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Second Edition
Assistive Technology
for People with Disabilities
Diane Pedrotty Bryant
The University of Texas at Austin
Brian R. Bryant
Psycho-Educational Services
Boston Columbus Indianapolis New York San Francisco Upper Saddle River
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Credits and acknowledgments for material borrowed from other sources and reproduced, with permission, in this
textbook appear on the appropriate page within the text.
Every effort has been made to provide accurate and current Internet information in this book. However, the Internet
and information posted on it are constantly changing, so it is inevitable that some of the Internet addresses listed in
this textbook will change.
Copyright © 2012, 2003 by Pearson Education, Inc. All rights reserved. Printed in the United States of America.
This publication is protected by Copyright, and permission should be obtained from the publisher prior to any
prohibited reproduction, storage in a retrieval system, or transmission in any form or by any means, electronic,
mechanical, photocopying, recording, or likewise. To obtain permission(s) to use material from this work, please
submit a written request to Pearson Education, Inc., Permissions Department, One Lake Street, Upper Saddle River,
NJ 07458 or you may fax your request to 201-236-3290.
10 9 8 7 6 5 4 3 2 1
This textbook is intended to provide readers with a wide range of information about assistive
technology adaptations with an emphasis on devices and services. Assistive technology (AT) is
an area that is characterized by rapid development and innovation as a result of work done by re-
searchers, engineers, educators, users and families, therapists, and rehabilitation specialists to in-
form and provide better and more promising devices to meet the needs of technology users. We
know more than ever about the benefits of assistive technology to enhance the lives of individu-
als with disabilities to promote independence, access, and equity.
• We included a case study in Chapter 3 to help the reader learn about the application of the
assessment process to the identification and evaluation of assistive technology devices for
individual users.
• We added newer concepts such as universal design, information about the Independent
Living Movement, information about efficacy, and vocabulary.
FEATURES
There are several noteworthy features that are intended to enrich the content and assist readers in
learning about assistive technology adaptations. First, we have included instructional features
such as Objectives, Making Connections, Scenario Applications, and Discussion Questions to
help readers think about the content before and after reading each chapter. Second, we have in-
cluded Personal Perspectives that highlight the viewpoints of individuals who use technology,
have children who use technology, provide professional development, and/or serve as advocates
for assistive technology. We think this feature helps to personalize the information presented in
the chapters and illustrate the impact of assistive technology on the lives of individuals who ben-
efit most. Third, we have included updated pictures of devices and URLs to help readers go on-
line to see and read about new technologies. We think providing URLs is a good way to help
readers stay apprised of current and new technologies. We hope these features will promote read-
er activity and connections with the content.
mobility, communication, and access to the information pervasive in our society—these are basic
life requirements. We provide a chapter that focuses on assistive technology during the school
years because of the importance of ensuring that all students have access to the curriculum and
that teachers examine ways to make instruction more meaningful for learning. Finally, we con-
clude the book with a chapter on independent living. We think this represents a good culminating
chapter that focuses on how assistive technology is applicable across all environments. We hope
you enjoy the book!
ACKNOWLEDGMENTS
When we started revising our book on assistive technology, we were struck by the considerable
amount of “new technologies” that have emerged for all consumers and more specifically for in-
dividuals with disabilities. One of the biggest challenges with this revision was to identify con-
tent that would not be outdated immediately. We hope that we have captured the “big ideas” in
assistive technology and that the examples we provided will illustrate the ideas successfully.
Throughout this book, you will read Personal Perspectives and references to a number of our col-
leagues whom we have met and worked with over the years. Their perspectives, we believe, en-
rich the content of this text, because they speak to the issues, challenges, and “new technologies”
from their vantage point, whether an educator, a parent, a researcher, and most importantly as a
user of AT. We acknowledge and thank our Personal Perspective authors: Diana Carl, Anne
Corn, Lewis Golinker, Mike Haynes, Tony “Mac” McGregor, Robin Lock, Peg Nosek, Bonnie
O’Reilly, Mark O’Reilly, Penny Reed, Sam, and Jamie Judd-Wall. We believe that the reflections
offered in the Personal Perspectives will help readers understand the application of assistive
technology from different viewpoints.
We also acknowledge our coauthors in several of the chapters. Their assistance in revising
the content is deeply appreciated, and their work strengthens the book. We thank Guliz Kraft,
Robin Lock, and Minyi Shih. In addition, we recognize Joy Zabala, Tricia Legler, and Marshall
Raskind, three friends, who have taught us much about assistive technology from their profes-
sional and personal experiences working with AT users and their families. Much of what we
know has come from working closely with these three professionals.
We also express our appreciation to our editor, Ann Davis, and Penny Burleson, editorial
assistant, for their assistance, support, and patience. We acknowledge and thank our reviewers,
whose insight and helpful feedback strengthened the content of this book. They offered many
thoughtful comments, suggestions, and feedback that addressed the areas that required attention
in this revision. We are deeply indebted to them for their time and expertise. Thank you to Emily
C. Bouck, Purdue University; Kristy K. Ehlers, Oklahoma State University; Linda Mechling,
University of North Carolina—Wilmington; and James Stachowiak, University of Iowa. We
hope that the combined efforts of all we have mentioned have made this book an informative and
pleasant reading experience for you.
Finally, we would like to acknowledge the students and parents with whom we have
worked over the years. They are the people who are most affected by AT’s promise. They have
taught us much over the years, and we hope that, for them, AT eventually fulfills its potential as
a tool for accessibility and full participation in all of life’s activities.
This page intentionally left blank
CONTENTS
ix
x Contents
Casters 94
Hand Rims 95
Other Features 95
Seating and Positioning Issues 95
• Personal Perspective 4.2 95
Other Seating and Positioning Issues 101
Summary 101 • Scenario Applications 102
• For Discussion 103 • References 103
Telecommunication 139
Telephones 139
Internet Access 140
Listening and Print Access 141
Listening Aids 141
• Personal Perspective 6.2 142
Print Aids 145
Summary 149 • Scenario Applications 149
• For Discussion 150 • References 151
Chapter at a Glance
ACCESS AND INDEPENDENCE
• Personal Perspective 1.1
ASSISTIVE TECHNOLOGY DEFINED
HISTORICAL OVERVIEW OF ASSISTIVE TECHNOLOGY
• Personal Perspective 1.2
MULTIDISCIPLINARY NATURE OF ASSISTIVE TECHNOLOGY SERVICE PROVISION
Objectives
1. Examine definitions of key assistive technology terms.
2. Demonstrate knowledge concerning the history of assistive technology.
3. Identify key professionals involved in assistive technology service delivery.
MAKING CONNECTIONS
Think about how inventions have changed people’s lives over the past 100 years. Some inventions,
such as automobiles, computers, the Internet, microwaves, televisions, refrigerators, and airplanes,
have dramatically altered our way of life. Others, such as remote control units and electric devices,
ATMs, and digital networks, have certainly made our lives easier on a daily basis. Now, think about
people you know with disabilities that could be developmental, acquired, or part of the aging
process. What special needs do these people have, and what devices do they use to access various
environmental contexts? Think about inventions that make things possible for people with disabili-
ties—for example, think about an aging grandparent who might use a remote control to turn on the
lights because of difficulty with standing and walking. Consider the ramifications to access and
independence if those inventions did not exist for people with disabilities. Now, recall legislation that
has been passed to help secure people’s civil rights. How might these laws apply to people with dis-
abilities? What laws are specifically designed for people with disabilities?
1
2 Chapter 1 • Introduction to Assistive Technology Devices and Services
In this chapter, we provide background information that sets the stage for the central themes (i.e.,
access and independence) that run throughout this text. In this chapter, we (a) introduce and dis-
cuss the concepts of access and independence; (b) define assistive technology (more specifically,
AT device, AT service, and instructional technology); (c) provide a historical overview of AT
development; and (d) discuss the multidisciplinary nature of AT service delivery.
would have severe and profound disabilities. She was being fed by tube and the doctors did not
anticipate that she would be able to suck a bottle or that we would be able to care for her at
home. We were asked to plan our next step and decide whether we would take her home or
place her in an institution. After considerable reflection and discussions with our doctors, family,
and friends, my husband and I decided that we would never know if we could care for her at
home unless we tried. That decision was made some 37 years ago and was the best decision of
our lives. During her first year, every cold would send her back to the hospital so we could not
take her out in public and had to screen everyone’s health that came over to the house. Today,
Dana uses a power wheelchair for mobility; she has cerebral palsy, seizures, and her right arm
doesn’t work well for her. However, what one will quickly discover is that her speech is not
involved; and when you talk with her, you will find out she does not consider herself “disabled.”
She does not like to be defined by her disability or categorized as disabled. Dana is very much a
self-confident individual with her own mind. One of Dana’s primary characteristics is that she is
quite social and makes friends easily. She has physical challenges but actually lives a physically
active and independent lifestyle. Swimming is her passion and her outlet from the wheelchair.
Year round she swims about 30 to 50 laps usually six days a week. Many people that we meet,
particularly at the health club, say that Dana has been an inspiration to them and they often nick-
name her the “Energizer Bunny.”
After 30 years in special education, I retired from Region 4. I continue to serve on national,
state, and local advisory boards and frequently present at conferences. As a consultant, I have been
contracting with the Center for Applied Special Technology (CAST) and working as the Special
Project Coordinator of the AIM [Accessible Instructional Materials] Consortium. I am a founding
member of the Quality Indicators in Assistive Technology (QIAT) Consortium and have served on the
QIAT Leadership Team for the past 10 years. Recently, I have been working with the National
Assistive Technology Technical Assistance Project at RESNA [Rehabilitation Engineering and Assistive
Technology Society of North America] to develop quality indicators for service provision for the
Assistive Technology Act state programs. As it turns out, I am not really retired, just repurposed.
You have worked in assistive technology for much of your career. What
changes have you seen that can be directly attributed to legislation?
The most profound changes in AT have occurred as a result of the Individuals with Disabilities
Education Act (IDEA) and its subsequent reauthorizations. My colleagues and I often talk about
the “legal evolution of access.” From the passage of the Education for All Handicapped Children
Act (EHA), Public Law 94-142, in 1975 to the present, public schools have been responsible for
providing each student with a disability a free, appropriate public education (FAPE). In 1975, EHA
provided “access to schools,” as prior to that time, many children with disabilities were not per-
mitted to attend schools. In 1990, EHA was reauthorized as the Individuals with Disabilities
Education Act (IDEA). At that time, although students with disabilities routinely attended school,
they were mostly educated in separate classrooms and facilities. IDEA (1990) provided “access to
classrooms” as it required students with disabilities to be educated with their general education
peers. By the reauthorization of IDEA in 1997, Congress was dissatisfied with the limited aca-
demic progress of students with disabilities. Although students were largely being educated in
the same schools and same classrooms as their peers without disabilities, their educational pro-
grams were designed specifically to meet their individual needs and generally were not correlated
with the general education curriculum. Therefore, IDEA (1997) emphasized “access to the gen-
eral education curriculum,” which may necessitate AT devices and services. As the perception
of what constitutes FAPE continues to evolve, in the reauthorization of IDEA in 2004, emphasis
was placed on “access to instructional materials.” This emphasis provides students who are
unable to read or use information through the use of traditional print materials with accessible
instructional materials appropriate to their individual needs. IDEA (2004) includes requirements
for state and local educational agencies to ensure that, when needed, textbooks and related core
instructional materials are provided to students with print disabilities in specialized formats in a
timely manner. The four specialized formats are Braille, audio, large print, and digital text. In most
instances, assistive technologies are needed for students to be able to use the materials in the
specialized formats. For example, digital text can be used on the computer with various reading
programs that allow the student to manipulate features and functions such as text size, text and
background colors, text-to-speech, and learning supports.
As we look forward to the future for today’s students with disabilities, we can be greatly
encouraged by the opportunities available to them through access to the schools, the classrooms,
the general education curriculum, and instructional materials. I am hopeful that Congress will
continue to provide legislation that strengthens the rights of students with disabilities to the same
education the other students receive and the provision of quality AT devices and services that are
needed to support them.
What are the most critical issues that will be faced by AT providers
in the near future?
Accountability continues to be a critical issue. Educators are increasingly being held accountable
to ensure that all students are learning. How to effectively include students with disabilities in the
Chapter 1 • Introduction to Assistive Technology Devices and Services 5
accountability system continues to be a challenge. Many states limit the allowable accommoda-
tions that can be used on the tests, and frequently AT is not allowed. It is often perceived as being
an unfair advantage. The definition of an accommodation is that it does not invalidate the nature
of the task or the construct that is being measured. It stands to reason that if the AT is truly an
accommodation, then its use should be allowed.
Another issue focuses on when AT is included in the IEP [Individualized Education Program],
the effectiveness of its use must be evaluated on a trial basis before adoption is recommended.
Prior to the use of an AT device, the team supporting that student will need to determine how
they will know if the trial is successful. Then, with clearly defined roles and responsibilities, the
team members will want to collect implementation data.
Yet another issue relates to the increasing national emphasis on universal design and uni-
versal design for learning, which may blur the lines between what is instructional technology
(used in general education) and AT (specifically required for a special education student). As class-
rooms increasingly incorporate universally designed technology, many of the features needed to
support learning will be available to all with the result that more students, who would otherwise
struggle and go through a cycle of failure, are successful at the outset and fewer will be referred
to special education services. It is important to remember that universally designed technology
meets the needs of many but does not meet the needs of all. There will continue to be a need for
AT for the specific needs of some of the students. For example, a student who is blind may need
a Braille note-taker with a refreshable Braille display, which would not be included in the class-
room technology infrastructure.
Finally, the connection between AT and the Response to Intervention (RtI) initiative, which
was spurred by IDEA (2004) as a means for identifying students with learning disabilities, remains
relatively unexplored and a challenging issue for educators. The critical question that needs to be
addressed by national, state, and local education agencies is the role of AT in the RtI process,
which includes prevention and intervention practices.