This week the Senate Committee on Health, Education, Labor & Pensions (HELP) held a hearing on Accessible Technology. The committee has been holding hearings over the last year designed to elicit information about barriers and opportunities that exist for employing people with disabilities. This particular hearing expanded their reach to include universities, secondary and elementary institutions and their role in providing people with disabilities access to accessible technology.
Accessible Technology
The hearing focused on the use of e-books, televisions, websites and the like. In the early intervention community we have seen an explosion in the number of families and providers using iPads and their apps. In the not so distant past, children with severe speech delays had to wait weeks as board-maker programs or social books were developed, or as requests for expensive DynaVoxes were approved. Today, some families have the ability to purchase an iTouch or iPad and download the DynaVox (Proloquo2Go) or Boardmaker (Mayer-Johnson) applications and work with their IFSP Team that same day. However, what about families who cannot afford the $500 or more price tag of an iPad? or the $189 fee for Proloquo2Go? What about local or state government agencies that question the usefulness of these apps? Are there good studies out there? Scholarly studies? We can find blogs like this, or this and even this. Unfortunately, that doesn't mean that families without the financial means are getting the same access as other families. Is there a further divide between families based on where they live? We have heard of families getting free iPad through local Autism Speaks programs and here are more ideas for how to get one for free or nearly free. If you want to know more about iPads and Autism you MUST read this blog by Squidalicious.
Assistive Technology
In our Facebook posting on this we (the EIFA Board) alluded to the low numbers that states report for the use of Assistive Technology. I wonder though, is there a low use of assistive technology, or is it low reporting? Remember,according to the NECTAC website, IDEA defines assistive technology as: "any item that supports a child's ability to participate actively in his or her home, childcare program, school, or other community settings. It is a broad term that includes items ranging from something as 'low tech' as a foam wedge for positioning to something as 'high tech' as a power wheelchair for independent mobility. Other examples of assistive technology for young children include such items as switch-operated toys, laminated picture boards, head pointers, specialized drinking cups, adpated spoons, augmentative and alternative communication (AAC) devices, computers and more."
Data on AT
Are some of these items being provided to families, but not getting reported in the IFSP? That is possible, families report early intervention providers showing them how to use pool noodles as wedges in the high chair, laundry baskets for bathing, or dycem for keeping plates on the table, but often those items are not listed out on the IFSP or considered Assistive Technology for data collection. (These tips and others can be found here). Are some of these items being accessed through other programs? Possibly. We've heard from families that their IFSP doesn't reference their need for a power wheelchair because their state won't pay for it through early intervention, but their Medicaid program will cover it. We hear from families that they borrow gait trainers or standers with no mention in their IFSP. Still others use private insurance, or privately fundraise again, with no mention in their IFSP. And as an avid Pinterest user, I can tell you I've seen lots of great homemade adaptations that families have uploaded and lots of assistive technology ideas.
It is possible that the data doesn't tell the whole story. What do you think? And how do you think the Senate HELP Committee's discussion will impact on infants and toddlers with disabilities?
For Early Intervention ,I think you are right - Assistive Technology is an all encompassing term - which includes low tech and high tech supports and accommodations. For the purpose of my post I will talk about high tech devices . There are a number of factors that are barriers to the increase use that are further impacted by the lack of studies regarding the efficacy of AT . I know for my family we were discourage from using the device because they wanted him to get a hold of the basics and that if we introduce something that helps him communicate then how would he learn to speak . I think this connection with AT devices as the easy way out is detrimental. It was not until he ( my son ) got a comprehensive evaluation for AT in the first grade did we (both his team and my family) realized how this could not only enhance his communication but could help him achieve other informal goals such as his clarity in his speech and expanding his vocabulary. I researched some articles around Asstive Tech , and this one in particular talked about the factors that served as barriers to providers use of AT for infants and toddlers .
ReplyDeleteDugan , Campbell, and Wilcox. "Making Decisions About Assistive Technology With Infants and Toddlers ", Topics in Early Childhood Special Education 26:1 http://florence.jefferson.edu/cfsrp/pdfs/TECSE25-32.pdf
From the conclusion:
As the literature has suggested, important areas to address may include professionals’ limited knowledge about the benefits of using AT with children under 36 months of age, the use of specific low- and high-tech AT devices, device availability, funding, and fears of technology (Lahm & Sizemore, 2002; Lesar, 1998). Professionals may also need systematic supports and mentoring so that they apply knowledge and skills about AT within a family-centered
framework and in ways that promote and support young children’s participation in everyday activities and routines (p.31)
Furthermore ... if we are going to continue to tout early intervention as the program that will ensure that many children will be better able to access general education , then we must bring the use of AT to the forefront of this conversation. Senator Harkin and the committee members are really focusing on Elementary and Secondary education , recognizing that the use of technology , both high and low tech , as a fundamental denial of civil rights due to the inaccessibility of the education curricula. I appreciate the connection Sen. Harkin made because it highlights the true spirit of AT which is access. A wedge in a highchair is important to a child because it provides them the stability to sit up and EAT. Power wheel chairs are important for children to learn early because they will have ease of use by the time they get to Kindergarten and will foster more INDEPENDENCE. Everyday activities and routines. For those parents who cannot access some of the technology, we need to talk about ways and support those in our state who are hubs for AT . The TRAID Centers are such valuable resources , yet I know so many families who know nothing about them. We need to be engaged in conversations about funding, finding out if their are states who have found ways to pay for increase use of AT , and continue to push for research around its efficacy . Oh yes , and put a call out to families whose child used/uses AT while in Early Intervention.. I think its important to really gather family perspective on it . Whether they know about At , wish they knew , how it was used , are they using it now that the child is older and what Dx,or delay does the child have ( to see if there is correlation to authorization around specific dx or delay) ...
ReplyDeleteTalina,
ReplyDeleteI think you make important points with regard to the resistance to introducing high tech AT to young children. It is important for people to understand that AT is not a "crutch" in the negative sense, but rather can enable a child to become independent on the same developmental trajectory as his/her typically developing peers.
According to this article, to achieve a high level of independent mobility, both manual and powered wheelchairs should be considered at an early age for children with impaired walking ability. http://www.biomedcentral.com/1471-2431/10/59