An assistive technology device is defined as any item, piece of equipment, or product system whether acquired commercially off the shelf, modified or customized, that is used to increase, maintain, or improve functional capabilities of individuals with disabilities.
Categories of Assistive Technology Devices
- Independent Living - aids, devices, and methods that allow people to perform the activities of daily living and to live at home independently.
- Computer Access - software, hardware, and special instruments that make computers accessible.
- Mobility - aids, devices, and methods that provide alternative means for walking, standing, or transferring.
- Communication - aids, devices, and methods that enhance personal expressive communication.
- Job Accommodation - aids, devices, and methods that help people carry out work-related tasks.
- Seating - modifications to wheelchairs or other seating systems that provide greater body stability, upright posture, or reduction of pressure on the skin surface.
- Education - educational and vocational resources, services, and products for use in assessments and training.
- Transportation - register vehicles, accessories, and services that assist people to travel.
- Recreation - aids, devices, and methods used for recreation, sports, and leisure.
- Sensory Aids - aids, devices, and methods to enhance usable hearing or vision and/or provide an alternative.
- Adaptive Switches - switches used to control computers, environmental control units, adaptive toys, communication devices, etc.
- Architectural Elements - structural adaptations to the home or work site that remove or reduce physical barriers.
- Therapeutic Aids - aids, devices, and methods that assist in therapy treatments.
- Orthotics/Prosthetics - aids, devices, and methods that replace or augment missing or non-functioning body parts.
Assistive Technology Services
An assistive technology service means any service that directly assists an individual with a disability in the selection, acquisition, or use of an assistive technology device.
Examples of assistive technology services:
- Evaluation of needs of an individual
- Purchase, lease, or other acquisition of devices
- Selection, design, fit, customization, adaptation, application, maintenance, repair, or replacement of devices
- Coordination and use of other therapies, interventions, or services
- Training or technical assistance for individuals with disabilities and their families
- Training or technical assistance for professionals, employers, and other service providers
What is Assistive Technology?
Assistive technology is any piece of equipment or device that may be used by a person with a disability to perform specific tasks, improve functional capabilities, and become more independent. It can help redefine what is possible for people with a wide range of cognitive, physical, or sensory disabilities. In other words, assistive technology may enable a person with a disability to do something they normally would not be able to do on their own, such as:
- Fishing or boating.
- Talking on the phone.
- Opening a drawer.
- Cooking dinner.
- Buttoning a shirt.
- Reading their bank statement.
Assistive technology can include:
- Cognitive aids
- Feeding devices
- Adaptive toys
- Communication aids
- Alternate computer access
- Aids to assist with walking, dressing, and other activities of daily living
- Visual aids
- Aids to augment hearing
This technology may range from very low-cost, low-tech adaptations (such as a battery interrupter to make a toy switch accessible) to high-tech, very expensive devices (such as a powered wheelchair and environmental controller operated by tongue-touch).
People with disabilities may use assistive technology to:
- Participate in everyday activities.
- Play and enjoy recreational activities.
- Become mobile.
- Hear better.
- See better.
- Learn easier.
- Use a computer.
- Become more independent at mealtime.
Services related to assistive technology may include:
- Evaluation for appropriate equipment and systems.
- Assistance with purchasing or leasing devices.
- Selecting, defining, fitting, adapting, applying, maintaining, repairing, or replacement of equipment and systems.
- Coordinating other therapies.
- Training and technical assistance for individuals and their families, and for professionals.
- Assistive technology may be used at home, in the workplace, in the classroom and in the community to provide creative solutions in assisting individuals as they go about their activities of living, learning, working, and playing.
The Assistive Technology Mindset
Assistive Technology is so much more than finding the newest catalog and placing an order. Assistive technology is a complex issue for both consumers and service providers. Previous procedures and policies that provided services to people with special needs don't always work when assistive technology becomes part of the picture. Successful use of assistive technology means the creation of an entirely new mindset.
Waiting for the Next, Newer Model
Nothing is more disconcerting than purchasing a piece of technology that becomes obsolete in a week. People who are just getting into technology are particularly afraid of this possibility, so they frequently advise waiting "a month or two" until a new model is released. Invariably, just at that release, there is another, newer model on the horizon. The cardinal rule of dealing with any technology is that it will change. Purchasing a piece of technology is never a permanent solution.
The Importance of Independence
Some people with disabilities become dependent on other people to accomplish certain tasks in their lives. Assistive technology often offers people the ability to do these tasks independently. While the "doing" might be slower, especially in the beginning, independence created by the use of assistive technology is often viewed as "the least restrictive environment" and as a road to real independent living.
Augmentative and Alternative Communication
Augmentative and Alternative Communication (AAC) refers to any technique or aid that supplements, replaces, or enhances conventional communication methods, such as speech or writing. When a person is unable to communicate effectively with traditional methods of expression, these techniques are used to enhance (augment) or completely replace the individual's mode of communication. Most of us incorporate conventional AAC methods into our own communication, including hand gestures, facial expressions and head nodding. Telephones, TTYs, fax machines, computers, and typewriters are also used to communicate ideas and needs. These AAC methods are used by most of the general public. Many forms of AAC have been developed specifically for people with severe communication difficulties. These forms typically fall into two categories: aided techniques, such as communication boards and electronic devices, and unaided techniques, such as sign language and gestures.
The most effective and functional AAC intervention for an individual is determined through an assessment, and should always use the team approach. The inter-disciplinary team traditionally includes a speech-language pathologist, an occupational therapist, the individual and his or her family members, an educator and rehab engineer. The age, disability, and goals of each individual will determine the makeup of the assessment team. Physical therapy, vocational rehabilitation, psychology, social services, recreational therapy, vision therapy, audiology, and medicine are other disciplines that may be involved in the assessment. The individual and their family members are the most important part of the process, and should be included in all components of the intervention. This includes the needs assessment, defining goals, identifying characteristics or features that will best meet the individual's communication needs, and then matching these features to the most suitable or appropriate system. In addition, the assessment may provide information on funding sources, and make recommendations for training and follow-up services. All AAC assessments should be guided by the needs of the individual.
The purpose of the team assessment is to determine the communication needs of an individual based on their physical, cognitive, and language abilities, while also taking into account the environmental factors that will affect modes of expression. It is therefore very useful to perform the assessment in the environment or environments where the individual will be using the communication system. To enable the individual to communicate effectively, an AAC evaluation includes the following steps:
- Assess the individual's abilities: cognitive, sensory and perceptual, motor, speech, and language. If needed, the assessment should also include seating and positioning, literacy, and emotional status.
- Determine communication needs in the individual's environments. For example: identify communication partners; does the individual need to speak face to face, in front of a group, use the telephone, or write messages?
- Set functional communication goals and prioritize them.
- Identify technology features that would provide the support necessary to reach goals.
- Select, purchase, set-up, and customize the system. This involves integrating the system and related technologies into the individual's environment or environments.
- Train and develop skills for the individual, family members, and other communication partners.
Communication Modes: Low-Tech Communication Devices
This form of AAC typically refers to communication boards, displays, or wallets (manual indicating the use of the hands). Language is displayed using pictures, photographs, objects (e.g. soda can, cup, toy, candy bar), textures, letters of the alphabet, words, symbols, or any combination of these. This type of system is accessed by pointing; using a finger, headwand or light pointer, or eye-gaze to indicate needs and ideas. Typically, manual communication boards are used as an introduction to AAC and electronic devices, although they are not always a precursor to the use of high-tech devices. However, they have proven beneficial as a communication aid for individuals who are just beginning to recognize abstract concepts through pictorial representations; as a tool for emergent literacy; and for individuals who are functioning at a lower level, and/or are sensitive to, or do not respond well to auditory feedback. They are also a very important component for high-tech users, both as a complement to an electronic device and as a back-up system. These systems are fairly inexpensive and relatively easy to create.
These systems typically fall into two broad categories: dedicated communication systems and computer-based communication systems. Dedicated devices are stand-alone systems designed for communication. However, they incorporate voice and can include printers and other features. Computer-based systems are typically laptop computers that incorporate communication software and usually a speech synthesizer; and can be used for other applications as well as for communication.
For the majority of high-tech AAC devices, language is generated through pictures, symbols, traditional writing, or a combination of these. Pictures or symbols may be used to represent a word, phrase, sentence, or concept. These may be sequenced together, meaning two or more pictures are selected to create a phrase or sentence. Language is then spoken using either synthesized speech, digitized speech, or a combination. Synthesized speech uses a computer chip to generate spoken words from written text, based on phonetics. Digitized speech is an actual recording of an individual's voice, and requires more memory than synthesized speech. If digitized speech is the sole output method, however, it eliminates the ability to communicate spontaneously, since every word, phrase and sentence must be thought out beforehand and recorded into the device. Many devices allow language to be created on different levels. For example, the first level may be used to represent communication concerning activities at home; the second level for school activities; and the third level for church-related activities. The amount of language created utilizing different levels, in conjunction with sequencing, is limited only by the amount of memory in the device.
Other systems have a single level or overlay and allow generation of unique messages by combining or sequencing pictures in different ways. When traditional orthography is used messages can be spelled, or rate enhancement techniques such as abbreviation expansion or word prediction can be used. These types of features increase the cognitive and sensory/perceptual demands of the user.
Selection techniques for accessing communication systems are varied and often unique. With an appropriate access evaluation, a selection technique can be identified for anyone.
Direct selection means the individual can access the device using their hands, a head stick, mouthstick or other typing aid, or an infrared or light-pointing device.
Scanning is typically used by individuals who cannot directly select because of physical limitations. In visual scanning, the vocabulary on the communication device is highlighted in a predetermined manner (one cell at a time, by row then column). When the selection the individual wants to access is lit up, speech is generated by activating a switch. Or, the switch may be held down until the appropriate selection is highlighted. When the switch is released speech will be generated. Auditory scanning is an option for individuals who are blind or visually impaired. With auditory scanning, selections are verbalized to the user through a small, external speaker. When the message they wish to express is heard, it may be verbalized to the communication partner by activating a switch. Communication systems may also be accessed through other indirect means, such as a joystick or trackball.
The type of communication system selected for an individual will depend on their sensory, motor, language, and cognitive levels. Other considerations include the portability of the system, how it will be mounted and/or carried, and expected battery life. How well does it stand up to typical daily wear and tear (being dropped, exposed to fluids)? Does the manufacturer have a toll free number for service and technical assistance? Is the system easy to program and use? How easily can changes be made? What is the "growth potential?" That is; does the device have the capacity to grow as the user's needs change? It is important to look at the way the person is communicating now and to try and modify or blend some of those methods into the AAC system.
Assistive Technology at Home and in the Community for People who are Deaf and Hard of Hearing
Assistive technology plays an important role in the lives of people who are deaf or hard of hearing. At home, at work, or at a public facility such as a restaurant or hotel, deaf and hard of hearing people depend on technology throughout the day. Assistive technology for deaf and hard of hearing people can be divided into the following four categories:
- Devices for alerting or signaling.
- Devices for telecommunications.
- Assistive listening devices.
- Telecaption decoders.
Devices for Alerting or Signaling
People with typical hearing often take for granted the number of auditory signals that are part of everyday life. Alarm clocks, doorbells, telephones, and fire alarms are just a few of the auditory signals that may not be heard by people who are deaf or hard of hearing. To compensate for this, assistive technology devices are used to replace or supplement the auditory signal with a visual or vibrotactile signal. Some examples include:
- Alarm clocks: specialized alarms can produce a loud auditory signal, or may be connected to a bed vibrator or flashing light.
- Telephones: signals from the telephone can be either amplified or transmitted to a receiver resulting in a flashing light.
- Doorbells: the signal from the doorbell may be amplified or transmitted to a receiver resulting in a flashing light. The light may flash at different rates depending on the source (telephone or doorbell), or signals may be transmitted through two separate lights.
- Baby cry monitors: babies' cries or vocalizations are transmitted to a receiver that signals a flashing light or by vibration (worn on a pager-like device). Other signals, such as doorbells or telephones also may be transmitted as vibrotactile signals.
- Smoke alarms: alerting devices such as smoke or fire alarms are adapted with powerful auditory signals and flashing strobe lights.
Devices for Telecommunications
Using the telephone without the use of an assistive device can be difficult, if not impossible, for people who are deaf or hard of hearing. Some people who are hard of hearing simply need amplification to communicate on the telephone. Several options for amplification are listed below:
- A hearing aid equipped with a T-coil used in conjunction with a telephone that is hearing aid compatible.
- Amplified handset.
- Amplifying telephone.
- Portable add-on amplifier.
- Amplifier added to the phone line.
People who cannot understand on the telephone, even when the signal is amplified, may use a device called a TTY (TeleTypewriter). Using this machine, a message is typed, transmitted over the telephone line, and received by another TTY that displays the message. TTYs are available with various features including printer and answering machine. TDD (Telecommunication Device for the Deaf), and TT (Text Telephone) are other common names for this device.
If a TTY user needs to contact a voice user, or vice versa, the Arizona Relay Service is available to serve as an intermediary between the two parties. A Communication Assistant (CA) will convey the text signal to the voice user, and the voice message in a text to the TTY user. All information is confidential and accurate. The Arizona Relay Service also is ASCII compatible.
Assistive Listening Devices
The following devices amplify sound for live interaction or for listening to the television or stereo:
- FM system: the FM transmitter can be used by directly plugging into the television or stereo, or by having the microphone in close proximity to the speaker. The signal is then transmitted to a receiver which the listener can adjust to the loudness level needed for individual hearing sensitivity.
- Induction loop: an amplifier is connected to the television or stereo and the signal is transmitted on a loop of wire surrounding the area where the person is situated. This system can be used with a hearing aid equipped with a T-coil and T-switch or with an induction loop receiver.
- Infrared: the infrared transmitter uses infrared light to send a signal to the receiver worn by the listener. The listener can adjust the loudness level needed for individual hearing sensitivity.
Today, many television shows, advertisements, and videotaped movies are "closed captioned". This means that the dialogue of the program has been converted to text, but is not seen without the use of a telecaption decoder. Until recently, this device had to be purchased to decode the captions, but now all televisions with screens larger than 13 inches must have the decoder built-in. Telecaption decoders still must be used with small TVs and televisions made before 1993.
Facilitating Community Living With Assistive Technology
All of us choose to engage in a wide variety of community living activities throughout our day. We participate in these activities as part of our jobs, for enjoyment, to socialize with peers, or for leisure. Community living activities typically occur across a wide variety of environments and incorporate many different persons.
Community activities provide opportunities for engaging in meaningful and productive employment activities, socialization with age peers, and integration into leisure activities. These activities enable children to develop new cognitive, social, motor, and communication skills. For adults, community activities provide a means of socializing with peers, participating in and attending recreational activities, and accessing needed services.
Community integration is often overlooked or de-emphasized when developing programs to assist an individual with a disability. Access to community and leisure activities is not often included in educational or habilitation plans.
The impact of the disability often requires that major features of the environment be altered to match an individual's unique abilities. Assistive devices are frequently needed to compensate for physical, cognitive, or sensory impairments that prevent an individual from participating in leisure activities. Indeed, one of the principal purposes of assistive devices is to foster inclusion into community environments. Assistive technology has helped individuals move about and control aspects of their environment and participate in educational and vocational tasks. Assistive technology has also helped children with disabilities engage in leisure activities.
Frequently, assistive technology devices are not provided due to anticipated high costs or a lack of available resources. Although high technology is necessary in some cases, low-cost solutions are often available and can be implemented in a variety of community settings. An awareness of available assistive technology devices or knowledge of assistive technology solutions is a necessary first step in enabling individuals to participate in ongoing activities in home, work, and community settings.
High and Low Tech
High Tech or Low Tech? When you hear people using these terms, they are sometimes referring to the device's degree of complexity but more often to the cost or sophistication of a particular technology solution. Why all the talk? Like everything in life, assistive technology solutions come in all shapes and sizes -- and all costs. For example, when a person can't use a pencil, there isn't just one easy solution. The person might dictate to another person who does the writing, use a computer, use a low-cost word processor or typewriter, tape record his or her answers, or merely answer verbally. How then is the decision made? A series of considerations should be used by the person, team or agency in arriving at an assistive technology solution:
- How often does the person need help with this task?
- Is this a temporary task or will the person need assistance for many years to come? If this is a long term need, is there a device that will "grow" with the person?
- What is available?
- What is the user's preference?
- What has been tried and how has it worked? (Has there been adequate training and time given during this trial period?)
- Does a more sophisticated device meet not only this need but also several other needs?
- Which devices under consideration offer the greatest personal independence?
- How current is the assistive technology being considered? Is it likely that this particular model will be outdated in the immediate future? Is a deal on an older, out-of-date model really a deal?
- What are the preview policies of the manufacturer? What is the price point? If the device just does not work out as expected, can it be returned for credit?
VATS Information Technology Access/Information and Referral Program
The Virginia Assistive Technology System is pleased to offer the services of the VATS Information Technology Access/Information and Referral Program. This program offers in-depth information on AT devices, services, and funding to consumers, family members, professionals, employers, case managers, and other service providers. The information specialist collaborates with service professionals, vendors, and manufacturers to develop a statewide network of assistive technology vendors and to obtain information on new and emerging technologies.
In addition, program staff will provide technical assistance to agencies and organizations on electronic and information access, and address policy and technological issues related to the access to information technologies, including the Internet, by people with disabilities. You can speak with the VATS Information Technology Access/Information and Referral Program staff person directly by calling 1-800-435-8490 or contact them via email. The website on the VATS Information Technology Access/Information and Referral Program contains an information and referral form.