Assistive technology evaluations can be requested when there is reason to believe that a child may benefit from the use of AT. AT evaluation are to be completed by a credentialed evaluator as in most situations the AT request is for a new AT item or
service. The need for AT devices/services may be identified:
- As part of the initial multidisciplinary evaluation, where the credentialed evaluator determines a need that can be addressed when eligibility is determined;
- As part of a supplemental evaluation included in the child's IFSP based on an anticipated or emerging need and as agreed upon by the team;
- Through the ongoing assessment process conducted by the child's provider(s) if they are a credentialed evaluator.
Note: Reimbursement for evaluations is done through the evaluation code for the specific provider type.
Assistive technology evaluations differ somewhat from "typical" evaluations conducted as part of eligibility or review of a child's needs and strengths. There are virtually no standardized tests to "find out" what kind of technology a child needs to
use. Instead, a good assistive technology evaluation looks at the results of all recent evaluations, along with the current IFSP goals and objectives. The evaluator should talk with the child's parents, interview people who work with the child, and
interact directly with the child and the devices. The environment should be carefully examined, especially when the device has to work in a variety of settings.
The actual evaluation process consists of considerable observation coupled with trials with a full range or continuum of possible devices from low to high technology. Data is gathered from these trials about the effectiveness of various technologies
to meet the child's needs.
Information is collected concerning the child's ability and accuracy when using various technologies, including the positioning and settings that work best. The child's and family's feelings about the actual devices tried should be considered, as even
very young children can show what they like and dislike by how they interact with different devices.
As the number of devices and the complexity of those technologies have grown exponentially in the past few years, many people who work extensively in this area have found the need to specialize in different areas of assistive technology. Typically,
these people have expertise in areas like assistive computer technology, augmentative communication, mobility and positioning and so forth. Other assistive technology experts specialize in age or disability-specific technologies, such as visual and
hearing impairment devices.
Components of an Assistive Technology Evaluation
The four principles to consider when evaluating the potential for AT solutions should include:
- Use of the multidisciplinary team.
- Family members are a crucial member of the team
- Focus on function - "What is it that the child needs to do that he/she currently cannot do?"
- Strive for simplicity.
Team members should have a basic understanding of the kinds of AT that exists and how it can be used to help a child achieve more independence and control of his/her environment. The team assessing AT needs should address the following:
- Current developmental needs and functioning of the child. Consideration should be given to the recommendation of the most appropriate device for the child's current development. Because technology devices and the needs of a child and
family change, devices should be used to enhance the child's current development and functioning, addressing immediate needs and the appropriateness of the equipment in attaining outcomes that address the development and functioning of the child.
- Cognitive and emotional resources. This should include assessing the child's ability to understand language, respond to prompts and trials, ability to make choices and the ability for social interaction. The child's response to
stimuli and reinforcers, distractability and attention span need also be considered.
- Health and development. Statements regarding child's current health status, vision, hearing, and motor status should be included.
- Needs of the child and family. Consideration should be given to devices that can fit easily into the family's lifestyle and will have the optimum functional and developmental impact on the child.
- Equipment and device options. Consideration should be given to whether outcomes can be accomplished through the creative use of existing resources (e.g. household items, toys, etc. currently available in the home), loan programs or
low-technology devices and other less intrusive option, prior to progressing to high technology equipment.
- Use of equipment. Consideration should be given to devices that are needed to help achieve a specific functional outcome and are not therapeutically "nice to have." Equipment should be used to achieve a functional goal that will
improve a child's development. Utilization of current equipment in the home should be documented as well.
- Proper recommendation for the device. Consideration should be given to using a team which includes the parent, Service Coordinator, other early intervention service providers and the AT specialist to ensure a common understanding of
the recommendation for a particular device or characteristic of the type of AT device.
- Use of loan equipment. Checking out equipment from available local lending libraries or accessing local Lekotek programs is strongly recommended to ensure the appropriateness of the device prior to purchase. The Illinois Assistive Technology Project
(IATP) can answer questions regarding specific AT needs and a comprehensive directory available to assist in locating equipment and funding. IATP can be reached at 800-852-5110 or on the web at www.iltech.org. If
equipment is needed for short-term use, utilizing equipment in this manner rather than purchase is strongly recommended.
The AT evaluation report should include information listed above and any other pertinent information regarding the reasons for evaluation, background of the child, observations of the child in the natural environment(s), observations of the child
using currently available technologies, and observations of the child using a variety of possible AT options.
If the report recommends AT, it should include a full range of options or minimum specifications for equipment and a detailed justification if one device is recommended over all other choices. Equipment choices should consider current equipment, as
well as high and low-tech options. Funding options must also be included as well as information about vendors and possible repair and maintenance providers.
There are a number of questions that the IFSP team including the family should answer when deciding about the inclusion of AT in a child's IFSP based on the conclusions included in the evaluation report.
- What are the parent's goals for their child? Is any AT necessary to meet the parent's current goals?
- What are the skills, needs, and likes of the child?
- What problem will the AT device solve?
- Will the proposed solution enable the child to function more independently and/or more successfully?
- What is the ability of the child to independently and successfully learn and use the device?
- Are there implications for the child's health status (e.g. effects of required positioning on respiratory or cardiac status)?
- What are the limitations of the device?
- Are there a number of equal device options for consideration?
- Why is this technology more appropriate than other low-tech or no-tech alternatives?
- How flexible is the device? Can it grow with the child's needs and abilities?
- Is there a way a currently available piece of technology can be modified to meet the need?
- How useful will the technology be with the other devices the child currently uses?
- Does the family (or child) like or have other feelings about the device?
- Are the size and weight of the device important issues?
- If the device is carried between home and other settings, what precautions need to be made?
- Have all the functional environments of the child's use been considered? What are the child's home and family activities?
- Is the device safe and/or sturdy?
- Is the technology current enough to provide service and part options for the immediate future? How easy is it to obtain repairs?
- Has the device been on the market long enough to establish itself and for problems to have been worked out?
- Has there been or is there a possibility for an adequate trial period?
- Is the device available?
- What is the expected lifetime and duration of use for the device?
- Can the device be used for a number of different tasks?
Parents play a vital role in the choice, implementation, and use of AT. They should be involved with choosing, adapting, routine maintenance, training, and on-going assessment associated with the child's use of the devices. They are also vital in
sharing their dreams and visions for their family and the child so that the team can better determine what kind of technologies would best suit their child.