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Please
click on any topic below to take you 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 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:
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.
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 Service (AT) (IDEA, 2004, Part A, Definitions, 300.6; Operating Standards for Ohio Schools Service Children with Disabilities (2007) 3301-51-01 (B)(3).)
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).)
Assistive Technology (IDEA 2004; 300.105(a)(1)(2)(3) (b))
Hearing aids. (IDEA 2004 300.113(a))
Related Services Exception: services that apply to children with surgically implanted devices, including cochlear implants. (IDEA 2004 300.34)
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:
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.
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.
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:
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
The Environments
The Tasks
The Tools
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:
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.
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:
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:
The team must also conduct an evaluation of the students environment. These questions should be asked and answered:
The team will also need to identify the communicative tasks that are required by the student:
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:
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 ServicesMedicaid 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
Dynavox
Private
Insurance 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) 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) Vocational
Rehabilitation AT
OHIO Service
Clubs and Organizations
AAC
Intervention.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
AAC
Institute 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 Issues
related to AAC and young children, such as:
ACE
Centre Success stories of children using AAC devices
AAC
Center at the University of Nebraska 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 A Starter-Set Vocabulary for Enhancement of Communication Curriculum and Functional Communication by Gail Van Tatenhove At
Home with Gail M. Van Tatenhove 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 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 Icons in various categories available for non-commercial use. Be sure to click on English upper right.
University
of Nebraska-Lincoln Sample
IEP for Child and Partner Goals for beginning AAC user. Speaking
of Speech.com 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.
YAACK:
AAC Assessment Information on choosing an AAC System. AAC
TechConnect 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 Webcast: Overview of Health-based Funding Programs that Cover SGDs by Lew Golinker, Esq.
Abledata 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: LINK
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 ASHA Leader article with practical ideas regarding daily use of AAC in school routines and classes AAC
Teaching Ideas Prentke Romich Co. resource for teaching use of any device, contributed by SLPs and educators AAC
Implementation 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 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 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 Caroline Musselwhite and Julie Maros site with great tech tips, articles about using AT, AAC therapy ideas, AAC & literacy
Introduction to Assistive Technology
OCALI
Assistive Technology Resource Guide This Guide covers all aspects of assistive technology including Legal Issues, Funding, AT in the IEP, AT Assessment, and Guiding Principles. Assistive
Technology Basics 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 Document by the Wisconsin Assistive Technology Initiative to guide school districts in implementing assistive technology to meet individual student needs Introduction
to Assistive Technology 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 The AT Wiki, an encyclopedia on assistive technology that anyone can edit Assistive
Technology in K-12 Schools Gives a range on information about integrating assistive technology into schools including Introduction, Tips & Tools, Success Stories, Operating System Access Features, Training for AT
SETTing
the Stage for Success Building Success through Effective Selection and Use of Assistive Technology Systems by Joy Zabala SETT
Forms Forms for Collaborative Consideration of Student Need for Assistive Technology Devices and Services WATI
Assessment Package Wisconsin Assistive Technology Initiatives comprehensive assessment to determine student need for AT
Considering
Assistive Technology in the IEP Documenting
AT in the IEP Articles developed by the Georgia Project for Assistive Technology (GPAT) regarding AT and IEPs
Supporting
Participation in Typical Classroom Activities for Students with
Disabilities Through the Use of Accommodations, Modifications, and
Assistive Technology Solutions 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 Univ. of Buffalo Assistive Technology Online Training Project tutorials on software for Reading/Writing Tools and Tools for Visually Impaired Adaptations
Across the Curriculum Many ideas ways to adapt books, writing art, music, gym, and leisure activities for students with disabilities, generally by using common household items
Assistive Technology Materials Enable
Mart An assistive technology shopping site searchable by type of disability and sensory need assistivetech.net
Search for Products 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]. 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]. American
Speech-Language-Hearing Association. (2004). Roles and Responsibilities
of Speech-Language Pathologists With Respect to Augmentative and
Alternative Communication: Technical Report [Technical
Report]. Augmentative
and Alternative Communication (AAC)
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