Submitted by
Kathy Staugler (kstaugler@gmail.com)
Nick Weiland (nweiland55@gmail.com)
The Individual with Disabilities Education Act (IDEA) requires that IEP teams consider whether the child with a disability needs assistive technology devices and services in order to receive a free appropriate public education (FAPE). Speech-language pathologists and audiologists are often called on to evaluate, recommend and support these devices and services within the IEP process.
The American
Speech-Language-Hearing Association. (ASHA) describe a set of beliefs that are
central to the provision of assistive technology devices and services by speech
language pathologists and audiologists.
Assistive
technology and its timely access should be available to all students who need
such technology to benefit from educational programs.
Assistive
technology increases a students opportunity for education, societal
integration, social interactions, and meaningful employment.
Students
who use assistive technology may not necessarily require special education
programs and services.
Assistive
technology supports student participation in learning in the least restrictive
environment.
Early
planning and coordination with both preschool and adult services ensures an
appropriate transition for students in need of assistive technology devices and
services.
As
the student grows and develops, the need for assistive technology must be
reevaluated and must continue to be appropriate and relevant for the student
and his or her learning abilities.
Families,
students, educators, and administrators need to participate in the assistive
technology decision-making process. Recommendations for assistive technology
shall be based on student need, not financial resources or life/career
expectations.
Attention
must be paid to both verbal and written communication modalities when
recommendations are made regarding assistive technology.
Adequate fiscal and human resources must be made available for the provision of assistive technology devices and services to students with communication disabilities.
(American
Speech-Language-Hearing Association. (1997). Maximizing the
Provision of Appropriate
Technology Services and Devices for Students in Schools)
Assistive
technology encompasses a continuum of adaptive switches, augmentative and
alternative communication (AAC) systems, Braille input-output devices,
assistive listening systems and devices, computer access devices, output
devices, environmental controls, mobility aids, and computer software. As part of the team, the speech-language
pathologist and/or audiologist may be participating in any one of these
areas. However, it is essential that
these professionals bring their communication expertise into these areas of
assistive technology:
Audiologists:
Assistive listening devices (ALDs) are designed to optimize residual hearing
(e.g., hearing aids, FM systems, infrared, cochlear implants, and sound field
systems) or to provide visual or tactile information (e.g., TTYs, captioned
video, alerting systems, or speech-detection systems).
Speech-language pathologists: AAC systems consist of dedicated systems and software written for non-dedicated computers, as well as unaided communication systems such as natural gestures, sign language, and eye blink codes. An AAC system is defined as An integrated group of components, including the symbols, aids, strategies and techniques used by individuals to enhance communication.
It is
imperative that speech-language pathologists and audiologists possess the
knowledge and skills necessary to promote comprehensive assistive technology
services. ASHA has published statements
on recommended knowledge and skills, which can be found in the Reference
section of this guide.
The Quality Indicators for Assistive Technology (QIAT) Consortium has defined a set of descriptors that serve as a guide for the provision of high-quality assistive technology services. The basics of these Quality Indicators should serve to assist districts as they integrate assistive technology service delivery into current district policies and procedures and/or continuous improvement plans. These descriptors can be found at the QIAT webpage, located at http://www.qiat.org. Additionally, QIAT Matrices may be used to guide a collaborative self-assessment conducted by a school district team and used to plan for changes that lead to improvement in attainable steps.
The remainder of
this guide will address general considerations related to assistive technology
and specific guidelines for augmentative and alternative communication.
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Federal and State
Regulations
Assistive
Technology Device (IDEA, 2004, Part A, Definitions, 300.5; Operating Standards for
Ohio Schools Service Children with Disabilities (2007) 3301-51-01 (B)(2).)
Assistive technology device means any item, piece of equipment, or product system, whether acquired commercially off the shelf, modified, or customized, that is used to increase, maintain, or improve the functional capabilities of a child with a disability. The term does not include a medical device that is surgically implanted, or the replacement of such device.
Assistive
Technology Service (AT) (IDEA,
2004, Part A, Definitions, 300.6; Operating
Standards for Ohio Schools Service Children with Disabilities (2007) 3301-51-01
(B)(3).)
Assistive technology service means any service that directly assists a child with a disability in the selection, acquisition, or use of an assistive technology device. The term includes-
(a) The evaluation of the needs of a child with a disability, including a functional evaluation of the child in the childs customary environment;
(b) Purchasing, leasing, or otherwise providing for the acquisition of assistive technology devices by children with disabilities;
(c) Selecting, designing, fitting, customizing, adapting, applying, maintaining, repairing, or replacing assistive technology devices,
(d) Coordinating and using other therapies, interventions, or services with assistive technology devices, such as those associated with existing education and rehabilitation plans and programs,
(e) Training or technical assistance for a child with a disability or, if appropriate, that childs family; and
(f) Training or technical assistance for professionals (including individuals providing education or rehabilitation services), employers, or other individuals who provide services to, employ, or are otherwise substantially involved in the major life functions of that child.
Consideration of Assistive Technology (IDEA 2004; 300.324 (a)(2)(v); Operating
Standards and Related Guidance for Ohio Educational Agencies Serving Children
with Disabilities (2008) 3301-51-07 (L)(b)(v).)
In developing the childs
IEP, the IEP team must consider whether the child needs assistive technology
devices and services.
Assistive Technology (IDEA 2004; 300.105(a)(1)(2)(3)
(b))
Each public agency must ensure that assistive technology devices or assistive technology services, or both as those terms are defined in RF 300.5 and 300.6 respectively, are made available to a child with a disability if required as a part of the childs;
(1) Special education under RF 300.36
(2) Related services under RF 300.34; or
(3) Supplementary aids and services under RF 300.38 and 300.114 (a)(2)(ii).
On a case-by-case basis, the use of school-purchased assistive technology devices in a childs home or in other settings is required if the childs IEP Team determines that the child needs access to those devices in or to receive FAPE.
Hearing aids. (IDEA
2004 300.113(a))
Each public agency must ensure that hearing aids worn in school by children with hearing impairments, including deafness, are functioning properly.
Related Services Exception: services that apply to children with surgically implanted
devices, including cochlear implants. (IDEA 2004 300.34)
Related services do not include a medical device that is surgically implanted, the optimization of that devices functioning (e.g. mapping), maintenance of that device, or the replacement of that device.
Prevents the routine checking of an external component of a surgically implanted device to make sure it is functioning properly, as required in RF 300.113 (b).
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Examples/Samples of
AT/AAC
Assistive technology may impact all areas of an individuals life. While it is important to recognize the scope of assistive technology, school districts must be concerned about the applications of these systems that enable a student with disabilities to realize his or her maximum potential within educational experiences.
Assistive technology solutions are often described by the level, which is generally a correlation between the technological difficulty of the device itself and the level of technical training the student needs to implement the device. Low technology refers to devices that are easy to use and generally do not require electrical power. The training period for use of such devices is relatively short. Higher-level technology systems incorporate a wide range of levels for all aspects of life skills. These systems may involve complex construction or internal structures. Manufacturers specialize in equipment to accommodate specific disability conditions and the performance tasks to be accomplished. Such devices may require specific training in order for the user to take full advantage of their capabilities. The continuum of low to high technology options should always be considered, and the selection of equipment should be a match between the students abilities and the purpose of the AT in enabling the student to participate in the educational setting. With this in mind, it is still important to recognize that it is never prudent to use a high technology solution for a low technology problem. It should also be noted that low technology options, (e.g. communication boards, picture exchange systems) may need to be in place even when a high technology device has been implemented.
It is helpful to classify AT according to the task it enables the student to perform. Various authors have attempted to define these categories. This is a sample of the scope of assistive technology:
Seating and Positioning
Activities of Daily Living
Environmental Control
Mobility
Visual Aids
Assistive Listening
Augmentative Communication
Physical Education, Leisure and Play
Writing
Reading
Learning and Studying
Computer Access
Examples of low and high technology options in each of these categories can be viewed at the Ohio Center for Autism and Low Incidence (OCALI) website located at http://www.ocali.org/at/at_learn_types.php.
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Assistive
Technology Consideration
Beginning with the reauthorization
of IDEA in 1997, the IEP team is required to
consider the assistive technology needs of every student who is
receiving special education services.
In developing the childs IEP, the IEP team must consider
whether the child needs assistive technology devices and services.
When addressing AT consideration
within the IEP process, it is important to realize that consideration is by
nature a brief process that can be conducted within every IEP development. There should be at least one person on the
IEP team who has some knowledge about AT.
These are questions that the IEP team should answer during an AT consideration:
What is it that we expect the student to be able to do in the educational program that he/she is unable to do because of his/her disability?
What current special strategies, accommodations or assistive technologies have been tried to meet the special education need?
o
Is it working? (If the
answer is yes, document this in the IEP.)
Are there concerns that need further examination related to the defined tasks or expectations?
Are there new or additional technologies to be implemented?
Does this collaborative team have the resources to
extend the consideration for new/additional assistive technology? (If no, then
what plan can be put into place for extended assessment?)
Recommended assistive technologies must be defined and
documented in the IEP, which may be part of the students goals, objectives, or
services.
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Assistive Technology
Decision Making
Selecting and implementing
assistive technology requires more than a simple assessment to determine a
match between the students abilities and the features of a device. The chosen assistive technology must be a
tool that is useful in the individuals environment to perform tasks that the
individual participates in. In order to
make this type of recommendation, the educational team must collaboratively
seek to identify the needs and generate solutions that will facilitate the
identified goals.
The SETT Framework, developed by
Joy Zabala, is an organizational tool used by many teams across the
country. It provides a foundation for
teams to gather and organize information for good decision-making. The questions posed in the SETT Framework
were developed as a guideline and a place to start. During an assistive
technology assessment, information about the Student, the Environments,
the Tasks, must be gathered and
thoughtfully considered before any appropriate system of Tools can be proposed and acted upon. Teams may need to seek
answers to other questions as the process proceeds. However, in most instances, the questions will relate to one of
the areas of these guidelines.
The Student
- What does the student need to do?
- What are the students current abilities?
- What are the students special needs?
The Environments
- What is the instructional setting?
- What is the physical arrangement?
- What materials and equipment are currently available?
- What supports are available?
- What are the attitudes and expectations?
- What are the concerns?
The Tasks
- What tasks occur which enable progress toward mastery of IEP
goals?
- What tasks are a part of being actively involved in the
environments?
- What is everyone else doing?
- What are the critical elements of the activity/task?
- How might the activity be modified to accommodate the students
active participation?
The Tools
- What system of no tech, low tech, and high tech tools should be
considered to support the student in doing the
identified tasks in these environments?
- What strategies might be used to increase student performance?
- How might these tools be tried out with the student in the
customary environments in which they will be used?
(Source: Joy Zabala,
http://sweb.uky.edu/~jszaba0/JoyZabala.html )
A variety of techniques may be
utilized in obtaining data related the SETT questions and the skills that the
student has related to the specific assistive technology tools. These may include:
Observation: Observations of
the student in natural settings will yield information on the students
abilities to participate in various activities. It will also provide an opportunity to view the participation
patterns of peers. Work samples offer
support to compare the students performance with what is expected of others in
the classroom.
Interaction: Interacting with the student may provide an opportunity to elicit
behaviors
that
might not typically be seen. Direct
assessment involves an interactive process.
When considering the assistive technology needs of a student, engage the
student in tasks similar to what is required in the classroom, creating opportunities for the student to try
assistive modifications that might be beneficial. A variety of assistive technology devices
may need to be available for this
assessment period.
Interviews: Asking specific
questions of the student, family, or school personnel will generate information
specific to the needs, abilities, interests, and participation patterns of the
student.
Record Review: Past history, medical, or specialized
assessment information may be
included
in records that provide insight on the various aspects of the student.
A resource that can assist the
team in effective data gathering processes is How Do You Know It, How Can You Show It? available from the Wisconsin Assistive Technology Initiative
(WATI) at http://www.wati.org/products/products.html.
An effective Assistive Technology
Decision Making Process requires team collaboration. Within a collaborative
model, all members of the team should contribute their talents to make the
process work. At various times
throughout the process, the emphasis may be heavier on one member or
another. Yet, when information is
discussed, each member should be present so that a balance is created to focus
on the purpose of the AT process.
In the collaborative model, it is assumed
that no one person or profession
has an adequate knowledge base or sufficient expertise to
execute all the
functions (assessment, planning, and intervention)
associated with
providing educational services for students.......All team members are
involved
in planning and monitoring educational goals and procedures, although each team
members responsibility for the implementation may
vary. Team members can be considered as sharing
joint ownership and responsibility
to intervention objectives. (ASHA,
1991)
A school district team may find
that additional data is needed to make a precise determination of the possible
tools that are applicable. Available
assistive technologies are ever-changing and advancing. There is no one person who can know
everything about every possible AT device and/or service. If the team feels they have exhausted their
knowledge base and resources to make specific tool selections, they may need to
seek input from other agencies or persons who have experience in the area of
assistive technology being considered.
Assistive technology
decision-making is a match between the students abilities, needs, and
expectations and features that will facilitate the identified student
performance. Keeping the required
features of a system in mind, the team may find it helpful to brainstorm a
continuum of options that will assist the student in achieving this desired
level of performance. The team must
also keep in mind that this may include both devices and services.
The team should determine that if
a trial period should be implemented with certain AT and strategies. The team should consider what options are
accessible for trial periods
The Ohio Center for Autism and Low
Incidence (OCALI) has an extensive loan library of assistive technology
equipment. These devices can be checked
out online from the OCALI webpage at http://www.ocali.org. Several
manufacturers and vendors of equipment will also provide loans to school
districts for trial periods. For every
trial period, the team should determine the training needed for staff and
families, the time frame for a fair trial, and the criteria for data collection
that will be used in determining success.
All team members should understand the criteria so that it can be
recognized for decision-making.
A team consensus on all AT
recommendations should be obtained. If
the process has progressed efficiently to this point, no team participant
should have to respond, I dont know enough to make that decision. Everyone should understand the needs of the
student and the applications of the suggested technologies, and feel
comfortable in making a recommendation decision.
Once a decision has been made on
the appropriate technology, the process must continue into acquisition and
implementation. This may include an
identification of equipment sources, funding options, training for staff, and
technical support.
It is important to note that AT
decision-making must be an ongoing process.
When changes in the students abilities and/or educational needs are
noted, steps should be taken to determine what additional information is needed
or which changes to the implementation of AT should be considered. Maintaining equipment in operational order
is important. The team should establish
a system designating the procedures that will be followed if technical issues
occur.
The IEP must include a description
of assistive technology devices or services, or both, to be provided if such
devices and/or services are required as part of the special education program.
There is no clear-cut criterion for where assistive technology devices and
services should be written in the IEP.
Necessary assistive technology may be included in several sections of
the IEP:
- Present Level of Performance
- Goals
- Objectives
- Services
- Supplementary aids and services
Teams are frequently faced with
the question if assistive technology devices should be named in the IEP. This depends. If the device is a student/family owned device that the family
has agreed to provide within the educational program, then it may be advisable
to state this in the IEP. Many school
districts prefer to describe the features of a device while not naming one
specific tool. The decision on how to
handle these situations should be made by the students IEP team in a manner
that assures the student will have access to the necessary assistive technology
in order to receive a free appropriate public education (FAPE).
The primary goal of an AAC assessment must be to determine the communication needs of a student, determine how many of these needs are met through current communication techniques, and to reduce the number of unmet communication needs through AAC interventions (Dowden, Beukelman & Lossing, 1986). Many of the strategies and techniques that were described in the AT Decision-Making section are pertinent to the process involved in AAC assessment. This assessment must be a team collaborative process that considers the student abilities, the environments in which the student is involved, and the specific communication tasks that are necessary to increase participation. It is never appropriate to start with a device and try to match the device features with the needs of the student.
As the team is gaining information on the student, it may be pertinent to examine these questions:
How does the student currently communicate?
o Consider non-verbal as well as verbal means.
Gestures, facial expressions, manual signs
Single words, word combinations, semi-intelligible speech
What is the prognosis that speech will become functional?
What is the students language ability?
o Is there a significant gap between receptive and expressive abilities?
o What is the students vocabulary ability and understanding of speech
o Does the student use situational language or attempt to create novel messages
What other areas of ability need to be considered in this assessment for AAC?
o Are there motor concerns?
o Are there vision concerns?
o Are there auditory concerns?
Gain information on any related areas that may affect the students ability to use an AAC system.
The team must also conduct an evaluation of the students environment. These questions should be asked and answered:
What opportunities does the student have to communicate?
How well do the people in the students environment understand present communication forms?
What are the limitations of the present communication forms in relation to the activities?
The team will also need to identify the communicative tasks that are required by the student:
- What communication functions does the student need to be able to communicate better?
- Gain attention
- Express basic needs and wants
- Share information
- Respond to and ask questions
- Socially interact with others
- Participate in specific activities
As the team defines and refines the problem, they will want to establish a clear reference to what the student needs are in regards to communication. This should include data that is obtained through observation and interactions that can be described by the frequency of identified communicative tasks. The team must also determine what has already been tried and how effective this was.
The selection of AAC devices and systems must be based on FEATURES of a system that MATCH the students needs and abilities. The AAC assessment must therefore examine the students capabilities and needs related to these features:
- LANGUAGE FEATURES
- What representational system is the student able to use?
- Pictures or symbols?
- Alphabet or numbers?
- How will messages be produced?
- Letters
- Words
- Phrases
- Sentences
- What vocabulary encoding features can this student use?
- Simple symbols or sequencing
- Levels and locations/pages
- Semantic encoding
- What are the students needs in regards to vocabulary expansion?
- Minimal messages needed
- Large vocabulary needed
- Preprogrammed and/or programmable vocabulary
- SELECTION TECHNIQUES
- How is the student able to access the system?
- Direct selection (e.g. finger, thumb, fist)
- Assisted direct selection (e.g. joystick, trackball)
- Single switch scanning (include access site, type of switch, mode of scan, presentation of scan)
- What overlay or keyboard features can the student use?
- Single level overlay
- Multiple level overlays
- Dynamic display
- Are there concerns about range of motion?
- What are the key space features that the student can use?
- How many keys spaces per page?
- What size of key space?
- What layout?
- Are there issues about the viewing angle of the system?
- OUTPUT MODES
- Does the student need voice output to messages?
- Digitized speech
- Synthesized speech
- Male, female, or child quality
- What visual features for the system does the student need?
- Static or dynamic display
- Color or black and white screen
- Message display window
- Is volume control needed?
- INTEGRATION WITH OTHER TECHNOLOGIES
- Does the student need to use this system with other systems?
- Computer
- Environmental control units
- Power wheelchair
- DEVICE CONSTRUCTION
- Does the student need a system that is portable?
- Weight considerations
- Independent transport
- Carrying case
- Does the student need a system that is mounted to a wheelchair?
- What consideration needs to be made for durability?
Using this framework of questions for assessment, lets take a look at how this applies to a student. Andys team has determined that he needs a more effective means to generate his own messages to share information with his parents, respond to curriculum content in the classroom, and interact with his peers. For the past year, Andy has been using a picture communication book to support his unintelligible verbal attempts. Although this has helped Andy clarify his message during some communication breakdowns, it does not meet his needs to expand his messages.
From the assessment process, it was determined that Andy requires a voice output communication device that is lightweight and portable so he can carry it himself. The device should have a large word based vocabulary that allows Andy to combine words and make sentences. The device should be have preprogrammed vocabulary, but also allows for custom words to be added. Andy is able to select 1/2 inch keyspaces by pointing to an overlay that contains up to 50 picture and word keys. He is developing early reading skills so the device should also have an alphabet overlay with text to speech capabilities. Volume control is needed for different locations.
From the features that have been defined, the team is now ready to explore AAC device options with these features. The team found two devices that met the criteria set forth. A trial period was set up for Andy to use each of these devices for a four-week period. Before beginning each trial period, the classroom staff, support personnel and parents were given training on the device from the district AAC specialist and a state vendor. The team established situations where the device would be implemented and procedures for training Andy to use it. Data collection forms were developed to track Andys use and progress.
At the end of each four-week trial, Andys team met to review the results. Andy and his parents were participants in these meeting. Andy had some definite opinions about each of the devices. The classroom teacher also expressed her concerns that the team could respond to. The team took this opportunity to discuss Andys low-tech picture communication book and decided that this was still a necessary tool for Andy, especially since it would take a significant amount of time before a voice output device might be acquired. After considering all options, the team selected one of the voice output devices as the appropriate tool that would enable Andy to address his unmet communication needs. The team carefully developed an action plan to assign responsibilities of team members for acquiring the device, including funding through Andys familys health insurance.
As we look at Andys situation, it is apparent that the AAC assessment process does not end once the features have been determined. This process must be ongoing. Conducting a trial period with the AAC device options is an important part of the assessment that can yield a variety of results. In some instances, the team may also discover that the creation or expansion of low-tech options are the most appropriate alternatives. The solutions and time frame for each AAC assessment will be as varied as the individual needs and abilities of the student. The key to a successful AAC assessment is that the team remains focused on the students communication potential that it hopes to be achieved.
Under IDEA, the special education program lists a variety of
assessments and services that school system must provide so students with
disabilities may receive a free and
appropriate public education (FAPE). The school
district is responsible for providing for the AT needs of the student, as
determined by the IEP team. However, the school district may utilize
alternative funding sources to provide for this assistive technology as long as
the use of such funds does not result in a reduction of medical or other types
of assistance to the student or the family.
Additionally, if a parent provides the AT device in order for the IEP to
be implemented, the school district must assume responsibility for repair and
maintenance. If the original cost of
the device includes an initial warranty, the district may want to pay for
further years of warranty when this expires.
The purpose for using the AT will determine the potential funding
sources.
Medicaid Department of Job and Family Services
Medicaid is a national program of medical assistance for
low-income individuals, including persons with disabilities. Many individuals with disabilities may
qualify for Medicaid under waiver options when they do not qualify due to
family income. Ohios Medicaid will provide for
certain assistive technologies that are considered medically necessary. If the family has private insurance in
addition to Medicaid for the student, the vendor will need to submit the
request to insurance prior to Medicaid.
Augmentative communication is
covered by Medicaid because it has the capacity of being described as a
medical necessity. The rules for
provision of a Speech Generating Device (SGD) in Ohio are separate from other
areas of Medicaid funding, and rules for application are specific for an
SGD. Under Ohios Medicaid rule, an SGD
may be prescribed to facilitate basic communication if the individual is unable
to use typical modes to express basic needs and wants, transfer information,
achieve social closeness, or demonstrate social etiquette. The SGD application
must be completed by an evaluation team, led by a licensed speech-language
pathologist (SLP). A licensed SLP is defined
as one who possesses licensure by the Ohio State Board of SLP&A and
Certificate of Clinical Competency (CCC) from the American Speech and Hearing
Association (ASHA), or is completing a program of supervised work experience
(CFY) from the above licensure agencies.
In addition, the licensed SLP must document experience with SGD service
delivery.
For an SGD application, a
physicians prescription is required based on an evaluation of the individuals
communication abilities and needs made by this licensed SLP. Medicaid is a third-party payment
program. Medicaid will only make
payment to recognized second parties, which, in the case of an SGD, is the
vendor. When an SGD is acquired through
Medicaid, it remains the property of the individual/family.
Several vendors have specific
funding information that can assist a team in completing the AAC/SGD evaluation
and submitting a report for Medicaid, including the following:
Prentke Romich Company
http://www.prentrom.com/funding/medicaid/oh
Dynavox
http://www.dynavoxtech.com/funding/Default.aspx
Private Insurance
Private Insurance is a contract
between the individual/family and the company.
The insurance policy coverage, enrollment requirements, and co-payment
requirements will vary between each.
Medical insurance is based on the medical necessity of services and
equipment. Private medical insurance
may provide certain types of assistive technology under three categories of
funding: prosthesis, durable medical equipment, and speech and language
therapy.
Augmentative communication devices
may be considered eligible items with some companies. Documentation to be sent to a private medical insurance company
should include a physicians prescription, a description of the client's
profile, including motor, sensory, and communication status, and a description
of the individuals communication limitations.
Emphasis should be made on the medical needs that will be met with the
use of this communication device.
Private insurance companies often utilize the guidelines for medical
necessity that have been adopted by Medicaid.
A school district may request but
cannot require parents to use private insurance to pay for a students required
services or devices. In many cases, the
parents are willing to pursue this avenue for a communication device since they
will retain ownership. If the device
is used at school to provide for the goals of the IEP, the district is
responsible to pay for repair and maintenance of the device.
Bureau for Children with Medical Handicaps (BCMH)
Ohios BCMH operates under two
programs: Diagnostic and Treatment. Any
Ohio resident who is under 21 years of age and has a possible medical handicap
is eligible for diagnostic services.
Financial eligibility must be established for the treatment program.
BCMH may provide medically
necessary services and assistive technologies, including durable medical equipment,
medical supplies, and medical appliances.
This includes wheelchairs, braces, prosthetic devices, glasses, and
hearing aids. In 1997, BCMH established
guidelines for augmentative communication devices. However,
BCMH operates as the payer of last resort, meaning that all other third-party
resources must be pursued before BCMH authorization is considered. Third-part entities include government
agencies such as Medicaid, Vocational Rehabilitation, Education, Early
Intervention, etc.
Family Support Services (MR/DD)
The Family Support Services (FSS)
is designed to assist families caring for an individual with a developmental
disability at home. Family Support Services are regulated by County Boards of
Mental Retardation and Developmental Disabilities (MR/DD). The family member with a disability must
qualify for MR/DD services by being evaluated under the Childrens Ohio
Eligibility Determination Instrument (COEDI).
A family may apply for family support services by contacting a case
manager at the county board of MR/DD. Some counties have a maximum amount that
families may receive, generally ranging from $500 to $2500. Families may
utilize their family resource money allotments for the purchase of AT. Schools may ask parents to pursue this
avenue of funding; however, the result should not pose a reduction of funds for
other needed items.
Vocational Rehabilitation
The intent of Vocational
Rehabilitation services is to provide training, assessment, placement and other
services to people with physical or mental disabilities who could benefit from
employment or other identified goals. A Rehabilitation Services Commission (RSC) counselor is the only person who may
determine an individuals eligibility for vocational rehabilitation. This
eligibility process involves an assessment, which results in an Individual
Written Rehabilitation Plan (IWRP), stating the employment objectives,
long-term rehabilitation goals, intermediate objectives, specific services to
be provided, and rehabilitation technology, if appropriate. Rehabilitation technology many include
rehabilitation engineering, assistive technology devices, and/or assistive
technology services. However, in many instances, local policy may state that
Vocational Rehabilitation will not get involved until 2 years prior to a
students graduation. The school district may need to operate as an advocate to
ensure vocational rehabilitation services can be obtained for a student.
AT OHIO
AT Ohio is funded under the
Assistive Technology Act, commonly referred to as the Tech Act. AT Ohio assists in acquiring assistive
technologies through programs for low interest loans, equipment exchange,
equipment loans and a computer recycling program. Their web page is located at http://www.atohio.org/.
Service Clubs and Organizations
Service clubs and organizations
are another source of funding for AT, yet it may be necessary to enlist help
from more than one to raise the amount of money needed. Local groups such as the Lions, Sertoma,
Shriners, Kiwanis, Rotary, churches, and sororities/fraternities often fill the
gap when human service delivery systems fall short. These organizations perceive their role as providing assistance
to an individual, rather than operating funds for an assistive technology
device. Parent/family permission should
always be obtained before initiating any contact with local organizations on
their behalf.
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Frequently Asked Questions (FAQ)
- Are schools required to pay for AT and
AAC devices?
School districts have the responsibility under IDEA to provide equipment, services, training, and programs for students with an IEP who needs AT in order to receive a free appropriate public education (FAPE). School districts may utilize outside funding sources as long as doing so will not reduce the benefits to the student or family.
- Do students have access to AT or AAC
if they are eligible for extended-year services?
Yes, if the IEP team decided that the student needs AT to access the curriculum in summer school or extended-year programs.
- Is a school district required to
provide state-of the-art equipment for a student?
The selected AT equipment needs to be appropriate for the students needs to ensure FAPE. The IEP is guided by the assessment and is under no obligation to select a more or less expensive or sophisticated device.
- How can school districts use Medicaid
funds to purchase AT or AAC?
Medicaid regulations vary in each state, but the parent must always give permission to access the funds. Funds can be used according to Medicaid regulations, which are based on medical necessity. See the section on Funding AT for information on accessing Medicaid funding in Ohio.
AAC
Resources
AAC
Intervention.com
http://www.aacintervention.com/
Caroline Musselwhite and Julie Maros site with great tech tips, articles about using AT, AAC therapy ideas, AAC & literacy
AAC-RERC
Rehabilitation Engineering Research Center provides information about recent developments in AAC, Funding and Device Use
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Introduction to Augmentative and Alternative
Communication
AAC Institute
http://aac.unl.edu/vocabulary.html
The Self-Study Program (SSP) offers the opportunity to learn about various aspects of AAC that support the goal of the most effective communication possible for the individual. The courses allow individuals to work at their own pace. No fee is charged.
YAACK
http://aac.unl.edu/yaack/index.html
Issues related to AAC and young
children, such as:
What is AAC? http://aac.unl.edu/yaack/b0.html
When Does a Child Need
AAC? http://aac.unl.edu/yaack/b1.html
Does AAC Impede Natural
Speech? http://aac.unl.edu/yaack/b2.html
ACE Centre
http://ace-centre.hostinguk.com
Success stories of children
using AAC devices
AAC Center at the University of
Nebraska
http://aac.unl.edu/vocabulary.html
AAC Messaging and Vocabulary contains core vocabulary and high-frequency word lists to use in building vocabulary for a device user.
Texas Assistive Technology Network
http://www.texasat.net/docs/100%20word%20core%20StarterVocab.pdf
A Starter-Set Vocabulary for Enhancement of Communication Curriculum and Functional Communication by Gail Van Tatenhove
At Home with Gail M. Van Tatenhove
http://www.vantatenhove.com/files/NLDAAC.pdf
Normal Language Development, Generative Language & AAC by Gail M. Van Tatenhove
Use of Browns stages with semantic and pragmatic functions in programming AAC devices
YAACK
http://aac.unl.edu/yaack/d5.html#d5b0
Vocabulary Selection Strategies for AAC users. Guiding principles for deciding vocabulary for a device.
Symbols.Net
Symbols.Net
is a directory to websites of free symbols for AAC and other uses
IconoArchive
http://home.wanadoo.nl/inca0/as/picto/index_us.htm
Icons
in various categories available for non-commercial use. Be sure to click on English upper right.
University of Nebraska-Lincoln
http://www.unl.edu/barkley/present/cress/sample.shtml
Sample IEP for Child and Partner Goals for beginning AAC user.
Article by Cynthia J. Cress, Ph.D.
Speaking of Speech.com
http://www.speakingofspeech.com/IEP_Goal_Bank.html#AAC
Examples of IEP Goals submitted by SLPs to give you ideas when writing your IEPs. Note: goals are posted as submitted and may be missing elements that you'll need to complete. Make needed changes so the goals/objectives are appropriate for your student.
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to Top
AAC Device
Selection
YAACK: AAC Assessment
http://aac.unl.edu/yaack/c0.html
Information on choosing an AAC System.
AAC TechConnect
http://www.aactechconnect.com/da.cfm
AAC Device Assistant. Provides information on close to 100 AAC devices currently on the market. Uses feature-match tool to search for AAC devices to do side-by-side comparisons of devices.
AAC RERC
http://www.aac-rerc.com/index.php?option=com_content&task=view&id=132&Itemid=149
Webcast: Overview of Health-based Funding Programs that Cover SGDs by Lew Golinker, Esq.
Abledata
http://www.abledata.com/abledata.cfm?pageid=19327&top=10837&deep=2&trail=22,10825
Database of all available AAC devices and related equipment. Use search box in upper right-hand corner for information on a specific device. Direct selection devices at: http://www.abledata.com/abledata.cfm?pageid=19327&top=10863&deep=2&trail=22,10825,10837
Augmentative Communication and Classroom Learning Considerations
http://sst6.org/images/stories/PDF/aacclassroom.pdf
Tips for Classroom Integration of AAC Devices by Kathy Staugler and Laura Yoder
Integrating AAC into the Classroom
http://www.asha.org/about/publications/leader-online/archives/2004/040921/f040921b.htm
ASHA Leader article with practical ideas regarding daily use of AAC in school routines and classes
AAC Teaching Ideas
http://www.prentrom.com/teaching_ideas/teaching_ideas_information/teaching_ideas_information
Prentke Romich Co. resource for teaching use of any device, contributed by SLPs and educators
AAC Implementation Toolkit
http://www.dynavoxtech.com/training/toolkit/
A collection of video and print-based resources at Dynavox Tech to help facilitate successful interaction using AAC such as Communication Partner Techniques and Scripting
AAC Institute: AAC Road Trip
http://www.aacinstitute.org/Resources/Press/AACRoadTrip/AACRoadTripPaper.html
This article describes the path of services, systems, and supports that result in the most effective communication possible for the individual using AAC. by Barry Romich and Katya Hill
AAC Therapy Materials
http://www.vantatenhove.com/materials.php
These free materials are designed for therapists, teachers, and parents who are in the frontlines doing AAC intervention. Primarily for Prentke Romich devices.
AAC Intervention.com
http://www.aacintervention.com/
Caroline Musselwhite and Julie Maros site with great tech tips, articles about using AT, AAC therapy ideas, AAC & literacy
AT
Resources
Introduction to Assistive
Technology
OCALI Assistive Technology Resource Guide
http://www.ocali.org/at/at_learn_guide.php
This Guide covers all aspects of assistive technology including Legal Issues, Funding, AT in the IEP, AT Assessment, and Guiding Principles
Assistive Technology Basics
http://atto.buffalo.edu/registered/ATBasics.php
AT Basic Module by Univ. of Buffalo Assistive Technology Online Training Project provides general assistive technology information on a variety of related uses for elementary students with disabilities.
A Resource Guide for Teachers and
Administrators about Assistive Technology
http://www.wati.org/Products/pdf/resource%20guide%20-%20general.pdf
Document by the
Wisconsin Assistive Technology Initiative to guide school districts in implementing
assistive technology to meet individual student needs
Introduction to Assistive
Technology
http://sweb.uky.edu/~jszaba0/GPAT%20Intro%20to%20AT.PDF
Paper by Joy Zabala, Univ. of Kentucky, with information on assistive technology that is frequently used in various academic areas
National Public Website on
Assistive Technology
http://atwiki.assistivetech.net/index.php/ATWiki_Home
The AT Wiki, an encyclopedia on assistive technology that anyone can edit
Assistive Technology in K-12
Schools
http://www.ataccess.org/resources/atk12/default.html
Gives a range on information about integrating assistive technology into schools including Introduction, Tips & Tools, Success Stories, Operating System Access Features, Training for AT
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Assistive Technology Decision
Process
SETTing the Stage for Success
http://sweb.uky.edu/~jszaba0/SETTPAPER2001.PDF
Building Success through Effective Selection and Use of Assistive Technology Systems by Joy Zabala
SETT Forms
http://sweb.uky.edu/~jszaba0/SETTFORMS2003.PDF
Forms for Collaborative Consideration of Student Need for Assistive
Technology Devices and Services
WATI Assessment Package
http://www.wati.org/products/pdf/wati%20assessment.pdf
Wisconsin
Assistive Technology Initiatives comprehensive assessment to determine student
need for AT
Considering Assistive Technology
in the IEP
http://www.gpat.org/Resources%20Main.htm
Documenting AT in the IEP
http://www.gpat.org/Resources%20Main.htm
Articles developed by the Georgia Project for Assistive Technology (GPAT) regarding AT and IEPs
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Assistive Technology Use
Supporting Participation in
Typical Classroom Activities for Students with Disabilities Through the Use of
Accommodations, Modifications, and Assistive Technology Solutions
Supporting Students with Disabilities Participation in Typical Classroom Activities Using.doc
Developed by the Georgia Project for Assistive Technology (GPAT) to provide information on support strategies that are used by students with disabilities to enhance their participation and achievement in typical classroom activities.
Assistive Technology Tutorials
http://atto.buffalo.edu/registered/Tutorials.php
Univ. of Buffalo Assistive Technology Online Training Project tutorials on software for Reading/Writing Tools and Tools for Visually Impaired
Adaptations Across the Curriculum
http://www.connsensebulletin.com/cor80202.html
Many ideas ways to adapt books, writing art, music, gym, and leisure activities for students with disabilities, generally by using common household items
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Assistive Technology
Materials
Enable Mart
An assistive technology shopping site searchable by type of disability and sensory need
assistivetech.net Search for Products
http://assistivetech.net/search/index.php
National Public Website on AT. Search for assistive technology products by key word, by functional limitation, by functional activity or vendor
American
Speech-Language-Hearing Association. (2002). Augmentative and
Alternative Communication: Knowledge and
Skills for Service Delivery [Knowledge
and Skills]. Available from www.asha.org/policy
.
American
Speech-Language-Hearing Association. (2001). Knowledge and Skills
Required for the Practice of
Audiologic/Aural Rehabilitation [Knowledge
and Skills]. Available from www.asha.org/policy
.
American
Speech-Language-Hearing Association. (1997). Maximizing the
Provision of Appropriate Technology Services and Devices for Students in Schools [Relevant Paper]. Available from www.asha.org/policy .
American Speech-Language-Hearing
Association. (2005). Roles and
Responsibilities of Speech-Language
Pathologists With Respect to Augmentative and Alternative Communication:
Position Statement [Position
Statement]. Available from www.asha.org/policy
.
American
Speech-Language-Hearing Association. (2004). Roles and
Responsibilities of Speech-Language
Pathologists With Respect to Augmentative and Alternative Communication:
Technical Report [Technical
Report]. Available from www.asha.org/policy.
Augmentative and Alternative Communication (AAC)
A quick overview of AAC systems with links to ASHA supporting info and ASHA Leader articles related to AAC assessment and implementation.
http://www.asha.org/public/speech/disorders/AAC.htm