Efficacy of Assistive Technology Interventions: Volume 1

Assistive technology has the potential to enable people with disabilities to live, learn, and work more independently through the application of specialized technologies that reduce, eliminate, or minimize the impact of a disability. This chapter provides an overview of the international application of assistive technology, summarizes the purpose of this new book series, and highlights the chapters in this volume that reflect the most recent research concerning the efficacy of assistive technology.

In this chapter, we present the findings of the National Assistive Technology Research Institute (NATRI). The institute was funded in October 2000 as a cooperative agreement with the U.S. Department of Education, Office of Special Education Programs to take a comprehensive look at the factors related to the planning, development, implementation, and evaluation of assistive technology (AT) services in schools. We present the data from seven research areas: (1) the status of AT use in schools, (2) policies and procedures in the development and delivery of AT services, (3) AT decision-making by IEP teams, (4) integration of AT use in learning environments (facilitate instruction, access to curriculum), (5) effects of AT use on academic, social, functional performance of students, (6) training and technical support needed by persons implementing AT, and (7) the extent to which institutions of higher education (IHEs) were developing AT knowledge and skills. In each area we summarize the lessons learned as a result of the research to assist policy-makers, researchers, and practitioners in improving AT services and delivery systems.

The effectiveness of different types of adult learning practices for promoting practitioner and parent use of different kinds of assistive technology and adaptations with young children of 18–105 months of age was the focus of a research synthesis described in this chapter. Six operationally defined adult learning methods and between two and five practices for each method were used to code and analyze the results for both adult (practitioner and parent) and child outcomes. The assistive technology and adaptations that were the focus of training included speech generative devices (e.g., CheapTalk), computers (e.g., adapted keyboards), and switch-activated devices and toys. Results showed that a combination of five or six of the most effective adult learning method practices were associated with the largest differences in both adult and child outcomes, but that few studies included the most effective practices. The relationship between the number of practices and the study outcomes was moderated by the type of training (individual vs. group) and whether the training included in vivo use of the devices with children with disabilities. The results point to at least several factors that explain non-use of assistive technology with young children with disabilities and highlight the need for better designed and implemented training.

This chapter presents an exploration of the phenomenon of speaking with, or perhaps better stated “through,” a device. Autobiographical works and other published accounts of perceptions of Speech-Generating Devices (SGDs) by persons who have used them are reviewed. The bulk of the chapter focuses on insights gathered from research into the lived experiences of young people who use SGDs. Emerging themes focus on what is “said” by a person who cannot speak, how SGDs announce one’s being in the word, the challenge of one’s words not being one’s own, and the constant sense of being out of time. Reflections on these themes provide insights for practice in the fields of speech language pathology, education, and rehabilitation engineering. The importance of further qualitative inquiry as a method to gather and listen to the voices and experiences of these often unheard individuals is stressed.

For students who are blind or visually impaired, technology enables greater access to the educational curriculum, immediate and independent access to information, and full participation in community and citizenship. This chapter reviews research on technology use by students with visual impairments, and highlights effective practices, promising developments, and ongoing challenges. The authors discuss the implications of these advancements on policy, instruction, professional development, and future research.

Assistive Technology (AT) helps address social and economic barriers and can positively impact the lives of people with disabilities. Single-entry point (SEP) systems have been shown as successful models for reducing barriers encountered when acquiring and using AT. This chapter highlights a mixed method case study in the province of Newfoundland and Labrador (NL), which sought to explore barriers consumers faced in acquiring and being satisfied with AT, as well as the potential for an SEP system in NL. NL is an Atlantic Canadian province characterized by a small population dispersed over a large island and remote mainland. Data were collected using individual interviews with disability service providers in community and post-secondary settings across the province and a survey to assess barriers to accessing AT, AT utilization, and satisfaction among consumers with disabilities. Many consumers and service providers demonstrated that they recognized the benefits of AT but expressed dissatisfaction with existing programs and services citing cost, lack of knowledge, training, and funding subsidies as the most significant barriers to access. Improving access to AT is a necessary step toward enhancing education and employment opportunities, facilitating social inclusion, and optimizing overall health for people with disabilities. Investigating the feasibility of SEP programs modeled after American and Australian initiatives should be part of future planning for Canada, especially in small urban, rural, and remote areas where demand for provision of AT is under-resourced.

Little is known about how assistive technology standards have been implemented in preservice teacher preparation. This chapter provides a review of the literature concerning the importance of evidence-based practice and the research base supporting assistive technology in order to set the context for reporting the results of a comprehensive national study of the status of assistive technology state standards for teachers in all of the 50 states (plus Washington, DC). This chapter includes the findings of the study, the research that the study was based upon, and a review of relevant research in the fields of assistive technology, educational technology, and evidence-based practice. Only six states reported having AT standards and six states reported having AT competencies. Three states reported having both standards and competencies, yielding nine unique states (out of 51) with AT standards and/or AT competencies. Regression analyses to determine the relationship between the study variables and national reading and math performance of students with disabilities were inconclusive. The implications of the study findings and recommendations for future research are presented.

Online communities of practice offer the potential for the development of a shared understanding regarding knowledge and skills related to a particular field or practice. Online communities of practice also offer researchers a means to analyze discussions to determine themes related to practices within a given field. This chapter presents two studies that have examined discussions that have occurred among members of a large assistive technology (AT) Listserv. The purpose of the studies was to identify and examine themes grounded in the conversations and experiences of those individuals actively engaged in AT service delivery. Findings are presented and implications of using online communities of practice within research as well as a means for knowledge and skill development are discussed.

This chapter describes the results of an exploratory study that examined parents’ experiences with the law as they obtained funding for speech generating devices for their children with communication disabilities, either through public health insurance, private health insurance, or a public school. Exploring legal consciousness: Experiences of families seeking funding for assistive technologies for children with disabilities. Law, Policy, and Society Dissertations. Paper 17. Retrieved from http://hdl.handle.net/2047/d20000265). The study explored how parents engaged with the law and how their experiences and perceptions about the law compared to the formal law. This research was based on sociolegal theory, particularly the concept of legal consciousness, which examines how people think and act in relation to the law as a consequence of social interactions, and analyzes how law in action compares with the formal law. Sociolegal theory broadens the definition of law to include “the meanings, sources of authority, and cultural practices” (Ewick & Silbey, 1998, p. 22) as well as the formal law.

Similar to other sociolegal research, this study collected personal narratives of law using grounded theory methods to identify themes within those narratives. The narratives revealed that while parents expressed varieties of legal consciousness, there was one overarching theme: the law provided a framework for parents to envision rights, discuss rights, and claim rights. While few parents invoked formal legal mechanisms to solve grievances, the law created a rights consciousness among parents which empowered them to acknowledge and validate the notion of rights and entitlements.

Assistive technology (AT) is a tool to help people gain, maintain, or regain independence. AT funding options in the United States are varied. One fairly unique option is last-resort state funding, which is available in just a few states. In this case study, we explore the kinds of AT that were purchased from a state AT fund over a five-year period and for whom the AT was purchased. The case study followed a three-phase community-based participatory research process that included initial interviews with key stakeholders, compiling the data into a usable form, and follow-up interviews with key stakeholders to seek their analysis and opinions related to the data. Overall, patterns in the results were generally expected, or at least didn’t cause alarm. The data suggest that AT providers are becoming more proficient at finding ways to provide more devices and services to their clients, they are likely becoming increasingly effective at providing services to their clients without having to purchase them, they are successful in finding funding for the less expensive devices or are reusing devices that have already been purchased, and that community outreach programs are successful in increasing fund usage by ethnic minority populations. General implications of these findings are presented with the goal of improving functional outcomes for AT users.