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SBCSELPA ASSISTIVE TECHNOLOGY (AT) GUIDELINES

Drafted by Jarice Butterfield SBCSELPA Director

I. INTRODUCTION

This SELPA AT Guideline document is intended to provide support and guidance to SBCSELPA Member local education agencies and districts related to planning for and implementation of AT for students with disabilities. The guide consists of evidence-based and best practices to assist staff with assessment and considering the need for AT as required in the 2004 authorization of IDEA.

Why AT Is Important “Assistive technology has great potential in providing access for all learners. Through the use of a variety of assistive technologies, student with disabilities can have the ability to access the general curriculum. When assistive technology is appropriately integrated into the regular classroom, students are provided with multiple means to complete their work.” Janet Jendron University of South Carolina Assistive Technology Project

Assistive technology increases a student’s opportunities for education, social interactions, and potential for meaningful employment. It also supports a student’s participation in learning experiences in the least restrictive environment. Assistive technology is a tool to help the student benefit from the general education curriculum, and access extracurricular activities in home, school, and work environments.

Research shows that technology aids in enhancing content and skill acquisition by students with disabilities by targeting a variety of learning styles. WATI 2004

It is the belief of SBCSELPA that consideration of AT needs does not necessarily need to be a separate assessment or process for all students in special education and that AT needs be considered as a natural part of the initial, annual and triennial Individual Education Plan (IEP) planning process. Education Tech Points 2012 AT Recommendations for Districts/LEAs within SBCSELPA:

1. Every school district/LEA employee who works with children with disabilities (including general education teachers) has at least awareness level knowledge about what assistive technology is and what it does.

2. Every employee who works with children with disabilities and has contact with parents of those children, knows the law about assistive technology, knows district procedures for obtaining assistive technology and assistive technology evaluations, and how to initiate those procedures.

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3. All district/LEA administrators understand and comply with the laws related to assistive technology.

4. There be specific individuals at both the school site and district/LEA level designated with specific responsibilities related to assistive technology and provided the necessary training, resources, and support to carry out those responsibilities.

5. Special education case managers in districts/LEAs be qualified and trained to consider the need for and implement AT with students on their caseload.

WATI 2004

Action Plan for Districts/LEAs within SBCSELPA School districts that have not yet done so, must:

1. Provide awareness level training to all employees who work with children with disabilities in any capacity.

2. Provide training on the legal requirements relative to educational AT to all administrators and monitor their compliance.

3. Designate individuals at the district and site levels to work together to gain more in-depth knowledge regarding AT.

4. Provide AT resources to keep staff members knowledgeable including catalogs, print materials, equipment and software to use, training opportunities, and access to on line resources.

5. Designate persons responsible for AT with specific responsibilities as needed so that everyone clearly understands their role.

It is the belief of SBCSELPA that it is not so important that a district follow a certain AT model, but rather that they undertake a systematic course of action related to AT, designed to meet the needs of their students with disabilities. WATI 2004

II. DEFINITION OF AT

Code of Federal Regulations (CFR) Definition of AT: “Any item, piece of equipment, or produce system, whether acquired commercially off the shelf, modified, or customized, that is used to increase, maintain, or improve functional capabilities of a child with a disability”. CFR 300.5 Further, CFR further defines AT as “Any service that directly assists an individual with a disability in the selection, acquisition, or use of an assistive technology device. Such terms include:

A) the evaluation of needs….. B) Purchasing, leasing or otherwise providing….. C) Selecting, designing, fitting, customizing…. D) Coordinating with other therapies, interventions… E) Training or technical assistance for individual with disability… F) Training or technical assistance for professionals”

CFR 300.6

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California Ed Code defines AT “…………means any item, piece of equipment, or product system, whether acquired commercially without the need for modification, modified, or customized, that is used to increase, maintain, or improve functional capabilities of an individual with exceptional needs. The term does not include a medical device that is surgically implanted, or the replacement of that device. 30 EC 56020.5 California Title 5 Code of Regulations defines an AT service as “Assistive technology service means any service that directly assists an individual with exceptional needs in the selection or use of an assistive technology device that is educationally necessary. The term includes the evaluation of the needs of an individual with exceptional needs including a functional evaluation of the individual in the individual’s customary environment; coordinating and using other therapies, interventions, or services with assistive technology devices, such as those associated with existing education programs and rehabilitation plans and programs; training or technical assistance for an individual with exceptional needs or, where appropriate, the family of an individual with exceptional needs or, if appropriate, that individual’s family; and training or technical assistance for professionals (including individuals providing education and rehabilitation services), employers or other individuals who provide services to, employ, or are otherwise substantially involved in the major life functions of individuals with exceptional needs.” 5 CCR 3065

Educationally related AT refers to any devices or services that are necessary for a student to:

1. Benefit from special education or a related (DIS) service. 2. Be educated in the least restrictive environment.

Assistive technology equipment include: Assistive technology may be purchased commercially off the shelf or customized. Samples of AT are: Devices that allow facility access, transportation and education. High-tech electronic and low-tech items such as cards, written materials,

page tabs, communication books, pencil grips and clipboards. Computer, computer access/interface and appropriate software. Augmentative communication systems electronic and non-electronic. Auditory training equipment such as an assistive listening device. Recording devices such as hand held digital recorder or tape recorder.

III. LEGAL REQUIREMENTS OF AT IN PUBLIC EDUCATION

The legal requirements for assistive technology in education are outlined in the federal law, consisting of: Education for All Handicapped Children Act of 1975, PL 94-142. q Education of the Handicapped Act Amendments of 1986, PL 99-457. Re-authorization of PL 94-142 as the Individuals with Disabilities Act of 1990

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(IDEA). PL 101-476. Re-authorization of IDEA in 1997. Medicaid Early and Periodic Screening, Diagnosis, and Treatment Amendments of 1989, PL 101-238. Americans with Disabilities Act (ADA) of 1990, PL 101-336. Technology-Related Assistance for Individuals with Disabilities Act (“Tech

Act”) of 1988. PL 100-407. And, Reauthorization of the “Tech Act” in 1994, PL 103-218.

The CFR states: “Each public agency shall ensure that assistive technology devices or assistive technology services or both, as those terms are defined in 300.-300.6 are made available to a child with a disability if required as part of the child’s a) Special education under 300.36 b) Related services under 300.34 c) Supplementary aids and services under 300.114 (a)(2)(ii) CFR 300.105

Must assistive technology be considered for each individual with a disability? IDEA ’97 added the requirement that each IEP Team consider the need for assistive technology (AT) as part of the Consideration of Special Factors. Consideration of Special Factors. “The IEP Team shall .... (v) consider whether the child requires assistive technology devices and services.” CFR 300.346 (a)(2) The amendments to the Individuals with Disabilities Education Act (IDEA) 2004 require that the Individualized Education Program (IEP) team consider whether the child requires assistive technology and services (20 U.S.C. Section 1414[d] [3] [B] (v).

Assistive technology equipment and services must be considered for all children eligible to receive specifically designed instruction through an IEP. This includes individuals from preschool to 21 years. Students that have a disability as defined by the Americans With Disabilities Act (ADA) must be considered for assistive technology equipment and services, even though they do not qualify for special education services under the IDEA (see below). Under the IDEA and Section 504 of ADA districts/LEA must consider the need for AT as part of providing a free appropriate public education (FAPE) in the least restrictive environment. Provision of AT by public schools is required when assistive technology is necessary for a student to benefit from educational placement. Who is qualified to determine AT needs and provide AT Services in California? Per the Title 5 CCR “Assistive technology services shall be provided only by personnel who possess a: (A) license in Physical Therapy issued by a licensing agency within the Department

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of Consumer Affairs, where the utilization of assistive technology services falls within the scope of practice of physical therapy as defined in Business and Professions Code section 2620 and implementing regulations; or; (B) license in Occupational Therapy issued by a licensing agency within the Department of Consumer Affairs; or (C) license in Speech-Language Pathology issued by a licensing agency within the Department of Consumer Affairs or a valid document, issued by the California Commission on Teacher Credentialing, where the function of the assistive technology service is augmentative communication; or (D) baccalaureate degree in engineering, with emphasis in assistive technology; or (E) baccalaureate degree in a related field of engineering with a graduate certificate in rehabilitation technology or assistive technology; or (F) certification from the Rehabilitation Engineering and Assistive Technology Society of North America and Assistive Technology Provider (RESNA/ATP); or (G) a certificate in assistive technology applications issued by a regionally accredited post-secondary institution; or (H) a credential that authorizes special education of physically handicapped, orthopedically handicapped, or severely handicapped pupils.” 5 CCR 3065

IV. CONSIDERATION OF AT NEEDS / ASSESSMENT

In Santa Barbara County SELPA the assessment of the need for AT or implementation of AT for students with an IEP shall be provided by Physical Therapists (PT), Occupational Therapists (OT), Speech and Language Pathologists (SLP), or persons with a credential that authorizes special education of physically handicapped, orthopedically handicapped, or severely handicapped pupils, or other special educators that obtain a certificate in assistive technology from issued by an accredited post-secondary institution (university).

It is important to note that it is not a legal requirement to conduct a “formal” AT assessment for every student in SPED in order to “consider the need for AT”. It is recommended that districts/LEAs conduct formal AT assessments in the following circumstances:

1) The parent or other party makes a request for an AT assessment and the district, via a Prior Written Notice (PWN) letter, agrees to conduct an AT assessment, and parent consents to an AT assessment via an Assessment Plan

or 2) The IEP team feels that an AT assessment is needed to inform the team about

AT needs at a higher level than just the IEP team’s “consideration of needs” and parent consents to an AT assessment via an Assessment Plan

or 3) At an initial or triennial assessment there is a suspected area of disability

that would potentially require a higher level of AT due to the severity of the need and parent consents to an AT assessment via an Assessment Plan

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V. CONSIDERATION OF AT NEEDS / DETERMINING THE EDUCATIONAL NECESSITY OF ASSISTIVE TECHNOLOGY / ASSESSMENT

IDEA 1997 specifically requires the IEP Team to consider a student’s need for AT. The IEP Team must have at least one member with sufficient knowledge to appropriately consider that need. Does this mean every student with an IEP needs a “formal” AT assessment? No, what it does mean is that there is some sort of a process in place to “consider need for AT” on a student-by-student basis. Best practice is for the case manager and/or other person(s) knowledgeable of AT to engage in some discussion and examination of potential assistive technology with the student prior to the IEP team meeting. This “consideration” should at least be a brief discussion at the IEP of which assistive technology might be useful and whether it is needed. In order to do that, someone on the IEP team will need to be sufficiently knowledgeable about assistive technology to help lead the discussion. That person may bring along specific resource information about assistive technology to help all team members focus on what assistive technology exists for the tasks that are challenging to the student. That information might be books, catalogs, printouts from a website, or actual hardware or software to see. Whether resources are brought along or not, there should be a brief discussion of assistive technology during which at least one person displays some knowledge about relevant assistive technology. Because this discussion should be brief, it should last at least a minute or two, but no more than 15 to 20 minutes. It should not be ignored or skipped over. It should not be someone saying, “Assistive technology? No, he doesn’t need that” (WATI, 2004). If the parent requests an “assessment or evaluation” for the IEP team to consider IEP AT needs then the district/LEA would need to treat this as it would any other formal request for assessment and provide prior written notice (PWN) in writing and deny or agree to the request. If agreed to, a formal AT assessment needs to be conducted as described in the prior section.

Considerations for determining if assistive technology is a required educational service: Is it an educationally Related Service? The device or service must be

necessary for the child to benefit from his or her educational program. It must be needed to provide a FAPE.

Is it a Supplementary Aid? It must support the student. Enabling him or her to benefit from and access the educational curriculum. If the lack of the device or service would place the student in a more restrictive environment. Then the device is required educationally.

The device or service must be specific to the student’s educational goals and must not be for “general overall benefit”. Otherwise, it may not be a required service or device for educational purposes.

Examples of Devices that May Not be AT Examples of devices that may not be educationally related assistive technology devices include medical equipment (such as wheel chairs), and individually

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prescribed devices or personal items (such as eye glasses and hearing aids). Assessment / Evaluation When evaluation is being conducted, considerations should include: fine-motor skills, communication, and alternatives to traditional learning approaches.

The following standards may be useful in determining whether a device or service is educationally necessary: Expertise required: If a physician is required to deliver the assistive

technology. It is considered medical (and therefore not educational). Intrusiveness: The more intrusive. The more likely the assistive technology

will be considered medical. Delivery environment: If the assistive technology must be delivered in a

hospital. Then it will probably be considered medical. Purpose: The more that the assistive technology is related to sustaining life.

The more it will be considered medical. Liability/Risk: If the assistive technology causes a life-threatening situation.

The more it will be considered medical. Burden: The more closely the assistive technology is for “virtual constant

care”. The more it may be considered medical. Time and expense by the district are taken into consideration. Diane Cordy Golden, Missouri Assistive Technology Project

Steps for Determining the Need for for AT:

Step 1 Would assistive technology of some kind enable the student to meet the goal? Step 2 What has been tried in the past, to meet the student’s special education

needs? Step 3 Is the current strategy, modification or device meeting the student’s specific

need in the educational environment? If so, document how or how not. Step 4 Does the IEP team have the necessary knowledge and resources to continue

to try and meet the student’s special education need(s)? If not, what expertise is needed? If yes, proceed to step 65

Step 5 What new AT will be tried? How long? How will it be tried? How will the results be documented? Answer the following questions: What is the expected outcome from the use of assistive technology? Is the Assistive technology device or service facilitating age-

appropriate activities? Is the activity important or necessary for the student to participate in

current environments? Is assistive technology necessary to acquire target skills and has it

been selected based on individual needs? Is the assistive technology device being substituted for instruction,

communication or Interaction with teachers and or peers? (It should not be.)

Step 6 Periodic Review

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Specific Educational benefit to Consider When Determining Need for AT Handwriting Spelling Reading Math Written expression Daily organization Communication Mobility Seating/positioning Recreation

The SETT Framework by Joy Zabala is a tool or process that may assist staff in considering AT needs. The SETT framework can be used as a stand alone assessment tool or as a framework for development of an AT plan (see Appendix). Note: See SELPA Form # 44 Consideration of AT Needs in Appendix (this is an optional form to help guide the process for considering needs and it is not required to use this form for all students with IEPS).

VI. DOCUMENTATION OF ASSISTIVE TECHNOLOGY IN THE IEP

The IEP team must also consider the need for any AT services. School districts are required to provide both the devices and the services, and the “consideration” requirement also includes assistive technology services. Specific assistive technology services may include:

1) Training of the student, members of the family, or staff on how to use the assistive technology;

2) Other supports to the school personnel that might be necessary for the assistive technology to be appropriately used.

For example, AT services could include training on how to add new vocabulary to an augmentative communication device or scan new materials into a software program that reads the text, or time for planning about how and when these things will happen and who is responsible. The IDEA regulations state that assistive technology may be included in the IEP for 3 reasons:

1) As part of Special Education required for a FAPE. Included as part of the goals and objectives.

2) As a related (DIS) service. Maybe be the related service itself, or AT may enable a student to benefit from a related service.

3) As a supplemental aid to allow the child to be educated in the least restrictive environment.

Where to Document AT in the SBCSELPA IEP:

1) Present Levels - AT needs may be listed in the present levels of performance (PLOPS). Examples of PLOPS where AT can be included:

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Pre academic/Academic/Functional Skills Student is able to read and understand print at grade level with use of a print magnification device such as……………… Communication Development Student is able to communicate basic needs through use of a communication devices such as……………… Gross/Fine Motor Development Student manifests weak fine motor skills that impact writing. Student is able to write readable print that is appropriately spaced using a specialized pencil grip……………………………….

2) Special Factors Examples: Does the student require assistive technology devices and/or services? No √ Yes - Specify The student requires use of a communication device to communicate basic wants and needs. or The student requires use of a speech to text word processing program via computer to communicate ideas in writing. √ No Student benefits from the use of a computer word processor.

3) Related Service Sample AT as a related service: Service: Occupational Therapy Provider: OT Start Date: 9-1-10 End Date: 12-1-10 Frequency: 2x weekly Duration: 30 minutes Comments: Student will be provided OT support in order to facilitate use of low level AT devices to support written language.

4) IEP goal - the IEP goal can be focused on training and use of AT or a material the student is using to achieve a specific goal.

IEP Goals also do one of the of the following: Enables student to be involved/progress in general curriculum/state

standard Addresses other educational needs resulting from the disability Transition Goal: Education, Training Employment or Independent

Living Are linguistically appropriate

Sample IEP AT Goal: Baseline: Mary is currently able to communicate her interests and needs by pointing to a visual in 2 out of five trials over a two week time period. She has not used a voice output device. Sample goal: Mary will communicate her interests and needs in three or more environments/situations using a single message voice input device 4 out of five trials as measured by observation and data tracking records. Sample Objectives:

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1. Mary will communicate her interests and needs in any given environment using a single message voice input device 3 out of 4 trials

2. Mary will communicate her interests and needs in two or more environments using a single message voice input device 3 out of 4 trials.

The IEP should clearly communicate to the parents and future readers of the IEP exactly what services related to AT needs are needed to access the core curriculum, who will provide the services, and the intended outcomes. Reminder: AT included in the IEP must be a no cost to the parent/guardian, and if so indicated, must also be allowed to go home with the student.

VII. AT CHECKLIST

Areas the IEP team should consider related to the need for AT include, but are not necessarily limited to are:

AREA OF NEED SAMPLE PRODUCTS / STRATEGIES Handwriting •Inspiration / graphic organizer, Co-Writer,

Write-out-loud, Dragon Speaks Naturally (speech to text app or software), First Author, Draft Builder

Spelling •Talking dictionary such as Franklin’s Reading •Commercial text reader such as Kurzweil, R & W

Gold, and SOLO, talking dictionary •Accessibility features on computers and mobile devices •Bookshare digital texts and publisher provided digital books

Math •Equation software, calculators (talking or non talking) •Number line •Multiplication chart •Specialized programs such as Web Math, or Kahn Academy

Written expression •Typing instruction such as Learning to Type, •Word prediction such as Co-Writer •Dictation to speech such as Siri or Dragon Speaks

Daily organization / Study Skills

•Notes in Text or on mobile device •Use of highlighters •Digital text •Mobile device scanned copies of notes from peer or teacher •Use of PDA or mobile device for maintaining schedules/calendars with auditory reminders, •PDA Apps for making lists, charts, etc.

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Communication •Boardmaker/communication board •Pro lo Quo to Go App for I device

Mobility •Walker •Stander •Wheelchair •Exoskeleton (goes from wheelchair to stander)

Seating/positioning •Strollers, Walkers, Car Seats, modular seats Recreation •Beach wheel chair

•Adapted Cycles •Bowling aids •Adapted exercise equipment •Switch adapted spinner •Card game holders

VIII. MISCELLANEOUS AT CONSIDERATIONS

Tape Recording: Students with disabilities who are unable to take or read notes have the right to tape record class lectures for their personal study only. Lectures taped for this purpose may not be shared with other people without the consent of the teacher. Tape-recorded lectures may not be used in any way against the faculty member, other lecturers, or students whose classroom comments are taped as a part of the class activity. Information contained in the tape-recorded lecture is protected under federal copyright laws and may not be published or quoted without the express consent of the teacher and without giving proper identity and credit to the lecturer.

Students are eligible for audio-recording accommodations if their disability impairs access to classroom lectures.

Note: This accommodation may need approval by district administration/staff depending on your district’s policies and procedures, and will depend on the symptoms and severity of the student’s disability and the requirements of the course.

Documenting AT Devices in the IEP

It is recommended that the IEP team specify a type of device rather than a specific brand name of AT. AT Use at Home A district must provide a device for use at home if necessary for a FAPE. Decisions regarding the use of the assistive technology device or service in other settings outside school must be made on an individual basis. The school retains ownership of the device and when the child leaves the school, they must return the device. If the child’s IEP specifies that the device is needed at home to ensure appropriate education, the device may be transported home from school.

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Clarification of this issue is provided in the U.S. Department of Education's document, Policy Guidance (2000). This document informed local education agencies that decisions about assistive technology devices for students with vision loss should be made "on a case-by-case basis," and that consideration of the use of school-purchased assistive technology devices in a child's home or in other settings may be required. If the child's IEP team determines that the child needs to have access to a school-purchased device at home or in another setting in order to receive FAPE, a statement to this effect must be included in the child's IEP, the child's IEP must be implemented as written, and the device must be provided at no cost to the parents. (65 Fed. Reg. 36590)

The regulations (34 CFR Sec. 300.105(b)) further provide that such decisions are made by the child's IEP team on a case-by-case basis. The IEP team can determine that a child needs access to a school-purchased device outside of the classroom in order to receive a free, appropriate public education. If it is in the IEP, it must be provided at no cost to parents.

http://nichcy.org/wp-content/uploads/docs/legacy/d9.pdf

IX. OBTAINING FUNDING FOR ASSISTIVE TECHNOLOGY Funding sources for assistive technology may be provided by sources other than the

school district. Potential funding sources may be: • LEA Medi-Cal - must be approved expenditure by LEA Medi-Cal Committee • Private Insurance (if your district/LEA has opted to seek payment through

private insurance and the parent consents • CCS children services or Easter Seals • Regional Center • Vocational Rehabilitation • Low Incidence Funding (must be a qualifying low incidence disability (PI, HH,

DHOH, VI, DB, B) and be included in IEP as needed for FAPE) • Grants – State, Local, Federal or through private companies

Other avenues that can be pursued include fundraising and local service organizations. Obtaining the loan for a device through S.E.L.P.A. or the ATEC Center venders will often rent a device. This trial period of time might insure inappropriateness of a device and the likelihood that it will meet a student’s needs.

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APPENDIX

I. ASSISTIVE TECHNOLOGY INFORMATION RESOURCES

Assistive technology specialists and knowledgeable persons in the S.E.L.P.A o Debbie Grant - Santa Barbara School District - dgrant@sbsdk12.org o Kirstin Escodedo - kescobedo@sbsdk12.org o Debbie Keys Thomas - dkeys-thomas@sbsdk12.org o Jarice Butterfield – SBCSELPA Director – jariceb@sbceo.org

AT Contractors

o Central Coast AT - http://www.ccatc.org/ - 805-549-7423 o Info Grip in Ventura, CA - http://www.infogrip.com/ - 800-397-0921

Online Resources

o W.A.T.I Assessment Package http://www.wati.org/content/supports/free/pdf/WATI%20Assessment.pdf

o Ed Tech Points file:///Users/Jarice/Desktop/AT%20Committee/Ed%20Tech%20Points%20AT

o ACCESS IT http://www.washington.edu/accessit/articles?109

o AT Network http://www.atnet.org/

o Westminister Technologies http://www.westminstertech.com/wt-insider

AT Product Vendors o Don Johnston

http://donjohnston.com/don-johnston-products/ o Enable Mart

http://www.enablemart.com/ o Able Data

http://www.abledata.com/ o Rehabtool.com

http://www.rehabtool.com/links.html o Attainment Company

http://www.attainmentcompany.com/products/assistive-technology o Kurzweil

http://www.kurzweiledu.com/company.html o Tobbi ATI

http://www.tobii.com/en/assistive-technology/north-america/ o Laureate Learning Systems

http://www.laureatelearning.com/information/demo_centers.html

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Conferences and trade shows / University Degrees o ATIA

http://www.atia.org/i4a/pages/index.cfm?pageid=3686 o Closing the Gap

http://www.closingthegap.com/ o California Diagnostic Center South

http://www.dcs-cde.ca.gov/ o Cal State Northridge (Master Degree in AT)

http://programs.csun.edu/at/?lead_source=google IPAD Resources

o Eric Sailor o Way Cool “App” Tivities in Education o AT Speech to Text Resources

Other Resources o Using Assistive Technology to Meet Literacy Standards, Grades K-3 o Using Assistive Technology to Meet Literacy Standards, Grades 4-6 o Using Assistive Technology to Meet Literacy Standards, Grades 7-12 o Using Assistive Technology to Meet Math Standards for Grades K-12

By Debbie Grant and Sherry L. Purcell, Ph. D.

Sample Integrated AT Lesson Plan SELPA Form 44 – Consideration of Needs SETT Framework

o SETT Scaffold for Gathering Data- Annotated o SETT Scaffold for Consideration of AT Needs o Student, Environment, and Tasks Worksheet: Assistive Technology

Planning Process o Planning and Implementation Summary: Assistive Technology Planning

and Evaluation Process o Activity-Based Implementation and Evaluation Plan Summary

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Santa Barbara County Special Education Local Plan Area……..A Joint Powers Agency

ASSISTIVE TECHNOLOGY (AT) CONSIDERATION OF NEEDS Optional form to be used to make IEP considerations for assistive technology devices

and/or services for students with mild to moderate disabilities

STUDENT NAME:

DATE OF REPORT:

BIRTH DATE:

CURRENT GRADE:

AGE OF STUDENT:

SCHOOL:

CASE MANAGER: DISTRICT:

PARENT(s)/GUARDIAN NAME(S):

PRIMARY PHONE NUMBER:

ADDRESS:

SECONDARY PHONE NUMBER:

PERSON COMPLETING FORM:

TITLE: Special Education Teacher/Case Manager Program Specialist Speech & Language Specialist Other________________________________

I. STUDENT BACKGROUND INFORMATION

II. PLANNING AND CONSIDERATION OF NEEDS:

A. Educational Team Members – A team effort is essential to successful planning and resulting implementation of assistive technology

Name: Role

B. AT needs should be related to students goals and objectives unless the goal is an AT goal that is required for

the student to access FAPE.

Area of Need: Goal: Objectives/Benchmarks: Progress Toward Goal Attainment:

Area of Need: Goal: Objectives/Benchmarks: Progress Toward Goal Attainment:

SELPA44 10-18-13 (E)

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Santa Barbara County Special Education Local Plan Area……..A Joint Powers Agency

Area of Need: Goal: Objectives/Benchmarks: Progress Toward Goal Attainment:

C. Factors preventing or impeding progress:

Sensory: Motor: Cognitive: Language: Social:

D. Consideration of AT needs must address the different setting in which AT is necessary for the student to Participate

Setting Demands in Setting

Amount of Time

Current Adaptation/Technology Used to Support Participation

Does the student support the use of

AT

YES NO

YES NO

YES NO

History of previously attempted modifications and their outcomes (AT or nonAT)

E. Would the student benefit from use of AT in the following subjects? YES NO

If YES, in what areas: ___ Reading ___ Written Language ___ Mechanics ___ Fluency ___ Handwriting ___ Math

___ Other: ___________________________ Brief explanation:

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Santa Barbara County Special Education Local Plan Area……..A Joint Powers Agency

F. Would the student benefit from the use of AT to assist with Reading? YES NO

If YES, what AT is suggested: ___Books on Tape ___ Word prediction program ___Word Processor only ___Text to Speech technology ___ Speech to Text technology ___ Other:_______________

Brief explanation:

G. If word processor is recommended, discuss the following considerations:

• Student’s current approximate word processing speed _______wpm • Students ability to use a word processor including keyboard access, dexterity, etc…

Brief Explanation:

H. Would student benefit from the use of AT to assist with Written Language?

YES NO If YES, what AT is suggested:

___Graphic Organizer ___ Spellchecker ___Other:_______________ Brief Explanation:

I. Would student benefit from AT for Writing Mechanics (Spelling/Punctuation)? YES NO If YES, what AT is suggested: ___ Spellchecker ___ Word processor ___Other:_______________

Brief Explanation:

J. Does the student demonstrate a need for low tech AT for Handwriting:

YES NO If YES, what AT is suggested: ___ Special pencil grip ___ Bold line paper ___ Raised line paper ___ Reading magnifier ___ Alternative type pencils ___ Sentence Window ___ Reading Helper (w/highlight color) ___Other___________________________

K. Student would benefit from AT in areas of Receptive/Expressive Communication?

YES NO If YES, in what areas: ___ Word Recall and Naming ___ Vocabulary Development ___ Auditory Processing ___ Social Skills ___ Visual Schedule ___ Other: __________________ Brief Explanation:

L. Does the student have other needs requiring AT?

YES NO Explanation:

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Santa Barbara County Special Education Local Plan Area……..A Joint Powers Agency

III. ACTION PLAN FOR IMPLEMENTATION

Action When How Responsible Team Member

Action When How Responsible Team Member

Action When How Responsible Team Member

A. Specific modification(s) to address interfering factors:

Setting Modification and Strategy

Trial Period Method of Documenting Progress

B. Support required to make modification work:

SELPA44 10-18-13 (E)

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Santa Barbara County Special Education Local Plan Area……..A Joint Powers Agency

IV. FOLLOW UP

A. Date of Follow Up Staffing _________________________________

B. Educational Team Members Name: Role

C. Summarize effects of Modifications Attempted

D. Do the modifications support the student’s attainment of the targeted IEP goals?

YES NO

a. If NO, does the team have the necessary knowledge and resources to address this student’s current

needs and explore alternative interventions including but not limited to strategies and/or modifications, AT devices and/or services?

YES NO, Refer to _________________________________________

SELPA44 10-18-13 (E) 19

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