Category: Assistive Technology

Posted in Assistive Technology, Occupational Therapy

The Challenge of Moving Toward Self-Sufficiency with or without Assistive Technology

Posted on by Eleanor Cawley

This blog is concurrently posted on Handwriting With Katherine.  Check out Katherine for some excellent resources.  She is the Handwriting GURU!

As school districts begin to think about transitioning students with disabilities out of school and onto the next phase of life, the idea of becoming as independent or self-sufficient as possible comes to mind. I prefer to use the term self-sufficient as this term implies a sense of power and strength in addition to not requiring assistance from others.  At the age of 14 years, school districts are required to begin developing a transition plan.  Educators, therapists and parents investigate vocational as well as, social and self-care tasks.  In many high schools, Life Skills Programs concentrating on just this effort are charged with the task of fostering self-sufficiency.

Collectively, we explore both basic [BADLs] and instrumental activities of daily living [IADLs]. BADLs include basic self-care tasks, such as feeding, toileting [including maintaining continence], dressing [donning/doffing and selecting clothes], grooming/bathing, walking and transfers (such as from bed to wheelchair). These are the skills that we have begun to develop since birth. IADLs are more complex skills that we are taught as our thinking skills become more developed and include things like money management, driving/using public transportation, shopping, meal prep, communication using a telephone, computer or tablet, managing medications, housework and basic home maintenance.  The IADL and vocational skills are the focus of the Life Skills Programs.

What happens, though, if despite our collective very best efforts, an individual is unable to complete these tasks without some type of assistance? We begin to explore compensatory strategies and levels of assistance that are needed to increase the individual’s ability to become self-sufficient. Assistive technology is a huge area of practice that can be considered and includes both low and high tech devices. Low tech generally means that the strategy or item is simple and generally does not require any type of power source like batteries.  Low tech items can include things like a pencil grip or hand-held grabber to a paper calendar or checklist.  High tech usually involves a technology device with apps [a computer, cell phone or tablet]. Adaptive technology is another term that is used. Adaptive technology is developed specifically for persons with disabilities and is rarely used by a non-disabled person.  Adaptive technology is electronic and includes things like a personal emergency response system [PERS]. A fall detector is a good example of PERS.  The purpose of all these technologies is to help the individual develop or maintain their ability to give the individual the power to be independent for as long as possible. Without these technologies, persons with disabilities would be dependent on others to meet many of their needs.

Each and every day, we are challenged with the task of identifying ways for these students to become self-sufficient.  There are always budgetary concerns and so we begin with the least restrictive strategy. Let’s use Marty, a life skills student, as an example.  Marty is 16 years old and is exploring vocational options.  He is enrolled in a retail work experience program through his school with a job coach.  We begin to explore his work readiness skills.  Is Marty capable of completing all BADL and IADL skills to get him ready to go to and then to get him to work? We look at Marty as he comes to school each day.

Marty comes to school neat and cleanly shaved with hair combed and appears to be well organized. We interview his parents, we may learn some things about Marty that we did not know.

  • Is Marty able to prepare for school each morning?
  • Can he bathe and dress himself?
  • Does he choose his own clothing? Tie his shoes?
  • Can he groom himself?
  • Can he pack his backpack?
  • Make his own lunch or remember to bring money to buy lunch?
  • Does he require any sort of assistance?
  • If he requires assistance, how much and what type?
  • Is there anything that can be done to improve his ability to get ready for school without help from his parents?

Marty is able to shave himself using an electric razor.  Initially, he had some difficulty and shaved off part of his eye brows. Marty’s dad worked with him and helped him learn the correct way to shave.  He is able to pick out clothing appropriate for the weather but his clothing is not always coordinated in color and patterns.  Marty’s mom hangs coordinating clothes on a hanger to help him appear well dressed.  It seems that Marty’s parents have many strategies already in hand to deal with his deficits.  Marty is able to make his favorite salami sandwich, taking two slices of bread, spreading mustard and adding salami without help.  He is able to place and seal his sandwich in a plastic reusable container, add 2 napkins, a cold drink, a piece of fruit and a packaged snack in his insulated lunch bag.  Mom checks his backpack before Marty gets on the bus to make sure that he has everything that he needs to get through his day.  At the end of the day, Marty is able to empty his backpack and lunch bag.  He places the reusable container into the dishwasher and removes any trash that he did not do so when in the cafeteria.  All of this shows us that Marty is capable of following a well-established routine with just supervision.

What about taking on new and variable tasks, like those required for his work experience program? In his retail work experience, Marty has a number of tasks to complete on any one day.  He needs to take inventory, stock shelves with new merchandise, re-stock shelves when merchandise is sold, organize that merchandise [i.e., matching pairs of shoes in color, size and style] and decide which merchandise needs to be returned.  Can Marty perform all these tasks with just a verbal directive?  Can he remember the steps to each task? Can he remember when to take lunch? Can he focus on each of the tasks and complete each, meeting the demands of his job?  We explore his abilities and begin to develop strategies beginning with the least restrictive.

  • Completing job tasks with without supervision requiring only simple verbal directives and a demonstration
  • Use a checklist to complete tasks
  • Use distant supervision, requiring only someone to monitor his job performance from a distance?
  • Use close supervision, requiring someone working in the same area and prompt him to follow his checklist and to complete tasks

Once we get to the level of close supervision, we look at how many tasks is Marty capable of completing?  How much of the task is he capable of completing? Does he need to focus on only one task at a time?  For example, does Marty need to focus on only matching pairs of shoes and then go back to put the shoes in the correct location?

Here is where we begin to look at low tech strategies. Will a checklist work? Will picture prompts work? Should Marty be partnered with another worker in the store? Finally, we may arrive at high tech solutions, such as needing a tablet with a picture schedule and video modelling to help Marty complete his work with the least amount of assistance from another worker or job coach.  At this point, we need to collect data on what Marty is capable of doing, how much assistance is required and what supports have been put in place and failed to get us to the determination that a device is warranted.

Hopefully, at this point, everyone is also focusing on Marty’s abilities to complete IADL skills.

  • Is he capable of handling money? Can he create a shopping list? Does he know what a recipe is? Can he differentiate a recipe from a shopping list and can he develop a shopping list by looking at the recipe, determine what he already has in the pantry or refrigerator and what he needs?
  • Does Marty take medication? Is Marty able to remember what medication he takes and when he needs to take it consistently? Does Marty know when he needs to order new medication? Does he know when he has to return to the doctor to get a new prescription? Can Marty keep track of his doctor’s appointments? Can he arrange transportation to get to the doctor’s office? Does Marty need a medication reminder?
  • Is Marty capable of making plans to organize his schedule? Does he know when others are available to drive him or accompany him on public transportation? Is Marty capable of using a cell phone and Google to navigate from one location to the next? Does Marty need to review a family or group schedule to figure out if, when and who is available to help him?

Many of the questions asked above can be addressed using simple, free or low cost and easily available apps that are available on either Apple or Android devices.  Highly structure training and data collection is required to determine if Marty will be capable of using this technology to become self-sufficient.  If it were not for technology, Marty may be dependent on others for all his needs and be independent in none.

For more information, please feel free to contact me.

Posted in Assistive Technology, Eleanor Cawley

Cost Effective School-Based Assistive Technology Programs

Posted on by Eleanor Cawley

By now, almost every school district has an Assistive Technology Program. Many students have access to graphic organizer, text to speech and word prediction software within their classrooms or at least in a computer lab. But, that is a BIG BUT, does the district have to provide computers for home use?  Not in my opinion!

School districts are switching over to Google and Google Apps for students to use while at school.  This allows the student to have a school-based e-mail with access to Google Drive.  Documents created in school with Google Apps can then be opened and worked on at home.

Companies, licensing assistive technology software to districts, provide a number of options for sharing this programming for the students to use at home.  This may come in the form of a web based version or an actual disc or thumb drive that a parent can use to load the software onto their home computer.

If students can access work from school at home and then have the assistive technology software available on their home computers, there is no reason for students to have a device to carry back and forth from home to school.

It is my belief that students should have two e-mail addresses to access between home and school.  One, of course, should be their g-mail account through Google and the other should be an Outlook account through Outlook.com.  One might think that a g-mail account would suffice.  It might if the student has no executive function issues and is very well organized. However, that Microsoft Office Suite that we know and have grown to love, has the best digital notebook program EVER!  Yes I mean, EVER!  Microsoft OneNote comes with every version of the Microsoft Office Suite.  If you have the Microsoft Office Suite, you have OneNote. School districts have had this programming forever and never knew it!

If you create an Outlook account, you have OneNote!  There is a modified version within your Outlook account, along with Word, PowerPoint and Excel. What is not to like?  Then the absolute best thing is to download the the free OneNote App.  Yes, that’s right, I said free!  With this app, a student can have access to his or her notes anywhere there is an internet connection!

The absolute best case scenario is to have the Microsoft Office Suite on your home computer.  Create your notebooks at home and store them within your Outlook account.  When you create your notebook, choose the web option as the location to store your notebook.  Under web location, log in with your Outlook log on and password.  You will use the same log on and password to open your notebook within the app on your iPad or Android device.

Setting up your notebooks from your home computer through the Microsoft Office Suite provides many more options, with my favorite option being the template feature.  This saves oodles of time.  Just add the template to your notebooks from your home computer and their will magically appear on your other devices. You can scan handouts and homework assignments into the notebook at home or photograph them with your tablet or phone when in school or in the community.  The best part about this program is IT IS AN AUTOSAVE PROGRAM!  If you forget to save something, no big deal, once you put it in a notebook, it is there until you take it out.

Microsoft OneNote is a life saver.

  • Parents never again will have to run to school with a forgotten assignment, as long as, the student put the assignment in their OneNote Notebook.
  • Is it time for a notebook review by your teacher?  Share the notebook with your teacher!
  • Left your notes in school and you have a test tomorrow?  Access your notes anywhere there is an internet connection.
  • Organize your OneNote Notebooks just like you would your paper notebooks or binders.  You can easily add tabs for sections and add new pages to each section.

I like my OneNote notebooks better than Evernote. There are organizational features in OneNote that Evernote cannot match. OneNote is easy to use. Open your notebook to where you need to add a new assignment then either use a scanner (if your at home) or take a photo of the assignment. It will go right to the place that you have open. Nothing could be easier.

So going back to the original topic of cost effective assistive technology, with the availability of a number of free options that work across platforms (PC or Mac), there is really no reason to provide each student with a device to take home. Students are entitled to a free and appropriate education but not necessarily a free computer.  If assistive technology is needed, then absolutely provide it. Send home the software but not a device.

Of course we all worry about where our tax dollars are being spent and in my opinion, sending home devices with students can be a huge waste of our tax dollars. There is an easy solution and we should take advantage of it. Yes, there are homes without internet or even a computer. Recently, many local libraries have begun distributing free wireless devices for internet access to families in need. Netbooks are a reasonable option, for those students requiring assistive technology, and who are without computers in the home. The netbook can be left at home and returned to the district at the end of the school year.  While there may be some normal wear and tear on the netbooks, there should not be damaged from transporting the devices repeatedly to and from school.

In my opinion, internet should be free and accessible to everyone.  If you need something faster than what is a free connection, then go ahead and pay for the faster service.

With the onset of a new technological age, where technology is the norm rather than the exception, we need to be just as careful about our money as we are about educating our students.

Posted in Assistive Technology, Eleanor Cawley, M.S., OT, Occupational Therapy

Keyboarding 101

Posted on by Eleanor Cawley
Photo Credit: Michael Maggs
Photo Credit: Michael Maggs

For the purposes of this series on Keyboarding, I will be referring to the standard QWERTY keyboard and 2-button mouse (with center scroll).  The information in this post comes from my memory of past investigations of keyboarding and computer skills.  I researched this topic quite extensively, reviewing the programs of a large number of districts throughout the United States and the standards outlined in ISTE, all of which I found on-line.

The Early Years (Pre-K)

Early computer skills include:

  • Developing accurate mouse skills (accurately reaching and clicking on the target)
  • Activating programming buttons using the mouse
  • Developing attention to the screen and the activity
  • Using ‘POWER’ keys, such as ‘ENTER,’ ‘TAB,’ and ‘SPACE BAR.’
  • Beginning letter recognition by depressing the requested key on the keyboard

When working with little ones, I used to use “Reader Rabbit.”  The kids loved the “Follow Me Theater.”  This is still available from Amazon and has worked on my Windows 7 computers, I am not sure about Windows 8.  This is the type of programming that can support learning, imitation and fine motor movement, in addition to learning mouse skills.  By Kindergarten, kids should be able to recognize and find all the letters in their first name.   He or she should also be able to capitalize the first letter of their name and use lowercase for the remainder of the letters.  Children , at this age, should be able to recognize and identify at least 20 letters [upper and lower case].  It is also a good idea, at this time, to experiment with different fonts–form consistency.

Be very careful not to make the computer the only activity that your child enjoys.  Limit computer time to 10 minutes or so.  Encourage plenty of gross and fine motor activities to prevent your child from developing a sedentary lifestyle.

http://www.rodale.com/computers-and-children
http://www.rodale.com/computers-and-children

 

Posted in Assistive Technology

-Using OneNote to take Notes in Secondary Schools and College

Posted on by Eleanor Cawley

Another of my favorite therapy areas is teaching students how to take notes.  Taking notes is not easy.  Students must be able to respond to auditory cues with a pen/pencil or a keyboard.  Some students feel the need to take down every word, while others can take down the highlights.  Since I am an occupational therapist, my job is to teach students how to respond to environmental cues with movement.  So I would like to talk about taking notes in my favorite note-taking program, OneNote.

There are a number of reasons to set up note – taking templates or forms in OneNote.  For example, this T-Chart can be used for a number of different classes and discussions within a class.  Prompts that may indicate that a T-Chart should be used are:  Compare/Contrast; Conversely; Vocabulary Words/Definitions; Pros/Cons, etc.  This note-taking template can also be used for pre-algebra/algebra or anywhere where there is a rule and a sample.  The Cornell style of note-taking also uses a asymmetrical T-Chart for cues and notes.

Simple T-Chart created from a table and saved as a template
Simple T-Chart created from a table and saved as a template

Much of the job is already done for the student.  The page is already formatted for the student.  I find that formatting is often part of the delay and disorganization in taking notes.  If you click on the date, a little calendar appears and the date can be easily changed (calendar will indicate the correct date).  The same can be done for the time. Rows can easily be added to the table by clicking on the appropriate icon in the ribbon at the top of the screen or by right-click and then click on Table.  The color of the page and print can also be changed to address any visual concerns.

The real trick is learning the verbal prompts so that the appropriate form can be identified and opened.  The great part of this system is that this is an auto-save program!  If the student closes the program before saving, the work will still be there.  Another factor to consider is keyboarding speed and accuracy.  Figure out if the student can take dictation on the keyboard accurately before recommending this method to any student.

Posted in Assistive Technology, Occupational Therapy

Using Microsoft OneNote for Documentation on the Run

Posted on by Eleanor Cawley

Many therapists are looking for a way to document on the run.  This means that they are looking for a way to become paperless, much like many other professions.  This saves the mounds of paper that over the course of the years has become insurmountable.  I frequently talk about using MS OneNote for all of these documents.  Not only can you create a template like this one.  You can also print out your documents for immediate submission if you have access to a printer.  In the event that you do not have access to a printer, you can certainly e-mail it through a HIPPA compliant service, like hushmail.com.

This is a portion of the template that I use for evaluations in OneNote
This is a portion of the template that I use for evaluations in OneNote.

 

If I really need to print out a report for one of those meetings that are occurring today, you can absolutely do so.

This is the screen that allows you to see what your quick report will look like.
This is the screen that allows you to see what your quick report will look like.

 

You can do the same thing with your Medicaid notes and many other note forms that you will need.  I have never had to use a specific form for a consult but I developed one anyway for me to keep track.  Each of the cells in these tables will expand to the size needed, once you start entering information.

My own consult note form.
My own consult note form.

This is the note form that I created for my Medicaid notes.  It works well and is accepted by any agency that I work with.

Medicaid Provider Session Note Form
Medicaid Provider Session Note Form

I do not find it as easy to create templates in the free version of Evernote.  I am a OneNote girl!

 

Enjoy your weekend,

 

Eleanor

 

 

 

Posted in Assistive Technology, Eleanor Cawley, M.S., OT, Occupational Therapy

How Important is the Content of a Referral When Evaluating for Occupational Therapy?

Posted on by Eleanor Cawley

When conducting an evaluation, in my case either an occupational therapy or assistive technology evaluation, is the quality of the referral important?  In my opinion, absolutely!

Occupational therapy [and assistive technology] cover a huge array of skills in an infinite number of areas.  When conducting a school-based evaluation, it is prudent to know what the student’s difficulties are.  For example, if a student is unable to take notes, I would explore a variety of skills in detail [visual tracking, handwriting, orientation to sound, etc.].  I would need to know that the student is having difficulty in this area and this is an area that the school would like to address.  I would also need to know what the student thinks:  Is writing notes the problem or is something else.  Students need to provide feedback during an evaluation.  Their feedback provides insight to strengths and limitations that professionals might not see.

If I were evaluating a senior citizen, I would need to know what current and future living situations are being discussed and what the expectations of the patient and possibly the family might be.  For example, does the patient and or the family expect that this patient will cook or shop independently?  Although I would surely conduct a global assessment of this patient’s skills, I would definitely expand and focus on the skills that the patient is expected to be able to do.  In the case of cooking and shopping, my evaluation would focus on handling utensils, navigating the kitchen, energy conservation and safety, including fall prevention, both in the kitchen and out in the community, the patient’s ability to follow written and verbal directions, generating a shopping list, etc.

The referral asks the questions that the patient and his or her family need answers to.  Having a referral focuses the evaluation on the client, the student, the patient.  It shows the person being evaluated that his or her needs are important and valued.  This helps develop a rapport with the client that can support the therapeutic process so that the client has a vested interest in participating in therapy.

So, in addition to the diagnosis, the client needs to learn what an occupational therapist does and what he or she can assist with prior to the evaluation.  My next blog will cover “Just What Does and Occupational Therapist do?”

Posted in Assistive Technology, Eleanor Cawley, M.S., OT, New Beginings, Occupational Therapy

When Is It The Time To Recommend Assistive Technology For Note-Taking?

Posted on by Eleanor Cawley

I must state, before anyone reads this, that I am a HUGE fan of using assistive technology.

I recently read a comment about a piece of technology not being “cool.”  I realize that there are students who will never feel “cool” when using assistive technology.   I also feel that students must be taught touch typing and the basics of functional programing before being asked to take notes using assistive technology.  It always boggles my mind when some recommends a piece of assistive technology, such as an Alpha Smart, without ever considering if it will really work for the student.  Many students consider an Alpha Smart to be ‘uncool’ for the following reasons:

  1. Looking different from peers
  2. Not knowing how to use the device
  3. Still not being able to keep up
  4. Fumbling with the technology in front of others

In my humble opinion, students need time to learn how to use such a piece of equipment or a program.  One of the reasons that a student might need the technology is due to an inability to handwrite legibly.  Another might be difficulty organizing thoughts and motor movements.   Assistive technology needs to be worked on privately with the student or in a very small group with other students using similar technology.  Every aspect of using that device and the skill that it is supposed to support needs to be worked on prior to giving this device/technology to the student to use in the real world.  For example, when providing an alternative keyboard to a student to use to take notes the following needs to be explored:

  1. Can the student take notes without the device even though his or her handwriting may be illegible to others?
  2. Does the student know the verbal cues that would trigger him or her to start taking notes?
  3. Is the student capable of taking dictation either written or using a keyboard?
  4. Can the student use those verbal cues to format notes?  If a student hears the terms “Pros and Cons” or the word “conversely” does the student know that this may be a great time to use a T-Chart style of notes?
  5. Can the student attend to the instructor long enough to follow the lecture?
  6. Is the student familiar enough with the keyboard to type at least 30 words per minute over the length of the class for note taking?
  7. Can the student use punctuation to help the notes make sense with any degree of success?
  8. Is the student comfortable enough with keyboarding in a room full of other students, who are not using a keyboard, to be successful?

Obviously, I could ramble on and on.  We need to think, “When is an alternative device or program better than the low-tech copy of notes provided to the student?  The technology that we supply is only as good as the support that we give to the student.  If we jump to provide assistive technology to a student without looking at the student’s overall ability to succeed without the device, then are we sabotaging the student to dump the device or program and throw in the towel?

I feel that note-taking should be a skill taught in every school, to every student.   A task analysis of note-taking skills needs to be completed and the student assessed using that analysis before providing a device.  The organization of the page should come before the thought of using an assistive technology device or program.  The language that we use in the classroom should trigger a particular format of notes.

There is so much learning that needs to be done by each and every student.  Students are getting frustrated and need to have a place, a structure to go back to.  At that point, once the structure has been taught and reinforced and the student is not yet successful, then and only then should a device or program be considered for taking notes.

I know that every teacher that I come in contact with is working day and night to help all the students learn everything they need to.  I know that many provide notes, study guides and review materials to students, hoping that somewhere, sometime, something will work at some point.  I think that those of us working with students need the structure, the organizational hierarchy, to assess a student’s abilities just like our students need to learn.

Posted in Assistive Technology, Eleanor Cawley, M.S., OT, New Beginings, Occupational Therapy

Note-Taking from an Occupational Therapist’s Perspective

Posted on by Eleanor Cawley

Taking notes is a very complex skill rooted in abilities developed in infancy.  While sitting in a classroom, a student is expected to have appropriate cognitive and motor responses to the teacher providing the lecture.  That is easier said than done! 

As an infant, we are supposed to alert to a sound, respond to that sound with head turning in that direction, differentiate pleasant sounds from unpleasant sound and learn to express pleasure or displeasure.  Visually, we are expected to respond in a similar way: alert to a visual stimulus, respond by following that stimulus by turning our head to follow it, differentiate pleasurable from displeasing.  Infants are expected to demonstrate a motor response to the stimulus, i.e., eye opening, finger splaying, and activation of limbs.

Just as an infant is expected to display a motor response to stimuli, a student is also expected to respond motorically to stimuli provided by the teacher.  Students learn to respond to certain cues, i.e., “This is important,” “Conversely,” repetition of the information, etc.  It is very difficult for student to respond if he or she lacks the prerequisite skills.  Alternatives for taking notes should be offered to the student.  The least invasive is to have the student copy notes from the board (far point).  Some students have difficulty with visual skills such as pursuits and saccades (visual tracking and changing fixation from one target to another) making this difficult.  First a slant board (often a binder) can be used to address this issue.  If that doesn’t work then maybe copying from near point will work. 

The next more invasive intervention might be providing the student with some form of prepared notes, i.e., Cloze Notes.  Cloze notes are fill-in the blank notes.  Students are only required to add one or two words to a statement rather than copy the entire statement.  The next level might be providing the student with a copy of teacher generated notes prior to the class for the student to highlight during class.  The next level might be having the student attempt whatever he or she is able then giving a copy of notes to the student, usually a copy from another student who takes very good notes. 

Another strategy is to use on-line notes for a site like www.studyblue.com.  You may be lucky enough to find course notes similar to class notes with flash cards.  Kno.com is a site where you can buy electronic textbooks (usually at a reduced cost), this site also provides lecture (from the book), study materials and social networking for studying.  Kno.com is iPad friendly.  Along with programs like Evernote with Penultimate, this maybe all the student needs to be in class.  A student could photograph handouts and never have to carry another piece of paper.  Assignments could be entered into Everstudent (a digital assignment book/agenda). 

 

One of the last options would be to type notes on a laptop or a computer.  If the student lacks the prerequisite skills for note taking, they cannot be expected to be successful if you give them something to type on even though they can type at a good speed with good accuracy.  A sixth grader is expected to type at a speed of 25-30 words per minute with 93% accuracy.  If a student has only handwriting concerns, is able to meet all the prerequisite skills for note taking, can type 25-30 words per minute with 93% accuracy then maybe the option for using a keyboard or laptop is the answer.

Posted in Assistive Technology, Eleanor Cawley, M.S., OT, New Beginings

Assistive Technology Assessment

Posted on by Eleanor Cawley

Thinking in Terms of Developing Skill Sets Rather Than Compensating for a Disability

There are many types of assistive technology evaluations including:  mobility, seating/positioning, communication, computer access, switch-access, and aids for daily living, work-site modification, home modification, and recreational assessments.  While assistive technology should be considered in the typical ways; it should also be considered in other ways, i.e., development of skill sets.

From the use of smart phones to navigating the community, developing visual picture schedules to support a cooking or grooming task to the use of laptops and desk top computers for literacy programming, assistive technology supports the development of skills or skill sets.  [Assistive] Technology is here to stay.

Students who are unable to develop skills similar to their peers may very well be more capable with the use of technology.  The Cloud, iPads, iPhones and tablets make taking notes and organizing those notes much easier [with training] increasing a student’s ability to be independent.  Using literacy programming may actually provide a student a voice where he or she did not have one before.  Using technology successfully has the potential to help a student develop confidence and self-esteem.

What makes the addition of developing a skill set different from the typical assistive technology evaluation?  First the referral is targeted toward a specific reason for that referral.  All of the same criteria for that typical evaluation are assessed.  The same programming and devices are explored as is the student’s responses.  Each teacher working with this student is provided with a questionnaire and interviewed based on those responses.  This then gives the evaluator a picture of the student and the skills required to meet the demands in each core class.  A clearer picture of the student’s abilities to achieve the desired skill set is then established.

Based on the demands of that particular skill set, the student is observed discreetly in a core class.  For example, if the desired skill set is to take notes, the following skills will be explored and data collected:  responses to sight and sound, orientation to the teacher, motor response to cue words, quality of the notes taken (content, legibility and organization), etc.  Based on the data collected, recommendations are then made to help the student reach the goal of the desired skill set.  This may be almost a full day of assessment for a particular student.

Once recommendations have been made, and the report has been submitted to the district, the real work begins.  It is important for the evaluator to be in contact with the district’s technology team.  Together with the technology team, a device can be prepared to meet the student’s needs in each of his or her classes.  In the case of note taking, it may mean that a device must be in sync with the Smart Board in class so that the student can save the lecture notes.  Different programs, based on teacher preference, may also need to be learned by the student to ensure that the notes are recorded.

So after a full day of evaluation, and further consult with the technology department, it is prudent to set up additional consult sessions to train the student and the staff in the use of the device, develop future goals and assess whether or not this plan of action will be successful for the student.  In order for assistive technology to meet the needs of the student, it must be constantly assessed and re-assessed, with additional support to the student.

In a different scenario, a student may be recommended for an assistive technology evaluation to address poor handwriting skills.  In addition to the typical assistive technology evaluation where the student’s keyboarding ability is assessed, he or she may need additional support in keyboarding using a touch typing method to improve speed and accuracy.  Often a student with poor handwriting skills has been provided with a computer as needed but he or she has not learned the correct method of keyboarding.  This leads to greater frustration and disenchantment, with any device provided, due to a higher error rate.

A traditional assistive technology evaluation may be requested if the student has reading difficulties, for example, Dyslexia.  Options for assistive technology include text to speech programming-having text from a computer read to the student in a computer voice.  Once the student has been approved for assistive technology, depending on the programming chosen by the district, the voice in the test to speech program can be somewhat pleasing or definitely irritating.  It is difficult to train a student to to modify and use this type of programming during the initial evaluation.  Digital book sharing services require that the student have an account.  This account needs to have a completed application, parent consent and a sign-off by a professional to indicate a visual print disability.  It can take a day or two for the company to approve the application.  Upon approval, a Welcome e-mail is sent to access the account.  Often, an additional program needs to be downloaded before the student or parent can download books to read.

There is a significant delay in the student accessing and using this programming.  If the teacher has not had access to digital book sharing prior to this student, he or she also needs to learn how to use the programming.  So in addition to the evaluation and initial training, follow up and ongoing training is necessary.  This training can be done by the evaluator or district personnel knowledgeable in this area.

In general, assistive technology can only be considered successful if the student is using it to function within his school and home environments and is able to perform the activities with an increased level of independence.  This brings attention to another issue that arises with the use of assistive technology, which is caregiver training.  Frequently, in this training loop, the parent [or caregiver] is left out.  It is important to have the parent participate in at least one training session, once the technology, approved by the district, is in place.

It is ny goal to ensure that every student receiving assistive technology, either through the district or through private funding, receive the training that he or she needs to gain independence.  Once again, if the student is not comfortable with the technology or does not fully understand how to use it, the technology is wasted as is the money spent or the evaluation, purchase and training.  We must also be very careful in not allowing the assistive technology provided being considered another failure.  This can further undermine a student’s self-confidence and self-esteem.