsquos letter to Ms Goodman if the IEP team deter-

mines that a child with disabilities requires assistive technology in

order to receive a free appropriate public education (FAPE) and

designate such assistive technology as either special education

or a related service the childrsquos IEP must include a specific state-

ment of such services including the nature and amount of such

services See 34 CFR sect 300346(c) App C to 34 CFR Part 300

(Ques 51) The need for assistive technology is determined on a

case-by-case basis taking into consideration the unique need of

each individual child If the IEP team determines that a particular

assistive technology item is required for home use in order for a

particular child to be provided FAPE the technology must be pro-

vided to implement the IEP

If the committee approves this request it will go to the School

Board for approval I would like to know what happens if

the School Board doesnrsquot approve the proposal Is it im-

partial hearing time

As part of the public agencyrsquos part B obligation to provide

FAPE to an eligible child with disabilities the public agency must

ensure that special education and related services are provided

in conformity with an IEP which meets the requirements of 34

CFR sectsect 300340-300349 One requirement at 34 CFR sect

300343(a) is that the public agency conduct a meeting to de-

velop review and revise a childrsquos IEP The Regulations require

that certain participants attend the IEP meeting See 34 CFR sect

300344 The role of the participants at the IEP meeting is to

determine the specific special education and related services that

a child needs in order to receive FAPE Once the determination is

made at a meeting convened pursuant to 34 CFR sect 300343(a)

Part B does not recognize any authority on the part of a local

School Board to unilaterally change the statement of special edu-

cation and related services contained in the IEP After the IEP is

developed and the placement decision is made by a group of

persons knowledgeable about the child the meaning of the evalu-

ation data and placement options the public agency must imple-

ment the IEP See 34 CFR sect 300533(a)(3) Without reconven-

ing the IEP meeting the local school board could not change the

IEP

Is there a time limit on implementation of updated IEPrsquos[]

Every year I have long delays on implementation of Board

approved IEPrsquos[]

Part B imposes no specific time limits for the implementation

of IEPs The Part B regulations at 34 CFR sect 300342(b) require

that an IEP (1) must be in effect before special education and

related services are provided to a child and (2) must be imple-

mented as soon as possible following the meetings required to

develop review or revise a childrsquos IEP The answer to Question 4

in Appendix C to the Part 300 regulations states that no delay is

permissible between the time a childrsquos IEP is finalized and when

special education and related services is provided It is expected

that the special education and related services set out in the IEP

will be provided by the agency beginning immediately after the

IEP is finalized In certain circumstances such as when the IEP

meeting occurs during the summer or a vacation period or where

there are circumstances which require a short delay (eg work-

ing out transportation arrangements) the implementation may not

be immediate See Comment 34 CFR sect 300342

I hope that this information is helpful to you Please let us

know if you have any additional questions or concerns

Judy A Schrag

Director

Office of Special Education Programs

_______________________

Cite as 18 IDELR 628

56

Sample Letter Requesting an Assistive Tech-nology Evaluation

March 1997

Dear Sir

Our daughter Catherine an IDEA-eligiblestudent is currently receiving special educationand supportive therapies through the publicschool district As she is progressing through theelementary school grades the curriculum is de-manding more and more written work from herAt this point teachers or assistants are writingfor her but this method does not allow Catherinethe opportunity to compose written work on herown

As Catherinersquos parents we think the time hascome to consider assistive technology forCatherine to allow her to learn to do written workon her own so that she can learn the mechanicsof writing and can put her own thoughts downon paper for others to read

To this end we are requesting an assistivetechnology evaluation for Catherine to determinewhat kinds of technology are necessary to assisther with written expression We are assumingthat the assistive technology evaluation will beperformed at district expense by professionalswho are qualified to determine (a) what assistivetechnology may be necessary for Catherine (b)what assistive technology devices might be help-ful and (c) what occupational and physicaltherapy services may be necessary to support thetechnology

We would like to have this evaluation com-pleted so that information is available prior tothe convening of the IEP Team to writeCatherinersquos Individualized Education Programfor next year

We appreciate your assistance with this mat-ter and look forward to hearing from you

Yours truly

Assistive TechnologyIssues to Address

_____What are the individualrsquos current unmetneeds for access to communication writ-ing or educational materials

_____What are the short and long term educa-tional goals

_____What are the daily educational demandswhich require the use of assistive technol-ogy

_____Have the appropriate team members in-cluding parents been involved in the as-sessment process

_____What are the features of the technology thatwould assist the individual in meetingdaily classroom demands

_____Why is the selected equipment more appro-priate than other alternatives

_____Have all of the individualrsquos environmentsbeen considered

_____Does the selected equipment reflect the leastrestrictive intervention strategy

_____Is the equipment necessary to achieve edu-cationallife goals

_____How will the individual physically man-age the equipment in all environments

_____How will the equipment be integrated intothe individualrsquos daily life

_____How will the use of the assistive technol-ogy promote inclusion of the individualinto activities in the school and commu-nity

_____Which members of the education team willbe trained to use the equipment

_____How will the individual be trained to usethe equipment

_____How will the family be involved with theindividual and the equipment

57

ExamplesEDUCATIONAL SOFTWARE EVALUATION

A IDENTIFYING INFORMATION

Name of instructional program

Publisher

Cost ____________Computer platform(PCMac)

Other equipment needed to run program

Grade level of the program

Skill levels required of users

Special needs addressed by program

B DESCRIPTIVE INFORMATION

1 What is the purpose of the instructional program as stated by

its publisher

2 What curriculum area or areas does it address

3 What type of instructional program is it

tutorial drill and practice___ arcade game type___

drill and practice ____ simulation ___

problem solving___ educational game___

teacher utility___ other___

4 For what type of learner was the program designed

age level __________ grade level ____________

ability level ________ interest level ___________

5 What skills or information does the program attempt to teach

or review

6 How does the program present information

__text __graphics __animation __color __sound effects

__music __speech __other __________________________

7 Is the information presented clearly

Is text legible and readable

Are graphics comprehensible

Are sounds audible and intelligible

8 Are directions for using the program clearly stated and under-

standable Where do directions appear

_____ within the program

_____ in the programs documentation or manual

9 Is the program under user control that is can the user control

the programs movement from screen to screen

Review directions at any time

Exit the program at any time

10 What computer use demands are placed on the learner

_____ insert disk and turn on computer

_____ select from menu

other ______________________________

11 What academic demands are placed on the learner

reading level _______________________________

spelling level _______________________________

other _____________________________________

12 What physical demands are placed on the learner

_____ keyboard must be used to enter responses

_____ press any key

_____ press a key from one half or one quadrant of key-

board

_____ press on specific key

_____ press several keys in order

_____ other devices used to enter responses

13 What speed demands are placed on the learner

_____ presentation of information controlled by program (

moderate fast or slow)

_____ presentation of information under user control

_____ unlimited response time

_____ response time set by program (moderate fast slow)

_____ response time varied by user

58

14 What accuracy demands are placed on the learner

_____ user can correct typing errors

_____ program does not allow correction of typing errors

_____ program locates common errors

_____ program requires correct spelling of all responses

_____ program allows only one correct response for most

questions

15 Is feedback about response accuracy provided to learners

appropriately

_____ knowledge of results provided after each response

_____ correct responses confirmed

_____ learner informed if response incorrect

_____ another trial provided if response incorrect

_____ number of trials provided

_____ correct response demonstrated if learner fails to an-

swer correctly

_____ learner allowed opportunity to respond after demon-

stration of correct response

16 Does the program use any branching procedures besides

differential treatment of correct and incorrect responses

17 What techniques are used for reinforcement and motivation

_____ knowledge of results and confirmation of correct re-

sponses

_____ summary information about learner performance

_____ text message of praise for correct responses

_____ graphics display and or sound for correct responses

_____ competitive game in which correct response earn

points

_____ other _________________________________

Reinforcement is _____ continuous _____ intermittent

18 What user options are available to students and teachers

Students can select

_____ activity from menu difficulty

_____ number of questions type of questions

_____ other ____________________________

Teacher or parent can select

_____ sound on or off

_____ number of questions

_____ type of questions

_____ sequence of instruction

_____ number of trials

_____ speed of presentation

_____ speed demands for responses

_____ other_________________________________

Teacher or parent can

_____ enter own content into program

_____ review student records

_____ other________________________________

19 Is the programs documentation adequate

All program features fully and clearly explained

Rationale for program purpose and objectives included

Print materials provided for students

20 Other comments about the instructional program

C OVERALL EVALUATION

Rate the appropriateness of the instructional program in each of

the following areas using this scale

excellent adequate inadequate

1 2 3

1 2 3 Curricular content (program addresses important skills

1 2 3 Interest level

1 2 3 Ease of use for learners

1 2 3 Demands on learner (eg computer use academic)

1 2 3 Instructional procedures

1 2 3 Motivational value

1 2 3 Appropriate use of the medium

1 2 3 Important instructional variables under teacher control

1 2 3 Other _______________________________

59

Software Featuresbull Easy-to-Read Screensbull Consistency in Formatbull Intuitive Characteristicsbull Logical Labelsbull Instructional Choicesbull Graphicsbull Friendly Documentationbull On-Screen Instructionsbull Auditory Cuesbull Visual Cuesbull Built-in Access Methodsbull Alternatives to a Mousebull Optional Cursorsbull Creation of Custom Programs

Alternative Inputbull Switches and Switch Softwarebull Alternative Keyboardsbull Keyboard Additionsbull Access Utilitiesbull Interface Devicesbull Voice Recognitionbull Optical Character Recognition

and Scannersbull Electronic pointing Devicesbull Pointing and Typing Aidsbull Touch Screensbull Joysticksbull Trackballsbull Arm and Wrist Supports

Processing Aidsbull Abbreviation Expansion and

Macro Programsbull Word Predictionbull Talking and Large Print Word

Processorsbull Grammar and Spell Checkersbull Reading Comprehension Pro-

gramsbull Writing Composition Pro-

gramsbull Electronic Reference Toolsbull Menu Management Programs

Alternative Outputbull Braille Embossers and Transla-

torsbull Refreshable Braille Displaysbull Speech Synthesizersbull Screen Readersbull Screen Enlargement Programsbull Monitor Additions

Specialized Productsbull Closed Circuit Television

(CCTV)bull Environmental Control Units

(ECU)bull Notetakersbull Reading Machinesbull Text Telephone (TDD)

60

Next

Ste

p

Try

havi

ng C

huck

use

earp

hone

s w

hen

he is

wor

d pr

oces

sing

Curre

nt S

tatu

s

Chu

ck is

abl

e to

do

grad

ele

vel a

ssig

nmen

ts b

ut h

e is

very

lite

ral i

n hi

s in

terp

reta

-tio

ns e

spec

ially

of a

bstra

ctco

ncep

ts

Chu

ck is

ver

y ea

sily

dis

-tra

cted

bot

h vi

sual

ly a

ndau

dito

rily

Chu

ck h

as a

blin

d sp

otw

hich

mak

es it

diff

icul

t for

him

to tr

ack

from

line

to lin

ew

hen

he is

read

ing

He

also

has

troub

le d

istin

guis

hing

the

figur

e fro

m t

he b

ack-

grou

nd

Bec

ause

of

per-

cept

ion

prob

lem

s C

huck

mus

t hav

e a

larg

e di

spla

ysc

reen

on

his

com

pute

r

Need

Cog

nitiv

e Ab

ility

Atte

ndin

g

Perc

eptio

n

ASSI

STIV

E TE

CHN

OLO

GY

EVAL

UATI

ON

Func

tion

al A

naly

sis

Nam

e C

huck

Dat

eG

rade

Lev

el

Sixt

h

Ove

rall D

escr

iptio

n C

huck

is a

six

th g

rade

stu

dent

who

rece

ives

all o

f his

inst

ruct

ion

in th

ere

gula

r cla

ssro

om

Chu

ck h

as ri

ght h

emip

legi

a H

is ri

ght u

pper

ext

rem

ity is

mor

e af

fect

edth

an h

is lo

wer

ext

rem

ity

He

has

diffi

culty

with

tota

l bod

y m

ovem

ents

requ

iring

bila

tera

lco

ordi

natio

n e

spec

ially

with

upp

er e

xtre

miti

es

Chu

ck h

as a

leg

leng

th d

iscr

epan

cy w

ith

Crite

ria fo

r Suc

cess

Com

plet

ion

of g

rade

leve

las

sign

men

ts w

ith e

vide

nce

of u

nder

stan

ding

of

mai

nco

ncep

ts

Chu

ck w

ill be

on

task

65-7

0 o

f tim

e du

ring

inde

-pe

nden

t wor

k pe

riods

Chu

ck w

ill co

mpl

ete

mod

ified

ass

ignm

ents

inde

-pe

nden

tly a

t leas

t 85

of t

hetim

e

Supp

ort R

equi

red

Lim

it re

quire

men

ts to

a fe

wco

ncre

te c

once

pts

in e

ach

acad

emic

uni

t

Dis

trac

tion

free

env

iron-

men

t st

udy

carre

l pr

oxim

-ity

to te

ache

r or a

ide

Enl

arge

wor

kshe

ets

and

read

ing

mat

eria

l H

ighl

ight

key

voca

bula

ry w

ords

U

sea

card

boar

d w

indo

w to

iso-

late

indi

vidu

al li

nes

whe

nre

adin

g E

nlar

ge o

n sc

reen

disp

lay

whe

n do

ing

wor

dpr

oces

sing

Loca

tions

Hom

eSc

hool

Com

mun

ityW

ork

Rec

reat

ion

Hom

eSc

hool

Com

mun

ityW

ork

Rec

reat

ion

Hom

eSc

hool

Com

mun

ityW

ork

Rec

reat

ion

his

right

leg

bein

g sh

orte

r tha

n hi

s le

ft H

e w

ars

a lif

t in

his

shoe

to c

ompe

nsat

e fo

r the

diffe

renc

e C

huck

has

low

ave

rage

inte

lligen

ce a

nd n

orm

al s

peec

h H

e re

ads

at th

eth

ird g

rade

leve

l a

nd d

oes

mat

h at

gra

de le

vel

exce

pt fo

r sto

ry p

robl

ems

Chu

ck is

very

con

cret

e in

his

thin

king

and

has

gre

at d

iffic

ulty

und

erst

andi

ng fi

gura

tive

lang

uage

C

huck

has

a fu

ll tim

e ai

de in

the

regu

lar

clas

sroo

m w

ho m

odifi

es a

ssig

nmen

ts a

ndhe

lps

to k

eep

him

on

task

So

cial

ly C

huck

is p

olite

and

wel

l-beh

aved

but

app

ears

tobe

imm

atur

e in

his

soc

ial r

elat

ions

hips

61

ASSI

STIV

E TE

CHN

OLO

GY

EVAL

UATI

ON

Func

tion

al A

naly

sis

Nam

e C

huck

Dat

eG

rade

Lev

el

Sixt

h

Ove

rall

Des

crip

tion

Chu

ck is

a s

ixth

gra

de s

tude

nt w

ho re

ceiv

es a

ll of

his

inst

ruct

ion

inth

e re

gula

r cla

ssro

om

Chu

ck h

as ri

ght h

emip

legi

a H

is ri

ght u

pper

ext

rem

ity is

mor

eaf

fect

ed th

an h

is lo

wer

ext

rem

ity

He

has

diffi

culty

with

tota

l bod

y m

ovem

ents

requ

iring

Need

Fine

Mot

or Han

d W

ritin

g

Not

e Ta

king

Self

Hel

p

Curre

nt S

tatu

s

Chu

ck c

an u

se o

nly

one

hand

for f

ine

mot

or ta

sks

incl

udin

g ty

ping

C

huck

isan

exc

elle

nt o

ne-h

ande

dty

pist

bot

h in

term

s of

spee

d an

d ac

cura

cy

Chu

ck c

an w

rite

in c

ursi

ve

but h

andw

ritin

g is

ver

yla

bor i

nten

sive

and

tirin

gfo

r him

H

e pr

oduc

esm

uch

bette

r writ

ten

prod

ucts

usi

ng a

com

pute

rC

huck

can

not t

ake

note

san

d lis

ten

at th

e sa

me

time

Chu

ck c

anno

t tie

his

ow

nsh

oes

and

he h

as d

iffic

ulty

zipp

ing

his

jack

et w

ith o

neha

nd

Next

Ste

p

Try

givi

ng C

huck

not

esbe

fore

the

clas

sroo

mpr

esen

tatio

n H

ave

him

hig

hlig

ht k

eyw

ords

with

a h

ighl

ight

ing

pen

as h

e is

list

enin

g to

the

disc

ussi

on

Try

havi

ng a

pee

rbu

ddy

assi

st C

huck

with

his

sho

es a

ndja

cket

bila

tera

l coo

rdin

atio

n e

spec

ially

with

upp

er e

xtre

miti

es

Chu

ck h

as a

leg

leng

thdi

scre

panc

y w

ith h

is ri

ght l

eg b

eing

sho

rter t

han

his

left

He

war

s a

lift i

n hi

s sh

oe to

com

pens

ate

for t

he d

iffer

ence

C

huck

has

low

ave

rage

inte

lligen

ce a

nd n

orm

alsp

eech

H

e re

ads

at th

e th

ird g

rade

leve

l a

nd d

oes

mat

h at

gra

de le

vel

exce

pt fo

rst

ory

prob

lem

s C

huck

is v

ery

conc

rete

in h

is th

inki

ng a

nd h

as g

reat

diff

icul

ty u

nder

-st

andi

ng fi

gura

tive

lang

uage

C

huck

has

a fu

ll tim

e ai

de in

the

regu

lar c

lass

room

who

mod

ifies

ass

ignm

ents

and

hel

ps to

kee

p hi

m o

n ta

sk

Soci

ally

Chu

ck is

pol

ite a

ndw

ell-b

ehav

ed b

ut a

ppea

rs to

be

imm

atur

e in

his

soc

ial r

elat

ions

hips

Crite

ria fo

r Suc

cess

Chu

ck w

ill be

abl

e to

prod

uce

writ

ten

wor

k at

abou

t the

sam

e pa

ce a

sot

her s

tude

nts

in h

is c

lass

Chu

ck w

ill be

abl

e to

rece

ive

help

with

am

inim

um o

f fus

s or

emba

rrass

men

t

Supp

ort R

equi

red

Lapt

op c

ompu

ter

Prin

ter

Enla

rged

scr

een

disp

lay

Co-

Writ

er w

ith W

rite-

Out

-Lo

ud fo

r wor

d pr

oces

sing

and

wor

d pr

edic

tion

Chu

ck n

eeds

to u

se w

ord

proc

essi

ng w

hene

ver

writ

ten

assi

gnm

ents

are

requ

ired

Whe

neve

rpo

ssib

le h

is w

ritte

nas

sign

men

ts s

houl

d be

shor

tene

d or

he

shou

ld b

eex

pect

ed to

resp

ond

usin

gm

ultip

le c

hoic

e or

one

wor

dan

swer

s

Teac

her s

uppo

rt of

the

peer

bud

dy re

latio

nshi

p

Loca

tions

Hom

eSc

hool

Com

mun

ityW

ork

Rec

reat

ion

Hom

eSc

hool

Com

mun

ityW

ork

Rec

reat

ion

62

ResourcesParent Trainingand InformationCenters

AlabamaSpecial Education ActionCommittee Inc (SEAC)600 Bel Air Blvd 210Mobile AL 36606-3501334-478-1208334-473-7877 FAX1-800-222-7322 AL onlyseacmob1junocomhttpwwwhsvtisnet~cja

AlaskaPARENTS ResourceCenter4743 E Northern Lights BlvdAnchorage AK 99508907-337-7678907-337-7671 FAX1-800-478-7678 in AKparentsalaskanethttpwwwalaskanet~parents

American SamoaAmerican Samoa ParentNetworkPO Box 3432Pago Pago AS 96799684-633-2407684-633-7707 (fax)

ArizonaPilot Parent Partnerships4750 N Black Canyon Hwy 101Phoenix AZ 85017-3621602-242-4366800-237-3007 (AZ only)602-242-4306 (fax)

ArkansasArkansas Disability Coalition2801 Lee Ave Suite BLittle Rock AR 72205501-614-7020501-614-9082 FAX1-800-223-1330 AR onlyadcceinet

FOCUS Inc305 W Jefferson AveJonesboro AR 72401870-935-2750870-931-3755 FAXfocusincipanet

CaliforniaDREDF2212 Sixth StreetBerkeley CA 94710510-644-2555510-841-8645 (fax)1-800-466-4232dredfdredforghttpwwwdredforg

Exceptional Parents Unlimited(EPU)4120 N First StreetFresno CA 93726209-229-2000209-229-2956 (fax)epu1cybergatecom

Matrix555 Northgate Dr Ste ASan Rafael CA 94903415-499-3877415-499-3854 (TDD)415-507-9457 (fax)1-800-578-2592matrixmatrixparentsorghttpwwwmatrixparentsorg

Parents Helping Parents - SanFrancisco594 Monterey BlvdSan Francisco CA 94127-2416415-841-8820415-841-8824 (fax)

Parents Helping Parents -Santa Clara3041 Olcott StSanta Clara CA 95054-3222408-727-5775408-727-7655 (TDD)408-727-0182 (fax)infophpcomhttpwwwphpco

Support for Families ofChildren with Disabilities2601 Mission 710San Francisco CA 94110-3111415-282-7494415-282-1226 (fax)sfcdmissaolcom

TASK100 W Cerritos AveAnaheim CA 92805-6546714-533-TASK (8275)714-533-2533 (fax)taskcaaolcom

TASK- San Diego3750 Convoy St Ste 303San Diego CA 92111-3741619-874-2386619-874-2375 (fax)

ColoradoPEAK Parent Center Inc6055 Lehman Drive Ste 101Colorado Springs CO 80918719-531-9400719-531-9403 (TDD)800-284-0251719-531-9452 (fax)PKPARENTaolcom

ConnecticutCPAC338 Main StreetNiantic CT 06357860-739-3089860-739-7460 (fax)1-800-445-2722 (in CT)cpacincaolcomhttpwwwmembersaolcomcpacinccpachtm

DelawareParent Information Center(PIC) of Delaware Inc700 Barksdale Road Ste 3Newark DE 19711302-366-0152302-366-0178 (TDD)302-366-0276 (fax)PEP700aolcom

FloridaFamily Network on Disabilitiesof Florida2735 Whitney RoadClearwater FL 24620813-523-1130800-285-5736 (FL only)813-523-8687 (fax)fndgatenethttpwwwgatenet~fnd

GeorgiaParents Educating Parentsand Professionals for AllChildren (PEPPAC)8318 Durelee Lane Ste 101Douglasville GA 30134770-577-7771770-577-7774 (fax)peppacbellsouthnet

HawaiiAWARELearning DisabilitiesAssociation of Hawaii200 N Vineyard Blvd Ste 310Honolulu HI 96817808-536-9684808-536-2280 (TTY)808-537-6780 (fax)ldahgtenet

IdahoIdaho Parents Unlimited Inc(IPUL)Parents Education amp ResourceCenter4696 Overland Rd Ste 478Boise ID 83705208-342-5884800-242-IPUL (4785)208-342-1408 (fax)ipulrmcinethttpwwwhomermcinetIPUL

IllinoisDesigns for Change6 N Michigan Ave Ste 1600Chicago IL 60602312-857-9292312-857-1013 (TDD)312-857-9299 (fax)1-800-851-8728DFC1aolcom

Family Resource Center onDisabilities (FRCD)20 East Jackson Blvd Rm 900Chicago IL 60604312-939-3513312-939-3519 (TDDTTY)312-939-7297 (fax)1-800-952-4199 (IL only)

Family TIES Network830 South Spring StreetSpringfield IL 62704800-865-7842217-544-6018 (fax)ftiesnaolcom

National Center for Latinoswith Disabilities1921 South Blue IslandChicago IL 60608312-666-3393312-666-1788 (TDD)312-666-1787 (fax)1-800-532-3393ncldinteraccesscom

4

for positioning are side lying frames walkerscrawling assists floor sitters chair inserts wheel-chairs straps trays standing aids bean bagchairs sand bags and so forth

Access In order to participate in school taskssome students require special devices that pro-vide access to computers or environmental con-trols The first step in providing access is to de-termine which body parts can be used to indi-cate the studentrsquos intentions Controllable ana-tomical sites like eye blinks head or neck move-ments mouth movements may be used to oper-ate equipment which provides access to the com-puter Once a controllable anatomical site hasbeen determined then decisions can be madeabout input devices selection techniques (directscanning) and acceleration strategies (codingprediction) Input devices include such thingsas switches alternative keyboards mousetrackball touch window speech recognition andhead pointers Once computer access has beenestablished it should be coordinated with othersystems that the student is using including pow-ered mobility communication or listening de-vices and environmental control systems

Access can also refer to physical entrance andexit of buildings or facilities This kind of assistivetechnology includes modifications to buildingsrooms and other facilities that let people with

physical impairments use ramps and door open-ers to enter allow people with visual disabilitiesto follow braille directions and move more freelywithin a facility and people of short stature orpeople who use wheelchairs to reach pay phonesor operate elevators Accessibility to shoppingcenters places of business schools recreationtransportation is possible because of assistivetechnology modifications

Environmental Control Independent useof equipment in the classroom can be achievedfor students with physical disabilities throughvarious types of environmental controls includ-ing remote control switches and special adapta-tions of onoff switches to make them accessible(eg velcro attachments pointer sticks)

Robotic arms and other environmental con-trol systems turn lights on and off open doorsoperate appliances Locational and orientationsystems give people with vision impairmentsinformation about where they are what theground nearby is like and whether or not thereis a curb close by

Augmentative Communication Every stu-dent in school needs some method of communi-cation in order to interact with others and learnfrom social contact Students who are nonverbalor whose speech is not fluent or understandableenough to communicate effectively may benefit

figure 1 Alternative and Pr ocessing Computer Access Methods

Inputbull Alternate keyboardsbull Interface devicesbull Joysticksbull Keyboard modificationsbull Keyboard additionsbull Optical pointing devicesbull Pointing and typing aidsbull Switches with scanningbull Scanners amp optical character recognitionbull Trackballsbull Touch screensbull Voice recognition

Processingbull Abbreviationexpansion and macro programsbull Access utilitiesbull Menu management programsbull Reading comprehension programsbull Writing composition programsbull Writing enhancement tools (ie grammar checkers)

Outputbull Braille displays and embossersbull Monitor additionsbull Screen enlargement programsbull Screen readersbull Speech synthesizersbull Talking and large print word processors

5

from using some type of communication deviceor devices Communication devices include suchthings as symbol systems communication boardsand wallets programmable switches electroniccommunication devices speech synthesizers re-corded speech devices communication enhance-ment software and voiced word processing

Assistive Listening Much of the time inschool students are expected to learn through lis-tening Students who have hearing impairmentsor auditory processing problems can be at a dis-tinct disadvantage unless they learn to use thehearing they have or they develop alternativemeans for getting information Hearing problemsmay be progressive permanent or intermittentAny of these impairments may interfere signifi-cantly with learning to speak read and followdirections Assistive devices to help with hear-ing and auditory processing problems includehearing aids personal FM units sound field FMsystems Phonic Ear TDDs or closed caption TV

Visual Aids Vision is also a major learningmode General methods for assisting with visionproblems include increasing contrast enlargingstimuli and making use of tactile and auditorymodels Devices that assist with vision includescreen readers screen enlargers magnifierslarge-type books taped books Braillers lightboxes high contrast materials thermoformgraphics synthesizers and scanners

Mobility Individuals whose physical impair-ments limit their mobility may need any of a num-ber of devices to help them get around in theschool building and participate in student activi-ties Mobility devices include such things as self-propelled walkers manual or powered wheel-chairs and powered recreational vehicles likebikes and scooters

Computer-Based Instruction Computer-based instruction can make possible independentparticipation in activities related to the curricu-lum Software can be selected which mirrors theconceptual framework of the regular curriculum

but offers an alternative way of responding to ex-ercises and learning activities Software can pro-vide the tools for written expression spelling cal-culation reading basic reasoning and higherlevel thinking skills The computer can also beused to access a wide variety of databases

Social Interaction and Recreation Studentswith disabilities want to have fun and interactsocially with their peers Assistive technologycan help them to participate in all sorts of recre-ational activities which can be interactive withfriends Some adapted recreational activities in-clude drawing software computer games com-puter simulations painting with a head or mouthwand interactive laser disks and adaptedpuzzles

Self Care In order to benefit from educa-tion some students require assistance with selfcare activities like feeding dressing and toiletingAssistive devices which assist with self care in-clude such things as robotics electric feedersadapted utensils specially designed toilet seatsand aids for tooth brushing washing dressingand grooming

What sort of students might use assistivetechnology

Students who require assistive technology arethose with mental or physical impairments thatinterfere with learning or other life functions Thetechnology helps the student to overcome or com-pensate for the impairment and be more inde-pendent in participating at school Students whobenefit from assistive technology may have mildlearning problems like learning disabilities orthey may have physical or cognitive disabilitiesthat range from mild to severe Assistive tech-nology is not necessary or helpful for every stu-dent in special education but it is an importantpart of the support system for many studentswith identified disabilities

Isnrsquot assistive technology appropriate only forstudents with more severe disabilities

Assistive technology is simply a set of tools

6

that can be used to compensate for some deficitthat a person may have For individuals with se-vere mental or physical disabilities the techno-logical solutions can help to solve multiple andcomplex problems But individuals with less in-volved problems also can benefit from assistivetechnology For example individuals with learn-ing disabilities who have difficulty with readingor writing can benefit educationally from usingthe word processing and voiced reading capa-bilities of computers

Isnrsquot assistive technology just a crutch Wonrsquotstudents become too dependent on technol-ogy and not learn to use the skills they have

Assistive technology should be used as sup-port for access learning and performing dailytasks In general assistive technology is appro-priate when it compensates for disabilities so thatthe individual can function as normally as pos-sible If assistive technology is necessary for astudent to have access to educational opportuni-ties or to benefit from education then it is not aldquocrutchrdquo but a legitimate support

Some skills are too laborious or taxing to ac-complish at a rate or with degree of proficiencyto allow for participation in the least restrictiveenvironment With assistive technology the stu-dent can participate more fully and more closelyapproximate the levels of achievement and in-teraction of his or her peers

The use of assistive technology enhancesfunction and increases skills and opportunitiesThough a student may be dependent upon a par-ticular device in order to perform skillfully de-nying the device denies the student an opportu-nity ever to achieve success at the level of his orher potential

When is using assistive technology appropri-ate

Assistive technology may be considered ap-propriate when it does any or all of the follow-ing things

bull Enables an individual to perform functions

that can be achieved by no other means

bull Enables an individual to approximate nor-mal fluency rate or standardsmdasha level ofaccomplishment which could not beachieved by any other means

bull Provides access for participation in pro-grams or activities which otherwise wouldbe closed to the individual

bull Increases endurance or ability to persevereand complete tasks that otherwise are toolaborious to be attempted on a routine ba-sis

bull Enables an individual to concentrate onlearning or employment tasks rather thanmechanical tasks

bull Provides greater access to information

bull Supports normal social interactions withpeers and adults

bull Supports participation in the least restric-tive educational environment

SummaryAssistive technology means any device which

helps an individual with an impairment to per-form tasks of daily living There is a wide rangeof types of devices in assistive technology fromlow tech homemade aids to computers and so-phisticated electronic equipment Assistive tech-nology is one of the services which can be pro-vided in a special education program under theIndividuals with Disabilities Education Act(IDEA) The requirements of IDEA say that stu-dents who need assistive technology are entitledto the aids and devices and the assistive technol-ogy services (eg evaluation for assistive tech-nology and modification and maintenance ofequipment) that are necessary for the student tobenefit from a free appropriate public education

Hints for Parents

It is never too soon to consider using assistive tech-nology Some infants with physical disabilities for ex-

7

ample really benefit from early interaction with toysthat operate by switch Here are suggestions for timesto evaluate a child for assistive technology

bull When disability limits interaction with the envi-ronment and interferes with experiential learn-ing

Assistive technology can be used to providephysical access to the environment (egswitch toys floor scooters touch window)

bull When a significant gap exists between receptiveand expressive abilities

Assistive technology can assist with expres-sion through the use of programmableswitches electronic communication devicesvoiced word processing braille embossingand so forth

bull When an individualrsquos performance falls behindthat of his or her peers

If an individualrsquos handwriting for exampleis very slow laborious and difficult to readuse of a word processing device can be sub-stituted for handwriting thus allowing theindividual to keep up with others in termsof written expression

bull When a physical disability is impeding the edu-cationalvocational potential of an individual

Assistive technology can provide access tothe workplace for example by allowing anindividual who is blind to learn to use ascreen reader and voiced word processingto do clerical tasks that would otherwise beimpossible

bull When a disability is impeding the independenceof an individual

Sometimes assistive technology can be usedto allow a person with a disability to func-tion more independently For example hav-ing a power wheelchair allows an individualto travel independently without the neces-sity of having someone to push the wheel-chair

SaraSara who has Down syndrome is eight

years-old Her language and speech skills arethree years delayed but she has age appropriatesocial skills Sara has spent part of her schoolday in a regular classroom ever since kindergar-ten but this year her third grade teacher is sug-gesting that Sara really cannot keep up with herclassmates The teacher thinks that Sara wouldbe better off in a self-contained class with stu-dents who work at her pace Sara has some finemotor coordination problems and she has haddifficulty learning to write in cursive Her oralreading is hampered by her speech difficultiesHowever Sara has learned to do addition andsubtraction problems well and has mastered add-ing with carrying and subtraction with borrow-ing She reads at about a second grade level withreasonably good comprehension Sararsquos parentswould like to see her continue in the regular class-room for as much time as possible but they rec-ognize that Sararsquos writing and speaking problemsare keeping her from doing her best work

What are Sararsquos needs

What kinds of technology should go in SararsquosIEP

How would you make a case for puttingassistive technology into her IEP

8

Sararsquos SolutionSararsquos IEP Team met to discuss her needs and

concluded that she is doing well in a regular class-room setting she is making adequate progressin academic skills and has learned how to inter-act socially with her peers It is to be expectedthat Sara will have difficulty keeping up with thepace in a third grade but as long as she is mak-ing progress toward her individual goals theregular classroom is a good setting for her How-ever some simple accommodations and technol-ogy may help Sara to work faster and more effi-ciently

At this point Sara may need some assistancewith handwriting and speaking but the solutionsto her problems in these areas need not be com-plex ones The team decided that Sara shouldcontinue to practice cursive until she has mas-tered all the letters and can be more facile in us-ing script However while she is still learningcursive she needs other means for respondingin writing For short written responses the teamagreed that Sara should be encouraged to usemanuscript printing When speed is importantor when writing assignments are longer Sarashould have access to a computer with an adap-tive keyboard (eg IntelliKeys) The adaptivekeyboard is helpful for Sara because the ldquokeysrdquoare larger and easier to see Using the keyboardrequires only a very light touch so Sara finds iteasier to use than a standard computer keyboard

In terms of oral reading the team decided tohave Sara practice reading into a tape recorderHer speech therapist will work with her on slow-ing down her rate of speech and reading withexpression When Sara has a good tape of heroral reading she will submit it to her teacher forreview

Solution SummaryPractice cursiveUse manuscript printing for short assign-

ments

Use computer with adaptive keyboard forlonger assignments

Practice oral reading using a tape recorder

9

Making Assistive Technology Decisions

W hen parents learn about assistive tech-nology and the wonderful opportuni-ties it can provide they want to jump

right in and get the latest in technology for theirchildren Who wouldnrsquot want an augmentativecommunication device for a child who cannottalk What parents wouldnrsquot want to buy a com-puter if it would help their child learn

When the world of assistive technology opensup for parents it can be like entering a great toystoremdasheverything looks so wonderful that itmakes it hard to know what to select Choosingthe right device to meet an individualrsquos needsrequires technical knowledge and indepth under-standing of the individualrsquos functional capabili-ties Not only is the selection of a device madedifficult by the complexity of the equipment andthe demands of the individualrsquos impairmentassistive technology devices can be very expen-sive Making such purchases is a major financialcommitment for most families one that takes agreat deal of soul searching and sometimes sig-nificant sacrifice

Families invest more than money in theirchildrenrsquos assistive technology Practical invest-ments of time and effort and emotional invest-ments of hope and enthusiasm are made withevery assistive technology purchase Because ofthe high level of financial personal and emotionalcommitment family disappointment is greatwhen equipment fails to perform as expected

Buying and then not using a device becauseof dissatisfaction can be a devastating experiencefor all concerned That is why it is so importantfor parents to proceed cautiously into the worldof assistive technology and make purchases onlyafter careful evaluation and trials with the newdevice Following is a summary of some sug-gestions for parents to consider before makingany assistive technology purchase be realisticabout your childrsquos capabilities and needs get a

multidisciplinary evaluation examine availabletechnology with a critical eye match the childrsquosneeds to specific equipment features do not makea purchase until you have used the device for atrial period identify next steps and determinewhat needs to be done for follow-up after pur-chase

Guidelines for Making Assistive TechnologyDecisions

bull Be realistic about your childrsquos capabilitiesand needs

Assistive technology can open up excitingnew opportunities for a child but it is not magicThere are certain basic requirements for any in-dividual to be successful with technology and itis important to face these requirements squarelyThere is nothing more disappointing or discour-aging than purchasing expensive equipment fora child which is beyond his or her capabilities touse

Prerequisites for Computer Use Physicalor sensory impairments do not limit access tocomputers but cognition is a factor in computeroperation The major prerequisite for using acomputer (with or without adaptations) is thecognitive ability to understand cause and effectThe child must be able to understand that thecomputer operates (eg changes does some-thing) because the child has activated the equip-ment through some volitional movement or ac-tivity (eg eyebeam speaking puffing into astraw hitting a switch) Some children enjoyplaying with switches by hitting them randomlybut may not be able to connect their own behav-ior to the response their movement activates Inorder to be successful in interacting with a com-puter the user must be able to control some voli-tional activity and to do so consistently For ex-ample the child would have to be able to acti-vate the computer in response to a visual tactileor auditory prompt

10

Another prerequisite to computer use is theability to make conscious meaningful choicesbetween alternatives like yes and no The choicescan be very simple ones but there has to be evi-dence that the child has made an actual decisionand not merely acted randomly

If a child does not have the concept of causeand effect or cannot make consistent choices us-ing a computer is probably not a worthwhile nextstep at this point in the childrsquos developmentOther types of activities may be more appropri-ate less expensive and just as rewarding devel-opmentally and personally

Prerequisites for Augmentative Communi-cation Augmentative communication devicescan literally give voice to the thoughts of indi-viduals who cannot speak or cannot speak clearlybutmdashagainmdashthese devices are not magic Elec-tronic communication devices are of no valueunless the user has some communicative intentThat is for a communication device to be help-ful the user has to have some basic understand-ing of the communication process and must beintentional in expressing choices desires orneeds

For example Maggie is a four-year-old whois nonverbal She communicates her wants andneeds by using eyeblinks as responses to yes orno questions When Maggiersquos dad asks her if shewould like another glass of milk she indicatesher choice by raising her eyes up vertically foryes or moving her eyes down for no Maggieclearly knows what she wants to communicateshe has a consistent method for making herwishes known and she expects that her dad willunderstand her communication and act on it

Dan who is also nonverbal communicatesin a different way He points to objects and makesgestures to show what he wants or needs Hisgestures are clear and used consistently so thatfamily members and even people who do notknow Dan well can understand most of the timewhat he is communicating

Shelley communicates very basic informationabout how she feels by crying when she is un-comfortable or wants attention and by laughingwhen she enjoys something like music brightlights or water running Shelley does not how-ever respond to yes or no questions She doesnot make choices even when objects are pre-sented to her individually or in pairs She can-not respond to a question like ldquoDo you want someice cream nowrdquo Or ldquoWould you like the teddybear or the dollrdquo

Maggie and Dan may benefit from usingsome communication device because they arealready using communication systems meaning-fully and consistently Shelley however mayneed to develop greater ability to communicatemeaningfully before moving on to electroniccommunication

Communication skills fall along a continuumAt one end of the continuum are very simplecommunications like expressing preferences byindicating yes or no pointing or gesturing towardobjects or pointing to pictures Use of sign is amore complex form of communication becauseit requires that the user understand that the signsare symbols for meaningful communicationsWhen an individual is able to string togethersigns or words into meaningful phrases this isan additional step toward more complex com-munication When a person understands syntaxand is aware of typical word order this is anotherstep forward Each of these advances along thecommunication continuum represents a step to-ward more complex and sophisticated commu-nication Whatever assistive communicationdevice is chosen should match or just slightlyexceed the place on the continuum where the in-dividual is functioning It makes no sense forexample to purchase an elaborate electronic com-munication device that requires understandingsymbols and syntax when the individual usingthe device is just at the point of learning how toexpress yes and no preferences

An electronic device does not teach commu-

11

nication it enhances communication by givingaudible expression to thoughts that already existin the mind of the user If the thoughts are notthere yet or are not completely formed they can-not be expressed by the device

Physical and Sensory Impairments Are NotBarriers Mastery of a few simple prerequisiteskills is necessary before computers or electroniccommunication devices should be consideredbut it is not necessary for a child to master everydevelopmental milestone before entering theworld of assistive technology Physical or sensoryimpairments can often be circumvented by thetechnology itself and typical developmentalmilestones can sometimes be bypassed so thatassistive technology can be used For examplesome educators assume that students cannot usecomputers until they have completely masteredkeyboarding skills This is a false assumptionMany students benefit from using computerseven though they operate the machine using aldquohunt and peckrdquo method or only one or two keysIn a similar fashion students with limited verbalability who have not mastered oral speech ben-efit from using augmentative communicationdevices while they continue to develop oral lan-guage

Overall the keys to knowing when to tryassistive technology are (a) being realistic aboutthe childrsquos cognitive abilities and potential and(b) being open to trying the level of technology

which meets the child where he or she is

bull Get a multidisciplinary evaluation

Evaluations for assistive technology are notalways easy to arrange In many parts of theUnited States there is no convenient center orldquoplacerdquo to go for an assessment The availablecenters may be far away in another city or evenanother state Since assistive technology is a newfield the systems for disseminating informationand providing assistance are in the process ofevolving Parents may have to be ldquoassistive tech-nology detectivesrdquo in order to put together theinformation needed for a complete AT evalua-tion for their child

The place to start the evaluation is by consid-ering the functions the child needs to performand cannot because of impairment The physi-cians teachers and therapists currently workingwith the child as well as family members andfriends who are around the child on a daily ba-sis can provide very valuable information aboutfunctional problems and potential solutions

Finding Functional Solutions The Alliancefor Technology Access (ATA) a national networkof assistive technology centers has developed aninformal method for using the functional infor-mation available from professionals family mem-bers and friends as a basis for analyzing assistivetechnology needs This process called a Solu-tion Circle is a means to bring people togetherin an informal session that allows for creative

figure 2 Factors to consider when selecting Assistive T echnology

Cognitive Factorsbull Diminished Cognitive Abilitiesbull Learning Disabilitiesbull Attention Deficitsbull SensoryPerceptual Deficitsbull Memory Deficitsbull Abstract Reasoning Deficitsbull Problem-Solving Deficits

Motor Factorsbull Voluntary Motor Deficitsbull Involuntary Motor Deficitsbull Fixed Posture amp Positioning Deficitsbull Recurring Purposeless Motionbull Motor Paralysisbull Low Muscle Tonebull Rigiditybull Spasticitybull Tremors

12

thinking and is not inhibited by what is ldquolegalrdquoldquocurrently availablerdquo or ldquowhat has been done be-forerdquo The individual with a disability and 4-10family members professionals and friends gettogether to brainstorm ideas about the technol-ogy which may help the individual perform func-tions that are hard or impossible to do becauseof disability The Circle usually includes a bal-ance between people who know the person whoneeds the technology and people who have spe-cialized knowledge about technology educationor work-related issues

Solution Circle for Tom To demonstratehow the Solution Circle works letrsquos take a lookat how this process was used in the case of Toma high school student with a learning disabilityFor Tom the print in textbooks is a significantbarrier to learning Tom is ldquoprint disabledrdquo thatis he cannot read the printed word with muchcomprehension Reading is a slow unproductiveprocess for him even though he is intelligent andeager to learn Tom and his parents were hopingthat there might be a way that new technologycould help Tom overcome or work around hisproblem with reading so that he could get moreout of school and perhaps go on to college

Tomrsquos Solution Circle included his parentsBetty and Bob his resource teacher a friendDarrell his soccer coach his 4-H leader and theowner of a local computer store This group mettogether to think about how Tom could partici-pate more fully in school and prepare himself forcollege even though he could not read with com-prehension past the second or third grade level

Solution Circles generally take 1 to 1 12 hoursto complete The steps include the following

1 Star Time The individual for whom theSolution Circle is being held is described in a ho-listic way The emphasis is on how the individualis functioning at home and in the communityWhat does he or she like and dislike What arehisher goals Interests If possible the indi-vidual with a disability speaks for himself or her-self or a video or pictures may be presented The

point of this part of the discussion is give a clearpicture of the individual as a whole person

At Tomrsquos Solution Circle he explained hisdream of going to college and becoming an agri-cultural botanist Tom loves plants he is inter-ested in breeding new strains of wheat and per-fecting various types of grain crops Tomrsquos 4-Hleader agreed that Tom had real gifts in under-standing plant growth and physiology and thathe already had sophisticated knowledge aboutbotany which would prepare him well for col-lege study

2 Strengths With a complete picture of theindividual in mind the group then makes an ex-haustive list of the individualrsquos strengths particu-larly noting any technological accommodationswhich the individual is already using What doesthe individual do well What are his or her un-impaired functions Often this discussion revealsan incredible number of adaptations that the in-dividual has already achieved

Tomrsquos Solution Circle discovered that he hadmany strengths including keen intelligence per-severance and thoroughness when approachinga task Tom already had some effective learningstrategies for remembering material that heheard He had also learned to use a small taperecorder for keeping track of information pro-vided in class

3 Obstacles With the individualrsquos strengthsin mind the group then turns its attention to aconsideration of the environment in which theindividual is functioning and the activities inwhich the individual wants to participate butcannot at this time The group considers whatthe obstacles and barriers might be for the indi-vidual in his or her environment and makes alist of these impediments

For Tom reading was a serious obstacle Hecould not keep up with homework assignmentsbecause it took him so long to read his textbooksIn addition he had difficulty reading directionson tests and often misread assignments on the

13

COGNITIVE FACTORSCognitive Ability

Documented below average abilityDocumented significant overall delayDoes not appear age appropriateLacks understanding of cause amp ef-

fectPaying Attention

Difficulty following prompts or direc-tions

Difficulty with multi-step proceduresDifficulty filtering informationDifficulty staying on task

PerceptionNeeds lengthened response timeRequires multi-sensory inputDifficulty with rapid changeSignificant visualperceptual problemsSlow visual-motor dexterity

MemoryDifficulty with recallRequires reteaching learned skillsRequires repeated practice

Abstract ReasoningDifficulty analyzing simple proceduresUnable to reproduce a sequenceUnable to analyze or synthesize in-

formationProblem Solving

Unable to use prompts or cues to ac-complish tasks

Unable to modify attempts and try an-other way

MOTOR FACTORSMobility

Needs help to be mobileNeeds motorized help to be indepen-

dentNeeds help boarding transportationUnable to transfer independentlyCannot climb stairsCannot open doors independentlyCannot carry materials in hands or

armsCannot lift weight

Voluntary MotorLimited control of head trunk or ex-

tremitiesVisual motor deficitsFixed position and posture

figure 3 ASSISTIVE TECHNOLOGY EVALUATIONIndividual Functional Analysis

Name Date

Needs support to sit or standNeeds adaptations in order to use

technologyMotor Paralysis

Changes in muscle tone interfere inmotor movements

Spastic movements result in poor con-trol

Limited movement of head arms orlegs

Difficulty balancing in sitting positionDifficulty maintaining good posture

Low Muscle ToneLimited use of arms or legsPoor posture controlFatigues quickly

RigidityInhibits arm and leg movementInhibits balance to sitInhibits good posture

SpasticityLimited upper range of motionLimited lower range of motionInterferes with accuracy and consis-

tency of motor movements on oneside

TremorsPresent all the timePresent when doing purposeful upper

extremity taskUnable to compensate for tremors

Extraneous MovementAthetoid (constant)Ataxia (poor coordination in move-

ment)FINE MOTOR

DexterityLimited fine motor controlHas limited hand movement

HandwritingWriting or copying ability is signifi-

cantly below peersSignificant legibility factor--written

work not readableCannot keep up with the pace of writ-

ten workIs frustrated by writingFatigue is a factorTyping appears to be potentially faster

than handwriting

SELF CARENeeds assistance with going to the

bathroomUnable to be toilet trainedNeeds assistance to eatCannot take in food orallyNeeds suctioning routinelyHas degenerative medical conditionIs medically fragileSeizures limit alertnessNeeds to rest frequentlyNeeds assistance to zip coat or tie

shoesCOMMUNICATION

Receptive LanguageReceptive language is significantly

lower than abilityReceptive language is significantly

higher than expressiveExpressive Language

Speech is unintelligibleExpressive language is significantly

lower than abilityMean Length of Utterance (MLU) is 3

words or lessSpontaneous or self initiated language

is significantly limitedDoes not make choices consistentlyDoes not respond appropriately with

yes or noDoes not have communicative intent

SENSORYVision

Requires corrective lensesRequires large print to readRequires mobility trainingHas blind spot

HearingRequires preferential seatingHearing limitations affect the language

thresholdsRequires assistance to receive lan-

guageRequires sign language to receive lan-

guageHas fluctuating hearing lossNeeds visual signals for safety pur-

poses

14

blackboard

4 The Enemy Within Physical and cogni-tive impairments may pose difficult obstacles foran individual but often the feelings that peoplehave about the individualrsquos disability or aboutassistive technology pose greater problems thanthe disabilities themselves The Solution Circleprocess recognizes that human fears concernsreservations and prejudices might stand in theway of a personrsquos success as much as other typesof limitations Getting these fears and concernsout on the table often helps the group to deal moreconstructively with what is possible and whatneeds to be done

One of the serious issues in Tomrsquos situationwas that his resource teacher felt he should con-tinue to try to read for himself instead of using aldquocrutchrdquo like assistive technology The teacherthought that if Tom did not have to read all thematerial he would lose what little reading skillhe had In some ways the teacherrsquos oppositionto considering assistive technology actually poseda greater barrier than the reading problem itself

5 Solutions The exciting part of a SolutionCircle occurs when the group takes each obstacleor concern and turns it into a possible solutionthrough the use of technology or some other typeof adaptation Not all solutions suggested even-tually prove to be feasible but the point of thediscussion is to produce many possible solutionsso that the individual and his or her family havean array of options from which to choose Withgood minds puzzling over the problems and aspirit of cooperation and collaboration seeminglyimpossible barriers can be removed or conqueredThe process recognizes the expertise and contri-butions of all participants including the indi-vidual with disabilities and his or her familymembers The freewheeling format of the dis-cussion promotes ingenuity and innovation Allinvolved come away from a Solution Circle ener-gized by the new possibilities

Tomrsquos Solution Circle became excited about

the possibility of solving his reading problem byusing computerized texts The computer storeoperator mentioned he had heard that Record-ings for the Blind (RFB) offered textbooks on diskTomrsquos parents got in touch with Recordings forthe Blind and ordered texts for Tom to try on hiscomputer at school Soon Tom found that hecould keep up with his classmates and study ex-actly the same material that they were coveringBecause Tom had good strategies for memoriz-ing information that he heard he learned quicklyfrom the texts that were read aloud to him by thecomputer When given oral tests by his classroomteachers he was able to recite appropriate an-swers which would have eluded him if he hadhad to read the tests for himself

Technology has made all the difference forTom he has every reason to think that he will beable to go to college and pursue his intellectualinterests His resource teacher is now completelysold on the idea of assistive technology and us-ing computerized books and wants to use thetechnique with other students More than thatTomrsquos teacher also appreciates the process of theSolution Circle which allowed professionals andnonprofessionals to work together to find prac-tical solutions without being too concerned aboutthe formalities of the special education processThe informal nature of the Solution Circle vali-dated the expertise of all the participants andgave everyone a chance to offer suggestions Thecombination of a new process for planning andnew technology made Tom a winner This samecombination holds potential for many studentslike Tom who benefit from technologies whicheliminate barriers and open up new possibilitiesfor learning

From Function to Technology Solution Ithappened that a participant in Tomrsquos SolutionCircle hit on a great idea for a solution to his func-tional problem with reading This was a fortu-nate connection to make At the suggestions ofhis Solution Circle Tom began to use computer-ized books which he ldquoreadsrdquo by having the com-

15

puter speak the words as he follows along withthe text For Tom computerized books proved tobe a successful solution to his reading problembecause they help him to get the information heneeds without struggling with the reading pro-cess

Not every Solution Circle will be like Tomrsquosand identify the exact technology that the indi-vidual needs But if a Solution Circle has workedwell the end result will be a clear analysis of thefunctions that need to be performed This func-tional information can then be brought to techni-cians who can make suggestions for possibleassistive technology solutions There are over 50assistive technology centers in the United Stateswhere knowledgeable individuals can assistpeople with disabilities and their families withmaking a match between functions that need tobe performed and the technology that is availableto perform those tasks A list of assistive technol-ogy centers is available in the Appendix to thisGuide

Formal Assessment Solution Circles are aneffective informal way to identify functionalneeds that can be met through technology How-ever in the school setting it is also necessary toestablish a studentrsquos needs for technology in amore formal way Formal evaluations for assistivetechnology must be multi-disciplinary involvingeducators and therapists who are knowledgeableabout the school curriculum and the particulartypes of impairments that the student being as-sessed may have For example for a student withcerebral palsy the assistive technology evaluationmight involve a teacher a physical therapist aspeech and language clinician and an occupa-tional therapist The teacher would assist thetherapists in determining what skills the studentneeded to learn and how technology might assistthe student in acquiring those skills Someassistive technology evaluations might require theadditional services of an A-V technician adap-tive physical education teacher a rehabilitationcounselor or speech and language pathologist

with specialized training in augmentative com-munication In school districts where there is nospecialized expertise in technology and its appli-cations it may be necessary to contract for evalu-ations with special education cooperatives medi-cal centers or centers that focus on technologyassessment

Individuals conducting an assistive technol-ogy evaluation should

bull Be knowledgeable of the studentrsquosstrengths and weaknesses medical needsmobility fine and gross motor skills cog-nitive ability communication abilities vo-cational potential self help needs sensoryabilities level of academic achievementand area(s) of disability

bull Have knowledge of and access to an arrayof assistive technology devices

bull Be familiar with the studentrsquos educationalsetting and educational needs

bull Be able to communicate effectively withparents and educators

Because the assistive technology field is sonew there are no particular licenses orcredentialing processes to identify a professionalas qualified to do assistive technology evalua-tions Generally speaking individuals with pro-fessional licenses as occupational or physicaltherapists special educators speech pathologistsor rehabilitative counselors may have the exper-tise to conduct an AT evaluation When consid-ering an evaluator it is wise to ask about theevaluatorrsquos specific experience with assistivetechnology It is also important to recognize thatno one person or discipline will know everythingabout assistive technology therefore access toknowledgeable people at the local level andthrough other agencies programs or services isessential

Conducting the AT Evaluation The assistivetechnology evaluation must be tailored to theunique needs of the student In some cases theevaluation may be conducted by at team of indi-

16

viduals in other cases the evaluation may beconducted by a single individual (eg the speechpathologist) Questions to be addressed duringthe assessment should be related to the specifictasks the student needs to be able to perform andwhat if any assistive technology would helpThe following questions may be considered dur-ing the assessment

bull What tasks does the student need to per-form that he or she cannot perform

bull Is there a low tech device which will ad-dress the studentrsquos needs satisfactorily

bull What types of high tech assistive devicesmay help the student in performing thetask

bull Will assistive technology help the studentto perform the task in the least restrictiveenvironment

bull Is the device being considered suited to thestudentrsquos educational needs and abilities

bull Will the assistive technology device remainsuitable over time How long lasting willthis solution potentially be

The above are only a few of the considerationswhich need to be addressed as part of the evalu-ation process There is no specific ldquotestrdquo forevaluating the need for assistive technologyTherefore prior to conducting the evaluation theindividuals doing the assessment need to have awell planned process in mind

The formal written assistive technologyevaluation report should address but not belimited to the following points

bull Procedures used to evaluate the student

bull Instruments employed in the evaluationassuring that a range of levels of technolo-gies has been considered

bull Results of evaluations including bothqualitative and quantitative measures

bull Recommendations for levels of technologyappropriate to the studentrsquos capabilitiesand potentials and

bull Implications for educational program-ming including discussion of both indi-vidual technology needs and recom-mended environmental and instructionalmodifications

In the end an assistive technology evaluationshould provide recommendations for accommo-dations adaptations devices and services basedon the individualrsquos strengths needs and pre-ferred lifestyle The evaluation should indicate(a) whether devices and services have potentialfor improving function and (b) what trainingmay be necessary in order to use the technologyequipment safely and effectively

bull Examine available technology with a criti-cal eye

It is easy to be dazzled by the possibilities innew assistive technology but it is important forparents to be wise consumers and ask probingquestions about the features and quality of anassistive technology device The following is alist of questions to consider when evaluating aparticular assistive technology device

Performance

Does it work efficiently and effectively

Is it easy to learn to use this device

Is it compatible with other devices

Does this device serve only one purposeor is it flexible

ldquoElegancerdquo

Does this device represent the simplestmost efficient way to accomplish the task

Or is this device too elaborate too com-plicated to be worthwhile

Ergonomics

Does it fit the individual

Is it convenient to use in the environment

Is the equipment portable enough to gowhere the user goes

Are different devices needed in differentenvironments

17

Reliability

What is the manufacturerrsquos reputation forreliability

Does it stand up well to normal use

Is it durable

Safety

Is it safe to use

What is the power source for the deviceIs it safe

Is a margin built in for foreseeable mis-use

Practicality

Do company sales people seem knowl-edgeable and helpful

Are the companyrsquos service people knowl-edgeable and helpful

Does the device have a warranty Howlong is the device guaranteed to function

How available are repair services Atwhat cost

Can this device be leased

Is this device available for a trial periodbefore purchase

Will this device soon be outdated Issomething better on the horizon

Will the company update the device

Does the manufacturer provide trainingin using the device

Aesthetics

Is this device attractive to the eye

Does the device fit well into the userrsquoslifestyle

Normalization

Does the device assist the user with morenormalized living

Can the user operate the device indepen-dently or with a minimum of assistance

Or does the device ldquostick outrdquo too muchand advertise the disability of the user

Does the equipment minimize differenceor exaggerate difference

Does the device have the potential to in-crease the quantity and quality of time spentwith nondisabled peers Or does the de-vice separate the user from others

Cost effectiveness

Do the benefits the device provides jus-tify the cost

Are there less expensive devices or mod-els that serve the purpose as well

Personal acceptance

Is this device the userrsquos own choice

Does the potential user like this deviceand want to use it

Does the potential user view this deviceas life-enhancing

Would the user have preferred some otherdevice or means to perform the task

Will using the device always be a choreor can using it become a habit

There are several ways that consumers canfind answers to their specific questions aboutassistive technology devices Most vendors willprovide good basic information about the prod-uct Call the vendor and ask for brochures prod-uct specifications price list and any other writ-ten information This is a place to start A sec-ond step is to read reviews of the product in trademagazines or Closing the Gap a widely respectedpublication that reviews new assistive technol-ogy products If possible it is very helpful totalk to other consumers who are already usingthe product Ask them about the pros and consof using the device Then visit a preview centerif there is one nearby and try out several typesof devices Ask for general recommendationsfrom the preview centerrsquos staff After identify-ing a device that appears to meet the potentialuserrsquos needs try the device out for a month tosix weeks to make sure that it performs as adver-tised and fits in well with the userrsquos lifestyle

18

During the trial period it will be possible to iden-tify training needs for the user family membersand school staff The trial period will also be atime for the user to test the device in several set-tings to determine its portability and flexibility

bull Match the Individualrsquos Needs to SpecificEquipment Features

When considering an assistive technologydevice it is very important to consider how adevice matches up with the particularindividualrsquos needs and habits In some ways anassistive device becomes an extension of theuserrsquos mind and body As such it is a highly per-sonal item A device may work as advertisedbut still not meet an individualrsquos needs becausethe individual just does not feel ldquocomfortablerdquo inusing it For example Cindy a fourteen-year-oldwho is totally blind and has mild cerebral palsyaffecting her hands and arms was being taughtMorse Code as a means to speed up her writingShe had difficulty using a Brailler because her armstrength was so limited so her teacher thoughtMorse Code would be an easier method of writ-ing for Cindy The only problem was that Cindydid not like using Morse Code To her it seemedlike she was having to learn another complicatedlanguage when she already knew braille andliked to use it Cindy admitted that writing inbraille was slow for her but she was more com-fortable with it Cindy and her teacher were atan impasse until a friend suggested to Cindy thatshe try writing on a voice-output computerCindy loved the computer With a headset at-tached to the sound system she could listen care-fully to the computer as it read aloud the lettersand words she was typing on a light touch tac-tile-marked keyboard This computer also had afeature of printing out text in either standard printor braille Cindy was delightedmdashshe could writecopy for herself to read in braille and for hersighted teachers to read in regular print Thissolution worked because it met Cindyrsquos learningneeds and responded to her own ideas about her-self She did not want to use Morse Code because

it was a separate type of communication knownonly to a few With her computer voiced soft-ware and dual printer she had the best of twoworldsmdashshe could ldquohearrdquo her writing as shetyped she could read it over in braille and hersighted teachers could read her finished prod-uct This solution helped Cindy to improve hercomposition skills speed up her writing timeand communicate more easily with sightedpeople

Cindy was fortunate because her assistivetechnology solution met her needs almost per-fectly Such a close match is not however al-ways possible Nonetheless every effort shouldbe made to have the match be as close as it canbe In general when assistive technology solu-tions are individualized simple to use and re-sponsive to the whole person they are more likelyto be used by the individual When the deviceperforms a task well but does not ldquofitrdquo the indi-vidual the technology is likely to be abandonedby the user in favor of something else whichmeets the need more exactly Too often devicesare purchased because of their technical poten-tial without thought to their relationship to theindividual and his or her lifestyle These mis-matched devices are the ones that end up lan-guishing in their packing boxesmdasha sad reminderof time and money spent to no avail

bull Try the Device Before Buying

It cannot be emphasized enough how vital itis to try out assistive technology devices andequipment before buying Trying out a devicefor several weeks provides the user with an op-portunity to learn how to use the device and howto adapt to its features while at the same timetesting the device in the various environmentswhere it will be used For example Mike triedout a communication device which attachednicely to his wheelchair tray and was compat-ible with his computer that he used for doingschool work Though the communication deviceworked well and was relatively easy to program

19

MOTORSELF CARE

manual wheelchairpower wheelchairbus liftsupportive classroom

chairstanderwalkerlift for transferspositioning devicecanes or crutchesadapted commodesuctioning devicebraces or supportsother ____________

________________

________________

________________

________________

________________

________________

________________

________________

________________

________________

________________

figure 4 ASSISTIVE TECHNOLOGY EVALUATION

Device or Equipment Features or Functions

Name Date

FINE MOTOR

word processorword processor with

predictionvoiced word proces-

sor with predictionadapted keyboardkeyguardalternative key

arrangementvoice activated

computer accessinfrared computer

accessmouse accesstrackballjoystickpower padswitch (eg mouth

lip chin)touch screenpointersdrag and click desk

accessorysticky keysonscreen keyboardprinter for written

work

adapted feedingutensils

braces or splintsother ____________

________________

________________

COGNITIVECOMMU-NICATION

communciationboard(s)

communication wallettotal communicationmanual signword processor with

voiceprogrammed voice

outputicon predictionelectronic communi-

cation deviceprogrammable switch

with voice output

no-reading-neces-sary word proces-sor

spell checkergrammar checkeroutlining programother ____________

________________

________________

________________

________________

________________

________________

________________

SENSORYPERCEP-TUAL

hearing aid(s)

classroom amplifica-tion

boosted signal tonoise ratio (egheadset to keepfocus during wordprocessing)

corrective lensesenlarged printtaped booksvoiced word process-

ingvoiced screen

directionsCCTVother ____________

________________

________________

________________

________________

________________

________________

________________

________________

________________

________________

20

Mike found out quickly that the device was justtoo bulky to be useful for him When he trav-eled around the school the communication de-vice blocked his view of the terrain and of peoplepassing by He found he missed opportunitiesto communicate because he could not see whowas coming his way Mike also discovered thatthe communication device did not serve him wellin crowds like at pep rallies or basketball gamesAfter a month of working with this communica-tion device Mike decided it was not for him andselected instead a device that was less compli-cated smaller and more portable The seconddevice was not as sophisticated as the first but itbetter met his needs for quick communicationwith friends in social settings If he had not hadthe opportunity to try out both devices for anextended period of time Mike might not haverealized the value of the second device and mayhave been stuck with a communication devicethat was too large and too sophisticated to matchhis lifestyle

Similarly Marilyn benefited from a trial pe-riod with her communication device She foundout the first week that the particular device shehad chosen would not work for her because itbroke too easily and it was difficult to get re-paired During the first week that Marilyn hadthe device for trial her teacher broke one of thebuttons during a programming session It tooktwo weeks to contact the manufacturer and thenthe device had to be mailed back to the factoryfor repairs The device was gone for over sixweeks and the manufacturer would not supplya ldquoloanerrdquo while Marilyn waited for repairs tothe first device This experience taught Marilynthe importance of having a responsive manufac-turer who is willing to repair devices quickly andto supply substitutes for the user while repairsare being made Marilyn decided on a differentdevice with similar features and a great helplineto provide assistance with the maintenance of themachine

The information that can be learned during a

trial period with a device is invaluable to the userIt is discouraging to find out during the trial thata device is not all it is purported to be or that itdoes not work as well as advertised but it is farbetter to learn before purchase that a device doesnot meet the userrsquos needs than to learn after pur-chase and be stuck with an expensive unusablemachine For the consumer it is daunting to thinkabout starting over again with the process of se-lecting a device Nonetheless it is worthwhileto seek more information and look again Hav-ing been through a trial even when the outcomeis not successful provides the user with greaterclarity about what an appropriate device willhave to be able to do The second time aroundthe search is likely to go faster and come out witha better result

bull Identify Next Steps

Once a device has been selected the con-sumer becomes impatient to have one and beginusing it right away But at this point importantwork still needs to be done Funding the deviceis a major consideration Sometimes families willpay for the device themselves but under othercircumstances the device will be purchased by aschool district through Medicaid or private in-surance or through some other means Parentsneed to become familiar with the various fund-ing options and determine which one will workfor them (See Funding Assistive Technology foradditional information about funding sources)

Also when considering funding familiesshould think about costs beyond the price of thedevice itself For example a computer set-upwith a keyboard monitor and printer might cost$3500 This equipment is basically useless un-less other equipment is purchased as well soft-ware adaptive devices paper manuals up-grades Prices for these additions can raise theactual cost of the device by hundreds of dollars

Devices often require training for the userfamily members and others to ensure effectiveand safe use How much does training cost Who

21

will provide it Repair and maintenance are othercosts usually additional to the price of the equip-ment Sometimes families will also want to insurethe assistive device so insurance payments be-come part of the overall cost

Since making an assistive technology pur-chase is such an important personal and finan-cial decision it is wise to have a realistic budgetin mind that includes all of the equipment andservices that are necessary to make the assistivetechnology work effectively With this budget inmind it becomes easier to plan the purchase seekout funding sources and make a compelling casefor financial assistance

bull Determine What Follow-up Is Needed

After the assistive technology device has beenpurchased and put to use there are additionalfollow-up activities that need to take place Theoriginal assistive technology evaluation shouldinclude a way to monitor the use of the devicePeriodic scheduled reviews the by evaluator fol-low-up calls to and from the family are some waysto help assure effective safe use Families whotravel great distances for evaluation need to becertain that services like maintenance repair andreplacement of devices are available within a rea-sonable distance from home

Assistive technology devices are used bestwhen all the people in the life of the individualwith disabilities understand the devices in thesame way At first devices may seem to exagger-ate differences between a person and the rest ofthe world Care should be taken to explain thatassistive equipment is a difference equalizer nota difference maker Classmates and friends needto understand that the adapted seating or adaptedkeyboard helps the individual do what other stu-dents do Adults in a childrsquos life need to under-stand that devices work to make life easier bet-ter and more functional People need to knowthat ramps help keep individuals with mobilitydisabilities from being separated from peers thatcommunication technology allows people to

ldquospeakrdquo their thoughts

Close communication between parents andtheir childrsquos helpersmdashteachers therapists daycare workers and othersmdashis essential to makesure devices and services are being used safelyand effectively If the device is working well butthe child is not being integrated into the class-room or other environments then there may bea need for additional training for the children andadults who interact with the child

Besides keeping track of how the device isworking and being used it is important to ob-serve progress in the areas of technology whichare useful to the individual with the assistivetechnology device As upgrades of equipmentoccur or more sophisticated models come on themarket the user may want to consider modify-ing or replacing the equipment that is currentlyin use Also as the individual becomes moreskilled at using technology the individual mayoutgrow the current device and need to look formore advanced equipment It can be assumedwith most high tech items that in three to fiveyears there will be a need for upgrade or replace-ment The wise consumer begins early to planfor the next step in technology including savingmoney for a new device and staying alert to thenew options that become available

What kinds of training are important to occurwhen a child has a new assistive technologydevice

Because assistive technology of the high techvariety is so new it is particularly important thattraining be provided to all those who may needit In the school setting it is helpful for all edu-cators and administrators to have some aware-ness training so that they have a general idea ofwhat assistive technology is Areas to be cov-ered in inservice training might include

bull legal issues related to assistive technology

bull awareness training concerning how toserve students with assistive technologyneeds

22

bull information on how assistive technologyrelates to the evaluation process

bull how to write IEPs for students who requireuse of assistive technology devices

bull the relationship between technology andstudent placement

bull the nature of common assistive technologydevices

bull resources to contact for information onassistive technology

Beyond these awareness activities thosemembers of the school staff who work directlywith a student who uses technology need to havetraining on the specifics of using the device andhow it is maintained and serviced Trainingshould include but not be limited to the follow-ing

bull review of the studentrsquos educational andassistive technology needs

bull review of goals and objectives supplemen-tary aids and services and related serviceson the IEP or IFSP

bull training on how to use and maintain thedevice

bull training on proper transport of the devicewithin the school building and from hometo school

bull training on how to program the device ifneeded

bull training on how to use the device effec-tively during instruction

bull training in trouble-shooting when the de-vice is not working properly

bull information about what to do when thedevice is not functioning or broken

bull information about how to coordinateassistive technology with all the activitiesin the studentrsquos day

bull training in methods to evaluate the effec-tiveness of assistive technology

Depending on the type of assistive technol-

ogy used by the student and the studentrsquos needsit may be advantageous for assistive technologyinformation to be shared with the studentrsquos peersSuch training will help fellow students to gainan understanding of the studentrsquos assistive de-vice foster acceptance in the social environmentand reduce fears other students may have aboutsocializing with the student who uses technol-ogy In some cases parents and the student maywant to be involved in the peer training

Parents may require training too in order forthe device to be used at home for the student tocomplete homework assignments or participatein extended school year services Once trainedthe parents can become a resource to the studentfor proper care and maintenance of the device

Most importantly the student himself or her-self will need training in how to use the deviceas independently as possible Training for thestudent may be written into the IEP as a separategoal or may be included as a related service thatsupports the studentrsquos special education pro-gram

SummaryPurchasing a high tech assistive technology

device is a major life decision because of the po-tential impact on the individual and because suchdevices can be costly When considering anassistive technology device it is important to dothe following be realistic about the consumerrsquoscapabilities and needs get a multidisciplinaryevaluation examine available technology with acritical eye match the individualrsquos needs to spe-cific equipment features test the device for a trialperiod identify next steps and determine whatneeds to be done for follow-up after purchaseEvaluations for assistive technology both infor-mal and formal should consider first of all thefunctions that the consumer wishes to performusing technology When evaluating a particularpiece of equipment consideration should begiven to the following features performance sim-

23

plicity of design ergonomics reliability safetypracticality aesthetics normalization cost effec-tiveness and personal acceptance Good sourcesof information about assistive devices are manu-facturers publications trade journals previewcenters and consumers who are already using thedevice Once a device is selected the consumerwill need to secure funding for the purchase andbe aware of additional costs for related equip-ment insurance and training

Hints for Parents

Donrsquot let the cost of assistive technology deter youfrom considering it for your child High tech assistivetechnology can be quite costly but it can also makethe difference for your child in terms of becoming welleducated employable and a fully-included member ofthe community Donrsquot leave any stone unturned whenlooking for funding sources Consider any or all ofthe following for funding or assistance

bull Early intervention programs

bull Schools

bull Transition programs

bull Vocational Rehabilitation

bull State Programs for Children with SpecialHealth Care Needs

bull Medicaid

bull Medicare

bull State Technology Resources

bull Used Equipment

bull Leasing

bull Equipment Loan Programs

bull Disability Organizations

SierraSierra wants to play with dolls like other chil-

dren her age but she has a muscle disease thathas caused her to lose muscle tone except in onehand What could be done to allow Sierra to dressand undress her dolls comb their hair and bathethem

Sierrarsquos SolutionThe assistive technology solution for Sierra

involved her whole family While vacationingin Mexico Sierrarsquos grandmother found her a fash-ion doll that was a bit larger than the typicalldquoBarbie dollrdquo The larger doll was easier for Si-erra to manipulate Sierrarsquos mother sewed sev-eral outfits for the doll using velcro instead ofsnaps or buttons as fasteners

Sierrarsquos dad bought doll stands at a toy storeand fastened several stands with clamps toSierrarsquos wheelchair tray He also fastened a plas-tic pouch to the tray Sierra puts the small dollaccessories in the pouch When Sierra wants todress her doll she puts the doll in one of thestands In this way the doll is held securely andSierra can dress and undress the doll with onehand

Sierrarsquos friends also use the doll stands fortheir dolls With this arrangement two or threegirls can play together

Solution SummaryLarger doll

Velcro fasteners

Plastic pouch

Doll stands

Clamps

24

Funding Assistive Technology

F unding for assistive technology is availablefrom a variety of public and privatesources To receive public or private fund-

ing the individual must meet eligibility criteriafor the specific program and provide sufficientdocumentation of the need for assistive technol-ogy

The following list includes some of the pro-grams which may pay for equipment if the indi-vidual needing the device meets their require-ments Many of these programs are run by dif-ferent agencies in different states making themhard to find In general the statersquos Tech Act of-fice can assist consumers and family members infinding and using these programs (See Appen-dix under Resources)

PUBLIC PROGRAMSEarly Intervention Programs (Individuals withDisabilities Education Act Part H)

Young children (0-3) and their families mayreceive help through early intervention programsin evaluating what the child needs in gettingassistive technology and in learning how to useit Equipment and services must be included ina written plan called an Individualized FamilyService Plan (IFSP) To find the program for aparticular state call National Early ChildhoodTechnical Assistance System (NECTAS) at 919-962-2001 or 919-966-4041 (TDD)

Head StartThis child development program provides

comprehensive educational and health servicesfor eligible children ages 3-5 Since 1982 federallaw has required that at least 10 percent of thetotal number of placements must be available tochildren who are disabled and require specialservices Head Start is a mainstream placementoption for children whose IEP calls for placementwith nondisabled children The January 1993Head Start regulations specifically require the

consideration of assistive technology services anddevices For more information contact NationalHead Start Association 201 N Union St Suite320 Alexandria VA 22314 703-739-0875

Schools (IDEA Part B)This program mandates a free appropriate

public education for preschoolers children andyouth with disabilities An Individualized Edu-cation Program (IEP) is required for all childrenwith a disability These children are entitled tospecial education related services or supplemen-tary aids If the IEP team determines that assistivetechnology is required for a free appropriatepublic education then it must be provided at nocost to the child The technology must be in-cluded in the childrsquos Individualized EducationProgram (IEP) Parents have a right to be in-volved and should help to develop the IEP goalswhich may include technology For help in get-ting assistive technology in the IEP call the TAPPFocus Center on Assistive Technology at 1-800-222-7585

State Operated and Supported Schools (Chap-ter I)

This program provides federal assistance tohelp educate children with disabilities who areenrolled in state-operated and state-supportedprograms Federal funds must be used to payfor services that supplement a childrsquos basic spe-cial education program such as construction andthe purchase of equipment For more informa-tion contact your State Department of Education

Section 504 of the Rehabilitation Act of 1973Section 504 provides a civil-rights mandate

that requires accommodations for students whohave disabilities such as orthopedic impairmentsbut who do not qualify for special education ser-vices It denies federal funds to any institutionincluding a school whose practices or policiesdiscriminate against individuals with disabilities

25

This legislation has resulted in a number of out-comes including various actions to remove physi-cal barriers to education which may incorporateassistive technology For more information con-tact the nearest regional Office of Civil Rights orthe State Vocational Rehabilitation Agency

State Programs for Children with SpecialHealth Care Needs

These programs provide and pay for servicesfor eligible children CSHCN programs varywidely from state to state in the services they of-fer the number of children served and the re-quirements for eligibility Some CSHCN pro-grams do pay for assistive technology deviceswhen no other funding source is available andthe equipment is necessary for health-related rea-sons Most CSHCN programs are run by the statehealth agency To contact CSHCN ask informa-tion for the telephone number of the state healthagency

School-to-Work Transition ProgramsTransition Programs are charged with assist-

ing students with disabilities to receive the jobrelated training and placement services to helpthem move from school to work Sometimesassistive technology may be necessary in orderfor a student to make a successful transition andbecome employable If technology is needed fortransition purposes it can be written into thestudentrsquos Individualized Transition Plan (ITP) Toreceive more information about transition andtechnology call the Parent Training and Informa-tion Center (PTI) in your state (See Appendix)

Vocational Rehabilitation ServicesState vocational rehabilitation agencies pro-

vide information evaluation services trainingand funding for technology and education to helpadults go to work or live more independently Iftechnology is necessary for an individual to workVocational Rehabilitation may pay for the equip-ment as part of an Individualized Work-RelatedPlan (IWRP) To locate the nearest Vocational Re-habilitation Agency look in the telephone book

under state government

Plan to Achieve Self-Support (PASS)One of many Social Security Administration

work incentive programs this program providesan income and resource exclusion that allows ablind or disabled person to set aside income andresources for a work goal such as educationequipment purchase vocational training andstarting a business It should be considered forall students with vocational goals who are receiv-ing social security benefits

This program provides a mechanism forpeople to set aside funds to purchase work-re-lated equipment such as assistive technologydevices and services In many cases if an indi-vidual is a recipient of SSI and writes a PASS topurchase education or equipment an additionalSSI check will be provided to cover other livingexpenses Sometimes if a person receives SocialSecurity Disability Insurance (SSDI) and designsa PASS it may make the individual eligible forSSI because the SSDI has been allocated for equip-ment and services

Impairment-Related Work Expense (IRWE)Impairment-Related Work Expense (IRWE)mdash

one of the Social Security Administrationrsquos workincentive programsmdashallows an employed indi-vidual with a disability who receives or is eligiblefor SSI or SSDI to deduct work-related expensesfrom gross reported income

This deduction allows the person to continuedrawing SSDI or SSI and associated benefits(Medicaid or Medicare) if the IRWE deductionreduces earning below the Substantial GainfulActivity (SGA) Test

Although this method does not provide fund-ing to pay for a device or service it is a way ofallowing the use of the individualrsquos own moneyto pay for assistive devices and services neces-sary to return to work The following is a list ofpossible work-related expenses special transpor-tation to and from work personal assistance onthe job structural modifications durable medi-

26

cal equipment prostheses medical supplies andservices work-related equipment non-medicalappliances and equipment routine drug andmedical costs and diagnostic procedure costs

MedicaidMedicaid is a joint federal and state program

which covers some equipment if it is consideredmedically necessary For more information aboutMedicaid and who and what is covered contactthe local Department of Human Services office

MedicareAlthough not a usual source of funds for

assistive technology Part B of Medicare providescoverage for some durable medical equipment ifit is considered medically necessary and is foruse in the personrsquos home For more informationabout Medicare benefits contact the Social Secu-rity Administration Regional Office

Technology-Related Assistance for Individualswith Disabilities Act of 1988

This federal competitive grants program pro-vides monies for states to establish a statewideconsumer-responsive service delivery system de-signed to effect systems change regardingassistive technology In most Tech Act states afunding specialist or policy analyst is availableto assist with accessing assistive technology Sev-eral states operate loan programs to help withthe purchase of devices and services For moreinformation contact RESNA Technology Assis-tance Project 1700 N Moore ST Suite 1540 Ar-lington VA 22209-1903 703-524-6686

PRIVATE PROGRAMS

Private InsuranceSome health insurance plans will buy equip-

ment but it depends on the specific wording ofthe policy Unless the policy says the equipmentis not covered it makes sense to ask the insur-ance company to pay for it The equipment mustbe considered medically necessary and thereforerequires a doctorrsquos prescription

Loans

There are several low or no interest loansavailable to help buy technology Call the stateTech Act program or the manufacturer of theequipment may know where to get this type ofloan

Non-Profit Disability AssociationsThere are many disability organizations

some of which may be able to loan equipment orprovide information about other funding sourcesor support groups These organizations includeNational Easter Seal Society March of DimesMuscular Dystrophy Association United WayUnited Cerebral Palsy Association and the BrailleInstitute

FoundationsSome private foundations have been set up

specifically to provide help to people with dis-abilities A listing of such foundations can befound at the library or may be available from thestate Tech Act program

Programs Providing Assistive TechnologyThe state Tech Act programs offer referrals

for evaluation and equipment recommendationsas well as assistance with identifying funding orequipment lending sources A therapy depart-ment in a local hospital or Disabled StudentsCenter at a local college or university may alsooffer to help locate technology programs in thearea Alliance for Technology Access Centers(ATA) sometimes have loan programs or infor-mation about purchasing used equipment orrenting equipment

Civic OrganizationsThere are many local civic and service orga-

nizations which may provide money to helpsomeone in their community Lists of these or-ganizations are available from the Chamber ofCommerce Examples of these organizations areLions Club Masons Grotto Veterans of ForeignWars (VFW) Elks Club Rotary Club KiwanisKnights of Columbus and Soroptomists Someof these organizations have a national focus on

27

disability or on a particular disability Others willfund devices for a particular child who is knownto the local club

Charities and Fund-RaisersLocal churches high school groups neighbor-

hood organizations labor unions or special in-terest groups (eg computer clubs ham opera-tors) may plan a fund-raiser to help purchaseassistive technology College student organiza-tions (fraternities and sororities) may give moneyor studentsrsquo time to help a special cause Even ifmoney is not available they may be willing tohelp organize a fund raiser

Local media (radio television newspapers)sometimes will sponsor fund-raising activities tofund devices They may not contribute moneybut will help with organizing the fund-raisingactivity and publicizing it to the community

OTHER OPTIONS

In addition to federal and private fundingsources there are a number of education-relatedgrants corporate technology donation programsand funding options that consumers should con-sider Information on these alternative options isavailable through a number of sources includ-ing the following

NewslettersEducation Grants Alert Capital Publications

Inc PO Box 1453 Alexandria VA 22313-2052800-655-5597

Education Technology News Business Publish-ers Inc 951 Pershing Dr Silver Spring MD 20910-4464 301-5878-6300

Financing Assistive Technology Smiling Inter-face PO Box 2792 Church St Station New YorkNY 10008-2792 415-864-2220

Special Education Report Capital PublicationsInc PO Box 1453 Alexandria VA 22313-2053800-655-5597

Technology and Learning Peter Li Inc Publish-ing 330 Progress Rd Dayton OH 45449 415-457-4333

Technology ManufacturersIf it is not possible financially to purchase

equipment consumers can sometimes rent orborrow equipment directly from the manufac-turer

Used EquipmentUsed equipment is often advertised for sale

in disability-related publications or the consumercan place a newspaper ad to see if used equip-ment can be purchased locally Several compa-nies refurbish old computers and sell them at lowprices Listings of used computer outlets can beobtained from ATA Centers or state Tech Act pro-grams

LeasingMany manufacturers of assistive technology

devices have equipment which is available forrent or lease Sometimes the rent or lease pay-ments can be applied toward purchase Checkwith the manufacturer to see if this is an option

Equipment Loan ProgramsMany states have equipment loan programs

as do some rehabilitation facilities and disabilityorganizations Information about loan programsis available from Tech Act programs

HOW TO APPLY FOR FUNDING

There is an art to applying for funding forassistive technology It is necessary to use justthe right words to suit the particular agency thatmight be the funding source It is also crucial todocument the need for and projected outcome ofassistive technology This documentation shouldinclude at minimum

bull A written statement of medical need fromdoctors or other health professionals If thechild had an evaluation by a rehabilitationprofession also include this report

bull A description of the childrsquos problems re-sulting from the disability This descrip-tion can come from the doctor or other pro-fessional who evaluated the child

28

bull Description of how the technology helpsthe child For example the equipment maymake the child safer or allow the child todo things more independently Be sure topoint out how money will be saved if useof the equipment allows attendant care tobe reduced

bull A clear statement based on assessmentthat the child is a good candidate who hasthe cognitive and physical capacities nec-essary for using the technology

In summary the documentation to supportan assistive technology funding request shouldinclude a physicianrsquos prescription the childrsquos as-sessment an explanation of projected benefitfrom use of the technology or service and anycorrespondence obtained from professionals thatwould support the childrsquos need for technology

The initial funding request should include notonly the cost of the device but also the cost ofongoing support and instruction in the use of thetechnology Assistive devices often have ldquohid-denrdquo expenses that are incurred with their pur-chase and these expenses are frequently costlyover time Battery-powered devices may requirefrequent charging or cleaning Upgrades for com-puter software may be necessary Special modi-fications of the home or school environment maybe necessary for the technology to be used Ineach of these examples costs associated with thetechnology may have to be assumed by the fam-ily if they are not considered in the initial appli-cation for funding

It is also helpful to include with the fundingrequest a picture or a descriptive brochure aboutthe device being requested This is importantbecause often persons who are reviewing theapplication do not know about the wide rangeof technologies that might be appropriate

Appropriate wording on the application isabsolutely necessary Key concepts for Medic-aid include ldquomedical necessityrdquo and ldquorestore thepatient to his or her best functional levelrdquo The

term medical necessity means that the device isincluded in the course of treatment being pro-vided to the child and that a professional suchas a physician or speech therapist is supervisingits use Medicaid and private insurers alike gen-erally pay for technologies that help restorepeople to ldquofunctioning levelsrdquo and take the placeof a body part that is not working Typically theseprograms do not pay for technologies or serviceswhose function is educational or life-enhancingrather than health related

The key for private insurance is ldquoterms of thepolicyrdquo It must be remembered that coverageby any insurance company does not set a prece-dent Just because one child receives needed tech-nology under a particular policy issued by a com-pany does not mean that all other covered chil-dren will also have technology paid for by thatcompany Each application stands on its ownbased on the expressed terms of the policy

It is usually under the major medical provi-sions of a health policy that assistive technologycan be provided as ldquoother medical services andsuppliesrdquo It may however be necessary to pur-chase additional insurance coverage or a ldquoriderrdquoin order for technology costs to be included inthe terms of the policy It is important to remem-ber that heath insurance policies are oriented to-ward health care and not toward changes in theenvironment or rehabilitation

Both private health insurance policies andMedicaid sometimes impose limits on the num-ber of assistive technology devices over a certaincost that can be purchased within a certain timeframe Sometimes the rule is that the fundingsource will purchase only one device in theindividualrsquos lifetime With these kinds of restric-tions it is all the more critical to be sure that thetechnology choice is the right one

TIPS THAT LEAD TO SUCCESS

bull Apply to several funding sources at thesame time Be sure to meet the require-

29

ments of each agency

bull Find out if agencies will share costs

bull Fill in the agencyrsquos forms correctly Manyapplications are denied because forms arenot filled out properly

bull In addition to the standard form includeany other information that describes orshows what the equipment does and howit benefits the child Assume no knowledgeon the part of the reviewers

bull Turn in all documentation at the same time

bull Avoid using jargon define all unfamiliarterms

bull Take the funding request package to theagency in person While there have itchecked to make sure everything requiredhas been included Get the name of theperson who reviewed the application

bull Call regularly to check on the funding re-quest each time try to talk to the same per-son

bull Be super politemdashand persistent

WHAT IF FUNDING IS DENIED

It is not at all unusual for an initial fundingrequest to be denied Even when family mem-bers and professionals have been meticulous inpreparing applications requesting funding forneeded technology denials should be anticipatedMaking an appeal is worth the effort since manydenials are reversed at the appeal level

To start the appeal process obtain any docu-mentation or information provided by the fund-ing agency (eg Medicaid or the private insur-ance company) relating to appeal proceduresforms to use timelines and filing procedures forinstance This information will help in the promptpreparation for appeal The kind of appeal to bemade depends on the reason for denial Whendeveloping an appeal find out the following

bull Why the request was denied Ask for thereason in writing Sometimes requests are

denied because a reviewer lacks under-standing of the technology or there maybe an error in the paperwork

bull If needed correct any mistakes or includemore information then resubmit the re-quest

Going to appeal makes sense because gener-ally the appeal places the application before moreexperienced persons in the decision-making hi-erarchy The technology requested is often newand the initial examiners in the process may beunaware of its usefulness Also insufficient docu-mentation may have been provided in the origi-nal application and the problem can be remediedon appeal

Donrsquot be daunted by the length of the appealprocess Follow it through to its completion Insome states families may be able to appeal a de-nial beyond the first level For example somestates have ldquounfair claims settlement practicesrdquoregulations which are administered through theinsurance commissionerrsquos office

Always make your appeal in person and takethe child and the equipment if possible If onlypart of the money is offered by one agency askanother agency to share costs If the appeal isdenied try again Submit the funding request toanother agency Being persistent will nearly al-ways result in success

When going through the appeal process turnto the state Protection and Advocacy Program (Pamp A) for guidance and support P amp A advocatescan help make sure that a childrsquos rights to tech-nology and related services are not denied

Who pays when assistive technology is neededat school

The party who is responsible for paying forassistive technology depends upon the circum-stances under which the technology is purchasedUnder the special education law students withdisabilities who are eligible for special educationare entitled to a free appropriate public educa-tion Parents do not have to pay for school ser-

30

vices including assistive technology if that ser-vice is part of the studentrsquos Individualized Edu-cation Program (IEP) If the student is eligible forMedicaid the school district can request thatMedicaid pay for the device If parents choose todo so they may agree to use private insurance topay for a device that is used at school Parentscannot however be forced to use their insurancein this way If the private insurance requires aco-payment the school district would have to paythis amount since parents should not have to payany special education related costs

Does Section 504 pay for assistive technologySection 504 part of the Rehabilitation Act of

1973 is basically a piece of civil rights legislationthat is intended to prevent discrimination againstindividuals with disabilities in any programwhich receives federal funding Students whohave disabilities but who do not qualify for spe-cial education may still be eligible for accommo-dations under Section 504 of the RehabilitationAct of 1973 Section 504 however does not pro-vide any funding for accommodations

Like the special education law Section 504requires public schools to provide students withdisabilities with a free appropriate public educa-tion and in addition ensures that students withdisabilities are afforded an equal opportunity toparticipate in school programs For students withdisabilities this means that schools may need tomake special arrangements so that these studentshave access to the full range of programs andactivities offered For example a student whoneeds a wheelchair lift on a school bus to get toschool must be provided with this technologyOther modifications which might be requiredunder Section 504 include installing ramps intobuildings and modifying bathrooms to provideaccess for individuals with physical disabilitiesEven though required by the law none of thesetypes of modifications would be funded by Sec-tion 504

Under what circumstances does private health

insurance pay for assistive technologySome private health insurance policies will

pay all or part of the cost for some assistive tech-nology devices The devices are unlikely to belisted specifically in the policy but may be in-cluded under some generic term like ldquotherapeu-tic aidsrdquo Usually the devices have to be pre-scribed by a physician in order to be covered bythe policy

When does Medicaid cover assistive technol-ogy

Medicaid (Title XIX) will pay for ldquoprostheticdevicesrdquondashthat is replacement corrective or sup-portive devices prescribed by a physician or otherlicensed person Each state has some flexibilityin determining which prosthetic devices it willinclude in its list of Medicaid covered expensesDevices that are frequently covered by Medicaidare canes crutches walkers manual wheelchairshospital beds and hearing aids or eyeglasses forchildren and youth

SummaryAssistive technology can be expensive to pur-

chase but there are a number of public and pri-vate sources for funding devices Common pub-lic funding sources include early childhood in-tervention programs schools Vocational Reha-bilitation and Medicaid Private sources mayinvolve health insurance personal loans chari-table donations or fundraising It is very impor-tant to provide proper documentation and usecorrect wording and procedures when request-ing funding Initial requests for funding are fre-quently turned down but appeals can be success-ful

31

TEDTed is an active four-year old who lives in a

small rural community with his parents andyounger sisters He was identified as speech im-paired and has been attending preschool specialeducation classes Ted has normal mental capa-bilities but his mild cerebral palsy impairs hisability to speak Because of the speech therapyhe has received Ted is able to make some speechsounds but he says no intelligible words Heuses sign to communicate with his special edu-cation teacher and his parents No one else inhis community uses sign so Ted is limited in hisability to communicate with others

As Tedrsquos IEP Team looks ahead to his entryinto elementary school the Team recognizes thathe will need better communication skills in or-der to participate successfully in the regular class-room His speech therapist has recommendedthat Ted begin to use an AlphaTalker

What funding sources might pay for theAlphaTalker

What case could you make for funding Arethere any obstacles to seeking funding

TEDrsquoS SOLUTIONAt this point Tedrsquos ability to communi-

cate is somewhat primitive Because of his cere-bral palsy he is not able to make conventionalsigns so the gestures he makes are understoodonly by those who know him well A simple elec-tronic communication device may work for Tedbut there are some prerequisite communicationskills he will have to master first Augmentativecommunication devices operate on the principleof choosing icons (abstract symbols) that repre-sent certain basic communications like a cup toindicate ldquoI want a drinkrdquo

In order to make a picturesymbol systemmeaningful and functional for Ted at his youngage his speech therapist began to work on point-to-object and point-to-picture activities WhenTed had mastered point-to-picture activities histherapist made a picture ring for him On thering were picture symbols (icons) for things thatTed might want to say Tedrsquos family his teacherand his classmates began to ask him to use hispictures to explain what he wanted Soon Tedwas using pictures to communicate simple wantsand needs effectively His word ring went withhim everywhere and helped him to ldquotalkrdquo topeople he did not know as well as to friends andfamily members

An unexpected bonus to the picture practiceis that Ted is verbalizing more and his speech hasbecome more intelligible He has even begun tosing An electronic communication device maybe in Tedrsquos future but for now he is learning tocommunicate well with his picture ring and somespoken words

Solution SummaryPoint-to-picture practice

Use of picture ring

32

GLORIAGloria an eighteen year-old with mild cog-

nitive delays and CP is about to finish highschool She has been using a laptop computerand switch access hardware and software in lieuof a pencil and paper to complete work in highschool The equipment and software were pro-vided by the school district through the IEP pro-cess Gloriarsquos current goal articulated in her In-dividual Transition Plan (ITP) as mandated byIDEA is to have a full-time job by the time she is22 She wants to work in an office and woulduse a computer system similar to her currentsetup As she moves into the transition periodthese questions must be addressed

Will the laptop computer she has been usingbe functional for her in the workplace

Will she need to consider new equipmentWhat would influence a decision to purchase newequipment

What funding sources might help Gloria topurchase new equipment

What case should Gloria make for funding

GLORIArsquoS SOLU-TION

Gloria is fortunate to have learned computerand word processing skills while she was inschool Now she must learn ways to transferthese skills into the work setting Laptop com-puters are not typical in offices instead whatGloria is more likely to encounter is a desktopworkstation with computer and printer In or-der to use a standard computer Gloria will needa switch access device and an onscreen keyboardto do word processing and data entry

Since single switch access is necessary forGloria to become employed in an office settingGloriarsquos Vocational Rehabilitation Counselor waswilling to make such a purchase for her Gloriaapplied to be a data processor with a temporaryemployment firm and got the job Gloriarsquos VRcounselor helped her to select switch access hard-ware compatible with most IBM compatible com-puters In her new job Gloria changes office set-tings frequently Each time she moves she takesher switch access device and onscreen keyboardsoftware with her With these portable items sheis able to adapt each new office setting to meether needs Having the right technology has madeGloria an adaptable and successful temporaryoffice employee

Solution SummarySwitch access

Onscreen keyboard software

33

Making Assistive Technology a Part ofChildrsquos Education

The ideal time for a child with a disabilityto learn to use assistive technology is whenthe child is learning all sorts of others skills

in early intervention services preschool and K-12 education Children who are eligible for earlyintervention services under Part C or special edu-cation under Part B of the Individuals with Dis-abilities Education Act (IDEA) are entitled to beevaluated for assistive technology needs and toreceive assistive technology devices and servicesif they are necessary to providing a free appro-priate public education In order for children toreceive the assistive technology to which they areentitled parents must be knowledgeable abouthow assistive technology fits into special educa-tion and the ways that AT can be included in achildrsquos Individualized Family Service Plan (IFSP)or Individualized Education Program (IEP)

ASSISTIVE TECHNOLOGY FOR YOUNG CHILDRENParents are often surprised to learn that

assistive technology can be appropriate for in-fants and toddlers Very young children whohave disabilities that limit their ability to inter-act with the environment by crawling touchingseeing or hearing can benefit from technologythat improves their interactions Federal educa-tion amendments require states to ldquopromote theuse of assistive technology devices and assistivetechnology services where appropriate to en-hance the development of infants and toddlerswith disabilitiesrdquo These amendments furtherrequire states to ldquofacilitate the transition of in-fants with disabilitiesfrom medical care to earlyintervention services and the transition fromearly intervention services to preschool specialeducation or regular education servicesrdquo

When Kayla was an infant her interactionswith the environment were very limited because

she has a genetic condition resulting in abnor-mally short arms and legs She could not turnover or crawl she had difficulty touching andgrasping objects As part of her early interven-tion program Kayla was introduced at the ageof six months to the use of switches When theswitches were positioned correctly she could ac-tivate switch-operated toys or noisemakers Theopportunity to interact with toys opened upKaylarsquos world She soon began to hunt for theswitches and to activate certain toys on com-mand She used the switches to make choicesbetween toys or sounds She became verballymore expressive and began to interact morereadily and more often with her parents and sib-lings

By the time that Kayla was three and readyfor preschool special education she was able tosit up and interact with a computer activated byswitches She could identify objects on the com-puter screen and match those objects to real ob-jects in the world around her At three Kaylacould identify and match some letters and shapeson the computer screen Though limited in hermobility Kayla became an active participant inclassroom activities She could interact withclassmates by playing computer games joiningin at circle time and participating in allpreacademic learning activities

Assistive technology was an integral and nec-essary part of Kaylarsquos early intervention servicesKaylarsquos parents were involved in writing the In-dividualized Family Service Plans (IFSPs) thatoutlined the services Kayla and their familyneeded From the beginning Kaylarsquos family hadthe opportunity to see how assistive technologycould be included in the IFSP and really make adifference in Kaylarsquos education and her life

Kaylarsquos story illustrates how assistive tech-

34

nology can be utilized from an early age and canbe part of the transition from medical treatmentto early intervention and from early interventioninto preschool special education or regular edu-cation Because of the availability of early inter-vention services there is no reason to wait untila child is of school age before trying assistive tech-nology Early use of the necessary technology willenhance a childrsquos development by increasingopportunities to interact with the environment

ASSISTIVE TECHNOLOGY AT SCHOOL AGE ANDBEYOND

When students enter kindergarten and begintheir regular public school years assistive tech-nology can continue to be a part of their specialeducation programs For students who are eli-gible for special education assistive technologymust be provided when it is necessary

(1) to support placement in the least restric-tive environment

(2) to ensure that a student benefits from hisor her education or

(3) to implement the goals and objectives inthe studentrsquos IEP

Needs for assistive technology should be oneof the considerations when a student is assessedto determine eligibility for special education Ifan assessment reveals that a student is eligiblefor special education then the multi-disciplinaryteam should consider assistive technology needswhen making recommendations for the Individu-alized Education Program (IEP) The team shouldanalyze what is required of nondisabled studentsof the same age and determine how many of theserequirements could be completely or partiallyfulfilled by the student being assessed if that stu-dent had access to appropriate assistive technol-ogy

In addition when information is being col-lected for the present level of performance sec-tion of the IEP part of that assessment should bea consideration of whether or not assistive tech-nology is necessary for the student to achieve

educational or social goals benefit from educa-tion or make reasonable progress in the least re-strictive educational setting Whoever is collect-ing the information might experiment withassistive technology applications to determinewhich ones might work for the particular student

Assistive technology should be considered asan option for every IEP Some students of coursewill not require technology but many studentswill benefit from technology that helps them tocompensate for their impairments School dis-tricts are not required to provide all of the pos-sible assistive devices that might be nice to haveor might provide the best possible arrangementsAssistive technology is required however whenits presence enables the student to make reason-able progress toward the goals the IEP Team iden-tifies

HOW TO INCLUDE ASSISTIVE TECHNOLOGY INTHE IEP

Assistive technology can be included in theIEP in a number of ways It may appear as partof the studentrsquos annual goals or short term objec-tives It may also appear in a list of specific ac-commodations which need to be made in orderfor the student to function in the least restrictiveenvironment For example the IEP might includesuch accommodations as the use of word pro-cessing use of a calculator use of a hand heldspell checker and so forth In addition the IEPmay specify that as a related service necessaryfor the student to benefit from his or her educa-tion the student will receive training in the useof assistive equipment like an electronic commu-nication device a power wheelchair or a personalcomputer

WHERE TO PUT ASSISTIVE TECHNOLOGY IN THEIEP

There are three places in the IEP whereassistive technology may appear (1) in the an-nual goals and short term objectives (2) in theenumeration of supplementary aids and servicesnecessary to maintain the student in the least re-

35

strictive educational setting and (3) in the list ofrelated services necessary for the student to ben-efit from his or her education

Assistive technology can be a part of the an-nual goals and short term objectives on an IEPbut there must be a certain degree of specificityin the goal in order for the role of assistive tech-nology to be clear An annual goal for the IEPshould express an estimate of what the studentcan accomplish in a particular domain during thecourse of one year under what conditions theskill is to be developed and what criteria will beused to indicate whether or not the skill has beenlearned

Many times IEP goals are broad vague andtotally nonspecific Such goals are impossible tomeasure and do not give any indication of whatis realistic to expect in terms of the studentrsquos be-havior or skill level in the course of a yearrsquos timeSuch broad goals are not useful in addressingassistive technology The inclusion of assistivetechnology in the IEP requires a degree of speci-ficity so that it is clear how and why the technol-ogy will be used to accomplish a particular goal

An annual goal which includes assistive tech-nology may indicate that the technology will bepart of the conditions under which some aca-demic or social skill will be acquired For ex-ample an IEP goal for a student with a learningdisability in written expression may look like this

10 Using a word processing program with spell-ing checker Shawn will compose three paragraphthemes composed of fifteen or more sentences with 80or better accuracy in the use of spelling punctuationand grammar

Objectives leading to this goal might includepreliminary exploration of the word processingprogram trials to learn effective use of the spell-ing checker drill and practice in writing singleparagraphs to the 80 level of accuracy in spell-ing punctuation and grammar increasing thelength of writing to two paragraphs and theneventually moving to three paragraphs with

gradually increasing degrees of accuracy

Another type of annual goal may address askill which is necessary for using assistive tech-nology Such a goal might appear this way

20 Using an adapted computer keyboard Rachelwill type 12 words per minute with no errors over 10or more consecutive trials

In this case Rachel would spend a year learn-ing keyboarding skills with the goal of achievingat least 12 words per minute with complete ac-curacy For a young student who experiencessome fine motor difficulties this goal would bechallenging but it might be achievable in a yearrsquostime Objectives leading to this goal might in-volve preliminary exploration of the keyboardgradual introduction of the letters and numberson the keyboard practice to build speed and ac-curacy and eventually timed trials until 10 con-secutive trials could be achieved with no errorsat a rate of 12 words per minute or better

Still another type of annual goal might ad-dress a social issue like communication withpeers

30 Using an electronic communication deviceSara will respond appropriately to social inquiries fromclassmates 5 times out of 5 opportunities over 5 con-secutive days

Objectives leading to this goal might includetraining in the use of particular words andphrases on the communication device drill andpractice in responding with the device in struc-tured settings increasing accuracy in respond-ing in structured settings practice in unstruc-tured conversational opportunities and gradualachievement of accuracy in unstructured conver-sational settings with peers

ASSISTIVE TECHNOLOGY AS A RELATED SERVICEAssistive technology can be a related service

just like audiology physical therapy or speech ifit is necessary for the student to benefit from hisor her education For a student to be successfulin using assistive technology he or she must be

36

trained in its use Training to use a computer anaugmentative communication device a PhonicEar or large type viewer or other similar devicescan occur as a related service which supports thestudentrsquos educational program Preparation forthe use of assistive technology can also be workedinto other related services like occupationaltherapy Occupational therapy may involve de-termining correct positioning to take advantageof assistive technology and exercises to preparethe student to use a computer keyboard or a com-munication board

Margo who has muscular dystrophy uses alaptop computer every day in her sixth gradeclass Margorsquos upper body strength is diminish-ing and she is gradually having greater andgreater difficulty using her hands for writing ordrawing Using a computer saves her energy andallows her to keep performing well in the class-room As a related service in her IEP Margo isreceiving occupational therapy designed to pre-pare her for even more adaptations which maybe necessary as she loses more strength Margoand her therapist are experimenting with com-puter access devices (eg switches trackball) andon screen keyboards to determine what methodMargo would like to use when her hands are nolonger strong enough to type on a standard key-board This special training for assistive technol-ogy is written into Margorsquos IEP as a related ser-vice because such training is necessary for her tocontinue to benefit from her education

ASSISTIVE TECHNOLOGY SUPPORT FOR PLACE-MENT IN THE LEAST RESTRICTIVE ENVIRON-MENT

One important feature of assistive technologyis the fact that it can make it easier for studentswith and without disabilities to learn togetherStudents with disabilities are guaranteed the rightto be with nondisabled peers and to receive theireducation in the setting which is the least restric-tive environment In order to be successful in theleast restrictive environment students are to be

afforded whatever supplementary aids and ser-vices are necessary Among the supplementaryaids which may allow a student to remain in aless restrictive environment are a variety ofassistive devices that compensate for disabilityand allow the student to perform educational andsocial tasks Assistive technology is necessary asa supplementary aid if its presence (along withother necessary aids) supports the student suffi-ciently to maintain the placement and its absencerequires the studentrsquos removal to a more restric-tive setting For example if a student with mul-tiple physical disabilities can make progress onhis or her IEP goals in the regular classroom withthe use of a computer and an augmentative com-munication device and cannot make suchprogress in that setting without the devices thenthose devices are necessary supplementary aids

Lyle a fourth grader with cerebral palsy is agood example of a student who thrives in theregular classroom if he has the use of appropri-ate technology Lyle is able to keep up academi-cally with his classmates if he has access to a com-puter with an adapted keyboard and word pre-diction software Lyle has learned to type welland is able to do written assignments in relativelythe same amount of time as other students in hisclass Without a computer Lyle could not keepup at all Handwriting is a laborious task for Lyleand his written product tends to be messy andbarely readable If he could not use a computerLyle would have to rely on others to do hand-writing for him or he would have to do alterna-tive assignments that require no writing

Lyle likes being a regular fourth grader Heis proud of his writing on the computer becausehe is using his own words and learning to editout his mistakes by himself With his computerhe does not need the services of an aide and canbe completely independent in doing his schoolwork

Assistive technology in the form of a com-puter with appropriate software and keyboard

37

adaptations is necessary for Lyle to remain in theregular classroom working independently Thisuse of the computer can be written into his IEPas a supplementary aid which is necessary tosupport Lylersquos placement in the least restrictiveenvironment

Does assistive technology include access toschool buildings

AT certainly can mean devices that provideaccess to school buildings and facilities Oneimportant part of a free appropriate public edu-cation is that students with disabilities are ableto get to school get into the school and use theschool building and facilities Assistive technol-ogy can be used to provide access to the schoolbus classroom playground gymnasium audi-torium lunchroom or the equipment in themAny or all of these needs can be addressed in theIEP

Bus modifications for improved access andappropriate seating can help with transportationto and from school and school activities Doorswalkways handles switches stairs steps can bemodified so that a student with disabilities canuse them as effectively as classmates Appropri-ate seating and playground modifications canhelp include students who have disabilities atclassroom lunchroom and recess times

When an individual graduates from publicschool is it still possible to have assistivetechnology

If individuals benefit from the use of assistivetechnology during their school years the likeli-hood is that assistive technology will be evenmore important for them in adult livingAssistive technology can certainly be part of anindividualrsquos future after high school but it is nec-essary to begin planning for the transition fromhigh school so that the technology and other nec-essary services are available when needed

The earlier a family can estimate their childrsquospost-high school needs including needs for tech-nology the earlier transition planning can begin

Federal legislation says that transition planningcan begin in school as early as ldquo14 or youngerrdquoEach student with a disability who has an Indi-vidualized Education Program (IEP) should havea ldquostatement of transition servicesbeginning nolater than age 16rdquo This means that as early asmiddle school but probably not later than fresh-man year in high school families should begintransition planning

Unlike school services services in the adultworld are not mandated An individual may beeligible for a disability service but not receive itbecause all of the slots are filled or funding is notavailable If an individual does not own his orher own assistive technology devices then partof transition planning will be looking into fund-ing sources that could help with technology pur-chases If technology is necessary for the indi-vidual to become employed it is possible thatVocational Rehabilitation will pay for the devicesas part of an Individual Work-Related Plan(IWRP) Students who go on to postsecondaryeducation at community college vocational-tech-nical schools or universities can expect to be ableto receive certain accommodations for their dis-abilities while on campus Most postsecondaryinstitutions have Student Support Services thathelp with assistive technology needs alternativetesting readers and notetakers

SummaryAssistive technology can be included as an

integral part of a studentrsquos education but par-ents have to be knowledgeable about how to goabout getting assistive technology into theirchildrenrsquos educational plans Assistive technol-ogy can be written into the Individualized Fam-ily Service Plan (IFSP) for infants and toddlers inearly intervention programs and into the Indi-vidualized Education Program (IEP) forpreschoolers and students in grades K through12 Assistive technology can appear in threeplaces in the IEP (a) as part of the goals and ob-jectives (b) as a supplementary aid to support

38

placement in the least restrictive environmentand (c) as a related service Assistive technologycan also be a part of studentsrsquo transition planningas they move from high school into adult pur-suits Assistive technology is available throughVocational Rehabilitation and other adult disabil-ity services but these services are not mandatedTo ensure continued use of assistive technologyit is important to plan ahead and secure fundingfor devices needed in the work or postsecondaryeducation environments

Hints for Parents

If your child is a successful assistive technologyuser begin to save money early in your childrsquos lifemdashjust as you might save for college Gradually accu-mulate enough funding to purchase the kinds of tech-nology your child will need as an adult Technologychanges so fast that it is impossible to predict whatwill be available fifteen years from now But a parentcan be certain that assistive technology of the futurewill be even better than what is available today

EmilyEmily is a seventh grade student who has

learning disabilities She is in regular classes allday in her neighborhood middle school A spe-cial education teacher monitors Emilyrsquos progressand provides the regular classroom teachers withassistance by modifying some of Emilyrsquos assign-ments giving her oral tests helping to organizeEmilyrsquos work and reteaching certain skills asnecessary In elementary school Emily did wellwith the limited amount of support she receivedin the regular classroom In middle school how-ever she is having trouble keeping up with as-signments Emilyrsquos spelling is inaccurate sheoften misspells the same word three or four dif-ferent ways on the same page Her handwritingis very slow and laborious so she spends manyhours each evening working on her homeworkShe has tried tape recording assignments but shefinds this process also to be laborious because itis so time consuming to correct mistakes

It has been recommended that Emily be re-moved from some of her academic classes andreceive instruction in the resource programEmily wants to remain in regular classes but shecanrsquot keep up with the pace

How could assistive technology help Emily

What are her needs

What case could be made for assistive tech-nology for her

39

Emilyrsquos SolutionEmily has reached the point in her educa-

tional career when she cannot keep pace with thedemands of the written work On observingEmily the occupational therapist noted that ittook Emily five times as long as the average stu-dent in her English class to complete written as-signments

Emilyrsquos IEP Team decided she was spendingfar too much time on the handwriting processTo help her with this problem the team agreedthat Emily should learn to use a computer with aword processing program and a voiced spellchecker One period per day Emily goes to theresource room to practice keyboarding and workon longer written assignments During her regu-lar classes Emily uses a portable word proces-sor (eg AlphaSmart) to take notes which shecan print out later in the resource room

These simple solutions allow Emily to speedup her writing time and produce written workthat is easy to correct and edit With technologyto aid her Emily is spending less time on thehandwriting process and more time on thinkingand processing information Her homework timehas been cut in half and Emily is much more re-laxed and confident at school

Solution SummaryKeyboarding training

Use of computer with word processingsoftware

Use of voiced spell checker

Use of portable word processor

BryanBryan is a seventh grader with a neuro-mus-

cular disease that has caused him to lose physi-cal function He is a bright student with excel-lent academic skills Bryan uses a laptop com-puter with a trackball and an onscreen keyboardto do all his written work He navigates skill-fully around the school building using a powerwheelchair Technology has really helped Bryanto fit in and do well at school However now asa young adolescent Bryan is beginning to feelleft out socially He requires so much help withhis physical needs that he has to spend lots oftime with adults Bryan wants to ldquohang outrdquo likethe other kids his age and escape adult scrutinyonce in a while

Bryan is nonverbal He uses a complex so-phisticated electronic communication device toparticipate in class The device is programmedwith phrases that Bryan frequently uses and healso can select icons to create sentences of hisown Bryanrsquos communication device works wellfor him in formal classroom settings but it isbulky and cumbersome to use in casual conver-sation with friends Bryan has come to believethat his communication device is actually a bar-rier to the kinds of informal interactions he wantsto have

Bryan knows that he has the best in technol-ogy and that the equipment he uses was very ex-pensive He doesnrsquot want to appear ldquogreedyrdquo ordemanding so he has not told his parents abouthis dissatisfaction with his ability to communi-cate One of Bryanrsquos friends Michael howevernoticed that Bryan was acting pensive and un-usually quiet Michael gently coaxed the truthout of Bryan and offered to help his friend thinkof a new way to ldquotalkrdquo that would provide himwith more flexibility and independence

40

Bryanrsquos SolutionWhen Bryan and Michael put their heads to-

gether they came up with lots of ideas The onethey settled on as the most feasible involved us-ing the laptop that Bryan already had The laptophad some advantages because it was small andportable and Bryan already knew how to use itvery well In a catalog of special needs softwarethe friends found communication software thatoperated on an icon system and the price wasright--around $100 With communication soft-ware installed on the laptop Bryan had asimplermore portable device for talking in ca-sual settings

Next Michael asked his father to help themmake a tray for Bryanrsquos wheelchair that wouldhold the laptop and fold down beside the chairout of the way when not in use Michaelrsquos dadcame up with a clever tray on hinges that foldedto the side The laptop fastened to the tray withwide rubber bands A handle on the tray allowedBryan to raise and lower the tray as needed

In addition to his laptop Bryan also neededa device for quick greetings and spontaneous re-torts Bryan and Michael chose a programmableswitch with the capacity to record up to 12 mes-sages Bryan could operate the switch quickly byhitting it with his elbow He and Michael had agreat time recording messages suitable for talk-ing to their friends or to girls

What Bryan found out was that he neededmultiple ways to communicate so that he couldcustomize his electronic speech to fit the settingand the occasion For a relatively small financialinvestment Bryan and Michael were able to ex-pand communication possibilities for Bryan andallow him greater control and personal choiceabout what he said how he said it and to whom

Solution SummaryCommunication softwareDrop-down wheelchair trayProgrammable switch

TracyTracy is a man in his mid-thirties who has

been blind from birth Since graduating fromcollege he has held a series of entry level jobs atminimum wage and without benefits Tracy isfrustrated by the lack of challenge in the jobs hehas had he would like to have a managerial po-sition with some opportunities for advancementbetter pay and benefits

Currently Tracy is working at a Pizza Hutrestaurant where he prepares pizzas for the ovenHe enjoys his co-workers and regular customersbut Tracy wants more A management traineeopening has been announced in the companynewsletter and Tracy decides to apply This newposition involves taking pizza orders over thetelephone and sending the order via computerand modem to the appropriate Pizza Hut outletwhere the pizzas will be made Having madeevery possible type and size of pizza Tracy isvery familiar with the options But how couldhe operate the computer and record orders asthey come in over the telephone Would he havea chance for this job which could be his first stepup

41

Tracyrsquos SolutionTracy and his Vocational Rehabilitation Coun-

selor filled out the job application for the posi-tion at Pizza Hutrsquos central ordering facility andTracy was called to set up an interview Prior tothe interview Tracy and his job counselor wentto the central ordering facility for Pizza Hut tostudy aspects of the job and to determine if tech-nology could assist Tracy to perform the essen-tial job functions The job involved the follow-ing steps (1) greeting the customer and takingdown customer information (2) asking a seriesof questions about the customerrsquos order (egtype size toppings) (3) simultaneous record-ing of the order via computer and (4) sendingthe order to the appropriate Pizza Hut outlet

After studying the process of taking ordersTracy and his counselor decided upon the follow-ing technology

(a) A computer compatible with the Pizza Hutnetwork

(b) Voiced software so that Tracy couldldquohearrdquo what he was typing

(c) A telephone headset to listen to the cus-tomer with one ear

(d) an ear piece to listen to the computer

At his interview for the job Tracy explainedhis qualifications for the position--college degreeexperience with Pizza Hut He also told the in-terview team about how technology would al-low him to do the job as efficiently and effectivelyas other workers

The interview team members were impressedby Tracyrsquos initiative and his work ethic Theychose him over several other qualified candi-dates Though it took some detective work toput together a computersoftware package com-patible with Pizza Hutrsquos system Tracy was ableto do it

From the first day on the job Tracy knew he

was going to like it better than anything he haddone before Listening to the computer and thecustomer simultaneously was challenging at firstbut soon Tracy had mastered the process Afterthree months in his new position Tracy wasasked to become the manager for his shift Nowhe hires and trains new order clerks schedulesworkers and evaluates their job performanceTracy has what he wanted--a managerial posi-tion better wages and a future with the com-pany

Solution SummaryCompatible computer terminal

Voiced software

Telephone headset

Ear piece for computer

42

Advocating forAssistive Technology

In the area of Assistive Technology mdash just as in so many areas of need mdash parents must betheir childrenrsquos best advocates Federal and

state laws support providing assistive technol-ogy to individuals with disabilities but theselaws are only meaningful when parents knowabout them and can use legal processes to securetheir childrenrsquos rights Here are just a few of thelaws on which parents can rely when advocat-ing for assistive technology for their children

THE AMERICANS WITH DISABILITIES ACT OF1990

The Americans with Disabilities Act (ADA)proposes to eliminate ldquodiscrimination againstindividuals with disabilitiesto address the ma-jor areas of discrimination faced day-to-day bypeople with disabilitiesrdquo The ADA applies spe-cifically to the areas of employment public ac-commodations and government functions Inthese areas the ADA requires that reasonable ac-commodations be made so that people with dis-abilities can have an equal opportunity to par-ticipate in employment opportunities public ac-commodations and government functions TheADArsquos definition of ldquoauxiliary aids and servicesrdquoits mandates for ldquoacquisition or modifications ofequipment and devicesrdquo and ldquoreasonable accom-modationsrdquo support the provision of assistivetechnology devices and services to individualswith disabilities

THE REHABILITATION ACT OF 1973Section 504 of the Rehabilitation Act requires

that any ldquoprogram or activity receiving Federalfinancial assistancerdquo comply with non-discrimi-nation rules Section 504 Regulations require thatpublic schools provide students who have dis-abilities an educational opportunity equal to theeducational opportunity provided to students

without disabilities Section 504 also uses theterm ldquoreasonable accommodationsrdquo which canmean the provision of assistive technology de-vices and services

THE INDIVIDUALS WITH DISABILITIES EDUCA-TION ACT (IDEA)

The Individuals with Disabilities EducationAct (IDEA) requires free appropriate public edu-cation (FAPE) for students with disabilities IDEAmandates education in the least restrictive envi-ronment requires schools to use supplementaryaids and services special and related services tohelp assure that students with disabilities par-ticipate in and benefit from public educationAssistive technology is specifically mentioned inIDEA as a service which school districts may haveto provide in order for a student with disabilitiesto benefit from special education

THE CARL PERKINS ACTThe Carl Perkins Act assures that Vocational

Education programs in public schools are madeaccessible to students with disabilities The lawassures supplementary services including class-room curriculum and equipment modificationssupportive personnel instructional aides and in-structional devices

PARENT RESPONSIBILITIESIn order to be effective advocates for their

children parents need to familiarize themselveswith all the laws that support the provision ofassistive technology Copies of the laws and theirregulations are available from the offices of mem-bers of the House of Representatives and the Sen-ate

Besides knowing the law parents must par-ticipate actively in developing plans for theirchildrenrsquos education that include assistive tech-nology when it is needed Parents must attend

43

IFSP and IEP meetings and be prepared to workcooperatively with other team members Whena parent questions an assistive technology evalu-ation or an IEP Team recommendation the par-ent must be prepared to follow-up on those ques-tions including using due process rights whennecessary

What should a parent do when an agencyrefuses to pay for assistive technology that achild needs

Agencies like early intervention programsand school districts are mandated to provideassistive technology if the need for technology isin the childrsquos written plan If one of these agen-cies refuses to pay for needed technology then aparent must consider using due process rightsIn early intervention services the parent wouldfollow the appeal process laid out by the leadagency for Part C When school district servicesare involved the parent can file a complaint ifservices in the IEP are not provided or can askfor a due process hearing if the parent and theschool district disagree about the need forassistive technology If a parent disagrees withthe results of an evaluation for assistive technol-ogy the parent can ask for an independent evalu-ation at school district expense

SummaryOverall getting the devices and services for

children with disabilities means that parents mustbe part of the planning team at every level of theirchildrenrsquos education It means talking with otherfamilies and users of assistive technology aboutdevices and services learning how they foundthe best technology and figuring out where togo when resources are few Getting assistive de-vices and services is not always an easy job Buthelp is available Working with professionalstalking with consumers and other families par-ents can find the best avenues for providing theirchildren with the assistive technology they needIn the end the effort is worth it because assistive

technology is not just a civil right guaranteed bylaw it is also a means to achieve human rights togrow up happy independent and self-sufficientas possible

Hints for Parents

When advocating for your child in the special edu-cation arena donrsquot forget the following facts aboutassistive technology and the IEP

bull Assistive technology needs must be con-sidered along with a studentrsquos other edu-cational needs

bull Needs for technology must be identifiedon an individual basis

bull Identification of technology needs mustinvolve parents the student when appro-priate and a multidisciplinary team

bull Parents or other IEP Team members can askfor additional evaluation or an indepen-dent evaluation to determine assistive tech-nology needs

bull When an evaluation is being conductedconsider mobility fine-motor skills com-munication and alternatives to traditionallearning approaches

bull Lack of availability of equipment or costalone cannot be used as an excuse for de-nying assistive technology services

bull If included in the IEP assistive technologyservices and devices must be provided atno cost to the family

bull Parents always have the right to appeal ifassistive technology services are denied

44

More Questions and Answers

A re schools required to pay forassistive technology devices andservices

It is the responsibility of the school dis-trict to provide for the equipment services orprograms identified in the IEP The school dis-trict may pay for the equipment service or pro-grams itself utilize other resources to provide orpay for the device or utilize private insurancefunds Medicaid or other sources of funds as longas the device or services identified in the IEP areprovided at no cost to the parent Private insur-ance or Medicaid may be used ony if the parentagrees

Can schools require the parents to payfor an assistive technology device orservice identified in the studentrsquos IEPor require the parents to use theirown private health insurance to payfor the device or service

No The ldquofreerdquo in FAPE means that parentsof students with disabilities who require assistivetechnology devices or services do not have to payfor these items As stated in IDEA and its regu-lations all special education and related servicesidentified in the studentrsquos IEP must be providedldquoat no cost to the parentrdquo The term ldquofreerdquo is in-terpreted broadly and goes far beyond the simplepaying of deductibles and co-payments Thecourts have interpreted ldquofreerdquo to apply to butnot be limited to future insurability depletionof maximum lifetime caps raised premiums dis-continuation of policies and preexisting condi-tion exclusions If the family agrees to allow theschool to access their Medicaid or private insur-ance this decision must be strictly voluntary onthe part of the family

How can school districts use Medicaidfunds to purchase assistive technologydevices

If Medicaid is capitated in any way concern-

ing its use for assistive devices school districtsmust request from parents the right to use Med-icaid funds However parents are not obligatedto use their Medicaid funds to purchase devicesor services used at school With permission aparentrsquos private insurance must be accessed be-fore Medicaid can be used for assistive technol-ogy devices Medicaid regulations vary some-what from state to state so it is wise to consultthe state Medicaid Service Bureau before mak-ing any assumptions about Medicaid and thepurchase of assistive technology

Are there other options for schools toconsider in lieu of purchasing theassistive technology device

Yes There are times when the outright pur-chase of equipment or devices is not necessaryor even advisable In such instances schoolsmight consider rental or long-term lease optionsThere are certain advantages to renting or leas-ing depending on the individual needs of thestudent For example renting equipment mightbe a reasonable strategy if the student is expectedto improve or deteriorate in a short period of timeor when it is necessary to try out the equipmentbefore purchase Long-term leasing or leasepurchase agreements also have potential benefitsfor schools which include no obligation on be-half of the school to purchase the device abilityto return leased equipment and thus reduce ob-solete inventory flexible leasing terms use ofequipment without a lump-sum purchase up-grading of equipment as more improved tech-nology becomes available and upgrading ofequipment as the studentrsquos needs change

Isnrsquot assistive technology just acrutch Wonrsquot students become toodependent on technology and notlearn to use the skills they have

Assistive technology should be used as sup-port for access learning and performing daily

45

tasks In general assistive technology is appro-priate when it compensates for disabilities so thatthe individual can function as normally as pos-sible If assistive technology is necessary for astudent to have access to educational opportuni-ties or to benefit from education then it is not aldquocrutchrdquo but a legitimate support Some skillsare too laborious or taxing to accomplish at a rateor with degree of proficiency to allow for partici-pation in the least restrictive environment Withassistive technology the student can participatemore fully and more closely approximate the lev-els of achievement and interaction of his or herpeers In general the use of assistive technologyenhances function and increases skills and op-portunities Though a student may be dependentupon a particular device in order to perform skill-fully denying the device denies the student anopportunity ever to achieve success at the levelof his or her potential

When is assistive technology appropri-ate

Assistive technology may be considered ap-propriate when it does any or all of the follow-ing things

bull Enables students to perform functions thatcan be achieved by no other means

bull Enables students to approximate normalfluency rate or standardsmdasha level of ac-complishment which could not beachieved by any other means

bull Provides access for participation in pro-grams or activities which otherwise wouldbe closed to the individual

bull Increases endurance or ability to persevereand complete tasks that otherwise are toolaborious to be attempted on a routine ba-sis

bull Enables students to concentrate on learn-ing tasks rather than mechanical tasks

bull Provides greater access to information

bull Supports normal social interactions with

peers and adults

bull Supports participation in the least restric-tive educational environment

Who owns the special equipment thatis purchased for students

If the school district purchases the equipmentthe equipment belongs to the district Someschool districts designate that a particular deviceis to be used by a specific student during the timewhen that device remains appropriate for thatstudent Other districts have ldquopoolsrdquo of assistivedevices and distribute them for use by a varietyof students The distribution and use of devicesis under the districtrsquos control as long as the needsdescribed in studentsrsquo IEPs are being met

If devices are purchased for a particular stu-dent using that studentrsquos Medicaid funds or pri-vate insurance then the device belongs to the stu-dent and is meant for the exclusive use of thatstudent

When a student moves from one levelof schooling to another like elemen-tary school to middle school does thedevice follow the student

If an assistive device is necessary in order tofulfill the requirements of a studentrsquos IEP such adevice must be provided in whatever school thestudent attends The same device may not nec-essarily follow the student from one school toanother but a comparable device which fulfillsthe IEP requirements would have to be providedin the new school that the student attends

If a family moves from one schooldistrict to another can a studentrsquosassistive technology go along

Devices bought by the school belong to theschool not the student who uses them When afamily moves from one school district to anotherthe equipment the student has been using doesnot automatically move to the new school

Assistive equipment can go with a studentto a new school if the sending school district

46

agrees to sell or give the device to the family orthe new school district

If the device was purchased by the familythrough the familyrsquos private health insurance orby Medicaid for this particular student then thedevice belongs to the student and can go withthe student to a new school district

What happens to assistive technologydevices when students leave the schoolsystem at graduation

If the school district purchased the device thedevice is the property of the school The schoolcould keep the device for use by other studentssell it or decide to transfer the device to anotherdistrict or loan program If the family or anotherfunding source purchased the device it is theproperty of the student and the family

If a piece of assistive technology is nolonger needed or relevant to a studentand the device was paid for by Medic-aid or private insurance can it bedonated for another studentrsquos benefit

Yes it is a parental decision The parentscould donate the device to the school for use byother students with disabilities or to some otherorganization which loans out equipment

Can assistive devices be insured

Many school district liability policies willcover devices purchased by the district for stu-dent use Devices purchased by other fundingsources may or may not be covered while onschool premises or involved in school activitiesIt is important for school staff to investigate thedistrictrsquos property insurance to determine whatthe policy currently covers and whether or notthe policy insures against loss or damage ofassistive devices

Parents who own assistive devices that areused at home and at school may also wish to pur-chase home owners or rentersrsquo insurance with aspecial rider that covers damage to or loss of thedevice

Who is responsible for the repair and

maintenance of assistive devices

In general the school district is responsiblefor repair and maintenance of assistive devicesused to support educational programs describedin the IEP or covered by Section 504

If a device is broken and is beyondrepair who replaces the broken de-vice

If an assistive device is necessary for thestudentrsquos IEP to be implemented then the schooldistrict will have to replace a broken lost or sto-len device

If a device is broken and sent off forrepairs must the school district sup-ply a substitute device until the origi-nal device is returned

If the assistive technology device is vital tothe studentrsquos daily special education program itis not reasonable for the student to be without adevice for long periods of time If a device isgoing to be unavailable for more than a day ortwo the district should provide a backup ma-chine which allows the student to continue work-ing on IEP goals

Is the school district obligated totrain substitute teachers and aides tooperate assistive technology devices

Again if the assistive technology device isvital to the studentrsquos daily special education pro-gram it is not reasonable for the student not tobe able to use the device for long periods of timebecause a substitute is teaching the class If thesubstitute is only going to be in the classroomfor a day or two it is probably not necessary toprovide elaborate training However if the sub-stitute is going to be in the classroom for an ex-tended time training should be provided

Must school districts allow students totake assistive devices home on schoolnights to do homework Over week-ends During school vacations Overthe summer

In many cases it is desirable for students to

47

have the opportunity to use the same assistivetechnology devices at home and in school Forexample when a student is completing home-work assignments assistive technology may benecessary to produce the type of product that isrequired Some school districts have policieswhich allow the devices to go home with the stu-dents overnight on weekends or during vaca-tion or summer periods In general these kindsof policies are a local district matter and may bedetermined according to local district needs Ifhowever a studentrsquos IEP includes a provisionwhich says the student is to have access to anassistive device both at school and at home thenthe school district would be obligated to allowthe student to take a device home or provide twodevices one for home use and one for school

What professionals are consideredqualified to assess a student in thearea of assistive technology

Because assistive technology is such a newfield there are no national standards and few lo-cal or state standards for licensing or certificationfor specialists in assistive technology Howeverschool districts often have professionals who havereceived training in conducting assistive technol-ogy evaluations and are able to provide the ser-vices identified in the IEP If a district does nothave personnel who are knowledgeable in con-ducting such evaluations the district can arrangefor such services from other knowledgeable pro-vidersndash such as Independent Living Projects Al-liance for Technology Access Centers or Tech ActProjects

How can one distinguish betweenassistive technology and personalitems (eg wheelchairs hearing aidseyeglasses crutches)

Currently IDEA does not make a clear dis-tinction between assistive technology devices andpersonal items This confusion stems in large partfrom IDEArsquos broad definition of assistive technol-ogy For example if a student with a disability

needs eye glasses in order to obtain FAPE thenthe school district is obligated to provide themat no cost to the parents In general howeverschool districts do not purchase personally pre-scribed devices such as hearing aids or glasses

Who determines how assistive tech-nology will be purchased and withwhat available funding resourcesmdashtheIEP Team or school administration

Once the IEP team makes the determinationthat assistive technology must be provided aspart of the studentrsquos IEP it is the responsibilityof school administration to determine how theassistive technology will be provided and withwhich funding sources

Is a school district responsible forproviding ldquostate of the artrdquo equip-ment for a student

No The school district need provide onlyappropriate technology in order to meet thestudentrsquos needs as described in the IEP The de-cision as to what type of assistive technology isappropriate should be based on the assistive tech-nology evaluation recommendations and IEPteam decision There may be ldquodevicesrdquo or fea-tures of equipment which may be nice for the stu-dent to have but if they are not necessary forFAPE the school district is not obligated to pro-vide them If a specific device is necessary toensure FAPE and no other device can meet thestudentrsquos needs then the district must providethe required device even though it is costly If aless expensive device would accomplish the samegoals the IEP team is under no obligation tochoose a more expensive option

If a student needs a computer can aschool owned computer be used in thelab or classroom

Yes a school owned computer can be used ifthe student has access to the equipment when heor she needs it If the student does not have thenecessary access then the appropriate equipmentshould be purchased for the studentrsquos use

48

Can school district administratorsinstruct personnel not to includecostly assistive technology devices inthe IEP

IEP teams are charged with the responsibil-ity for determining a studentrsquos need for assistivetechnology devices and services and for specify-ing those devices and services Therefore it isimportant that IEP teams are clearly informed oftheir responsibility to determine if a studentneeds a device and the need for an assistive tech-nology evaluation to assist in making the deter-mination A school district may not have a policywhich prevents IEP teams from identifying astudentrsquos need for assistive devices or services

How does assistive technology getintegrated into the curriculum

The IEP team needs to discuss how the de-vice will be used by the student and how it willbe integrated into the curriculum The IEP teamshould identify on the IEP how the device willbe used by the student in the classroom Thisinformation should be shared with the generalclassroom teachers so that they are aware of howit is to be used

How can assistive technology be pro-vided from year to year with a degreeof continuity

As part of the annual review of the IEP a pointshould be made to devise ways to communicatewith next yearrsquos teachers about the technologythe student uses and how it should be integratedinto the curriculum Teachers who are new toworking with the student who uses technologyshould be provided training if they are unfamil-iar with the device and its use Training for teach-ers and support staff should be written into theIEP as a related service

Can an assistive technology device beused by more than one student

Yes if the device is the property of the schooldistrict and if all of the students using the devicehave access to the equipment when they need it

Can an independent evaluation berequested to address assistive tech-nology

Yes The school district is required to evalu-ate a student in all areas of suspected disabilityincluding if appropriate evaluating the studentrsquosneed for assistive technology A parent has theright to an independent educational evaluationat public expense if the parent disagrees with anevaluation obtained by the school district How-ever the school district may initiate a due pro-cess hearing to show that its evaluation is appro-priate If the final decision is that the evaluationis appropriate the parent still has the right to anindependent educational evaluation but not atpublic expense If the parent obtains an inde-pendent educational evaluation at private ex-pense the results of the evaluation (a) must beconsidered by the school district in any decisionmade with respect to the provision of FAPE tothe child and (b) may be presented as evidenceat a due process hearing

What is a product system

A product system is more than one piece ofequipment working together to produce a resultFor example an FM system that works in con-junction with a studentrsquos hearing aid is a prod-uct system

Can the school district require a stu-dent to bring a personally ownedassistive device such as an augmenta-tive communication system or laptopcomputer to school in order to doschoolwork

No However the family may wish the childto use his or her equipment in school since thechild may be more familiar or comfortable withit The IEP team should decide who is respon-sible for repair and maintenance of family owneddevices

Is it sufficient for a school district tosupply access to a district-ownedcomputer but provide no software

49

that is appropriate for the student touse

Just providing access to a computer does notfulfill the districtrsquos obligation to provide assistivetechnology to support FAPE The educationalaspect of the computer is very much related tothe software that the student uses If no appro-priate software is available then the student can-not pursue the IEP goals

50

Appendix

GlossaryASSISTIVE TECHNOLOGY any sort of aidincluding computers switches calculators spell-ing devices communication devices and voicesynthesizers which is used to help an individualperform some task of daily livingALTERNATIVE KEYBOARD may include en-larged reduced varied key placement one-handed braille chordic or any other device forentering text on a computerAUGMENTATIVE COMMUNICATION anydevice (electronic or otherwise) to enhance com-munication for a person with limited speechBRAILLE EMBOSSER a printer for producingbraille output either manually or when connectedto a computer When printing standard text froma computer it must first be translated into brailleBRANCHING describes the process of choos-ing among a sequence of choices or actions toproduce another sequence of choices This pro-cess is used in the ldquoscanningrdquo method of accessCD-ROM ldquoCompact Disk Read-Only Memoryrdquorefers to the 4-inch silver disks that typically hold700 megabytes of digital information and theplayers that access the information on these disksCURSOR either the flashing vertical or horizon-tal line on a computer screen that indicates theinsertion point for text or the arrow or I-beamthat indicates the position of the mouse pointeron the computer screenDESK ACCESSARY a small utility program thatruns on a computer and may be accessed fromany program at any time (such as a calculator)DRILL AND PRACTICE presents questionsrepetetively but is not a tutorial Software thatis only drill and practise doesnrsquot necessarily teachthe concepts needed to answer the questions pre-sented

ENVIRONMENTAL CONTROL any type ofdevice that an individual may use to control theirenvironment (lights appliances TV telephoneetc) This may include anything from simplereachers or sticks to computers and voice-acti-vated electronic systemsFM SYSTEM a local wireless broadcast systemthat consists of a microphone and transmitter forthe speaker and ldquowalkman-likerdquo receivers withheadphones for listeners with hearingimpairements or attention disordersHIGH TECH use of electronics or computers asa solutionICON a small computer graphic that appears onthe computer screen and may represent differ-ent types of objects (files or applications) or ac-tions depending on the context Use the mousepointer to click on icons that open files or per-form other actionsINDIVIDUAL FAMILY SERVICE PLAN (IFSP)the written document which defines the earlyintervention services provided to the child andfamily The program is designed to meet theneeds of the child and the family and is based onfamily-identified prioritiesINDIVIDUALIZED EDUCATION PROGRAM(IEP) a written plan specifying instructionalgoals and any special education and related ser-vices a student may need which must be writ-ten and reviewed annually Included are (1) thepresent educational levels of the student (2) astatement of annual goals including short-termobjectives (3) a statement of specific services ifneeded (4) the programs (5) the date when spe-cial services are to begin and the expected dura-tion of these services and (6) the tests and otherrequirements or information used to guage thestudentrsquos progress to determine if the instruc-tional objectives are being metINPUT the information that is transmitted to acomputer from a keyboard mouse or other in-

51

put deviceKEYBOARD a device for inputing text and com-mands to a computerKEYGUARD a plexiglass or other cover for akeyboard with holes for the individual keys Itallows more precise selection of keys for an indi-vidual with fine motor difficultiesKEYPAD a small keyboard with a 10-key setupfor numeric input or it may also be used as a con-trol for a screen-reader programLAPTOP a portable battery-powered computerthat is typically the size of a 3-ring binder weighs5-10 pounds and consists of a screen keyboardand disk-drivesLASER DISCS large (12-inch) CD-ROMs thatnormally contain moviesLOW TECH indicates use of low cost non-elec-tronic solutionsMACRO a simple short program that performsan action on a computer They are usually cre-ated by recording the keyboard andor mouseinput and storing them as an icon or key combi-nationMEGABYTE 1000 X 210 bytes of informationwhich basically means over one million key-strokes of computer storage (about 10 novels)MORSE CODE a direct method for computerinput using one to three switches and coded in-put to replace the keyboard and mouseMOUSE the name given to the pointing deviceused to control graphical user interfaces (GUI) ofmodern personal computersONSCREEN KEYBOARD a software programthat places the keyboard on the screen of the com-puter and may be accessed using a mouse or otherpointing device This is ideal for individuals whocannot use a regular keyboard but can use sometype of pointing deviceOPTICAL CHARACTER RECOGNITION(OCR) a process that utilizes special computersoftware to convert the scanned image of text intoactual text that may be edited by a word proces-sorOUTPUT computer-generated information for

the user This may be printed output from aprinter visual information from the screen orsounds from speakersSCANNER an electronic copier connected to acomputer Scanners are used to input drawingspictures or printed text into the computerSCANNING has nothing to do with the elec-tronic copier above It is another method for ac-cessing a computer or communication deviceusing one or more switches Scanning involvespresenting a group of choices cycling amongthem and making choices by activating a switchSCREEN READER software that reads text ona computer screen using a speech synthesizerThis allows individuals with visual impairmentsor other print disabilities to access text on thecomputer screenSIMULATION software that simulates real-world situations on a computer This may rangefrom a joystick trainer for driving an electricwheelchair to running citiesSPEECH SYNTHESIZER hardware or softwarefor producing electronic human speech on a com-puterSPELL CHECKER utility for checking the spell-ing in a documentSTICKY KEYS software or mechanical utility forallowing typing of multiple keystrokes with onefinger (using the shift or other modifier keys)SWITCH a device that is like a single button ofa keyboard or mouse Switches may be used byan individual with servere motor difficulties byany controllable muscle in their body (headhand toe eye breath etc) to operate any typeof computer communication or environmentalcontrol deviceSWITCH INTERFACE black box that connectsto a computer or other device that has plugs forswitchesTDD a text telephone used for communicatingin typed text over a phone line A TDD has akeyboard and text display or small printer Bothparties who are communicating over a phone linemust have TDDs

52

TOUCH WINDOW a computer input devicethat uses a touch-sensitive transparent windowplaced on the computer screen It performsmouse functions with a finger or stylus directlyon the screenTRACKBALL another replacement for themouse pointing device that uses a rolling ball toperform mouse movementsTUTORIAL teaches concepts presents informa-tion as opposed to simple drill and practiceVOICE RECOGNITION computer softwareand microphone that allows input and controlwith voice commandsWORD PREDICTION productivity softwarethat increases typing speed for one-finger typistsand others by predicting and choosing completewordsWORD PROCESSOR software for inputing andformatting textUSER person using a computerUTILITY software for adding function or per-forming housekeeping tasks on a computer

53

DocumentsSCHRAG LETTER ON ASSISTIVE TECHNOLOGY

August 10 1990

Dear Ms Goodman

This is in response to your recent letter to the Office of Special

Education Programs (OSEP) concerning the obligations of public

agencies under Part B of the Education of the Handicapped Act

(EHA-B) to provide assistive technology to children with handi-

caps

Specifically your letter asks

1 Can a school district presumptively deny assistive technol-

ogy to a handicapped student

2 Should the need for assistive technology be considered on

an individual case-by-case basis in the development of the

childs Individual Education Program

In brief it is impermissible under EHA-B for public agencies

(including school districts) to presumptively deny assistive tech-

nology to a child with handicaps before a determination is made

as to whether such technology is an element of a free appropriate

public education (FAPE) for that child Thus consideration of a

childs need for assistive technology must occur on a case-by-

case basis in connection with development of a childs individual-

ized education program (IEP)

We note that your inquiry does not define the term assistive

technology and that the term is not used either in the EHA-B

statute or regulations The technology Related Assistance for

Individuals with Disabilities Act of 1988 PL 100-407 contains

broad definitions of both the terms assistive technology device

and ldquoassistive technology service See Section 3 of PL 100-

407 codified as 29 USC 2201 2202 Our response will use

assistive technology to encompass assistive technology ser-

vices and ldquoassistive technology devices

Under EHA-B State and local educational agencies have re-

sponsibility to ensure that eligible children with handicaps receive

FAPE which includes the provision of special education and re-

lated services without charge in conformity with an IEP 20 USC

1401(18) 34 CFR S3004(a) and (d) The term special educa-

tion is defined as specially designed instruction at no cost to

the parent to meet the unique needs of a handicapped child 34

CFR S30014(a) Further related services is defined as includ-

ing transportation and such developmental corrective and other

supportive services as are required to assist a handicapped child

to benefit from special education 34 CFR ss33013 (a)

The EHA-B regulation includes as examples 13 services that

qualify as related services under EHA-B See 34 CFR S30013

(b)(1)-(13) We emphasize that this list is not exhaustive and

may include other developmental corrective or other supportive

servicesif they are required to assist a handicapped child to

benefit from special education 34 CFR S30013 and Comment

Thus under EHA-B assistive technology could qualify as spe-

cial education or related services

A determination of what is an appropriate educational program

for each child must be individualized and must be reflected in the

content of each childs IEP Each childs IEP must be developed

at a meeting which includes parents and school officials 34 CFR

S300343-300344 Thus if the participants on the IEP team de-

termine that child with handicaps requires assistive technology in

order to receive FAPE and designate such assistive technology

as either special education or a related service the childs IEP

must include a specific statement of such services including the

nature and amount of such services 34 CFR S300346(c) App

C to 34 CFR Part 3000 (Ques 51)

EHA-Bs least restrictive environment (LRE) provisions require

each agency to ensure (t)hat special classes separate school-

ing or other removal of handicapped children from their regular

educational environment occurs only when the nature or severity

of the handicap is such that education in regular classes with the

use of supplementary aids and services cannot be achieved sat-

isfactorily Part 121a 42FR 4251113 (August 23 1977)

Assistive technology can be a form of supplementary aid or ser-

vice utilized to facilitate a childs education in a regular educa-

tional environment Such supplementary aids and services or

modifications to the regular education program must be included

in a childs IEP Id Appendix C to 34 CF art 300 (Ques 48)

In sum a childs needs for assistive technology must be deter-

mined on a case-by-case basis and could be special education

related services or supplementary aids and services for children

with handicaps who are educated in regular classes

I hope the above information has been helpful If we may pro-

vide further assistance please let me know

Sincerely

Judy A Schrag EdD

Director Office of Special Education Programs

54

INDIVIDUALS WITH DISABILITIES EDUCATIONLAW REPORT

Cite as 18 IDELR 627

Digest of Inquiry

(Inquirerrsquos Name Not Provided)

(Date Not Provided)

bull Is a school district responsible to provide assistive

technology devices for home use

bull May a school board overrule a determination by an IEP

team that a child with a disability needs access to an

assistive technology device at home

bull What is the time limit on implementation of an IEP

Digest of Response

(November 27 1991)

Assistive Technology Devices May Be Required for Home Use

If an IEP team determines that a child with a disability needs

access to an assistive technology device at home as a matter of

FAPE then the school district must provide the device for home

use in order to implement the childrsquos IEP

School Board May Not Change IEP Teamrsquos Determination

Under Part B a school board has no authority to unilaterally

change any statement of special education or related services

contained in an IEP including a statement of a childrsquos need to

have access to an assistive technology device at home Without

reconvening the IEP team the school board may not change the

IEP and the school district is obligated to implement the IEP re-

quirements regardless of the school boardrsquos objections

IEPs Must Generally Be Implemented

Under Reg 300342(b) an IEP must be in effect before the

provision of special education or related services and must be

implemented as soon as possible following the conclusion of the

IEP meeting(s) In accordance with Appendix C to the Part 300

regulations an IEP should generally be implemented without de-

lay after being finalized although a reasonable delay may be per-

missible in limited circumstances

__________________

Text of Inquiry

I would like to have a copy of the policy classification on

Assistive Technology

I also have a question to ask regarding Assistive Technology

such as a closed circuit TV

My daughter uses a CCTV in school and it is on her IEP

program My daughter is visually impaired The initial request

was made by me the parent to the appropriate people involved

in her education and discussed and approved by the committee

on an individual basis

My question is I would like to make the request to the ap-

propriate officials for another CCTV for home use to accomplish

the same results at home as is done in school (For homework

reading books any assignments from school)

Another question is If the committee approves this request

it will go to School Board for approval I would like to know what

happens if the School Board doesnrsquot approve the proposal Is it

impartial hearing time

Thank you for your assistance in this matter

Any information regarding Assistive Technology Informative

for school and home use would be greatly appreciated

Is there a time limit on implementation of yearly updated

IEPs[] Every year I have long delays on implementation of board

approved IEPs[]

Text of Response

This is in response to your recent letter to the Office of Spe-

cial Education Programs (OSEP) requesting a copy of any OSEP

policy clarifications on assistive technology as well as asking spe-

cific questions concerning the assistive technology needs for your

daughter You also asked a question about the time limits for

implementation of an individualized education program (IEP)

In response to your request I am enclosing a copy of OSEPrsquos

August 10 1990 letter to Ms Susan Goodman concerning the

obligations of public agencies under Part B of the Individuals with

Disabilities Education Act (Part B) formerly cited as Part B of the

Education of the Handicapped Act to provide assistive technol-

55

ogy to children with disabilities along with some additional infor-

mation on assistive technology and a copy of the Part B regula-

tions I would also like to provide you with OSEPrsquos response to

each of your specific questions as stated below

I would like to make the request to the appropriate officials

for another CCTV for home use to accomplish the same

results as is done in school (For homework reading books

any assignment from school)

The IEP which must be developed at a meeting that includes

parents and school officials must contain among other things a

statement of the specific special education and related services

to be provided to the child See 34 CFR sectsect 300343-300346 As

stated in OSEPrsquos letter to Ms Goodman if the IEP team deter-

mines that a child with disabilities requires assistive technology in

order to receive a free appropriate public education (FAPE) and

designate such assistive technology as either special education

or a related service the childrsquos IEP must include a specific state-

ment of such services including the nature and amount of such

services See 34 CFR sect 300346(c) App C to 34 CFR Part 300

(Ques 51) The need for assistive technology is determined on a

case-by-case basis taking into consideration the unique need of

each individual child If the IEP team determines that a particular

assistive technology item is required for home use in order for a

particular child to be provided FAPE the technology must be pro-

vided to implement the IEP

If the committee approves this request it will go to the School

Board for approval I would like to know what happens if

the School Board doesnrsquot approve the proposal Is it im-

partial hearing time

As part of the public agencyrsquos part B obligation to provide

FAPE to an eligible child with disabilities the public agency must

ensure that special education and related services are provided

in conformity with an IEP which meets the requirements of 34

CFR sectsect 300340-300349 One requirement at 34 CFR sect

300343(a) is that the public agency conduct a meeting to de-

velop review and revise a childrsquos IEP The Regulations require

that certain participants attend the IEP meeting See 34 CFR sect

300344 The role of the participants at the IEP meeting is to

determine the specific special education and related services that

a child needs in order to receive FAPE Once the determination is

made at a meeting convened pursuant to 34 CFR sect 300343(a)

Part B does not recognize any authority on the part of a local

School Board to unilaterally change the statement of special edu-

cation and related services contained in the IEP After the IEP is

developed and the placement decision is made by a group of

persons knowledgeable about the child the meaning of the evalu-

ation data and placement options the public agency must imple-

ment the IEP See 34 CFR sect 300533(a)(3) Without reconven-

ing the IEP meeting the local school board could not change the

IEP

Is there a time limit on implementation of updated IEPrsquos[]

Every year I have long delays on implementation of Board

approved IEPrsquos[]

Part B imposes no specific time limits for the implementation

of IEPs The Part B regulations at 34 CFR sect 300342(b) require

that an IEP (1) must be in effect before special education and

related services are provided to a child and (2) must be imple-

mented as soon as possible following the meetings required to

develop review or revise a childrsquos IEP The answer to Question 4

in Appendix C to the Part 300 regulations states that no delay is

permissible between the time a childrsquos IEP is finalized and when

special education and related services is provided It is expected

that the special education and related services set out in the IEP

will be provided by the agency beginning immediately after the

IEP is finalized In certain circumstances such as when the IEP

meeting occurs during the summer or a vacation period or where

there are circumstances which require a short delay (eg work-

ing out transportation arrangements) the implementation may not

be immediate See Comment 34 CFR sect 300342

I hope that this information is helpful to you Please let us

know if you have any additional questions or concerns

Judy A Schrag

Director

Office of Special Education Programs

_______________________

Cite as 18 IDELR 628

56

Sample Letter Requesting an Assistive Tech-nology Evaluation

March 1997

Dear Sir

Our daughter Catherine an IDEA-eligiblestudent is currently receiving special educationand supportive therapies through the publicschool district As she is progressing through theelementary school grades the curriculum is de-manding more and more written work from herAt this point teachers or assistants are writingfor her but this method does not allow Catherinethe opportunity to compose written work on herown

As Catherinersquos parents we think the time hascome to consider assistive technology forCatherine to allow her to learn to do written workon her own so that she can learn the mechanicsof writing and can put her own thoughts downon paper for others to read

To this end we are requesting an assistivetechnology evaluation for Catherine to determinewhat kinds of technology are necessary to assisther with written expression We are assumingthat the assistive technology evaluation will beperformed at district expense by professionalswho are qualified to determine (a) what assistivetechnology may be necessary for Catherine (b)what assistive technology devices might be help-ful and (c) what occupational and physicaltherapy services may be necessary to support thetechnology

We would like to have this evaluation com-pleted so that information is available prior tothe convening of the IEP Team to writeCatherinersquos Individualized Education Programfor next year

We appreciate your assistance with this mat-ter and look forward to hearing from you

Yours truly

Assistive TechnologyIssues to Address

_____What are the individualrsquos current unmetneeds for access to communication writ-ing or educational materials

_____What are the short and long term educa-tional goals

_____What are the daily educational demandswhich require the use of assistive technol-ogy

_____Have the appropriate team members in-cluding parents been involved in the as-sessment process

_____What are the features of the technology thatwould assist the individual in meetingdaily classroom demands

_____Why is the selected equipment more appro-priate than other alternatives

_____Have all of the individualrsquos environmentsbeen considered

_____Does the selected equipment reflect the leastrestrictive intervention strategy

_____Is the equipment necessary to achieve edu-cationallife goals

_____How will the individual physically man-age the equipment in all environments

_____How will the equipment be integrated intothe individualrsquos daily life

_____How will the use of the assistive technol-ogy promote inclusion of the individualinto activities in the school and commu-nity

_____Which members of the education team willbe trained to use the equipment

_____How will the individual be trained to usethe equipment

_____How will the family be involved with theindividual and the equipment

57

ExamplesEDUCATIONAL SOFTWARE EVALUATION

A IDENTIFYING INFORMATION

Name of instructional program

Publisher

Cost ____________Computer platform(PCMac)

Other equipment needed to run program

Grade level of the program

Skill levels required of users

Special needs addressed by program

B DESCRIPTIVE INFORMATION

1 What is the purpose of the instructional program as stated by

its publisher

2 What curriculum area or areas does it address

3 What type of instructional program is it

tutorial drill and practice___ arcade game type___

drill and practice ____ simulation ___

problem solving___ educational game___

teacher utility___ other___

4 For what type of learner was the program designed

age level __________ grade level ____________

ability level ________ interest level ___________

5 What skills or information does the program attempt to teach

or review

6 How does the program present information

__text __graphics __animation __color __sound effects

__music __speech __other __________________________

7 Is the information presented clearly

Is text legible and readable

Are graphics comprehensible

Are sounds audible and intelligible

8 Are directions for using the program clearly stated and under-

standable Where do directions appear

_____ within the program

_____ in the programs documentation or manual

9 Is the program under user control that is can the user control

the programs movement from screen to screen

Review directions at any time

Exit the program at any time

10 What computer use demands are placed on the learner

_____ insert disk and turn on computer

_____ select from menu

other ______________________________

11 What academic demands are placed on the learner

reading level _______________________________

spelling level _______________________________

other _____________________________________

12 What physical demands are placed on the learner

_____ keyboard must be used to enter responses

_____ press any key

_____ press a key from one half or one quadrant of key-

board

_____ press on specific key

_____ press several keys in order

_____ other devices used to enter responses

13 What speed demands are placed on the learner

_____ presentation of information controlled by program (

moderate fast or slow)

_____ presentation of information under user control

_____ unlimited response time

_____ response time set by program (moderate fast slow)

_____ response time varied by user

58

14 What accuracy demands are placed on the learner

_____ user can correct typing errors

_____ program does not allow correction of typing errors

_____ program locates common errors

_____ program requires correct spelling of all responses

_____ program allows only one correct response for most

questions

15 Is feedback about response accuracy provided to learners

appropriately

_____ knowledge of results provided after each response

_____ correct responses confirmed

_____ learner informed if response incorrect

_____ another trial provided if response incorrect

_____ number of trials provided

_____ correct response demonstrated if learner fails to an-

swer correctly

_____ learner allowed opportunity to respond after demon-

stration of correct response

16 Does the program use any branching procedures besides

differential treatment of correct and incorrect responses

17 What techniques are used for reinforcement and motivation

_____ knowledge of results and confirmation of correct re-

sponses

_____ summary information about learner performance

_____ text message of praise for correct responses

_____ graphics display and or sound for correct responses

_____ competitive game in which correct response earn

points

_____ other _________________________________

Reinforcement is _____ continuous _____ intermittent

18 What user options are available to students and teachers

Students can select

_____ activity from menu difficulty

_____ number of questions type of questions

_____ other ____________________________

Teacher or parent can select

_____ sound on or off

_____ number of questions

_____ type of questions

_____ sequence of instruction

_____ number of trials

_____ speed of presentation

_____ speed demands for responses

_____ other_________________________________

Teacher or parent can

_____ enter own content into program

_____ review student records

_____ other________________________________

19 Is the programs documentation adequate

All program features fully and clearly explained

Rationale for program purpose and objectives included

Print materials provided for students

20 Other comments about the instructional program

C OVERALL EVALUATION

Rate the appropriateness of the instructional program in each of

the following areas using this scale

excellent adequate inadequate

1 2 3

1 2 3 Curricular content (program addresses important skills

1 2 3 Interest level

1 2 3 Ease of use for learners

1 2 3 Demands on learner (eg computer use academic)

1 2 3 Instructional procedures

1 2 3 Motivational value

1 2 3 Appropriate use of the medium

1 2 3 Important instructional variables under teacher control

1 2 3 Other _______________________________

59

Software Featuresbull Easy-to-Read Screensbull Consistency in Formatbull Intuitive Characteristicsbull Logical Labelsbull Instructional Choicesbull Graphicsbull Friendly Documentationbull On-Screen Instructionsbull Auditory Cuesbull Visual Cuesbull Built-in Access Methodsbull Alternatives to a Mousebull Optional Cursorsbull Creation of Custom Programs

Alternative Inputbull Switches and Switch Softwarebull Alternative Keyboardsbull Keyboard Additionsbull Access Utilitiesbull Interface Devicesbull Voice Recognitionbull Optical Character Recognition

and Scannersbull Electronic pointing Devicesbull Pointing and Typing Aidsbull Touch Screensbull Joysticksbull Trackballsbull Arm and Wrist Supports

Processing Aidsbull Abbreviation Expansion and

Macro Programsbull Word Predictionbull Talking and Large Print Word

Processorsbull Grammar and Spell Checkersbull Reading Comprehension Pro-

gramsbull Writing Composition Pro-

gramsbull Electronic Reference Toolsbull Menu Management Programs

Alternative Outputbull Braille Embossers and Transla-

torsbull Refreshable Braille Displaysbull Speech Synthesizersbull Screen Readersbull Screen Enlargement Programsbull Monitor Additions

Specialized Productsbull Closed Circuit Television

(CCTV)bull Environmental Control Units

(ECU)bull Notetakersbull Reading Machinesbull Text Telephone (TDD)

60

Next

Ste

p

Try

havi

ng C

huck

use

earp

hone

s w

hen

he is

wor

d pr

oces

sing

Curre

nt S

tatu

s

Chu

ck is

abl

e to

do

grad

ele

vel a

ssig

nmen

ts b

ut h

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very

lite

ral i

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s in

terp

reta

-tio

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spec

ially

of a

bstra

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ts

Chu

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bot

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sual

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mak

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line

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61

ASSI

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tude

nt w

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es a

ll of

his

inst

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inth

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r cla

ssro

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legi

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mor

eaf

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ext

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or Han

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62

ResourcesParent Trainingand InformationCenters

AlabamaSpecial Education ActionCommittee Inc (SEAC)600 Bel Air Blvd 210Mobile AL 36606-3501334-478-1208334-473-7877 FAX1-800-222-7322 AL onlyseacmob1junocomhttpwwwhsvtisnet~cja

AlaskaPARENTS ResourceCenter4743 E Northern Lights BlvdAnchorage AK 99508907-337-7678907-337-7671 FAX1-800-478-7678 in AKparentsalaskanethttpwwwalaskanet~parents

American SamoaAmerican Samoa ParentNetworkPO Box 3432Pago Pago AS 96799684-633-2407684-633-7707 (fax)

ArizonaPilot Parent Partnerships4750 N Black Canyon Hwy 101Phoenix AZ 85017-3621602-242-4366800-237-3007 (AZ only)602-242-4306 (fax)

ArkansasArkansas Disability Coalition2801 Lee Ave Suite BLittle Rock AR 72205501-614-7020501-614-9082 FAX1-800-223-1330 AR onlyadcceinet

FOCUS Inc305 W Jefferson AveJonesboro AR 72401870-935-2750870-931-3755 FAXfocusincipanet

CaliforniaDREDF2212 Sixth StreetBerkeley CA 94710510-644-2555510-841-8645 (fax)1-800-466-4232dredfdredforghttpwwwdredforg

Exceptional Parents Unlimited(EPU)4120 N First StreetFresno CA 93726209-229-2000209-229-2956 (fax)epu1cybergatecom

Matrix555 Northgate Dr Ste ASan Rafael CA 94903415-499-3877415-499-3854 (TDD)415-507-9457 (fax)1-800-578-2592matrixmatrixparentsorghttpwwwmatrixparentsorg

Parents Helping Parents - SanFrancisco594 Monterey BlvdSan Francisco CA 94127-2416415-841-8820415-841-8824 (fax)

Parents Helping Parents -Santa Clara3041 Olcott StSanta Clara CA 95054-3222408-727-5775408-727-7655 (TDD)408-727-0182 (fax)infophpcomhttpwwwphpco

Support for Families ofChildren with Disabilities2601 Mission 710San Francisco CA 94110-3111415-282-7494415-282-1226 (fax)sfcdmissaolcom

TASK100 W Cerritos AveAnaheim CA 92805-6546714-533-TASK (8275)714-533-2533 (fax)taskcaaolcom

TASK- San Diego3750 Convoy St Ste 303San Diego CA 92111-3741619-874-2386619-874-2375 (fax)

ColoradoPEAK Parent Center Inc6055 Lehman Drive Ste 101Colorado Springs CO 80918719-531-9400719-531-9403 (TDD)800-284-0251719-531-9452 (fax)PKPARENTaolcom

ConnecticutCPAC338 Main StreetNiantic CT 06357860-739-3089860-739-7460 (fax)1-800-445-2722 (in CT)cpacincaolcomhttpwwwmembersaolcomcpacinccpachtm

DelawareParent Information Center(PIC) of Delaware Inc700 Barksdale Road Ste 3Newark DE 19711302-366-0152302-366-0178 (TDD)302-366-0276 (fax)PEP700aolcom

FloridaFamily Network on Disabilitiesof Florida2735 Whitney RoadClearwater FL 24620813-523-1130800-285-5736 (FL only)813-523-8687 (fax)fndgatenethttpwwwgatenet~fnd

GeorgiaParents Educating Parentsand Professionals for AllChildren (PEPPAC)8318 Durelee Lane Ste 101Douglasville GA 30134770-577-7771770-577-7774 (fax)peppacbellsouthnet

HawaiiAWARELearning DisabilitiesAssociation of Hawaii200 N Vineyard Blvd Ste 310Honolulu HI 96817808-536-9684808-536-2280 (TTY)808-537-6780 (fax)ldahgtenet

IdahoIdaho Parents Unlimited Inc(IPUL)Parents Education amp ResourceCenter4696 Overland Rd Ste 478Boise ID 83705208-342-5884800-242-IPUL (4785)208-342-1408 (fax)ipulrmcinethttpwwwhomermcinetIPUL

IllinoisDesigns for Change6 N Michigan Ave Ste 1600Chicago IL 60602312-857-9292312-857-1013 (TDD)312-857-9299 (fax)1-800-851-8728DFC1aolcom

Family Resource Center onDisabilities (FRCD)20 East Jackson Blvd Rm 900Chicago IL 60604312-939-3513312-939-3519 (TDDTTY)312-939-7297 (fax)1-800-952-4199 (IL only)

Family TIES Network830 South Spring StreetSpringfield IL 62704800-865-7842217-544-6018 (fax)ftiesnaolcom

National Center for Latinoswith Disabilities1921 South Blue IslandChicago IL 60608312-666-3393312-666-1788 (TDD)312-666-1787 (fax)1-800-532-3393ncldinteraccesscom

5

from using some type of communication deviceor devices Communication devices include suchthings as symbol systems communication boardsand wallets programmable switches electroniccommunication devices speech synthesizers re-corded speech devices communication enhance-ment software and voiced word processing

Assistive Listening Much of the time inschool students are expected to learn through lis-tening Students who have hearing impairmentsor auditory processing problems can be at a dis-tinct disadvantage unless they learn to use thehearing they have or they develop alternativemeans for getting information Hearing problemsmay be progressive permanent or intermittentAny of these impairments may interfere signifi-cantly with learning to speak read and followdirections Assistive devices to help with hear-ing and auditory processing problems includehearing aids personal FM units sound field FMsystems Phonic Ear TDDs or closed caption TV

Visual Aids Vision is also a major learningmode General methods for assisting with visionproblems include increasing contrast enlargingstimuli and making use of tactile and auditorymodels Devices that assist with vision includescreen readers screen enlargers magnifierslarge-type books taped books Braillers lightboxes high contrast materials thermoformgraphics synthesizers and scanners

Mobility Individuals whose physical impair-ments limit their mobility may need any of a num-ber of devices to help them get around in theschool building and participate in student activi-ties Mobility devices include such things as self-propelled walkers manual or powered wheel-chairs and powered recreational vehicles likebikes and scooters

Computer-Based Instruction Computer-based instruction can make possible independentparticipation in activities related to the curricu-lum Software can be selected which mirrors theconceptual framework of the regular curriculum

but offers an alternative way of responding to ex-ercises and learning activities Software can pro-vide the tools for written expression spelling cal-culation reading basic reasoning and higherlevel thinking skills The computer can also beused to access a wide variety of databases

Social Interaction and Recreation Studentswith disabilities want to have fun and interactsocially with their peers Assistive technologycan help them to participate in all sorts of recre-ational activities which can be interactive withfriends Some adapted recreational activities in-clude drawing software computer games com-puter simulations painting with a head or mouthwand interactive laser disks and adaptedpuzzles

Self Care In order to benefit from educa-tion some students require assistance with selfcare activities like feeding dressing and toiletingAssistive devices which assist with self care in-clude such things as robotics electric feedersadapted utensils specially designed toilet seatsand aids for tooth brushing washing dressingand grooming

What sort of students might use assistivetechnology

Students who require assistive technology arethose with mental or physical impairments thatinterfere with learning or other life functions Thetechnology helps the student to overcome or com-pensate for the impairment and be more inde-pendent in participating at school Students whobenefit from assistive technology may have mildlearning problems like learning disabilities orthey may have physical or cognitive disabilitiesthat range from mild to severe Assistive tech-nology is not necessary or helpful for every stu-dent in special education but it is an importantpart of the support system for many studentswith identified disabilities

Isnrsquot assistive technology appropriate only forstudents with more severe disabilities

Assistive technology is simply a set of tools

6

that can be used to compensate for some deficitthat a person may have For individuals with se-vere mental or physical disabilities the techno-logical solutions can help to solve multiple andcomplex problems But individuals with less in-volved problems also can benefit from assistivetechnology For example individuals with learn-ing disabilities who have difficulty with readingor writing can benefit educationally from usingthe word processing and voiced reading capa-bilities of computers

Isnrsquot assistive technology just a crutch Wonrsquotstudents become too dependent on technol-ogy and not learn to use the skills they have

Assistive technology should be used as sup-port for access learning and performing dailytasks In general assistive technology is appro-priate when it compensates for disabilities so thatthe individual can function as normally as pos-sible If assistive technology is necessary for astudent to have access to educational opportuni-ties or to benefit from education then it is not aldquocrutchrdquo but a legitimate support

Some skills are too laborious or taxing to ac-complish at a rate or with degree of proficiencyto allow for participation in the least restrictiveenvironment With assistive technology the stu-dent can participate more fully and more closelyapproximate the levels of achievement and in-teraction of his or her peers

The use of assistive technology enhancesfunction and increases skills and opportunitiesThough a student may be dependent upon a par-ticular device in order to perform skillfully de-nying the device denies the student an opportu-nity ever to achieve success at the level of his orher potential

When is using assistive technology appropri-ate

Assistive technology may be considered ap-propriate when it does any or all of the follow-ing things

bull Enables an individual to perform functions

that can be achieved by no other means

bull Enables an individual to approximate nor-mal fluency rate or standardsmdasha level ofaccomplishment which could not beachieved by any other means

bull Provides access for participation in pro-grams or activities which otherwise wouldbe closed to the individual

bull Increases endurance or ability to persevereand complete tasks that otherwise are toolaborious to be attempted on a routine ba-sis

bull Enables an individual to concentrate onlearning or employment tasks rather thanmechanical tasks

bull Provides greater access to information

bull Supports normal social interactions withpeers and adults

bull Supports participation in the least restric-tive educational environment

SummaryAssistive technology means any device which

helps an individual with an impairment to per-form tasks of daily living There is a wide rangeof types of devices in assistive technology fromlow tech homemade aids to computers and so-phisticated electronic equipment Assistive tech-nology is one of the services which can be pro-vided in a special education program under theIndividuals with Disabilities Education Act(IDEA) The requirements of IDEA say that stu-dents who need assistive technology are entitledto the aids and devices and the assistive technol-ogy services (eg evaluation for assistive tech-nology and modification and maintenance ofequipment) that are necessary for the student tobenefit from a free appropriate public education

Hints for Parents

It is never too soon to consider using assistive tech-nology Some infants with physical disabilities for ex-

7

ample really benefit from early interaction with toysthat operate by switch Here are suggestions for timesto evaluate a child for assistive technology

bull When disability limits interaction with the envi-ronment and interferes with experiential learn-ing

Assistive technology can be used to providephysical access to the environment (egswitch toys floor scooters touch window)

bull When a significant gap exists between receptiveand expressive abilities

Assistive technology can assist with expres-sion through the use of programmableswitches electronic communication devicesvoiced word processing braille embossingand so forth

bull When an individualrsquos performance falls behindthat of his or her peers

If an individualrsquos handwriting for exampleis very slow laborious and difficult to readuse of a word processing device can be sub-stituted for handwriting thus allowing theindividual to keep up with others in termsof written expression

bull When a physical disability is impeding the edu-cationalvocational potential of an individual

Assistive technology can provide access tothe workplace for example by allowing anindividual who is blind to learn to use ascreen reader and voiced word processingto do clerical tasks that would otherwise beimpossible

bull When a disability is impeding the independenceof an individual

Sometimes assistive technology can be usedto allow a person with a disability to func-tion more independently For example hav-ing a power wheelchair allows an individualto travel independently without the neces-sity of having someone to push the wheel-chair

SaraSara who has Down syndrome is eight

years-old Her language and speech skills arethree years delayed but she has age appropriatesocial skills Sara has spent part of her schoolday in a regular classroom ever since kindergar-ten but this year her third grade teacher is sug-gesting that Sara really cannot keep up with herclassmates The teacher thinks that Sara wouldbe better off in a self-contained class with stu-dents who work at her pace Sara has some finemotor coordination problems and she has haddifficulty learning to write in cursive Her oralreading is hampered by her speech difficultiesHowever Sara has learned to do addition andsubtraction problems well and has mastered add-ing with carrying and subtraction with borrow-ing She reads at about a second grade level withreasonably good comprehension Sararsquos parentswould like to see her continue in the regular class-room for as much time as possible but they rec-ognize that Sararsquos writing and speaking problemsare keeping her from doing her best work

What are Sararsquos needs

What kinds of technology should go in SararsquosIEP

How would you make a case for puttingassistive technology into her IEP

8

Sararsquos SolutionSararsquos IEP Team met to discuss her needs and

concluded that she is doing well in a regular class-room setting she is making adequate progressin academic skills and has learned how to inter-act socially with her peers It is to be expectedthat Sara will have difficulty keeping up with thepace in a third grade but as long as she is mak-ing progress toward her individual goals theregular classroom is a good setting for her How-ever some simple accommodations and technol-ogy may help Sara to work faster and more effi-ciently

At this point Sara may need some assistancewith handwriting and speaking but the solutionsto her problems in these areas need not be com-plex ones The team decided that Sara shouldcontinue to practice cursive until she has mas-tered all the letters and can be more facile in us-ing script However while she is still learningcursive she needs other means for respondingin writing For short written responses the teamagreed that Sara should be encouraged to usemanuscript printing When speed is importantor when writing assignments are longer Sarashould have access to a computer with an adap-tive keyboard (eg IntelliKeys) The adaptivekeyboard is helpful for Sara because the ldquokeysrdquoare larger and easier to see Using the keyboardrequires only a very light touch so Sara finds iteasier to use than a standard computer keyboard

In terms of oral reading the team decided tohave Sara practice reading into a tape recorderHer speech therapist will work with her on slow-ing down her rate of speech and reading withexpression When Sara has a good tape of heroral reading she will submit it to her teacher forreview

Solution SummaryPractice cursiveUse manuscript printing for short assign-

ments

Use computer with adaptive keyboard forlonger assignments

Practice oral reading using a tape recorder

9

Making Assistive Technology Decisions

W hen parents learn about assistive tech-nology and the wonderful opportuni-ties it can provide they want to jump

right in and get the latest in technology for theirchildren Who wouldnrsquot want an augmentativecommunication device for a child who cannottalk What parents wouldnrsquot want to buy a com-puter if it would help their child learn

When the world of assistive technology opensup for parents it can be like entering a great toystoremdasheverything looks so wonderful that itmakes it hard to know what to select Choosingthe right device to meet an individualrsquos needsrequires technical knowledge and indepth under-standing of the individualrsquos functional capabili-ties Not only is the selection of a device madedifficult by the complexity of the equipment andthe demands of the individualrsquos impairmentassistive technology devices can be very expen-sive Making such purchases is a major financialcommitment for most families one that takes agreat deal of soul searching and sometimes sig-nificant sacrifice

Families invest more than money in theirchildrenrsquos assistive technology Practical invest-ments of time and effort and emotional invest-ments of hope and enthusiasm are made withevery assistive technology purchase Because ofthe high level of financial personal and emotionalcommitment family disappointment is greatwhen equipment fails to perform as expected

Buying and then not using a device becauseof dissatisfaction can be a devastating experiencefor all concerned That is why it is so importantfor parents to proceed cautiously into the worldof assistive technology and make purchases onlyafter careful evaluation and trials with the newdevice Following is a summary of some sug-gestions for parents to consider before makingany assistive technology purchase be realisticabout your childrsquos capabilities and needs get a

multidisciplinary evaluation examine availabletechnology with a critical eye match the childrsquosneeds to specific equipment features do not makea purchase until you have used the device for atrial period identify next steps and determinewhat needs to be done for follow-up after pur-chase

Guidelines for Making Assistive TechnologyDecisions

bull Be realistic about your childrsquos capabilitiesand needs

Assistive technology can open up excitingnew opportunities for a child but it is not magicThere are certain basic requirements for any in-dividual to be successful with technology and itis important to face these requirements squarelyThere is nothing more disappointing or discour-aging than purchasing expensive equipment fora child which is beyond his or her capabilities touse

Prerequisites for Computer Use Physicalor sensory impairments do not limit access tocomputers but cognition is a factor in computeroperation The major prerequisite for using acomputer (with or without adaptations) is thecognitive ability to understand cause and effectThe child must be able to understand that thecomputer operates (eg changes does some-thing) because the child has activated the equip-ment through some volitional movement or ac-tivity (eg eyebeam speaking puffing into astraw hitting a switch) Some children enjoyplaying with switches by hitting them randomlybut may not be able to connect their own behav-ior to the response their movement activates Inorder to be successful in interacting with a com-puter the user must be able to control some voli-tional activity and to do so consistently For ex-ample the child would have to be able to acti-vate the computer in response to a visual tactileor auditory prompt

10

Another prerequisite to computer use is theability to make conscious meaningful choicesbetween alternatives like yes and no The choicescan be very simple ones but there has to be evi-dence that the child has made an actual decisionand not merely acted randomly

If a child does not have the concept of causeand effect or cannot make consistent choices us-ing a computer is probably not a worthwhile nextstep at this point in the childrsquos developmentOther types of activities may be more appropri-ate less expensive and just as rewarding devel-opmentally and personally

Prerequisites for Augmentative Communi-cation Augmentative communication devicescan literally give voice to the thoughts of indi-viduals who cannot speak or cannot speak clearlybutmdashagainmdashthese devices are not magic Elec-tronic communication devices are of no valueunless the user has some communicative intentThat is for a communication device to be help-ful the user has to have some basic understand-ing of the communication process and must beintentional in expressing choices desires orneeds

For example Maggie is a four-year-old whois nonverbal She communicates her wants andneeds by using eyeblinks as responses to yes orno questions When Maggiersquos dad asks her if shewould like another glass of milk she indicatesher choice by raising her eyes up vertically foryes or moving her eyes down for no Maggieclearly knows what she wants to communicateshe has a consistent method for making herwishes known and she expects that her dad willunderstand her communication and act on it

Dan who is also nonverbal communicatesin a different way He points to objects and makesgestures to show what he wants or needs Hisgestures are clear and used consistently so thatfamily members and even people who do notknow Dan well can understand most of the timewhat he is communicating

Shelley communicates very basic informationabout how she feels by crying when she is un-comfortable or wants attention and by laughingwhen she enjoys something like music brightlights or water running Shelley does not how-ever respond to yes or no questions She doesnot make choices even when objects are pre-sented to her individually or in pairs She can-not respond to a question like ldquoDo you want someice cream nowrdquo Or ldquoWould you like the teddybear or the dollrdquo

Maggie and Dan may benefit from usingsome communication device because they arealready using communication systems meaning-fully and consistently Shelley however mayneed to develop greater ability to communicatemeaningfully before moving on to electroniccommunication

Communication skills fall along a continuumAt one end of the continuum are very simplecommunications like expressing preferences byindicating yes or no pointing or gesturing towardobjects or pointing to pictures Use of sign is amore complex form of communication becauseit requires that the user understand that the signsare symbols for meaningful communicationsWhen an individual is able to string togethersigns or words into meaningful phrases this isan additional step toward more complex com-munication When a person understands syntaxand is aware of typical word order this is anotherstep forward Each of these advances along thecommunication continuum represents a step to-ward more complex and sophisticated commu-nication Whatever assistive communicationdevice is chosen should match or just slightlyexceed the place on the continuum where the in-dividual is functioning It makes no sense forexample to purchase an elaborate electronic com-munication device that requires understandingsymbols and syntax when the individual usingthe device is just at the point of learning how toexpress yes and no preferences

An electronic device does not teach commu-

11

nication it enhances communication by givingaudible expression to thoughts that already existin the mind of the user If the thoughts are notthere yet or are not completely formed they can-not be expressed by the device

Physical and Sensory Impairments Are NotBarriers Mastery of a few simple prerequisiteskills is necessary before computers or electroniccommunication devices should be consideredbut it is not necessary for a child to master everydevelopmental milestone before entering theworld of assistive technology Physical or sensoryimpairments can often be circumvented by thetechnology itself and typical developmentalmilestones can sometimes be bypassed so thatassistive technology can be used For examplesome educators assume that students cannot usecomputers until they have completely masteredkeyboarding skills This is a false assumptionMany students benefit from using computerseven though they operate the machine using aldquohunt and peckrdquo method or only one or two keysIn a similar fashion students with limited verbalability who have not mastered oral speech ben-efit from using augmentative communicationdevices while they continue to develop oral lan-guage

Overall the keys to knowing when to tryassistive technology are (a) being realistic aboutthe childrsquos cognitive abilities and potential and(b) being open to trying the level of technology

which meets the child where he or she is

bull Get a multidisciplinary evaluation

Evaluations for assistive technology are notalways easy to arrange In many parts of theUnited States there is no convenient center orldquoplacerdquo to go for an assessment The availablecenters may be far away in another city or evenanother state Since assistive technology is a newfield the systems for disseminating informationand providing assistance are in the process ofevolving Parents may have to be ldquoassistive tech-nology detectivesrdquo in order to put together theinformation needed for a complete AT evalua-tion for their child

The place to start the evaluation is by consid-ering the functions the child needs to performand cannot because of impairment The physi-cians teachers and therapists currently workingwith the child as well as family members andfriends who are around the child on a daily ba-sis can provide very valuable information aboutfunctional problems and potential solutions

Finding Functional Solutions The Alliancefor Technology Access (ATA) a national networkof assistive technology centers has developed aninformal method for using the functional infor-mation available from professionals family mem-bers and friends as a basis for analyzing assistivetechnology needs This process called a Solu-tion Circle is a means to bring people togetherin an informal session that allows for creative

figure 2 Factors to consider when selecting Assistive T echnology

Cognitive Factorsbull Diminished Cognitive Abilitiesbull Learning Disabilitiesbull Attention Deficitsbull SensoryPerceptual Deficitsbull Memory Deficitsbull Abstract Reasoning Deficitsbull Problem-Solving Deficits

Motor Factorsbull Voluntary Motor Deficitsbull Involuntary Motor Deficitsbull Fixed Posture amp Positioning Deficitsbull Recurring Purposeless Motionbull Motor Paralysisbull Low Muscle Tonebull Rigiditybull Spasticitybull Tremors

12

thinking and is not inhibited by what is ldquolegalrdquoldquocurrently availablerdquo or ldquowhat has been done be-forerdquo The individual with a disability and 4-10family members professionals and friends gettogether to brainstorm ideas about the technol-ogy which may help the individual perform func-tions that are hard or impossible to do becauseof disability The Circle usually includes a bal-ance between people who know the person whoneeds the technology and people who have spe-cialized knowledge about technology educationor work-related issues

Solution Circle for Tom To demonstratehow the Solution Circle works letrsquos take a lookat how this process was used in the case of Toma high school student with a learning disabilityFor Tom the print in textbooks is a significantbarrier to learning Tom is ldquoprint disabledrdquo thatis he cannot read the printed word with muchcomprehension Reading is a slow unproductiveprocess for him even though he is intelligent andeager to learn Tom and his parents were hopingthat there might be a way that new technologycould help Tom overcome or work around hisproblem with reading so that he could get moreout of school and perhaps go on to college

Tomrsquos Solution Circle included his parentsBetty and Bob his resource teacher a friendDarrell his soccer coach his 4-H leader and theowner of a local computer store This group mettogether to think about how Tom could partici-pate more fully in school and prepare himself forcollege even though he could not read with com-prehension past the second or third grade level

Solution Circles generally take 1 to 1 12 hoursto complete The steps include the following

1 Star Time The individual for whom theSolution Circle is being held is described in a ho-listic way The emphasis is on how the individualis functioning at home and in the communityWhat does he or she like and dislike What arehisher goals Interests If possible the indi-vidual with a disability speaks for himself or her-self or a video or pictures may be presented The

point of this part of the discussion is give a clearpicture of the individual as a whole person

At Tomrsquos Solution Circle he explained hisdream of going to college and becoming an agri-cultural botanist Tom loves plants he is inter-ested in breeding new strains of wheat and per-fecting various types of grain crops Tomrsquos 4-Hleader agreed that Tom had real gifts in under-standing plant growth and physiology and thathe already had sophisticated knowledge aboutbotany which would prepare him well for col-lege study

2 Strengths With a complete picture of theindividual in mind the group then makes an ex-haustive list of the individualrsquos strengths particu-larly noting any technological accommodationswhich the individual is already using What doesthe individual do well What are his or her un-impaired functions Often this discussion revealsan incredible number of adaptations that the in-dividual has already achieved

Tomrsquos Solution Circle discovered that he hadmany strengths including keen intelligence per-severance and thoroughness when approachinga task Tom already had some effective learningstrategies for remembering material that heheard He had also learned to use a small taperecorder for keeping track of information pro-vided in class

3 Obstacles With the individualrsquos strengthsin mind the group then turns its attention to aconsideration of the environment in which theindividual is functioning and the activities inwhich the individual wants to participate butcannot at this time The group considers whatthe obstacles and barriers might be for the indi-vidual in his or her environment and makes alist of these impediments

For Tom reading was a serious obstacle Hecould not keep up with homework assignmentsbecause it took him so long to read his textbooksIn addition he had difficulty reading directionson tests and often misread assignments on the

13

COGNITIVE FACTORSCognitive Ability

Documented below average abilityDocumented significant overall delayDoes not appear age appropriateLacks understanding of cause amp ef-

fectPaying Attention

Difficulty following prompts or direc-tions

Difficulty with multi-step proceduresDifficulty filtering informationDifficulty staying on task

PerceptionNeeds lengthened response timeRequires multi-sensory inputDifficulty with rapid changeSignificant visualperceptual problemsSlow visual-motor dexterity

MemoryDifficulty with recallRequires reteaching learned skillsRequires repeated practice

Abstract ReasoningDifficulty analyzing simple proceduresUnable to reproduce a sequenceUnable to analyze or synthesize in-

formationProblem Solving

Unable to use prompts or cues to ac-complish tasks

Unable to modify attempts and try an-other way

MOTOR FACTORSMobility

Needs help to be mobileNeeds motorized help to be indepen-

dentNeeds help boarding transportationUnable to transfer independentlyCannot climb stairsCannot open doors independentlyCannot carry materials in hands or

armsCannot lift weight

Voluntary MotorLimited control of head trunk or ex-

tremitiesVisual motor deficitsFixed position and posture

figure 3 ASSISTIVE TECHNOLOGY EVALUATIONIndividual Functional Analysis

Name Date

Needs support to sit or standNeeds adaptations in order to use

technologyMotor Paralysis

Changes in muscle tone interfere inmotor movements

Spastic movements result in poor con-trol

Limited movement of head arms orlegs

Difficulty balancing in sitting positionDifficulty maintaining good posture

Low Muscle ToneLimited use of arms or legsPoor posture controlFatigues quickly

RigidityInhibits arm and leg movementInhibits balance to sitInhibits good posture

SpasticityLimited upper range of motionLimited lower range of motionInterferes with accuracy and consis-

tency of motor movements on oneside

TremorsPresent all the timePresent when doing purposeful upper

extremity taskUnable to compensate for tremors

Extraneous MovementAthetoid (constant)Ataxia (poor coordination in move-

ment)FINE MOTOR

DexterityLimited fine motor controlHas limited hand movement

HandwritingWriting or copying ability is signifi-

cantly below peersSignificant legibility factor--written

work not readableCannot keep up with the pace of writ-

ten workIs frustrated by writingFatigue is a factorTyping appears to be potentially faster

than handwriting

SELF CARENeeds assistance with going to the

bathroomUnable to be toilet trainedNeeds assistance to eatCannot take in food orallyNeeds suctioning routinelyHas degenerative medical conditionIs medically fragileSeizures limit alertnessNeeds to rest frequentlyNeeds assistance to zip coat or tie

shoesCOMMUNICATION

Receptive LanguageReceptive language is significantly

lower than abilityReceptive language is significantly

higher than expressiveExpressive Language

Speech is unintelligibleExpressive language is significantly

lower than abilityMean Length of Utterance (MLU) is 3

words or lessSpontaneous or self initiated language

is significantly limitedDoes not make choices consistentlyDoes not respond appropriately with

yes or noDoes not have communicative intent

SENSORYVision

Requires corrective lensesRequires large print to readRequires mobility trainingHas blind spot

HearingRequires preferential seatingHearing limitations affect the language

thresholdsRequires assistance to receive lan-

guageRequires sign language to receive lan-

guageHas fluctuating hearing lossNeeds visual signals for safety pur-

poses

14

blackboard

4 The Enemy Within Physical and cogni-tive impairments may pose difficult obstacles foran individual but often the feelings that peoplehave about the individualrsquos disability or aboutassistive technology pose greater problems thanthe disabilities themselves The Solution Circleprocess recognizes that human fears concernsreservations and prejudices might stand in theway of a personrsquos success as much as other typesof limitations Getting these fears and concernsout on the table often helps the group to deal moreconstructively with what is possible and whatneeds to be done

One of the serious issues in Tomrsquos situationwas that his resource teacher felt he should con-tinue to try to read for himself instead of using aldquocrutchrdquo like assistive technology The teacherthought that if Tom did not have to read all thematerial he would lose what little reading skillhe had In some ways the teacherrsquos oppositionto considering assistive technology actually poseda greater barrier than the reading problem itself

5 Solutions The exciting part of a SolutionCircle occurs when the group takes each obstacleor concern and turns it into a possible solutionthrough the use of technology or some other typeof adaptation Not all solutions suggested even-tually prove to be feasible but the point of thediscussion is to produce many possible solutionsso that the individual and his or her family havean array of options from which to choose Withgood minds puzzling over the problems and aspirit of cooperation and collaboration seeminglyimpossible barriers can be removed or conqueredThe process recognizes the expertise and contri-butions of all participants including the indi-vidual with disabilities and his or her familymembers The freewheeling format of the dis-cussion promotes ingenuity and innovation Allinvolved come away from a Solution Circle ener-gized by the new possibilities

Tomrsquos Solution Circle became excited about

the possibility of solving his reading problem byusing computerized texts The computer storeoperator mentioned he had heard that Record-ings for the Blind (RFB) offered textbooks on diskTomrsquos parents got in touch with Recordings forthe Blind and ordered texts for Tom to try on hiscomputer at school Soon Tom found that hecould keep up with his classmates and study ex-actly the same material that they were coveringBecause Tom had good strategies for memoriz-ing information that he heard he learned quicklyfrom the texts that were read aloud to him by thecomputer When given oral tests by his classroomteachers he was able to recite appropriate an-swers which would have eluded him if he hadhad to read the tests for himself

Technology has made all the difference forTom he has every reason to think that he will beable to go to college and pursue his intellectualinterests His resource teacher is now completelysold on the idea of assistive technology and us-ing computerized books and wants to use thetechnique with other students More than thatTomrsquos teacher also appreciates the process of theSolution Circle which allowed professionals andnonprofessionals to work together to find prac-tical solutions without being too concerned aboutthe formalities of the special education processThe informal nature of the Solution Circle vali-dated the expertise of all the participants andgave everyone a chance to offer suggestions Thecombination of a new process for planning andnew technology made Tom a winner This samecombination holds potential for many studentslike Tom who benefit from technologies whicheliminate barriers and open up new possibilitiesfor learning

From Function to Technology Solution Ithappened that a participant in Tomrsquos SolutionCircle hit on a great idea for a solution to his func-tional problem with reading This was a fortu-nate connection to make At the suggestions ofhis Solution Circle Tom began to use computer-ized books which he ldquoreadsrdquo by having the com-

15

puter speak the words as he follows along withthe text For Tom computerized books proved tobe a successful solution to his reading problembecause they help him to get the information heneeds without struggling with the reading pro-cess

Not every Solution Circle will be like Tomrsquosand identify the exact technology that the indi-vidual needs But if a Solution Circle has workedwell the end result will be a clear analysis of thefunctions that need to be performed This func-tional information can then be brought to techni-cians who can make suggestions for possibleassistive technology solutions There are over 50assistive technology centers in the United Stateswhere knowledgeable individuals can assistpeople with disabilities and their families withmaking a match between functions that need tobe performed and the technology that is availableto perform those tasks A list of assistive technol-ogy centers is available in the Appendix to thisGuide

Formal Assessment Solution Circles are aneffective informal way to identify functionalneeds that can be met through technology How-ever in the school setting it is also necessary toestablish a studentrsquos needs for technology in amore formal way Formal evaluations for assistivetechnology must be multi-disciplinary involvingeducators and therapists who are knowledgeableabout the school curriculum and the particulartypes of impairments that the student being as-sessed may have For example for a student withcerebral palsy the assistive technology evaluationmight involve a teacher a physical therapist aspeech and language clinician and an occupa-tional therapist The teacher would assist thetherapists in determining what skills the studentneeded to learn and how technology might assistthe student in acquiring those skills Someassistive technology evaluations might require theadditional services of an A-V technician adap-tive physical education teacher a rehabilitationcounselor or speech and language pathologist

with specialized training in augmentative com-munication In school districts where there is nospecialized expertise in technology and its appli-cations it may be necessary to contract for evalu-ations with special education cooperatives medi-cal centers or centers that focus on technologyassessment

Individuals conducting an assistive technol-ogy evaluation should

bull Be knowledgeable of the studentrsquosstrengths and weaknesses medical needsmobility fine and gross motor skills cog-nitive ability communication abilities vo-cational potential self help needs sensoryabilities level of academic achievementand area(s) of disability

bull Have knowledge of and access to an arrayof assistive technology devices

bull Be familiar with the studentrsquos educationalsetting and educational needs

bull Be able to communicate effectively withparents and educators

Because the assistive technology field is sonew there are no particular licenses orcredentialing processes to identify a professionalas qualified to do assistive technology evalua-tions Generally speaking individuals with pro-fessional licenses as occupational or physicaltherapists special educators speech pathologistsor rehabilitative counselors may have the exper-tise to conduct an AT evaluation When consid-ering an evaluator it is wise to ask about theevaluatorrsquos specific experience with assistivetechnology It is also important to recognize thatno one person or discipline will know everythingabout assistive technology therefore access toknowledgeable people at the local level andthrough other agencies programs or services isessential

Conducting the AT Evaluation The assistivetechnology evaluation must be tailored to theunique needs of the student In some cases theevaluation may be conducted by at team of indi-

16

viduals in other cases the evaluation may beconducted by a single individual (eg the speechpathologist) Questions to be addressed duringthe assessment should be related to the specifictasks the student needs to be able to perform andwhat if any assistive technology would helpThe following questions may be considered dur-ing the assessment

bull What tasks does the student need to per-form that he or she cannot perform

bull Is there a low tech device which will ad-dress the studentrsquos needs satisfactorily

bull What types of high tech assistive devicesmay help the student in performing thetask

bull Will assistive technology help the studentto perform the task in the least restrictiveenvironment

bull Is the device being considered suited to thestudentrsquos educational needs and abilities

bull Will the assistive technology device remainsuitable over time How long lasting willthis solution potentially be

The above are only a few of the considerationswhich need to be addressed as part of the evalu-ation process There is no specific ldquotestrdquo forevaluating the need for assistive technologyTherefore prior to conducting the evaluation theindividuals doing the assessment need to have awell planned process in mind

The formal written assistive technologyevaluation report should address but not belimited to the following points

bull Procedures used to evaluate the student

bull Instruments employed in the evaluationassuring that a range of levels of technolo-gies has been considered

bull Results of evaluations including bothqualitative and quantitative measures

bull Recommendations for levels of technologyappropriate to the studentrsquos capabilitiesand potentials and

bull Implications for educational program-ming including discussion of both indi-vidual technology needs and recom-mended environmental and instructionalmodifications

In the end an assistive technology evaluationshould provide recommendations for accommo-dations adaptations devices and services basedon the individualrsquos strengths needs and pre-ferred lifestyle The evaluation should indicate(a) whether devices and services have potentialfor improving function and (b) what trainingmay be necessary in order to use the technologyequipment safely and effectively

bull Examine available technology with a criti-cal eye

It is easy to be dazzled by the possibilities innew assistive technology but it is important forparents to be wise consumers and ask probingquestions about the features and quality of anassistive technology device The following is alist of questions to consider when evaluating aparticular assistive technology device

Performance

Does it work efficiently and effectively

Is it easy to learn to use this device

Is it compatible with other devices

Does this device serve only one purposeor is it flexible

ldquoElegancerdquo

Does this device represent the simplestmost efficient way to accomplish the task

Or is this device too elaborate too com-plicated to be worthwhile

Ergonomics

Does it fit the individual

Is it convenient to use in the environment

Is the equipment portable enough to gowhere the user goes

Are different devices needed in differentenvironments

17

Reliability

What is the manufacturerrsquos reputation forreliability

Does it stand up well to normal use

Is it durable

Safety

Is it safe to use

What is the power source for the deviceIs it safe

Is a margin built in for foreseeable mis-use

Practicality

Do company sales people seem knowl-edgeable and helpful

Are the companyrsquos service people knowl-edgeable and helpful

Does the device have a warranty Howlong is the device guaranteed to function

How available are repair services Atwhat cost

Can this device be leased

Is this device available for a trial periodbefore purchase

Will this device soon be outdated Issomething better on the horizon

Will the company update the device

Does the manufacturer provide trainingin using the device

Aesthetics

Is this device attractive to the eye

Does the device fit well into the userrsquoslifestyle

Normalization

Does the device assist the user with morenormalized living

Can the user operate the device indepen-dently or with a minimum of assistance

Or does the device ldquostick outrdquo too muchand advertise the disability of the user

Does the equipment minimize differenceor exaggerate difference

Does the device have the potential to in-crease the quantity and quality of time spentwith nondisabled peers Or does the de-vice separate the user from others

Cost effectiveness

Do the benefits the device provides jus-tify the cost

Are there less expensive devices or mod-els that serve the purpose as well

Personal acceptance

Is this device the userrsquos own choice

Does the potential user like this deviceand want to use it

Does the potential user view this deviceas life-enhancing

Would the user have preferred some otherdevice or means to perform the task

Will using the device always be a choreor can using it become a habit

There are several ways that consumers canfind answers to their specific questions aboutassistive technology devices Most vendors willprovide good basic information about the prod-uct Call the vendor and ask for brochures prod-uct specifications price list and any other writ-ten information This is a place to start A sec-ond step is to read reviews of the product in trademagazines or Closing the Gap a widely respectedpublication that reviews new assistive technol-ogy products If possible it is very helpful totalk to other consumers who are already usingthe product Ask them about the pros and consof using the device Then visit a preview centerif there is one nearby and try out several typesof devices Ask for general recommendationsfrom the preview centerrsquos staff After identify-ing a device that appears to meet the potentialuserrsquos needs try the device out for a month tosix weeks to make sure that it performs as adver-tised and fits in well with the userrsquos lifestyle

18

During the trial period it will be possible to iden-tify training needs for the user family membersand school staff The trial period will also be atime for the user to test the device in several set-tings to determine its portability and flexibility

bull Match the Individualrsquos Needs to SpecificEquipment Features

When considering an assistive technologydevice it is very important to consider how adevice matches up with the particularindividualrsquos needs and habits In some ways anassistive device becomes an extension of theuserrsquos mind and body As such it is a highly per-sonal item A device may work as advertisedbut still not meet an individualrsquos needs becausethe individual just does not feel ldquocomfortablerdquo inusing it For example Cindy a fourteen-year-oldwho is totally blind and has mild cerebral palsyaffecting her hands and arms was being taughtMorse Code as a means to speed up her writingShe had difficulty using a Brailler because her armstrength was so limited so her teacher thoughtMorse Code would be an easier method of writ-ing for Cindy The only problem was that Cindydid not like using Morse Code To her it seemedlike she was having to learn another complicatedlanguage when she already knew braille andliked to use it Cindy admitted that writing inbraille was slow for her but she was more com-fortable with it Cindy and her teacher were atan impasse until a friend suggested to Cindy thatshe try writing on a voice-output computerCindy loved the computer With a headset at-tached to the sound system she could listen care-fully to the computer as it read aloud the lettersand words she was typing on a light touch tac-tile-marked keyboard This computer also had afeature of printing out text in either standard printor braille Cindy was delightedmdashshe could writecopy for herself to read in braille and for hersighted teachers to read in regular print Thissolution worked because it met Cindyrsquos learningneeds and responded to her own ideas about her-self She did not want to use Morse Code because

it was a separate type of communication knownonly to a few With her computer voiced soft-ware and dual printer she had the best of twoworldsmdashshe could ldquohearrdquo her writing as shetyped she could read it over in braille and hersighted teachers could read her finished prod-uct This solution helped Cindy to improve hercomposition skills speed up her writing timeand communicate more easily with sightedpeople

Cindy was fortunate because her assistivetechnology solution met her needs almost per-fectly Such a close match is not however al-ways possible Nonetheless every effort shouldbe made to have the match be as close as it canbe In general when assistive technology solu-tions are individualized simple to use and re-sponsive to the whole person they are more likelyto be used by the individual When the deviceperforms a task well but does not ldquofitrdquo the indi-vidual the technology is likely to be abandonedby the user in favor of something else whichmeets the need more exactly Too often devicesare purchased because of their technical poten-tial without thought to their relationship to theindividual and his or her lifestyle These mis-matched devices are the ones that end up lan-guishing in their packing boxesmdasha sad reminderof time and money spent to no avail

bull Try the Device Before Buying

It cannot be emphasized enough how vital itis to try out assistive technology devices andequipment before buying Trying out a devicefor several weeks provides the user with an op-portunity to learn how to use the device and howto adapt to its features while at the same timetesting the device in the various environmentswhere it will be used For example Mike triedout a communication device which attachednicely to his wheelchair tray and was compat-ible with his computer that he used for doingschool work Though the communication deviceworked well and was relatively easy to program

19

MOTORSELF CARE

manual wheelchairpower wheelchairbus liftsupportive classroom

chairstanderwalkerlift for transferspositioning devicecanes or crutchesadapted commodesuctioning devicebraces or supportsother ____________

________________

________________

________________

________________

________________

________________

________________

________________

________________

________________

________________

figure 4 ASSISTIVE TECHNOLOGY EVALUATION

Device or Equipment Features or Functions

Name Date

FINE MOTOR

word processorword processor with

predictionvoiced word proces-

sor with predictionadapted keyboardkeyguardalternative key

arrangementvoice activated

computer accessinfrared computer

accessmouse accesstrackballjoystickpower padswitch (eg mouth

lip chin)touch screenpointersdrag and click desk

accessorysticky keysonscreen keyboardprinter for written

work

adapted feedingutensils

braces or splintsother ____________

________________

________________

COGNITIVECOMMU-NICATION

communciationboard(s)

communication wallettotal communicationmanual signword processor with

voiceprogrammed voice

outputicon predictionelectronic communi-

cation deviceprogrammable switch

with voice output

no-reading-neces-sary word proces-sor

spell checkergrammar checkeroutlining programother ____________

________________

________________

________________

________________

________________

________________

________________

SENSORYPERCEP-TUAL

hearing aid(s)

classroom amplifica-tion

boosted signal tonoise ratio (egheadset to keepfocus during wordprocessing)

corrective lensesenlarged printtaped booksvoiced word process-

ingvoiced screen

directionsCCTVother ____________

________________

________________

________________

________________

________________

________________

________________

________________

________________

________________

20

Mike found out quickly that the device was justtoo bulky to be useful for him When he trav-eled around the school the communication de-vice blocked his view of the terrain and of peoplepassing by He found he missed opportunitiesto communicate because he could not see whowas coming his way Mike also discovered thatthe communication device did not serve him wellin crowds like at pep rallies or basketball gamesAfter a month of working with this communica-tion device Mike decided it was not for him andselected instead a device that was less compli-cated smaller and more portable The seconddevice was not as sophisticated as the first but itbetter met his needs for quick communicationwith friends in social settings If he had not hadthe opportunity to try out both devices for anextended period of time Mike might not haverealized the value of the second device and mayhave been stuck with a communication devicethat was too large and too sophisticated to matchhis lifestyle

Similarly Marilyn benefited from a trial pe-riod with her communication device She foundout the first week that the particular device shehad chosen would not work for her because itbroke too easily and it was difficult to get re-paired During the first week that Marilyn hadthe device for trial her teacher broke one of thebuttons during a programming session It tooktwo weeks to contact the manufacturer and thenthe device had to be mailed back to the factoryfor repairs The device was gone for over sixweeks and the manufacturer would not supplya ldquoloanerrdquo while Marilyn waited for repairs tothe first device This experience taught Marilynthe importance of having a responsive manufac-turer who is willing to repair devices quickly andto supply substitutes for the user while repairsare being made Marilyn decided on a differentdevice with similar features and a great helplineto provide assistance with the maintenance of themachine

The information that can be learned during a

trial period with a device is invaluable to the userIt is discouraging to find out during the trial thata device is not all it is purported to be or that itdoes not work as well as advertised but it is farbetter to learn before purchase that a device doesnot meet the userrsquos needs than to learn after pur-chase and be stuck with an expensive unusablemachine For the consumer it is daunting to thinkabout starting over again with the process of se-lecting a device Nonetheless it is worthwhileto seek more information and look again Hav-ing been through a trial even when the outcomeis not successful provides the user with greaterclarity about what an appropriate device willhave to be able to do The second time aroundthe search is likely to go faster and come out witha better result

bull Identify Next Steps

Once a device has been selected the con-sumer becomes impatient to have one and beginusing it right away But at this point importantwork still needs to be done Funding the deviceis a major consideration Sometimes families willpay for the device themselves but under othercircumstances the device will be purchased by aschool district through Medicaid or private in-surance or through some other means Parentsneed to become familiar with the various fund-ing options and determine which one will workfor them (See Funding Assistive Technology foradditional information about funding sources)

Also when considering funding familiesshould think about costs beyond the price of thedevice itself For example a computer set-upwith a keyboard monitor and printer might cost$3500 This equipment is basically useless un-less other equipment is purchased as well soft-ware adaptive devices paper manuals up-grades Prices for these additions can raise theactual cost of the device by hundreds of dollars

Devices often require training for the userfamily members and others to ensure effectiveand safe use How much does training cost Who

21

will provide it Repair and maintenance are othercosts usually additional to the price of the equip-ment Sometimes families will also want to insurethe assistive device so insurance payments be-come part of the overall cost

Since making an assistive technology pur-chase is such an important personal and finan-cial decision it is wise to have a realistic budgetin mind that includes all of the equipment andservices that are necessary to make the assistivetechnology work effectively With this budget inmind it becomes easier to plan the purchase seekout funding sources and make a compelling casefor financial assistance

bull Determine What Follow-up Is Needed

After the assistive technology device has beenpurchased and put to use there are additionalfollow-up activities that need to take place Theoriginal assistive technology evaluation shouldinclude a way to monitor the use of the devicePeriodic scheduled reviews the by evaluator fol-low-up calls to and from the family are some waysto help assure effective safe use Families whotravel great distances for evaluation need to becertain that services like maintenance repair andreplacement of devices are available within a rea-sonable distance from home

Assistive technology devices are used bestwhen all the people in the life of the individualwith disabilities understand the devices in thesame way At first devices may seem to exagger-ate differences between a person and the rest ofthe world Care should be taken to explain thatassistive equipment is a difference equalizer nota difference maker Classmates and friends needto understand that the adapted seating or adaptedkeyboard helps the individual do what other stu-dents do Adults in a childrsquos life need to under-stand that devices work to make life easier bet-ter and more functional People need to knowthat ramps help keep individuals with mobilitydisabilities from being separated from peers thatcommunication technology allows people to

ldquospeakrdquo their thoughts

Close communication between parents andtheir childrsquos helpersmdashteachers therapists daycare workers and othersmdashis essential to makesure devices and services are being used safelyand effectively If the device is working well butthe child is not being integrated into the class-room or other environments then there may bea need for additional training for the children andadults who interact with the child

Besides keeping track of how the device isworking and being used it is important to ob-serve progress in the areas of technology whichare useful to the individual with the assistivetechnology device As upgrades of equipmentoccur or more sophisticated models come on themarket the user may want to consider modify-ing or replacing the equipment that is currentlyin use Also as the individual becomes moreskilled at using technology the individual mayoutgrow the current device and need to look formore advanced equipment It can be assumedwith most high tech items that in three to fiveyears there will be a need for upgrade or replace-ment The wise consumer begins early to planfor the next step in technology including savingmoney for a new device and staying alert to thenew options that become available

What kinds of training are important to occurwhen a child has a new assistive technologydevice

Because assistive technology of the high techvariety is so new it is particularly important thattraining be provided to all those who may needit In the school setting it is helpful for all edu-cators and administrators to have some aware-ness training so that they have a general idea ofwhat assistive technology is Areas to be cov-ered in inservice training might include

bull legal issues related to assistive technology

bull awareness training concerning how toserve students with assistive technologyneeds

22

bull information on how assistive technologyrelates to the evaluation process

bull how to write IEPs for students who requireuse of assistive technology devices

bull the relationship between technology andstudent placement

bull the nature of common assistive technologydevices

bull resources to contact for information onassistive technology

Beyond these awareness activities thosemembers of the school staff who work directlywith a student who uses technology need to havetraining on the specifics of using the device andhow it is maintained and serviced Trainingshould include but not be limited to the follow-ing

bull review of the studentrsquos educational andassistive technology needs

bull review of goals and objectives supplemen-tary aids and services and related serviceson the IEP or IFSP

bull training on how to use and maintain thedevice

bull training on proper transport of the devicewithin the school building and from hometo school

bull training on how to program the device ifneeded

bull training on how to use the device effec-tively during instruction

bull training in trouble-shooting when the de-vice is not working properly

bull information about what to do when thedevice is not functioning or broken

bull information about how to coordinateassistive technology with all the activitiesin the studentrsquos day

bull training in methods to evaluate the effec-tiveness of assistive technology

Depending on the type of assistive technol-

ogy used by the student and the studentrsquos needsit may be advantageous for assistive technologyinformation to be shared with the studentrsquos peersSuch training will help fellow students to gainan understanding of the studentrsquos assistive de-vice foster acceptance in the social environmentand reduce fears other students may have aboutsocializing with the student who uses technol-ogy In some cases parents and the student maywant to be involved in the peer training

Parents may require training too in order forthe device to be used at home for the student tocomplete homework assignments or participatein extended school year services Once trainedthe parents can become a resource to the studentfor proper care and maintenance of the device

Most importantly the student himself or her-self will need training in how to use the deviceas independently as possible Training for thestudent may be written into the IEP as a separategoal or may be included as a related service thatsupports the studentrsquos special education pro-gram

SummaryPurchasing a high tech assistive technology

device is a major life decision because of the po-tential impact on the individual and because suchdevices can be costly When considering anassistive technology device it is important to dothe following be realistic about the consumerrsquoscapabilities and needs get a multidisciplinaryevaluation examine available technology with acritical eye match the individualrsquos needs to spe-cific equipment features test the device for a trialperiod identify next steps and determine whatneeds to be done for follow-up after purchaseEvaluations for assistive technology both infor-mal and formal should consider first of all thefunctions that the consumer wishes to performusing technology When evaluating a particularpiece of equipment consideration should begiven to the following features performance sim-

23

plicity of design ergonomics reliability safetypracticality aesthetics normalization cost effec-tiveness and personal acceptance Good sourcesof information about assistive devices are manu-facturers publications trade journals previewcenters and consumers who are already using thedevice Once a device is selected the consumerwill need to secure funding for the purchase andbe aware of additional costs for related equip-ment insurance and training

Hints for Parents

Donrsquot let the cost of assistive technology deter youfrom considering it for your child High tech assistivetechnology can be quite costly but it can also makethe difference for your child in terms of becoming welleducated employable and a fully-included member ofthe community Donrsquot leave any stone unturned whenlooking for funding sources Consider any or all ofthe following for funding or assistance

bull Early intervention programs

bull Schools

bull Transition programs

bull Vocational Rehabilitation

bull State Programs for Children with SpecialHealth Care Needs

bull Medicaid

bull Medicare

bull State Technology Resources

bull Used Equipment

bull Leasing

bull Equipment Loan Programs

bull Disability Organizations

SierraSierra wants to play with dolls like other chil-

dren her age but she has a muscle disease thathas caused her to lose muscle tone except in onehand What could be done to allow Sierra to dressand undress her dolls comb their hair and bathethem

Sierrarsquos SolutionThe assistive technology solution for Sierra

involved her whole family While vacationingin Mexico Sierrarsquos grandmother found her a fash-ion doll that was a bit larger than the typicalldquoBarbie dollrdquo The larger doll was easier for Si-erra to manipulate Sierrarsquos mother sewed sev-eral outfits for the doll using velcro instead ofsnaps or buttons as fasteners

Sierrarsquos dad bought doll stands at a toy storeand fastened several stands with clamps toSierrarsquos wheelchair tray He also fastened a plas-tic pouch to the tray Sierra puts the small dollaccessories in the pouch When Sierra wants todress her doll she puts the doll in one of thestands In this way the doll is held securely andSierra can dress and undress the doll with onehand

Sierrarsquos friends also use the doll stands fortheir dolls With this arrangement two or threegirls can play together

Solution SummaryLarger doll

Velcro fasteners

Plastic pouch

Doll stands

Clamps

24

Funding Assistive Technology

F unding for assistive technology is availablefrom a variety of public and privatesources To receive public or private fund-

ing the individual must meet eligibility criteriafor the specific program and provide sufficientdocumentation of the need for assistive technol-ogy

The following list includes some of the pro-grams which may pay for equipment if the indi-vidual needing the device meets their require-ments Many of these programs are run by dif-ferent agencies in different states making themhard to find In general the statersquos Tech Act of-fice can assist consumers and family members infinding and using these programs (See Appen-dix under Resources)

PUBLIC PROGRAMSEarly Intervention Programs (Individuals withDisabilities Education Act Part H)

Young children (0-3) and their families mayreceive help through early intervention programsin evaluating what the child needs in gettingassistive technology and in learning how to useit Equipment and services must be included ina written plan called an Individualized FamilyService Plan (IFSP) To find the program for aparticular state call National Early ChildhoodTechnical Assistance System (NECTAS) at 919-962-2001 or 919-966-4041 (TDD)

Head StartThis child development program provides

comprehensive educational and health servicesfor eligible children ages 3-5 Since 1982 federallaw has required that at least 10 percent of thetotal number of placements must be available tochildren who are disabled and require specialservices Head Start is a mainstream placementoption for children whose IEP calls for placementwith nondisabled children The January 1993Head Start regulations specifically require the

consideration of assistive technology services anddevices For more information contact NationalHead Start Association 201 N Union St Suite320 Alexandria VA 22314 703-739-0875

Schools (IDEA Part B)This program mandates a free appropriate

public education for preschoolers children andyouth with disabilities An Individualized Edu-cation Program (IEP) is required for all childrenwith a disability These children are entitled tospecial education related services or supplemen-tary aids If the IEP team determines that assistivetechnology is required for a free appropriatepublic education then it must be provided at nocost to the child The technology must be in-cluded in the childrsquos Individualized EducationProgram (IEP) Parents have a right to be in-volved and should help to develop the IEP goalswhich may include technology For help in get-ting assistive technology in the IEP call the TAPPFocus Center on Assistive Technology at 1-800-222-7585

State Operated and Supported Schools (Chap-ter I)

This program provides federal assistance tohelp educate children with disabilities who areenrolled in state-operated and state-supportedprograms Federal funds must be used to payfor services that supplement a childrsquos basic spe-cial education program such as construction andthe purchase of equipment For more informa-tion contact your State Department of Education

Section 504 of the Rehabilitation Act of 1973Section 504 provides a civil-rights mandate

that requires accommodations for students whohave disabilities such as orthopedic impairmentsbut who do not qualify for special education ser-vices It denies federal funds to any institutionincluding a school whose practices or policiesdiscriminate against individuals with disabilities

25

This legislation has resulted in a number of out-comes including various actions to remove physi-cal barriers to education which may incorporateassistive technology For more information con-tact the nearest regional Office of Civil Rights orthe State Vocational Rehabilitation Agency

State Programs for Children with SpecialHealth Care Needs

These programs provide and pay for servicesfor eligible children CSHCN programs varywidely from state to state in the services they of-fer the number of children served and the re-quirements for eligibility Some CSHCN pro-grams do pay for assistive technology deviceswhen no other funding source is available andthe equipment is necessary for health-related rea-sons Most CSHCN programs are run by the statehealth agency To contact CSHCN ask informa-tion for the telephone number of the state healthagency

School-to-Work Transition ProgramsTransition Programs are charged with assist-

ing students with disabilities to receive the jobrelated training and placement services to helpthem move from school to work Sometimesassistive technology may be necessary in orderfor a student to make a successful transition andbecome employable If technology is needed fortransition purposes it can be written into thestudentrsquos Individualized Transition Plan (ITP) Toreceive more information about transition andtechnology call the Parent Training and Informa-tion Center (PTI) in your state (See Appendix)

Vocational Rehabilitation ServicesState vocational rehabilitation agencies pro-

vide information evaluation services trainingand funding for technology and education to helpadults go to work or live more independently Iftechnology is necessary for an individual to workVocational Rehabilitation may pay for the equip-ment as part of an Individualized Work-RelatedPlan (IWRP) To locate the nearest Vocational Re-habilitation Agency look in the telephone book

under state government

Plan to Achieve Self-Support (PASS)One of many Social Security Administration

work incentive programs this program providesan income and resource exclusion that allows ablind or disabled person to set aside income andresources for a work goal such as educationequipment purchase vocational training andstarting a business It should be considered forall students with vocational goals who are receiv-ing social security benefits

This program provides a mechanism forpeople to set aside funds to purchase work-re-lated equipment such as assistive technologydevices and services In many cases if an indi-vidual is a recipient of SSI and writes a PASS topurchase education or equipment an additionalSSI check will be provided to cover other livingexpenses Sometimes if a person receives SocialSecurity Disability Insurance (SSDI) and designsa PASS it may make the individual eligible forSSI because the SSDI has been allocated for equip-ment and services

Impairment-Related Work Expense (IRWE)Impairment-Related Work Expense (IRWE)mdash

one of the Social Security Administrationrsquos workincentive programsmdashallows an employed indi-vidual with a disability who receives or is eligiblefor SSI or SSDI to deduct work-related expensesfrom gross reported income

This deduction allows the person to continuedrawing SSDI or SSI and associated benefits(Medicaid or Medicare) if the IRWE deductionreduces earning below the Substantial GainfulActivity (SGA) Test

Although this method does not provide fund-ing to pay for a device or service it is a way ofallowing the use of the individualrsquos own moneyto pay for assistive devices and services neces-sary to return to work The following is a list ofpossible work-related expenses special transpor-tation to and from work personal assistance onthe job structural modifications durable medi-

26

cal equipment prostheses medical supplies andservices work-related equipment non-medicalappliances and equipment routine drug andmedical costs and diagnostic procedure costs

MedicaidMedicaid is a joint federal and state program

which covers some equipment if it is consideredmedically necessary For more information aboutMedicaid and who and what is covered contactthe local Department of Human Services office

MedicareAlthough not a usual source of funds for

assistive technology Part B of Medicare providescoverage for some durable medical equipment ifit is considered medically necessary and is foruse in the personrsquos home For more informationabout Medicare benefits contact the Social Secu-rity Administration Regional Office

Technology-Related Assistance for Individualswith Disabilities Act of 1988

This federal competitive grants program pro-vides monies for states to establish a statewideconsumer-responsive service delivery system de-signed to effect systems change regardingassistive technology In most Tech Act states afunding specialist or policy analyst is availableto assist with accessing assistive technology Sev-eral states operate loan programs to help withthe purchase of devices and services For moreinformation contact RESNA Technology Assis-tance Project 1700 N Moore ST Suite 1540 Ar-lington VA 22209-1903 703-524-6686

PRIVATE PROGRAMS

Private InsuranceSome health insurance plans will buy equip-

ment but it depends on the specific wording ofthe policy Unless the policy says the equipmentis not covered it makes sense to ask the insur-ance company to pay for it The equipment mustbe considered medically necessary and thereforerequires a doctorrsquos prescription

Loans

There are several low or no interest loansavailable to help buy technology Call the stateTech Act program or the manufacturer of theequipment may know where to get this type ofloan

Non-Profit Disability AssociationsThere are many disability organizations

some of which may be able to loan equipment orprovide information about other funding sourcesor support groups These organizations includeNational Easter Seal Society March of DimesMuscular Dystrophy Association United WayUnited Cerebral Palsy Association and the BrailleInstitute

FoundationsSome private foundations have been set up

specifically to provide help to people with dis-abilities A listing of such foundations can befound at the library or may be available from thestate Tech Act program

Programs Providing Assistive TechnologyThe state Tech Act programs offer referrals

for evaluation and equipment recommendationsas well as assistance with identifying funding orequipment lending sources A therapy depart-ment in a local hospital or Disabled StudentsCenter at a local college or university may alsooffer to help locate technology programs in thearea Alliance for Technology Access Centers(ATA) sometimes have loan programs or infor-mation about purchasing used equipment orrenting equipment

Civic OrganizationsThere are many local civic and service orga-

nizations which may provide money to helpsomeone in their community Lists of these or-ganizations are available from the Chamber ofCommerce Examples of these organizations areLions Club Masons Grotto Veterans of ForeignWars (VFW) Elks Club Rotary Club KiwanisKnights of Columbus and Soroptomists Someof these organizations have a national focus on

27

disability or on a particular disability Others willfund devices for a particular child who is knownto the local club

Charities and Fund-RaisersLocal churches high school groups neighbor-

hood organizations labor unions or special in-terest groups (eg computer clubs ham opera-tors) may plan a fund-raiser to help purchaseassistive technology College student organiza-tions (fraternities and sororities) may give moneyor studentsrsquo time to help a special cause Even ifmoney is not available they may be willing tohelp organize a fund raiser

Local media (radio television newspapers)sometimes will sponsor fund-raising activities tofund devices They may not contribute moneybut will help with organizing the fund-raisingactivity and publicizing it to the community

OTHER OPTIONS

In addition to federal and private fundingsources there are a number of education-relatedgrants corporate technology donation programsand funding options that consumers should con-sider Information on these alternative options isavailable through a number of sources includ-ing the following

NewslettersEducation Grants Alert Capital Publications

Inc PO Box 1453 Alexandria VA 22313-2052800-655-5597

Education Technology News Business Publish-ers Inc 951 Pershing Dr Silver Spring MD 20910-4464 301-5878-6300

Financing Assistive Technology Smiling Inter-face PO Box 2792 Church St Station New YorkNY 10008-2792 415-864-2220

Special Education Report Capital PublicationsInc PO Box 1453 Alexandria VA 22313-2053800-655-5597

Technology and Learning Peter Li Inc Publish-ing 330 Progress Rd Dayton OH 45449 415-457-4333

Technology ManufacturersIf it is not possible financially to purchase

equipment consumers can sometimes rent orborrow equipment directly from the manufac-turer

Used EquipmentUsed equipment is often advertised for sale

in disability-related publications or the consumercan place a newspaper ad to see if used equip-ment can be purchased locally Several compa-nies refurbish old computers and sell them at lowprices Listings of used computer outlets can beobtained from ATA Centers or state Tech Act pro-grams

LeasingMany manufacturers of assistive technology

devices have equipment which is available forrent or lease Sometimes the rent or lease pay-ments can be applied toward purchase Checkwith the manufacturer to see if this is an option

Equipment Loan ProgramsMany states have equipment loan programs

as do some rehabilitation facilities and disabilityorganizations Information about loan programsis available from Tech Act programs

HOW TO APPLY FOR FUNDING

There is an art to applying for funding forassistive technology It is necessary to use justthe right words to suit the particular agency thatmight be the funding source It is also crucial todocument the need for and projected outcome ofassistive technology This documentation shouldinclude at minimum

bull A written statement of medical need fromdoctors or other health professionals If thechild had an evaluation by a rehabilitationprofession also include this report

bull A description of the childrsquos problems re-sulting from the disability This descrip-tion can come from the doctor or other pro-fessional who evaluated the child

28

bull Description of how the technology helpsthe child For example the equipment maymake the child safer or allow the child todo things more independently Be sure topoint out how money will be saved if useof the equipment allows attendant care tobe reduced

bull A clear statement based on assessmentthat the child is a good candidate who hasthe cognitive and physical capacities nec-essary for using the technology

In summary the documentation to supportan assistive technology funding request shouldinclude a physicianrsquos prescription the childrsquos as-sessment an explanation of projected benefitfrom use of the technology or service and anycorrespondence obtained from professionals thatwould support the childrsquos need for technology

The initial funding request should include notonly the cost of the device but also the cost ofongoing support and instruction in the use of thetechnology Assistive devices often have ldquohid-denrdquo expenses that are incurred with their pur-chase and these expenses are frequently costlyover time Battery-powered devices may requirefrequent charging or cleaning Upgrades for com-puter software may be necessary Special modi-fications of the home or school environment maybe necessary for the technology to be used Ineach of these examples costs associated with thetechnology may have to be assumed by the fam-ily if they are not considered in the initial appli-cation for funding

It is also helpful to include with the fundingrequest a picture or a descriptive brochure aboutthe device being requested This is importantbecause often persons who are reviewing theapplication do not know about the wide rangeof technologies that might be appropriate

Appropriate wording on the application isabsolutely necessary Key concepts for Medic-aid include ldquomedical necessityrdquo and ldquorestore thepatient to his or her best functional levelrdquo The

term medical necessity means that the device isincluded in the course of treatment being pro-vided to the child and that a professional suchas a physician or speech therapist is supervisingits use Medicaid and private insurers alike gen-erally pay for technologies that help restorepeople to ldquofunctioning levelsrdquo and take the placeof a body part that is not working Typically theseprograms do not pay for technologies or serviceswhose function is educational or life-enhancingrather than health related

The key for private insurance is ldquoterms of thepolicyrdquo It must be remembered that coverageby any insurance company does not set a prece-dent Just because one child receives needed tech-nology under a particular policy issued by a com-pany does not mean that all other covered chil-dren will also have technology paid for by thatcompany Each application stands on its ownbased on the expressed terms of the policy

It is usually under the major medical provi-sions of a health policy that assistive technologycan be provided as ldquoother medical services andsuppliesrdquo It may however be necessary to pur-chase additional insurance coverage or a ldquoriderrdquoin order for technology costs to be included inthe terms of the policy It is important to remem-ber that heath insurance policies are oriented to-ward health care and not toward changes in theenvironment or rehabilitation

Both private health insurance policies andMedicaid sometimes impose limits on the num-ber of assistive technology devices over a certaincost that can be purchased within a certain timeframe Sometimes the rule is that the fundingsource will purchase only one device in theindividualrsquos lifetime With these kinds of restric-tions it is all the more critical to be sure that thetechnology choice is the right one

TIPS THAT LEAD TO SUCCESS

bull Apply to several funding sources at thesame time Be sure to meet the require-

29

ments of each agency

bull Find out if agencies will share costs

bull Fill in the agencyrsquos forms correctly Manyapplications are denied because forms arenot filled out properly

bull In addition to the standard form includeany other information that describes orshows what the equipment does and howit benefits the child Assume no knowledgeon the part of the reviewers

bull Turn in all documentation at the same time

bull Avoid using jargon define all unfamiliarterms

bull Take the funding request package to theagency in person While there have itchecked to make sure everything requiredhas been included Get the name of theperson who reviewed the application

bull Call regularly to check on the funding re-quest each time try to talk to the same per-son

bull Be super politemdashand persistent

WHAT IF FUNDING IS DENIED

It is not at all unusual for an initial fundingrequest to be denied Even when family mem-bers and professionals have been meticulous inpreparing applications requesting funding forneeded technology denials should be anticipatedMaking an appeal is worth the effort since manydenials are reversed at the appeal level

To start the appeal process obtain any docu-mentation or information provided by the fund-ing agency (eg Medicaid or the private insur-ance company) relating to appeal proceduresforms to use timelines and filing procedures forinstance This information will help in the promptpreparation for appeal The kind of appeal to bemade depends on the reason for denial Whendeveloping an appeal find out the following

bull Why the request was denied Ask for thereason in writing Sometimes requests are

denied because a reviewer lacks under-standing of the technology or there maybe an error in the paperwork

bull If needed correct any mistakes or includemore information then resubmit the re-quest

Going to appeal makes sense because gener-ally the appeal places the application before moreexperienced persons in the decision-making hi-erarchy The technology requested is often newand the initial examiners in the process may beunaware of its usefulness Also insufficient docu-mentation may have been provided in the origi-nal application and the problem can be remediedon appeal

Donrsquot be daunted by the length of the appealprocess Follow it through to its completion Insome states families may be able to appeal a de-nial beyond the first level For example somestates have ldquounfair claims settlement practicesrdquoregulations which are administered through theinsurance commissionerrsquos office

Always make your appeal in person and takethe child and the equipment if possible If onlypart of the money is offered by one agency askanother agency to share costs If the appeal isdenied try again Submit the funding request toanother agency Being persistent will nearly al-ways result in success

When going through the appeal process turnto the state Protection and Advocacy Program (Pamp A) for guidance and support P amp A advocatescan help make sure that a childrsquos rights to tech-nology and related services are not denied

Who pays when assistive technology is neededat school

The party who is responsible for paying forassistive technology depends upon the circum-stances under which the technology is purchasedUnder the special education law students withdisabilities who are eligible for special educationare entitled to a free appropriate public educa-tion Parents do not have to pay for school ser-

30

vices including assistive technology if that ser-vice is part of the studentrsquos Individualized Edu-cation Program (IEP) If the student is eligible forMedicaid the school district can request thatMedicaid pay for the device If parents choose todo so they may agree to use private insurance topay for a device that is used at school Parentscannot however be forced to use their insurancein this way If the private insurance requires aco-payment the school district would have to paythis amount since parents should not have to payany special education related costs

Does Section 504 pay for assistive technologySection 504 part of the Rehabilitation Act of

1973 is basically a piece of civil rights legislationthat is intended to prevent discrimination againstindividuals with disabilities in any programwhich receives federal funding Students whohave disabilities but who do not qualify for spe-cial education may still be eligible for accommo-dations under Section 504 of the RehabilitationAct of 1973 Section 504 however does not pro-vide any funding for accommodations

Like the special education law Section 504requires public schools to provide students withdisabilities with a free appropriate public educa-tion and in addition ensures that students withdisabilities are afforded an equal opportunity toparticipate in school programs For students withdisabilities this means that schools may need tomake special arrangements so that these studentshave access to the full range of programs andactivities offered For example a student whoneeds a wheelchair lift on a school bus to get toschool must be provided with this technologyOther modifications which might be requiredunder Section 504 include installing ramps intobuildings and modifying bathrooms to provideaccess for individuals with physical disabilitiesEven though required by the law none of thesetypes of modifications would be funded by Sec-tion 504

Under what circumstances does private health

insurance pay for assistive technologySome private health insurance policies will

pay all or part of the cost for some assistive tech-nology devices The devices are unlikely to belisted specifically in the policy but may be in-cluded under some generic term like ldquotherapeu-tic aidsrdquo Usually the devices have to be pre-scribed by a physician in order to be covered bythe policy

When does Medicaid cover assistive technol-ogy

Medicaid (Title XIX) will pay for ldquoprostheticdevicesrdquondashthat is replacement corrective or sup-portive devices prescribed by a physician or otherlicensed person Each state has some flexibilityin determining which prosthetic devices it willinclude in its list of Medicaid covered expensesDevices that are frequently covered by Medicaidare canes crutches walkers manual wheelchairshospital beds and hearing aids or eyeglasses forchildren and youth

SummaryAssistive technology can be expensive to pur-

chase but there are a number of public and pri-vate sources for funding devices Common pub-lic funding sources include early childhood in-tervention programs schools Vocational Reha-bilitation and Medicaid Private sources mayinvolve health insurance personal loans chari-table donations or fundraising It is very impor-tant to provide proper documentation and usecorrect wording and procedures when request-ing funding Initial requests for funding are fre-quently turned down but appeals can be success-ful

31

TEDTed is an active four-year old who lives in a

small rural community with his parents andyounger sisters He was identified as speech im-paired and has been attending preschool specialeducation classes Ted has normal mental capa-bilities but his mild cerebral palsy impairs hisability to speak Because of the speech therapyhe has received Ted is able to make some speechsounds but he says no intelligible words Heuses sign to communicate with his special edu-cation teacher and his parents No one else inhis community uses sign so Ted is limited in hisability to communicate with others

As Tedrsquos IEP Team looks ahead to his entryinto elementary school the Team recognizes thathe will need better communication skills in or-der to participate successfully in the regular class-room His speech therapist has recommendedthat Ted begin to use an AlphaTalker

What funding sources might pay for theAlphaTalker

What case could you make for funding Arethere any obstacles to seeking funding

TEDrsquoS SOLUTIONAt this point Tedrsquos ability to communi-

cate is somewhat primitive Because of his cere-bral palsy he is not able to make conventionalsigns so the gestures he makes are understoodonly by those who know him well A simple elec-tronic communication device may work for Tedbut there are some prerequisite communicationskills he will have to master first Augmentativecommunication devices operate on the principleof choosing icons (abstract symbols) that repre-sent certain basic communications like a cup toindicate ldquoI want a drinkrdquo

In order to make a picturesymbol systemmeaningful and functional for Ted at his youngage his speech therapist began to work on point-to-object and point-to-picture activities WhenTed had mastered point-to-picture activities histherapist made a picture ring for him On thering were picture symbols (icons) for things thatTed might want to say Tedrsquos family his teacherand his classmates began to ask him to use hispictures to explain what he wanted Soon Tedwas using pictures to communicate simple wantsand needs effectively His word ring went withhim everywhere and helped him to ldquotalkrdquo topeople he did not know as well as to friends andfamily members

An unexpected bonus to the picture practiceis that Ted is verbalizing more and his speech hasbecome more intelligible He has even begun tosing An electronic communication device maybe in Tedrsquos future but for now he is learning tocommunicate well with his picture ring and somespoken words

Solution SummaryPoint-to-picture practice

Use of picture ring

32

GLORIAGloria an eighteen year-old with mild cog-

nitive delays and CP is about to finish highschool She has been using a laptop computerand switch access hardware and software in lieuof a pencil and paper to complete work in highschool The equipment and software were pro-vided by the school district through the IEP pro-cess Gloriarsquos current goal articulated in her In-dividual Transition Plan (ITP) as mandated byIDEA is to have a full-time job by the time she is22 She wants to work in an office and woulduse a computer system similar to her currentsetup As she moves into the transition periodthese questions must be addressed

Will the laptop computer she has been usingbe functional for her in the workplace

Will she need to consider new equipmentWhat would influence a decision to purchase newequipment

What funding sources might help Gloria topurchase new equipment

What case should Gloria make for funding

GLORIArsquoS SOLU-TION

Gloria is fortunate to have learned computerand word processing skills while she was inschool Now she must learn ways to transferthese skills into the work setting Laptop com-puters are not typical in offices instead whatGloria is more likely to encounter is a desktopworkstation with computer and printer In or-der to use a standard computer Gloria will needa switch access device and an onscreen keyboardto do word processing and data entry

Since single switch access is necessary forGloria to become employed in an office settingGloriarsquos Vocational Rehabilitation Counselor waswilling to make such a purchase for her Gloriaapplied to be a data processor with a temporaryemployment firm and got the job Gloriarsquos VRcounselor helped her to select switch access hard-ware compatible with most IBM compatible com-puters In her new job Gloria changes office set-tings frequently Each time she moves she takesher switch access device and onscreen keyboardsoftware with her With these portable items sheis able to adapt each new office setting to meether needs Having the right technology has madeGloria an adaptable and successful temporaryoffice employee

Solution SummarySwitch access

Onscreen keyboard software

33

Making Assistive Technology a Part ofChildrsquos Education

The ideal time for a child with a disabilityto learn to use assistive technology is whenthe child is learning all sorts of others skills

in early intervention services preschool and K-12 education Children who are eligible for earlyintervention services under Part C or special edu-cation under Part B of the Individuals with Dis-abilities Education Act (IDEA) are entitled to beevaluated for assistive technology needs and toreceive assistive technology devices and servicesif they are necessary to providing a free appro-priate public education In order for children toreceive the assistive technology to which they areentitled parents must be knowledgeable abouthow assistive technology fits into special educa-tion and the ways that AT can be included in achildrsquos Individualized Family Service Plan (IFSP)or Individualized Education Program (IEP)

ASSISTIVE TECHNOLOGY FOR YOUNG CHILDRENParents are often surprised to learn that

assistive technology can be appropriate for in-fants and toddlers Very young children whohave disabilities that limit their ability to inter-act with the environment by crawling touchingseeing or hearing can benefit from technologythat improves their interactions Federal educa-tion amendments require states to ldquopromote theuse of assistive technology devices and assistivetechnology services where appropriate to en-hance the development of infants and toddlerswith disabilitiesrdquo These amendments furtherrequire states to ldquofacilitate the transition of in-fants with disabilitiesfrom medical care to earlyintervention services and the transition fromearly intervention services to preschool specialeducation or regular education servicesrdquo

When Kayla was an infant her interactionswith the environment were very limited because

she has a genetic condition resulting in abnor-mally short arms and legs She could not turnover or crawl she had difficulty touching andgrasping objects As part of her early interven-tion program Kayla was introduced at the ageof six months to the use of switches When theswitches were positioned correctly she could ac-tivate switch-operated toys or noisemakers Theopportunity to interact with toys opened upKaylarsquos world She soon began to hunt for theswitches and to activate certain toys on com-mand She used the switches to make choicesbetween toys or sounds She became verballymore expressive and began to interact morereadily and more often with her parents and sib-lings

By the time that Kayla was three and readyfor preschool special education she was able tosit up and interact with a computer activated byswitches She could identify objects on the com-puter screen and match those objects to real ob-jects in the world around her At three Kaylacould identify and match some letters and shapeson the computer screen Though limited in hermobility Kayla became an active participant inclassroom activities She could interact withclassmates by playing computer games joiningin at circle time and participating in allpreacademic learning activities

Assistive technology was an integral and nec-essary part of Kaylarsquos early intervention servicesKaylarsquos parents were involved in writing the In-dividualized Family Service Plans (IFSPs) thatoutlined the services Kayla and their familyneeded From the beginning Kaylarsquos family hadthe opportunity to see how assistive technologycould be included in the IFSP and really make adifference in Kaylarsquos education and her life

Kaylarsquos story illustrates how assistive tech-

34

nology can be utilized from an early age and canbe part of the transition from medical treatmentto early intervention and from early interventioninto preschool special education or regular edu-cation Because of the availability of early inter-vention services there is no reason to wait untila child is of school age before trying assistive tech-nology Early use of the necessary technology willenhance a childrsquos development by increasingopportunities to interact with the environment

ASSISTIVE TECHNOLOGY AT SCHOOL AGE ANDBEYOND

When students enter kindergarten and begintheir regular public school years assistive tech-nology can continue to be a part of their specialeducation programs For students who are eli-gible for special education assistive technologymust be provided when it is necessary

(1) to support placement in the least restric-tive environment

(2) to ensure that a student benefits from hisor her education or

(3) to implement the goals and objectives inthe studentrsquos IEP

Needs for assistive technology should be oneof the considerations when a student is assessedto determine eligibility for special education Ifan assessment reveals that a student is eligiblefor special education then the multi-disciplinaryteam should consider assistive technology needswhen making recommendations for the Individu-alized Education Program (IEP) The team shouldanalyze what is required of nondisabled studentsof the same age and determine how many of theserequirements could be completely or partiallyfulfilled by the student being assessed if that stu-dent had access to appropriate assistive technol-ogy

In addition when information is being col-lected for the present level of performance sec-tion of the IEP part of that assessment should bea consideration of whether or not assistive tech-nology is necessary for the student to achieve

educational or social goals benefit from educa-tion or make reasonable progress in the least re-strictive educational setting Whoever is collect-ing the information might experiment withassistive technology applications to determinewhich ones might work for the particular student

Assistive technology should be considered asan option for every IEP Some students of coursewill not require technology but many studentswill benefit from technology that helps them tocompensate for their impairments School dis-tricts are not required to provide all of the pos-sible assistive devices that might be nice to haveor might provide the best possible arrangementsAssistive technology is required however whenits presence enables the student to make reason-able progress toward the goals the IEP Team iden-tifies

HOW TO INCLUDE ASSISTIVE TECHNOLOGY INTHE IEP

Assistive technology can be included in theIEP in a number of ways It may appear as partof the studentrsquos annual goals or short term objec-tives It may also appear in a list of specific ac-commodations which need to be made in orderfor the student to function in the least restrictiveenvironment For example the IEP might includesuch accommodations as the use of word pro-cessing use of a calculator use of a hand heldspell checker and so forth In addition the IEPmay specify that as a related service necessaryfor the student to benefit from his or her educa-tion the student will receive training in the useof assistive equipment like an electronic commu-nication device a power wheelchair or a personalcomputer

WHERE TO PUT ASSISTIVE TECHNOLOGY IN THEIEP

There are three places in the IEP whereassistive technology may appear (1) in the an-nual goals and short term objectives (2) in theenumeration of supplementary aids and servicesnecessary to maintain the student in the least re-

35

strictive educational setting and (3) in the list ofrelated services necessary for the student to ben-efit from his or her education

Assistive technology can be a part of the an-nual goals and short term objectives on an IEPbut there must be a certain degree of specificityin the goal in order for the role of assistive tech-nology to be clear An annual goal for the IEPshould express an estimate of what the studentcan accomplish in a particular domain during thecourse of one year under what conditions theskill is to be developed and what criteria will beused to indicate whether or not the skill has beenlearned

Many times IEP goals are broad vague andtotally nonspecific Such goals are impossible tomeasure and do not give any indication of whatis realistic to expect in terms of the studentrsquos be-havior or skill level in the course of a yearrsquos timeSuch broad goals are not useful in addressingassistive technology The inclusion of assistivetechnology in the IEP requires a degree of speci-ficity so that it is clear how and why the technol-ogy will be used to accomplish a particular goal

An annual goal which includes assistive tech-nology may indicate that the technology will bepart of the conditions under which some aca-demic or social skill will be acquired For ex-ample an IEP goal for a student with a learningdisability in written expression may look like this

10 Using a word processing program with spell-ing checker Shawn will compose three paragraphthemes composed of fifteen or more sentences with 80or better accuracy in the use of spelling punctuationand grammar

Objectives leading to this goal might includepreliminary exploration of the word processingprogram trials to learn effective use of the spell-ing checker drill and practice in writing singleparagraphs to the 80 level of accuracy in spell-ing punctuation and grammar increasing thelength of writing to two paragraphs and theneventually moving to three paragraphs with

gradually increasing degrees of accuracy

Another type of annual goal may address askill which is necessary for using assistive tech-nology Such a goal might appear this way

20 Using an adapted computer keyboard Rachelwill type 12 words per minute with no errors over 10or more consecutive trials

In this case Rachel would spend a year learn-ing keyboarding skills with the goal of achievingat least 12 words per minute with complete ac-curacy For a young student who experiencessome fine motor difficulties this goal would bechallenging but it might be achievable in a yearrsquostime Objectives leading to this goal might in-volve preliminary exploration of the keyboardgradual introduction of the letters and numberson the keyboard practice to build speed and ac-curacy and eventually timed trials until 10 con-secutive trials could be achieved with no errorsat a rate of 12 words per minute or better

Still another type of annual goal might ad-dress a social issue like communication withpeers

30 Using an electronic communication deviceSara will respond appropriately to social inquiries fromclassmates 5 times out of 5 opportunities over 5 con-secutive days

Objectives leading to this goal might includetraining in the use of particular words andphrases on the communication device drill andpractice in responding with the device in struc-tured settings increasing accuracy in respond-ing in structured settings practice in unstruc-tured conversational opportunities and gradualachievement of accuracy in unstructured conver-sational settings with peers

ASSISTIVE TECHNOLOGY AS A RELATED SERVICEAssistive technology can be a related service

just like audiology physical therapy or speech ifit is necessary for the student to benefit from hisor her education For a student to be successfulin using assistive technology he or she must be

36

trained in its use Training to use a computer anaugmentative communication device a PhonicEar or large type viewer or other similar devicescan occur as a related service which supports thestudentrsquos educational program Preparation forthe use of assistive technology can also be workedinto other related services like occupationaltherapy Occupational therapy may involve de-termining correct positioning to take advantageof assistive technology and exercises to preparethe student to use a computer keyboard or a com-munication board

Margo who has muscular dystrophy uses alaptop computer every day in her sixth gradeclass Margorsquos upper body strength is diminish-ing and she is gradually having greater andgreater difficulty using her hands for writing ordrawing Using a computer saves her energy andallows her to keep performing well in the class-room As a related service in her IEP Margo isreceiving occupational therapy designed to pre-pare her for even more adaptations which maybe necessary as she loses more strength Margoand her therapist are experimenting with com-puter access devices (eg switches trackball) andon screen keyboards to determine what methodMargo would like to use when her hands are nolonger strong enough to type on a standard key-board This special training for assistive technol-ogy is written into Margorsquos IEP as a related ser-vice because such training is necessary for her tocontinue to benefit from her education

ASSISTIVE TECHNOLOGY SUPPORT FOR PLACE-MENT IN THE LEAST RESTRICTIVE ENVIRON-MENT

One important feature of assistive technologyis the fact that it can make it easier for studentswith and without disabilities to learn togetherStudents with disabilities are guaranteed the rightto be with nondisabled peers and to receive theireducation in the setting which is the least restric-tive environment In order to be successful in theleast restrictive environment students are to be

afforded whatever supplementary aids and ser-vices are necessary Among the supplementaryaids which may allow a student to remain in aless restrictive environment are a variety ofassistive devices that compensate for disabilityand allow the student to perform educational andsocial tasks Assistive technology is necessary asa supplementary aid if its presence (along withother necessary aids) supports the student suffi-ciently to maintain the placement and its absencerequires the studentrsquos removal to a more restric-tive setting For example if a student with mul-tiple physical disabilities can make progress onhis or her IEP goals in the regular classroom withthe use of a computer and an augmentative com-munication device and cannot make suchprogress in that setting without the devices thenthose devices are necessary supplementary aids

Lyle a fourth grader with cerebral palsy is agood example of a student who thrives in theregular classroom if he has the use of appropri-ate technology Lyle is able to keep up academi-cally with his classmates if he has access to a com-puter with an adapted keyboard and word pre-diction software Lyle has learned to type welland is able to do written assignments in relativelythe same amount of time as other students in hisclass Without a computer Lyle could not keepup at all Handwriting is a laborious task for Lyleand his written product tends to be messy andbarely readable If he could not use a computerLyle would have to rely on others to do hand-writing for him or he would have to do alterna-tive assignments that require no writing

Lyle likes being a regular fourth grader Heis proud of his writing on the computer becausehe is using his own words and learning to editout his mistakes by himself With his computerhe does not need the services of an aide and canbe completely independent in doing his schoolwork

Assistive technology in the form of a com-puter with appropriate software and keyboard

37

adaptations is necessary for Lyle to remain in theregular classroom working independently Thisuse of the computer can be written into his IEPas a supplementary aid which is necessary tosupport Lylersquos placement in the least restrictiveenvironment

Does assistive technology include access toschool buildings

AT certainly can mean devices that provideaccess to school buildings and facilities Oneimportant part of a free appropriate public edu-cation is that students with disabilities are ableto get to school get into the school and use theschool building and facilities Assistive technol-ogy can be used to provide access to the schoolbus classroom playground gymnasium audi-torium lunchroom or the equipment in themAny or all of these needs can be addressed in theIEP

Bus modifications for improved access andappropriate seating can help with transportationto and from school and school activities Doorswalkways handles switches stairs steps can bemodified so that a student with disabilities canuse them as effectively as classmates Appropri-ate seating and playground modifications canhelp include students who have disabilities atclassroom lunchroom and recess times

When an individual graduates from publicschool is it still possible to have assistivetechnology

If individuals benefit from the use of assistivetechnology during their school years the likeli-hood is that assistive technology will be evenmore important for them in adult livingAssistive technology can certainly be part of anindividualrsquos future after high school but it is nec-essary to begin planning for the transition fromhigh school so that the technology and other nec-essary services are available when needed

The earlier a family can estimate their childrsquospost-high school needs including needs for tech-nology the earlier transition planning can begin

Federal legislation says that transition planningcan begin in school as early as ldquo14 or youngerrdquoEach student with a disability who has an Indi-vidualized Education Program (IEP) should havea ldquostatement of transition servicesbeginning nolater than age 16rdquo This means that as early asmiddle school but probably not later than fresh-man year in high school families should begintransition planning

Unlike school services services in the adultworld are not mandated An individual may beeligible for a disability service but not receive itbecause all of the slots are filled or funding is notavailable If an individual does not own his orher own assistive technology devices then partof transition planning will be looking into fund-ing sources that could help with technology pur-chases If technology is necessary for the indi-vidual to become employed it is possible thatVocational Rehabilitation will pay for the devicesas part of an Individual Work-Related Plan(IWRP) Students who go on to postsecondaryeducation at community college vocational-tech-nical schools or universities can expect to be ableto receive certain accommodations for their dis-abilities while on campus Most postsecondaryinstitutions have Student Support Services thathelp with assistive technology needs alternativetesting readers and notetakers

SummaryAssistive technology can be included as an

integral part of a studentrsquos education but par-ents have to be knowledgeable about how to goabout getting assistive technology into theirchildrenrsquos educational plans Assistive technol-ogy can be written into the Individualized Fam-ily Service Plan (IFSP) for infants and toddlers inearly intervention programs and into the Indi-vidualized Education Program (IEP) forpreschoolers and students in grades K through12 Assistive technology can appear in threeplaces in the IEP (a) as part of the goals and ob-jectives (b) as a supplementary aid to support

38

placement in the least restrictive environmentand (c) as a related service Assistive technologycan also be a part of studentsrsquo transition planningas they move from high school into adult pur-suits Assistive technology is available throughVocational Rehabilitation and other adult disabil-ity services but these services are not mandatedTo ensure continued use of assistive technologyit is important to plan ahead and secure fundingfor devices needed in the work or postsecondaryeducation environments

Hints for Parents

If your child is a successful assistive technologyuser begin to save money early in your childrsquos lifemdashjust as you might save for college Gradually accu-mulate enough funding to purchase the kinds of tech-nology your child will need as an adult Technologychanges so fast that it is impossible to predict whatwill be available fifteen years from now But a parentcan be certain that assistive technology of the futurewill be even better than what is available today

EmilyEmily is a seventh grade student who has

learning disabilities She is in regular classes allday in her neighborhood middle school A spe-cial education teacher monitors Emilyrsquos progressand provides the regular classroom teachers withassistance by modifying some of Emilyrsquos assign-ments giving her oral tests helping to organizeEmilyrsquos work and reteaching certain skills asnecessary In elementary school Emily did wellwith the limited amount of support she receivedin the regular classroom In middle school how-ever she is having trouble keeping up with as-signments Emilyrsquos spelling is inaccurate sheoften misspells the same word three or four dif-ferent ways on the same page Her handwritingis very slow and laborious so she spends manyhours each evening working on her homeworkShe has tried tape recording assignments but shefinds this process also to be laborious because itis so time consuming to correct mistakes

It has been recommended that Emily be re-moved from some of her academic classes andreceive instruction in the resource programEmily wants to remain in regular classes but shecanrsquot keep up with the pace

How could assistive technology help Emily

What are her needs

What case could be made for assistive tech-nology for her

39

Emilyrsquos SolutionEmily has reached the point in her educa-

tional career when she cannot keep pace with thedemands of the written work On observingEmily the occupational therapist noted that ittook Emily five times as long as the average stu-dent in her English class to complete written as-signments

Emilyrsquos IEP Team decided she was spendingfar too much time on the handwriting processTo help her with this problem the team agreedthat Emily should learn to use a computer with aword processing program and a voiced spellchecker One period per day Emily goes to theresource room to practice keyboarding and workon longer written assignments During her regu-lar classes Emily uses a portable word proces-sor (eg AlphaSmart) to take notes which shecan print out later in the resource room

These simple solutions allow Emily to speedup her writing time and produce written workthat is easy to correct and edit With technologyto aid her Emily is spending less time on thehandwriting process and more time on thinkingand processing information Her homework timehas been cut in half and Emily is much more re-laxed and confident at school

Solution SummaryKeyboarding training

Use of computer with word processingsoftware

Use of voiced spell checker

Use of portable word processor

BryanBryan is a seventh grader with a neuro-mus-

cular disease that has caused him to lose physi-cal function He is a bright student with excel-lent academic skills Bryan uses a laptop com-puter with a trackball and an onscreen keyboardto do all his written work He navigates skill-fully around the school building using a powerwheelchair Technology has really helped Bryanto fit in and do well at school However now asa young adolescent Bryan is beginning to feelleft out socially He requires so much help withhis physical needs that he has to spend lots oftime with adults Bryan wants to ldquohang outrdquo likethe other kids his age and escape adult scrutinyonce in a while

Bryan is nonverbal He uses a complex so-phisticated electronic communication device toparticipate in class The device is programmedwith phrases that Bryan frequently uses and healso can select icons to create sentences of hisown Bryanrsquos communication device works wellfor him in formal classroom settings but it isbulky and cumbersome to use in casual conver-sation with friends Bryan has come to believethat his communication device is actually a bar-rier to the kinds of informal interactions he wantsto have

Bryan knows that he has the best in technol-ogy and that the equipment he uses was very ex-pensive He doesnrsquot want to appear ldquogreedyrdquo ordemanding so he has not told his parents abouthis dissatisfaction with his ability to communi-cate One of Bryanrsquos friends Michael howevernoticed that Bryan was acting pensive and un-usually quiet Michael gently coaxed the truthout of Bryan and offered to help his friend thinkof a new way to ldquotalkrdquo that would provide himwith more flexibility and independence

40

Bryanrsquos SolutionWhen Bryan and Michael put their heads to-

gether they came up with lots of ideas The onethey settled on as the most feasible involved us-ing the laptop that Bryan already had The laptophad some advantages because it was small andportable and Bryan already knew how to use itvery well In a catalog of special needs softwarethe friends found communication software thatoperated on an icon system and the price wasright--around $100 With communication soft-ware installed on the laptop Bryan had asimplermore portable device for talking in ca-sual settings

Next Michael asked his father to help themmake a tray for Bryanrsquos wheelchair that wouldhold the laptop and fold down beside the chairout of the way when not in use Michaelrsquos dadcame up with a clever tray on hinges that foldedto the side The laptop fastened to the tray withwide rubber bands A handle on the tray allowedBryan to raise and lower the tray as needed

In addition to his laptop Bryan also neededa device for quick greetings and spontaneous re-torts Bryan and Michael chose a programmableswitch with the capacity to record up to 12 mes-sages Bryan could operate the switch quickly byhitting it with his elbow He and Michael had agreat time recording messages suitable for talk-ing to their friends or to girls

What Bryan found out was that he neededmultiple ways to communicate so that he couldcustomize his electronic speech to fit the settingand the occasion For a relatively small financialinvestment Bryan and Michael were able to ex-pand communication possibilities for Bryan andallow him greater control and personal choiceabout what he said how he said it and to whom

Solution SummaryCommunication softwareDrop-down wheelchair trayProgrammable switch

TracyTracy is a man in his mid-thirties who has

been blind from birth Since graduating fromcollege he has held a series of entry level jobs atminimum wage and without benefits Tracy isfrustrated by the lack of challenge in the jobs hehas had he would like to have a managerial po-sition with some opportunities for advancementbetter pay and benefits

Currently Tracy is working at a Pizza Hutrestaurant where he prepares pizzas for the ovenHe enjoys his co-workers and regular customersbut Tracy wants more A management traineeopening has been announced in the companynewsletter and Tracy decides to apply This newposition involves taking pizza orders over thetelephone and sending the order via computerand modem to the appropriate Pizza Hut outletwhere the pizzas will be made Having madeevery possible type and size of pizza Tracy isvery familiar with the options But how couldhe operate the computer and record orders asthey come in over the telephone Would he havea chance for this job which could be his first stepup

41

Tracyrsquos SolutionTracy and his Vocational Rehabilitation Coun-

selor filled out the job application for the posi-tion at Pizza Hutrsquos central ordering facility andTracy was called to set up an interview Prior tothe interview Tracy and his job counselor wentto the central ordering facility for Pizza Hut tostudy aspects of the job and to determine if tech-nology could assist Tracy to perform the essen-tial job functions The job involved the follow-ing steps (1) greeting the customer and takingdown customer information (2) asking a seriesof questions about the customerrsquos order (egtype size toppings) (3) simultaneous record-ing of the order via computer and (4) sendingthe order to the appropriate Pizza Hut outlet

After studying the process of taking ordersTracy and his counselor decided upon the follow-ing technology

(a) A computer compatible with the Pizza Hutnetwork

(b) Voiced software so that Tracy couldldquohearrdquo what he was typing

(c) A telephone headset to listen to the cus-tomer with one ear

(d) an ear piece to listen to the computer

At his interview for the job Tracy explainedhis qualifications for the position--college degreeexperience with Pizza Hut He also told the in-terview team about how technology would al-low him to do the job as efficiently and effectivelyas other workers

The interview team members were impressedby Tracyrsquos initiative and his work ethic Theychose him over several other qualified candi-dates Though it took some detective work toput together a computersoftware package com-patible with Pizza Hutrsquos system Tracy was ableto do it

From the first day on the job Tracy knew he

was going to like it better than anything he haddone before Listening to the computer and thecustomer simultaneously was challenging at firstbut soon Tracy had mastered the process Afterthree months in his new position Tracy wasasked to become the manager for his shift Nowhe hires and trains new order clerks schedulesworkers and evaluates their job performanceTracy has what he wanted--a managerial posi-tion better wages and a future with the com-pany

Solution SummaryCompatible computer terminal

Voiced software

Telephone headset

Ear piece for computer

42

Advocating forAssistive Technology

In the area of Assistive Technology mdash just as in so many areas of need mdash parents must betheir childrenrsquos best advocates Federal and

state laws support providing assistive technol-ogy to individuals with disabilities but theselaws are only meaningful when parents knowabout them and can use legal processes to securetheir childrenrsquos rights Here are just a few of thelaws on which parents can rely when advocat-ing for assistive technology for their children

THE AMERICANS WITH DISABILITIES ACT OF1990

The Americans with Disabilities Act (ADA)proposes to eliminate ldquodiscrimination againstindividuals with disabilitiesto address the ma-jor areas of discrimination faced day-to-day bypeople with disabilitiesrdquo The ADA applies spe-cifically to the areas of employment public ac-commodations and government functions Inthese areas the ADA requires that reasonable ac-commodations be made so that people with dis-abilities can have an equal opportunity to par-ticipate in employment opportunities public ac-commodations and government functions TheADArsquos definition of ldquoauxiliary aids and servicesrdquoits mandates for ldquoacquisition or modifications ofequipment and devicesrdquo and ldquoreasonable accom-modationsrdquo support the provision of assistivetechnology devices and services to individualswith disabilities

THE REHABILITATION ACT OF 1973Section 504 of the Rehabilitation Act requires

that any ldquoprogram or activity receiving Federalfinancial assistancerdquo comply with non-discrimi-nation rules Section 504 Regulations require thatpublic schools provide students who have dis-abilities an educational opportunity equal to theeducational opportunity provided to students

without disabilities Section 504 also uses theterm ldquoreasonable accommodationsrdquo which canmean the provision of assistive technology de-vices and services

THE INDIVIDUALS WITH DISABILITIES EDUCA-TION ACT (IDEA)

The Individuals with Disabilities EducationAct (IDEA) requires free appropriate public edu-cation (FAPE) for students with disabilities IDEAmandates education in the least restrictive envi-ronment requires schools to use supplementaryaids and services special and related services tohelp assure that students with disabilities par-ticipate in and benefit from public educationAssistive technology is specifically mentioned inIDEA as a service which school districts may haveto provide in order for a student with disabilitiesto benefit from special education

THE CARL PERKINS ACTThe Carl Perkins Act assures that Vocational

Education programs in public schools are madeaccessible to students with disabilities The lawassures supplementary services including class-room curriculum and equipment modificationssupportive personnel instructional aides and in-structional devices

PARENT RESPONSIBILITIESIn order to be effective advocates for their

children parents need to familiarize themselveswith all the laws that support the provision ofassistive technology Copies of the laws and theirregulations are available from the offices of mem-bers of the House of Representatives and the Sen-ate

Besides knowing the law parents must par-ticipate actively in developing plans for theirchildrenrsquos education that include assistive tech-nology when it is needed Parents must attend

43

IFSP and IEP meetings and be prepared to workcooperatively with other team members Whena parent questions an assistive technology evalu-ation or an IEP Team recommendation the par-ent must be prepared to follow-up on those ques-tions including using due process rights whennecessary

What should a parent do when an agencyrefuses to pay for assistive technology that achild needs

Agencies like early intervention programsand school districts are mandated to provideassistive technology if the need for technology isin the childrsquos written plan If one of these agen-cies refuses to pay for needed technology then aparent must consider using due process rightsIn early intervention services the parent wouldfollow the appeal process laid out by the leadagency for Part C When school district servicesare involved the parent can file a complaint ifservices in the IEP are not provided or can askfor a due process hearing if the parent and theschool district disagree about the need forassistive technology If a parent disagrees withthe results of an evaluation for assistive technol-ogy the parent can ask for an independent evalu-ation at school district expense

SummaryOverall getting the devices and services for

children with disabilities means that parents mustbe part of the planning team at every level of theirchildrenrsquos education It means talking with otherfamilies and users of assistive technology aboutdevices and services learning how they foundthe best technology and figuring out where togo when resources are few Getting assistive de-vices and services is not always an easy job Buthelp is available Working with professionalstalking with consumers and other families par-ents can find the best avenues for providing theirchildren with the assistive technology they needIn the end the effort is worth it because assistive

technology is not just a civil right guaranteed bylaw it is also a means to achieve human rights togrow up happy independent and self-sufficientas possible

Hints for Parents

When advocating for your child in the special edu-cation arena donrsquot forget the following facts aboutassistive technology and the IEP

bull Assistive technology needs must be con-sidered along with a studentrsquos other edu-cational needs

bull Needs for technology must be identifiedon an individual basis

bull Identification of technology needs mustinvolve parents the student when appro-priate and a multidisciplinary team

bull Parents or other IEP Team members can askfor additional evaluation or an indepen-dent evaluation to determine assistive tech-nology needs

bull When an evaluation is being conductedconsider mobility fine-motor skills com-munication and alternatives to traditionallearning approaches

bull Lack of availability of equipment or costalone cannot be used as an excuse for de-nying assistive technology services

bull If included in the IEP assistive technologyservices and devices must be provided atno cost to the family

bull Parents always have the right to appeal ifassistive technology services are denied

44

More Questions and Answers

A re schools required to pay forassistive technology devices andservices

It is the responsibility of the school dis-trict to provide for the equipment services orprograms identified in the IEP The school dis-trict may pay for the equipment service or pro-grams itself utilize other resources to provide orpay for the device or utilize private insurancefunds Medicaid or other sources of funds as longas the device or services identified in the IEP areprovided at no cost to the parent Private insur-ance or Medicaid may be used ony if the parentagrees

Can schools require the parents to payfor an assistive technology device orservice identified in the studentrsquos IEPor require the parents to use theirown private health insurance to payfor the device or service

No The ldquofreerdquo in FAPE means that parentsof students with disabilities who require assistivetechnology devices or services do not have to payfor these items As stated in IDEA and its regu-lations all special education and related servicesidentified in the studentrsquos IEP must be providedldquoat no cost to the parentrdquo The term ldquofreerdquo is in-terpreted broadly and goes far beyond the simplepaying of deductibles and co-payments Thecourts have interpreted ldquofreerdquo to apply to butnot be limited to future insurability depletionof maximum lifetime caps raised premiums dis-continuation of policies and preexisting condi-tion exclusions If the family agrees to allow theschool to access their Medicaid or private insur-ance this decision must be strictly voluntary onthe part of the family

How can school districts use Medicaidfunds to purchase assistive technologydevices

If Medicaid is capitated in any way concern-

ing its use for assistive devices school districtsmust request from parents the right to use Med-icaid funds However parents are not obligatedto use their Medicaid funds to purchase devicesor services used at school With permission aparentrsquos private insurance must be accessed be-fore Medicaid can be used for assistive technol-ogy devices Medicaid regulations vary some-what from state to state so it is wise to consultthe state Medicaid Service Bureau before mak-ing any assumptions about Medicaid and thepurchase of assistive technology

Are there other options for schools toconsider in lieu of purchasing theassistive technology device

Yes There are times when the outright pur-chase of equipment or devices is not necessaryor even advisable In such instances schoolsmight consider rental or long-term lease optionsThere are certain advantages to renting or leas-ing depending on the individual needs of thestudent For example renting equipment mightbe a reasonable strategy if the student is expectedto improve or deteriorate in a short period of timeor when it is necessary to try out the equipmentbefore purchase Long-term leasing or leasepurchase agreements also have potential benefitsfor schools which include no obligation on be-half of the school to purchase the device abilityto return leased equipment and thus reduce ob-solete inventory flexible leasing terms use ofequipment without a lump-sum purchase up-grading of equipment as more improved tech-nology becomes available and upgrading ofequipment as the studentrsquos needs change

Isnrsquot assistive technology just acrutch Wonrsquot students become toodependent on technology and notlearn to use the skills they have

Assistive technology should be used as sup-port for access learning and performing daily

45

tasks In general assistive technology is appro-priate when it compensates for disabilities so thatthe individual can function as normally as pos-sible If assistive technology is necessary for astudent to have access to educational opportuni-ties or to benefit from education then it is not aldquocrutchrdquo but a legitimate support Some skillsare too laborious or taxing to accomplish at a rateor with degree of proficiency to allow for partici-pation in the least restrictive environment Withassistive technology the student can participatemore fully and more closely approximate the lev-els of achievement and interaction of his or herpeers In general the use of assistive technologyenhances function and increases skills and op-portunities Though a student may be dependentupon a particular device in order to perform skill-fully denying the device denies the student anopportunity ever to achieve success at the levelof his or her potential

When is assistive technology appropri-ate

Assistive technology may be considered ap-propriate when it does any or all of the follow-ing things

bull Enables students to perform functions thatcan be achieved by no other means

bull Enables students to approximate normalfluency rate or standardsmdasha level of ac-complishment which could not beachieved by any other means

bull Provides access for participation in pro-grams or activities which otherwise wouldbe closed to the individual

bull Increases endurance or ability to persevereand complete tasks that otherwise are toolaborious to be attempted on a routine ba-sis

bull Enables students to concentrate on learn-ing tasks rather than mechanical tasks

bull Provides greater access to information

bull Supports normal social interactions with

peers and adults

bull Supports participation in the least restric-tive educational environment

Who owns the special equipment thatis purchased for students

If the school district purchases the equipmentthe equipment belongs to the district Someschool districts designate that a particular deviceis to be used by a specific student during the timewhen that device remains appropriate for thatstudent Other districts have ldquopoolsrdquo of assistivedevices and distribute them for use by a varietyof students The distribution and use of devicesis under the districtrsquos control as long as the needsdescribed in studentsrsquo IEPs are being met

If devices are purchased for a particular stu-dent using that studentrsquos Medicaid funds or pri-vate insurance then the device belongs to the stu-dent and is meant for the exclusive use of thatstudent

When a student moves from one levelof schooling to another like elemen-tary school to middle school does thedevice follow the student

If an assistive device is necessary in order tofulfill the requirements of a studentrsquos IEP such adevice must be provided in whatever school thestudent attends The same device may not nec-essarily follow the student from one school toanother but a comparable device which fulfillsthe IEP requirements would have to be providedin the new school that the student attends

If a family moves from one schooldistrict to another can a studentrsquosassistive technology go along

Devices bought by the school belong to theschool not the student who uses them When afamily moves from one school district to anotherthe equipment the student has been using doesnot automatically move to the new school

Assistive equipment can go with a studentto a new school if the sending school district

46

agrees to sell or give the device to the family orthe new school district

If the device was purchased by the familythrough the familyrsquos private health insurance orby Medicaid for this particular student then thedevice belongs to the student and can go withthe student to a new school district

What happens to assistive technologydevices when students leave the schoolsystem at graduation

If the school district purchased the device thedevice is the property of the school The schoolcould keep the device for use by other studentssell it or decide to transfer the device to anotherdistrict or loan program If the family or anotherfunding source purchased the device it is theproperty of the student and the family

If a piece of assistive technology is nolonger needed or relevant to a studentand the device was paid for by Medic-aid or private insurance can it bedonated for another studentrsquos benefit

Yes it is a parental decision The parentscould donate the device to the school for use byother students with disabilities or to some otherorganization which loans out equipment

Can assistive devices be insured

Many school district liability policies willcover devices purchased by the district for stu-dent use Devices purchased by other fundingsources may or may not be covered while onschool premises or involved in school activitiesIt is important for school staff to investigate thedistrictrsquos property insurance to determine whatthe policy currently covers and whether or notthe policy insures against loss or damage ofassistive devices

Parents who own assistive devices that areused at home and at school may also wish to pur-chase home owners or rentersrsquo insurance with aspecial rider that covers damage to or loss of thedevice

Who is responsible for the repair and

maintenance of assistive devices

In general the school district is responsiblefor repair and maintenance of assistive devicesused to support educational programs describedin the IEP or covered by Section 504

If a device is broken and is beyondrepair who replaces the broken de-vice

If an assistive device is necessary for thestudentrsquos IEP to be implemented then the schooldistrict will have to replace a broken lost or sto-len device

If a device is broken and sent off forrepairs must the school district sup-ply a substitute device until the origi-nal device is returned

If the assistive technology device is vital tothe studentrsquos daily special education program itis not reasonable for the student to be without adevice for long periods of time If a device isgoing to be unavailable for more than a day ortwo the district should provide a backup ma-chine which allows the student to continue work-ing on IEP goals

Is the school district obligated totrain substitute teachers and aides tooperate assistive technology devices

Again if the assistive technology device isvital to the studentrsquos daily special education pro-gram it is not reasonable for the student not tobe able to use the device for long periods of timebecause a substitute is teaching the class If thesubstitute is only going to be in the classroomfor a day or two it is probably not necessary toprovide elaborate training However if the sub-stitute is going to be in the classroom for an ex-tended time training should be provided

Must school districts allow students totake assistive devices home on schoolnights to do homework Over week-ends During school vacations Overthe summer

In many cases it is desirable for students to

47

have the opportunity to use the same assistivetechnology devices at home and in school Forexample when a student is completing home-work assignments assistive technology may benecessary to produce the type of product that isrequired Some school districts have policieswhich allow the devices to go home with the stu-dents overnight on weekends or during vaca-tion or summer periods In general these kindsof policies are a local district matter and may bedetermined according to local district needs Ifhowever a studentrsquos IEP includes a provisionwhich says the student is to have access to anassistive device both at school and at home thenthe school district would be obligated to allowthe student to take a device home or provide twodevices one for home use and one for school

What professionals are consideredqualified to assess a student in thearea of assistive technology

Because assistive technology is such a newfield there are no national standards and few lo-cal or state standards for licensing or certificationfor specialists in assistive technology Howeverschool districts often have professionals who havereceived training in conducting assistive technol-ogy evaluations and are able to provide the ser-vices identified in the IEP If a district does nothave personnel who are knowledgeable in con-ducting such evaluations the district can arrangefor such services from other knowledgeable pro-vidersndash such as Independent Living Projects Al-liance for Technology Access Centers or Tech ActProjects

How can one distinguish betweenassistive technology and personalitems (eg wheelchairs hearing aidseyeglasses crutches)

Currently IDEA does not make a clear dis-tinction between assistive technology devices andpersonal items This confusion stems in large partfrom IDEArsquos broad definition of assistive technol-ogy For example if a student with a disability

needs eye glasses in order to obtain FAPE thenthe school district is obligated to provide themat no cost to the parents In general howeverschool districts do not purchase personally pre-scribed devices such as hearing aids or glasses

Who determines how assistive tech-nology will be purchased and withwhat available funding resourcesmdashtheIEP Team or school administration

Once the IEP team makes the determinationthat assistive technology must be provided aspart of the studentrsquos IEP it is the responsibilityof school administration to determine how theassistive technology will be provided and withwhich funding sources

Is a school district responsible forproviding ldquostate of the artrdquo equip-ment for a student

No The school district need provide onlyappropriate technology in order to meet thestudentrsquos needs as described in the IEP The de-cision as to what type of assistive technology isappropriate should be based on the assistive tech-nology evaluation recommendations and IEPteam decision There may be ldquodevicesrdquo or fea-tures of equipment which may be nice for the stu-dent to have but if they are not necessary forFAPE the school district is not obligated to pro-vide them If a specific device is necessary toensure FAPE and no other device can meet thestudentrsquos needs then the district must providethe required device even though it is costly If aless expensive device would accomplish the samegoals the IEP team is under no obligation tochoose a more expensive option

If a student needs a computer can aschool owned computer be used in thelab or classroom

Yes a school owned computer can be used ifthe student has access to the equipment when heor she needs it If the student does not have thenecessary access then the appropriate equipmentshould be purchased for the studentrsquos use

48

Can school district administratorsinstruct personnel not to includecostly assistive technology devices inthe IEP

IEP teams are charged with the responsibil-ity for determining a studentrsquos need for assistivetechnology devices and services and for specify-ing those devices and services Therefore it isimportant that IEP teams are clearly informed oftheir responsibility to determine if a studentneeds a device and the need for an assistive tech-nology evaluation to assist in making the deter-mination A school district may not have a policywhich prevents IEP teams from identifying astudentrsquos need for assistive devices or services

How does assistive technology getintegrated into the curriculum

The IEP team needs to discuss how the de-vice will be used by the student and how it willbe integrated into the curriculum The IEP teamshould identify on the IEP how the device willbe used by the student in the classroom Thisinformation should be shared with the generalclassroom teachers so that they are aware of howit is to be used

How can assistive technology be pro-vided from year to year with a degreeof continuity

As part of the annual review of the IEP a pointshould be made to devise ways to communicatewith next yearrsquos teachers about the technologythe student uses and how it should be integratedinto the curriculum Teachers who are new toworking with the student who uses technologyshould be provided training if they are unfamil-iar with the device and its use Training for teach-ers and support staff should be written into theIEP as a related service

Can an assistive technology device beused by more than one student

Yes if the device is the property of the schooldistrict and if all of the students using the devicehave access to the equipment when they need it

Can an independent evaluation berequested to address assistive tech-nology

Yes The school district is required to evalu-ate a student in all areas of suspected disabilityincluding if appropriate evaluating the studentrsquosneed for assistive technology A parent has theright to an independent educational evaluationat public expense if the parent disagrees with anevaluation obtained by the school district How-ever the school district may initiate a due pro-cess hearing to show that its evaluation is appro-priate If the final decision is that the evaluationis appropriate the parent still has the right to anindependent educational evaluation but not atpublic expense If the parent obtains an inde-pendent educational evaluation at private ex-pense the results of the evaluation (a) must beconsidered by the school district in any decisionmade with respect to the provision of FAPE tothe child and (b) may be presented as evidenceat a due process hearing

What is a product system

A product system is more than one piece ofequipment working together to produce a resultFor example an FM system that works in con-junction with a studentrsquos hearing aid is a prod-uct system

Can the school district require a stu-dent to bring a personally ownedassistive device such as an augmenta-tive communication system or laptopcomputer to school in order to doschoolwork

No However the family may wish the childto use his or her equipment in school since thechild may be more familiar or comfortable withit The IEP team should decide who is respon-sible for repair and maintenance of family owneddevices

Is it sufficient for a school district tosupply access to a district-ownedcomputer but provide no software

49

that is appropriate for the student touse

Just providing access to a computer does notfulfill the districtrsquos obligation to provide assistivetechnology to support FAPE The educationalaspect of the computer is very much related tothe software that the student uses If no appro-priate software is available then the student can-not pursue the IEP goals

50

Appendix

GlossaryASSISTIVE TECHNOLOGY any sort of aidincluding computers switches calculators spell-ing devices communication devices and voicesynthesizers which is used to help an individualperform some task of daily livingALTERNATIVE KEYBOARD may include en-larged reduced varied key placement one-handed braille chordic or any other device forentering text on a computerAUGMENTATIVE COMMUNICATION anydevice (electronic or otherwise) to enhance com-munication for a person with limited speechBRAILLE EMBOSSER a printer for producingbraille output either manually or when connectedto a computer When printing standard text froma computer it must first be translated into brailleBRANCHING describes the process of choos-ing among a sequence of choices or actions toproduce another sequence of choices This pro-cess is used in the ldquoscanningrdquo method of accessCD-ROM ldquoCompact Disk Read-Only Memoryrdquorefers to the 4-inch silver disks that typically hold700 megabytes of digital information and theplayers that access the information on these disksCURSOR either the flashing vertical or horizon-tal line on a computer screen that indicates theinsertion point for text or the arrow or I-beamthat indicates the position of the mouse pointeron the computer screenDESK ACCESSARY a small utility program thatruns on a computer and may be accessed fromany program at any time (such as a calculator)DRILL AND PRACTICE presents questionsrepetetively but is not a tutorial Software thatis only drill and practise doesnrsquot necessarily teachthe concepts needed to answer the questions pre-sented

ENVIRONMENTAL CONTROL any type ofdevice that an individual may use to control theirenvironment (lights appliances TV telephoneetc) This may include anything from simplereachers or sticks to computers and voice-acti-vated electronic systemsFM SYSTEM a local wireless broadcast systemthat consists of a microphone and transmitter forthe speaker and ldquowalkman-likerdquo receivers withheadphones for listeners with hearingimpairements or attention disordersHIGH TECH use of electronics or computers asa solutionICON a small computer graphic that appears onthe computer screen and may represent differ-ent types of objects (files or applications) or ac-tions depending on the context Use the mousepointer to click on icons that open files or per-form other actionsINDIVIDUAL FAMILY SERVICE PLAN (IFSP)the written document which defines the earlyintervention services provided to the child andfamily The program is designed to meet theneeds of the child and the family and is based onfamily-identified prioritiesINDIVIDUALIZED EDUCATION PROGRAM(IEP) a written plan specifying instructionalgoals and any special education and related ser-vices a student may need which must be writ-ten and reviewed annually Included are (1) thepresent educational levels of the student (2) astatement of annual goals including short-termobjectives (3) a statement of specific services ifneeded (4) the programs (5) the date when spe-cial services are to begin and the expected dura-tion of these services and (6) the tests and otherrequirements or information used to guage thestudentrsquos progress to determine if the instruc-tional objectives are being metINPUT the information that is transmitted to acomputer from a keyboard mouse or other in-

51

put deviceKEYBOARD a device for inputing text and com-mands to a computerKEYGUARD a plexiglass or other cover for akeyboard with holes for the individual keys Itallows more precise selection of keys for an indi-vidual with fine motor difficultiesKEYPAD a small keyboard with a 10-key setupfor numeric input or it may also be used as a con-trol for a screen-reader programLAPTOP a portable battery-powered computerthat is typically the size of a 3-ring binder weighs5-10 pounds and consists of a screen keyboardand disk-drivesLASER DISCS large (12-inch) CD-ROMs thatnormally contain moviesLOW TECH indicates use of low cost non-elec-tronic solutionsMACRO a simple short program that performsan action on a computer They are usually cre-ated by recording the keyboard andor mouseinput and storing them as an icon or key combi-nationMEGABYTE 1000 X 210 bytes of informationwhich basically means over one million key-strokes of computer storage (about 10 novels)MORSE CODE a direct method for computerinput using one to three switches and coded in-put to replace the keyboard and mouseMOUSE the name given to the pointing deviceused to control graphical user interfaces (GUI) ofmodern personal computersONSCREEN KEYBOARD a software programthat places the keyboard on the screen of the com-puter and may be accessed using a mouse or otherpointing device This is ideal for individuals whocannot use a regular keyboard but can use sometype of pointing deviceOPTICAL CHARACTER RECOGNITION(OCR) a process that utilizes special computersoftware to convert the scanned image of text intoactual text that may be edited by a word proces-sorOUTPUT computer-generated information for

the user This may be printed output from aprinter visual information from the screen orsounds from speakersSCANNER an electronic copier connected to acomputer Scanners are used to input drawingspictures or printed text into the computerSCANNING has nothing to do with the elec-tronic copier above It is another method for ac-cessing a computer or communication deviceusing one or more switches Scanning involvespresenting a group of choices cycling amongthem and making choices by activating a switchSCREEN READER software that reads text ona computer screen using a speech synthesizerThis allows individuals with visual impairmentsor other print disabilities to access text on thecomputer screenSIMULATION software that simulates real-world situations on a computer This may rangefrom a joystick trainer for driving an electricwheelchair to running citiesSPEECH SYNTHESIZER hardware or softwarefor producing electronic human speech on a com-puterSPELL CHECKER utility for checking the spell-ing in a documentSTICKY KEYS software or mechanical utility forallowing typing of multiple keystrokes with onefinger (using the shift or other modifier keys)SWITCH a device that is like a single button ofa keyboard or mouse Switches may be used byan individual with servere motor difficulties byany controllable muscle in their body (headhand toe eye breath etc) to operate any typeof computer communication or environmentalcontrol deviceSWITCH INTERFACE black box that connectsto a computer or other device that has plugs forswitchesTDD a text telephone used for communicatingin typed text over a phone line A TDD has akeyboard and text display or small printer Bothparties who are communicating over a phone linemust have TDDs

52

TOUCH WINDOW a computer input devicethat uses a touch-sensitive transparent windowplaced on the computer screen It performsmouse functions with a finger or stylus directlyon the screenTRACKBALL another replacement for themouse pointing device that uses a rolling ball toperform mouse movementsTUTORIAL teaches concepts presents informa-tion as opposed to simple drill and practiceVOICE RECOGNITION computer softwareand microphone that allows input and controlwith voice commandsWORD PREDICTION productivity softwarethat increases typing speed for one-finger typistsand others by predicting and choosing completewordsWORD PROCESSOR software for inputing andformatting textUSER person using a computerUTILITY software for adding function or per-forming housekeeping tasks on a computer

53

DocumentsSCHRAG LETTER ON ASSISTIVE TECHNOLOGY

August 10 1990

Dear Ms Goodman

This is in response to your recent letter to the Office of Special

Education Programs (OSEP) concerning the obligations of public

agencies under Part B of the Education of the Handicapped Act

(EHA-B) to provide assistive technology to children with handi-

caps

Specifically your letter asks

1 Can a school district presumptively deny assistive technol-

ogy to a handicapped student

2 Should the need for assistive technology be considered on

an individual case-by-case basis in the development of the

childs Individual Education Program

In brief it is impermissible under EHA-B for public agencies

(including school districts) to presumptively deny assistive tech-

nology to a child with handicaps before a determination is made

as to whether such technology is an element of a free appropriate

public education (FAPE) for that child Thus consideration of a

childs need for assistive technology must occur on a case-by-

case basis in connection with development of a childs individual-

ized education program (IEP)

We note that your inquiry does not define the term assistive

technology and that the term is not used either in the EHA-B

statute or regulations The technology Related Assistance for

Individuals with Disabilities Act of 1988 PL 100-407 contains

broad definitions of both the terms assistive technology device

and ldquoassistive technology service See Section 3 of PL 100-

407 codified as 29 USC 2201 2202 Our response will use

assistive technology to encompass assistive technology ser-

vices and ldquoassistive technology devices

Under EHA-B State and local educational agencies have re-

sponsibility to ensure that eligible children with handicaps receive

FAPE which includes the provision of special education and re-

lated services without charge in conformity with an IEP 20 USC

1401(18) 34 CFR S3004(a) and (d) The term special educa-

tion is defined as specially designed instruction at no cost to

the parent to meet the unique needs of a handicapped child 34

CFR S30014(a) Further related services is defined as includ-

ing transportation and such developmental corrective and other

supportive services as are required to assist a handicapped child

to benefit from special education 34 CFR ss33013 (a)

The EHA-B regulation includes as examples 13 services that

qualify as related services under EHA-B See 34 CFR S30013

(b)(1)-(13) We emphasize that this list is not exhaustive and

may include other developmental corrective or other supportive

servicesif they are required to assist a handicapped child to

benefit from special education 34 CFR S30013 and Comment

Thus under EHA-B assistive technology could qualify as spe-

cial education or related services

A determination of what is an appropriate educational program

for each child must be individualized and must be reflected in the

content of each childs IEP Each childs IEP must be developed

at a meeting which includes parents and school officials 34 CFR

S300343-300344 Thus if the participants on the IEP team de-

termine that child with handicaps requires assistive technology in

order to receive FAPE and designate such assistive technology

as either special education or a related service the childs IEP

must include a specific statement of such services including the

nature and amount of such services 34 CFR S300346(c) App

C to 34 CFR Part 3000 (Ques 51)

EHA-Bs least restrictive environment (LRE) provisions require

each agency to ensure (t)hat special classes separate school-

ing or other removal of handicapped children from their regular

educational environment occurs only when the nature or severity

of the handicap is such that education in regular classes with the

use of supplementary aids and services cannot be achieved sat-

isfactorily Part 121a 42FR 4251113 (August 23 1977)

Assistive technology can be a form of supplementary aid or ser-

vice utilized to facilitate a childs education in a regular educa-

tional environment Such supplementary aids and services or

modifications to the regular education program must be included

in a childs IEP Id Appendix C to 34 CF art 300 (Ques 48)

In sum a childs needs for assistive technology must be deter-

mined on a case-by-case basis and could be special education

related services or supplementary aids and services for children

with handicaps who are educated in regular classes

I hope the above information has been helpful If we may pro-

vide further assistance please let me know

Sincerely

Judy A Schrag EdD

Director Office of Special Education Programs

54

INDIVIDUALS WITH DISABILITIES EDUCATIONLAW REPORT

Cite as 18 IDELR 627

Digest of Inquiry

(Inquirerrsquos Name Not Provided)

(Date Not Provided)

bull Is a school district responsible to provide assistive

technology devices for home use

bull May a school board overrule a determination by an IEP

team that a child with a disability needs access to an

assistive technology device at home

bull What is the time limit on implementation of an IEP

Digest of Response

(November 27 1991)

Assistive Technology Devices May Be Required for Home Use

If an IEP team determines that a child with a disability needs

access to an assistive technology device at home as a matter of

FAPE then the school district must provide the device for home

use in order to implement the childrsquos IEP

School Board May Not Change IEP Teamrsquos Determination

Under Part B a school board has no authority to unilaterally

change any statement of special education or related services

contained in an IEP including a statement of a childrsquos need to

have access to an assistive technology device at home Without

reconvening the IEP team the school board may not change the

IEP and the school district is obligated to implement the IEP re-

quirements regardless of the school boardrsquos objections

IEPs Must Generally Be Implemented

Under Reg 300342(b) an IEP must be in effect before the

provision of special education or related services and must be

implemented as soon as possible following the conclusion of the

IEP meeting(s) In accordance with Appendix C to the Part 300

regulations an IEP should generally be implemented without de-

lay after being finalized although a reasonable delay may be per-

missible in limited circumstances

__________________

Text of Inquiry

I would like to have a copy of the policy classification on

Assistive Technology

I also have a question to ask regarding Assistive Technology

such as a closed circuit TV

My daughter uses a CCTV in school and it is on her IEP

program My daughter is visually impaired The initial request

was made by me the parent to the appropriate people involved

in her education and discussed and approved by the committee

on an individual basis

My question is I would like to make the request to the ap-

propriate officials for another CCTV for home use to accomplish

the same results at home as is done in school (For homework

reading books any assignments from school)

Another question is If the committee approves this request

it will go to School Board for approval I would like to know what

happens if the School Board doesnrsquot approve the proposal Is it

impartial hearing time

Thank you for your assistance in this matter

Any information regarding Assistive Technology Informative

for school and home use would be greatly appreciated

Is there a time limit on implementation of yearly updated

IEPs[] Every year I have long delays on implementation of board

approved IEPs[]

Text of Response

This is in response to your recent letter to the Office of Spe-

cial Education Programs (OSEP) requesting a copy of any OSEP

policy clarifications on assistive technology as well as asking spe-

cific questions concerning the assistive technology needs for your

daughter You also asked a question about the time limits for

implementation of an individualized education program (IEP)

In response to your request I am enclosing a copy of OSEPrsquos

August 10 1990 letter to Ms Susan Goodman concerning the

obligations of public agencies under Part B of the Individuals with

Disabilities Education Act (Part B) formerly cited as Part B of the

Education of the Handicapped Act to provide assistive technol-

55

ogy to children with disabilities along with some additional infor-

mation on assistive technology and a copy of the Part B regula-

tions I would also like to provide you with OSEPrsquos response to

each of your specific questions as stated below

I would like to make the request to the appropriate officials

for another CCTV for home use to accomplish the same

results as is done in school (For homework reading books

any assignment from school)

The IEP which must be developed at a meeting that includes

parents and school officials must contain among other things a

statement of the specific special education and related services

to be provided to the child See 34 CFR sectsect 300343-300346 As

stated in OSEPrsquos letter to Ms Goodman if the IEP team deter-

mines that a child with disabilities requires assistive technology in

order to receive a free appropriate public education (FAPE) and

designate such assistive technology as either special education

or a related service the childrsquos IEP must include a specific state-

ment of such services including the nature and amount of such

services See 34 CFR sect 300346(c) App C to 34 CFR Part 300

(Ques 51) The need for assistive technology is determined on a

case-by-case basis taking into consideration the unique need of

each individual child If the IEP team determines that a particular

assistive technology item is required for home use in order for a

particular child to be provided FAPE the technology must be pro-

vided to implement the IEP

If the committee approves this request it will go to the School

Board for approval I would like to know what happens if

the School Board doesnrsquot approve the proposal Is it im-

partial hearing time

As part of the public agencyrsquos part B obligation to provide

FAPE to an eligible child with disabilities the public agency must

ensure that special education and related services are provided

in conformity with an IEP which meets the requirements of 34

CFR sectsect 300340-300349 One requirement at 34 CFR sect

300343(a) is that the public agency conduct a meeting to de-

velop review and revise a childrsquos IEP The Regulations require

that certain participants attend the IEP meeting See 34 CFR sect

300344 The role of the participants at the IEP meeting is to

determine the specific special education and related services that

a child needs in order to receive FAPE Once the determination is

made at a meeting convened pursuant to 34 CFR sect 300343(a)

Part B does not recognize any authority on the part of a local

School Board to unilaterally change the statement of special edu-

cation and related services contained in the IEP After the IEP is

developed and the placement decision is made by a group of

persons knowledgeable about the child the meaning of the evalu-

ation data and placement options the public agency must imple-

ment the IEP See 34 CFR sect 300533(a)(3) Without reconven-

ing the IEP meeting the local school board could not change the

IEP

Is there a time limit on implementation of updated IEPrsquos[]

Every year I have long delays on implementation of Board

approved IEPrsquos[]

Part B imposes no specific time limits for the implementation

of IEPs The Part B regulations at 34 CFR sect 300342(b) require

that an IEP (1) must be in effect before special education and

related services are provided to a child and (2) must be imple-

mented as soon as possible following the meetings required to

develop review or revise a childrsquos IEP The answer to Question 4

in Appendix C to the Part 300 regulations states that no delay is

permissible between the time a childrsquos IEP is finalized and when

special education and related services is provided It is expected

that the special education and related services set out in the IEP

will be provided by the agency beginning immediately after the

IEP is finalized In certain circumstances such as when the IEP

meeting occurs during the summer or a vacation period or where

there are circumstances which require a short delay (eg work-

ing out transportation arrangements) the implementation may not

be immediate See Comment 34 CFR sect 300342

I hope that this information is helpful to you Please let us

know if you have any additional questions or concerns

Judy A Schrag

Director

Office of Special Education Programs

_______________________

Cite as 18 IDELR 628

56

Sample Letter Requesting an Assistive Tech-nology Evaluation

March 1997

Dear Sir

Our daughter Catherine an IDEA-eligiblestudent is currently receiving special educationand supportive therapies through the publicschool district As she is progressing through theelementary school grades the curriculum is de-manding more and more written work from herAt this point teachers or assistants are writingfor her but this method does not allow Catherinethe opportunity to compose written work on herown

As Catherinersquos parents we think the time hascome to consider assistive technology forCatherine to allow her to learn to do written workon her own so that she can learn the mechanicsof writing and can put her own thoughts downon paper for others to read

To this end we are requesting an assistivetechnology evaluation for Catherine to determinewhat kinds of technology are necessary to assisther with written expression We are assumingthat the assistive technology evaluation will beperformed at district expense by professionalswho are qualified to determine (a) what assistivetechnology may be necessary for Catherine (b)what assistive technology devices might be help-ful and (c) what occupational and physicaltherapy services may be necessary to support thetechnology

We would like to have this evaluation com-pleted so that information is available prior tothe convening of the IEP Team to writeCatherinersquos Individualized Education Programfor next year

We appreciate your assistance with this mat-ter and look forward to hearing from you

Yours truly

Assistive TechnologyIssues to Address

_____What are the individualrsquos current unmetneeds for access to communication writ-ing or educational materials

_____What are the short and long term educa-tional goals

_____What are the daily educational demandswhich require the use of assistive technol-ogy

_____Have the appropriate team members in-cluding parents been involved in the as-sessment process

_____What are the features of the technology thatwould assist the individual in meetingdaily classroom demands

_____Why is the selected equipment more appro-priate than other alternatives

_____Have all of the individualrsquos environmentsbeen considered

_____Does the selected equipment reflect the leastrestrictive intervention strategy

_____Is the equipment necessary to achieve edu-cationallife goals

_____How will the individual physically man-age the equipment in all environments

_____How will the equipment be integrated intothe individualrsquos daily life

_____How will the use of the assistive technol-ogy promote inclusion of the individualinto activities in the school and commu-nity

_____Which members of the education team willbe trained to use the equipment

_____How will the individual be trained to usethe equipment

_____How will the family be involved with theindividual and the equipment

57

ExamplesEDUCATIONAL SOFTWARE EVALUATION

A IDENTIFYING INFORMATION

Name of instructional program

Publisher

Cost ____________Computer platform(PCMac)

Other equipment needed to run program

Grade level of the program

Skill levels required of users

Special needs addressed by program

B DESCRIPTIVE INFORMATION

1 What is the purpose of the instructional program as stated by

its publisher

2 What curriculum area or areas does it address

3 What type of instructional program is it

tutorial drill and practice___ arcade game type___

drill and practice ____ simulation ___

problem solving___ educational game___

teacher utility___ other___

4 For what type of learner was the program designed

age level __________ grade level ____________

ability level ________ interest level ___________

5 What skills or information does the program attempt to teach

or review

6 How does the program present information

__text __graphics __animation __color __sound effects

__music __speech __other __________________________

7 Is the information presented clearly

Is text legible and readable

Are graphics comprehensible

Are sounds audible and intelligible

8 Are directions for using the program clearly stated and under-

standable Where do directions appear

_____ within the program

_____ in the programs documentation or manual

9 Is the program under user control that is can the user control

the programs movement from screen to screen

Review directions at any time

Exit the program at any time

10 What computer use demands are placed on the learner

_____ insert disk and turn on computer

_____ select from menu

other ______________________________

11 What academic demands are placed on the learner

reading level _______________________________

spelling level _______________________________

other _____________________________________

12 What physical demands are placed on the learner

_____ keyboard must be used to enter responses

_____ press any key

_____ press a key from one half or one quadrant of key-

board

_____ press on specific key

_____ press several keys in order

_____ other devices used to enter responses

13 What speed demands are placed on the learner

_____ presentation of information controlled by program (

moderate fast or slow)

_____ presentation of information under user control

_____ unlimited response time

_____ response time set by program (moderate fast slow)

_____ response time varied by user

58

14 What accuracy demands are placed on the learner

_____ user can correct typing errors

_____ program does not allow correction of typing errors

_____ program locates common errors

_____ program requires correct spelling of all responses

_____ program allows only one correct response for most

questions

15 Is feedback about response accuracy provided to learners

appropriately

_____ knowledge of results provided after each response

_____ correct responses confirmed

_____ learner informed if response incorrect

_____ another trial provided if response incorrect

_____ number of trials provided

_____ correct response demonstrated if learner fails to an-

swer correctly

_____ learner allowed opportunity to respond after demon-

stration of correct response

16 Does the program use any branching procedures besides

differential treatment of correct and incorrect responses

17 What techniques are used for reinforcement and motivation

_____ knowledge of results and confirmation of correct re-

sponses

_____ summary information about learner performance

_____ text message of praise for correct responses

_____ graphics display and or sound for correct responses

_____ competitive game in which correct response earn

points

_____ other _________________________________

Reinforcement is _____ continuous _____ intermittent

18 What user options are available to students and teachers

Students can select

_____ activity from menu difficulty

_____ number of questions type of questions

_____ other ____________________________

Teacher or parent can select

_____ sound on or off

_____ number of questions

_____ type of questions

_____ sequence of instruction

_____ number of trials

_____ speed of presentation

_____ speed demands for responses

_____ other_________________________________

Teacher or parent can

_____ enter own content into program

_____ review student records

_____ other________________________________

19 Is the programs documentation adequate

All program features fully and clearly explained

Rationale for program purpose and objectives included

Print materials provided for students

20 Other comments about the instructional program

C OVERALL EVALUATION

Rate the appropriateness of the instructional program in each of

the following areas using this scale

excellent adequate inadequate

1 2 3

1 2 3 Curricular content (program addresses important skills

1 2 3 Interest level

1 2 3 Ease of use for learners

1 2 3 Demands on learner (eg computer use academic)

1 2 3 Instructional procedures

1 2 3 Motivational value

1 2 3 Appropriate use of the medium

1 2 3 Important instructional variables under teacher control

1 2 3 Other _______________________________

59

Software Featuresbull Easy-to-Read Screensbull Consistency in Formatbull Intuitive Characteristicsbull Logical Labelsbull Instructional Choicesbull Graphicsbull Friendly Documentationbull On-Screen Instructionsbull Auditory Cuesbull Visual Cuesbull Built-in Access Methodsbull Alternatives to a Mousebull Optional Cursorsbull Creation of Custom Programs

Alternative Inputbull Switches and Switch Softwarebull Alternative Keyboardsbull Keyboard Additionsbull Access Utilitiesbull Interface Devicesbull Voice Recognitionbull Optical Character Recognition

and Scannersbull Electronic pointing Devicesbull Pointing and Typing Aidsbull Touch Screensbull Joysticksbull Trackballsbull Arm and Wrist Supports

Processing Aidsbull Abbreviation Expansion and

Macro Programsbull Word Predictionbull Talking and Large Print Word

Processorsbull Grammar and Spell Checkersbull Reading Comprehension Pro-

gramsbull Writing Composition Pro-

gramsbull Electronic Reference Toolsbull Menu Management Programs

Alternative Outputbull Braille Embossers and Transla-

torsbull Refreshable Braille Displaysbull Speech Synthesizersbull Screen Readersbull Screen Enlargement Programsbull Monitor Additions

Specialized Productsbull Closed Circuit Television

(CCTV)bull Environmental Control Units

(ECU)bull Notetakersbull Reading Machinesbull Text Telephone (TDD)

60

Next

Ste

p

Try

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ng C

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s w

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oces

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Curre

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his

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h at

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ck is

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and

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at d

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ng fi

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m w

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odifi

es a

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ndhe

lps

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eep

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cial

ly C

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olite

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l-beh

aved

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app

ears

tobe

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atur

e in

his

soc

ial r

elat

ions

hips

61

ASSI

STIV

E TE

CHN

OLO

GY

EVAL

UATI

ON

Func

tion

al A

naly

sis

Nam

e C

huck

Dat

eG

rade

Lev

el

Sixt

h

Ove

rall

Des

crip

tion

Chu

ck is

a s

ixth

gra

de s

tude

nt w

ho re

ceiv

es a

ll of

his

inst

ruct

ion

inth

e re

gula

r cla

ssro

om

Chu

ck h

as ri

ght h

emip

legi

a H

is ri

ght u

pper

ext

rem

ity is

mor

eaf

fect

ed th

an h

is lo

wer

ext

rem

ity

He

has

diffi

culty

with

tota

l bod

y m

ovem

ents

requ

iring

Need

Fine

Mot

or Han

d W

ritin

g

Not

e Ta

king

Self

Hel

p

Curre

nt S

tatu

s

Chu

ck c

an u

se o

nly

one

hand

for f

ine

mot

or ta

sks

incl

udin

g ty

ping

C

huck

isan

exc

elle

nt o

ne-h

ande

dty

pist

bot

h in

term

s of

spee

d an

d ac

cura

cy

Chu

ck c

an w

rite

in c

ursi

ve

but h

andw

ritin

g is

ver

yla

bor i

nten

sive

and

tirin

gfo

r him

H

e pr

oduc

esm

uch

bette

r writ

ten

prod

ucts

usi

ng a

com

pute

rC

huck

can

not t

ake

note

san

d lis

ten

at th

e sa

me

time

Chu

ck c

anno

t tie

his

ow

nsh

oes

and

he h

as d

iffic

ulty

zipp

ing

his

jack

et w

ith o

neha

nd

Next

Ste

p

Try

givi

ng C

huck

not

esbe

fore

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clas

sroo

mpr

esen

tatio

n H

ave

him

hig

hlig

ht k

eyw

ords

with

a h

ighl

ight

ing

pen

as h

e is

list

enin

g to

the

disc

ussi

on

Try

havi

ng a

pee

rbu

ddy

assi

st C

huck

with

his

sho

es a

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cket

bila

tera

l coo

rdin

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n e

spec

ially

with

upp

er e

xtre

miti

es

Chu

ck h

as a

leg

leng

thdi

scre

panc

y w

ith h

is ri

ght l

eg b

eing

sho

rter t

han

his

left

He

war

s a

lift i

n hi

s sh

oe to

com

pens

ate

for t

he d

iffer

ence

C

huck

has

low

ave

rage

inte

lligen

ce a

nd n

orm

alsp

eech

H

e re

ads

at th

e th

ird g

rade

leve

l a

nd d

oes

mat

h at

gra

de le

vel

exce

pt fo

rst

ory

prob

lem

s C

huck

is v

ery

conc

rete

in h

is th

inki

ng a

nd h

as g

reat

diff

icul

ty u

nder

-st

andi

ng fi

gura

tive

lang

uage

C

huck

has

a fu

ll tim

e ai

de in

the

regu

lar c

lass

room

who

mod

ifies

ass

ignm

ents

and

hel

ps to

kee

p hi

m o

n ta

sk

Soci

ally

Chu

ck is

pol

ite a

ndw

ell-b

ehav

ed b

ut a

ppea

rs to

be

imm

atur

e in

his

soc

ial r

elat

ions

hips

Crite

ria fo

r Suc

cess

Chu

ck w

ill be

abl

e to

prod

uce

writ

ten

wor

k at

abou

t the

sam

e pa

ce a

sot

her s

tude

nts

in h

is c

lass

Chu

ck w

ill be

abl

e to

rece

ive

help

with

am

inim

um o

f fus

s or

emba

rrass

men

t

Supp

ort R

equi

red

Lapt

op c

ompu

ter

Prin

ter

Enla

rged

scr

een

disp

lay

Co-

Writ

er w

ith W

rite-

Out

-Lo

ud fo

r wor

d pr

oces

sing

and

wor

d pr

edic

tion

Chu

ck n

eeds

to u

se w

ord

proc

essi

ng w

hene

ver

writ

ten

assi

gnm

ents

are

requ

ired

Whe

neve

rpo

ssib

le h

is w

ritte

nas

sign

men

ts s

houl

d be

shor

tene

d or

he

shou

ld b

eex

pect

ed to

resp

ond

usin

gm

ultip

le c

hoic

e or

one

wor

dan

swer

s

Teac

her s

uppo

rt of

the

peer

bud

dy re

latio

nshi

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Loca

tions

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eSc

hool

Com

mun

ityW

ork

Rec

reat

ion

Hom

eSc

hool

Com

mun

ityW

ork

Rec

reat

ion

62

ResourcesParent Trainingand InformationCenters

AlabamaSpecial Education ActionCommittee Inc (SEAC)600 Bel Air Blvd 210Mobile AL 36606-3501334-478-1208334-473-7877 FAX1-800-222-7322 AL onlyseacmob1junocomhttpwwwhsvtisnet~cja

AlaskaPARENTS ResourceCenter4743 E Northern Lights BlvdAnchorage AK 99508907-337-7678907-337-7671 FAX1-800-478-7678 in AKparentsalaskanethttpwwwalaskanet~parents

American SamoaAmerican Samoa ParentNetworkPO Box 3432Pago Pago AS 96799684-633-2407684-633-7707 (fax)

ArizonaPilot Parent Partnerships4750 N Black Canyon Hwy 101Phoenix AZ 85017-3621602-242-4366800-237-3007 (AZ only)602-242-4306 (fax)

ArkansasArkansas Disability Coalition2801 Lee Ave Suite BLittle Rock AR 72205501-614-7020501-614-9082 FAX1-800-223-1330 AR onlyadcceinet

FOCUS Inc305 W Jefferson AveJonesboro AR 72401870-935-2750870-931-3755 FAXfocusincipanet

CaliforniaDREDF2212 Sixth StreetBerkeley CA 94710510-644-2555510-841-8645 (fax)1-800-466-4232dredfdredforghttpwwwdredforg

Exceptional Parents Unlimited(EPU)4120 N First StreetFresno CA 93726209-229-2000209-229-2956 (fax)epu1cybergatecom

Matrix555 Northgate Dr Ste ASan Rafael CA 94903415-499-3877415-499-3854 (TDD)415-507-9457 (fax)1-800-578-2592matrixmatrixparentsorghttpwwwmatrixparentsorg

Parents Helping Parents - SanFrancisco594 Monterey BlvdSan Francisco CA 94127-2416415-841-8820415-841-8824 (fax)

Parents Helping Parents -Santa Clara3041 Olcott StSanta Clara CA 95054-3222408-727-5775408-727-7655 (TDD)408-727-0182 (fax)infophpcomhttpwwwphpco

Support for Families ofChildren with Disabilities2601 Mission 710San Francisco CA 94110-3111415-282-7494415-282-1226 (fax)sfcdmissaolcom

TASK100 W Cerritos AveAnaheim CA 92805-6546714-533-TASK (8275)714-533-2533 (fax)taskcaaolcom

TASK- San Diego3750 Convoy St Ste 303San Diego CA 92111-3741619-874-2386619-874-2375 (fax)

ColoradoPEAK Parent Center Inc6055 Lehman Drive Ste 101Colorado Springs CO 80918719-531-9400719-531-9403 (TDD)800-284-0251719-531-9452 (fax)PKPARENTaolcom

ConnecticutCPAC338 Main StreetNiantic CT 06357860-739-3089860-739-7460 (fax)1-800-445-2722 (in CT)cpacincaolcomhttpwwwmembersaolcomcpacinccpachtm

DelawareParent Information Center(PIC) of Delaware Inc700 Barksdale Road Ste 3Newark DE 19711302-366-0152302-366-0178 (TDD)302-366-0276 (fax)PEP700aolcom

FloridaFamily Network on Disabilitiesof Florida2735 Whitney RoadClearwater FL 24620813-523-1130800-285-5736 (FL only)813-523-8687 (fax)fndgatenethttpwwwgatenet~fnd

GeorgiaParents Educating Parentsand Professionals for AllChildren (PEPPAC)8318 Durelee Lane Ste 101Douglasville GA 30134770-577-7771770-577-7774 (fax)peppacbellsouthnet

HawaiiAWARELearning DisabilitiesAssociation of Hawaii200 N Vineyard Blvd Ste 310Honolulu HI 96817808-536-9684808-536-2280 (TTY)808-537-6780 (fax)ldahgtenet

IdahoIdaho Parents Unlimited Inc(IPUL)Parents Education amp ResourceCenter4696 Overland Rd Ste 478Boise ID 83705208-342-5884800-242-IPUL (4785)208-342-1408 (fax)ipulrmcinethttpwwwhomermcinetIPUL

IllinoisDesigns for Change6 N Michigan Ave Ste 1600Chicago IL 60602312-857-9292312-857-1013 (TDD)312-857-9299 (fax)1-800-851-8728DFC1aolcom

Family Resource Center onDisabilities (FRCD)20 East Jackson Blvd Rm 900Chicago IL 60604312-939-3513312-939-3519 (TDDTTY)312-939-7297 (fax)1-800-952-4199 (IL only)

Family TIES Network830 South Spring StreetSpringfield IL 62704800-865-7842217-544-6018 (fax)ftiesnaolcom

National Center for Latinoswith Disabilities1921 South Blue IslandChicago IL 60608312-666-3393312-666-1788 (TDD)312-666-1787 (fax)1-800-532-3393ncldinteraccesscom

6

that can be used to compensate for some deficitthat a person may have For individuals with se-vere mental or physical disabilities the techno-logical solutions can help to solve multiple andcomplex problems But individuals with less in-volved problems also can benefit from assistivetechnology For example individuals with learn-ing disabilities who have difficulty with readingor writing can benefit educationally from usingthe word processing and voiced reading capa-bilities of computers

Isnrsquot assistive technology just a crutch Wonrsquotstudents become too dependent on technol-ogy and not learn to use the skills they have

Assistive technology should be used as sup-port for access learning and performing dailytasks In general assistive technology is appro-priate when it compensates for disabilities so thatthe individual can function as normally as pos-sible If assistive technology is necessary for astudent to have access to educational opportuni-ties or to benefit from education then it is not aldquocrutchrdquo but a legitimate support

Some skills are too laborious or taxing to ac-complish at a rate or with degree of proficiencyto allow for participation in the least restrictiveenvironment With assistive technology the stu-dent can participate more fully and more closelyapproximate the levels of achievement and in-teraction of his or her peers

The use of assistive technology enhancesfunction and increases skills and opportunitiesThough a student may be dependent upon a par-ticular device in order to perform skillfully de-nying the device denies the student an opportu-nity ever to achieve success at the level of his orher potential

When is using assistive technology appropri-ate

Assistive technology may be considered ap-propriate when it does any or all of the follow-ing things

bull Enables an individual to perform functions

that can be achieved by no other means

bull Enables an individual to approximate nor-mal fluency rate or standardsmdasha level ofaccomplishment which could not beachieved by any other means

bull Provides access for participation in pro-grams or activities which otherwise wouldbe closed to the individual

bull Increases endurance or ability to persevereand complete tasks that otherwise are toolaborious to be attempted on a routine ba-sis

bull Enables an individual to concentrate onlearning or employment tasks rather thanmechanical tasks

bull Provides greater access to information

bull Supports normal social interactions withpeers and adults

bull Supports participation in the least restric-tive educational environment

SummaryAssistive technology means any device which

helps an individual with an impairment to per-form tasks of daily living There is a wide rangeof types of devices in assistive technology fromlow tech homemade aids to computers and so-phisticated electronic equipment Assistive tech-nology is one of the services which can be pro-vided in a special education program under theIndividuals with Disabilities Education Act(IDEA) The requirements of IDEA say that stu-dents who need assistive technology are entitledto the aids and devices and the assistive technol-ogy services (eg evaluation for assistive tech-nology and modification and maintenance ofequipment) that are necessary for the student tobenefit from a free appropriate public education

Hints for Parents

It is never too soon to consider using assistive tech-nology Some infants with physical disabilities for ex-

7

ample really benefit from early interaction with toysthat operate by switch Here are suggestions for timesto evaluate a child for assistive technology

bull When disability limits interaction with the envi-ronment and interferes with experiential learn-ing

Assistive technology can be used to providephysical access to the environment (egswitch toys floor scooters touch window)

bull When a significant gap exists between receptiveand expressive abilities

Assistive technology can assist with expres-sion through the use of programmableswitches electronic communication devicesvoiced word processing braille embossingand so forth

bull When an individualrsquos performance falls behindthat of his or her peers

If an individualrsquos handwriting for exampleis very slow laborious and difficult to readuse of a word processing device can be sub-stituted for handwriting thus allowing theindividual to keep up with others in termsof written expression

bull When a physical disability is impeding the edu-cationalvocational potential of an individual

Assistive technology can provide access tothe workplace for example by allowing anindividual who is blind to learn to use ascreen reader and voiced word processingto do clerical tasks that would otherwise beimpossible

bull When a disability is impeding the independenceof an individual

Sometimes assistive technology can be usedto allow a person with a disability to func-tion more independently For example hav-ing a power wheelchair allows an individualto travel independently without the neces-sity of having someone to push the wheel-chair

SaraSara who has Down syndrome is eight

years-old Her language and speech skills arethree years delayed but she has age appropriatesocial skills Sara has spent part of her schoolday in a regular classroom ever since kindergar-ten but this year her third grade teacher is sug-gesting that Sara really cannot keep up with herclassmates The teacher thinks that Sara wouldbe better off in a self-contained class with stu-dents who work at her pace Sara has some finemotor coordination problems and she has haddifficulty learning to write in cursive Her oralreading is hampered by her speech difficultiesHowever Sara has learned to do addition andsubtraction problems well and has mastered add-ing with carrying and subtraction with borrow-ing She reads at about a second grade level withreasonably good comprehension Sararsquos parentswould like to see her continue in the regular class-room for as much time as possible but they rec-ognize that Sararsquos writing and speaking problemsare keeping her from doing her best work

What are Sararsquos needs

What kinds of technology should go in SararsquosIEP

How would you make a case for puttingassistive technology into her IEP

8

Sararsquos SolutionSararsquos IEP Team met to discuss her needs and

concluded that she is doing well in a regular class-room setting she is making adequate progressin academic skills and has learned how to inter-act socially with her peers It is to be expectedthat Sara will have difficulty keeping up with thepace in a third grade but as long as she is mak-ing progress toward her individual goals theregular classroom is a good setting for her How-ever some simple accommodations and technol-ogy may help Sara to work faster and more effi-ciently

At this point Sara may need some assistancewith handwriting and speaking but the solutionsto her problems in these areas need not be com-plex ones The team decided that Sara shouldcontinue to practice cursive until she has mas-tered all the letters and can be more facile in us-ing script However while she is still learningcursive she needs other means for respondingin writing For short written responses the teamagreed that Sara should be encouraged to usemanuscript printing When speed is importantor when writing assignments are longer Sarashould have access to a computer with an adap-tive keyboard (eg IntelliKeys) The adaptivekeyboard is helpful for Sara because the ldquokeysrdquoare larger and easier to see Using the keyboardrequires only a very light touch so Sara finds iteasier to use than a standard computer keyboard

In terms of oral reading the team decided tohave Sara practice reading into a tape recorderHer speech therapist will work with her on slow-ing down her rate of speech and reading withexpression When Sara has a good tape of heroral reading she will submit it to her teacher forreview

Solution SummaryPractice cursiveUse manuscript printing for short assign-

ments

Use computer with adaptive keyboard forlonger assignments

Practice oral reading using a tape recorder

9

Making Assistive Technology Decisions

W hen parents learn about assistive tech-nology and the wonderful opportuni-ties it can provide they want to jump

right in and get the latest in technology for theirchildren Who wouldnrsquot want an augmentativecommunication device for a child who cannottalk What parents wouldnrsquot want to buy a com-puter if it would help their child learn

When the world of assistive technology opensup for parents it can be like entering a great toystoremdasheverything looks so wonderful that itmakes it hard to know what to select Choosingthe right device to meet an individualrsquos needsrequires technical knowledge and indepth under-standing of the individualrsquos functional capabili-ties Not only is the selection of a device madedifficult by the complexity of the equipment andthe demands of the individualrsquos impairmentassistive technology devices can be very expen-sive Making such purchases is a major financialcommitment for most families one that takes agreat deal of soul searching and sometimes sig-nificant sacrifice

Families invest more than money in theirchildrenrsquos assistive technology Practical invest-ments of time and effort and emotional invest-ments of hope and enthusiasm are made withevery assistive technology purchase Because ofthe high level of financial personal and emotionalcommitment family disappointment is greatwhen equipment fails to perform as expected

Buying and then not using a device becauseof dissatisfaction can be a devastating experiencefor all concerned That is why it is so importantfor parents to proceed cautiously into the worldof assistive technology and make purchases onlyafter careful evaluation and trials with the newdevice Following is a summary of some sug-gestions for parents to consider before makingany assistive technology purchase be realisticabout your childrsquos capabilities and needs get a

multidisciplinary evaluation examine availabletechnology with a critical eye match the childrsquosneeds to specific equipment features do not makea purchase until you have used the device for atrial period identify next steps and determinewhat needs to be done for follow-up after pur-chase

Guidelines for Making Assistive TechnologyDecisions

bull Be realistic about your childrsquos capabilitiesand needs

Assistive technology can open up excitingnew opportunities for a child but it is not magicThere are certain basic requirements for any in-dividual to be successful with technology and itis important to face these requirements squarelyThere is nothing more disappointing or discour-aging than purchasing expensive equipment fora child which is beyond his or her capabilities touse

Prerequisites for Computer Use Physicalor sensory impairments do not limit access tocomputers but cognition is a factor in computeroperation The major prerequisite for using acomputer (with or without adaptations) is thecognitive ability to understand cause and effectThe child must be able to understand that thecomputer operates (eg changes does some-thing) because the child has activated the equip-ment through some volitional movement or ac-tivity (eg eyebeam speaking puffing into astraw hitting a switch) Some children enjoyplaying with switches by hitting them randomlybut may not be able to connect their own behav-ior to the response their movement activates Inorder to be successful in interacting with a com-puter the user must be able to control some voli-tional activity and to do so consistently For ex-ample the child would have to be able to acti-vate the computer in response to a visual tactileor auditory prompt

10

Another prerequisite to computer use is theability to make conscious meaningful choicesbetween alternatives like yes and no The choicescan be very simple ones but there has to be evi-dence that the child has made an actual decisionand not merely acted randomly

If a child does not have the concept of causeand effect or cannot make consistent choices us-ing a computer is probably not a worthwhile nextstep at this point in the childrsquos developmentOther types of activities may be more appropri-ate less expensive and just as rewarding devel-opmentally and personally

Prerequisites for Augmentative Communi-cation Augmentative communication devicescan literally give voice to the thoughts of indi-viduals who cannot speak or cannot speak clearlybutmdashagainmdashthese devices are not magic Elec-tronic communication devices are of no valueunless the user has some communicative intentThat is for a communication device to be help-ful the user has to have some basic understand-ing of the communication process and must beintentional in expressing choices desires orneeds

For example Maggie is a four-year-old whois nonverbal She communicates her wants andneeds by using eyeblinks as responses to yes orno questions When Maggiersquos dad asks her if shewould like another glass of milk she indicatesher choice by raising her eyes up vertically foryes or moving her eyes down for no Maggieclearly knows what she wants to communicateshe has a consistent method for making herwishes known and she expects that her dad willunderstand her communication and act on it

Dan who is also nonverbal communicatesin a different way He points to objects and makesgestures to show what he wants or needs Hisgestures are clear and used consistently so thatfamily members and even people who do notknow Dan well can understand most of the timewhat he is communicating

Shelley communicates very basic informationabout how she feels by crying when she is un-comfortable or wants attention and by laughingwhen she enjoys something like music brightlights or water running Shelley does not how-ever respond to yes or no questions She doesnot make choices even when objects are pre-sented to her individually or in pairs She can-not respond to a question like ldquoDo you want someice cream nowrdquo Or ldquoWould you like the teddybear or the dollrdquo

Maggie and Dan may benefit from usingsome communication device because they arealready using communication systems meaning-fully and consistently Shelley however mayneed to develop greater ability to communicatemeaningfully before moving on to electroniccommunication

Communication skills fall along a continuumAt one end of the continuum are very simplecommunications like expressing preferences byindicating yes or no pointing or gesturing towardobjects or pointing to pictures Use of sign is amore complex form of communication becauseit requires that the user understand that the signsare symbols for meaningful communicationsWhen an individual is able to string togethersigns or words into meaningful phrases this isan additional step toward more complex com-munication When a person understands syntaxand is aware of typical word order this is anotherstep forward Each of these advances along thecommunication continuum represents a step to-ward more complex and sophisticated commu-nication Whatever assistive communicationdevice is chosen should match or just slightlyexceed the place on the continuum where the in-dividual is functioning It makes no sense forexample to purchase an elaborate electronic com-munication device that requires understandingsymbols and syntax when the individual usingthe device is just at the point of learning how toexpress yes and no preferences

An electronic device does not teach commu-

11

nication it enhances communication by givingaudible expression to thoughts that already existin the mind of the user If the thoughts are notthere yet or are not completely formed they can-not be expressed by the device

Physical and Sensory Impairments Are NotBarriers Mastery of a few simple prerequisiteskills is necessary before computers or electroniccommunication devices should be consideredbut it is not necessary for a child to master everydevelopmental milestone before entering theworld of assistive technology Physical or sensoryimpairments can often be circumvented by thetechnology itself and typical developmentalmilestones can sometimes be bypassed so thatassistive technology can be used For examplesome educators assume that students cannot usecomputers until they have completely masteredkeyboarding skills This is a false assumptionMany students benefit from using computerseven though they operate the machine using aldquohunt and peckrdquo method or only one or two keysIn a similar fashion students with limited verbalability who have not mastered oral speech ben-efit from using augmentative communicationdevices while they continue to develop oral lan-guage

Overall the keys to knowing when to tryassistive technology are (a) being realistic aboutthe childrsquos cognitive abilities and potential and(b) being open to trying the level of technology

which meets the child where he or she is

bull Get a multidisciplinary evaluation

Evaluations for assistive technology are notalways easy to arrange In many parts of theUnited States there is no convenient center orldquoplacerdquo to go for an assessment The availablecenters may be far away in another city or evenanother state Since assistive technology is a newfield the systems for disseminating informationand providing assistance are in the process ofevolving Parents may have to be ldquoassistive tech-nology detectivesrdquo in order to put together theinformation needed for a complete AT evalua-tion for their child

The place to start the evaluation is by consid-ering the functions the child needs to performand cannot because of impairment The physi-cians teachers and therapists currently workingwith the child as well as family members andfriends who are around the child on a daily ba-sis can provide very valuable information aboutfunctional problems and potential solutions

Finding Functional Solutions The Alliancefor Technology Access (ATA) a national networkof assistive technology centers has developed aninformal method for using the functional infor-mation available from professionals family mem-bers and friends as a basis for analyzing assistivetechnology needs This process called a Solu-tion Circle is a means to bring people togetherin an informal session that allows for creative

figure 2 Factors to consider when selecting Assistive T echnology

Cognitive Factorsbull Diminished Cognitive Abilitiesbull Learning Disabilitiesbull Attention Deficitsbull SensoryPerceptual Deficitsbull Memory Deficitsbull Abstract Reasoning Deficitsbull Problem-Solving Deficits

Motor Factorsbull Voluntary Motor Deficitsbull Involuntary Motor Deficitsbull Fixed Posture amp Positioning Deficitsbull Recurring Purposeless Motionbull Motor Paralysisbull Low Muscle Tonebull Rigiditybull Spasticitybull Tremors

12

thinking and is not inhibited by what is ldquolegalrdquoldquocurrently availablerdquo or ldquowhat has been done be-forerdquo The individual with a disability and 4-10family members professionals and friends gettogether to brainstorm ideas about the technol-ogy which may help the individual perform func-tions that are hard or impossible to do becauseof disability The Circle usually includes a bal-ance between people who know the person whoneeds the technology and people who have spe-cialized knowledge about technology educationor work-related issues

Solution Circle for Tom To demonstratehow the Solution Circle works letrsquos take a lookat how this process was used in the case of Toma high school student with a learning disabilityFor Tom the print in textbooks is a significantbarrier to learning Tom is ldquoprint disabledrdquo thatis he cannot read the printed word with muchcomprehension Reading is a slow unproductiveprocess for him even though he is intelligent andeager to learn Tom and his parents were hopingthat there might be a way that new technologycould help Tom overcome or work around hisproblem with reading so that he could get moreout of school and perhaps go on to college

Tomrsquos Solution Circle included his parentsBetty and Bob his resource teacher a friendDarrell his soccer coach his 4-H leader and theowner of a local computer store This group mettogether to think about how Tom could partici-pate more fully in school and prepare himself forcollege even though he could not read with com-prehension past the second or third grade level

Solution Circles generally take 1 to 1 12 hoursto complete The steps include the following

1 Star Time The individual for whom theSolution Circle is being held is described in a ho-listic way The emphasis is on how the individualis functioning at home and in the communityWhat does he or she like and dislike What arehisher goals Interests If possible the indi-vidual with a disability speaks for himself or her-self or a video or pictures may be presented The

point of this part of the discussion is give a clearpicture of the individual as a whole person

At Tomrsquos Solution Circle he explained hisdream of going to college and becoming an agri-cultural botanist Tom loves plants he is inter-ested in breeding new strains of wheat and per-fecting various types of grain crops Tomrsquos 4-Hleader agreed that Tom had real gifts in under-standing plant growth and physiology and thathe already had sophisticated knowledge aboutbotany which would prepare him well for col-lege study

2 Strengths With a complete picture of theindividual in mind the group then makes an ex-haustive list of the individualrsquos strengths particu-larly noting any technological accommodationswhich the individual is already using What doesthe individual do well What are his or her un-impaired functions Often this discussion revealsan incredible number of adaptations that the in-dividual has already achieved

Tomrsquos Solution Circle discovered that he hadmany strengths including keen intelligence per-severance and thoroughness when approachinga task Tom already had some effective learningstrategies for remembering material that heheard He had also learned to use a small taperecorder for keeping track of information pro-vided in class

3 Obstacles With the individualrsquos strengthsin mind the group then turns its attention to aconsideration of the environment in which theindividual is functioning and the activities inwhich the individual wants to participate butcannot at this time The group considers whatthe obstacles and barriers might be for the indi-vidual in his or her environment and makes alist of these impediments

For Tom reading was a serious obstacle Hecould not keep up with homework assignmentsbecause it took him so long to read his textbooksIn addition he had difficulty reading directionson tests and often misread assignments on the

13

COGNITIVE FACTORSCognitive Ability

Documented below average abilityDocumented significant overall delayDoes not appear age appropriateLacks understanding of cause amp ef-

fectPaying Attention

Difficulty following prompts or direc-tions

Difficulty with multi-step proceduresDifficulty filtering informationDifficulty staying on task

PerceptionNeeds lengthened response timeRequires multi-sensory inputDifficulty with rapid changeSignificant visualperceptual problemsSlow visual-motor dexterity

MemoryDifficulty with recallRequires reteaching learned skillsRequires repeated practice

Abstract ReasoningDifficulty analyzing simple proceduresUnable to reproduce a sequenceUnable to analyze or synthesize in-

formationProblem Solving

Unable to use prompts or cues to ac-complish tasks

Unable to modify attempts and try an-other way

MOTOR FACTORSMobility

Needs help to be mobileNeeds motorized help to be indepen-

dentNeeds help boarding transportationUnable to transfer independentlyCannot climb stairsCannot open doors independentlyCannot carry materials in hands or

armsCannot lift weight

Voluntary MotorLimited control of head trunk or ex-

tremitiesVisual motor deficitsFixed position and posture

figure 3 ASSISTIVE TECHNOLOGY EVALUATIONIndividual Functional Analysis

Name Date

Needs support to sit or standNeeds adaptations in order to use

technologyMotor Paralysis

Changes in muscle tone interfere inmotor movements

Spastic movements result in poor con-trol

Limited movement of head arms orlegs

Difficulty balancing in sitting positionDifficulty maintaining good posture

Low Muscle ToneLimited use of arms or legsPoor posture controlFatigues quickly

RigidityInhibits arm and leg movementInhibits balance to sitInhibits good posture

SpasticityLimited upper range of motionLimited lower range of motionInterferes with accuracy and consis-

tency of motor movements on oneside

TremorsPresent all the timePresent when doing purposeful upper

extremity taskUnable to compensate for tremors

Extraneous MovementAthetoid (constant)Ataxia (poor coordination in move-

ment)FINE MOTOR

DexterityLimited fine motor controlHas limited hand movement

HandwritingWriting or copying ability is signifi-

cantly below peersSignificant legibility factor--written

work not readableCannot keep up with the pace of writ-

ten workIs frustrated by writingFatigue is a factorTyping appears to be potentially faster

than handwriting

SELF CARENeeds assistance with going to the

bathroomUnable to be toilet trainedNeeds assistance to eatCannot take in food orallyNeeds suctioning routinelyHas degenerative medical conditionIs medically fragileSeizures limit alertnessNeeds to rest frequentlyNeeds assistance to zip coat or tie

shoesCOMMUNICATION

Receptive LanguageReceptive language is significantly

lower than abilityReceptive language is significantly

higher than expressiveExpressive Language

Speech is unintelligibleExpressive language is significantly

lower than abilityMean Length of Utterance (MLU) is 3

words or lessSpontaneous or self initiated language

is significantly limitedDoes not make choices consistentlyDoes not respond appropriately with

yes or noDoes not have communicative intent

SENSORYVision

Requires corrective lensesRequires large print to readRequires mobility trainingHas blind spot

HearingRequires preferential seatingHearing limitations affect the language

thresholdsRequires assistance to receive lan-

guageRequires sign language to receive lan-

guageHas fluctuating hearing lossNeeds visual signals for safety pur-

poses

14

blackboard

4 The Enemy Within Physical and cogni-tive impairments may pose difficult obstacles foran individual but often the feelings that peoplehave about the individualrsquos disability or aboutassistive technology pose greater problems thanthe disabilities themselves The Solution Circleprocess recognizes that human fears concernsreservations and prejudices might stand in theway of a personrsquos success as much as other typesof limitations Getting these fears and concernsout on the table often helps the group to deal moreconstructively with what is possible and whatneeds to be done

One of the serious issues in Tomrsquos situationwas that his resource teacher felt he should con-tinue to try to read for himself instead of using aldquocrutchrdquo like assistive technology The teacherthought that if Tom did not have to read all thematerial he would lose what little reading skillhe had In some ways the teacherrsquos oppositionto considering assistive technology actually poseda greater barrier than the reading problem itself

5 Solutions The exciting part of a SolutionCircle occurs when the group takes each obstacleor concern and turns it into a possible solutionthrough the use of technology or some other typeof adaptation Not all solutions suggested even-tually prove to be feasible but the point of thediscussion is to produce many possible solutionsso that the individual and his or her family havean array of options from which to choose Withgood minds puzzling over the problems and aspirit of cooperation and collaboration seeminglyimpossible barriers can be removed or conqueredThe process recognizes the expertise and contri-butions of all participants including the indi-vidual with disabilities and his or her familymembers The freewheeling format of the dis-cussion promotes ingenuity and innovation Allinvolved come away from a Solution Circle ener-gized by the new possibilities

Tomrsquos Solution Circle became excited about

the possibility of solving his reading problem byusing computerized texts The computer storeoperator mentioned he had heard that Record-ings for the Blind (RFB) offered textbooks on diskTomrsquos parents got in touch with Recordings forthe Blind and ordered texts for Tom to try on hiscomputer at school Soon Tom found that hecould keep up with his classmates and study ex-actly the same material that they were coveringBecause Tom had good strategies for memoriz-ing information that he heard he learned quicklyfrom the texts that were read aloud to him by thecomputer When given oral tests by his classroomteachers he was able to recite appropriate an-swers which would have eluded him if he hadhad to read the tests for himself

Technology has made all the difference forTom he has every reason to think that he will beable to go to college and pursue his intellectualinterests His resource teacher is now completelysold on the idea of assistive technology and us-ing computerized books and wants to use thetechnique with other students More than thatTomrsquos teacher also appreciates the process of theSolution Circle which allowed professionals andnonprofessionals to work together to find prac-tical solutions without being too concerned aboutthe formalities of the special education processThe informal nature of the Solution Circle vali-dated the expertise of all the participants andgave everyone a chance to offer suggestions Thecombination of a new process for planning andnew technology made Tom a winner This samecombination holds potential for many studentslike Tom who benefit from technologies whicheliminate barriers and open up new possibilitiesfor learning

From Function to Technology Solution Ithappened that a participant in Tomrsquos SolutionCircle hit on a great idea for a solution to his func-tional problem with reading This was a fortu-nate connection to make At the suggestions ofhis Solution Circle Tom began to use computer-ized books which he ldquoreadsrdquo by having the com-

15

puter speak the words as he follows along withthe text For Tom computerized books proved tobe a successful solution to his reading problembecause they help him to get the information heneeds without struggling with the reading pro-cess

Not every Solution Circle will be like Tomrsquosand identify the exact technology that the indi-vidual needs But if a Solution Circle has workedwell the end result will be a clear analysis of thefunctions that need to be performed This func-tional information can then be brought to techni-cians who can make suggestions for possibleassistive technology solutions There are over 50assistive technology centers in the United Stateswhere knowledgeable individuals can assistpeople with disabilities and their families withmaking a match between functions that need tobe performed and the technology that is availableto perform those tasks A list of assistive technol-ogy centers is available in the Appendix to thisGuide

Formal Assessment Solution Circles are aneffective informal way to identify functionalneeds that can be met through technology How-ever in the school setting it is also necessary toestablish a studentrsquos needs for technology in amore formal way Formal evaluations for assistivetechnology must be multi-disciplinary involvingeducators and therapists who are knowledgeableabout the school curriculum and the particulartypes of impairments that the student being as-sessed may have For example for a student withcerebral palsy the assistive technology evaluationmight involve a teacher a physical therapist aspeech and language clinician and an occupa-tional therapist The teacher would assist thetherapists in determining what skills the studentneeded to learn and how technology might assistthe student in acquiring those skills Someassistive technology evaluations might require theadditional services of an A-V technician adap-tive physical education teacher a rehabilitationcounselor or speech and language pathologist

with specialized training in augmentative com-munication In school districts where there is nospecialized expertise in technology and its appli-cations it may be necessary to contract for evalu-ations with special education cooperatives medi-cal centers or centers that focus on technologyassessment

Individuals conducting an assistive technol-ogy evaluation should

bull Be knowledgeable of the studentrsquosstrengths and weaknesses medical needsmobility fine and gross motor skills cog-nitive ability communication abilities vo-cational potential self help needs sensoryabilities level of academic achievementand area(s) of disability

bull Have knowledge of and access to an arrayof assistive technology devices

bull Be familiar with the studentrsquos educationalsetting and educational needs

bull Be able to communicate effectively withparents and educators

Because the assistive technology field is sonew there are no particular licenses orcredentialing processes to identify a professionalas qualified to do assistive technology evalua-tions Generally speaking individuals with pro-fessional licenses as occupational or physicaltherapists special educators speech pathologistsor rehabilitative counselors may have the exper-tise to conduct an AT evaluation When consid-ering an evaluator it is wise to ask about theevaluatorrsquos specific experience with assistivetechnology It is also important to recognize thatno one person or discipline will know everythingabout assistive technology therefore access toknowledgeable people at the local level andthrough other agencies programs or services isessential

Conducting the AT Evaluation The assistivetechnology evaluation must be tailored to theunique needs of the student In some cases theevaluation may be conducted by at team of indi-

16

viduals in other cases the evaluation may beconducted by a single individual (eg the speechpathologist) Questions to be addressed duringthe assessment should be related to the specifictasks the student needs to be able to perform andwhat if any assistive technology would helpThe following questions may be considered dur-ing the assessment

bull What tasks does the student need to per-form that he or she cannot perform

bull Is there a low tech device which will ad-dress the studentrsquos needs satisfactorily

bull What types of high tech assistive devicesmay help the student in performing thetask

bull Will assistive technology help the studentto perform the task in the least restrictiveenvironment

bull Is the device being considered suited to thestudentrsquos educational needs and abilities

bull Will the assistive technology device remainsuitable over time How long lasting willthis solution potentially be

The above are only a few of the considerationswhich need to be addressed as part of the evalu-ation process There is no specific ldquotestrdquo forevaluating the need for assistive technologyTherefore prior to conducting the evaluation theindividuals doing the assessment need to have awell planned process in mind

The formal written assistive technologyevaluation report should address but not belimited to the following points

bull Procedures used to evaluate the student

bull Instruments employed in the evaluationassuring that a range of levels of technolo-gies has been considered

bull Results of evaluations including bothqualitative and quantitative measures

bull Recommendations for levels of technologyappropriate to the studentrsquos capabilitiesand potentials and

bull Implications for educational program-ming including discussion of both indi-vidual technology needs and recom-mended environmental and instructionalmodifications

In the end an assistive technology evaluationshould provide recommendations for accommo-dations adaptations devices and services basedon the individualrsquos strengths needs and pre-ferred lifestyle The evaluation should indicate(a) whether devices and services have potentialfor improving function and (b) what trainingmay be necessary in order to use the technologyequipment safely and effectively

bull Examine available technology with a criti-cal eye

It is easy to be dazzled by the possibilities innew assistive technology but it is important forparents to be wise consumers and ask probingquestions about the features and quality of anassistive technology device The following is alist of questions to consider when evaluating aparticular assistive technology device

Performance

Does it work efficiently and effectively

Is it easy to learn to use this device

Is it compatible with other devices

Does this device serve only one purposeor is it flexible

ldquoElegancerdquo

Does this device represent the simplestmost efficient way to accomplish the task

Or is this device too elaborate too com-plicated to be worthwhile

Ergonomics

Does it fit the individual

Is it convenient to use in the environment

Is the equipment portable enough to gowhere the user goes

Are different devices needed in differentenvironments

17

Reliability

What is the manufacturerrsquos reputation forreliability

Does it stand up well to normal use

Is it durable

Safety

Is it safe to use

What is the power source for the deviceIs it safe

Is a margin built in for foreseeable mis-use

Practicality

Do company sales people seem knowl-edgeable and helpful

Are the companyrsquos service people knowl-edgeable and helpful

Does the device have a warranty Howlong is the device guaranteed to function

How available are repair services Atwhat cost

Can this device be leased

Is this device available for a trial periodbefore purchase

Will this device soon be outdated Issomething better on the horizon

Will the company update the device

Does the manufacturer provide trainingin using the device

Aesthetics

Is this device attractive to the eye

Does the device fit well into the userrsquoslifestyle

Normalization

Does the device assist the user with morenormalized living

Can the user operate the device indepen-dently or with a minimum of assistance

Or does the device ldquostick outrdquo too muchand advertise the disability of the user

Does the equipment minimize differenceor exaggerate difference

Does the device have the potential to in-crease the quantity and quality of time spentwith nondisabled peers Or does the de-vice separate the user from others

Cost effectiveness

Do the benefits the device provides jus-tify the cost

Are there less expensive devices or mod-els that serve the purpose as well

Personal acceptance

Is this device the userrsquos own choice

Does the potential user like this deviceand want to use it

Does the potential user view this deviceas life-enhancing

Would the user have preferred some otherdevice or means to perform the task

Will using the device always be a choreor can using it become a habit

There are several ways that consumers canfind answers to their specific questions aboutassistive technology devices Most vendors willprovide good basic information about the prod-uct Call the vendor and ask for brochures prod-uct specifications price list and any other writ-ten information This is a place to start A sec-ond step is to read reviews of the product in trademagazines or Closing the Gap a widely respectedpublication that reviews new assistive technol-ogy products If possible it is very helpful totalk to other consumers who are already usingthe product Ask them about the pros and consof using the device Then visit a preview centerif there is one nearby and try out several typesof devices Ask for general recommendationsfrom the preview centerrsquos staff After identify-ing a device that appears to meet the potentialuserrsquos needs try the device out for a month tosix weeks to make sure that it performs as adver-tised and fits in well with the userrsquos lifestyle

18

During the trial period it will be possible to iden-tify training needs for the user family membersand school staff The trial period will also be atime for the user to test the device in several set-tings to determine its portability and flexibility

bull Match the Individualrsquos Needs to SpecificEquipment Features

When considering an assistive technologydevice it is very important to consider how adevice matches up with the particularindividualrsquos needs and habits In some ways anassistive device becomes an extension of theuserrsquos mind and body As such it is a highly per-sonal item A device may work as advertisedbut still not meet an individualrsquos needs becausethe individual just does not feel ldquocomfortablerdquo inusing it For example Cindy a fourteen-year-oldwho is totally blind and has mild cerebral palsyaffecting her hands and arms was being taughtMorse Code as a means to speed up her writingShe had difficulty using a Brailler because her armstrength was so limited so her teacher thoughtMorse Code would be an easier method of writ-ing for Cindy The only problem was that Cindydid not like using Morse Code To her it seemedlike she was having to learn another complicatedlanguage when she already knew braille andliked to use it Cindy admitted that writing inbraille was slow for her but she was more com-fortable with it Cindy and her teacher were atan impasse until a friend suggested to Cindy thatshe try writing on a voice-output computerCindy loved the computer With a headset at-tached to the sound system she could listen care-fully to the computer as it read aloud the lettersand words she was typing on a light touch tac-tile-marked keyboard This computer also had afeature of printing out text in either standard printor braille Cindy was delightedmdashshe could writecopy for herself to read in braille and for hersighted teachers to read in regular print Thissolution worked because it met Cindyrsquos learningneeds and responded to her own ideas about her-self She did not want to use Morse Code because

it was a separate type of communication knownonly to a few With her computer voiced soft-ware and dual printer she had the best of twoworldsmdashshe could ldquohearrdquo her writing as shetyped she could read it over in braille and hersighted teachers could read her finished prod-uct This solution helped Cindy to improve hercomposition skills speed up her writing timeand communicate more easily with sightedpeople

Cindy was fortunate because her assistivetechnology solution met her needs almost per-fectly Such a close match is not however al-ways possible Nonetheless every effort shouldbe made to have the match be as close as it canbe In general when assistive technology solu-tions are individualized simple to use and re-sponsive to the whole person they are more likelyto be used by the individual When the deviceperforms a task well but does not ldquofitrdquo the indi-vidual the technology is likely to be abandonedby the user in favor of something else whichmeets the need more exactly Too often devicesare purchased because of their technical poten-tial without thought to their relationship to theindividual and his or her lifestyle These mis-matched devices are the ones that end up lan-guishing in their packing boxesmdasha sad reminderof time and money spent to no avail

bull Try the Device Before Buying

It cannot be emphasized enough how vital itis to try out assistive technology devices andequipment before buying Trying out a devicefor several weeks provides the user with an op-portunity to learn how to use the device and howto adapt to its features while at the same timetesting the device in the various environmentswhere it will be used For example Mike triedout a communication device which attachednicely to his wheelchair tray and was compat-ible with his computer that he used for doingschool work Though the communication deviceworked well and was relatively easy to program

19

MOTORSELF CARE

manual wheelchairpower wheelchairbus liftsupportive classroom

chairstanderwalkerlift for transferspositioning devicecanes or crutchesadapted commodesuctioning devicebraces or supportsother ____________

________________

________________

________________

________________

________________

________________

________________

________________

________________

________________

________________

figure 4 ASSISTIVE TECHNOLOGY EVALUATION

Device or Equipment Features or Functions

Name Date

FINE MOTOR

word processorword processor with

predictionvoiced word proces-

sor with predictionadapted keyboardkeyguardalternative key

arrangementvoice activated

computer accessinfrared computer

accessmouse accesstrackballjoystickpower padswitch (eg mouth

lip chin)touch screenpointersdrag and click desk

accessorysticky keysonscreen keyboardprinter for written

work

adapted feedingutensils

braces or splintsother ____________

________________

________________

COGNITIVECOMMU-NICATION

communciationboard(s)

communication wallettotal communicationmanual signword processor with

voiceprogrammed voice

outputicon predictionelectronic communi-

cation deviceprogrammable switch

with voice output

no-reading-neces-sary word proces-sor

spell checkergrammar checkeroutlining programother ____________

________________

________________

________________

________________

________________

________________

________________

SENSORYPERCEP-TUAL

hearing aid(s)

classroom amplifica-tion

boosted signal tonoise ratio (egheadset to keepfocus during wordprocessing)

corrective lensesenlarged printtaped booksvoiced word process-

ingvoiced screen

directionsCCTVother ____________

________________

________________

________________

________________

________________

________________

________________

________________

________________

________________

20

Mike found out quickly that the device was justtoo bulky to be useful for him When he trav-eled around the school the communication de-vice blocked his view of the terrain and of peoplepassing by He found he missed opportunitiesto communicate because he could not see whowas coming his way Mike also discovered thatthe communication device did not serve him wellin crowds like at pep rallies or basketball gamesAfter a month of working with this communica-tion device Mike decided it was not for him andselected instead a device that was less compli-cated smaller and more portable The seconddevice was not as sophisticated as the first but itbetter met his needs for quick communicationwith friends in social settings If he had not hadthe opportunity to try out both devices for anextended period of time Mike might not haverealized the value of the second device and mayhave been stuck with a communication devicethat was too large and too sophisticated to matchhis lifestyle

Similarly Marilyn benefited from a trial pe-riod with her communication device She foundout the first week that the particular device shehad chosen would not work for her because itbroke too easily and it was difficult to get re-paired During the first week that Marilyn hadthe device for trial her teacher broke one of thebuttons during a programming session It tooktwo weeks to contact the manufacturer and thenthe device had to be mailed back to the factoryfor repairs The device was gone for over sixweeks and the manufacturer would not supplya ldquoloanerrdquo while Marilyn waited for repairs tothe first device This experience taught Marilynthe importance of having a responsive manufac-turer who is willing to repair devices quickly andto supply substitutes for the user while repairsare being made Marilyn decided on a differentdevice with similar features and a great helplineto provide assistance with the maintenance of themachine

The information that can be learned during a

trial period with a device is invaluable to the userIt is discouraging to find out during the trial thata device is not all it is purported to be or that itdoes not work as well as advertised but it is farbetter to learn before purchase that a device doesnot meet the userrsquos needs than to learn after pur-chase and be stuck with an expensive unusablemachine For the consumer it is daunting to thinkabout starting over again with the process of se-lecting a device Nonetheless it is worthwhileto seek more information and look again Hav-ing been through a trial even when the outcomeis not successful provides the user with greaterclarity about what an appropriate device willhave to be able to do The second time aroundthe search is likely to go faster and come out witha better result

bull Identify Next Steps

Once a device has been selected the con-sumer becomes impatient to have one and beginusing it right away But at this point importantwork still needs to be done Funding the deviceis a major consideration Sometimes families willpay for the device themselves but under othercircumstances the device will be purchased by aschool district through Medicaid or private in-surance or through some other means Parentsneed to become familiar with the various fund-ing options and determine which one will workfor them (See Funding Assistive Technology foradditional information about funding sources)

Also when considering funding familiesshould think about costs beyond the price of thedevice itself For example a computer set-upwith a keyboard monitor and printer might cost$3500 This equipment is basically useless un-less other equipment is purchased as well soft-ware adaptive devices paper manuals up-grades Prices for these additions can raise theactual cost of the device by hundreds of dollars

Devices often require training for the userfamily members and others to ensure effectiveand safe use How much does training cost Who

21

will provide it Repair and maintenance are othercosts usually additional to the price of the equip-ment Sometimes families will also want to insurethe assistive device so insurance payments be-come part of the overall cost

Since making an assistive technology pur-chase is such an important personal and finan-cial decision it is wise to have a realistic budgetin mind that includes all of the equipment andservices that are necessary to make the assistivetechnology work effectively With this budget inmind it becomes easier to plan the purchase seekout funding sources and make a compelling casefor financial assistance

bull Determine What Follow-up Is Needed

After the assistive technology device has beenpurchased and put to use there are additionalfollow-up activities that need to take place Theoriginal assistive technology evaluation shouldinclude a way to monitor the use of the devicePeriodic scheduled reviews the by evaluator fol-low-up calls to and from the family are some waysto help assure effective safe use Families whotravel great distances for evaluation need to becertain that services like maintenance repair andreplacement of devices are available within a rea-sonable distance from home

Assistive technology devices are used bestwhen all the people in the life of the individualwith disabilities understand the devices in thesame way At first devices may seem to exagger-ate differences between a person and the rest ofthe world Care should be taken to explain thatassistive equipment is a difference equalizer nota difference maker Classmates and friends needto understand that the adapted seating or adaptedkeyboard helps the individual do what other stu-dents do Adults in a childrsquos life need to under-stand that devices work to make life easier bet-ter and more functional People need to knowthat ramps help keep individuals with mobilitydisabilities from being separated from peers thatcommunication technology allows people to

ldquospeakrdquo their thoughts

Close communication between parents andtheir childrsquos helpersmdashteachers therapists daycare workers and othersmdashis essential to makesure devices and services are being used safelyand effectively If the device is working well butthe child is not being integrated into the class-room or other environments then there may bea need for additional training for the children andadults who interact with the child

Besides keeping track of how the device isworking and being used it is important to ob-serve progress in the areas of technology whichare useful to the individual with the assistivetechnology device As upgrades of equipmentoccur or more sophisticated models come on themarket the user may want to consider modify-ing or replacing the equipment that is currentlyin use Also as the individual becomes moreskilled at using technology the individual mayoutgrow the current device and need to look formore advanced equipment It can be assumedwith most high tech items that in three to fiveyears there will be a need for upgrade or replace-ment The wise consumer begins early to planfor the next step in technology including savingmoney for a new device and staying alert to thenew options that become available

What kinds of training are important to occurwhen a child has a new assistive technologydevice

Because assistive technology of the high techvariety is so new it is particularly important thattraining be provided to all those who may needit In the school setting it is helpful for all edu-cators and administrators to have some aware-ness training so that they have a general idea ofwhat assistive technology is Areas to be cov-ered in inservice training might include

bull legal issues related to assistive technology

bull awareness training concerning how toserve students with assistive technologyneeds

22

bull information on how assistive technologyrelates to the evaluation process

bull how to write IEPs for students who requireuse of assistive technology devices

bull the relationship between technology andstudent placement

bull the nature of common assistive technologydevices

bull resources to contact for information onassistive technology

Beyond these awareness activities thosemembers of the school staff who work directlywith a student who uses technology need to havetraining on the specifics of using the device andhow it is maintained and serviced Trainingshould include but not be limited to the follow-ing

bull review of the studentrsquos educational andassistive technology needs

bull review of goals and objectives supplemen-tary aids and services and related serviceson the IEP or IFSP

bull training on how to use and maintain thedevice

bull training on proper transport of the devicewithin the school building and from hometo school

bull training on how to program the device ifneeded

bull training on how to use the device effec-tively during instruction

bull training in trouble-shooting when the de-vice is not working properly

bull information about what to do when thedevice is not functioning or broken

bull information about how to coordinateassistive technology with all the activitiesin the studentrsquos day

bull training in methods to evaluate the effec-tiveness of assistive technology

Depending on the type of assistive technol-

ogy used by the student and the studentrsquos needsit may be advantageous for assistive technologyinformation to be shared with the studentrsquos peersSuch training will help fellow students to gainan understanding of the studentrsquos assistive de-vice foster acceptance in the social environmentand reduce fears other students may have aboutsocializing with the student who uses technol-ogy In some cases parents and the student maywant to be involved in the peer training

Parents may require training too in order forthe device to be used at home for the student tocomplete homework assignments or participatein extended school year services Once trainedthe parents can become a resource to the studentfor proper care and maintenance of the device

Most importantly the student himself or her-self will need training in how to use the deviceas independently as possible Training for thestudent may be written into the IEP as a separategoal or may be included as a related service thatsupports the studentrsquos special education pro-gram

SummaryPurchasing a high tech assistive technology

device is a major life decision because of the po-tential impact on the individual and because suchdevices can be costly When considering anassistive technology device it is important to dothe following be realistic about the consumerrsquoscapabilities and needs get a multidisciplinaryevaluation examine available technology with acritical eye match the individualrsquos needs to spe-cific equipment features test the device for a trialperiod identify next steps and determine whatneeds to be done for follow-up after purchaseEvaluations for assistive technology both infor-mal and formal should consider first of all thefunctions that the consumer wishes to performusing technology When evaluating a particularpiece of equipment consideration should begiven to the following features performance sim-

23

plicity of design ergonomics reliability safetypracticality aesthetics normalization cost effec-tiveness and personal acceptance Good sourcesof information about assistive devices are manu-facturers publications trade journals previewcenters and consumers who are already using thedevice Once a device is selected the consumerwill need to secure funding for the purchase andbe aware of additional costs for related equip-ment insurance and training

Hints for Parents

Donrsquot let the cost of assistive technology deter youfrom considering it for your child High tech assistivetechnology can be quite costly but it can also makethe difference for your child in terms of becoming welleducated employable and a fully-included member ofthe community Donrsquot leave any stone unturned whenlooking for funding sources Consider any or all ofthe following for funding or assistance

bull Early intervention programs

bull Schools

bull Transition programs

bull Vocational Rehabilitation

bull State Programs for Children with SpecialHealth Care Needs

bull Medicaid

bull Medicare

bull State Technology Resources

bull Used Equipment

bull Leasing

bull Equipment Loan Programs

bull Disability Organizations

SierraSierra wants to play with dolls like other chil-

dren her age but she has a muscle disease thathas caused her to lose muscle tone except in onehand What could be done to allow Sierra to dressand undress her dolls comb their hair and bathethem

Sierrarsquos SolutionThe assistive technology solution for Sierra

involved her whole family While vacationingin Mexico Sierrarsquos grandmother found her a fash-ion doll that was a bit larger than the typicalldquoBarbie dollrdquo The larger doll was easier for Si-erra to manipulate Sierrarsquos mother sewed sev-eral outfits for the doll using velcro instead ofsnaps or buttons as fasteners

Sierrarsquos dad bought doll stands at a toy storeand fastened several stands with clamps toSierrarsquos wheelchair tray He also fastened a plas-tic pouch to the tray Sierra puts the small dollaccessories in the pouch When Sierra wants todress her doll she puts the doll in one of thestands In this way the doll is held securely andSierra can dress and undress the doll with onehand

Sierrarsquos friends also use the doll stands fortheir dolls With this arrangement two or threegirls can play together

Solution SummaryLarger doll

Velcro fasteners

Plastic pouch

Doll stands

Clamps

24

Funding Assistive Technology

F unding for assistive technology is availablefrom a variety of public and privatesources To receive public or private fund-

ing the individual must meet eligibility criteriafor the specific program and provide sufficientdocumentation of the need for assistive technol-ogy

The following list includes some of the pro-grams which may pay for equipment if the indi-vidual needing the device meets their require-ments Many of these programs are run by dif-ferent agencies in different states making themhard to find In general the statersquos Tech Act of-fice can assist consumers and family members infinding and using these programs (See Appen-dix under Resources)

PUBLIC PROGRAMSEarly Intervention Programs (Individuals withDisabilities Education Act Part H)

Young children (0-3) and their families mayreceive help through early intervention programsin evaluating what the child needs in gettingassistive technology and in learning how to useit Equipment and services must be included ina written plan called an Individualized FamilyService Plan (IFSP) To find the program for aparticular state call National Early ChildhoodTechnical Assistance System (NECTAS) at 919-962-2001 or 919-966-4041 (TDD)

Head StartThis child development program provides

comprehensive educational and health servicesfor eligible children ages 3-5 Since 1982 federallaw has required that at least 10 percent of thetotal number of placements must be available tochildren who are disabled and require specialservices Head Start is a mainstream placementoption for children whose IEP calls for placementwith nondisabled children The January 1993Head Start regulations specifically require the

consideration of assistive technology services anddevices For more information contact NationalHead Start Association 201 N Union St Suite320 Alexandria VA 22314 703-739-0875

Schools (IDEA Part B)This program mandates a free appropriate

public education for preschoolers children andyouth with disabilities An Individualized Edu-cation Program (IEP) is required for all childrenwith a disability These children are entitled tospecial education related services or supplemen-tary aids If the IEP team determines that assistivetechnology is required for a free appropriatepublic education then it must be provided at nocost to the child The technology must be in-cluded in the childrsquos Individualized EducationProgram (IEP) Parents have a right to be in-volved and should help to develop the IEP goalswhich may include technology For help in get-ting assistive technology in the IEP call the TAPPFocus Center on Assistive Technology at 1-800-222-7585

State Operated and Supported Schools (Chap-ter I)

This program provides federal assistance tohelp educate children with disabilities who areenrolled in state-operated and state-supportedprograms Federal funds must be used to payfor services that supplement a childrsquos basic spe-cial education program such as construction andthe purchase of equipment For more informa-tion contact your State Department of Education

Section 504 of the Rehabilitation Act of 1973Section 504 provides a civil-rights mandate

that requires accommodations for students whohave disabilities such as orthopedic impairmentsbut who do not qualify for special education ser-vices It denies federal funds to any institutionincluding a school whose practices or policiesdiscriminate against individuals with disabilities

25

This legislation has resulted in a number of out-comes including various actions to remove physi-cal barriers to education which may incorporateassistive technology For more information con-tact the nearest regional Office of Civil Rights orthe State Vocational Rehabilitation Agency

State Programs for Children with SpecialHealth Care Needs

These programs provide and pay for servicesfor eligible children CSHCN programs varywidely from state to state in the services they of-fer the number of children served and the re-quirements for eligibility Some CSHCN pro-grams do pay for assistive technology deviceswhen no other funding source is available andthe equipment is necessary for health-related rea-sons Most CSHCN programs are run by the statehealth agency To contact CSHCN ask informa-tion for the telephone number of the state healthagency

School-to-Work Transition ProgramsTransition Programs are charged with assist-

ing students with disabilities to receive the jobrelated training and placement services to helpthem move from school to work Sometimesassistive technology may be necessary in orderfor a student to make a successful transition andbecome employable If technology is needed fortransition purposes it can be written into thestudentrsquos Individualized Transition Plan (ITP) Toreceive more information about transition andtechnology call the Parent Training and Informa-tion Center (PTI) in your state (See Appendix)

Vocational Rehabilitation ServicesState vocational rehabilitation agencies pro-

vide information evaluation services trainingand funding for technology and education to helpadults go to work or live more independently Iftechnology is necessary for an individual to workVocational Rehabilitation may pay for the equip-ment as part of an Individualized Work-RelatedPlan (IWRP) To locate the nearest Vocational Re-habilitation Agency look in the telephone book

under state government

Plan to Achieve Self-Support (PASS)One of many Social Security Administration

work incentive programs this program providesan income and resource exclusion that allows ablind or disabled person to set aside income andresources for a work goal such as educationequipment purchase vocational training andstarting a business It should be considered forall students with vocational goals who are receiv-ing social security benefits

This program provides a mechanism forpeople to set aside funds to purchase work-re-lated equipment such as assistive technologydevices and services In many cases if an indi-vidual is a recipient of SSI and writes a PASS topurchase education or equipment an additionalSSI check will be provided to cover other livingexpenses Sometimes if a person receives SocialSecurity Disability Insurance (SSDI) and designsa PASS it may make the individual eligible forSSI because the SSDI has been allocated for equip-ment and services

Impairment-Related Work Expense (IRWE)Impairment-Related Work Expense (IRWE)mdash

one of the Social Security Administrationrsquos workincentive programsmdashallows an employed indi-vidual with a disability who receives or is eligiblefor SSI or SSDI to deduct work-related expensesfrom gross reported income

This deduction allows the person to continuedrawing SSDI or SSI and associated benefits(Medicaid or Medicare) if the IRWE deductionreduces earning below the Substantial GainfulActivity (SGA) Test

Although this method does not provide fund-ing to pay for a device or service it is a way ofallowing the use of the individualrsquos own moneyto pay for assistive devices and services neces-sary to return to work The following is a list ofpossible work-related expenses special transpor-tation to and from work personal assistance onthe job structural modifications durable medi-

26

cal equipment prostheses medical supplies andservices work-related equipment non-medicalappliances and equipment routine drug andmedical costs and diagnostic procedure costs

MedicaidMedicaid is a joint federal and state program

which covers some equipment if it is consideredmedically necessary For more information aboutMedicaid and who and what is covered contactthe local Department of Human Services office

MedicareAlthough not a usual source of funds for

assistive technology Part B of Medicare providescoverage for some durable medical equipment ifit is considered medically necessary and is foruse in the personrsquos home For more informationabout Medicare benefits contact the Social Secu-rity Administration Regional Office

Technology-Related Assistance for Individualswith Disabilities Act of 1988

This federal competitive grants program pro-vides monies for states to establish a statewideconsumer-responsive service delivery system de-signed to effect systems change regardingassistive technology In most Tech Act states afunding specialist or policy analyst is availableto assist with accessing assistive technology Sev-eral states operate loan programs to help withthe purchase of devices and services For moreinformation contact RESNA Technology Assis-tance Project 1700 N Moore ST Suite 1540 Ar-lington VA 22209-1903 703-524-6686

PRIVATE PROGRAMS

Private InsuranceSome health insurance plans will buy equip-

ment but it depends on the specific wording ofthe policy Unless the policy says the equipmentis not covered it makes sense to ask the insur-ance company to pay for it The equipment mustbe considered medically necessary and thereforerequires a doctorrsquos prescription

Loans

There are several low or no interest loansavailable to help buy technology Call the stateTech Act program or the manufacturer of theequipment may know where to get this type ofloan

Non-Profit Disability AssociationsThere are many disability organizations

some of which may be able to loan equipment orprovide information about other funding sourcesor support groups These organizations includeNational Easter Seal Society March of DimesMuscular Dystrophy Association United WayUnited Cerebral Palsy Association and the BrailleInstitute

FoundationsSome private foundations have been set up

specifically to provide help to people with dis-abilities A listing of such foundations can befound at the library or may be available from thestate Tech Act program

Programs Providing Assistive TechnologyThe state Tech Act programs offer referrals

for evaluation and equipment recommendationsas well as assistance with identifying funding orequipment lending sources A therapy depart-ment in a local hospital or Disabled StudentsCenter at a local college or university may alsooffer to help locate technology programs in thearea Alliance for Technology Access Centers(ATA) sometimes have loan programs or infor-mation about purchasing used equipment orrenting equipment

Civic OrganizationsThere are many local civic and service orga-

nizations which may provide money to helpsomeone in their community Lists of these or-ganizations are available from the Chamber ofCommerce Examples of these organizations areLions Club Masons Grotto Veterans of ForeignWars (VFW) Elks Club Rotary Club KiwanisKnights of Columbus and Soroptomists Someof these organizations have a national focus on

27

disability or on a particular disability Others willfund devices for a particular child who is knownto the local club

Charities and Fund-RaisersLocal churches high school groups neighbor-

hood organizations labor unions or special in-terest groups (eg computer clubs ham opera-tors) may plan a fund-raiser to help purchaseassistive technology College student organiza-tions (fraternities and sororities) may give moneyor studentsrsquo time to help a special cause Even ifmoney is not available they may be willing tohelp organize a fund raiser

Local media (radio television newspapers)sometimes will sponsor fund-raising activities tofund devices They may not contribute moneybut will help with organizing the fund-raisingactivity and publicizing it to the community

OTHER OPTIONS

In addition to federal and private fundingsources there are a number of education-relatedgrants corporate technology donation programsand funding options that consumers should con-sider Information on these alternative options isavailable through a number of sources includ-ing the following

NewslettersEducation Grants Alert Capital Publications

Inc PO Box 1453 Alexandria VA 22313-2052800-655-5597

Education Technology News Business Publish-ers Inc 951 Pershing Dr Silver Spring MD 20910-4464 301-5878-6300

Financing Assistive Technology Smiling Inter-face PO Box 2792 Church St Station New YorkNY 10008-2792 415-864-2220

Special Education Report Capital PublicationsInc PO Box 1453 Alexandria VA 22313-2053800-655-5597

Technology and Learning Peter Li Inc Publish-ing 330 Progress Rd Dayton OH 45449 415-457-4333

Technology ManufacturersIf it is not possible financially to purchase

equipment consumers can sometimes rent orborrow equipment directly from the manufac-turer

Used EquipmentUsed equipment is often advertised for sale

in disability-related publications or the consumercan place a newspaper ad to see if used equip-ment can be purchased locally Several compa-nies refurbish old computers and sell them at lowprices Listings of used computer outlets can beobtained from ATA Centers or state Tech Act pro-grams

LeasingMany manufacturers of assistive technology

devices have equipment which is available forrent or lease Sometimes the rent or lease pay-ments can be applied toward purchase Checkwith the manufacturer to see if this is an option

Equipment Loan ProgramsMany states have equipment loan programs

as do some rehabilitation facilities and disabilityorganizations Information about loan programsis available from Tech Act programs

HOW TO APPLY FOR FUNDING

There is an art to applying for funding forassistive technology It is necessary to use justthe right words to suit the particular agency thatmight be the funding source It is also crucial todocument the need for and projected outcome ofassistive technology This documentation shouldinclude at minimum

bull A written statement of medical need fromdoctors or other health professionals If thechild had an evaluation by a rehabilitationprofession also include this report

bull A description of the childrsquos problems re-sulting from the disability This descrip-tion can come from the doctor or other pro-fessional who evaluated the child

28

bull Description of how the technology helpsthe child For example the equipment maymake the child safer or allow the child todo things more independently Be sure topoint out how money will be saved if useof the equipment allows attendant care tobe reduced

bull A clear statement based on assessmentthat the child is a good candidate who hasthe cognitive and physical capacities nec-essary for using the technology

In summary the documentation to supportan assistive technology funding request shouldinclude a physicianrsquos prescription the childrsquos as-sessment an explanation of projected benefitfrom use of the technology or service and anycorrespondence obtained from professionals thatwould support the childrsquos need for technology

The initial funding request should include notonly the cost of the device but also the cost ofongoing support and instruction in the use of thetechnology Assistive devices often have ldquohid-denrdquo expenses that are incurred with their pur-chase and these expenses are frequently costlyover time Battery-powered devices may requirefrequent charging or cleaning Upgrades for com-puter software may be necessary Special modi-fications of the home or school environment maybe necessary for the technology to be used Ineach of these examples costs associated with thetechnology may have to be assumed by the fam-ily if they are not considered in the initial appli-cation for funding

It is also helpful to include with the fundingrequest a picture or a descriptive brochure aboutthe device being requested This is importantbecause often persons who are reviewing theapplication do not know about the wide rangeof technologies that might be appropriate

Appropriate wording on the application isabsolutely necessary Key concepts for Medic-aid include ldquomedical necessityrdquo and ldquorestore thepatient to his or her best functional levelrdquo The

term medical necessity means that the device isincluded in the course of treatment being pro-vided to the child and that a professional suchas a physician or speech therapist is supervisingits use Medicaid and private insurers alike gen-erally pay for technologies that help restorepeople to ldquofunctioning levelsrdquo and take the placeof a body part that is not working Typically theseprograms do not pay for technologies or serviceswhose function is educational or life-enhancingrather than health related

The key for private insurance is ldquoterms of thepolicyrdquo It must be remembered that coverageby any insurance company does not set a prece-dent Just because one child receives needed tech-nology under a particular policy issued by a com-pany does not mean that all other covered chil-dren will also have technology paid for by thatcompany Each application stands on its ownbased on the expressed terms of the policy

It is usually under the major medical provi-sions of a health policy that assistive technologycan be provided as ldquoother medical services andsuppliesrdquo It may however be necessary to pur-chase additional insurance coverage or a ldquoriderrdquoin order for technology costs to be included inthe terms of the policy It is important to remem-ber that heath insurance policies are oriented to-ward health care and not toward changes in theenvironment or rehabilitation

Both private health insurance policies andMedicaid sometimes impose limits on the num-ber of assistive technology devices over a certaincost that can be purchased within a certain timeframe Sometimes the rule is that the fundingsource will purchase only one device in theindividualrsquos lifetime With these kinds of restric-tions it is all the more critical to be sure that thetechnology choice is the right one

TIPS THAT LEAD TO SUCCESS

bull Apply to several funding sources at thesame time Be sure to meet the require-

29

ments of each agency

bull Find out if agencies will share costs

bull Fill in the agencyrsquos forms correctly Manyapplications are denied because forms arenot filled out properly

bull In addition to the standard form includeany other information that describes orshows what the equipment does and howit benefits the child Assume no knowledgeon the part of the reviewers

bull Turn in all documentation at the same time

bull Avoid using jargon define all unfamiliarterms

bull Take the funding request package to theagency in person While there have itchecked to make sure everything requiredhas been included Get the name of theperson who reviewed the application

bull Call regularly to check on the funding re-quest each time try to talk to the same per-son

bull Be super politemdashand persistent

WHAT IF FUNDING IS DENIED

It is not at all unusual for an initial fundingrequest to be denied Even when family mem-bers and professionals have been meticulous inpreparing applications requesting funding forneeded technology denials should be anticipatedMaking an appeal is worth the effort since manydenials are reversed at the appeal level

To start the appeal process obtain any docu-mentation or information provided by the fund-ing agency (eg Medicaid or the private insur-ance company) relating to appeal proceduresforms to use timelines and filing procedures forinstance This information will help in the promptpreparation for appeal The kind of appeal to bemade depends on the reason for denial Whendeveloping an appeal find out the following

bull Why the request was denied Ask for thereason in writing Sometimes requests are

denied because a reviewer lacks under-standing of the technology or there maybe an error in the paperwork

bull If needed correct any mistakes or includemore information then resubmit the re-quest

Going to appeal makes sense because gener-ally the appeal places the application before moreexperienced persons in the decision-making hi-erarchy The technology requested is often newand the initial examiners in the process may beunaware of its usefulness Also insufficient docu-mentation may have been provided in the origi-nal application and the problem can be remediedon appeal

Donrsquot be daunted by the length of the appealprocess Follow it through to its completion Insome states families may be able to appeal a de-nial beyond the first level For example somestates have ldquounfair claims settlement practicesrdquoregulations which are administered through theinsurance commissionerrsquos office

Always make your appeal in person and takethe child and the equipment if possible If onlypart of the money is offered by one agency askanother agency to share costs If the appeal isdenied try again Submit the funding request toanother agency Being persistent will nearly al-ways result in success

When going through the appeal process turnto the state Protection and Advocacy Program (Pamp A) for guidance and support P amp A advocatescan help make sure that a childrsquos rights to tech-nology and related services are not denied

Who pays when assistive technology is neededat school

The party who is responsible for paying forassistive technology depends upon the circum-stances under which the technology is purchasedUnder the special education law students withdisabilities who are eligible for special educationare entitled to a free appropriate public educa-tion Parents do not have to pay for school ser-

30

vices including assistive technology if that ser-vice is part of the studentrsquos Individualized Edu-cation Program (IEP) If the student is eligible forMedicaid the school district can request thatMedicaid pay for the device If parents choose todo so they may agree to use private insurance topay for a device that is used at school Parentscannot however be forced to use their insurancein this way If the private insurance requires aco-payment the school district would have to paythis amount since parents should not have to payany special education related costs

Does Section 504 pay for assistive technologySection 504 part of the Rehabilitation Act of

1973 is basically a piece of civil rights legislationthat is intended to prevent discrimination againstindividuals with disabilities in any programwhich receives federal funding Students whohave disabilities but who do not qualify for spe-cial education may still be eligible for accommo-dations under Section 504 of the RehabilitationAct of 1973 Section 504 however does not pro-vide any funding for accommodations

Like the special education law Section 504requires public schools to provide students withdisabilities with a free appropriate public educa-tion and in addition ensures that students withdisabilities are afforded an equal opportunity toparticipate in school programs For students withdisabilities this means that schools may need tomake special arrangements so that these studentshave access to the full range of programs andactivities offered For example a student whoneeds a wheelchair lift on a school bus to get toschool must be provided with this technologyOther modifications which might be requiredunder Section 504 include installing ramps intobuildings and modifying bathrooms to provideaccess for individuals with physical disabilitiesEven though required by the law none of thesetypes of modifications would be funded by Sec-tion 504

Under what circumstances does private health

insurance pay for assistive technologySome private health insurance policies will

pay all or part of the cost for some assistive tech-nology devices The devices are unlikely to belisted specifically in the policy but may be in-cluded under some generic term like ldquotherapeu-tic aidsrdquo Usually the devices have to be pre-scribed by a physician in order to be covered bythe policy

When does Medicaid cover assistive technol-ogy

Medicaid (Title XIX) will pay for ldquoprostheticdevicesrdquondashthat is replacement corrective or sup-portive devices prescribed by a physician or otherlicensed person Each state has some flexibilityin determining which prosthetic devices it willinclude in its list of Medicaid covered expensesDevices that are frequently covered by Medicaidare canes crutches walkers manual wheelchairshospital beds and hearing aids or eyeglasses forchildren and youth

SummaryAssistive technology can be expensive to pur-

chase but there are a number of public and pri-vate sources for funding devices Common pub-lic funding sources include early childhood in-tervention programs schools Vocational Reha-bilitation and Medicaid Private sources mayinvolve health insurance personal loans chari-table donations or fundraising It is very impor-tant to provide proper documentation and usecorrect wording and procedures when request-ing funding Initial requests for funding are fre-quently turned down but appeals can be success-ful

31

TEDTed is an active four-year old who lives in a

small rural community with his parents andyounger sisters He was identified as speech im-paired and has been attending preschool specialeducation classes Ted has normal mental capa-bilities but his mild cerebral palsy impairs hisability to speak Because of the speech therapyhe has received Ted is able to make some speechsounds but he says no intelligible words Heuses sign to communicate with his special edu-cation teacher and his parents No one else inhis community uses sign so Ted is limited in hisability to communicate with others

As Tedrsquos IEP Team looks ahead to his entryinto elementary school the Team recognizes thathe will need better communication skills in or-der to participate successfully in the regular class-room His speech therapist has recommendedthat Ted begin to use an AlphaTalker

What funding sources might pay for theAlphaTalker

What case could you make for funding Arethere any obstacles to seeking funding

TEDrsquoS SOLUTIONAt this point Tedrsquos ability to communi-

cate is somewhat primitive Because of his cere-bral palsy he is not able to make conventionalsigns so the gestures he makes are understoodonly by those who know him well A simple elec-tronic communication device may work for Tedbut there are some prerequisite communicationskills he will have to master first Augmentativecommunication devices operate on the principleof choosing icons (abstract symbols) that repre-sent certain basic communications like a cup toindicate ldquoI want a drinkrdquo

In order to make a picturesymbol systemmeaningful and functional for Ted at his youngage his speech therapist began to work on point-to-object and point-to-picture activities WhenTed had mastered point-to-picture activities histherapist made a picture ring for him On thering were picture symbols (icons) for things thatTed might want to say Tedrsquos family his teacherand his classmates began to ask him to use hispictures to explain what he wanted Soon Tedwas using pictures to communicate simple wantsand needs effectively His word ring went withhim everywhere and helped him to ldquotalkrdquo topeople he did not know as well as to friends andfamily members

An unexpected bonus to the picture practiceis that Ted is verbalizing more and his speech hasbecome more intelligible He has even begun tosing An electronic communication device maybe in Tedrsquos future but for now he is learning tocommunicate well with his picture ring and somespoken words

Solution SummaryPoint-to-picture practice

Use of picture ring

32

GLORIAGloria an eighteen year-old with mild cog-

nitive delays and CP is about to finish highschool She has been using a laptop computerand switch access hardware and software in lieuof a pencil and paper to complete work in highschool The equipment and software were pro-vided by the school district through the IEP pro-cess Gloriarsquos current goal articulated in her In-dividual Transition Plan (ITP) as mandated byIDEA is to have a full-time job by the time she is22 She wants to work in an office and woulduse a computer system similar to her currentsetup As she moves into the transition periodthese questions must be addressed

Will the laptop computer she has been usingbe functional for her in the workplace

Will she need to consider new equipmentWhat would influence a decision to purchase newequipment

What funding sources might help Gloria topurchase new equipment

What case should Gloria make for funding

GLORIArsquoS SOLU-TION

Gloria is fortunate to have learned computerand word processing skills while she was inschool Now she must learn ways to transferthese skills into the work setting Laptop com-puters are not typical in offices instead whatGloria is more likely to encounter is a desktopworkstation with computer and printer In or-der to use a standard computer Gloria will needa switch access device and an onscreen keyboardto do word processing and data entry

Since single switch access is necessary forGloria to become employed in an office settingGloriarsquos Vocational Rehabilitation Counselor waswilling to make such a purchase for her Gloriaapplied to be a data processor with a temporaryemployment firm and got the job Gloriarsquos VRcounselor helped her to select switch access hard-ware compatible with most IBM compatible com-puters In her new job Gloria changes office set-tings frequently Each time she moves she takesher switch access device and onscreen keyboardsoftware with her With these portable items sheis able to adapt each new office setting to meether needs Having the right technology has madeGloria an adaptable and successful temporaryoffice employee

Solution SummarySwitch access

Onscreen keyboard software

33

Making Assistive Technology a Part ofChildrsquos Education

The ideal time for a child with a disabilityto learn to use assistive technology is whenthe child is learning all sorts of others skills

in early intervention services preschool and K-12 education Children who are eligible for earlyintervention services under Part C or special edu-cation under Part B of the Individuals with Dis-abilities Education Act (IDEA) are entitled to beevaluated for assistive technology needs and toreceive assistive technology devices and servicesif they are necessary to providing a free appro-priate public education In order for children toreceive the assistive technology to which they areentitled parents must be knowledgeable abouthow assistive technology fits into special educa-tion and the ways that AT can be included in achildrsquos Individualized Family Service Plan (IFSP)or Individualized Education Program (IEP)

ASSISTIVE TECHNOLOGY FOR YOUNG CHILDRENParents are often surprised to learn that

assistive technology can be appropriate for in-fants and toddlers Very young children whohave disabilities that limit their ability to inter-act with the environment by crawling touchingseeing or hearing can benefit from technologythat improves their interactions Federal educa-tion amendments require states to ldquopromote theuse of assistive technology devices and assistivetechnology services where appropriate to en-hance the development of infants and toddlerswith disabilitiesrdquo These amendments furtherrequire states to ldquofacilitate the transition of in-fants with disabilitiesfrom medical care to earlyintervention services and the transition fromearly intervention services to preschool specialeducation or regular education servicesrdquo

When Kayla was an infant her interactionswith the environment were very limited because

she has a genetic condition resulting in abnor-mally short arms and legs She could not turnover or crawl she had difficulty touching andgrasping objects As part of her early interven-tion program Kayla was introduced at the ageof six months to the use of switches When theswitches were positioned correctly she could ac-tivate switch-operated toys or noisemakers Theopportunity to interact with toys opened upKaylarsquos world She soon began to hunt for theswitches and to activate certain toys on com-mand She used the switches to make choicesbetween toys or sounds She became verballymore expressive and began to interact morereadily and more often with her parents and sib-lings

By the time that Kayla was three and readyfor preschool special education she was able tosit up and interact with a computer activated byswitches She could identify objects on the com-puter screen and match those objects to real ob-jects in the world around her At three Kaylacould identify and match some letters and shapeson the computer screen Though limited in hermobility Kayla became an active participant inclassroom activities She could interact withclassmates by playing computer games joiningin at circle time and participating in allpreacademic learning activities

Assistive technology was an integral and nec-essary part of Kaylarsquos early intervention servicesKaylarsquos parents were involved in writing the In-dividualized Family Service Plans (IFSPs) thatoutlined the services Kayla and their familyneeded From the beginning Kaylarsquos family hadthe opportunity to see how assistive technologycould be included in the IFSP and really make adifference in Kaylarsquos education and her life

Kaylarsquos story illustrates how assistive tech-

34

nology can be utilized from an early age and canbe part of the transition from medical treatmentto early intervention and from early interventioninto preschool special education or regular edu-cation Because of the availability of early inter-vention services there is no reason to wait untila child is of school age before trying assistive tech-nology Early use of the necessary technology willenhance a childrsquos development by increasingopportunities to interact with the environment

ASSISTIVE TECHNOLOGY AT SCHOOL AGE ANDBEYOND

When students enter kindergarten and begintheir regular public school years assistive tech-nology can continue to be a part of their specialeducation programs For students who are eli-gible for special education assistive technologymust be provided when it is necessary

(1) to support placement in the least restric-tive environment

(2) to ensure that a student benefits from hisor her education or

(3) to implement the goals and objectives inthe studentrsquos IEP

Needs for assistive technology should be oneof the considerations when a student is assessedto determine eligibility for special education Ifan assessment reveals that a student is eligiblefor special education then the multi-disciplinaryteam should consider assistive technology needswhen making recommendations for the Individu-alized Education Program (IEP) The team shouldanalyze what is required of nondisabled studentsof the same age and determine how many of theserequirements could be completely or partiallyfulfilled by the student being assessed if that stu-dent had access to appropriate assistive technol-ogy

In addition when information is being col-lected for the present level of performance sec-tion of the IEP part of that assessment should bea consideration of whether or not assistive tech-nology is necessary for the student to achieve

educational or social goals benefit from educa-tion or make reasonable progress in the least re-strictive educational setting Whoever is collect-ing the information might experiment withassistive technology applications to determinewhich ones might work for the particular student

Assistive technology should be considered asan option for every IEP Some students of coursewill not require technology but many studentswill benefit from technology that helps them tocompensate for their impairments School dis-tricts are not required to provide all of the pos-sible assistive devices that might be nice to haveor might provide the best possible arrangementsAssistive technology is required however whenits presence enables the student to make reason-able progress toward the goals the IEP Team iden-tifies

HOW TO INCLUDE ASSISTIVE TECHNOLOGY INTHE IEP

Assistive technology can be included in theIEP in a number of ways It may appear as partof the studentrsquos annual goals or short term objec-tives It may also appear in a list of specific ac-commodations which need to be made in orderfor the student to function in the least restrictiveenvironment For example the IEP might includesuch accommodations as the use of word pro-cessing use of a calculator use of a hand heldspell checker and so forth In addition the IEPmay specify that as a related service necessaryfor the student to benefit from his or her educa-tion the student will receive training in the useof assistive equipment like an electronic commu-nication device a power wheelchair or a personalcomputer

WHERE TO PUT ASSISTIVE TECHNOLOGY IN THEIEP

There are three places in the IEP whereassistive technology may appear (1) in the an-nual goals and short term objectives (2) in theenumeration of supplementary aids and servicesnecessary to maintain the student in the least re-

35

strictive educational setting and (3) in the list ofrelated services necessary for the student to ben-efit from his or her education

Assistive technology can be a part of the an-nual goals and short term objectives on an IEPbut there must be a certain degree of specificityin the goal in order for the role of assistive tech-nology to be clear An annual goal for the IEPshould express an estimate of what the studentcan accomplish in a particular domain during thecourse of one year under what conditions theskill is to be developed and what criteria will beused to indicate whether or not the skill has beenlearned

Many times IEP goals are broad vague andtotally nonspecific Such goals are impossible tomeasure and do not give any indication of whatis realistic to expect in terms of the studentrsquos be-havior or skill level in the course of a yearrsquos timeSuch broad goals are not useful in addressingassistive technology The inclusion of assistivetechnology in the IEP requires a degree of speci-ficity so that it is clear how and why the technol-ogy will be used to accomplish a particular goal

An annual goal which includes assistive tech-nology may indicate that the technology will bepart of the conditions under which some aca-demic or social skill will be acquired For ex-ample an IEP goal for a student with a learningdisability in written expression may look like this

10 Using a word processing program with spell-ing checker Shawn will compose three paragraphthemes composed of fifteen or more sentences with 80or better accuracy in the use of spelling punctuationand grammar

Objectives leading to this goal might includepreliminary exploration of the word processingprogram trials to learn effective use of the spell-ing checker drill and practice in writing singleparagraphs to the 80 level of accuracy in spell-ing punctuation and grammar increasing thelength of writing to two paragraphs and theneventually moving to three paragraphs with

gradually increasing degrees of accuracy

Another type of annual goal may address askill which is necessary for using assistive tech-nology Such a goal might appear this way

20 Using an adapted computer keyboard Rachelwill type 12 words per minute with no errors over 10or more consecutive trials

In this case Rachel would spend a year learn-ing keyboarding skills with the goal of achievingat least 12 words per minute with complete ac-curacy For a young student who experiencessome fine motor difficulties this goal would bechallenging but it might be achievable in a yearrsquostime Objectives leading to this goal might in-volve preliminary exploration of the keyboardgradual introduction of the letters and numberson the keyboard practice to build speed and ac-curacy and eventually timed trials until 10 con-secutive trials could be achieved with no errorsat a rate of 12 words per minute or better

Still another type of annual goal might ad-dress a social issue like communication withpeers

30 Using an electronic communication deviceSara will respond appropriately to social inquiries fromclassmates 5 times out of 5 opportunities over 5 con-secutive days

Objectives leading to this goal might includetraining in the use of particular words andphrases on the communication device drill andpractice in responding with the device in struc-tured settings increasing accuracy in respond-ing in structured settings practice in unstruc-tured conversational opportunities and gradualachievement of accuracy in unstructured conver-sational settings with peers

ASSISTIVE TECHNOLOGY AS A RELATED SERVICEAssistive technology can be a related service

just like audiology physical therapy or speech ifit is necessary for the student to benefit from hisor her education For a student to be successfulin using assistive technology he or she must be

36

trained in its use Training to use a computer anaugmentative communication device a PhonicEar or large type viewer or other similar devicescan occur as a related service which supports thestudentrsquos educational program Preparation forthe use of assistive technology can also be workedinto other related services like occupationaltherapy Occupational therapy may involve de-termining correct positioning to take advantageof assistive technology and exercises to preparethe student to use a computer keyboard or a com-munication board

Margo who has muscular dystrophy uses alaptop computer every day in her sixth gradeclass Margorsquos upper body strength is diminish-ing and she is gradually having greater andgreater difficulty using her hands for writing ordrawing Using a computer saves her energy andallows her to keep performing well in the class-room As a related service in her IEP Margo isreceiving occupational therapy designed to pre-pare her for even more adaptations which maybe necessary as she loses more strength Margoand her therapist are experimenting with com-puter access devices (eg switches trackball) andon screen keyboards to determine what methodMargo would like to use when her hands are nolonger strong enough to type on a standard key-board This special training for assistive technol-ogy is written into Margorsquos IEP as a related ser-vice because such training is necessary for her tocontinue to benefit from her education

ASSISTIVE TECHNOLOGY SUPPORT FOR PLACE-MENT IN THE LEAST RESTRICTIVE ENVIRON-MENT

One important feature of assistive technologyis the fact that it can make it easier for studentswith and without disabilities to learn togetherStudents with disabilities are guaranteed the rightto be with nondisabled peers and to receive theireducation in the setting which is the least restric-tive environment In order to be successful in theleast restrictive environment students are to be

afforded whatever supplementary aids and ser-vices are necessary Among the supplementaryaids which may allow a student to remain in aless restrictive environment are a variety ofassistive devices that compensate for disabilityand allow the student to perform educational andsocial tasks Assistive technology is necessary asa supplementary aid if its presence (along withother necessary aids) supports the student suffi-ciently to maintain the placement and its absencerequires the studentrsquos removal to a more restric-tive setting For example if a student with mul-tiple physical disabilities can make progress onhis or her IEP goals in the regular classroom withthe use of a computer and an augmentative com-munication device and cannot make suchprogress in that setting without the devices thenthose devices are necessary supplementary aids

Lyle a fourth grader with cerebral palsy is agood example of a student who thrives in theregular classroom if he has the use of appropri-ate technology Lyle is able to keep up academi-cally with his classmates if he has access to a com-puter with an adapted keyboard and word pre-diction software Lyle has learned to type welland is able to do written assignments in relativelythe same amount of time as other students in hisclass Without a computer Lyle could not keepup at all Handwriting is a laborious task for Lyleand his written product tends to be messy andbarely readable If he could not use a computerLyle would have to rely on others to do hand-writing for him or he would have to do alterna-tive assignments that require no writing

Lyle likes being a regular fourth grader Heis proud of his writing on the computer becausehe is using his own words and learning to editout his mistakes by himself With his computerhe does not need the services of an aide and canbe completely independent in doing his schoolwork

Assistive technology in the form of a com-puter with appropriate software and keyboard

37

adaptations is necessary for Lyle to remain in theregular classroom working independently Thisuse of the computer can be written into his IEPas a supplementary aid which is necessary tosupport Lylersquos placement in the least restrictiveenvironment

Does assistive technology include access toschool buildings

AT certainly can mean devices that provideaccess to school buildings and facilities Oneimportant part of a free appropriate public edu-cation is that students with disabilities are ableto get to school get into the school and use theschool building and facilities Assistive technol-ogy can be used to provide access to the schoolbus classroom playground gymnasium audi-torium lunchroom or the equipment in themAny or all of these needs can be addressed in theIEP

Bus modifications for improved access andappropriate seating can help with transportationto and from school and school activities Doorswalkways handles switches stairs steps can bemodified so that a student with disabilities canuse them as effectively as classmates Appropri-ate seating and playground modifications canhelp include students who have disabilities atclassroom lunchroom and recess times

When an individual graduates from publicschool is it still possible to have assistivetechnology

If individuals benefit from the use of assistivetechnology during their school years the likeli-hood is that assistive technology will be evenmore important for them in adult livingAssistive technology can certainly be part of anindividualrsquos future after high school but it is nec-essary to begin planning for the transition fromhigh school so that the technology and other nec-essary services are available when needed

The earlier a family can estimate their childrsquospost-high school needs including needs for tech-nology the earlier transition planning can begin

Federal legislation says that transition planningcan begin in school as early as ldquo14 or youngerrdquoEach student with a disability who has an Indi-vidualized Education Program (IEP) should havea ldquostatement of transition servicesbeginning nolater than age 16rdquo This means that as early asmiddle school but probably not later than fresh-man year in high school families should begintransition planning

Unlike school services services in the adultworld are not mandated An individual may beeligible for a disability service but not receive itbecause all of the slots are filled or funding is notavailable If an individual does not own his orher own assistive technology devices then partof transition planning will be looking into fund-ing sources that could help with technology pur-chases If technology is necessary for the indi-vidual to become employed it is possible thatVocational Rehabilitation will pay for the devicesas part of an Individual Work-Related Plan(IWRP) Students who go on to postsecondaryeducation at community college vocational-tech-nical schools or universities can expect to be ableto receive certain accommodations for their dis-abilities while on campus Most postsecondaryinstitutions have Student Support Services thathelp with assistive technology needs alternativetesting readers and notetakers

SummaryAssistive technology can be included as an

integral part of a studentrsquos education but par-ents have to be knowledgeable about how to goabout getting assistive technology into theirchildrenrsquos educational plans Assistive technol-ogy can be written into the Individualized Fam-ily Service Plan (IFSP) for infants and toddlers inearly intervention programs and into the Indi-vidualized Education Program (IEP) forpreschoolers and students in grades K through12 Assistive technology can appear in threeplaces in the IEP (a) as part of the goals and ob-jectives (b) as a supplementary aid to support

38

placement in the least restrictive environmentand (c) as a related service Assistive technologycan also be a part of studentsrsquo transition planningas they move from high school into adult pur-suits Assistive technology is available throughVocational Rehabilitation and other adult disabil-ity services but these services are not mandatedTo ensure continued use of assistive technologyit is important to plan ahead and secure fundingfor devices needed in the work or postsecondaryeducation environments

Hints for Parents

If your child is a successful assistive technologyuser begin to save money early in your childrsquos lifemdashjust as you might save for college Gradually accu-mulate enough funding to purchase the kinds of tech-nology your child will need as an adult Technologychanges so fast that it is impossible to predict whatwill be available fifteen years from now But a parentcan be certain that assistive technology of the futurewill be even better than what is available today

EmilyEmily is a seventh grade student who has

learning disabilities She is in regular classes allday in her neighborhood middle school A spe-cial education teacher monitors Emilyrsquos progressand provides the regular classroom teachers withassistance by modifying some of Emilyrsquos assign-ments giving her oral tests helping to organizeEmilyrsquos work and reteaching certain skills asnecessary In elementary school Emily did wellwith the limited amount of support she receivedin the regular classroom In middle school how-ever she is having trouble keeping up with as-signments Emilyrsquos spelling is inaccurate sheoften misspells the same word three or four dif-ferent ways on the same page Her handwritingis very slow and laborious so she spends manyhours each evening working on her homeworkShe has tried tape recording assignments but shefinds this process also to be laborious because itis so time consuming to correct mistakes

It has been recommended that Emily be re-moved from some of her academic classes andreceive instruction in the resource programEmily wants to remain in regular classes but shecanrsquot keep up with the pace

How could assistive technology help Emily

What are her needs

What case could be made for assistive tech-nology for her

39

Emilyrsquos SolutionEmily has reached the point in her educa-

tional career when she cannot keep pace with thedemands of the written work On observingEmily the occupational therapist noted that ittook Emily five times as long as the average stu-dent in her English class to complete written as-signments

Emilyrsquos IEP Team decided she was spendingfar too much time on the handwriting processTo help her with this problem the team agreedthat Emily should learn to use a computer with aword processing program and a voiced spellchecker One period per day Emily goes to theresource room to practice keyboarding and workon longer written assignments During her regu-lar classes Emily uses a portable word proces-sor (eg AlphaSmart) to take notes which shecan print out later in the resource room

These simple solutions allow Emily to speedup her writing time and produce written workthat is easy to correct and edit With technologyto aid her Emily is spending less time on thehandwriting process and more time on thinkingand processing information Her homework timehas been cut in half and Emily is much more re-laxed and confident at school

Solution SummaryKeyboarding training

Use of computer with word processingsoftware

Use of voiced spell checker

Use of portable word processor

BryanBryan is a seventh grader with a neuro-mus-

cular disease that has caused him to lose physi-cal function He is a bright student with excel-lent academic skills Bryan uses a laptop com-puter with a trackball and an onscreen keyboardto do all his written work He navigates skill-fully around the school building using a powerwheelchair Technology has really helped Bryanto fit in and do well at school However now asa young adolescent Bryan is beginning to feelleft out socially He requires so much help withhis physical needs that he has to spend lots oftime with adults Bryan wants to ldquohang outrdquo likethe other kids his age and escape adult scrutinyonce in a while

Bryan is nonverbal He uses a complex so-phisticated electronic communication device toparticipate in class The device is programmedwith phrases that Bryan frequently uses and healso can select icons to create sentences of hisown Bryanrsquos communication device works wellfor him in formal classroom settings but it isbulky and cumbersome to use in casual conver-sation with friends Bryan has come to believethat his communication device is actually a bar-rier to the kinds of informal interactions he wantsto have

Bryan knows that he has the best in technol-ogy and that the equipment he uses was very ex-pensive He doesnrsquot want to appear ldquogreedyrdquo ordemanding so he has not told his parents abouthis dissatisfaction with his ability to communi-cate One of Bryanrsquos friends Michael howevernoticed that Bryan was acting pensive and un-usually quiet Michael gently coaxed the truthout of Bryan and offered to help his friend thinkof a new way to ldquotalkrdquo that would provide himwith more flexibility and independence

40

Bryanrsquos SolutionWhen Bryan and Michael put their heads to-

gether they came up with lots of ideas The onethey settled on as the most feasible involved us-ing the laptop that Bryan already had The laptophad some advantages because it was small andportable and Bryan already knew how to use itvery well In a catalog of special needs softwarethe friends found communication software thatoperated on an icon system and the price wasright--around $100 With communication soft-ware installed on the laptop Bryan had asimplermore portable device for talking in ca-sual settings

Next Michael asked his father to help themmake a tray for Bryanrsquos wheelchair that wouldhold the laptop and fold down beside the chairout of the way when not in use Michaelrsquos dadcame up with a clever tray on hinges that foldedto the side The laptop fastened to the tray withwide rubber bands A handle on the tray allowedBryan to raise and lower the tray as needed

In addition to his laptop Bryan also neededa device for quick greetings and spontaneous re-torts Bryan and Michael chose a programmableswitch with the capacity to record up to 12 mes-sages Bryan could operate the switch quickly byhitting it with his elbow He and Michael had agreat time recording messages suitable for talk-ing to their friends or to girls

What Bryan found out was that he neededmultiple ways to communicate so that he couldcustomize his electronic speech to fit the settingand the occasion For a relatively small financialinvestment Bryan and Michael were able to ex-pand communication possibilities for Bryan andallow him greater control and personal choiceabout what he said how he said it and to whom

Solution SummaryCommunication softwareDrop-down wheelchair trayProgrammable switch

TracyTracy is a man in his mid-thirties who has

been blind from birth Since graduating fromcollege he has held a series of entry level jobs atminimum wage and without benefits Tracy isfrustrated by the lack of challenge in the jobs hehas had he would like to have a managerial po-sition with some opportunities for advancementbetter pay and benefits

Currently Tracy is working at a Pizza Hutrestaurant where he prepares pizzas for the ovenHe enjoys his co-workers and regular customersbut Tracy wants more A management traineeopening has been announced in the companynewsletter and Tracy decides to apply This newposition involves taking pizza orders over thetelephone and sending the order via computerand modem to the appropriate Pizza Hut outletwhere the pizzas will be made Having madeevery possible type and size of pizza Tracy isvery familiar with the options But how couldhe operate the computer and record orders asthey come in over the telephone Would he havea chance for this job which could be his first stepup

41

Tracyrsquos SolutionTracy and his Vocational Rehabilitation Coun-

selor filled out the job application for the posi-tion at Pizza Hutrsquos central ordering facility andTracy was called to set up an interview Prior tothe interview Tracy and his job counselor wentto the central ordering facility for Pizza Hut tostudy aspects of the job and to determine if tech-nology could assist Tracy to perform the essen-tial job functions The job involved the follow-ing steps (1) greeting the customer and takingdown customer information (2) asking a seriesof questions about the customerrsquos order (egtype size toppings) (3) simultaneous record-ing of the order via computer and (4) sendingthe order to the appropriate Pizza Hut outlet

After studying the process of taking ordersTracy and his counselor decided upon the follow-ing technology

(a) A computer compatible with the Pizza Hutnetwork

(b) Voiced software so that Tracy couldldquohearrdquo what he was typing

(c) A telephone headset to listen to the cus-tomer with one ear

(d) an ear piece to listen to the computer

At his interview for the job Tracy explainedhis qualifications for the position--college degreeexperience with Pizza Hut He also told the in-terview team about how technology would al-low him to do the job as efficiently and effectivelyas other workers

The interview team members were impressedby Tracyrsquos initiative and his work ethic Theychose him over several other qualified candi-dates Though it took some detective work toput together a computersoftware package com-patible with Pizza Hutrsquos system Tracy was ableto do it

From the first day on the job Tracy knew he

was going to like it better than anything he haddone before Listening to the computer and thecustomer simultaneously was challenging at firstbut soon Tracy had mastered the process Afterthree months in his new position Tracy wasasked to become the manager for his shift Nowhe hires and trains new order clerks schedulesworkers and evaluates their job performanceTracy has what he wanted--a managerial posi-tion better wages and a future with the com-pany

Solution SummaryCompatible computer terminal

Voiced software

Telephone headset

Ear piece for computer

42

Advocating forAssistive Technology

In the area of Assistive Technology mdash just as in so many areas of need mdash parents must betheir childrenrsquos best advocates Federal and

state laws support providing assistive technol-ogy to individuals with disabilities but theselaws are only meaningful when parents knowabout them and can use legal processes to securetheir childrenrsquos rights Here are just a few of thelaws on which parents can rely when advocat-ing for assistive technology for their children

THE AMERICANS WITH DISABILITIES ACT OF1990

The Americans with Disabilities Act (ADA)proposes to eliminate ldquodiscrimination againstindividuals with disabilitiesto address the ma-jor areas of discrimination faced day-to-day bypeople with disabilitiesrdquo The ADA applies spe-cifically to the areas of employment public ac-commodations and government functions Inthese areas the ADA requires that reasonable ac-commodations be made so that people with dis-abilities can have an equal opportunity to par-ticipate in employment opportunities public ac-commodations and government functions TheADArsquos definition of ldquoauxiliary aids and servicesrdquoits mandates for ldquoacquisition or modifications ofequipment and devicesrdquo and ldquoreasonable accom-modationsrdquo support the provision of assistivetechnology devices and services to individualswith disabilities

THE REHABILITATION ACT OF 1973Section 504 of the Rehabilitation Act requires

that any ldquoprogram or activity receiving Federalfinancial assistancerdquo comply with non-discrimi-nation rules Section 504 Regulations require thatpublic schools provide students who have dis-abilities an educational opportunity equal to theeducational opportunity provided to students

without disabilities Section 504 also uses theterm ldquoreasonable accommodationsrdquo which canmean the provision of assistive technology de-vices and services

THE INDIVIDUALS WITH DISABILITIES EDUCA-TION ACT (IDEA)

The Individuals with Disabilities EducationAct (IDEA) requires free appropriate public edu-cation (FAPE) for students with disabilities IDEAmandates education in the least restrictive envi-ronment requires schools to use supplementaryaids and services special and related services tohelp assure that students with disabilities par-ticipate in and benefit from public educationAssistive technology is specifically mentioned inIDEA as a service which school districts may haveto provide in order for a student with disabilitiesto benefit from special education

THE CARL PERKINS ACTThe Carl Perkins Act assures that Vocational

Education programs in public schools are madeaccessible to students with disabilities The lawassures supplementary services including class-room curriculum and equipment modificationssupportive personnel instructional aides and in-structional devices

PARENT RESPONSIBILITIESIn order to be effective advocates for their

children parents need to familiarize themselveswith all the laws that support the provision ofassistive technology Copies of the laws and theirregulations are available from the offices of mem-bers of the House of Representatives and the Sen-ate

Besides knowing the law parents must par-ticipate actively in developing plans for theirchildrenrsquos education that include assistive tech-nology when it is needed Parents must attend

43

IFSP and IEP meetings and be prepared to workcooperatively with other team members Whena parent questions an assistive technology evalu-ation or an IEP Team recommendation the par-ent must be prepared to follow-up on those ques-tions including using due process rights whennecessary

What should a parent do when an agencyrefuses to pay for assistive technology that achild needs

Agencies like early intervention programsand school districts are mandated to provideassistive technology if the need for technology isin the childrsquos written plan If one of these agen-cies refuses to pay for needed technology then aparent must consider using due process rightsIn early intervention services the parent wouldfollow the appeal process laid out by the leadagency for Part C When school district servicesare involved the parent can file a complaint ifservices in the IEP are not provided or can askfor a due process hearing if the parent and theschool district disagree about the need forassistive technology If a parent disagrees withthe results of an evaluation for assistive technol-ogy the parent can ask for an independent evalu-ation at school district expense

SummaryOverall getting the devices and services for

children with disabilities means that parents mustbe part of the planning team at every level of theirchildrenrsquos education It means talking with otherfamilies and users of assistive technology aboutdevices and services learning how they foundthe best technology and figuring out where togo when resources are few Getting assistive de-vices and services is not always an easy job Buthelp is available Working with professionalstalking with consumers and other families par-ents can find the best avenues for providing theirchildren with the assistive technology they needIn the end the effort is worth it because assistive

technology is not just a civil right guaranteed bylaw it is also a means to achieve human rights togrow up happy independent and self-sufficientas possible

Hints for Parents

When advocating for your child in the special edu-cation arena donrsquot forget the following facts aboutassistive technology and the IEP

bull Assistive technology needs must be con-sidered along with a studentrsquos other edu-cational needs

bull Needs for technology must be identifiedon an individual basis

bull Identification of technology needs mustinvolve parents the student when appro-priate and a multidisciplinary team

bull Parents or other IEP Team members can askfor additional evaluation or an indepen-dent evaluation to determine assistive tech-nology needs

bull When an evaluation is being conductedconsider mobility fine-motor skills com-munication and alternatives to traditionallearning approaches

bull Lack of availability of equipment or costalone cannot be used as an excuse for de-nying assistive technology services

bull If included in the IEP assistive technologyservices and devices must be provided atno cost to the family

bull Parents always have the right to appeal ifassistive technology services are denied

44

More Questions and Answers

A re schools required to pay forassistive technology devices andservices

It is the responsibility of the school dis-trict to provide for the equipment services orprograms identified in the IEP The school dis-trict may pay for the equipment service or pro-grams itself utilize other resources to provide orpay for the device or utilize private insurancefunds Medicaid or other sources of funds as longas the device or services identified in the IEP areprovided at no cost to the parent Private insur-ance or Medicaid may be used ony if the parentagrees

Can schools require the parents to payfor an assistive technology device orservice identified in the studentrsquos IEPor require the parents to use theirown private health insurance to payfor the device or service

No The ldquofreerdquo in FAPE means that parentsof students with disabilities who require assistivetechnology devices or services do not have to payfor these items As stated in IDEA and its regu-lations all special education and related servicesidentified in the studentrsquos IEP must be providedldquoat no cost to the parentrdquo The term ldquofreerdquo is in-terpreted broadly and goes far beyond the simplepaying of deductibles and co-payments Thecourts have interpreted ldquofreerdquo to apply to butnot be limited to future insurability depletionof maximum lifetime caps raised premiums dis-continuation of policies and preexisting condi-tion exclusions If the family agrees to allow theschool to access their Medicaid or private insur-ance this decision must be strictly voluntary onthe part of the family

How can school districts use Medicaidfunds to purchase assistive technologydevices

If Medicaid is capitated in any way concern-

ing its use for assistive devices school districtsmust request from parents the right to use Med-icaid funds However parents are not obligatedto use their Medicaid funds to purchase devicesor services used at school With permission aparentrsquos private insurance must be accessed be-fore Medicaid can be used for assistive technol-ogy devices Medicaid regulations vary some-what from state to state so it is wise to consultthe state Medicaid Service Bureau before mak-ing any assumptions about Medicaid and thepurchase of assistive technology

Are there other options for schools toconsider in lieu of purchasing theassistive technology device

Yes There are times when the outright pur-chase of equipment or devices is not necessaryor even advisable In such instances schoolsmight consider rental or long-term lease optionsThere are certain advantages to renting or leas-ing depending on the individual needs of thestudent For example renting equipment mightbe a reasonable strategy if the student is expectedto improve or deteriorate in a short period of timeor when it is necessary to try out the equipmentbefore purchase Long-term leasing or leasepurchase agreements also have potential benefitsfor schools which include no obligation on be-half of the school to purchase the device abilityto return leased equipment and thus reduce ob-solete inventory flexible leasing terms use ofequipment without a lump-sum purchase up-grading of equipment as more improved tech-nology becomes available and upgrading ofequipment as the studentrsquos needs change

Isnrsquot assistive technology just acrutch Wonrsquot students become toodependent on technology and notlearn to use the skills they have

Assistive technology should be used as sup-port for access learning and performing daily

45

tasks In general assistive technology is appro-priate when it compensates for disabilities so thatthe individual can function as normally as pos-sible If assistive technology is necessary for astudent to have access to educational opportuni-ties or to benefit from education then it is not aldquocrutchrdquo but a legitimate support Some skillsare too laborious or taxing to accomplish at a rateor with degree of proficiency to allow for partici-pation in the least restrictive environment Withassistive technology the student can participatemore fully and more closely approximate the lev-els of achievement and interaction of his or herpeers In general the use of assistive technologyenhances function and increases skills and op-portunities Though a student may be dependentupon a particular device in order to perform skill-fully denying the device denies the student anopportunity ever to achieve success at the levelof his or her potential

When is assistive technology appropri-ate

Assistive technology may be considered ap-propriate when it does any or all of the follow-ing things

bull Enables students to perform functions thatcan be achieved by no other means

bull Enables students to approximate normalfluency rate or standardsmdasha level of ac-complishment which could not beachieved by any other means

bull Provides access for participation in pro-grams or activities which otherwise wouldbe closed to the individual

bull Increases endurance or ability to persevereand complete tasks that otherwise are toolaborious to be attempted on a routine ba-sis

bull Enables students to concentrate on learn-ing tasks rather than mechanical tasks

bull Provides greater access to information

bull Supports normal social interactions with

peers and adults

bull Supports participation in the least restric-tive educational environment

Who owns the special equipment thatis purchased for students

If the school district purchases the equipmentthe equipment belongs to the district Someschool districts designate that a particular deviceis to be used by a specific student during the timewhen that device remains appropriate for thatstudent Other districts have ldquopoolsrdquo of assistivedevices and distribute them for use by a varietyof students The distribution and use of devicesis under the districtrsquos control as long as the needsdescribed in studentsrsquo IEPs are being met

If devices are purchased for a particular stu-dent using that studentrsquos Medicaid funds or pri-vate insurance then the device belongs to the stu-dent and is meant for the exclusive use of thatstudent

When a student moves from one levelof schooling to another like elemen-tary school to middle school does thedevice follow the student

If an assistive device is necessary in order tofulfill the requirements of a studentrsquos IEP such adevice must be provided in whatever school thestudent attends The same device may not nec-essarily follow the student from one school toanother but a comparable device which fulfillsthe IEP requirements would have to be providedin the new school that the student attends

If a family moves from one schooldistrict to another can a studentrsquosassistive technology go along

Devices bought by the school belong to theschool not the student who uses them When afamily moves from one school district to anotherthe equipment the student has been using doesnot automatically move to the new school

Assistive equipment can go with a studentto a new school if the sending school district

46

agrees to sell or give the device to the family orthe new school district

If the device was purchased by the familythrough the familyrsquos private health insurance orby Medicaid for this particular student then thedevice belongs to the student and can go withthe student to a new school district

What happens to assistive technologydevices when students leave the schoolsystem at graduation

If the school district purchased the device thedevice is the property of the school The schoolcould keep the device for use by other studentssell it or decide to transfer the device to anotherdistrict or loan program If the family or anotherfunding source purchased the device it is theproperty of the student and the family

If a piece of assistive technology is nolonger needed or relevant to a studentand the device was paid for by Medic-aid or private insurance can it bedonated for another studentrsquos benefit

Yes it is a parental decision The parentscould donate the device to the school for use byother students with disabilities or to some otherorganization which loans out equipment

Can assistive devices be insured

Many school district liability policies willcover devices purchased by the district for stu-dent use Devices purchased by other fundingsources may or may not be covered while onschool premises or involved in school activitiesIt is important for school staff to investigate thedistrictrsquos property insurance to determine whatthe policy currently covers and whether or notthe policy insures against loss or damage ofassistive devices

Parents who own assistive devices that areused at home and at school may also wish to pur-chase home owners or rentersrsquo insurance with aspecial rider that covers damage to or loss of thedevice

Who is responsible for the repair and

maintenance of assistive devices

In general the school district is responsiblefor repair and maintenance of assistive devicesused to support educational programs describedin the IEP or covered by Section 504

If a device is broken and is beyondrepair who replaces the broken de-vice

If an assistive device is necessary for thestudentrsquos IEP to be implemented then the schooldistrict will have to replace a broken lost or sto-len device

If a device is broken and sent off forrepairs must the school district sup-ply a substitute device until the origi-nal device is returned

If the assistive technology device is vital tothe studentrsquos daily special education program itis not reasonable for the student to be without adevice for long periods of time If a device isgoing to be unavailable for more than a day ortwo the district should provide a backup ma-chine which allows the student to continue work-ing on IEP goals

Is the school district obligated totrain substitute teachers and aides tooperate assistive technology devices

Again if the assistive technology device isvital to the studentrsquos daily special education pro-gram it is not reasonable for the student not tobe able to use the device for long periods of timebecause a substitute is teaching the class If thesubstitute is only going to be in the classroomfor a day or two it is probably not necessary toprovide elaborate training However if the sub-stitute is going to be in the classroom for an ex-tended time training should be provided

Must school districts allow students totake assistive devices home on schoolnights to do homework Over week-ends During school vacations Overthe summer

In many cases it is desirable for students to

47

have the opportunity to use the same assistivetechnology devices at home and in school Forexample when a student is completing home-work assignments assistive technology may benecessary to produce the type of product that isrequired Some school districts have policieswhich allow the devices to go home with the stu-dents overnight on weekends or during vaca-tion or summer periods In general these kindsof policies are a local district matter and may bedetermined according to local district needs Ifhowever a studentrsquos IEP includes a provisionwhich says the student is to have access to anassistive device both at school and at home thenthe school district would be obligated to allowthe student to take a device home or provide twodevices one for home use and one for school

What professionals are consideredqualified to assess a student in thearea of assistive technology

Because assistive technology is such a newfield there are no national standards and few lo-cal or state standards for licensing or certificationfor specialists in assistive technology Howeverschool districts often have professionals who havereceived training in conducting assistive technol-ogy evaluations and are able to provide the ser-vices identified in the IEP If a district does nothave personnel who are knowledgeable in con-ducting such evaluations the district can arrangefor such services from other knowledgeable pro-vidersndash such as Independent Living Projects Al-liance for Technology Access Centers or Tech ActProjects

How can one distinguish betweenassistive technology and personalitems (eg wheelchairs hearing aidseyeglasses crutches)

Currently IDEA does not make a clear dis-tinction between assistive technology devices andpersonal items This confusion stems in large partfrom IDEArsquos broad definition of assistive technol-ogy For example if a student with a disability

needs eye glasses in order to obtain FAPE thenthe school district is obligated to provide themat no cost to the parents In general howeverschool districts do not purchase personally pre-scribed devices such as hearing aids or glasses

Who determines how assistive tech-nology will be purchased and withwhat available funding resourcesmdashtheIEP Team or school administration

Once the IEP team makes the determinationthat assistive technology must be provided aspart of the studentrsquos IEP it is the responsibilityof school administration to determine how theassistive technology will be provided and withwhich funding sources

Is a school district responsible forproviding ldquostate of the artrdquo equip-ment for a student

No The school district need provide onlyappropriate technology in order to meet thestudentrsquos needs as described in the IEP The de-cision as to what type of assistive technology isappropriate should be based on the assistive tech-nology evaluation recommendations and IEPteam decision There may be ldquodevicesrdquo or fea-tures of equipment which may be nice for the stu-dent to have but if they are not necessary forFAPE the school district is not obligated to pro-vide them If a specific device is necessary toensure FAPE and no other device can meet thestudentrsquos needs then the district must providethe required device even though it is costly If aless expensive device would accomplish the samegoals the IEP team is under no obligation tochoose a more expensive option

If a student needs a computer can aschool owned computer be used in thelab or classroom

Yes a school owned computer can be used ifthe student has access to the equipment when heor she needs it If the student does not have thenecessary access then the appropriate equipmentshould be purchased for the studentrsquos use

48

Can school district administratorsinstruct personnel not to includecostly assistive technology devices inthe IEP

IEP teams are charged with the responsibil-ity for determining a studentrsquos need for assistivetechnology devices and services and for specify-ing those devices and services Therefore it isimportant that IEP teams are clearly informed oftheir responsibility to determine if a studentneeds a device and the need for an assistive tech-nology evaluation to assist in making the deter-mination A school district may not have a policywhich prevents IEP teams from identifying astudentrsquos need for assistive devices or services

How does assistive technology getintegrated into the curriculum

The IEP team needs to discuss how the de-vice will be used by the student and how it willbe integrated into the curriculum The IEP teamshould identify on the IEP how the device willbe used by the student in the classroom Thisinformation should be shared with the generalclassroom teachers so that they are aware of howit is to be used

How can assistive technology be pro-vided from year to year with a degreeof continuity

As part of the annual review of the IEP a pointshould be made to devise ways to communicatewith next yearrsquos teachers about the technologythe student uses and how it should be integratedinto the curriculum Teachers who are new toworking with the student who uses technologyshould be provided training if they are unfamil-iar with the device and its use Training for teach-ers and support staff should be written into theIEP as a related service

Can an assistive technology device beused by more than one student

Yes if the device is the property of the schooldistrict and if all of the students using the devicehave access to the equipment when they need it

Can an independent evaluation berequested to address assistive tech-nology

Yes The school district is required to evalu-ate a student in all areas of suspected disabilityincluding if appropriate evaluating the studentrsquosneed for assistive technology A parent has theright to an independent educational evaluationat public expense if the parent disagrees with anevaluation obtained by the school district How-ever the school district may initiate a due pro-cess hearing to show that its evaluation is appro-priate If the final decision is that the evaluationis appropriate the parent still has the right to anindependent educational evaluation but not atpublic expense If the parent obtains an inde-pendent educational evaluation at private ex-pense the results of the evaluation (a) must beconsidered by the school district in any decisionmade with respect to the provision of FAPE tothe child and (b) may be presented as evidenceat a due process hearing

What is a product system

A product system is more than one piece ofequipment working together to produce a resultFor example an FM system that works in con-junction with a studentrsquos hearing aid is a prod-uct system

Can the school district require a stu-dent to bring a personally ownedassistive device such as an augmenta-tive communication system or laptopcomputer to school in order to doschoolwork

No However the family may wish the childto use his or her equipment in school since thechild may be more familiar or comfortable withit The IEP team should decide who is respon-sible for repair and maintenance of family owneddevices

Is it sufficient for a school district tosupply access to a district-ownedcomputer but provide no software

49

that is appropriate for the student touse

Just providing access to a computer does notfulfill the districtrsquos obligation to provide assistivetechnology to support FAPE The educationalaspect of the computer is very much related tothe software that the student uses If no appro-priate software is available then the student can-not pursue the IEP goals

50

Appendix

GlossaryASSISTIVE TECHNOLOGY any sort of aidincluding computers switches calculators spell-ing devices communication devices and voicesynthesizers which is used to help an individualperform some task of daily livingALTERNATIVE KEYBOARD may include en-larged reduced varied key placement one-handed braille chordic or any other device forentering text on a computerAUGMENTATIVE COMMUNICATION anydevice (electronic or otherwise) to enhance com-munication for a person with limited speechBRAILLE EMBOSSER a printer for producingbraille output either manually or when connectedto a computer When printing standard text froma computer it must first be translated into brailleBRANCHING describes the process of choos-ing among a sequence of choices or actions toproduce another sequence of choices This pro-cess is used in the ldquoscanningrdquo method of accessCD-ROM ldquoCompact Disk Read-Only Memoryrdquorefers to the 4-inch silver disks that typically hold700 megabytes of digital information and theplayers that access the information on these disksCURSOR either the flashing vertical or horizon-tal line on a computer screen that indicates theinsertion point for text or the arrow or I-beamthat indicates the position of the mouse pointeron the computer screenDESK ACCESSARY a small utility program thatruns on a computer and may be accessed fromany program at any time (such as a calculator)DRILL AND PRACTICE presents questionsrepetetively but is not a tutorial Software thatis only drill and practise doesnrsquot necessarily teachthe concepts needed to answer the questions pre-sented

ENVIRONMENTAL CONTROL any type ofdevice that an individual may use to control theirenvironment (lights appliances TV telephoneetc) This may include anything from simplereachers or sticks to computers and voice-acti-vated electronic systemsFM SYSTEM a local wireless broadcast systemthat consists of a microphone and transmitter forthe speaker and ldquowalkman-likerdquo receivers withheadphones for listeners with hearingimpairements or attention disordersHIGH TECH use of electronics or computers asa solutionICON a small computer graphic that appears onthe computer screen and may represent differ-ent types of objects (files or applications) or ac-tions depending on the context Use the mousepointer to click on icons that open files or per-form other actionsINDIVIDUAL FAMILY SERVICE PLAN (IFSP)the written document which defines the earlyintervention services provided to the child andfamily The program is designed to meet theneeds of the child and the family and is based onfamily-identified prioritiesINDIVIDUALIZED EDUCATION PROGRAM(IEP) a written plan specifying instructionalgoals and any special education and related ser-vices a student may need which must be writ-ten and reviewed annually Included are (1) thepresent educational levels of the student (2) astatement of annual goals including short-termobjectives (3) a statement of specific services ifneeded (4) the programs (5) the date when spe-cial services are to begin and the expected dura-tion of these services and (6) the tests and otherrequirements or information used to guage thestudentrsquos progress to determine if the instruc-tional objectives are being metINPUT the information that is transmitted to acomputer from a keyboard mouse or other in-

51

put deviceKEYBOARD a device for inputing text and com-mands to a computerKEYGUARD a plexiglass or other cover for akeyboard with holes for the individual keys Itallows more precise selection of keys for an indi-vidual with fine motor difficultiesKEYPAD a small keyboard with a 10-key setupfor numeric input or it may also be used as a con-trol for a screen-reader programLAPTOP a portable battery-powered computerthat is typically the size of a 3-ring binder weighs5-10 pounds and consists of a screen keyboardand disk-drivesLASER DISCS large (12-inch) CD-ROMs thatnormally contain moviesLOW TECH indicates use of low cost non-elec-tronic solutionsMACRO a simple short program that performsan action on a computer They are usually cre-ated by recording the keyboard andor mouseinput and storing them as an icon or key combi-nationMEGABYTE 1000 X 210 bytes of informationwhich basically means over one million key-strokes of computer storage (about 10 novels)MORSE CODE a direct method for computerinput using one to three switches and coded in-put to replace the keyboard and mouseMOUSE the name given to the pointing deviceused to control graphical user interfaces (GUI) ofmodern personal computersONSCREEN KEYBOARD a software programthat places the keyboard on the screen of the com-puter and may be accessed using a mouse or otherpointing device This is ideal for individuals whocannot use a regular keyboard but can use sometype of pointing deviceOPTICAL CHARACTER RECOGNITION(OCR) a process that utilizes special computersoftware to convert the scanned image of text intoactual text that may be edited by a word proces-sorOUTPUT computer-generated information for

the user This may be printed output from aprinter visual information from the screen orsounds from speakersSCANNER an electronic copier connected to acomputer Scanners are used to input drawingspictures or printed text into the computerSCANNING has nothing to do with the elec-tronic copier above It is another method for ac-cessing a computer or communication deviceusing one or more switches Scanning involvespresenting a group of choices cycling amongthem and making choices by activating a switchSCREEN READER software that reads text ona computer screen using a speech synthesizerThis allows individuals with visual impairmentsor other print disabilities to access text on thecomputer screenSIMULATION software that simulates real-world situations on a computer This may rangefrom a joystick trainer for driving an electricwheelchair to running citiesSPEECH SYNTHESIZER hardware or softwarefor producing electronic human speech on a com-puterSPELL CHECKER utility for checking the spell-ing in a documentSTICKY KEYS software or mechanical utility forallowing typing of multiple keystrokes with onefinger (using the shift or other modifier keys)SWITCH a device that is like a single button ofa keyboard or mouse Switches may be used byan individual with servere motor difficulties byany controllable muscle in their body (headhand toe eye breath etc) to operate any typeof computer communication or environmentalcontrol deviceSWITCH INTERFACE black box that connectsto a computer or other device that has plugs forswitchesTDD a text telephone used for communicatingin typed text over a phone line A TDD has akeyboard and text display or small printer Bothparties who are communicating over a phone linemust have TDDs

52

TOUCH WINDOW a computer input devicethat uses a touch-sensitive transparent windowplaced on the computer screen It performsmouse functions with a finger or stylus directlyon the screenTRACKBALL another replacement for themouse pointing device that uses a rolling ball toperform mouse movementsTUTORIAL teaches concepts presents informa-tion as opposed to simple drill and practiceVOICE RECOGNITION computer softwareand microphone that allows input and controlwith voice commandsWORD PREDICTION productivity softwarethat increases typing speed for one-finger typistsand others by predicting and choosing completewordsWORD PROCESSOR software for inputing andformatting textUSER person using a computerUTILITY software for adding function or per-forming housekeeping tasks on a computer

53

DocumentsSCHRAG LETTER ON ASSISTIVE TECHNOLOGY

August 10 1990

Dear Ms Goodman

This is in response to your recent letter to the Office of Special

Education Programs (OSEP) concerning the obligations of public

agencies under Part B of the Education of the Handicapped Act

(EHA-B) to provide assistive technology to children with handi-

caps

Specifically your letter asks

1 Can a school district presumptively deny assistive technol-

ogy to a handicapped student

2 Should the need for assistive technology be considered on

an individual case-by-case basis in the development of the

childs Individual Education Program

In brief it is impermissible under EHA-B for public agencies

(including school districts) to presumptively deny assistive tech-

nology to a child with handicaps before a determination is made

as to whether such technology is an element of a free appropriate

public education (FAPE) for that child Thus consideration of a

childs need for assistive technology must occur on a case-by-

case basis in connection with development of a childs individual-

ized education program (IEP)

We note that your inquiry does not define the term assistive

technology and that the term is not used either in the EHA-B

statute or regulations The technology Related Assistance for

Individuals with Disabilities Act of 1988 PL 100-407 contains

broad definitions of both the terms assistive technology device

and ldquoassistive technology service See Section 3 of PL 100-

407 codified as 29 USC 2201 2202 Our response will use

assistive technology to encompass assistive technology ser-

vices and ldquoassistive technology devices

Under EHA-B State and local educational agencies have re-

sponsibility to ensure that eligible children with handicaps receive

FAPE which includes the provision of special education and re-

lated services without charge in conformity with an IEP 20 USC

1401(18) 34 CFR S3004(a) and (d) The term special educa-

tion is defined as specially designed instruction at no cost to

the parent to meet the unique needs of a handicapped child 34

CFR S30014(a) Further related services is defined as includ-

ing transportation and such developmental corrective and other

supportive services as are required to assist a handicapped child

to benefit from special education 34 CFR ss33013 (a)

The EHA-B regulation includes as examples 13 services that

qualify as related services under EHA-B See 34 CFR S30013

(b)(1)-(13) We emphasize that this list is not exhaustive and

may include other developmental corrective or other supportive

servicesif they are required to assist a handicapped child to

benefit from special education 34 CFR S30013 and Comment

Thus under EHA-B assistive technology could qualify as spe-

cial education or related services

A determination of what is an appropriate educational program

for each child must be individualized and must be reflected in the

content of each childs IEP Each childs IEP must be developed

at a meeting which includes parents and school officials 34 CFR

S300343-300344 Thus if the participants on the IEP team de-

termine that child with handicaps requires assistive technology in

order to receive FAPE and designate such assistive technology

as either special education or a related service the childs IEP

must include a specific statement of such services including the

nature and amount of such services 34 CFR S300346(c) App

C to 34 CFR Part 3000 (Ques 51)

EHA-Bs least restrictive environment (LRE) provisions require

each agency to ensure (t)hat special classes separate school-

ing or other removal of handicapped children from their regular

educational environment occurs only when the nature or severity

of the handicap is such that education in regular classes with the

use of supplementary aids and services cannot be achieved sat-

isfactorily Part 121a 42FR 4251113 (August 23 1977)

Assistive technology can be a form of supplementary aid or ser-

vice utilized to facilitate a childs education in a regular educa-

tional environment Such supplementary aids and services or

modifications to the regular education program must be included

in a childs IEP Id Appendix C to 34 CF art 300 (Ques 48)

In sum a childs needs for assistive technology must be deter-

mined on a case-by-case basis and could be special education

related services or supplementary aids and services for children

with handicaps who are educated in regular classes

I hope the above information has been helpful If we may pro-

vide further assistance please let me know

Sincerely

Judy A Schrag EdD

Director Office of Special Education Programs

54

INDIVIDUALS WITH DISABILITIES EDUCATIONLAW REPORT

Cite as 18 IDELR 627

Digest of Inquiry

(Inquirerrsquos Name Not Provided)

(Date Not Provided)

bull Is a school district responsible to provide assistive

technology devices for home use

bull May a school board overrule a determination by an IEP

team that a child with a disability needs access to an

assistive technology device at home

bull What is the time limit on implementation of an IEP

Digest of Response

(November 27 1991)

Assistive Technology Devices May Be Required for Home Use

If an IEP team determines that a child with a disability needs

access to an assistive technology device at home as a matter of

FAPE then the school district must provide the device for home

use in order to implement the childrsquos IEP

School Board May Not Change IEP Teamrsquos Determination

Under Part B a school board has no authority to unilaterally

change any statement of special education or related services

contained in an IEP including a statement of a childrsquos need to

have access to an assistive technology device at home Without

reconvening the IEP team the school board may not change the

IEP and the school district is obligated to implement the IEP re-

quirements regardless of the school boardrsquos objections

IEPs Must Generally Be Implemented

Under Reg 300342(b) an IEP must be in effect before the

provision of special education or related services and must be

implemented as soon as possible following the conclusion of the

IEP meeting(s) In accordance with Appendix C to the Part 300

regulations an IEP should generally be implemented without de-

lay after being finalized although a reasonable delay may be per-

missible in limited circumstances

__________________

Text of Inquiry

I would like to have a copy of the policy classification on

Assistive Technology

I also have a question to ask regarding Assistive Technology

such as a closed circuit TV

My daughter uses a CCTV in school and it is on her IEP

program My daughter is visually impaired The initial request

was made by me the parent to the appropriate people involved

in her education and discussed and approved by the committee

on an individual basis

My question is I would like to make the request to the ap-

propriate officials for another CCTV for home use to accomplish

the same results at home as is done in school (For homework

reading books any assignments from school)

Another question is If the committee approves this request

it will go to School Board for approval I would like to know what

happens if the School Board doesnrsquot approve the proposal Is it

impartial hearing time

Thank you for your assistance in this matter

Any information regarding Assistive Technology Informative

for school and home use would be greatly appreciated

Is there a time limit on implementation of yearly updated

IEPs[] Every year I have long delays on implementation of board

approved IEPs[]

Text of Response

This is in response to your recent letter to the Office of Spe-

cial Education Programs (OSEP) requesting a copy of any OSEP

policy clarifications on assistive technology as well as asking spe-

cific questions concerning the assistive technology needs for your

daughter You also asked a question about the time limits for

implementation of an individualized education program (IEP)

In response to your request I am enclosing a copy of OSEPrsquos

August 10 1990 letter to Ms Susan Goodman concerning the

obligations of public agencies under Part B of the Individuals with

Disabilities Education Act (Part B) formerly cited as Part B of the

Education of the Handicapped Act to provide assistive technol-

55

ogy to children with disabilities along with some additional infor-

mation on assistive technology and a copy of the Part B regula-

tions I would also like to provide you with OSEPrsquos response to

each of your specific questions as stated below

I would like to make the request to the appropriate officials

for another CCTV for home use to accomplish the same

results as is done in school (For homework reading books

any assignment from school)

The IEP which must be developed at a meeting that includes

parents and school officials must contain among other things a

statement of the specific special education and related services

to be provided to the child See 34 CFR sectsect 300343-300346 As

stated in OSEPrsquos letter to Ms Goodman if the IEP team deter-

mines that a child with disabilities requires assistive technology in

order to receive a free appropriate public education (FAPE) and

designate such assistive technology as either special education

or a related service the childrsquos IEP must include a specific state-

ment of such services including the nature and amount of such

services See 34 CFR sect 300346(c) App C to 34 CFR Part 300

(Ques 51) The need for assistive technology is determined on a

case-by-case basis taking into consideration the unique need of

each individual child If the IEP team determines that a particular

assistive technology item is required for home use in order for a

particular child to be provided FAPE the technology must be pro-

vided to implement the IEP

If the committee approves this request it will go to the School

Board for approval I would like to know what happens if

the School Board doesnrsquot approve the proposal Is it im-

partial hearing time

As part of the public agencyrsquos part B obligation to provide

FAPE to an eligible child with disabilities the public agency must

ensure that special education and related services are provided

in conformity with an IEP which meets the requirements of 34

CFR sectsect 300340-300349 One requirement at 34 CFR sect

300343(a) is that the public agency conduct a meeting to de-

velop review and revise a childrsquos IEP The Regulations require

that certain participants attend the IEP meeting See 34 CFR sect

300344 The role of the participants at the IEP meeting is to

determine the specific special education and related services that

a child needs in order to receive FAPE Once the determination is

made at a meeting convened pursuant to 34 CFR sect 300343(a)

Part B does not recognize any authority on the part of a local

School Board to unilaterally change the statement of special edu-

cation and related services contained in the IEP After the IEP is

developed and the placement decision is made by a group of

persons knowledgeable about the child the meaning of the evalu-

ation data and placement options the public agency must imple-

ment the IEP See 34 CFR sect 300533(a)(3) Without reconven-

ing the IEP meeting the local school board could not change the

IEP

Is there a time limit on implementation of updated IEPrsquos[]

Every year I have long delays on implementation of Board

approved IEPrsquos[]

Part B imposes no specific time limits for the implementation

of IEPs The Part B regulations at 34 CFR sect 300342(b) require

that an IEP (1) must be in effect before special education and

related services are provided to a child and (2) must be imple-

mented as soon as possible following the meetings required to

develop review or revise a childrsquos IEP The answer to Question 4

in Appendix C to the Part 300 regulations states that no delay is

permissible between the time a childrsquos IEP is finalized and when

special education and related services is provided It is expected

that the special education and related services set out in the IEP

will be provided by the agency beginning immediately after the

IEP is finalized In certain circumstances such as when the IEP

meeting occurs during the summer or a vacation period or where

there are circumstances which require a short delay (eg work-

ing out transportation arrangements) the implementation may not

be immediate See Comment 34 CFR sect 300342

I hope that this information is helpful to you Please let us

know if you have any additional questions or concerns

Judy A Schrag

Director

Office of Special Education Programs

_______________________

Cite as 18 IDELR 628

56

Sample Letter Requesting an Assistive Tech-nology Evaluation

March 1997

Dear Sir

Our daughter Catherine an IDEA-eligiblestudent is currently receiving special educationand supportive therapies through the publicschool district As she is progressing through theelementary school grades the curriculum is de-manding more and more written work from herAt this point teachers or assistants are writingfor her but this method does not allow Catherinethe opportunity to compose written work on herown

As Catherinersquos parents we think the time hascome to consider assistive technology forCatherine to allow her to learn to do written workon her own so that she can learn the mechanicsof writing and can put her own thoughts downon paper for others to read

To this end we are requesting an assistivetechnology evaluation for Catherine to determinewhat kinds of technology are necessary to assisther with written expression We are assumingthat the assistive technology evaluation will beperformed at district expense by professionalswho are qualified to determine (a) what assistivetechnology may be necessary for Catherine (b)what assistive technology devices might be help-ful and (c) what occupational and physicaltherapy services may be necessary to support thetechnology

We would like to have this evaluation com-pleted so that information is available prior tothe convening of the IEP Team to writeCatherinersquos Individualized Education Programfor next year

We appreciate your assistance with this mat-ter and look forward to hearing from you

Yours truly

Assistive TechnologyIssues to Address

_____What are the individualrsquos current unmetneeds for access to communication writ-ing or educational materials

_____What are the short and long term educa-tional goals

_____What are the daily educational demandswhich require the use of assistive technol-ogy

_____Have the appropriate team members in-cluding parents been involved in the as-sessment process

_____What are the features of the technology thatwould assist the individual in meetingdaily classroom demands

_____Why is the selected equipment more appro-priate than other alternatives

_____Have all of the individualrsquos environmentsbeen considered

_____Does the selected equipment reflect the leastrestrictive intervention strategy

_____Is the equipment necessary to achieve edu-cationallife goals

_____How will the individual physically man-age the equipment in all environments

_____How will the equipment be integrated intothe individualrsquos daily life

_____How will the use of the assistive technol-ogy promote inclusion of the individualinto activities in the school and commu-nity

_____Which members of the education team willbe trained to use the equipment

_____How will the individual be trained to usethe equipment

_____How will the family be involved with theindividual and the equipment

57

ExamplesEDUCATIONAL SOFTWARE EVALUATION

A IDENTIFYING INFORMATION

Name of instructional program

Publisher

Cost ____________Computer platform(PCMac)

Other equipment needed to run program

Grade level of the program

Skill levels required of users

Special needs addressed by program

B DESCRIPTIVE INFORMATION

1 What is the purpose of the instructional program as stated by

its publisher

2 What curriculum area or areas does it address

3 What type of instructional program is it

tutorial drill and practice___ arcade game type___

drill and practice ____ simulation ___

problem solving___ educational game___

teacher utility___ other___

4 For what type of learner was the program designed

age level __________ grade level ____________

ability level ________ interest level ___________

5 What skills or information does the program attempt to teach

or review

6 How does the program present information

__text __graphics __animation __color __sound effects

__music __speech __other __________________________

7 Is the information presented clearly

Is text legible and readable

Are graphics comprehensible

Are sounds audible and intelligible

8 Are directions for using the program clearly stated and under-

standable Where do directions appear

_____ within the program

_____ in the programs documentation or manual

9 Is the program under user control that is can the user control

the programs movement from screen to screen

Review directions at any time

Exit the program at any time

10 What computer use demands are placed on the learner

_____ insert disk and turn on computer

_____ select from menu

other ______________________________

11 What academic demands are placed on the learner

reading level _______________________________

spelling level _______________________________

other _____________________________________

12 What physical demands are placed on the learner

_____ keyboard must be used to enter responses

_____ press any key

_____ press a key from one half or one quadrant of key-

board

_____ press on specific key

_____ press several keys in order

_____ other devices used to enter responses

13 What speed demands are placed on the learner

_____ presentation of information controlled by program (

moderate fast or slow)

_____ presentation of information under user control

_____ unlimited response time

_____ response time set by program (moderate fast slow)

_____ response time varied by user

58

14 What accuracy demands are placed on the learner

_____ user can correct typing errors

_____ program does not allow correction of typing errors

_____ program locates common errors

_____ program requires correct spelling of all responses

_____ program allows only one correct response for most

questions

15 Is feedback about response accuracy provided to learners

appropriately

_____ knowledge of results provided after each response

_____ correct responses confirmed

_____ learner informed if response incorrect

_____ another trial provided if response incorrect

_____ number of trials provided

_____ correct response demonstrated if learner fails to an-

swer correctly

_____ learner allowed opportunity to respond after demon-

stration of correct response

16 Does the program use any branching procedures besides

differential treatment of correct and incorrect responses

17 What techniques are used for reinforcement and motivation

_____ knowledge of results and confirmation of correct re-

sponses

_____ summary information about learner performance

_____ text message of praise for correct responses

_____ graphics display and or sound for correct responses

_____ competitive game in which correct response earn

points

_____ other _________________________________

Reinforcement is _____ continuous _____ intermittent

18 What user options are available to students and teachers

Students can select

_____ activity from menu difficulty

_____ number of questions type of questions

_____ other ____________________________

Teacher or parent can select

_____ sound on or off

_____ number of questions

_____ type of questions

_____ sequence of instruction

_____ number of trials

_____ speed of presentation

_____ speed demands for responses

_____ other_________________________________

Teacher or parent can

_____ enter own content into program

_____ review student records

_____ other________________________________

19 Is the programs documentation adequate

All program features fully and clearly explained

Rationale for program purpose and objectives included

Print materials provided for students

20 Other comments about the instructional program

C OVERALL EVALUATION

Rate the appropriateness of the instructional program in each of

the following areas using this scale

excellent adequate inadequate

1 2 3

1 2 3 Curricular content (program addresses important skills

1 2 3 Interest level

1 2 3 Ease of use for learners

1 2 3 Demands on learner (eg computer use academic)

1 2 3 Instructional procedures

1 2 3 Motivational value

1 2 3 Appropriate use of the medium

1 2 3 Important instructional variables under teacher control

1 2 3 Other _______________________________

59

Software Featuresbull Easy-to-Read Screensbull Consistency in Formatbull Intuitive Characteristicsbull Logical Labelsbull Instructional Choicesbull Graphicsbull Friendly Documentationbull On-Screen Instructionsbull Auditory Cuesbull Visual Cuesbull Built-in Access Methodsbull Alternatives to a Mousebull Optional Cursorsbull Creation of Custom Programs

Alternative Inputbull Switches and Switch Softwarebull Alternative Keyboardsbull Keyboard Additionsbull Access Utilitiesbull Interface Devicesbull Voice Recognitionbull Optical Character Recognition

and Scannersbull Electronic pointing Devicesbull Pointing and Typing Aidsbull Touch Screensbull Joysticksbull Trackballsbull Arm and Wrist Supports

Processing Aidsbull Abbreviation Expansion and

Macro Programsbull Word Predictionbull Talking and Large Print Word

Processorsbull Grammar and Spell Checkersbull Reading Comprehension Pro-

gramsbull Writing Composition Pro-

gramsbull Electronic Reference Toolsbull Menu Management Programs

Alternative Outputbull Braille Embossers and Transla-

torsbull Refreshable Braille Displaysbull Speech Synthesizersbull Screen Readersbull Screen Enlargement Programsbull Monitor Additions

Specialized Productsbull Closed Circuit Television

(CCTV)bull Environmental Control Units

(ECU)bull Notetakersbull Reading Machinesbull Text Telephone (TDD)

60

Next

Ste

p

Try

havi

ng C

huck

use

earp

hone

s w

hen

he is

wor

d pr

oces

sing

Curre

nt S

tatu

s

Chu

ck is

abl

e to

do

grad

ele

vel a

ssig

nmen

ts b

ut h

e is

very

lite

ral i

n hi

s in

terp

reta

-tio

ns e

spec

ially

of a

bstra

ctco

ncep

ts

Chu

ck is

ver

y ea

sily

dis

-tra

cted

bot

h vi

sual

ly a

ndau

dito

rily

Chu

ck h

as a

blin

d sp

otw

hich

mak

es it

diff

icul

t for

him

to tr

ack

from

line

to lin

ew

hen

he is

read

ing

He

also

has

troub

le d

istin

guis

hing

the

figur

e fro

m t

he b

ack-

grou

nd

Bec

ause

of

per-

cept

ion

prob

lem

s C

huck

mus

t hav

e a

larg

e di

spla

ysc

reen

on

his

com

pute

r

Need

Cog

nitiv

e Ab

ility

Atte

ndin

g

Perc

eptio

n

ASSI

STIV

E TE

CHN

OLO

GY

EVAL

UATI

ON

Func

tion

al A

naly

sis

Nam

e C

huck

Dat

eG

rade

Lev

el

Sixt

h

Ove

rall D

escr

iptio

n C

huck

is a

six

th g

rade

stu

dent

who

rece

ives

all o

f his

inst

ruct

ion

in th

ere

gula

r cla

ssro

om

Chu

ck h

as ri

ght h

emip

legi

a H

is ri

ght u

pper

ext

rem

ity is

mor

e af

fect

edth

an h

is lo

wer

ext

rem

ity

He

has

diffi

culty

with

tota

l bod

y m

ovem

ents

requ

iring

bila

tera

lco

ordi

natio

n e

spec

ially

with

upp

er e

xtre

miti

es

Chu

ck h

as a

leg

leng

th d

iscr

epan

cy w

ith

Crite

ria fo

r Suc

cess

Com

plet

ion

of g

rade

leve

las

sign

men

ts w

ith e

vide

nce

of u

nder

stan

ding

of

mai

nco

ncep

ts

Chu

ck w

ill be

on

task

65-7

0 o

f tim

e du

ring

inde

-pe

nden

t wor

k pe

riods

Chu

ck w

ill co

mpl

ete

mod

ified

ass

ignm

ents

inde

-pe

nden

tly a

t leas

t 85

of t

hetim

e

Supp

ort R

equi

red

Lim

it re

quire

men

ts to

a fe

wco

ncre

te c

once

pts

in e

ach

acad

emic

uni

t

Dis

trac

tion

free

env

iron-

men

t st

udy

carre

l pr

oxim

-ity

to te

ache

r or a

ide

Enl

arge

wor

kshe

ets

and

read

ing

mat

eria

l H

ighl

ight

key

voca

bula

ry w

ords

U

sea

card

boar

d w

indo

w to

iso-

late

indi

vidu

al li

nes

whe

nre

adin

g E

nlar

ge o

n sc

reen

disp

lay

whe

n do

ing

wor

dpr

oces

sing

Loca

tions

Hom

eSc

hool

Com

mun

ityW

ork

Rec

reat

ion

Hom

eSc

hool

Com

mun

ityW

ork

Rec

reat

ion

Hom

eSc

hool

Com

mun

ityW

ork

Rec

reat

ion

his

right

leg

bein

g sh

orte

r tha

n hi

s le

ft H

e w

ars

a lif

t in

his

shoe

to c

ompe

nsat

e fo

r the

diffe

renc

e C

huck

has

low

ave

rage

inte

lligen

ce a

nd n

orm

al s

peec

h H

e re

ads

at th

eth

ird g

rade

leve

l a

nd d

oes

mat

h at

gra

de le

vel

exce

pt fo

r sto

ry p

robl

ems

Chu

ck is

very

con

cret

e in

his

thin

king

and

has

gre

at d

iffic

ulty

und

erst

andi

ng fi

gura

tive

lang

uage

C

huck

has

a fu

ll tim

e ai

de in

the

regu

lar

clas

sroo

m w

ho m

odifi

es a

ssig

nmen

ts a

ndhe

lps

to k

eep

him

on

task

So

cial

ly C

huck

is p

olite

and

wel

l-beh

aved

but

app

ears

tobe

imm

atur

e in

his

soc

ial r

elat

ions

hips

61

ASSI

STIV

E TE

CHN

OLO

GY

EVAL

UATI

ON

Func

tion

al A

naly

sis

Nam

e C

huck

Dat

eG

rade

Lev

el

Sixt

h

Ove

rall

Des

crip

tion

Chu

ck is

a s

ixth

gra

de s

tude

nt w

ho re

ceiv

es a

ll of

his

inst

ruct

ion

inth

e re

gula

r cla

ssro

om

Chu

ck h

as ri

ght h

emip

legi

a H

is ri

ght u

pper

ext

rem

ity is

mor

eaf

fect

ed th

an h

is lo

wer

ext

rem

ity

He

has

diffi

culty

with

tota

l bod

y m

ovem

ents

requ

iring

Need

Fine

Mot

or Han

d W

ritin

g

Not

e Ta

king

Self

Hel

p

Curre

nt S

tatu

s

Chu

ck c

an u

se o

nly

one

hand

for f

ine

mot

or ta

sks

incl

udin

g ty

ping

C

huck

isan

exc

elle

nt o

ne-h

ande

dty

pist

bot

h in

term

s of

spee

d an

d ac

cura

cy

Chu

ck c

an w

rite

in c

ursi

ve

but h

andw

ritin

g is

ver

yla

bor i

nten

sive

and

tirin

gfo

r him

H

e pr

oduc

esm

uch

bette

r writ

ten

prod

ucts

usi

ng a

com

pute

rC

huck

can

not t

ake

note

san

d lis

ten

at th

e sa

me

time

Chu

ck c

anno

t tie

his

ow

nsh

oes

and

he h

as d

iffic

ulty

zipp

ing

his

jack

et w

ith o

neha

nd

Next

Ste

p

Try

givi

ng C

huck

not

esbe

fore

the

clas

sroo

mpr

esen

tatio

n H

ave

him

hig

hlig

ht k

eyw

ords

with

a h

ighl

ight

ing

pen

as h

e is

list

enin

g to

the

disc

ussi

on

Try

havi

ng a

pee

rbu

ddy

assi

st C

huck

with

his

sho

es a

ndja

cket

bila

tera

l coo

rdin

atio

n e

spec

ially

with

upp

er e

xtre

miti

es

Chu

ck h

as a

leg

leng

thdi

scre

panc

y w

ith h

is ri

ght l

eg b

eing

sho

rter t

han

his

left

He

war

s a

lift i

n hi

s sh

oe to

com

pens

ate

for t

he d

iffer

ence

C

huck

has

low

ave

rage

inte

lligen

ce a

nd n

orm

alsp

eech

H

e re

ads

at th

e th

ird g

rade

leve

l a

nd d

oes

mat

h at

gra

de le

vel

exce

pt fo

rst

ory

prob

lem

s C

huck

is v

ery

conc

rete

in h

is th

inki

ng a

nd h

as g

reat

diff

icul

ty u

nder

-st

andi

ng fi

gura

tive

lang

uage

C

huck

has

a fu

ll tim

e ai

de in

the

regu

lar c

lass

room

who

mod

ifies

ass

ignm

ents

and

hel

ps to

kee

p hi

m o

n ta

sk

Soci

ally

Chu

ck is

pol

ite a

ndw

ell-b

ehav

ed b

ut a

ppea

rs to

be

imm

atur

e in

his

soc

ial r

elat

ions

hips

Crite

ria fo

r Suc

cess

Chu

ck w

ill be

abl

e to

prod

uce

writ

ten

wor

k at

abou

t the

sam

e pa

ce a

sot

her s

tude

nts

in h

is c

lass

Chu

ck w

ill be

abl

e to

rece

ive

help

with

am

inim

um o

f fus

s or

emba

rrass

men

t

Supp

ort R

equi

red

Lapt

op c

ompu

ter

Prin

ter

Enla

rged

scr

een

disp

lay

Co-

Writ

er w

ith W

rite-

Out

-Lo

ud fo

r wor

d pr

oces

sing

and

wor

d pr

edic

tion

Chu

ck n

eeds

to u

se w

ord

proc

essi

ng w

hene

ver

writ

ten

assi

gnm

ents

are

requ

ired

Whe

neve

rpo

ssib

le h

is w

ritte

nas

sign

men

ts s

houl

d be

shor

tene

d or

he

shou

ld b

eex

pect

ed to

resp

ond

usin

gm

ultip

le c

hoic

e or

one

wor

dan

swer

s

Teac

her s

uppo

rt of

the

peer

bud

dy re

latio

nshi

p

Loca

tions

Hom

eSc

hool

Com

mun

ityW

ork

Rec

reat

ion

Hom

eSc

hool

Com

mun

ityW

ork

Rec

reat

ion

62

ResourcesParent Trainingand InformationCenters

AlabamaSpecial Education ActionCommittee Inc (SEAC)600 Bel Air Blvd 210Mobile AL 36606-3501334-478-1208334-473-7877 FAX1-800-222-7322 AL onlyseacmob1junocomhttpwwwhsvtisnet~cja

AlaskaPARENTS ResourceCenter4743 E Northern Lights BlvdAnchorage AK 99508907-337-7678907-337-7671 FAX1-800-478-7678 in AKparentsalaskanethttpwwwalaskanet~parents

American SamoaAmerican Samoa ParentNetworkPO Box 3432Pago Pago AS 96799684-633-2407684-633-7707 (fax)

ArizonaPilot Parent Partnerships4750 N Black Canyon Hwy 101Phoenix AZ 85017-3621602-242-4366800-237-3007 (AZ only)602-242-4306 (fax)

ArkansasArkansas Disability Coalition2801 Lee Ave Suite BLittle Rock AR 72205501-614-7020501-614-9082 FAX1-800-223-1330 AR onlyadcceinet

FOCUS Inc305 W Jefferson AveJonesboro AR 72401870-935-2750870-931-3755 FAXfocusincipanet

CaliforniaDREDF2212 Sixth StreetBerkeley CA 94710510-644-2555510-841-8645 (fax)1-800-466-4232dredfdredforghttpwwwdredforg

Exceptional Parents Unlimited(EPU)4120 N First StreetFresno CA 93726209-229-2000209-229-2956 (fax)epu1cybergatecom

Matrix555 Northgate Dr Ste ASan Rafael CA 94903415-499-3877415-499-3854 (TDD)415-507-9457 (fax)1-800-578-2592matrixmatrixparentsorghttpwwwmatrixparentsorg

Parents Helping Parents - SanFrancisco594 Monterey BlvdSan Francisco CA 94127-2416415-841-8820415-841-8824 (fax)

Parents Helping Parents -Santa Clara3041 Olcott StSanta Clara CA 95054-3222408-727-5775408-727-7655 (TDD)408-727-0182 (fax)infophpcomhttpwwwphpco

Support for Families ofChildren with Disabilities2601 Mission 710San Francisco CA 94110-3111415-282-7494415-282-1226 (fax)sfcdmissaolcom

TASK100 W Cerritos AveAnaheim CA 92805-6546714-533-TASK (8275)714-533-2533 (fax)taskcaaolcom

TASK- San Diego3750 Convoy St Ste 303San Diego CA 92111-3741619-874-2386619-874-2375 (fax)

ColoradoPEAK Parent Center Inc6055 Lehman Drive Ste 101Colorado Springs CO 80918719-531-9400719-531-9403 (TDD)800-284-0251719-531-9452 (fax)PKPARENTaolcom

ConnecticutCPAC338 Main StreetNiantic CT 06357860-739-3089860-739-7460 (fax)1-800-445-2722 (in CT)cpacincaolcomhttpwwwmembersaolcomcpacinccpachtm

DelawareParent Information Center(PIC) of Delaware Inc700 Barksdale Road Ste 3Newark DE 19711302-366-0152302-366-0178 (TDD)302-366-0276 (fax)PEP700aolcom

FloridaFamily Network on Disabilitiesof Florida2735 Whitney RoadClearwater FL 24620813-523-1130800-285-5736 (FL only)813-523-8687 (fax)fndgatenethttpwwwgatenet~fnd

GeorgiaParents Educating Parentsand Professionals for AllChildren (PEPPAC)8318 Durelee Lane Ste 101Douglasville GA 30134770-577-7771770-577-7774 (fax)peppacbellsouthnet

HawaiiAWARELearning DisabilitiesAssociation of Hawaii200 N Vineyard Blvd Ste 310Honolulu HI 96817808-536-9684808-536-2280 (TTY)808-537-6780 (fax)ldahgtenet

IdahoIdaho Parents Unlimited Inc(IPUL)Parents Education amp ResourceCenter4696 Overland Rd Ste 478Boise ID 83705208-342-5884800-242-IPUL (4785)208-342-1408 (fax)ipulrmcinethttpwwwhomermcinetIPUL

IllinoisDesigns for Change6 N Michigan Ave Ste 1600Chicago IL 60602312-857-9292312-857-1013 (TDD)312-857-9299 (fax)1-800-851-8728DFC1aolcom

Family Resource Center onDisabilities (FRCD)20 East Jackson Blvd Rm 900Chicago IL 60604312-939-3513312-939-3519 (TDDTTY)312-939-7297 (fax)1-800-952-4199 (IL only)

Family TIES Network830 South Spring StreetSpringfield IL 62704800-865-7842217-544-6018 (fax)ftiesnaolcom

National Center for Latinoswith Disabilities1921 South Blue IslandChicago IL 60608312-666-3393312-666-1788 (TDD)312-666-1787 (fax)1-800-532-3393ncldinteraccesscom