Evaluation & Assessment of Assistive Technology

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Posted by ICAN on January 17, 2003 at 22:11:00:

In Reply to: How to decide what technology is right for you? posted by Elizabeth on December 29, 2001 at 00:10:30:


Source: ICAN(Increasing Capabilities Access Network)

A good assessment matches a person with a disability to the best assistive technology and usually requires more than one evaluation. Each evaluation looks at specific things based on the individual's needs which may include augmentative communication, mobility, environmental control, recreation, or computer access. No one person can do an assessment for all needs, so a team of specialists is usually required. All team members work closely with one another and each team member makes a unique contribution. Not all specialists need to be available for a particular assessment. Team members may include:

* The individual with a disability and, where appropriate, family members or caregivers. They are the most important members of the team because they identify needs for technology and have a unique insight into what will work.

* The referral source. This is the person that contacts the assistive technology assessment center. The referral source may be a family member, school teacher, employer, or anyone else who interacts frequently with the individual and has specific information about the need and the environment.

* The Occupational Therapist (OT) evaluates hand (fine motor) and total body (gross motor) skills, touch and movement abilities, visual perception, positioning, and helps to find the person's best method to use assistive technology.

* The Physical Therapist (PT) evaluates seating, positioning, and mobility. The PT works closely with the OT and Speech-Language Pathologist (SLP) to find the best position for the person to be in when using the technology.

* The Speech-Language Pathologist evaluates the person's communication abilities. The SLP is very important in deciding the type of augmentative communication that will work.

* Other, more specialized team members may be needed. Rehabilitation engineers design and make customized technology. Architects plan any structural changes needed in buildings. Physicians write prescriptions for an assistive technology assessment and for recommended equipment. Audiologists assess and recommend hearing and listening aids. Rehabilitation counselors and social workers help find funding sources and help move the individual into the community.

The steps involved in the assessment process are:

STEP 1 - Referral
Locate a center that assesses the type of assistive technology needed. There are several centers in Arkansas that do assessments and they are listed at the end of this fact sheet. If an assessment is needed, the center needs information about the person with a disability including the person's age, diagnosis, medical information, and technology needs. When calling, be sure to ask the cost and what is included in the assessment. Ask if a doctor's prescription is needed. Ask if there is a waiting list.

If the person needing an assessment is in the public schools or is in vocational rehabilitation, the need for the referral should be put on the Individualized Education Program (IEP) or the Individualized Written Rehabilitation Plan (IWRP). This ensures a funding source is available.

STEP 2 - Team meeting
Once a referral is received, the assessment team meets to discuss the referral. If necessary, a team member may contact the person or the family to get more information such as a daily schedule and current use of aids or other assistive technology. This information is helpful in planning the evaluation.

Team members decide what members to include, when and where to do the assessment and the amount of time that will be required. The team will also discuss the types of technology that may be needed during the assessment. Ideally, the assessment is done in the individual's own environment. This allows the team to identify the strengths and needs in the actual environment where the devices will be used. sometimes, it is too hard to take everything the team might need, so the assessment would have to take place at the center.

STEP 3 - Evaluations
During the assessment, the team looks at the activities that the individual needs to do and the environment where these activities are done. This means assessing both the individual and the environment. The team members work together during the assessment. The team starts by talking to the individual, the family, and any other participants. The individual's and family members' inputs guide the assessment process. If the evaluation does not seem to meet specific needs, say so. The team observes the individual's seating and positioning. A more complete seating and positioning evaluation may be done if the current seating system is not working right. Next, a therapist evaluates the quantity and quality of the individual's :

* Posture, physical status including pressure sensitivity, sensation, muscle tone, range of motion, strength, and alignment.

* Specific gross and fine motor control, including specific hand skills and use.

* Method of mobility.

* Visual-perception skills and visual memory.

As these areas are evaluated, the therapist identifies motor movements the person could use to control technology devices.

An augmentative communication assessment requires all of the above and evaluating the individual's:

* Current method of communication including receptive and expressive language, speech, vocabulary selection, literacy skills, understanding of encoding strategies, use of gestures and facial expressions, and interactive language skills across partners and situations.

* Auditory perception and memory.

* Cognitive skills including the ability to handle codes that may be used to control augmentative communication devices.

The Environment Assessment is important because this is where the individual will use the technology. Work, school, and home environments have different needs. All must be considered. Space is the square footage available for the technology. At home, space is used by one person (my room). At school and work, space is not specific to an individual. Both should be considered.

* Accessibility is entering and performing in the environment alone and with the technology.

* Accommodation is the fit between the environment and the technology.

* Family needs include the ability of the technology to fit into the routine of the family.

* Peers, both co-workers or classmates, are affected by the technology. Sometimes technology is too noisy or disrupts the routines of the peers. The team will want to avoid adversely affecting others.

Other considerations include is the technology portable? Can it be moved by the individual, or does someone else have to move it? Is a support network available? Does the individual have peers or a teacher that will help the individual use the technology?

STEP 4 - Trying technology
During the assessment, the team will try different things to se how the person does. Sometimes a simple change in the way the individual does something is all that's needed.

If technology is needed, the team may recommend something from a store or through a catalog. Sometimes, technology needs to be very specialized which may require making modifications to a device or making one. This can be cheap or very expensive. Ideally, the team should recommend more than one type technology and where to buy it so that there's a choice. In addition, the team should remember that the simpler and more reliable the technology, the better.

STEP 5 - Written report
This is done 2-4 weeks after the last contact with the individual and has the results of the assessment and recommendations. If technology is recommended, it should include where to get it and its approximate cost. If the team recommends customized technology, the report will say who can make it, how long it will take, and what the cost will be.

The report must contain reasons for the technology and be written in terms of the function that the person can do with the technology. This will help in getting funding sources to pay for the technology.

STEP 6 - Follow-up
The team should check back with the individual to find out if the recommendations were acceptable. Sometimes, it takes six months to get the technology. Follow-up finds out if the individual got it or not or what else needs to be done to get it. If the individual has received the technology, the center will ask if training is needed for the individual, the family, and anyone the individual works with so that everyone knows how to use the technology. Sometimes, the assessment center will do the training. Other times, they will help someone that is closer to the individual to do the training.

If getting the technology takes a long time, the individual's needs may have changed and another evaluation may be necessary.

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