Abstract
The re-authorization of the Individuals with Disabilities Education Act (IDEA), United States federal legislation PL:42-142, established that individuals who are in need of assistive technology be given access to such equipment. This law also states that assistive technology assessments and evaluations be presented at individualized education program meetings. This article will give interested parties an overview of how to assess an individual for assistive technology needs and will help identify the best available assistive technology and augmentative communication assessment tools. The article will identify the criteria needed for developing an effective assessment tool for the assistive technology and augmentative communication needs of special education students.
The global effect that assistive technology can have upon an individual's participation and learning potential in any environment would warrant any interested parties gaining information in how to assess and use assistive technology. Teachers will find this information useful in assessing their current student population and for making decisions about assistive technology that could allow their students to perform to the best of their abilities within the learning environment. This may be accomplished by providing a means through which communication during instruction might occur and allow greater student performance and interest in the classroom. Speech professionals will find this information useful as a tool for implementing augmentative communication needs and assistive technology needs to improve the student's communication abilities. The student and parents might wish to gain this information to understand how their student will be assessed for assistive technology needs and the basis for granting or denying assistive technology equipment. Parents and the student may also wish to understand how to place and use assistive technology equipment for best accessibility and usefulness.
The article will delineate the criteria that will need to be addressed by an assessment instrument to provide the best overall picture of the students functioning and assistive technology needs and choices. A review of the literature gives several ideas of what and whom should be involved in an assistive technology /augmentative communication assessment. These include team members, access issues, responsiveness to technology, criteria for inclusion in an assessment, family issues regarding assistive technology and assessment, safety concerns, and others.
This article will review current best practices in assistive technology assessment and give examples and descriptions of the needed components of a complete assistive technology assessment instrument. The article will also examine cost effective ways for classroom professionals to use informal observations, checklists and anecdotal records to gain information for an informal assistive technology assessment , placement, and implementation of assistive technology.
Introduction
Assistive technology (AT) is not about expensive equipment, it's not about learning to program this gadget or that thing-a-ma-jig, it's not about the new this or that, it's not about complaining parents who want anything free, and it's not about how much money you have or don't have to spend on equipment. It's about people, students, children, needs, desires, and fairness. It's about giving students that even playing field we hear so much about. It's about equity.
What is assistive technology? As defined by the Individuals with Disabilities Education Act (IDEA), assistive technology is any item, piece of equipment or product system, whether acquired commercially off the shelf, modified or customized, that is used to increase maintain, or improve the functional capabilities of children with disabilities. But the central question is, what is equity? We can aspire as teachers to give our students an equal education, but is this truly feasible or even possible? Equality implies that we can give every child the same quality of instruction and the same experiences in education. The same quality teachers and lectures must be available to every student. Is this possible? Instead, we must strive for equity in our education. We are all different and all students have different gifts and needs. We must strive to give all of our students an equitable education. Equity implies that we can give students the tools, assistance, instruction, and technology that allow each student access to the same opportunities as their peers. That is what assistive technology is all about, evening the playing field. Giving our special education students the technology and equipment needed so that they might access the same educational opportunities as their peers. How do we use assistive technology? We use it every day. Isn't a pencil a form of assistive technology? Isn't a pad or pen, paper, a car, a table, a chair, a spoon, a computer, or a switch assistive technology? It looks like all of us benefit from assistive technology every day. Then why are we so hesitant to explore assistive technology for our students? Why are we so afraid of learning how to use assistive technology or so resistant to assistive technology training?
We should consider assistive technology for every student receiving special education services, as the law mandates. This is the heart of IDEA's intent; that every student enrolled in special education programs be "considered" for assistive technology.
Assistive technology isn't a multi-billion dollar box of computer chips or a programming nightmare. It's not just a voice box or a head pointer either. I hope you'll see in this article that assistive technology, for the most part, is easy to access and even easier to learn.
Who is affected by assistive technology?
So who is affected by assistive technology? Parents are usually going to be the main users of any system we design. They will have to learn all of the "ins and outs" of the equipment, just as everyone else does. And they will be the primary evaluators of its effectiveness, because no matter what we may think is viable for any given student or situation, the real world is the only proving ground for assistive technology.
Teachers have to see the need, make the referral and, most importantly, use the equipment. School districts have to shell out the money for the purchase of equipment and the maintenance. They have to decide policy and compliance with federal laws, and they have to decide how best to implement assistive technology planning. And finally, but certainly the most important group, the student.
Let's take a quick look at how assistive technology affects these groups. How will AT affect parents? Parents need to know what assistive technology is. Don't parents have a need to understand the terminology we're going to be discussing about their students? We need to take responsibility to inform parents of what AT is and how it can affect and benefit the lives of their children. With the vast amount of newly released equipment at any given time, it's very confusing to know exactly what's available for student use. We should try and give parents new catalogs of equipment, we should try to go to trade shows, and read magazines. We should understand the pros and cons of AT.
Parents need to know their rights regarding assistive technology under IDEA. This can be a very complex issue, but ethically it is our duty to inform parents about what services their children are entitled to receive. The easiest way to address this question is to provide parents with copies of local laws regarding assistive technology. We need to inform parents as to how we will assess their student. By law, they are also to be informed of assessments before they are given. Assistive technology assessments fall under the same guidelines as any other assessments that are done for the student's Individualized Education Program (IEP).
Finally, we must de-mystify assistive technology so that parents won't fear the use of assistive technology with their child, and assure them that training will be made available for them and their child for any piece of equipment their child receives.
Teachers are also affected by assistive technology placements. Teachers need to have a working understanding of assistive technology and laws governing its use. AT can give teachers feedback from students to test their ability for further progress and instructional needs.
Assessment of student needs for assistive technology must be done by professionals who have an understanding of the individuals current performance and needs, available resources for the student, laws of the locality of the student, implications of placement of technology on the family and community, and possible options for assessing various needs. In short, assistive technology assessments should be conducted by a team of professionals working together to gather the most current and pertinent information about the student in order to make an informed efficient decision about placement options. The teacher is most certainly an important link in the assessment process.
Teachers need to be familiar with the types of assistive technology that are currently available. It's not reasonable for anyone to expect all teachers to know every piece of new gear that comes out, but certainly teachers need to know the types of equipment and services available to address a student's communication needs.
Who's going to pay for assistive technology? In the United States, federal regulations state that school districts are responsible for the purchase and upkeep of any and all assistive technology needs for students. This can place great financial demands on state an local education agencies, but ensures placement of needed technology for students.
Teachers need to be aware of how to receive training on specific pieces of assistive technology. Many manufacturers will give personal instruction and many districts have assistive technology teams standing ready to offer any assistance they can about equipment they provide.
What about the school district? School districts are faced with many responsibilities concerning assistive technology. They are required to purchase equipment, train staff, students, and parents, maintain equipment purchased, decide on what equipment needs to be purchased, determine how to assess individual student needs, and how they will handle service delivery and parent requests for assistive technology.
Given all of these concerns, it's easy to see why many school districts have gone to outside sources to manage their assistive technology needs. Many districts currently use outside consulting agencies to assess and plan assistive technology assessments and equipment purchases. This, however, does not relieve the school system from federal responsibilities to assessment and placement of any assistive technology needs that a student may exhibit.
In my district, we have developed a system that involves teachers making a referral to an actual assistive technology team. The parents could request this referral from the teacher, or the actual team. Once a referral is received, the chairperson for the AT team would select one member from the team to act as a coordinator for assessment and implementation of any assistive technology needs that might arise for the student referred.
The most important person affected by assistive technology is the student. The student demonstrates increased ability. This includes the chance for many students to do things they have never been able to do before, the chance to learn at a different level, the chance to explore life from a different perspective, the chance to demonstrate what they already know and facilitate better instruction.
Students receive increased independence. This includes the chance for many students to do things for themselves for the first time, the freedom to choose or simply control something on their own. It may establish communication for instruction and allow the student to function on their true intellectual level. The student may demonstrate increased acceptance into their environment. They may have the chance to be interactive in their lives, the chance to "feel" the same as their peers. The power of assistive technology is as limitless as your imagination to utilize it. It can be just another tape recorder, or it can be the window to literature and communication.
Assistive technology can help level the playing field so that all students can receive an equitable education! Now that we understand the global effects of assistive technology, let's take a quick look at the different environments for AT.
What happens when assistive technology comes to your school? Teachers need to be aware of how to use the assistive technology in the classroom. It is estimated that almost 80 percent of assistive technology is shelved within the first three months of use, why? Many excuses are given; those involved with using the equipment don't learn how to properly use it, the equipment takes too long to "set up", the device doesn't "do anything", or because it's "just too much trouble." Teachers must commit to use the equipment given to their students!
Parents may be concerned that the equipment isn't working at school, or isn't getting the desired results. Like anything else with which we attempt to educate our students, learning takes time. Learning is a continuous process of progress from one point of understanding to another, and parents need to understand that knowing how to use a device might not come instantly. Results may take time, as most learning does!
Which takes us to the fact that students need to learn how to operate their own equipment. They need to understand where and when to use it, as well as how its use can help them. Training is for everyone involved if assistive technology is to truly be effective. Training must occur for the family, teacher and student in how to set up the equipment, use it, and involve it in instruction.
And last but not least, the administration needs to feel comfortable with the fact that, after spending money on AT equipment, it is being used to its fullest potential in the classroom setting.
What happens when AT goes home? Many questions surround assistive technology going home, after all, controlling use of the equipment is hard to do when the equipment is out of sight and off school grounds, but according to IDEA, if the student needs this equipment to enhance their educational abilities, it needs to go home. So, how do we address the multiple use problem? Stories abound about families that use school laptop computers for their taxes, games and the Internet, and the student has yet to use the equipment. Well, in some cases, as in some school districts, parents and family members are asked to sign a responsibility form that says only the student will have access to the equipment. Of course, this is not foolproof, as with any agreement. It is merely a way to let families know that the intent is for the student to use this equipment, and it is not a toy or piece of gear for the "family." I also think that if we can emphasize the importance of the student's need for the equipment and his/her need to have complete access, we may be able to head off this problem before it starts. Certainly rules and consequences should be included in any use agreement parents and the students are asked to sign.
Many question surround home use. Who will decide who can use what equipment? Who's going to train all those that use the equipment? Who's going to repair the equipment when "Tommy" spills a Coke on the front of it? The answer to all these questions is…the school district. United States federal laws state that the local education agency is responsible for all maintenance and training involving AT. This is why some form of "home control" needs to be devised.
Assistive technology in the community poses several other concerns. After all, isn't this our optimal goal, for the student to use this technology to integrate themselves into our larger community and life? Use of technology in the community is about opening doors. Some doors may swing wide open, others may give students a mere peek, but at any level, assistive technology can give students a "taste of life" that they may not have gotten before.
Unfortunately, some concerns arise when we think of how our assistive technology may be used, and the issues raised in community placements. Portability is a key question. Is the equipment able to be moved and used in the community without a great deal of effort? A piece of equipment may be perfect for a student to use in school to communicate with his peers, but if he can't take it to the store to communicate with the clerk, have we really opened the door for his communication needs? Another issue is the technology's durability. If the equipment is in the shop every other day, because it can't handle daily use and stress, it's not doing the student any good.
So, how do we make this transition easier? Easy, we take the assistive technology with us into the community. We use it in every available environment that we can think of where the student may use this equipment. We "test drive" the equipment as we instruct. We always want our students to learn in their natural environments, and that's also the best way to check the effectiveness of equipment, in the natural environments where it will be used. How do we integrate the home and school learning environments? This, in my opinion, is the easiest part of all. When we give students AT equipment, we give parents the same thing. We give the community the same thing, we ALL share in the student's assistive technology implementation. Homework should involve using the placed device. We should also ask parents to use it with the student in their daily activities. When students take the equipment into the community, goals should be written to include functional use of the equipment in their interactions. Simply put, assistive technology should be integrated whenever it's appropriate and by anyone who uses or benefits from this integration!
Assessment Tools
There are literally hundreds of different assistive technology assessment tools available on the market today. It's very difficult to know which test is better than another, or which form works the best with which population of students. Deciding on who and where to give an assessment is sometimes just as important as what type of assessment you will be giving. In all of these considerations, the main point needs to be the fact that all of this occurs so that we can better serve the students and give them the most honest and fair assessment we can possibly administer. With that in mind, I think it is very important to remember that assistive technology assessments are tools for helping people live life in a better way.
Who should assess a student for assistive technology needs? A study conducted at the Arkansas Technology Resource Center in 1998 looked at the most effective way to assess students. They stated that several key personnel are needed to give a full and honest account of a student's assistive technology potential. These included the student's primary teacher. He or she would have the best information regarding the student's classroom abilities and needs. The teacher will also have more time with the student than any other school professional. The student's family and friends need to be included in any assessment efforts because of the vast source of information they possess.
Sometimes, outside consulting agencies may be needed to perform observations or tests of ability on the student. Many localities may not have the needed equipment to fully assess a student's needs or abilities and outside agencies may be hired to provide one-time tests or observations. In-school specialists such as speech therapists, occupational therapists, physical therapists, and any other specialists a student may be working with should be involved in the data collection and decision making process for assistive technology.
The main point the authors of the Arkansas study make is that any assessment needs to use an integrated approach. This means that many people are involved in the assessment and many varied viewpoints are brought to the assessment process. Assistive technology assessments are on going and can never be done by just one person, during just one observation, at just one time. (Heiple, Sweet, Lynch, Graham, Shadden, Sbabo, & Sick, 1998) What we assess about a student is just as important as how we assess it. Stacy Dymond at Virginia Commonwealth University has published an article called "Augmentative Communication Assessment" which delineates several areas that need to be considered during an assistive or augmentative communication assessment. She recommends assessing the student's physical capabilities. Many questions she raises deal with hand positioning and posture, as well as how much mobility and strength the student possesses. She also recommends assessing cognitive abilities, which include understanding communication, cause and effect, symbolic representation and other areas of cognitive functioning. (Dymond, 1995)
In "Facilitating Responsiveness Using Technology," an article published by the organization Closing The Gap, the authors state that emotional responsiveness needs to be addressed when dealing with emerging technology users (Diener, 1998).
Environmental concerns deal with where the assessment takes place and how that will affect student performance. Ginny Heiple states that the work, school and home environments all pose different needs and students may exhibit different abilities in each setting (Heiple, et al. 1998). For that reason it is important that we assess students in natural settings.
And availability of equipment as well as training needs may also impact what type of equipment is recommended and purchased. Ms. Heiple states that some equipment may require modification and all of these concerns need to be addressed in the assessment process as early as possible (Heiple, et al. 1998).
Data Collection Methods
There are many types of assessment tools available. Some of these assessments use various techniques for gathering information. One of these is a checklist. With a checklist, the user simply checks off a choice from several options. An example might be, can the student understand symbolic communication? The evaluator would simply check off "yes" or "no".
Rating systems are used to collect data. In a rating system, a question would use a continuum of answers and the evaluator would choose the closest correct choice. Using our question above, the answers might range from "never", "rarely", "sometimes", to "always".
Narratives involve the use of open-ended questions that the evaluator would answer in their own language. Again, our sample question might be stated: "How does the student use symbolic communication?" The evaluator would simply write out his observation of the student's symbolic communication abilities.
Observation of trial and error is another form of data collection and simply means that the evaluator uses various tools or types of equipment with the student and writes down observable behaviors the student exhibits with each tool.
An important approach for judging the value of an assessment tool for a particular individual was developed in Texas by Ms. Joy Zabala (Zabala, 1995). This approach is known as the SETT framework. The SETT framework shows the critical areas that need to be addressed in any type of assessment tool. SETT stands for student, environment, tasks, and tools. Ms. Zabala states that in any assessment, these areas must be examined and addressed in order to provide the most complete picture of the student's skills and needs, where the student needs the assistance, what the student will be doing and what we will need to do to help the student perform the desired task. Too many times we have students performing tasks that we cannot justify. That is to say that we may tell a student to place pegs in a pegboard, but we can't explain why are we asking them to do this. The central question is, "What does the student gain by performing this task?" If there is a good reason for the student to perform the task, then we can move to finding ways to help the student perform the task.
The SETT framework is an excellent tool for evaluating assessment instruments that would be used on specific students to gauge specific assistive technology or augmentative communication needs. By comparing the question content of the assessment instrument to the essential components of the SETT framework we can see if the instrument addresses the student, the environment, the task, and the tools needed to perform the task. By looking at different assessment instruments and the current research in assistive technology assessment, we can come up with a list of criteria that should be in any quality assessment. Obviously, many of you may prefer one type of assessment over another, and it is not my intention to rate or give you a "best" assessment instrument that's available, but I do feel that many of the items you will see need to be a part of any assessment instrument you decide to use. Keep in mind that most of the criteria we will look at come from the assessments themselves or from research articles that have stated the need to assess these characteristics. Another important point to note is that many assessment instruments may contain some or none of these criteria. In those cases, it is really up to you to decide if this assessment instrument is providing you with the most complete and honest assessment of the student's needs and abilities, or if a self designed assessment instrument best fits your student or districts needs.
We must always remember that the student is the reason we are assessing in the first place and we should try to pick assessment instruments that will give students the best chance to demonstrate their abilities and shortcomings in the most natural environments possible. We should always assess students in the environments where they will be using the technology. When this is not possible, we should strive to provide the closest possible simulation of these environments. That is the only way we can be sure of how the student will perform when given the technology in these environments (Zabala, 1995).
Criteria
Physical Abilities
Physical abilities need to be assessed by any assistive technology instrument. These include hearing, vision, tactile sensations, coordination, mobility, and range of motion. Standard hearing and vision tests need to be performed by qualified personnel to address the student's abilities and needs. Tactile sensations should be addressed to see if the student is able to respond to various tactile stimuli. This could be used for switch design, Braille ability, and other tactile related tools. Coordination can be assessed to understand how well the student can move in order to use multiple switches, computer keys, door knobs, water faucets, and so on. Mobility is a key assessment issue for assistive technology. Many assistive technology referrals will be for mobility related issues. This can often be handled best by trained physical therapists that can assess the student's mobility and physical limitations in a more professional way. Finally, range of motion is important to assess to see how effective the student will be when using switches. This will also help with seeing if the student can manipulate a computer keyboard, or use other assistive technology devices.
The physical abilities of the student can be critical to understanding the student's assistive technology needs. A complete picture of the student's physical abilities and limitations provides the assistive technology team with an excellent starting point for implementation of an assistive technology plan.
Cognitive Abilities
Cognitive abilities are naturally a vital part of any assistive technology assessment, but just which cognitive skills need to be addressed in order to determine a student's assistive technology needs and abilities? Switch comprehension is important to understand for students who may be using switches to control various devices. Visual and auditory scanning capabilities are needed for students who may require scanning in these forms as a means of communication. Stacy Dymond of V.C.U. recommends assessing a student's expressive and receptive communication abilities. What can the student express and what does the student understand (Dymond, 1995)? Sign language is also important to assess if the student will be using this as a means of communication. Another area that needs to be addressed is the student's gestural ability. What gestures can the student comprehend? Does the student communicate with gestures and sounds? How can others understand the student's primary communication system? All of these issues deal with the student's cognitive abilities and communication means. Cynthia Brown and Tracy Shepherd of the Department of Children's Rehabilitation Center of Canada state that, traditionally it has "been difficult to achieve an integrated method of input and output for this clientele" (Brown & Shepherd, 1996). Given this, assessing a student's cognitive skills may be one of the most difficult tasks we have when conducting assistive technology assessments. We need to remember that a certain amount of cognitive awareness is needed to work with the most basic of assistive technology devices.
Emotional Responsiveness
Emotional response is a challenging area of AT assessment. Many professionals feel that emotional response is not necessarily tied to cognitive awareness. Other professionals assert that emotional response indicates some type of self-awareness and cognition. Areas that need to be assessed include the student's reaction to stimulus. Correct emotional response to verbal and gestural cues is also important. The student's ability to emotionally react to negative and positive visual and verbal information can be a key signal in student cognitive levels. The student's attention span can also provide information about what to expect when using assistive technology devices. Distractibility and frustration level can provide information about the type and duration of assistive technology that needs to be in place to assure success from the student.
It is important to note that simply because a student displays emotional responses, does not mean that the student has self-awareness or cognition. On the other hand, appropriate emotional response to verbal or visual cues can indicate a sense of self-awareness or surroundings. Therefore, as with any other criteria in the assessment process, emotional response cannot be used as a sole indicator of cognitive awareness. Emotional response must be considered as a part of the bigger picture in a complete assistive technology assessment.
Technology Support
Technology support deals with the ways assistive technology can be implemented and supported in various environments. Including this area in an assistive technology assessment can help assessors determine what types of technology can be prescribed and how placement may affect the student, parents, and community with demands or concerns. Possibly the most important environment to consider is the home and family environment. A study conducted at Southeast Missouri State University looked at family participation and concerns in assistive technology assessments. The authors noted that support and inclusion of family wants and desires in the assessment process are founded in the roots of theory and law (Parette & Brotherson, 1996). Other issues raised were the need for technology training for family members, how the device will alter family routines, and whether the device fits into the family's system of beliefs and cultural heritage (Parette & Brotherson, 1996).
School support must include training for teachers and para-professionals that will be impacted by the placement of assistive technology with the student. Penny Reed and Gayl Bowser of the Wisconsin Assistive Technology Initiative addressed this issue in an article. They state that training and technical assistance is mandated by federal legislation in IDEA'97 (Reed & Bowser, 1998).
An often-overlooked area of concern is that of community support. In his article about multicultural assessment issues, Mr.Ted Pinnock says that we must understand how the community affects the students we assess. He states that we need to understand the "cultural niche that is the world of experience for a family" (Pinnock, 1996).
Environmental Concerns
Where the student is assessed is almost as important as what we are assessing. The environment where the student will use the assistive technology should be the environment where we assess the student (Heiple, et al. 1998). Although this may seem difficult, it is crucial to see how the student will use technology and what the environment has to offer the student in his use of that same technology. We must assess what limits or assistance the environment will provide the student. We can take an ecological inventory of the environment and gauge what help or hindrance the environment will be for the student. An ecological inventory is a way to look at the student's task and determine exactly what the student does, what a "normal" person would do, and the discrepancy between the two. Ecological inventories can be used in any environment to understand what may or may not be helping the student complete the given task. They are simply one more way we can assess the student's environment and it's affect on student performance.
Finally, we need to examine what the student will gain from the assistive device and how the environment will affect its use. As we mentioned earlier, we often give students tasks that have no relation to real life scenarios. We need to make sure that we are assessing environments that are functional and tasks that are needed for the student to function in society. An often-overlooked component of an assistive technology assessment is the process of examining what and why we want the student to have access to assistive technology. Often this may refer to a piece of equipment that will be used throughout the student's life and at other times we may be assessing a student for a specific piece of gear for a specific task. In either case, it is very important for us to understand what we want the student to do with the piece of equipment. How will it help the student perform more like their peers or what opportunities will this piece of equipment open up for student learning and communication? Why do we want the student to have this ability? What do we need the student to do and what equipment could be helpful in assisting the student perform the desired task? These all seem like simple questions, but in fact are the cornerstones for many mistakes occurring in assistive technology placement. We should be using assistive technology to enable students to communicate and participate more like their peers. We should not be using assistive technology to get students to "jump through meaningless hoops."
Finally, we should ask ourselves if assistive technology is absolutely needed to perform the desired task. If we provide assistive devices to students who may be capable of learning the task under modified circumstances or through added instruction, placement of assistive technology is a poor choice because we have added dependence on a device that the student did not need!
The Assessment Process
The assessment process shouldn't be filled with doubts or fears about "doing what's right." In the same breath, we should also seek to only report items that we know are true and accurate. To err on the side of the student is to do a disservice to the process of assessment. As much as we may want to "help" our students get a good result from testing, or show them in the most positive light possible, we only add to their disability if we project them as having abilities or qualities that they do not have. We should only report the findings that you know are true and only give honest observations of behavior. I know this may sound repetitive or nagging, but it is very easy to "assign" emotional responses to students whom we truly can observe as not responding. Honest assessments lead to useful and successful placements of assistive technology devices. By being as accurate and meticulous as possible with our testing protocol and report writing we can assure ourselves and our students the best possible results for assistive technology.
Conclusions
Don't underestimate the power of assessments and assistive technology. Your placement can change the life of a student forever. The following story is an example of the power of assistive technology and implementation when all members of the team are consistent and conscientious in their practice. I want to begin this story by telling you that professional codes prohibit me from giving out the real names of anyone involved in this story, but I assure you that what I am going to tell you is true.
Tiffany was 12 years old when she was struck by a drunk driver while walking home from school one afternoon. In critical condition for over two weeks, she came out of a coma and was totally paralyzed. The movement she had was limited to eye closure and blinks. Doctors and family at the Children's Hospital tried with little effect to communicate with Tiffany, but all attempts left everyone frustrated. Tiffany stayed in this state for several weeks, when her physician was in the room and telling Tiffany that her mother was unable to come to see her that evening. After giving the sad 12 year old this news, Dr. Brown noticed a small tear well up in Tiffany's right eye. After a moment or so, he watched as the single tear slowly glided down the cheek of this bright young face. Dr. Brown immediately went to the nurse's station and phoned Psychiatric services to demand that somehow, someone was going to find a way to "talk to Tiffany!" The next few months saw a fevered pace of activity surrounding Tiffany. Devices of all types and styles were placed on her with little or no effect. Tests and more tests were given until everyone involved began to feel helpless in freeing the mind of this bright young woman. Dr. Brown had mentioned in a treatment team meeting that a new computer system was available that worked off of infrared sensors to detect the slightest movements of the eye. Within a few days, the system was at our hospital. The learning process for staff and Tiffany was a long one. At first, the placement seemed inappropriate for her. She was unable to use the switch, it wouldn't do anything, the system was hard to hook up and remove given all of the medical needs that Tiffany displayed. Weeks turned into months and still no results were showing. But, as Dr. Brown stated in a later treatment team meeting, we have no cause to believe that we "aren't" progressing. Therapy continued. Slowly but surely, and over the process of two years, Tiffany began to emerge from her silence. No one can place a finger on the exact day or time that Tiffany first exhibited "understanding" of what she was saying with the computer, but today there is no doubt that Tiffany has her own opinions about life at the age of 16. She writes letters to her friends and family, has become fast friends with famous people, loves music and boys, and enjoys beating everyone at Trivial Pursuit. Tiffany is after all, herself. She is the same person that she has always been, only now she is free to express herself again because of assistive technology.
Assistive technology is not the device, but the impact the device makes on the lives of those touched by its use, parents, peers, teachers, friends, the community, and most importantly, the student. A proper and thorough assessment will give assessors valuable tools and information about making effective placements of assistive technology. Assessments can be done using commercial tools or homemade tools, but the considerations and criteria that need to be addressed should remain the same. Finding information about student needs and skills can be challenging and time consuming, but using all available information sources, and remaining creative with ways to collect data, will provide information that is accurate and useful. o
References:
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Brown, C. & Shepherd, T. (1996). Cerebral palsy and visual impairment: An access challenge. [On-line]. Available: http://www.closingthegap.com/library/Feb-Mar96/brown.html
Center for Special Education Technology. (1990). Augmentative and alternative communication tech use guide: Using computer technology. [Brochure]. Washington, DC: Mineo, B.
Diener, B., Walz, K., & Bischof Rosario, J. (1998). Facilitating responsiveness using technology. [On-line]. Available: http://www.closingthegap.com/library/April-May-98/diener-walz-bischof.html
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