Assistive Technology program focuses on training and systems change

However, as is often the case with assistive technology, people who need these devices encounter difficulty in obtaining and using them. Barriers such as lack of funding or lack of training and other support services get in the way.

Assistive technology is any device or equipment that a person with a disability can use to more fully participate in school, work, home and community activities. Hundreds of technology-based solutions can assist people with various types of disabilities in performing tasks of daily life. In addition to computers with adaptive hardware and software, there are communication devices that synthesize speech, pagers that serve as memory prompts and motorized wheelchairs, to name but a few. Assistive technology also includes services such as evaluations to help select an appropriate device and training to use a device.

The Assistive Technology Resource Center (ATRC), a component of CHDD's University Center for Excellence in Developmental Disabilities (UCEDD), focuses on increasing access to assistive technology for people with disabilities of all ages. Directed by Dr. Kurt Johnson, associate professor of rehabilitation medicine and head of the Division of Rehabilitation Counseling, the ATRC is funded by the federal Administration on Developmental Disabilities and, as a partner in the Washington Assistive Technology Alliance (WATA), by the National Institute on Disability and Rehabilitation Research (NIDRR).

The ATRC addresses barriers that arise from lack of knowledge about assistive technology through a multi-faceted training program for service providers and consumers. The ATRC works to overcome barriers related to funding and policy issues by conducting policy analysis and fostering systems change in partnership with WATA.

"The 'Assistive Technology for Kids' bill is a prime example of our systems-change efforts," says Johnson. "And, it is an issue that illustrates the critical links between training and systems change, because no matter how much training we do, system barriers can get in the way of people being able to use it."

The legislation, sponsored by WATA and prepared with technical assistance from the ATRC, was passed by the Washington state legislature during its 1997 session. It allows school districts to sell, transfer or lease assistive technology to parents, other school districts or not-for-profit agencies serving people with disabilities. Prior to the new law, when a child who used assistive technology owned by the school district moved from one school district to another, or graduated from high school, there was no mechanism for the child to take the device along. Since schools were reluctant to invest in equipment that might have a limited use, there were difficulties reconciling differences between the individual needs of a child and the institutional responsibilities of the school.

"This bill allows the school to depreciate the cost of the device and sell it to the family, which means the school district recovers some funds, and the family is able to own a device," explains Johnson. "It also takes care of some problems for schools when they have a child with a low-incidence disability. The district can purchase a device that meets that child's needs, knowing the device can go along with the child or to another district or agency that could use it."

The ATRC has its roots in a training program begun by Johnson and his colleagues to integrate assistive technology training for UW graduate and undergraduate students, working professionals and consumers. Training takes place in a variety of settings and each year involves nearly 2,000 people who either use assistive technology, provide related services or are preparing to become service providers.

"We started in 1991 when we were awarded our first UCEDD Assistive Technology training grant," says Johnson. "Shortly after that we also received support from a NIDRR-funded Careers in Assistive Technology grant to the Department of Rehabilitation Medicine. With support from both funding sources we were able to put together a comprehensive program to provide interdisciplinary training in assistive technology for students in speech pathology, special education, social work, occupational therapy, physical therapy and rehabilitation medicine."

The training program now includes an online course in augmentative and alternative communication taught by Dr. Patricia Dowden, clinical assistant professor of speech and hearing sciences. According to student evaluations, a key aspect of the course has been participation by users of assistive technology as instructors. "We've hired two guest lecturers who have cerebral palsy and use augmentative communication devices and powered mobility," says Johnson. "They interact with students in the class through e-mail discussions and share the expertise they've gained from their personal experiences with communication devices and the service delivery system."

Offering courses over the Internet with meetings in a "virtual" classroom (via e-mail discussion groups) has several benefits, according to Johnson, including availability to people who live in outlying areas or for other reasons have difficulty taking an on-campus course. A specific benefit of using e-mail for course discussion or other types of communication is that it renders a person's disability irrelevant to interaction with others.

Outreach training that incorporates a mini-consultation process is another major emphasis of the ATRC. "An example is continuing education workshops for special education professionals where we conduct sessions in which a K-12 student with a disability and his or her family work together with us as we model the consultation process," explains Johnson. "We talk with the student and family for about 30 minutes, trying to elicit the major issues and come up with strategies for addressing those issues. Trainees, seated around us, are welcome to ask questions and participate. We try to teach people to ask appropriate questions, generate hypotheses and do creative problem solving. We also emphasize that as they consider assistive technology questions they should think about not only the technology, but also the psychoeducational, environmental and family issues involved."

Another form of outreach training involves demonstrating specific devices, says Johnson. "For example, we put together a two-day workshop for computer information consultants with the Washington Division of Vocational Rehabilitation whose jobs involve providing technical assistance with computer-related assistive technology purchases. We set up a laboratory with computer stations with all kinds of adaptive software, gave them a didactic overview and some pretty specific hands-on training on different computer access devices. And, because none of us believes in one-shot training, we set up an online forum to support them."

Online technology plays a large role in the ATRC's training and systems change efforts. The WATA Web site (http://wata.org), managed by Dagmar Amtmann, ATRC project manager, is an extensive information resource and a forum to facilitate advocacy and systems change. The site includes up-to-date reports on legislative activities related to assistive technology and disability policy, funding tips and a directory of disability-related legal advice and services. It offers direct access to the Assistive Technology Discussion Forum, a networking resource for consumers, their families and service providers. The WATA Web site also features articles describing various types of assistive technology, information about where to go for products and services, and a link to the AT-Exchange, a searchable database designed to link a person or an agency with an assistive technology device they no longer need with a person who can use it.

ATRC work related to information technology also includes a joint effort with WATA to raise awareness about barriers to accessibility in online information. "We're talking about a different incarnation of architectural barriers, except they appear online," Amtmann points out. One example is flashing graphics, which capture the focus of a screen reader and deny access to a Web site for many users of assistive technology who are blind.

The accessibility issue is especially crucial for state agencies that provide public information online, notes Amtmann. The ATRC provides free consultation to disability-related not-for-profit and state agencies, including libraries, to establish policies that assure their Web sites are accessible to people with different functional limitations. "If you build a spiral staircase, you won't get a motorized wheelchair up it, and if you build a spiral staircase in your information platforms, you won't reach a person who uses an alternative input or output device. It costs a lot more to remove the spiral staircase and replace it with something that is accessible than putting in something that is accessible right from the beginning."