Assistive Technology Assessment: More Than the Device
By: Andrew R. Beigel
Assessing an individual for assistive technology (AT) use is an important part of the reauthorization of IDEA (1997) and an essential support in the path to greater independence and integration into society. Unfortunately, AT devices are frequently abandoned for many reasons. Sometimes AT selection is based on a mismatch between the individual's desires and/or needs. Sometimes the individual outgrows the capabilities of the device. To foster optimal AT use, this article presents guidelines that educators can follow to put the individual user of AT at the center of the assessment process.
Remember the child in your class who always wanted to answer questions, who wanted to add to class discussions? That bright-eyed child who wanted so much to share and learn everything in your class? Anna is that child. Anna, who is a child in fourth grade, has also been diagnosed with a learning disability. Her teacher and peers have difficulties in deciphering her written output, because of both poor spelling and poor handwriting. They have difficulties with how long it takes Anna to write a response. She has minor difficulties with small fine motor movements, so writing is daunting. Anna also has some difficulties in reading textbooks by herself. Anna has an above-average IQ, enjoys being in school, and loves to interact with her peers-but she wants to read the books her friends are currently reading.
The Committee for Special Education (CSE) recognized Anna's potential. The committee met and examined a wide range of possible devices with the intent of maximizing Anna's potential. Following the meetings Anna was equipped with a small, state-of-the-art, easily held laptop, equipped with a speech synthesizer and software to provide speech, as well as voice recognition. This AT device, though technologically impressive, was not effective. There was no way for Anna to use it as a reading device. As a result, Anna did not use the device; she carried it to school, and it stayed in her pack.
Educators frequently encounter learners like Anna-quite capable of using various assistive devices, yet not doing so. This may in part be due to the CSE's tendency to focus on "gee-whiz" technology as a means for successful inclusion into the general classroom. Or, it may be due to the CSE's failure to focus on how the learner might use the AT in the many environments in the school. For Anna, the small size of the laptop, as well as and its closely spaced keyboard, made it too difficult to use. In addition, the voice of the synthesizer did not appeal to Anna, and adding words to its vocabulary base was quite difficult. The voice recognition component was fine when Anna was alone doing some work, but in a classroom with the hubbub of other students, the voice recognition frequently failed. However, the computer was state-of-the-art, and an impressive technological creation.
Had the CSE kept Anna at the center of the assistive technology (AT) assessment process, a much different computer configuration would have been selected. For Anna, the use of a computer as a written and oral communication device would allow her to accomplish several tasks in the school. The use of the technology would include responding in writing to questions from her teacher or working with her peers in group projects, as well as showing what she learned in a manner more like that of her peers. In addition to the written output provided, the computer would afford Anna the opportunity to become more independent in responding to assignments at the blackboard. This task requires writing skills, and as the computer could be easily attached to a screen reader, it would give Anna the opportunity to "answer" questions at the blackboard.
Much to its credit, the CSE recognized the mistake and reconvened to review Anna's use of the AT and modify her Individualized Education Program (IEP) as needed. The reassessment kept Anna's needs and desires as the focus of the process, and a new device with new capabilities was recommended.
The revised IEP provided Anna with a laptop with a larger keyboard, which led to greater access to the device and provided an impetus to continued use. That is, the larger size gave Anna greater functional access to the device. The greater functional access Anna had, the greater the chances that the device would not be abandoned-and it was not. In addition, the CSE suggested the addition of a scanner so that Anna's textbooks could be scanned and then she could use the computer as a reading device with the speech synthesizer/screen reader (Bryant, Bryant, & Raskind, 1998). The oral representations of the screen reader would allow Anna to hear the text while she read the text on screen. One positive outcome was that Anna could now read books that her friends were reading and could enjoy talking about them and trading them with her friends. This was one of the goals that Anna had hoped to attain through the use of AT, and it led to Anna using the device even more.
The speech device was also adapted to meet Anna's personal needs. The voice that did not sound "right" to Anna originally led to non-use of the device. Difficulty in adding vocabulary to the software effectively limited Anna's classroom written vocabulary, which in turn limited Anna's interaction within the learning environment. This interaction was most important to her, just as it is for any fourth-grade learner.
To be used, the device must "sound" like what Anna wants and must be programmable so that new vocabulary, including current slang, can be added with relative ease. Meeting these needs is vital in addressing the student's social needs (Krefting & Krefting, 1991), which in turn aids in meeting Anna's academic needs. Educators and family members cannot force a learner to use a device that they have selected; putting the learner at the center of the assessment is more likely to result in a good learner-AT fit.
Anna is a typical fourth grader in many ways. She wants to be active in the classroom. She wants to join her peers in their activities. She is like so many learners that are encountered in schools today, many of whom can participate more fully with the use of AT. Anna's original AT device was abandoned because it did not meet her needs. When the CSE attended to Anna's individual needs, modifying the AT to meet those needs, Anna was much better able to use the AT effectively-and motivated to use it on a long-term basis.
Schools are active environments and present a wide range of challenges to all members of the learning community. For learners who have learning problems or other conditions that interfere with participating in a traditional school setting, the support provided by AT can be a way to level the learning/living playing field (Galvin & Scherer, 1996). The question is, how do we prevent students like Anna from abandoning devices?
AT use in the school-or in any environment-is only as effective as the assessment of the learners in their multiple environments. Effective AT assessment leads to finding devices that build on the strengths of the learners in their various environments in order to ameliorate the weaknesses in their environments. AT assessment does not mean finding a device and then matching it with the learner and the environment. It means beginning with the learners and their multiple life environments, finding where the environments affect the learners in troublesome ways, and then looking for a device (or devices) that mitigate that impact by building on the learner's strengths. Possible environments among the many frequented by most children include the bus to school, the cafeteria, the classroom, the gym, and the movie theater.
Purpose Of assessment
The use of AT in the school environment is a cause of both interest and much concern to parents, teachers, and administrators. The current iteration of the Individuals with Disabilities Education Act of 1990 (IDEA) requires that all learners evaluated for possible special education services undergo an evaluation for AT use. An inappropriate AT assessment can invalidate the assessment in other areas of possible concern. Invalid results from assessments are costly for the learner in terms of missed instructional and interaction opportunities. These opportunities are irreplaceable. Educators need a set of guidelines that will help keep the learner and the learner's strengths and possible weaknesses in the center of the assessment process. This article presents a set of questions that can be used to frame the assessment process.
AT assessment for school is successful if it finds a device or devices that will be useful to the learner in multiple school environments. AT assessment is not successful if it provides a prescription for a device that the learner does not find useful, which is likely to be abandoned. Thus, the purpose of AT assessment is to find ways to meet the needs of the learners by matching the strengths and weaknesses of the learner to the device.
There are many reasons why AT is abandoned, in and out of schools. Scherer (1993) pointed out that the foremost reason for abandoning AT is the failure to consider the learner's ideas and desires for the purposes and uses of the device. Krefting and Krefting (1991) discussed the social context of AT use, suggesting that devices that do not allow the learners to fit into their social milieu, without great stress, on either the part of the learner or those around the learner, will not meet the needs of the learner. Not meeting the needs and desires of the learner using AT will lead to the abandonment of the device.
Part of the definition of AT as stated in the federal regulations is that it helps to maintain current functioning or improve functional skills (Technology-Related Assistance for Individuals with Disabilities Act of 1988). Functional skills are those skills that allow the individual to have control in the environment with the least amount of assistance from others. A deficit in functional skills means that an individual will need greater personal assistance. A device that provides little improvement in functional skills or does not lessen an individual's reliance on others will not be used.
Establishing functional needs in school is based on a careful examination of the learner's strengths and weaknesses in the learner's school environment. This examination leads to goals for the learner in the academic, psychomotor, and/or social arenas. Regardless of the content, the goals must have the intent to include and integrate all learners in the traditional classroom milieu to the maximum extent attainable. To ensure the inclusion and integration of the learner who uses AT, goals and their attendant short-term objectives must be clearly articulated and relate to the use of AT, as expressed in the IEP (RESNA Technical Assistance Project, 1992). Failure to have clear and specific AT goals is likely to relegate the AT device to the locker floor or closet shelf
For example, if the device is to be used as a communication device, immediate objectives should deal with using the device to communicate, and then refining the skills needed to use the device. If the intended use of the AT device is to be an aid in taking tests (e.g., a computer as a word processor), then the goals should be to give the learner the skills to use the computer and then work on refining test-taking skills. In either case, the device must be physically accessible to the learner.
Once the AT goals and objectives are formulated, possible future goals and activities must be examined (Hutinger et al., 1990). This examination should include employment possibilities, future educational settings, and potential living environments, and should be based on integrating the learner as completely as possible into the mainstream society. All of these possible areas for the use of AT must be addressed. For older learners, long-range planning leads to the creation of the Individualized Transition Plan (ITP), which is needed by all learners who have IEPs. By specifying the AT needs and uses for the individual, the ITP provides support for continued AT assessment and use of AT devices in society at large.
Learner focus during assessment
The overarching objective during the assessment process is to keep the learner's strengths and abilities squarely at the forefront of the assessment and to use these to ameliorate potential difficulties in the classroom. If the assessor loses sight of the learner and becomes too enamored of "gee-whiz" technology - for example, voice-activated devices - then the learner is no longer at the center of the assessment process and may not find much of a functional use for the AT device.
The center of AT assessment must be the learner. This includes assessment of the learner's strengths in the cognitive, psychomotor, and affective domains and the impact that the environment has on these areas. The goal of the assessment at this point is to determine what strengths the learner has and how the use of AT might enhance these strengths to enhance the educational outcomes for the learner. Most importantly, putting the learner at the center of the assessment means giving the learner the opportunity to provide his or her own vision for the use of AT. Without this collaborative vision, very little will be accomplished in terms of AT use.
Involving the learner at this point means providing the learner with a voice through interview and discussion. Asking learners what goals they might have for AT in a non-clinical setting and method is the preferred approach. This method requires the use of a structured interview schedule-not a schedule with predetermined responses, but a schedule that is flexible and moderately open-ended.
In schools, learners' academic strengths and needs are an obviously important area to examine. Key in examining the academic area is remembering that the device should not be used to replace interactions with the teacher or peers, nor should it be used to replace instruction (Garner & Campbell, 1987). The device should enhance interactions and learning. The goal for AT use is to allow learners to use their strengths and participate as fully as possible in the school.
The assessment process has three strands-the learners, their environments, and the technology-which are directly connected. The learner must use the device in many environments. Failure to consider any one of these areas may lead to a failed evaluation, as the device prescribed may be abandoned.
Abandonment or non-use of AT is an individual action on the part of the learner. There are two general areas directly involving the learner that affect abandonment: the learner's personal style and the learner's physical strengths and needs. Personal style includes attributes such as independence and resolve in learning new skills and tasks.
Determining an individual's predilection toward performing any activity or an individual's willingness to address and cope with change and uncertainty is done only through many interactions. These interactions take much time with the learner as the learner begins and works through new tasks. This should occur before AT use and then again after AT use has begun.
Beyond this personal style, it is important to recognize the psychomotor strengths that a learner has. A device that a learner cannot physically manipulate in all likelihood will not be used. This does not mean that a device that is physically complicated to use should be avoided; rather, it means that the learner and/or teachers or caregivers may need intensive training in using the device, or the device may have to be modified for the learner's use.
The following questions should be addressed when the assessment process begins. These questions are aimed at identifying learners' strengths as assessors search for the most useful device.
1. What purposeful motoric movement does the individual have?
Examples of purposeful motoric movement would be controlling rate of breathing or being able to raise an eyebrow, being able to move the fingers of one hand in a motion similar to that of typing, or a larger movement such as lifting a leg or an arm. A purposeful movement is one that the learner controls in a conscious, consistent manner. This includes the ability to type in some fashion or to use a pen or pencil to write or draw. The key is determining learners' purposeful, conscious movements and then finding an input device that will allow the learners to use these conscious movements to make use of the device. AT devices range from traditional keyboards, mice or a graphics tablet, to sip and puff switches, such as the Breath Input Device (from Neil Squire Foundation) or alternative ergonomic keyboards.
2. How willing is the learner in trying new activities or tasks?
This refers to the learner's personal style, as previously mentioned. In an assessment for a first-time use of AT, the answers to this question will most likely not be apparent. It takes time and many face-to-face interactions with the learner to determine the answers to this question. It is important to observe closely as the learner attacks new problems and new challenges as time passes. From these observations a general picture may emerge that will be of use in assessing the individual for AT use in the future. Using AT requires the learner to have a willingness to change. These characteristics are needed as part of the trial-and-error processes involved with learning the skills in using AT and then taking control of it.
3. What does the learner desire from the use of AT?
Beyond the goals found in documents supporting the learner having a device, the personal goals of the learner greatly influence AT use. Anna, for example, had a desire to read the books that all her friends were reading. This personal goal could be met with coupling of the computer and a scanner with a speech synthesizer/screen reader, leading to a leisure reading device. Relevance of material is a key in learning any task or performing any skill. Using the AT to read leisure books and then being able to talk to her peers about the books gives the use of the device relevance. So, if Anna's expressed personal goal of reading the books her friends were reading had not been met by using the device, then the academic goals (e.g., responding in writing to assignments) associated with using the device would not have been so easily met.
4. What supports will the learner require in using the device?
Obviously, learners need to have adequate technological support to use AT, which is included in the IEP. However, this question deals with the psychological/emotional support that learners need as they begin to use and then handle the device with facility. Learners who do not receive support from the teacher in the classroom, or from other individuals who work with the learners, are not likely to use the device in those settings. A learner who does not receive constant feedback from individuals in the environment when using the device will put the device away. A learner cannot be forced to use an AT device; the learner can only be encouraged and supported whenever using the AT device.
5. What level of training will the learner and others who interact with the learner need?
Training needs are enumerated in the IEP, but they are discovered during the AT assessment. During the AT assessment, the learner, the teachers, and other professionals who work with the learner and the parents or caregivers are given the opportunity to see how the various devices work and to see their role helping the learner use the device. From this part of the assessment, the training needs of all persons who will be involved with the AT are determined. This information is also important for understanding the level of support that the learner might find in the school environment.
6. What impact will the learner's socioeconomic status and cultural background have on the use of AT?
This question requires further research. It is well established that low socioeconomic status lowers teacher's expectations (Knapp, 1995). This lowered expectation frequently leads to fast-paced, skills-based instruction designed to imprint skills in the minds of the learners (Knapp, 1995). This type of learning can be seen as memory work and does not require learners to develop higher level cognitive skills. The emphasis is on rapid, low-level response, which does little to encourage the use of AT.
The potential impact of cultural differences also needs exploration. All too frequently, learners who are not like their teachers face lowered teacher expectations. Again, teachers tend to expect low-level responses, which does little to promote the use of AT. There is also the question of the intrinsic impact that a learner's culture has on the learner's acceptance of AT and the acceptance of AT by the learner's family.
The learner is the key to any assessment, whether it is a psychological assessment or an assessment for AT. The learners in their day-to-day environments must be at the center of the AT assessment; otherwise, faulty decisions are likely, and the device will not be used.
The school environment
Schools are busy places with multiple demands being made on all learners and all teachers constantly. The style of teacher-student interaction in the schools defines the prevailing learning and response modes. It is the assessment of learning in the classroom that identifies success for many learners. The willingness of teachers to work with persons using AT provides the support for learners using AT in the school environment. The following questions can be used to guide examination of the school.
1. How do the teachers of learners using AT present information to the learners?
This question begins the process of determining what the needs of the learner are concerning interacting with the teacher. For example, teachers who lecture a great deal place burdens on a learner's writing and organizational skills, requiring the use of a scribe or a tape recorder. A teacher who uses a lot of discussion places a different strain on the learning, speaking, and organizational skills of members of the classroom, requiring a different prescription for AT.
2. What is the preferred learning-teaching interaction style of the classroom-a cooperative learning style, an individualized style, project driven, or small independent and dependent groups?
Each of these styles presents a different challenge to the learners. Interaction style also affects the AT that is selected for the learner. For example, a cooperative classroom places a burden on the communication and organizational skills of learners. A project-driven classroom stretches a learner's time management and organizational skills, along with research and writing skills. The need to communicate in the cooperative classroom means that AT should facilitate communication, so an augmentative communication device might be most useful. A project-driven classroom requires the learner to find and organize resource materials, then to present them in a coherent fashion. This means that the AT provided has to aid in these tasks. Thus a semantic network program to create word webs might be of assistance in organizing the information for presentation.
3. What is the primary method of assessment in the classroom?
The teacher's assessment of learning in the classroom is an important part of the classroom milieu. In AT assessment, it is important to determine how the teacher assesses the growth of the learners in the classroom. For example, does the teacher use oral or written presentations, among the many possible methods? Each type of assessment places a different pressure on learners' response mode systems and requires a different approach with regard to AT. The use of short-answer tests may require a scribe to record the learner's responses. An oral assessment creates a strain on the verbal communication skills of a learner, requiring a different approach in the use of AT-perhaps the use of semantic organizers and speech synthesis.
4. How receptive is the teacher to having a learner who uses AT in the classroom?
A teacher who is not receptive to having a learner using AT may not provide the kinds of academic support or interpersonal, non-academic support needed for effective use of AT. Without teacher support for learning to use AT and then continuing its use, the learner may abandon the device. For example, a speech synthesizer/screen reader for a student who has a writing disability can be very valuable (Salend, 1998). The use of a screen reader would allow the learner to hear what he or she entered into the computer. This oral feedback would allow the learner to "check" to see if the entry is indeed what was intended. However, if a teacher does not understand how the device is used or does not want a student to use it, then the learner will not receive needed encouragement to use the program or find support when encountering problems in its use.
This area is related to the amount of support a teacher receives in training and education on the uses of, and need for, a specific device or set of devices. The level of training needed is expressed in the IEP, but ongoing training must be delivered, or else good intentions will fall by the wayside.
5. What is the physical structure of the classroom and school?
Is the school spacious enough for learners with mobility needs? Although the doors may be wide enough for a learner in a wheelchair to enter with ease, the desks or tables must be high enough for the wheelchair to fit under them or, if they are not, there must be enough room in the classroom for the learner to use a lap table. Are there electrical outlets for learners who need AT devices that must be plugged in? Are the desks the traditional small surfaces with chairs attached, or are there tables available large enough to accommodate a computer and various peripherals? These are but a few questions that fall under the concept of physical space concerns. For each learner the questions in this area will be different and driven by the needs of the learner and the environmental demands placed on the learner.
Only after examining the learner and the school environment should possible devices be examined. This examination is based on the determinations made during the examination of the environment and assessment of the learner. The questions that follow are aimed at examining the device.
1. How durable is the device?
The school is an active environment. Learners and adults alike are not always as careful with devices as we would like. In the school, many learners and adults may "bump" into the device. All devices that are going to be used in schools should be able to withstand minimal bumps and jars seen in schools.
2. How easy is the device to update and/or repair?
A device that is not easily repaired or that takes a long time to repair is not going to serve the needs of a learner who is an active participant in life. A device that is not easily upgraded or is costly to upgrade will soon lose its utility and be abandoned.
3. What is the willingness of the vendor of the device to provide a trial or loaner period of use for the learner?
The answer to this question cannot be understated, as the assessment process should include trying several devices in the school environment before a final prescriptive decision can be made. Without the assessment of the device in the learner's school environment, there is no reason to think that the device will serve a useful purpose for the learner.
4. What is the general reputation of the company in terms of construction, service, training, and reliability?
These are questions that can be answered by examining the various publications dealing with AT, such as TeamRehab, the TAM Connector, or the Augmentative and Alternative Communication Journal; or by contacting any one of a number of organizations involved with AT, such as The Arc or the Council for Exceptional Children, the Center for Applied Special Technology, and the Trafford Center for Technology and Learning Disabilities at Frostig Center; or by asking others who use AT.
5. Does the AT user have the psychomotor skills needed to use the device in a functional manner where benefit is gained, or merely on an operational level where the learner can turn the device on and off?
This question should be answered during the assessment of the learner. Many devices can be adapted for learners with limited motoric control. If the learner does not have the psychomotor skills to use the device in a functional manner, or the device cannot be adapted to match the psychomotor skills of the learner, it is unrealistic to think the device will be used.
6. Is the device aesthetically acceptable to the learner?
One learner might not like the typical beige, black, or gray exterior of many computers, and prefer something more vibrant-hot pink, for example-while another might like the blandly colored box, but wants an alternative keyboard or greater portability. One learner might want to use a mouse that has a colored ball, while another youngster might want a traditional mouse. If the learners, in any case, have the capabilities to use the device, then they should have the option to decorate the device to meet their own desires, as long as they don't negatively affect device performance or violate the warranty. AT devices should be selected with this in mind. It is important to remember that the aesthetics of the AT device are in the realm of the learner and not the realm of the teacher or the assessment team. Without the learners' aesthetic sense somehow being addressed, they might feel that they will not fit into their social milieu and are very apt to abandon the device.
7. Will the device meet the needs of the individual in the school environment in a manner that is transparent or easily understood by those who interact with the learner?
For a device to be used in the school, it must not be intrusive; that is, it should not involve extraneous noises and lights. The learner should be able to use the device without causing a distraction in the learning environment. Furthermore, the device should not be so complex that only the vendor/technician can program the device or explain how to use it. The device should be easy enough to use so that the learner's parents or teachers can model its use.
8. How portable is the device?
As noted, the school is a busy and active environment. Schools are active and require that learners be able to move from place to place and into many types of environments. For AT to be useful, the learner or a support person must be able to move the device from one environment to another. If the device is not easily moved, then the device is not meeting the needs of the learner in the scholastic environment.
Once the process of information gathering is complete and device possibilities have been decided on, it is time to introduce the learner to the device in the learner's various environments. AT assessment leads to device selection, but only after the learner has tried the devices in as many possible environments as the learner frequents. Without this trial period, a device that looks good during the information-gathering stage may be abandoned because those expectations for the device do not match the reality of using the device.
The learner's reality, not the assessment team's, ultimately determines device selection and utility. Learners may not select the "best" device from a technological point of view. Nevertheless, they will select devices that give them what they want in their lives, and understanding this is the key to AT assessment.
Persons interested in submitting material for Technology Trends should contact M. Raskind, University of Texas at Austin, Special Education Dept, SZB 306, Austin, TX 78712,
About The author
Andrew R. Beigel, PhD, is an assistant professor of education and coordinator of the inclusion program at SUNY New Paltz. His current interests include the use of technology to facilitate inclusion of all students and the preparation of teachers for inclusionary practices. Address: Andrew Beigel, SUNY New Paltz, OMB 208, New Paltz, NY 12561; e mail: email@example.com
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ANDREW R. BEIGEL Intervention in School and Clinic Vol.35, No. 4, pp. 237-243 March 2000 Copyright PRO-ED, Inc.