Can Technology Really Help My Child?

by Linda Robinson and Carol Schneider

"Can technology really help?" is a question often asked by early intervention personnel and parents of young children with disabilities. The answer can be found through a technology assessment in which family members, therapists, teachers and assistants, a school psychologist, and child development computer specialists make decisions as a team about technology considerations for an individual child.

The technology assessment is a process which begins with a referral and continues through follow-up services. Macomb Projects' Project TTAP: Technology Team Assessment Process has established procedures for the process before, during and after the assessment.

Procedures Prior to Assessment
Part of the pre-assessment process is gathering background information on the child. This includes completion by the family of a form developed by Project TTAP which provides personal data, diagnosis and medical information, the reason for the assessment, information on the child's behaviors, the child's physical status, communication abilities, seating requirements, and previous experience with switch-operated toys and computer equipment. In addition to this form, TTAP staff request copies of pertinent information, such as evaluation reports and the IEP or IFSP. Also the family and/or teacher is asked to provide a short videotape which shows the child's normal activities either at home or at school or both places, if possible. Viewing the videotape and reviewing the background information is an important part of the assessment planning process.

Once all the information is received, team members may meet to discuss goals and an agenda for the assessment. Decisions about software and any necessary equipment adaptations are made at this meeting. Changes in the plans may be made on the day of the assessment after discussion with other team members.

A room with ample space for equipment, adaptive seating, conference table and chairs, and, if possible, a play area, is chosen for the assessment. Videotape equipment is set up in a position with minimal distraction for the child. Videotape is an essential means of record keeping for team members. A review of the tape later may reveal behaviors or abilities not apparent during actual observation of the assessment. Videotape is also a valuable record from which to write an accurate evaluation report. A conference area is important for meeting with team members before the assessment, as well as at the end of the day's session. A play area in or near the assessment room is essential so that the child can take breaks and return to the task within a short period of time. The younger the child is, the more breaks may be needed.

Assessment Day Arrives
So all the arrangements are made and the assessment day finally arrives! After the child is introduced to all team members, and made comfortable in the new surroundings, he/she may be taken for a walk around the building or to the play area to relax. It is at this time that the team members meet to discuss the goals for the assessment and to plan the agenda for the session. The meeting time is limited to 20 minutes so that the child does not get too tired before the actual assessment begins.

The first steps taken during the assessment concern the child's positioning and the placement of equipment. Depending on the child and the amount of adaptations needed, decisions on these factors may take a long time. Child positioning and equipment placement are considerations which are constantly re-assessed during the session as different switches or other adaptive devices are used with the child.

Decisions on what software to use during the assessment are based on a number of factors, including what input method is used, the child's cognitive level, and the child's interests. As an example, we will use the case of four-year-old Steven whose mother and teacher say that he likes music and different sounds, but they are not sure whether he knows he is starting his tape recorder when he presses his switch. He is very physically limited in his ability to use his hands, and his only means of communication is an inconsistent utterance or look with his eyes.

Where to Begin
Initially our main goal is to assess Steven's understanding of causality concepts through simple programs which react to any switch press. Therefore we start with a program, such as Switch Intro (Don Johnston). One part of this program is "Make It Sound," which focuses on sounds and related pictures on the monitor. After positioning and placement of the switch, we observe Steven's actions. We look first at his interest in making an effort to reach toward the switch, and his physical ability to press on it. When he does activate the switch, we observe his reactions, any facial or verbal responses to the sounds, and his visual attending to the monitor. If he makes no attempt to activate the switch, physical assistance is provided once or twice to get him started. At this point, a determination may be made that the placement or type of switch needs to be changed. These are variables which are assessed on an ongoing basis throughout the session.

Let's assume Steven is able to press his switch and does so randomly to make the sounds change in the program. Then the next step would be to assess his ability to press the switch at an appropriate time. This skill is needed in order to advance to functional use of communication through scanning. It also indicates to us that he is able to control his movements in order to get the desired result. Press to Play - Animals (Don Johnston) is one program which can be used to test appropriate switch pressing or train a child to develop this skill. This is a simple way to test or teach appropriate switch pressing skills.

If it is determined that Steven does have an understanding of waiting and pressing his switch at a specific time, then the next step is to test more specifically his ability to attend to the monitor and visually track an object across the screen. A simple program which can be used to assess this skill is the "Willy the Worm" portion of Switch Intro. This program can be used to assess the child's ability to visually track the object and to press his switch appropriately. The requirement of starting the object movement with a switch press each time is similar to the action which is needed to control a scanning array, one press to start the scanning, another press to stop at the desired word or letter. With an auditory beep added to the intitial switch press, this program can be used to assess beginning auditory scanning, as well as visual scanning skills.

If Steven has the ability to do these beginning scanning skills, then the next step is to assess his intentional use of progressively more difficult scans. We may use aMAZEing Ways (Don Johnston) which contains several switch activities with mazes. We would continue to assess his scanning skills until either Steven tires or the team has a good evaluation of his abilities.

Other methods of input, such as a touch tablet or adapted mouse, may be assessed during the session. If a child has enough hand control to use direct select method of input, the Key Largo or IntelliKeys may be an option. Assessment of these devices should begin with simple software which is activated by a press anywhere on the surface of the device. This way the team can assess the child's physical ability to use the device, before progressing to different levels of touch tablet use.

Note: A complete description of the TTAP assessment procedures and a copy of TTAP's assessment forms are available in the manual, The Technology Team Assessment Process. Contact the Macomb Projects office for ordering information.

Note: Software referred to in this article can be purchased from Don Johnston Inc., 800/999-4660.

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