Assistive Technology

October 21st, 2008

Why are we talking about this…?

Definition of Assistive Technology (AT) “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 functional capabilities of individuals with disabilities” AT Act 1988

What are some examples?

Examples… Wheelchairs Walkers Hearing aids Reachers Medi sets PDAs Computers Augmentative Communication Devices The list is endless…

Who Qualifies for AT? Since AT is specifically related to those

with impairments, anyone with any type of impairment can and may benefit from AT Cognitive impairments Mobility impairments Visual impairments Auditory impairments Speech impairments The list goes on…

History of AT No real beginning in history… Advances in AT seen following wars

Major advances in sockets for artificial limbs created post Civil War

First hearing aid was patented in 1890s but it was post WWI when the development dramatically increased

Huge increase in AT in recent history due to advances in technology

Polio Chronicle – 1932 http://www.disabilitymuseum.org/

Assistive Technology Act 1988

Amended in 1994 and 1998 First federal legislation regarding AT Does 3 things

Supports states in their AT programs Support the investment of AT in federal

agencies and departments Support microloan programs for

individuals who want to purchase AT

Rehab Act of 1973 and Assistive Technology Many employers and universities made

architectural and environmental changes as a result of the Rehab Act

Begin seeing assistive technologies to help create LRE

Act was amended in 1986, 1992, 1993, and 1998

1986 amendments included provisions that required accessibility to “electronic office equipment”

This is where we start to see accessibility of computers

IDEA 1975 and Assistive Technology Guarantees educational services for all

children ages 3-18 (now it is birth to 21) Amended in 1991, 1997, 2004 1991 Amendments included language

regarding assistive technology Gave policy statement regarding what was

possible to include in IEP and included AT If it is included on the IEP, the school has to

provide it 1997 Amendment was a requirement that

AT must be considered when creating an IEP

How does one get AT? On own Employment Children might receive it through school Health Insurance

Medicare and Medicaid Private insurance

Many times rehabilitation therapists specialize in the more non-off the shelf devices

Physical therapists, occupational therapists, and speech therapists

You can become a certified assistive technology specialist (ATP)

Now a focus on AAC…

AAC stands for Augmentative and Alternative Communication

Definition Use of any other method besides

speaking to communicate a message Can augment (assist) speech or be an

alternative to speech Involves no tech, low tech, and high tech

Who benefits from AAC?

Technically we all use AAC when we communicate

AAC is specifically used with people with speech and/or language impairments severe enough that they cannot functionally communicate with verbal speech

Who is AAC appropriate for?

Any and all… Infants to elderly No matter diagnosis No cognitive minimum

AAC Categories Unaided

Only uses your body Gestures Facial expressions

Aided Uses something besides your body Broken down into:

Low tech Medium tech High tech

Aided Communication

Low tech Pencil and paper Alphabet board Etran

Etran

Aided Communication

Medium Tech MessageMate GoTalk

MessageMate GoTalk

Aided Communication High Tech

Devices Examples

DynaVox V Mercury LightWriter PalmTop Vantage

Vantage by Prentke Romich Company

LightWriter

Tango! by BlinkTwice

ChatPC

Deciding on a system…features analysis

Physical Sensory Cognitive Other technologies

Physical

Ambulation Wheelchair or no wheelchair This affects the size, weight, and

durability of a system

Physical (cont.) Access

Direct Indirect

Joystick Mouse

Head Hand Foot

Eyegaze

Sensory Visual Auditory

Digitized Speech – recorded speech Can be labor intensive The person recording should be a similar age and gender of user More human sounding Quality of recording can be poor which greatly impacts

intelligibility Synthesized Speech – computer generated speech

This is important for spelling as you can have text-to-speech Computer sounding and so it is quite hard to understand Previously used DecTalk Voices but now moving towards AT&T and

Acapella voices Mainly available in English, beginning to do Spanish, French,

German

Cognition

Attention and memory Dynamic Screen – screen changes

when you hit a button (think in terms of links on a webpage)

Static Display – screen always stays the same

Cognition

Icons based Transparency Concreteness

Spelling based

Boardmaker Symbols from Mayer-Johnson

Minspeak symbols from PRC

Connection to other devices

Computer Printer ECU Cell phone Wheelchairs

So how does one get one of these devices…?

Go home and check your insurance plan Look under your Durable Medical

Equipment Provisions Medicaid Medicare School districts DVR (Department of Vocational Rehab)

Why I do what I do Survey results from 40 adults who use

AAC indicated that 45% of individuals experienced crime or

abuse. Theft – 56% Physical harm – 44% Unwanted sexual touch – 39% Treat of sexual assault – 28% Forced sex – 22% Only 28% reported their experiences to the police

Bryen et al. 2004

Myth 1 “I want my child (friend, parent, sibling…)

to talk so we don’t want them to use AAC” NOT TRUE!! AAC is not a speech replacement Think about communication

AAC is all about communicating and letting a person’s needs and wishes be known

People will communicate in the method that is easiest and most efficient

Research has shown the opposite to be true with SGD

Myth 2 “Why don’t we just teach the child

(adult) to use sign language?” ASL is a completely new language so it is

requiring a person to learn a new language to communicate

Not everyone in an environment uses sign language

Sign language takes an incredible amount of fine motor skills which is something that is problematic in persons who use AAC

Myth 3

Anyone can pick up and use AAC… AAC takes an incredible amount of

training of the user, facilitators, and partners

Special Considerations when Communicating w/ Someone use AAC

Patience is key Before you try and predict what they

are trying to say, ask them what they prefer

Don’t touch their device, that is an extension of them

Links to People Using AAC

http://youtube.com/watch?v=1rXUxk3wFZo&feature=related

http://depts.washington.edu/enables/profiles/profiles_at_aac.htm