Assistive technology service delivery models: Scalable to meet
the needs of students with high incidence disabilities?
An Essay by Dave L. Edyburn,Ph.D.
In an attempt to understand the conceptual and theoretical framework supporting
the field of special education technology, earlier this year I prepared a
review of twelve models, theories, and frameworks (Edyburn, 2002). Analysis
of the function of each model revealed three clusters: (1) assistive technology
consideration, (2) technology-enhanced performance, and (3) developmental
models which describe specific aspects of technology use in special education.
Assistive Technology Service Delivery Model
Four of the twelve models serve to advance our understanding of factors involved
in assistive technology consideration. Readers are likely to be quite familiar
with The SETT Framework (Zabala, 1995) (http://www.joyzabala.com),
Education Tech Points (Bowser & Reed, 1995) (http://www.edtechpoints.org/),
and Has Technology been Considered? (Chambers, 1997) (http://www.assistivetechnology.com).
Less well-known are the efforts of Haines & Sanche (2000) to lay multiple
models on top of each other to view similarities among the models and identify
unique contributions made by each for their AT CoPlanner Model.
The discovery of twelve models was exciting as it indicated a maturation of
the discipline and highlighted areas of commonality among different theorists.
However, this work also serves to reveal some gaps in our conceptual understanding.
For example, little is known about the efficacy of current assistive technology
service delivery models.
Common practice suggests that interdisciplinary teams are needed to conduct
assistive technology evaluations. Frequently this involves the services of
a diverse group of professionals, such as: assistive technology specialists,
occupational therapists, speech and language therapists, physical therapists,
teachers (both special and general education), and administrators.
The essence of this professional practice is that it mirrors the special education
referral process: multidisciplinary team evaluation, extensive in-depth evaluation,
team meeting, recommendations. Despite the attributes of such a process, it
is also subject to the same criticisms as the special education identification
and placement system: the decision-making system is extremely costly in terms
of staff time; it creates an intimidating environment for parents who must
participate in a meeting with many professionals; it devotes more energy and
resources to initial evaluation and few to on-going follow-up or support;
and given the size of the group, it becomes extremely difficult to schedule
frequent or timely meetings.
Developmentally, it is important to note that the current practices associated
with assistive technology consideration were developed in the 1990s as the
profession sought to meet the assistive technology needs of students with
low incidence disabilities. In my opinion, the current assistive technology
consideration models, policies, and practices have failed to adequately serve
the needs of students with low incidence disabilities. That is, there is no
evidence to indicate that all students who could benefit from assistive technology
have received appropriate devices and services.
Assistive Technology for Students with High Incidence Disabilities
Three factors suggest the complexity of issues regarding systems that provide
and support assistive technology devices and services for students with high
incidence disabilities: the immense size of the population, the lack of personnel
preparation programs, and insufficient content knowledge about the nature
of assistive technology when the disabilities involve inadequate cognitive,
behavioral, or social performance.
The 1997 reauthorization of IDEA explicitly requires that assistive technology
consideration be conducted for all students with disabilities. In effect,
this federal mandate added 3.8 million students, ages 6-21, to the assistive
technology case load (Edyburn, 2000). Given the inability of current systems
to meet the needs of students with low incidence disabilities, there is little
evidence to suggest that current assistive technology staff and procedures
are capable of being scaled-up to meet the assistive technology needs of students
with high incidence disabilities.
Besides the deficiencies in service delivery systems, the profession has been
caught unprepared in terms of personnel preparation. Efforts to identify personnel
preparation programs focusing on assistive technology and students with mild
disabilities resulted in locating a single program in the United States. This
means that few schools have staff adequately trained in the characteristics
of mild disabilities with advanced knowledge about appropriate applications
of assistive technology for this population.
A third factor associated with assistive technology for students with high
incidence disabilities involves the form and function of assistive technology.
That is, when the nature of the disability involves cognitive, behavioral,
or social factors, assistive technology is likely to be fundamentally different
than when the factors are physical or sensory. As a result, students with
mild disabilities have an urgent unmet need for assistive technology that
serves as a cognitive prosthesis. Assistive technology which provide behavioral
or social support are also lacking.
Rethinking Assistive Technology Service Delivery Systems
In a flashback to the early 1980s we see students with mild disabilities in
general education classrooms, not achieving to their potential, and an assistive
technology referral system that looks strikingly familiar to the special education
referral model. While we have yet to experience the overload of referrals
that prompted an interest in pre-referral strategies, we are in no better
position to respond to the mandate to provide appropriate services.
Given the opportunity to rethink assistive technology delivery systems so
that all students can receive and utilize appropriate assistive technologies
to facilitate their participation in general education as well as demonstrate
academic gains, several ideas for alternatives to the current service delivery
systems come to mind.
1. AT/Child Find. At the present time there is little evidence that all students
have systematic access to assistive technology devices and services. Rather,
it appears that students who have access to assistive technology often do
so as the result of advocacy efforts that challenge the system rather than
through a systemic process that ensures that all students in need of devices
have them. To meet the mandate of consideration, new policies and procedures
need to be developed, paralleling child find processes, to ensure that all
children who can benefit from assistive technology have access to appropriate
devices and services.
2. New Tools to Support AT Consideration. In many cases, consideration simply
means checking a yes/no box on an IEP without adequate information and insight
about how a child can be empowered through assistive technology. There is
a need for new tools that facilitate assistive technology consideration decision
making. In order for IEP teams to fulfill their responsibility to consider
assistive technology, leadership, training, resources, and new tools are sorely
needed for preservice and inservice personnel preparation.
3. AT Pre-referral Interventions. When students with learning disabilities
routinely have
Co:Writer and
Inspiration recommended after an
expensive individual assessment, it makes more sense to put these products
into all classrooms as a pre-referral intervention and to collect evidence
about their use and value for individual students. Given a host of common
instructional challenges characteristic of students with mild disabilities,
there is an immediate need to develop pre-referral interventions (e.g., learner
productivity toolkits that offer text-to-speech, word prediction, graphic
organizers software and web-based tools) that can be used to gather evidence
of need as well as outcome.
4. Alternative Service Delivery Systems. New service delivery systems must
be developed in response to traditional assistive technology assessment systems
which focus disproportionate resources on initial evaluation and little or
no resources on follow-up support and on-going evaluation of technology-enhanced
performance. The immense size of the high incidence population requires that
creative alternatives to costly, indepth evaluations as a first-step for service
be found.
5. AT Outcome Data Collection Systems. Since the federal regulations do not
require the systematic collection and evaluation of data, no evidence is required
that assistive technology actually improves a students’ academic performance.
Questions like, “Who gets to use assistive technology?” (and, its
corollary, who doesn’t get to use AT?) and “How do we know assistive
technology is useful?” must be answered. The creation of assistive technology
data collection and outcome systems are urgently needed in the context of
high incidence disabilities to understand which students and under which conditions
benefits can be gained.
Concluding Thoughts
More attention, energy, and resources need to be devoted to understanding
the assistive technology needs of students with mild disabilities. At the
same time, sustained effort must focus on creating alternative service delivery
systems that will enable students with mild disabilities to realize the potential
assistive technology can offer.
While it remains to be seen whether current reauthorization efforts will result
in significant changes concerning the IDEA requirements involving assistive
technology, there is still time to influence the process. Visit the IDEA Practices
web site (http://www.ideapractices.org/ideanews/index.php)
to stay abreast of the latest legislative developments. Then, make a new years
resolution to share your comments with your elected representatives in Washington.
References
Bowser, G. & Reed, P.R. (1995). Education TECH Points for assistive technology
planning.
Journal of Special Education Technology, 12(4), 325-338.
Chambers, A.C. (1997).
Has technology been considered? A guide for IEP
teams. Reston, VA: CASE/TAM.
Edyburn, D.L. (2002). Models, theories, and frameworks: Contributions to understanding
special education technology.
Special Education Technology Practice,
4(2), 16-24.
Edyburn, D.L. (2000). Assistive technology and students with mild disabilities.
Focus on Exceptional Children, 32(9), 1-24.
Haines, L., & Sanche, B. (2000). Assessment models and software support
for assistive technology teams.
Diagnostique, 25(3), 291-306.
Zabala, J. (1995). The SETT Framework: Critical areas to consider when making
informed assistive technology decisions.
