2) Assistive Technology Devices

Assistive technology devices range from low technology to high technology items. Low technology devices are devices that rely on mechanical principles and can be purchased or made using simple hand tools and easy to find materials, such as homemade or modified items already used in the home. High technology devices include sophisticated equipment and may involve electronics.

Consideration of the types of AT devices and services available through this system is continually monitored. Determination of what equipment and services falls within these guidelines will be updated periodically as these considerations are reviewed. Eligible devices and services refer to items and services for which payment can be made. A written recommendation (order), signed and dated by the child's physician (often a prescription form) is required for all items requested.

Early Intervention deals only with AT that is directly relevant to the developmental needs of the child and specifically excludes devices and services that are necessary to treat or control a medical condition or assist a parent of caregiver with a disability. Equipment/devices must be developmentally and age appropriate to be considered eligible for Early Intervention funding.

The following sections address those items currently eligible for Early Intervention funding and those items that are not considered eligible under the definition of AT.

Information contained in this document supercedes any previous decisions regarding approval of specific AT equipment or services

Eligible Services

As the term AT covers so many different types of devices, it is often useful to divide the devices into functional categories. The following are examples of the types of AT devices that may be provided to eligible children and their families under this program. The AT available to young children is changing and expanding at a rapid pace, and it should be noted that this list is not an exhaustive list of AT devices, but is intended to provide guidance. There may be other items not listed that would appropriately meet the needs of children in this program.

Available assistive technology include:

• Aids for Daily Living. Self-help aids are designed for use in activities such as bathing, eating, dressing, and personal hygiene. Ex.: Bath chairs, adaptive utensils.
• Assistive Listening. Assistive listening devices to help with auditory processing. Ex.: hearing aids.
• Assistive Toys and Switches. Because "play" is the work of infants and toddlers, assistive devices such as switch-operated toys serve a vital role in the development of young children with disabilities. Playing with switch-operated toys helps build important cause and effect and choice-making skills that prepare a child for communication aids and computer use. Ex.: Single-use switches, switch battery adapters, switch adapted toy items.
• Augmentative Communication. Augmentative communication devices are devices that should be used across all the natural settings so that the child learns how to communicate with a variety of different people in different circumstances. The inclusion of a variety of different augmentative communication strategies is particularly important for young children and may include a program that uses signing, device, gestures, and communication pictures and boards. Ex.: Symbol systems, picture or object communication boards, electronic communication devices, and communication enhancement software.
• Computer Access. There are a wide variety of technologies that provide access to the computer. Once an access method has been determined, then decisions can be made about input devices and selection techniques. Input devices can include switches, touch windows, head pointers, etc. In some cases, access to keyboards can be improved by simple modifications such as slant boards, keyguards or keyboard overlays. Output devices include any adaptation that may be needed to access the screen display. Computer technology can help very young children acquire important developmental skills and work toward their individual goals. A variety of software programs have been developed for this population. These programs help infants and toddlers learn and practice cause and effect, early choice making, and build fine motor and visual motor skills.
• Mobility. Mobility devices include braces, certain types of orthotics, self-propelled walkers and crawling assist devices.
• Positioning. Proper positioning is important so that a child can interact effectively in their environment and to aid in promotion of the child's physical development. Proper positioning is typically achieved by using padding, structured chairs, straps, supports, or restraints to hold the child's body in a stable and comfortable position. Also considered is a child's position in relation to family or peers. Often, it is necessary to design positioning systems for a variety of setting so the child can participate in multiple activities in their natural environment. Ex.: Standers, walkers, floor sitters, chair inserts, trays, side-lyers, straps, rolls, weighted vests and garments, etc.
• Visual aids. General methods for assisting with vision needs include increasing contrast, enlarging images, and making use of tactile and auditory materials. Devices that assist with vision may include optical or electronic magnifying devices, low vision aids such as hand-held or spectacle mounted magnifiers, and vision stimulation devices such as light boxes.
• Repair and Maintenance. Repair, alteration and maintenance of necessary equipment. The provider is responsible for the fulfillment of all warranty service and warranty repair.

It is important to realize that within each of these categories, there is a continuum of device choices from simple to complex that should be considered when trying to find the AT to use with a particular child for different tasks and in different settings.

When an infant or toddler's needs are being assessed for the possible use of AT, there are usually a number of options that can and should be explored. The selection of devices should always start with simpler, low or mid tech tools to meet the child's needs. If a low-tech device, such as a laminated picture for making a choice, meets the child's needs, then that should be the device provided. Different devices from across the continuum should also be carefully matched to the different environments in which the devices will be used, appreciating that while a device may be useful in one setting, it may not be appropriate or effective in other settings.

When choosing a device, it is important to note that trials with a variety of different devices can actually help determine the child's needs, preferences and learning styles.

Limitations

• EI reserves the right to limit items of the same or similar nature such as switches, adapted switch toys, adapted utensils and tableware, computer software, therapy balls, rolls, bolsters, wedges, sensory items, etc.

Certain equipment/services are not covered in the scope of AT and payment will not be made for their provision. The following are examples of devices or services that are not considered AT under this program.

• Equipment/services that are prescribed by a physician, primarily medical in nature and not directly related to a child's developmental needs. Examples include but are not limited to helmets, oxygen, feeding pumps, heart monitors, apnea monitors, intravenous supplies, electrical stimulation units, beds, etc.;
• Devices requested for children 2 years, 9 months of age and over, as equipment requested during this time would not be available long enough to achieve identified outcomes. Request must be on the IFSP prior to 2 years, 9 months and received for review prior to 2 years, 10 months;
• Equipment/services for which developmental necessity is not clearly established;
• Equipment/services covered by another agency;
• Equipment/services where prior approval (when applicable) has not been obtained;
• Typical equipment, materials, and supplies related to infants and toddlers utilized by all children and which require no special adaptation. Examples include clothing, diapers, cribs, high chairs, car seats, infant swings, typical baby/toddler bottles, cups, utensils, dishes, infant monitors, etc. Toys that are not adapted, used by all children and are not specifically designed to increase, maintain, or improve the functional capabilities of children with disabilities include such examples as building blocks, dolls, puzzles, balls, ball pits, tents, tunnels and other common play materials;
• Standard equipment used by service providers in the provision of early intervention services (regardless of service delivery setting), such as therapy mats, tables, desks, etc;
• Seating and mobility devices such as car seats, strollers, wheelchairs or any part thereof;
• Equipment/services which are considered duplicative in nature, generally promoting the same goal and/or objective with current or previously approved equipment/services;
• Equipment/service if a less expensive item or service is available and appropriate to meet the child's need;
• FM systems;
• Replacement equipment if original item has not been returned to vendor or if payment for equipment has not been returned to the CBO by the supplying vendor;
• Sales tax, shipping and handling charges.