Family Guide to Assistive Technology |PLUKHome Page |What'sNew??? | PLUKFacts | Newsletters| Publications| Links| Family Guide to Assistive Technology  Prepared By: Parents, Let's Unite for Kids (PLUK) in cooperation with The Federation for Children with Special Needs EDITOR: Katharin A. Kelker, Ed.D. PRODUCTION: Roger Holt, ATP ILLUSTRATION: Karen Moses © Parents, Let's Unite for Kids 1997 This guide was funded through a subcontract between the Federation and Parents, Let's Unite for Kids from monies awarded to the Federation by the Office of Special Education and Rehabilitation Services (OSERS), U.S. Department of Education. Points of view or opinions herein do not necessarily represent the Education Department's position or policy. The Department of Education ensures equal employment, equal educational opportunities, and affirmative action regardless of race, sex, color, national origin, religion, marital status, age, or disability. This material is available upon request in alternative formats by calling: 406/255-0540 or email: plukinfo@pluk.org Table of Contents Introduction Defining Assistive Technology Sara Making Assistive Technology Decisions Sierra Funding Assistive Technology Ted Gloria Making Assistive Technology a Part of Child's Education Emily Bryan Tracy Advocating for Assistive Technology More Questions and Answers Appendix Glossary Documents Schrag Letter on Assistive Technology Individuals with Disabilities Education Law Report Letter Requesting an Assistive Technology Evaluation Assistive Technology...Issues to Address Examples Educational Software Evaluation Software Features Alternative Input Processing Aids Alternative Output Specialized Products Assistive Technology Evaluation Resources Parent Training and Information Centers Alliance for Technology Access Resource Centers State Tech Act Projects Return to beginning___NextArticleIntroductionAssistive technology is redefining what is possible for peoplewith a wide range of cognitive and physical disabilities. In thehome, classroom, workplace, and community, assistive technology isenabling individuals with disabilities to be more independent,self-confident, productive, and better integrated into themainstream.Beginning early in life, technology is making it possible forchildren with disabilities to do more for themselves. A child whocannot use her hands can operate a computer with a switch and anon-screen keyboard. A child with speech problems can communicateusing a portable electronic device that "speaks." A child who isunable to get in and out of the bathtub can be safely and easilylifted using a mechanical device. These are just a few examples ofthe wide variety of equipment, called assistive technology, that isavailable today.Assistive technology can mean anything from simple, homemadedevices to highly sophisticated environmental control systems. It canbe adapted toys, computers, powered mobility, augmentativecommunication devices, special switches, and thousands ofcommercially available or adapted tools to assist an individual withlearning, working, and interacting socially.As wonderful as assistive technology can be, it is not always easyto acquire. It takes expertise and persistence to find the correctdevices and figure out ways to pay for them. For example, childrenwith disabilities who are eligible for special education have a legalright to technology to assist them with learning. Both theIndividualized Family Service Plan (IFSP) and the IndividualizedEducation Program (IEP) which are required by tthe Individuals withDisabilities Education Act (IDEA) are potentially powerful tools forincorporating assistive technology into the education of studentswith disabilities. But assistive technology does not become part of astudent's special education plan unless parents are knowledgeableabout technology and know what to do to ensure that assistivetechnology becomes an integral part of their child's program.This Guide is intended to help parents learn more about assistivetechnology and how it can help their children. The Guide includestips for getting started, ideas about where to look for money, andsuggestions for what to do when applying for funding. Places tocontact for more information or to find software and equipment arelisted in the Appendix at the end of the Guide.Finding and paying for the right technology requires commitmentand energy. Professionals in education and medicine can help, butparents cannot rely on professionals to do everything that isnecessary to get the equipment. As a parent, you have a much betterchance of getting what is needed if you and your child are involvedin selecting the technology and planning for its use. This Guideshould help you to understand the processes for acquiring assistivetechnology and provide you with the tools to advocate for yourchild's special technology needs.Return to beginning___ NextArticle___PreviousArticleDefining Assistive TechnologyAssistive technology devices are mechanical aids which substitutefor or enhance the function of some physical or mental ability thatis impaired. Assistive technology can be anything homemade, purchasedoff the shelf, modified, or commercially available which is used tohelp an individual perform some task of daily living. The termassistive technology encompasses a broad range of devices from "lowtech" (e.g., pencil grips, splints, paper stabilizers) to "high tech"(e.g., computers, voice synthesizers, braille readers). These devicesinclude the entire range of supportive tools and equipment fromadapted spoons to wheelchairs and computer systems for environmentalcontrol.The Individuals with Disabilities Education Act (IDEA), thefederal special education law, provides the following legaldefinition of an assistive technology device: "any item, piece ofequipment, or product system... that is used to increase, maintain,or improve functional capabilities of individuals with disabilities."Under IDEA, assistive technology devices can be used in theeducational setting to provide a variety of accommodations oradaptations for people with disabilities.The IDEA also lists the services a school district may need toprovide in order to ensure that assistive technology is useful to astudent in the school setting. The law defines assistive technologyservice as: "any service that directly assists an individual with adisability in the selection, acquisition, or use of an assistivetechnology device." This service includes all of the followingpossibilities: evaluation of the technology needs of the individual, including a functional evaluation in the individual's customary environment; purchasing, leasing, or otherwise providing for the acquisition of assistive technology devices for individuals with disabilities; selecting, designing, fitting, customizing, adapting, applying, maintaining, repairing, or replacing of assistive technology devices; coordinating and using other therapies, interventions, or services with assistive technology devices, such as those associated with existing education and rehabilitation plans and programs; assistive technology training or technical assistance with assistive technology for an individual with a disability, or, where appropriate, the family of an individual with disabilities; training or technical assistance for professionals, employers, or other individuals who provide services to, employ, or otherwise are substantially involved in the major life functions of individuals with disabilities.The intention of the special education law is that, if a studentwith disabilities needs technology in order to be able to learn, theschool district will (a) evaluate the student's technology needs, (b)acquire the necessary technology, (c) coordinate technology use withother therapies and interventions, and (d) provide training for theindividual, the individual's family, and the school staff in theeffective use of the technology.During the time that students with disabilities are in school,they can have the opportunity to learn to use technology at the sametime that they are learning academic subjects and social skills. Theefficient and effective use of assistive technology can be as basic askill for students with disabilities as reading, writing, andarithmetic since the use of technology can go a long way towardcircumventing the limitations of disability and providing studentswith disabilities with a "level playing field" in every area of lifeaccomplishment.What is an accommodation?Accommodations are reasonable modifications that are made tocompensate for skills or abilities that an individual lacks. Forexample, if a person does not digest spicy foods well, we mightaccommodate this individual by adjusting his or her diet so that theperson was eating only bland foods.When the word accommodation is used in connection with disabilityissues, it refers to a way of modifying a task or assignment so thata person with a disability can participate in spite of whateverchallenges the disability may pose. For example, when a student whois unable to remember math facts is allowed to do math problems witha calculator, the use of the calculator is an accommodation whichallows the student to work around his or her disability. With anaccommodation, the student can still perform math problems, but thestudent does so using a different method.In the school setting, sometimes it is necessary to makeaccommodations for individuals with disabilities in order tocompensate for skills or abilities that they do not have. Forexample, for some students with learning disabilities learning tospell words correctly may be a skill they never acquire or neveracquire with a high enough degree of fluency to do them any good inwritten expression. To compensate for this inability to spell, suchstudents may be encouraged to use alternative methods for spellinglike a spell check software program on the computer or a hand-heldspelling device.What is an adaptation? How does adaptation differ fromaccommodation?Adaptation means developing unique devices or methods designedspecifically to assist persons with disabilities to perform dailytasks. An adaptation is something specially designed which is notnormally used by other people. An accommodation, on the other hand,is simply a change in routine, method, or approach which may be usedby people with or without disabilities. Examples of adaptationsinclude special grips to turn stove knobs or specially designedkeyboards to operate computers.What are common types of assistive technology? Does assistivetechnology just mean computers?Assistive technology certainly includes computers, but it alsorefers to a number of other types of accommodations and adaptationswhich enable individuals with disabilities to function moreindependently. Computers are an important type of assistivetechnology because they open up so many exciting possibilities forwriting, speaking, finding information, or controlling anindividual's environment. But computers are not the only avenues tosolving problems through technology. There are many low tech (and lowcost) solutions for problems that disabilities pose. Examples ofinexpensive, low tech solutions include wrist splints, clip boardsfor holding papers steady, or velcro tabs to keep positioning pads inplace.The following is a list of common assistive technologyapplications:Positioning. In the classroom, individuals with physicaldisabilities may need assistance with their positions for seating sothat they can participate effectively in school work. Generally,therapists try to achieve an upright, forward facing position byusing padding, structured chairs, straps, supports, or restraints tohold the body in a stable and comfortable manner. Also considered isthe student's position in relation to peers and the teacher. Often,it is necessary to design positioning systems for a variety ofsettings so that the student can participate in multiple activitiesat school. Examples of equipment used for positioning are side lyingframes, walkers, crawling assists, floor sitters, chair inserts,wheelchairs, straps, trays, standing aids, bean bag chairs, sand bagsand so forth.Access. In order to participate in school tasks, somestudents require special devices that provide access to computers orenvironmental controls. The first step in providing access is todetermine which body parts can be used to indicate the student'sintentions. Controllable, anatomical sites like eye blinks, head orneck movements, mouth movements may be used to operate equipmentwhich provides access to the computer. Once a controllable,anatomical site has been determined, then decisions can be made aboutinput devices, selection techniques (direct, scanning), andacceleration strategies (coding, prediction). Input devices includesuch things as switches, alternative keyboards, mouse, trackball,touch window, speech recognition, and head pointers. Once computeraccess has been established, it should be coordinated with othersystems that the student is using including powered mobility,communication or listening devices, and environmental controlsystems. figure 1: Alternative and Processing Computer Access Methods Input Processing Output Alternate keyboards Interface devices Joysticks Keyboard modifications Keyboard additions Optical pointing devices Pointing and typing aids Switches with scanning Scanners & optical character recognition Trackballs Touch screens Voice recognition Abbreviation/expansion and macro programs Access utilities Menu management programs Reading comprehension programs Writing composition programs Writing enhancement tools (i.e. grammar checkers) Braille displays and embossers Monitor additions Screen enlargement programs Screen readers Speech synthesizers Talking and large print word processors Access can also refer to physical entrance and exit of buildingsor facilities. This kind of assistive technology includesmodifications to buildings, rooms and other facilities that letpeople with physical impairments use ramps and door openers to enter,allow people with visual disabilities to follow braille directionsand move more freely within a facility, and people of short statureor people who use wheelchairs to reach pay phones or operateelevators. Accessibility to shopping centers, places of business,schools, recreation, transportation is possible because of assistivetechnology modifications.Environmental Control. Independent use of equipment in theclassroom can be achieved for students with physical disabilitiesthrough various types of environmental controls, including remotecontrol switches and special adaptations of on/off switches to makethem accessible (e.g. velcro attachments, pointer sticks).Robotic arms and other environmental control systems turn lightson and off, open doors, operate appliances. Locational andorientation systems give people with vision impairments informationabout where they are, what the ground nearby is like, and whether ornot there is a curb close by.Augmentative Communication. Every student in school needssome method of communication in order to interact with others andlearn from social contact. Students who are nonverbal or whose speechis not fluent or understandable enough to communicate effectively maybenefit from using some type of communication device or devices.Communication devices include such things as symbol systems,communication boards and wallets, programmable switches, electroniccommunication devices, speech synthesizers, recorded speech devices,communication enhancement software, and voiced word processing.Assistive Listening. Much of the time in school, studentsare expected to learn through listening. Students who have hearingimpairments or auditory processing problems can be at a distinctdisadvantage unless they learn to use the hearing they have, or theydevelop alternative means for getting information. Hearing problemsmay be progressive, permanent, or intermittent. Any of theseimpairments may interfere significantly with learning to speak, read,and follow directions. Assistive devices to help with hearing andauditory processing problems include: hearing aids, personal FMunits, sound field FM systems, Phonic Ear, TDDs, or closed captionTV.Visual Aids. Vision is also a major learning mode. Generalmethods for assisting with vision problems include increasingcontrast, enlarging stimuli and making use of tactile and auditorymodels. Devices that assist with vision include screen readers,screen enlargers, magnifiers, large-type books, taped books,Braillers, light boxes, high contrast materials, thermoform graphics,synthesizers, and scanners.Mobility. Individuals whose physical impairments limittheir mobility may need any of a number of devices to help them getaround in the school building and participate in student activities.Mobility devices include such things as self-propelled walkers,manual or powered wheelchairs, and powered recreational vehicles likebikes and scooters.Computer-Based Instruction. Computer-based instruction canmake possible independent participation in activities related to thecurriculum. Software can be selected which mirrors the conceptualframework of the regular curriculum, but offers an alternative way ofresponding to exercises and learning activities. Software can providethe tools for written expression, spelling, calculation, reading,basic reasoning, and higher level thinking skills. The computer canalso be used to access a wide variety of databases.Social Interaction and Recreation. Students withdisabilities want to have fun and interact socially with their peers.Assistive technology can help them to participate in all sorts ofrecreational activities which can be interactive with friends. Someadapted recreational activities include drawing software, computergames, computer simulations, painting with a head or mouth wand,interactive laser disks, and adapted puzzles.Self Care. In order to benefit from education, somestudents require assistance with self care activities like feeding,dressing, and toileting. Assistive devices which assist with selfcare include such things as robotics, electric feeders, adaptedutensils, specially designed toilet seats, and aids for toothbrushing, washing, dressing, and grooming.What sort of students might use assistive technology?Students who require assistive technology are those with mental orphysical impairments that interfere with learning or other lifefunctions. The technology helps the student to overcome or compensatefor the impairment and be more independent in participating atschool. Students who benefit from assistive technology may have mildlearning problems like learning disabilities or they may havephysical or cognitive disabilities that range from mild to severe.Assistive technology is not necessary or helpful for every student inspecial education, but it is an important part of the support systemfor many students with identified disabilities.Isn't assistive technology appropriate only for students withmore severe disabilities?Assistive technology is simply a set of tools that can be used tocompensate for some deficit that a person may have. For individualswith severe mental or physical disabilities, the technologicalsolutions can help to solve multiple and complex problems. Butindividuals with less involved problems also can benefit fromassistive technology. For example, individuals with learningdisabilities who have difficulty with reading or writing can benefiteducationally from using the word processing and voiced readingcapabilities of computers.Isn't assistive technology just a crutch? Won't students becometoo dependent on technology and not learn to use the skills theyhave?Assistive technology should be used as support for access,learning and performing daily tasks. In general, assistive technologyis appropriate when it compensates for disabilities so that theindividual can function as normally as possible. If assistivetechnology is necessary for a student to have access to educationalopportunities or to benefit from education, then it is not a"crutch," but a legitimate support.Some skills are too laborious or taxing to accomplish at a rate orwith degree of proficiency to allow for participation in the leastrestrictive environment. With assistive technology, the student canparticipate more fully and more closely approximate the levels ofachievement and interaction of his or her peers.The use of assistive technology enhances function and increasesskills and opportunities. Though a student may be dependent upon aparticular device in order to perform skillfully, denying the devicedenies the student an opportunity ever to achieve success at thelevel of his or her potential.When is using assistive technology appropriate?Assistive technology may be considered appropriate when it doesany or all of the following things: Enables an individual to perform functions that can be achieved by no other means Enables an individual to approximate normal fluency, rate, or standards--a level of accomplishment which could not be achieved by any other means Provides access for participation in programs or activities which otherwise would be closed to the individual Increases endurance or ability to persevere and complete tasks that otherwise are too laborious to be attempted on a routine basis Enables an individual to concentrate on learning or employment tasks, rather than mechanical tasks Provides greater access to information Supports normal social interactions with peers and adults Supports participation in the least restrictive educational environment.SummaryAssistive technology means any device which helps an individualwith an impairment to perform tasks of daily living. There is a widerange of types of devices in assistive technology from low tech,homemade aids to computers and sophisticated electronic equipment.Assistive technology is one of the services which can be provided ina special education program under the Individuals with DisabilitiesEducation Act (IDEA). The requirements of IDEA say that students whoneed assistive technology are entitled to the aids and devices andthe assistive technology services (e.g., evaluation for assistivetechnology and modification and maintenance of equipment) that arenecessary for the student to benefit from a free, appropriate publiceducation.Hints for ParentsIt is never too soon to consider using assistive technology.Some infants with physical disabilities, for example, really benefitfrom early interaction with toys that operate by switch. Here aresuggestions for times to evaluate a child for assistivetechnology: When disability limits interaction with the environment and interferes with experiential learning. Assistive technology can be used to provide physical access to the environment (e.g., switch toys, floor scooters, touch window) When a significant gap exists between receptive and expressive abilities. Assistive technology can assist with expression through the use of programmable switches, electronic communication devices, voiced word processing, braille embossing and so forth. When an individual's performance falls behind that of his or her peers. If an individual's handwriting, for example, is very slow, laborious and difficult to read, use of a word processing device can be substituted for handwriting; thus allowing the individual to keep up with others in terms of written expression. When a physical disability is impeding the educational/vocational potential of an individual. Assistive technology can provide access to the workplace, for example, by allowing an individual who is blind to learn to use a screen reader and voiced word processing to do clerical tasks that would otherwise be impossible. When a disability is impeding the independence of an individual. Sometimes assistive technology can be used to allow a person with a disability to function more independently. For example, having a power wheelchair allows an individual to travel independently without the necessity of having someone to push the wheelchair.Return to beginning___ NextArticle___PreviousArticleSaraSara, who has Down syndrome, is eight years-old. Her language andspeech skills are three years delayed, but she has age appropriatesocial skills. Sara has spent part of her school day in a regularclassroom ever since kindergarten, but this year her third gradeteacher is suggesting that Sara really cannot keep up with herclassmates. The teacher thinks that Sara would be better off in aself-contained class with students who work at her pace. Sara hassome fine motor coordination problems, and she has had difficultylearning to write in cursive. Her oral reading is hampered by herspeech difficulties. However, Sara has learned to do addition andsubtraction problems well and has mastered adding with carrying andsubtraction with borrowing. She reads at about a second grade levelwith reasonably good comprehension. Sara's parents would like to seeher continue in the regular classroom for as much time as possible,but they recognize that Sara's writing and speaking problems arekeeping her from doing her best work.What are Sara's needs? What kinds of technology should go in Sara's IEP? How would you make a case for putting assistive technology into her IEP?Sara's SolutionSara's IEP Team met to discuss her needs and concluded that she isdoing well in a regular classroom setting; she is making adequateprogress in academic skills and has learned how to interact sociallywith her peers. It is to be expected that Sara will have difficultykeeping up with the pace in a third grade, but as long as she ismaking progress toward her individual goals, the regular classroom isa good setting for her. However, some simple accommodations andtechnology may help Sara to work faster and more efficiently.At this point Sara may need some assistance with handwriting andspeaking, but the solutions to her problems in these areas need notbe complex ones. The team decided that Sara should continue topractice cursive until she has mastered all the letters and can bemore facile in using script. However, while she is still learningcursive, she needs other means for responding in writing. For shortwritten responses, the team agreed that Sara should be encouraged touse manuscript printing. When speed is important or when writingassignments are longer, Sara should have access to a computer with anadaptive keyboard (e.g., IntelliKeys). The adaptive keyboard ishelpful for Sara because the "keys" are larger and easier to see.Using the keyboard requires only a very light touch so Sara finds iteasier to use than a standard computer keyboard.In terms of oral reading, the team decided to have Sara practicereading into a tape recorder. Her speech therapist will work with heron slowing down her rate of speech and reading with expression. WhenSara has a good tape of her oral reading, she will submit it to herteacher for review.Solution Summary Practice cursive Use manuscript printing for short assignments Use computer with adaptive keyboard for longer assignments Practice oral reading using a tape recorderReturn to beginning___ NextArticle___PreviousArticleMaking Assistive TechnologyDecisionsWhen parents learn about assistive technology and the wonderfulopportunities it can provide, they want to jump right in and get thelatest in technology for their children. Who wouldn't want anaugmentative communication device for a child who cannot talk? Whatparents wouldn't want to buy a computer if it would help their childlearn?When the world of assistive technology opens up for parents, itcan be like entering a great toy store--everything looks so wonderfulthat it makes it hard to know what to select. Choosing the rightdevice to meet an individual's needs requires technical knowledge andindepth understanding of the individual's functional capabilities.Not only is the selection of a device made difficult by thecomplexity of the equipment and the demands of the individual'simpairment, assistive technology devices can be very expensive.Making such purchases is a major financial commitment for mostfamilies, one that takes a great deal of soul searching and sometimessignificant sacrifice.Families invest more than money in their children's assistivetechnology. Practical investments of time and effort and emotionalinvestments of hope and enthusiasm are made with every assistivetechnology purchase. Because of the high level of financial, personaland emotional commitment, family disappointment is great whenequipment fails to perform as expected.Buying and then not using a device because of dissatisfaction canbe a devastating experience for all concerned. That is why it is soimportant for parents to proceed cautiously into the world ofassistive technology and make purchases only after careful evaluationand trials with the new device. Following is a summary of somesuggestions for parents to consider before making any assistivetechnology purchase: be realistic about your child's capabilities andneeds; get a multidisciplinary evaluation; examine availabletechnology with a critical eye; match the child's needs to specificequipment features; do not make a purchase until you have used thedevice for a trial period; identify next steps; and determine whatneeds to be done for follow-up after purchase.Guidelines for Making Assistive Technology Decisions Be realistic about your child's capabilities and needs.Assistive technology can open up exciting new opportunities for achild, but it is not magic. There are certain basic requirements forany individual to be successful with technology, and it is importantto face these requirements squarely. There is nothing moredisappointing or discouraging than purchasing expensive equipment fora child which is beyond his or her capabilities to use.Prerequisites for Computer Use. Physical or sensoryimpairments do not limit access to computers, but cognition is afactor in computer operation. The major prerequisite for using acomputer (with or without adaptations) is the cognitive ability tounderstand cause and effect. The child must be able to understandthat the computer operates (e.g., changes, does something) becausethe child has activated the equipment through some volitionalmovement or activity (e.g., eyebeam, speaking, puffing into a straw,hitting a switch). Some children enjoy playing with switches byhitting them randomly but may not be able to connect their ownbehavior to the response their movement activates. In order to besuccessful in interacting with a computer, the user must be able tocontrol some volitional activity and to do so consistently. Forexample, the child would have to be able to activate the computer inresponse to a visual, tactile, or auditory prompt.Another prerequisite to computer use is the ability to makeconscious, meaningful choices between alternatives like yes and no.The choices can be very simple ones, but there has to be evidencethat the child has made an actual decision and not merely actedrandomly.If a child does not have the concept of cause and effect or cannotmake consistent choices, using a computer is probably not aworthwhile next step at this point in the child's development. Othertypes of activities may be more appropriate, less expensive, and justas rewarding developmentally and personally.Prerequisites for Augmentative Communication. Augmentativecommunication devices can literally give voice to the thoughts ofindividuals who cannot speak or cannot speak clearly,but--again--these devices are not magic. Electronic communicationdevices are of no value unless the user has some communicativeintent. That is, for a communication device to be helpful, the userhas to have some basic understanding of the communication process andmust be intentional in expressing choices, desires, or needs.For example, Maggie is a four-year-old who is nonverbal. Shecommunicates her wants and needs by using eyeblinks as responses toyes or no questions. When Maggie's dad asks her if she would likeanother glass of milk, she indicates her choice by raising her eyesup vertically for yes or moving her eyes down for no. Maggie clearlyknows what she wants to communicate, she has a consistent method formaking her wishes known, and she expects that her dad will understandher communication and act on it.Dan, who is also nonverbal, communicates in a different way. Hepoints to objects and makes gestures to show what he wants or needs.His gestures are clear and used consistently so that family membersand even people who do not know Dan well can understand most of thetime what he is communicating.Shelley communicates very basic information about how she feels bycrying when she is uncomfortable or wants attention and by laughingwhen she enjoys something like music, bright lights, or waterrunning. Shelley does not, however, respond to yes or no questions.She does not make choices, even when objects are presented to herindividually or in pairs. She cannot respond to a question like "Doyou want some ice cream now?" Or "Would you like the teddy bear orthe doll?"Maggie and Dan may benefit from using some communication devicebecause they are already using communication systems meaningfully andconsistently. Shelley, however, may need to develop greater abilityto communicate meaningfully before moving on to electroniccommunication.Communication skills fall along a continuum. At one end of thecontinuum are very simple communications like expressing preferencesby indicating yes or no, pointing or gesturing toward objects, orpointing to pictures. Use of sign is a more complex form ofcommunication because it requires that the user understand that thesigns are symbols for meaningful communications. When an individualis able to string together signs or words into meaningful phrases,this is an additional step toward more complex communication. When aperson understands syntax and is aware of typical word order, this isanother step forward. Each of these advances along the communicationcontinuum represents a step toward more complex and sophisticatedcommunication. Whatever assistive communication device is chosenshould match or just slightly exceed the place on the continuum wherethe individual is functioning. It makes no sense, for example, topurchase an elaborate electronic communication device that requiresunderstanding symbols and syntax when the individual using the deviceis just at the point of learning how to express yes and nopreferences.An electronic device does not teach communication; it enhancescommunication by giving audible expression to thoughts that alreadyexist in the mind of the user. If the thoughts are not there yet orare not completely formed, they cannot be expressed by thedevice.Physical and Sensory Impairments Are Not Barriers. Masteryof a few simple prerequisite skills is necessary before computers orelectronic communication devices should be considered, but it is notnecessary for a child to master every developmental milestone beforeentering the world of assistive technology. Physical or sensoryimpairments can often be circumvented by the technology itself, andtypical developmental milestones can sometimes be bypassed so thatassistive technology can be used. For example, some educators assumethat students cannot use computers until they have completelymastered keyboarding skills. This is a false assumption. Manystudents benefit from using computers, even though they operate themachine using a "hunt and peck" method or only one or two keys. In asimilar fashion, students with limited verbal ability who have notmastered oral speech benefit from using augmentative communicationdevices while they continue to develop oral language.Overall, the keys to knowing when to try assistive technology are(a) being realistic about the child's cognitive abilities andpotential, and (b) being open to trying the level of technology whichmeets the child where he or she is. figure 2: Factors to consider when selecting Assistive Technology Cognitive Factors Motor Factors Diminished Cognitive Abilities Learning Disabilities Attention Deficits Sensory/Perceptual Deficits Memory Deficits Abstract Reasoning Deficits Problem-Solving Deficits Voluntary Motor Deficits Involuntary Motor Deficits Fixed Posture & Positioning Deficits Recurring Purposeless Motion Motor Paralysis Low Muscle Tone Rigidity Spasticity Tremors Get a multidisciplinary evaluation.Evaluations for assistive technology are not always easy toarrange. In many parts of the United States, there is no convenientcenter or "place" to go for an assessment. The available centers maybe far away in another city or even another state. Since assistivetechnology is a new field, the systems for disseminating informationand providing assistance are in the process of evolving. Parents mayhave to be "assistive technology detectives" in order to put togetherthe information needed for a complete AT evaluation for theirchild.The place to start the evaluation is by considering the functionsthe child needs to perform and cannot because of impairment. Thephysicians, teachers, and therapists currently working with thechild, as well as family members and friends who are around the childon a daily basis, can provide very valuable information aboutfunctional problems and potential solutions.Finding Functional Solutions. The Alliance for TechnologyAccess (ATA), a national network of assistive technology centers, hasdeveloped an informal method for using the functional informationavailable from professionals, family members and friends as a basisfor analyzing assistive technology needs. This process, called aSolution Circle, is a means to bring people together in an informalsession that allows for creative thinking and is not inhibited bywhat is "legal," "currently available," or "what has been donebefore." The individual with a disability and 4-10 family members,professionals, and friends get together to brainstorm ideas about thetechnology which may help the individual perform functions that arehard, or impossible, to do because of disability. The Circle usuallyincludes a balance between people who know the person who needs thetechnology and people who have specialized knowledge abouttechnology, education, or work-related issues.Solution Circle for Tom. To demonstrate how the SolutionCircle works, let's take a look at how this process was used in thecase of Tom, a high school student with a learning disability. ForTom, the print in textbooks is a significant barrier to learning. Tomis "print disabled"; that is, he cannot read the printed word withmuch comprehension. Reading is a slow, unproductive process for him,even though he is intelligent and eager to learn. Tom and his parentswere hoping that there might be a way that new technology could helpTom overcome or work around his problem with reading so that he couldget more out of school and perhaps go on to college.Tom's Solution Circle included his parents, Betty and Bob; hisresource teacher; a friend Darrell; his soccer coach; his 4-H leader;and the owner of a local computer store. This group met together tothink about how Tom could participate more fully in school andprepare himself for college, even though he could not read withcomprehension past the second or third grade level.Solution Circles generally take 1 to 1 1/2 hours to complete. Thesteps include the following:1. Star Time. The individual for whom the Solution Circleis being held is described in a holistic way. The emphasis is on howthe individual is functioning at home and in the community. What doeshe or she like and dislike? What are his/her goals? Interests? Ifpossible, the individual with a disability speaks for himself orherself or a video or pictures may be presented. The point of thispart of the discussion is give a clear picture of the individual as awhole person.At Tom's Solution Circle, he explained his dream of going tocollege and becoming an agricultural botanist. Tom loves plants; heis interested in breeding new strains of wheat and perfecting varioustypes of grain crops. Tom's 4-H leader agreed that Tom had real giftsin understanding plant growth and physiology, and that he already hadsophisticated knowledge about botany which would prepare him well forcollege study.2. Strengths. With a complete picture of the individual inmind, the group then makes an exhaustive list of the individual'sstrengths, particularly noting any technological accommodations whichthe individual is already using. What does the individual do well?What are his or her unimpaired functions? Often this discussionreveals an incredible number of adaptations that the individual hasalready achieved.Tom's Solution Circle discovered that he had many strengths,including keen intelligence, perseverance, and thoroughness whenapproaching a task. Tom already had some effective learningstrategies for remembering material that he heard. He had alsolearned to use a small tape recorder for keeping track of informationprovided in class.3. Obstacles. With the individual's strengths in mind, thegroup then turns its attention to a consideration of the environmentin which the individual is functioning and the activities in whichthe individual wants to participate but cannot at this time. Thegroup considers what the obstacles and barriers might be for theindividual in his or her environment and makes a list of theseimpediments.For Tom, reading was a serious obstacle. He could not keep up withhomework assignments because it took him so long to read histextbooks. In addition, he had difficulty reading directions on testsand often misread assignments on the blackboard.4. The Enemy Within. Physical and cognitive impairments maypose difficult obstacles for an individual, but often the feelingsthat people have about the individual's disability or about assistivetechnology pose greater problems than the disabilities themselves.The Solution Circle process recognizes that human fears, concerns,reservations, and prejudices might stand in the way of a person'ssuccess as much as other types of limitations. Getting these fearsand concerns out on the table often helps the group to deal moreconstructively with what is possible and what needs to be done.One of the serious issues in Tom's situation was that his resourceteacher felt he should continue to try to read for himself instead ofusing a "crutch" like assistive technology. The teacher thought thatif Tom did not have to read all the material, he would lose whatlittle reading skill he had. In some ways, the teacher's oppositionto considering assistive technology actually posed a greater barrierthan the reading problem itself.5. Solutions. The exciting part of a Solution Circle occurswhen the group takes each obstacle or concern and turns it into apossible solution through the use of technology or some other type ofadaptation. Not all solutions suggested eventually prove to befeasible, but the point of the discussion is to produce many possiblesolutions so that the individual and his or her family have an arrayof options from which to choose. With good minds puzzling over theproblems and a spirit of cooperation and collaboration, seeminglyimpossible barriers can be removed or conquered. The processrecognizes the expertise and contributions of all participants,including the individual with disabilities and his or her familymembers. The freewheeling format of the discussion promotes ingenuityand innovation. All involved come away from a Solution Circleenergized by the new possibilities.Tom's Solution Circle became excited about the possibility ofsolving his reading problem by using computerized texts. The computerstore operator mentioned he had heard that Recordings for the Blind(RFB) offered textbooks on disk. Tom's parents got in touch withRecordings for the Blind and ordered texts for Tom to try on hiscomputer at school. Soon Tom found that he could keep up with hisclassmates and study exactly the same material that they werecovering. Because Tom had good strategies for memorizing informationthat he heard, he learned quickly from the texts that were read aloudto him by the computer. When given oral tests by his classroomteachers, he was able to recite appropriate answers which would haveeluded him if he had had to read the tests for himself.Technology has made all the difference for Tom; he has everyreason to think that he will be able to go to college and pursue hisintellectual interests. His resource teacher is now completely soldon the idea of assistive technology and using computerized books andwants to use the technique with other students. More than that, Tom'steacher also appreciates the process of the Solution Circle whichallowed professionals and nonprofessionals to work together to findpractical solutions without being too concerned about the formalitiesof the special education process. The informal nature of the SolutionCircle validated the expertise of all the participants and gaveeveryone a chance to offer suggestions. The combination of a newprocess for planning and new technology made Tom a winner. This samecombination holds potential for many students like Tom who benefitfrom technologies which eliminate barriers and open up newpossibilities for learning. f igure 3: ASSISTIVE TECHNOLOGY EVALUATION Individual Functional Analysis Name: Date: COGNITIVE FACTORS MOTOR FACTORS Cognitive Ability Documented below average ability Documented significant overall delay Does not appear age appropriate Lacks understanding of cause & effect Paying Attention Difficulty following prompts or directions Difficulty with multi-step procedures Difficulty filtering information Difficulty staying on task Perception Needs lengthened response time Requires multi-sensory input Difficulty with rapid change Significant visual/perceptual problems Slow visual-motor dexterity Memory Difficulty with recall Requires reteaching learned skills Requires repeated practice Abstract Reasoning Difficulty analyzing simple procedures Unable to reproduce a sequence Unable to analyze or synthesize information Problem Solving Unable to use prompts or cues to accomplish tasks Unable to modify attempts and try another way Mobility Needs help to be mobile Needs motorized help to be independent Needs help boarding transportation Unable to transfer independently Cannot climb stairs Cannot open doors independently Cannot carry materials in hands or arms Cannot lift weight Voluntary Motor Limited control of head, trunk, or extremities Visual motor deficits Fixed position and posture Needs support to sit or stand Needs adaptations in order to use technology Motor Paralysis Changes in muscle tone interfere in motor movements Spastic movements result in poor control Limited movement of head, arms or legs Difficulty balancing in sitting position Difficulty maintaining good posture Low Muscle Tone Limited use of arms or legs Poor posture control Fatigues quickly Rigidity Inhibits arm and leg movement Inhibits balance to sit Inhibits good posture Spasticity Limited upper range of motion Limited lower range of motion Interferes with accuracy and consistency of motor movements on one side Tremors Present all the time Present when doing purposeful upper extremity task Unable to compensate for tremors Extraneous Movement Athetoid (constant) Ataxia (poor coordination in movement) FINE MOTOR SELF CARE Dexterity Limited fine motor control Has limited hand movement Handwriting Writing or copying ability is significantly below peers Significant legibility factor--written work not readable Cannot keep up with the pace of written work Is frustrated by writing Fatigue is a factor Typing appears to be potentially faster than handwriting Needs assistance with going to the bathroom Unable to be toilet trained Needs assistance to eat Cannot take in food orally Needs suctioning routinely Has degenerative medical condition Is medically fragile Seizures limit alertness Needs to rest frequently Needs assistance to zip coat or tie shoes COMMUNICATION SENSORY Receptive Language Receptive language is significantly lower than ability Receptive language is significantly higher than expressive Expressive Language Speech is unintelligible Expressive language is significantly lower than ability Mean Length of Utterance (MLU) is 3 words or less Spontaneous or self initiated language is significantly limited Does not make choices consistently Does not respond appropriately with yes or no Does not have communicative intent Vision Requires corrective lenses Requires large print to read Requires mobility training Has blind spot Hearing Requires preferential seating Hearing limitations affect the language thresholds Requires assistance to receive language Requires sign language to receive language Has fluctuating hearing loss Needs visual signals for safety purposes From Function to Technology Solution. It happened that aparticipant in Tom's Solution Circle hit on a great idea for asolution to his functional problem with reading. This was a fortunateconnection to make. At the suggestions of his Solution Circle, Tombegan to use computerized books which he "reads" by having thecomputer speak the words as he follows along with the text. For Tom,computerized books proved to be a successful solution to his readingproblem because they help him to get the information he needs withoutstruggling with the reading process.Not every Solution Circle will be like Tom's and identify theexact technology that the individual needs. But if a Solution Circlehas worked well, the end result will be a clear analysis of thefunctions that need to be performed. This functional information canthen be brought to technicians who can make suggestions for possibleassistive technology solutions. There are over 50 assistivetechnology centers in the United States where knowledgeableindividuals can assist people with disabilities and their familieswith making a match between functions that need to be performed andthe technology that is available to perform those tasks. A list ofassistive technology centers is available in the Appendix to thisGuide.Formal Assessment. Solution Circles are an effective,informal way to identify functional needs that can be met throughtechnology. However, in the school setting, it is also necessary toestablish a student's needs for technology in a more formal way.Formal evaluations for assistive technology must bemulti-disciplinary, involving educators and therapists who areknowledgeable about the school curriculum and the particular types ofimpairments that the student being assessed may have. For example,for a student with cerebral palsy the assistive technology evaluationmight involve a teacher, a physical therapist, a speech and languageclinician, and an occupational therapist. The teacher would assistthe therapists in determining what skills the student needed to learnand how technology might assist the student in acquiring thoseskills. Some assistive technology evaluations might require theadditional services of an A-V technician, adaptive physical educationteacher, a rehabilitation counselor, or speech and languagepathologist with specialized training in augmentative communication.In school districts where there is no specialized expertise intechnology and its applications, it may be necessary to contract forevaluations with special education cooperatives, medical centers, orcenters that focus on technology assessment.Individuals conducting an assistive technology evaluationshould: Be knowledgeable of the student's strengths and weaknesses: medical needs, mobility, fine and gross motor skills, cognitive ability, communication abilities, vocational potential, self help needs, sensory abilities, level of academic achievement, and area(s) of disability; Have knowledge of and access to an array of assistive technology devices; Be familiar with the student's educational setting and educational needs; Be able to communicate effectively with parents and educators.Because the assistive technology field is so new, there are noparticular licenses or credentialing processes to identify aprofessional as qualified to do assistive technology evaluations.Generally speaking, individuals with professional licenses asoccupational or physical therapists, special educators, speechpathologists, or rehabilitative counselors may have the expertise toconduct an AT evaluation. When considering an evaluator, it is wiseto ask about the evaluator's specific experience with assistivetechnology. It is also important to recognize that no one person ordiscipline will know everything about assistive technology;therefore, access to knowledgeable people at the local level andthrough other agencies, programs or services is essential.Conducting the AT Evaluation. The assistive technologyevaluation must be tailored to the unique needs of the student. Insome cases, the evaluation may be conducted by at team ofindividuals; in other cases, the evaluation may be conducted by asingle individual (e.g., the speech pathologist). Questions to beaddressed during the assessment should be related to the specifictasks the student needs to be able to perform and what, if any,assistive technology would help. The following questions may beconsidered during the assessment: What tasks does the student need to perform that he or she cannot perform? Is there a low tech device which will address the student's needs satisfactorily? What types of high tech assistive devices may help the student in performing the task? Will assistive technology help the student to perform the task in the least restrictive environment? Is the device being considered suited to the student's educational needs and abilities? Will the assistive technology device remain suitable over time? How long lasting will this solution potentially be?The above are only a few of the considerations which need to beaddressed as part of the evaluation process. There is no specific"test" for evaluating the need for assistive technology. Therefore,prior to conducting the evaluation, the individuals doing theassessment need to have a well planned process in mind.The formal written assistive technology evaluation reportshould address, but not be limited to, the following points: Procedures used to evaluate the student; Instruments employed in the evaluation, assuring that a range of levels of technologies has been considered; Results of evaluations, including both qualitative and quantitative measures; Recommendations for levels of technology appropriate to the student's capabilities and potentials, and Implications for educational programming, including discussion of both individual technology needs and recommended environmental and instructional modifications.In the end, an assistive technology evaluation should providerecommendations for accommodations, adaptations, devices, andservices based on the individual's strengths, needs, and preferredlifestyle. The evaluation should indicate (a) whether devices andservices have potential for improving function, and (b) what trainingmay be necessary in order to use the technology equipment safely andeffectively. Examine available technology with a critical eye.It is easy to be dazzled by the possibilities in new assistivetechnology, but it is important for parents to be wise consumers andask probing questions about the features and quality of an assistivetechnology device. The following is a list of questions to considerwhen evaluating a particular assistive technology device:PerformanceDoes 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 purpose or is itflexible?"Elegance"Does this device represent the simplest, most efficient wayto accomplish the task?Or is this device too elaborate, too complicated to beworthwhile?ErgonomicsDoes it fit the individual?Is it convenient to use in the environment?Is the equipment portable enough to go where the usergoes?Are different devices needed in differentenvironments?ReliabilityWhat is the manufacturer's reputation forreliability?Does it stand up well to normal use?Is it durable?SafetyIs it safe to use?What is the power source for the device? Is itsafe?Is a margin built in for foreseeable misuse?PracticalityDo company sales people seem knowledgeable andhelpful?Are the company's service people knowledgeable andhelpful?Does the device have a warranty? How long is the deviceguaranteed to function?How available are repair services? At what cost?Can this device be leased?Is this device available for a trial period beforepurchase?Will this device soon be outdated? Is something better onthe horizon?Will the company update the device?Does the manufacturer provide training in using thedevice?AestheticsIs this device attractive to the eye?Does the device fit well into the user'slifestyle?NormalizationDoes the device assist the user with more normalizedliving?Can the user operate the device independently or with aminimum of assistance?Or does the device "stick out" too much and advertise thedisability of the user?Does the equipment minimize difference or exaggeratedifference?Does the device have the potential to increase the quantityand quality of time spent with nondisabled peers? Or does the deviceseparate the user from others?Cost effectivenessDo the benefits the device provides justify thecost?Are there less expensive devices or models that serve thepurpose as well?Personal acceptanceIs this device the user's own choice?Does the potential user like this device and want to useit?Does the potential user view this device aslife-enhancing?Would the user have preferred some other device or means toperform the task?Will using the device always be a chore or can using itbecome a habit?There are several ways that consumers can find answers to theirspecific questions about assistive technology devices. Most vendorswill provide good basic information about the product. Call thevendor and ask for brochures, product specifications, price list andany other written information. This is a place to start. A secondstep is to read reviews of the product in trade magazines or Closingthe Gap, a widely respected publication that reviews new assistivetechnology products. If possible, it is very helpful to talk to otherconsumers who are already using the product. Ask them about the prosand cons of using the device. Then visit a preview center, if thereis one nearby, and try out several types of devices. Ask for generalrecommendations from the preview center's staff. After identifying adevice that appears to meet the potential user's needs, try thedevice out for a month to six weeks to make sure that it performs asadvertised and fits in well with the user's lifestyle. During thetrial period, it will be possible to identify training needs for theuser, family members and school staff. The trial period will also bea time for the user to test the device in several settings todetermine its portability and flexibility. figure 4: ASSISTIVE TECHNOLOGY EVALUATION Device or Equipment Features or Functions Name: Date: Motor/Self Care Fine Motor manual wheelchair power wheelchair bus lift supportive classroom chair stander walker lift for transfers positioning device canes or crutches adapted commode suctioning device braces or supports other____________________ word processor word processor with prediction voiced word processor with prediction adapted keyboard keyguard alternative key arrangement voice activated computer access infrared computer access mouse access trackball joystick power pad switch (e.g., mouth, lip, chin) touch screen pointers drag and click desk accessory sticky keys onscreen keyboard printer for written work adapted feeding utensils braces or splints other____________________ Cognitive/Communication Sensory/Perceptual communciation board(s) communication wallet total communication manual sign word processor with voice programmed voice output icon prediction electronic communication device programmable switch with voice output no-reading-necessary word processor spell checker grammar checker outlining program other____________________ hearing aid(s) classroom amplification boosted signal to noise ratio (e.g., headset to keep focus during word processing) corrective lenses enlarged print taped books voiced word processing voiced screen directions CCTV other____________________ Match the Individual's Needs to Specific Equipment Features.When considering an assistive technology device, it is veryimportant to consider how a device matches up with the particularindividual's needs and habits. In some ways, an assistive devicebecomes an extension of the user's mind and body. As such, it is ahighly personal item. A device may work as advertised, but still notmeet an individual's needs because the individual just does not feel"comfortable" in using it. For example, Cindy, a fourteen-year-oldwho is totally blind and has mild cerebral palsy affecting her handsand arms, was being taught Morse Code as a means to speed up herwriting. She had difficulty using a Brailler because her arm strengthwas so limited so her teacher thought Morse Code would be an easiermethod of writing for Cindy. The only problem was that Cindy did notlike using Morse Code. To her, it seemed like she was having to learnanother complicated language when she already knew braille and likedto use it. Cindy admitted that writing in braille was slow for herbut she was more comfortable with it. Cindy and her teacher were atan impasse until a friend suggested to Cindy that she try writing ona voice-output computer. Cindy loved the computer! With a headsetattached to the sound system, she could listen carefully to thecomputer as it read aloud the letters and words she was typing on alight touch, tactile-marked keyboard. This computer also had afeature of printing out text in either standard print or braille.Cindy was delighted--she could write copy for herself to read inbraille and for her sighted teachers to read in regular print. Thissolution worked because it met Cindy's learning needs and respondedto her own ideas about herself. She did not want to use Morse Codebecause it was a separate type of communication known only to a few.With her computer, voiced software, and dual printer, she had thebest of two worlds--she could "hear" her writing as she typed, shecould read it over in braille, and her sighted teachers could readher finished product. This solution helped Cindy to improve hercomposition skills, speed up her writing time, and communicate moreeasily with sighted people.Cindy was fortunate because her assistive technology solution mether needs almost perfectly. Such a close match is not, however,always possible. Nonetheless, every effort should be made to have thematch be as close as it can be. In general, when assistive technologysolutions are individualized, simple to use, and responsive to thewhole person, they are more likely to be used by the individual. Whenthe device performs a task well, but does not "fit" the individual,the technology is likely to be abandoned by the user in favor ofsomething else which meets the need more exactly. Too often devicesare purchased because of their technical potential without thought totheir relationship to the individual and his or her lifestyle. Thesemismatched devices are the ones that end up languishing in theirpacking boxes--a sad reminder of time and money spent to noavail. Try the Device Before Buying.It cannot be emphasized enough how vital it is to try outassistive technology devices and equipment before buying. Trying outa device for several weeks provides the user with an opportunity tolearn how to use the device and how to adapt to its features while atthe same time testing the device in the various environments where itwill be used. For example, Mike tried out a communication devicewhich attached nicely to his wheelchair tray and was compatible withhis computer that he used for doing school work. Though thecommunication device worked well and was relatively easy to program,Mike found out quickly that the device was just too bulky to beuseful for him. When he traveled around the school, the communicationdevice blocked his view of the terrain and of people passing by. Hefound he missed opportunities to communicate because he could not seewho was coming his way. Mike also discovered that the communicationdevice did not serve him well in crowds like at pep rallies orbasketball games. After a month of working with this communicationdevice, Mike decided it was not for him and selected instead a devicethat was less complicated, smaller, and more portable. The seconddevice was not as sophisticated as the first, but it better met hisneeds for quick communication with friends in social settings. If hehad not had the opportunity to try out both devices for an extendedperiod of time, Mike might not have realized the value of the seconddevice and may have been stuck with a communication device that wastoo large and too sophisticated to match his lifestyle.Similarly, Marilyn benefited from a trial period with hercommunication device. She found out the first week that theparticular device she had chosen would not work for her because itbroke too easily and it was difficult to get repaired. During thefirst week that Marilyn had the device for trial, her teacher brokeone of the buttons during a programming session. It took two weeks tocontact the manufacturer and then the device had to be mailed back tothe factory for repairs. The device was gone for over six weeks, andthe manufacturer would not supply a "loaner" while Marilyn waited forrepairs to the first device. This experience taught Marilyn theimportance of having a responsive manufacturer who is willing torepair devices quickly and to supply substitutes for the user whilerepairs are being made. Marilyn decided on a different device withsimilar features and a great helpline to provide assistance with themaintenance of the machine.The information that can be learned during a trial period with adevice is invaluable to the user. It is discouraging to find outduring the trial that a device is not all it is purported to be orthat it does not work as well as advertised, but it is far better tolearn before purchase that a device does not meet the user's needsthan to learn after purchase and be stuck with an expensive, unusablemachine. For the consumer, it is daunting to think about startingover again with the process of selecting a device. Nonetheless, it isworthwhile to seek more information and look again. Having beenthrough a trial, even when the outcome is not successful, providesthe user with greater clarity about what an appropriate device willhave to be able to do. The second time around the search is likely togo faster and come out with a better result. Identify Next Steps.Once a device has been selected, the consumer becomes impatient tohave one and begin using it right away. But at this point, importantwork still needs to be done. Funding the device is a majorconsideration. Sometimes families will pay for the device themselves,but under other circumstances, the device will be purchased by aschool district, through Medicaid or private insurance, or throughsome other means. Parents need to become familiar with the variousfunding options and determine which one will work for them (SeeFunding Assistive Technology for additional information about fundingsources).Also when considering funding, families should think about costsbeyond the price of the device itself. For example, a computer set-upwith a keyboard, monitor and printer might cost $3,500. Thisequipment is basically useless unless other equipment is purchased aswell: software, adaptive devices, paper, manuals, upgrades. Pricesfor these additions can raise the actual cost of the device byhundreds of dollars.Devices often require training for the user, family members, andothers to ensure effective and safe use. How much does training cost?Who will provide it? Repair and maintenance are other costs usuallyadditional to the price of the equipment. Sometimes families willalso want to insure the assistive device so insurance payments becomepart of the overall cost.Since making an assistive technology purchase is such an importantpersonal and financial decision, it is wise to have a realisticbudget in mind that includes all of the equipment and services thatare necessary to make the assistive technology work effectively. Withthis budget in mind, it becomes easier to plan the purchase, seek outfunding sources, and make a compelling case for financialassistance. Determine What Follow-up Is Needed.After the assistive technology device has been purchased and putto use, there are additional follow-up activities that need to takeplace. The original assistive technology evaluation should include away to monitor the use of the device. Periodic scheduled reviews theby evaluator, follow-up calls to and from the family are some ways tohelp assure effective, safe use. Families who travel great distancesfor evaluation need to be certain that services like maintenance,repair and replacement of devices are available within a reasonabledistance from home.Assistive technology devices are used best when all the people inthe life of the individual with disabilities understand the devicesin the same way. At first, devices may seem to exaggerate differencesbetween a person and the rest of the world. Care should be taken toexplain that assistive equipment is a difference equalizer, not adifference maker. Classmates and friends need to understand that theadapted seating or adapted keyboard helps the individual do whatother students do. Adults in a child's life need to understand thatdevices work to make life easier, better, and more functional. Peopleneed to know that ramps help keep individuals with mobilitydisabilities from being separated from peers; that communicationtechnology allows people to "speak" their thoughts.Close communication between parents and their child'shelpers--teachers, therapists, day care workers and others--isessential to make sure devices and services are being used safely andeffectively. If the device is working well, but the child is notbeing integrated into the classroom or other environments, then theremay be a need for additional training for the children and adults whointeract with the child.Besides keeping track of how the device is working and being used,it is important to observe progress in the areas of technology whichare useful to the individual with the assistive technology device. Asupgrades of equipment occur or more sophisticated models come on themarket, the user may want to consider modifying or replacing theequipment that is currently in use. Also as the individual becomesmore skilled at using technology, the individual may outgrow thecurrent device and need to look for more advanced equipment. It canbe assumed with most high tech items that in three to five yearsthere will be a need for upgrade or replacement. The wise consumerbegins early to plan for the next step in technology, includingsaving money for a new device and staying alert to the new optionsthat become available.What kinds of training are important to occur when a child hasa new assistive technology device?Because assistive technology of the high tech variety is so new,it is particularly important that training be provided to all thosewho may need it. In the school setting, it is helpful for alleducators and administrators to have some awareness training so thatthey have a general idea of what assistive technology is. Areas to becovered in inservice training might include: legal issues related to assistive technology awareness training concerning how to serve students with assistive technology needs information on how assistive technology relates to the evaluation process how to write IEPs for students who require use of assistive technology devices the relationship between technology and student placement the nature of common assistive technology devices resources to contact for information on assistive technology.Beyond these awareness activities, those members of the schoolstaff who work directly with a student who uses technology, need tohave training on the specifics of using the device and how it ismaintained and serviced. Training should include, but not be limitedto, the following: review of the student's educational and assistive technology needs review of goals and objectives, supplementary aids and services, and related services on the IEP or IFSP training on how to use and maintain the device training on proper transport of the device within the school building and from home to school training on how to program the device, if needed training on how to use the device effectively during instruction training in trouble-shooting when the device is not working properly information about what to do when the device is not functioning or broken information about how to coordinate assistive technology with all the activities in the student's day training in methods to evaluate the effectiveness of assistive technology.Depending on the type of assistive technology used by the studentand the student's needs, it may be advantageous for assistivetechnology information to be shared with the student's peers. Suchtraining will help fellow students to gain an understanding of thestudent's assistive device, foster acceptance in the socialenvironment, and reduce fears other students may have aboutsocializing with the student who uses technology. In some cases,parents and the student may want to be involved in the peertraining.Parents may require training, too, in order for the device to beused at home for the student to complete homework assignments orparticipate in extended school year services. Once trained, theparents can become a resource to the student for proper care andmaintenance of the device.Most importantly, the student himself or herself, will needtraining in how to use the device as independently as possible.Training for the student may be written into the IEP as a separategoal or may be included as a related service that supports thestudent's special education program.SummaryPurchasing a high tech assistive technology device is a major lifedecision because of the potential impact on the individual andbecause such devices can be costly. When considering an assistivetechnology device, it is important to do the following: be realisticabout the consumer's capabilities and needs; get a multidisciplinaryevaluation; examine available technology with a critical eye; matchthe individual's needs to specific equipment features; test thedevice for a trial period; identify next steps; and determine whatneeds to be done for follow-up after purchase. Evaluations forassistive technology, both informal and formal, should consider firstof all the functions that the consumer wishes to perform usingtechnology. When evaluating a particular piece of equipment,consideration should be given to the following features: performance,simplicity of design, ergonomics, reliability, safety, practicality,aesthetics, normalization, cost effectiveness, and personalacceptance. Good sources of information about assistive devices aremanufacturers publications, trade journals, preview centers, andconsumers who are already using the device. Once a device isselected, the consumer will need to secure funding for the purchaseand be aware of additional costs for related equipment, insurance andtraining.Hints for ParentsDon't let the cost of assistive technology deter you fromconsidering it for your child. High tech assistive technology can bequite costly, but it can also make the difference for your child interms of becoming well educated, employable, and a fully-includedmember of the community. Don't leave any stone unturned when lookingfor funding sources. Consider any or all of the following for fundingor assistance: Early intervention programs Schools Transition programs Vocational Rehabilitation State Programs for Children with Special Health Care Needs Medicaid Medicare State Technology Resources Used Equipment Leasing Equipment Loan Programs Disability OrganizationsReturn to beginning___ NextArticle___PreviousArticleSierra Sierra wants to play with dolls like other children her age, butshe has a muscle disease that has caused her to lose muscle toneexcept in one hand. What could be done to allow Sierra to dress andundress her dolls, comb their hair, and bathe them?Sierra's SolutionThe assistive technology solution for Sierra involved her wholefamily. While vacationing in Mexico, Sierra's grandmother found her afashion doll that was a bit larger than the typical "Barbie doll."The larger doll was easier for Sierra to manipulate. Sierra's mothersewed several outfits for the doll using velcro instead of snaps orbuttons as fasteners.Sierra's dad bought doll stands at a toy store and fastenedseveral stands with clamps to Sierra's wheelchair tray. He alsofastened a plastic pouch to the tray. Sierra puts the small dollaccessories in the pouch. When Sierra wants to dress her doll, sheputs the doll in one of the stands. In this way, the doll is heldsecurely and Sierra can dress and undress the doll with one hand.Sierra's friends also use the doll stands for their dolls. Withthis arrangement, two or three girls can play together.Solution SummaryLarger doll Velcro fasteners Plastic pouch Doll stands ClampsReturn to beginning___ NextArticle___PreviousArticleFunding Assistive TechnologyFunding for assistive technology is available from a variety ofpublic and private sources. To receive public or private funding, theindividual must meet eligibility criteria for the specific programand provide sufficient documentation of the need for assistivetechnology.The following list includes some of the programs which may pay forequipment if the individual needing the device meets theirrequirements. Many of these programs are run by different agencies indifferent states, making them hard to find. In general, the state'sTech Act office can assist consumers and family members in findingand using these programs (See Appendix under Resources).PUBLIC PROGRAMSEarly Intervention Programs (Individuals with DisabilitiesEducation Act, Part H)Young children (0-3) and their families may receive help throughearly intervention programs in evaluating what the child needs, ingetting assistive technology, and in learning how to use it.Equipment and services must be included in a written plan, called anIndividualized Family Service Plan (IFSP). To find the program for aparticular state, call National Early Childhood Technical AssistanceSystem (NEC*TAS) at 919-962-2001 or 919-966-4041 (TDD).Head StartThis child development program provides comprehensive educationaland health services for eligible children ages 3-5. Since 1982,federal law has required that at least 10 percent of the total numberof placements must be available to children who are disabled andrequire special services. Head Start is a mainstream placement optionfor children whose IEP calls for placement with nondisabled children.The January 1993 Head Start regulations specifically require theconsideration of assistive technology services and devices. For moreinformation, contact National Head Start Association, 201 N. UnionSt., Suite 320, Alexandria, VA 22314; 703-739-0875.Schools (IDEA, Part B)This program mandates a free, appropriate public education forpreschoolers, children and youth with disabilities. An IndividualizedEducation Program (IEP) is required for all children with adisability. These children are entitled to special education, relatedservices or supplementary aids. If the IEP team determines thatassistive technology is required for a free, appropriate publiceducation, then it must be provided at no cost to the child. Thetechnology must be included in the child's Individualized EducationProgram (IEP). Parents have a right to be involved and should help todevelop the IEP goals which may include technology. For help ingetting assistive technology in the IEP, call the TAPP Focus Centeron Assistive Technology at 1-800-222-7585.State Operated and Supported Schools (Chapter I)This program provides federal assistance to help educate childrenwith disabilities who are enrolled in state-operated andstate-supported programs. Federal funds must be used to pay forservices that supplement a child's basic special education program,such as construction and the purchase of equipment. For moreinformation, contact your State Department of Education.Section 504 of the Rehabilitation Act of 1973Section 504 provides a civil-rights mandate that requiresaccommodations for students who have disabilities such as orthopedicimpairments, but who do not qualify for special education services.It denies federal funds to any institution, including a school, whosepractices or policies discriminate against individuals withdisabilities. This legislation has resulted in a number of outcomes,including various actions to remove physical barriers to education,which may incorporate assistive technology. For more information,contact the nearest regional Office of Civil Rights or the StateVocational Rehabilitation Agency.State Programs for Children with Special Health CareNeedsThese programs provide and pay for services for eligible children.CSHCN programs vary widely from state to state in the services theyoffer, the number of children served, and the requirements foreligibility. Some CSHCN programs do pay for assistive technologydevices when no other funding source is available and the equipmentis necessary for health-related reasons. Most CSHCN programs are runby the state health agency. To contact CSHCN, ask information for thetelephone number of the state health agency.School-to-Work Transition ProgramsTransition Programs are charged with assisting students withdisabilities to receive the job related training and placementservices to help them move from school to work. Sometimes assistivetechnology may be necessary in order for a student to make asuccessful transition and become employable. If technology is neededfor transition purposes, it can be written into the student'sIndividualized Transition Plan (ITP). To receive more informationabout transition and technology, call the Parent Training andInformation Center (PTI) in your state (See Appendix).Vocational Rehabilitation ServicesState vocational rehabilitation agencies provide information,evaluation services, training and funding for technology andeducation to help adults go to work or live more independently. Iftechnology is necessary for an individual to work, VocationalRehabilitation may pay for the equipment as part of an IndividualizedWork-Related Plan (IWRP). To locate the nearest VocationalRehabilitation Agency, look in the telephone book under stategovernment.Plan to Achieve Self-Support (PASS)One of many Social Security Administration work incentiveprograms, this program provides an income and resource exclusion thatallows a blind or disabled person to set aside income and resourcesfor a work goal such as education, equipment purchase, vocationaltraining and starting a business. It should be considered for allstudents with vocational goals who are receiving social securitybenefits.This program provides a mechanism for people to set aside funds topurchase work-related equipment, such as assistive technology devicesand services. In many cases, if an individual is a recipient of SSIand writes a PASS to purchase education or equipment, an additionalSSI check will be provided to cover other living expenses. Sometimesif a person receives Social Security Disability Insurance (SSDI) anddesigns a PASS, it may make the individual eligible for SSI becausethe SSDI has been allocated for equipment and services.Impairment-Related Work Expense (IRWE)Impairment-Related Work Expense (IRWE)--one of the Social SecurityAdministration's work incentive programs--allows an employedindividual with a disability who receives or is eligible for SSI orSSDI to deduct work-related expenses from gross reported income.This deduction allows the person to continue drawing SSDI or SSIand associated benefits (Medicaid or Medicare) if the IRWE deductionreduces earning below the Substantial Gainful Activity (SGA)Test.Although this method does not provide funding to pay for a deviceor service, it is a way of allowing the use of the individual's ownmoney to pay for assistive devices and services necessary to returnto work. The following is a list of possible work-related expenses:special transportation to and from work, personal assistance on thejob, structural modifications, durable medical equipment, prostheses,medical supplies and services, work-related equipment, non-medicalappliances and equipment, routine drug and medical costs, anddiagnostic procedure costs.MedicaidMedicaid is a joint federal and state program which covers someequipment if it is considered medically necessary. For moreinformation about Medicaid and who and what is covered, contact thelocal Department of Human Services office.MedicareAlthough not a usual source of funds for assistive technology,Part B of Medicare provides coverage for some durable medicalequipment if it is considered medically necessary and is for use inthe person's home. For more information about Medicare benefits,contact the Social Security Administration Regional Office.Technology-Related Assistance for Individuals with DisabilitiesAct of 1988This federal competitive grants program provides monies for statesto establish a statewide, consumer-responsive service delivery systemdesigned to effect systems change regarding assistive technology. Inmost Tech Act states, a funding specialist or policy analyst isavailable to assist with accessing assistive technology. Severalstates operate loan programs to help with the purchase of devices andservices. For more information, contact RESNA Technology AssistanceProject, 1700 N. Moore ST., Suite 1540, Arlington VA 22209-1903;703-524-6686.PRIVATE PROGRAMSPrivate InsuranceSome health insurance plans will buy equipment, but it depends onthe specific wording of the policy. Unless the policy says theequipment is not covered, it makes sense to ask the insurance companyto pay for it. The equipment must be considered medically necessaryand therefore requires a doctor's prescription.LoansThere are several low or no interest loans available to help buytechnology. Call the state Tech Act program or the manufacturer ofthe equipment may know where to get this type of loan.Non-Profit Disability AssociationsThere are many disability organizations, some of which may be ableto loan equipment or provide information about other funding sourcesor support groups. These organizations include: National Easter SealSociety, March of Dimes, Muscular Dystrophy Association, United Way,United Cerebral Palsy Association, and the Braille Institute.FoundationsSome private foundations have been set up specifically to providehelp to people with disabilities. A listing of such foundations canbe found at the library or may be available from the state Tech Actprogram.Programs Providing Assistive TechnologyThe state Tech Act programs offer referrals for evaluation andequipment recommendations as well as assistance with identifyingfunding or equipment lending sources. A therapy department in a localhospital or Disabled Students Center at a local college or universitymay also offer to help locate technology programs in the area.Alliance for Technology Access Centers (ATA) sometimes have loanprograms or information about purchasing used equipment or rentingequipment.Civic OrganizationsThere are many local civic and service organizations which mayprovide money to help someone in their community. Lists of theseorganizations are available from the Chamber of Commerce. Examples ofthese organizations are: Lions Club, Masons, Grotto, Veterans ofForeign Wars (VFW), Elks Club, Rotary Club, Kiwanis, Knights ofColumbus and Soroptomists. Some of these organizations have anational focus on disability or on a particular disability. Otherswill fund devices for a particular child who is known to the localclub.Charities and Fund-RaisersLocal churches, high school groups, neighborhood organizations,labor unions, or special interest groups (e.g., computer clubs, hamoperators) may plan a fund-raiser to help purchase assistivetechnology. College student organizations (fraternities andsororities) may give money or students' time to help a special cause.Even if money is not available, they may be willing to help organizea fund raiser.Local media (radio, television, newspapers) sometimes will sponsorfund-raising activities to fund devices. They may not contributemoney but will help with organizing the fund-raising activity andpublicizing it to the community.OTHER OPTIONSIn addition to federal and private funding sources, there are anumber of education-related grants, corporate technology donationprograms, and funding options that consumers should consider.Information on these alternative options is available through anumber of sources, including the following:NewslettersEducation Grants Alert, Capital Publications Inc., P.O. Box1453, Alexandria VA 22313-2052; 800-655-5597.Education Technology News, Business Publishers Inc, 951Pershing Dr., Silver Spring MD 20910-4464; 301-5878-6300.Financing Assistive Technology, Smiling Interface, P.O. Box2792, Church St. Station, New York NY 10008-2792; 415-864-2220.Special Education Report, Capital Publications Inc., P.O.Box 1453, Alexandria VA 22313-2053; 800-655-5597.Technology and Learning, Peter Li Inc. Publishing, 330Progress Rd., Dayton OH 45449; 415-457-4333.Technology ManufacturersIf it is not possible financially to purchase equipment, consumerscan sometimes rent or borrow equipment directly from themanufacturer.Used EquipmentUsed equipment is often advertised for sale in disability-relatedpublications, or the consumer can place a newspaper ad to see if usedequipment can be purchased locally. Several companies refurbish oldcomputers and sell them at low prices. Listings of used computeroutlets can be obtained from ATA Centers or state Tech Actprograms.LeasingMany manufacturers of assistive technology devices have equipmentwhich is available for rent or lease. Sometimes the rent or leasepayments can be applied toward purchase. Check with the manufacturerto see if this is an option.Equipment Loan ProgramsMany states have equipment loan programs as do some rehabilitationfacilities and disability organizations. Information about loanprograms is available from Tech Act programs.HOW TO APPLY FOR FUNDINGThere is an art to applying for funding for assistive technology.It is necessary to use just the right words to suit the particularagency that might be the funding source. It is also crucial todocument the need for and projected outcome of assistive technology.This documentation should include at minimum: A written statement of medical need from doctors or other health professionals. If the child had an evaluation by a rehabilitation profession, also include this report. A description of the child's problems resulting from the disability. This description can come from the doctor or other professional who evaluated the child. Description of how the technology helps the child. For example, the equipment may make the child safer or allow the child to do things more independently. Be sure to point out how money will be saved if use of the equipment allows attendant care to be reduced. A clear statement, based on assessment, that the child is a good candidate who has the cognitive and physical capacities necessary for using the technology.In summary, the documentation to support an assistive technologyfunding request should include a physician's prescription, thechild's assessment, an explanation of projected benefit from use ofthe technology or service, and any correspondence obtained fromprofessionals that would support the child's need for technology.The initial funding request should include not only the cost ofthe device, but also the cost of ongoing support and instruction inthe use of the technology. Assistive devices often have "hidden"expenses that are incurred with their purchase, and these expensesare frequently costly over time. Battery-powered devices may requirefrequent charging or cleaning. Upgrades for computer software may benecessary. Special modifications of the home or school environmentmay be necessary for the technology to be used. In each of theseexamples, costs associated with the technology may have to be assumedby the family if they are not considered in the initial applicationfor funding.It is also helpful to include with the funding request a pictureor a descriptive brochure about the device being requested. This isimportant because often persons who are reviewing the application donot know about the wide range of technologies that might beappropriate.Appropriate wording on the application is absolutely necessary.Key concepts for Medicaid include "medical necessity" and "restorethe patient to his or her best functional level." The term medicalnecessity means that the device is included in the course oftreatment being provided to the child and that a professional, suchas a physician or speech therapist, is supervising its use. Medicaidand private insurers alike generally pay for technologies that helprestore people to "functioning levels" and take the place of a bodypart that is not working. Typically, these programs do not pay fortechnologies or services whose function is educational orlife-enhancing rather than health related.The key for private insurance is "terms of the policy." It must beremembered that coverage by any insurance company does not set aprecedent. Just because one child receives needed technology under aparticular policy issued by a company does not mean that all othercovered children will also have technology paid for by that company.Each application stands on its own based on the expressed terms ofthe policy.It is usually under the major medical provisions of a healthpolicy that assistive technology can be provided as "other medicalservices and supplies." It may, however, be necessary to purchaseadditional insurance coverage or a "rider" in order for technologycosts to be included in the terms of the policy. It is important toremember that heath insurance policies are oriented toward healthcare, and not toward changes in the environment orrehabilitation.Both private health insurance policies and Medicaid sometimesimpose limits on the number of assistive technology devices over acertain cost that can be purchased within a certain time frame.Sometimes the rule is that the funding source will purchase only onedevice in the individual's lifetime. With these kinds ofrestrictions, it is all the more critical to be sure that thetechnology choice is the right one.TIPS THAT LEAD TO SUCCESS Apply to several funding sources at the same time. Be sure to meet the requirements of each agency. Find out if agencies will share costs. Fill in the agency's forms correctly. Many applications are denied because forms are not filled out properly. In addition to the standard form, include any other information that describes or shows what the equipment does and how it benefits the child. Assume no knowledge on the part of the reviewers. Turn in all documentation at the same time. Avoid using jargon; define all unfamiliar terms. Take the funding request package to the agency in person. While there, have it checked to make sure everything required has been included. Get the name of the person who reviewed the application. Call regularly to check on the funding request; each time try to talk to the same person. Be super polite--and persistent!WHAT IF FUNDING IS DENIED?It is not at all unusual for an initial funding request to bedenied. Even when family members and professionals have beenmeticulous in preparing applications requesting funding for neededtechnology, denials should be anticipated. Making an appeal is worththe effort since many denials are reversed at the appeal level.To start the appeal process, obtain any documentation orinformation provided by the funding agency (e.g., Medicaid or theprivate insurance company) relating to appeal procedures; forms touse, timelines, and filing procedures, for instance. This informationwill help in the prompt preparation for appeal. The kind of appeal tobe made depends on the reason for denial. When developing an appeal,find out the following: Why the request was denied. Ask for the reason in writing. Sometimes requests are denied because a reviewer lacks understanding of the technology or there may be an error in the paperwork. If needed, correct any mistakes or include more information; then resubmit the request.Going to appeal makes sense because generally the appeal placesthe application before more experienced persons in thedecision-making hierarchy. The technology requested is often new, andthe initial examiners in the process may be unaware of itsusefulness. Also, insufficient documentation may have been providedin the original application, and the problem can be remedied onappeal.Don't be daunted by the length of the appeal process. Follow itthrough to its completion. In some states, families may be able toappeal a denial beyond the first level. For example, some states have"unfair claims settlement practices" regulations, which areadministered through the insurance commissioner's office.Always make your appeal in person and take the child and theequipment if possible. If only part of the money is offered by oneagency, ask another agency to share costs. If the appeal is denied,try again. Submit the funding request to another agency. Beingpersistent will nearly always result in success.When going through the appeal process, turn to the stateProtection and Advocacy Program (P & A) for guidance and support.P & A advocates can help make sure that a child's rights totechnology and related services are not denied.Who pays when assistive technology is needed at school?The party who is responsible for paying for assistive technologydepends upon the circumstances under which the technology ispurchased. Under the special education law, students withdisabilities who are eligible for special education are entitled to afree appropriate public education. Parents do not have to pay forschool services, including assistive technology, if that service ispart of the student's Individualized Education Program (IEP). If thestudent is eligible for Medicaid, the school district can requestthat Medicaid pay for the device. If parents choose to do so, theymay agree to use private insurance to pay for a device that is usedat school. Parents cannot, however, be forced to use their insurancein this way. If the private insurance requires a co-payment, theschool district would have to pay this amount since parents shouldnot have to pay any special education related costs.Does Section 504 pay for assistive technology?Section 504, part of the Rehabilitation Act of 1973, is basicallya piece of civil rights legislation that is intended to preventdiscrimination against individuals with disabilities in any programwhich receives federal funding. Students who have disabilities, butwho do not qualify for special education, may still be eligible foraccommodations under Section 504 of the Rehabilitation Act of 1973.Section 504, however, does not provide any funding foraccommodations.Like the special education law, Section 504 requires publicschools to provide students with disabilities with a free appropriatepublic education and, in addition, ensures that students withdisabilities are afforded an equal opportunity to participate inschool programs. For students with disabilities, this means thatschools may need to make special arrangements so that these studentshave access to the full range of programs and activities offered. Forexample, a student who needs a wheelchair lift on a school bus to getto school must be provided with this technology. Other modificationswhich might be required under Section 504 include installing rampsinto buildings and modifying bathrooms to provide access forindividuals with physical disabilities. Even though required by thelaw, none of these types of modifications would be funded by Section504.Under what circumstances does private health insurance pay forassistive technology?Some private health insurance policies will pay all or part of thecost for some assistive technology devices. The devices are unlikelyto be listed specifically in the policy, but may be included undersome generic term like "therapeutic aids." Usually the devices haveto be prescribed by a physician in order to be covered by thepolicy.When does Medicaid cover assistive technology?Medicaid (Title XIX) will pay for "prosthetic devices"&endash;thatis, replacement, corrective, or supportive devices prescribed by aphysician or other licensed person. Each state has some flexibilityin determining which prosthetic devices it will include in its listof Medicaid covered expenses. Devices that are frequently covered byMedicaid are canes, crutches, walkers, manual wheelchairs, hospitalbeds, and hearing aids or eyeglasses for children and youth.SummaryAssistive technology can be expensive to purchase, but there are anumber of public and private sources for funding devices. Commonpublic funding sources include: early childhood interventionprograms, schools, Vocational Rehabilitation, and Medicaid. Privatesources may involve health insurance, personal loans, charitabledonations, or fundraising. It is very important to provide properdocumentation and use correct wording and procedures when requestingfunding. Initial requests for funding are frequently turned down, butappeals can be successful.Return to beginning___ NextArticle___PreviousArticleTEDTed is an active four-year old who lives in a small ruralcommunity with his parents and younger sisters. He was identified asspeech impaired and has been attending preschool special educationclasses. Ted has normal mental capabili | |
