Current Issues

The concept of team assessment, whether joint assessment(s) or combined individual assessments, continues to be essential in the service delivery process. The earlier concept of a “complete team” that is responsible for assessment, with referral to other individuals for training and service delivery, has given way to the idea of team-member involvement as needed for the individual student's technology issues. In other words, team members are identified who have the in-depth knowledge needed for a child's specific problem areas or the ability to provide assessment and training information in those particular areas. They may then relinquish direct involvement as the technology plan progresses. For this process to be cost effective and productive, team development of technology plans must reinforce the idea of identifying and using individuals with specialized knowledge in the needed area and allowing them time to develop the assessment, training, and service delivery process. All this information must be considered in the development of the IEP.

Many schools do not have an assessment team with competency in assistive technology services. Teams that do exist often do not focus on functional issues, but rather are driven by technology. Assessment teams often do not participate in intervention and therefore do not see if the systems work. Recommendations are sometimes made on the basis of the present limitations of the student, rather than on the student's future potential. By underestimating the student's ability to progress in specific skills, the team may recommend a limiting system or make recommendations based on equipment availability.

Inappropriate or inadequate assessments often lead to poorly drafted IFSPs/IEPs/ITPs. If a student's ability is consistently underestimated, the goals will be similarly limited and education placements may be inappropriate. Goals must be measurable and give an indication of the student's behavior or skill level over the course of a year. Technology must be written into the document and goals need to be specific and descriptive. The IEP should be clear with regard to how and why technology will be used to achieve particular education goals. This phase of the process often necessitates staff skilled in the integration of assistive technology.

Many schools do not have a speech-language pathologist or audiologist who possesses the knowledge and skills necessary to promote comprehensive assistive technology services. Concerned about the time factors involved with this process, administrators and staff respond by leaning toward a program that is easier rather than appropriate, and are discouraged from including technology recommendations in the IEP. School administrators need to provide for yearly upgrading of knowledge and skills to speech-language pathologists, audiologists, and other school staff.

Teachers express concerns regarding their limited knowledge of the integration of technology into the curriculum. Realizing that they are responsible for managing a classroom of children, many are willing to help students who have or need assistive technology devices and services; however, they are unable to devote uninterrupted periods of time to one student. To this end, time and funding are needed for the routine upgrading of the knowledge and skills of the teacher.

Another common concern across the country is the sense that assessment teams, audiologists, and speech-language pathologists may be specifically instructed by administrators not to recommend “high tech” equipment because of the related expenses. Parents are not informed that such instructions have been given, and this lack of information prevents them from exercising their rights under the due process protection of the law. Even if assistive technology is written into the IFSP/IEP/ITP, it may be 6 to 8 months before the equipment is actually obtained, programmed (as appropriate), and used by the student.

Students must be prepared to use technology effectively. There are basic skills and considerations such as the sequencing and selection of icons and vocabulary, seating and positioning, mobility and gross/fine motor skills, the use of residual hearing, and so forth, that should be addressed in order to prepare a student for the appropriate utilization of assistive technology. Often, none of this training is completed before the system is in place. However, an ongoing diagnostic process should occur as needs and environment change. Technology will work well only for the person who has the skills to use it appropriately. Students who rely on technology require intervention at a level that is totally different from the intervention needs of other students. School administrators must recognize essential differences in service delivery so that the necessary program changes may be identified and implemented. Progressive school systems have accomplished this intervention with positive results. ASHA (1989) has developed competency guidelines that specify the areas of expertise that speech-language pathologists and audiologists should have when training students in the use of assistive technology.

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Emerging Issues

Inclusive practices are intervention services based on the unique and specific needs of the individual and are provided in a setting that is least restrictive. There are a variety of models through which inclusive practices can be provided, including direct, classroom-based, community-based, and consultative interventions (ASHA, 1996a). Implementation of inclusive practices requires consideration of multiple issues, such as cost effectiveness, program efficacy, educational preparation, personnel qualifications, and the effects of inclusive practices on all learners. Although the research (ASHA, 1996a) requires cautious optimism for the effectiveness of inclusive practices, use of assistive technology must be addressed in all settings and within all service delivery models. This continuum of inclusive practices requires careful customization of each student's technology need and an understanding of the issues that arise through implementation of each service delivery model.

Literacy. Literacy has become an international educational issue as well an emerging area of research. Emerging literacy and literacy issues for older students are receiving and will be receiving considerably more attention in the future. School personnel view the relationship between assistive technology and literacy to be the base on which to build successful academic skills and/or independence in performing daily tasks that are necessary for avocational or vocational pursuits. Individual educational plans need goals that relate to emerging or conventional literacy; the technology recommended and implemented should support literacy.

Multicultural ethnic diversity. Cultural and linguistic diversity issues will intensify during the remainder of this century and into the next. If trends continue, demographers indicate that by the year 2010, one-third of the population will be people of color and, by the middle of the twenty-first century, whites will be a minority population. As demographics change, so too will the demographics of the work force, student bodies, and, most significantly, child and adult populations in need of speech, language, and audiology services. Speech-language pathologists and audiologists will need to have an increased knowledge of language, cultural diversity, cognition, social environments, and health issues associated with an increasingly diverse population. Knowledge in these areas influences the development and use of assistive technology in schools and communities. Social context and communication are closely related to and influenced by culture. Krefting and Krefting (1991) defined culture based on three concepts: (1) culture is a system of learned patterns of behavior; (2) it is shared by members of the group rather than being the property of an individual; and (3) it includes effective mechanisms for interacting with others and with the environment.

The first of these concepts is closely related to the definition of activity as a pattern of behaviors and the emphasis on human performance in the use of assistive technologies. The social aspect of culture is underscored by the second concept, which emphasizes the interdependence of all people, regardless of disability. The third concept, interaction with the external world—both socially and physically—illustrates the relationship of culture to the social and physical aspects of assistive technology context. Krefting and Krefting (1991) pointed out that we view the world through a “cultural screen” that is the product of our experiences, family relationships, heritage, and many other factors. This cultural screen differs for each person and biases the way individuals interact with others and the ways in which various activities, tasks, and life roles are perceived. If the speech-language pathologist and the student or the audiologist and the student have differing cultural screens, then they may have difficulty making appropriate assistive technology recommendations and establishing and achieving mutual goals. There are a number of ASHA-accredited education programs that specifically address diversity. Many of these programs impact the way assistive technology services are delivered.

Rural versus urban settings. Speech-language pathologists and audiologists are also experiencing an increasing number of children who are medically fragile and/or homebound, a growing number of children with multiple disabilities, and economic issues such as shrinking budgets that can limit access to and the appropriateness of assistive technology. These cases, which are challenging to urban communities, become even more complicated in rural areas. Location and distance have a direct effect on the delivery of assistive technology services, the monitoring and maintenance of technology, and a speech-language pathologist's and audiologist's ability to obtain professional support and continuing education. The unique needs and concerns of rural communities with respect to assistive technology must be addressed through federal, state, and local initiatives, pre- and post-training programs; and assistive technology service providers and programs.

Use of support personnel. Changes in the service delivery system in schools, increasing numbers of persons who need communication and related services, ever-rising costs of providing services in education, and technological and scientific advances have resulted in the use of support personnel. Support personnel are people who, following academic and/or on-the-job training, perform tasks as prescribed, directed, and supervised by certified speech-language pathologists. There are different levels of support personnel based on training and scope of responsibilities. At present, ASHA supports the establishment and credentialing of categories of support personnel for the profession of speech-language pathology, and has developed support personnel position statements and guidelines (1996b) as well as a proposed strategic plan for credentialing speech-language pathology assistants (ASHA, 1996c). Some specific responsibilities that have been considered for support personnel, if assigned and directly supervised by certified speech-language pathologists, include:

• maintaining technology in working order;

• performing screenings in accordance with specified screening protocols;

• maintaining documentation and records;

• providing direct treatment assistance to students identified by the supervising speech-language pathologist;

• following documented treatment plans or protocols developed by the supervising speech-language pathologist;

• assisting with assessment and scheduling activities;

• preparing records;

• participating with the speech-language pathologist in research projects;

• providing or partaking of in-service training; and

• participating in public relations programs.

As of this writing, an updated position statement and guidelines for the use of support personnel in the profession of audiology have been developed and submitted for approval to the ASHA Legislative Council.

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Unresolved Issues

Twenty years of special education case law decisions leave us with still unresolved questions regarding assistive technology. These include:

• How does one determine when assistive technology is needed for home use to provide an appropriate education? Is the decision different depending on the use of technology, for example, for print access as opposed to instructional enrichment?

• How does one determine when assistive technology is required to meet an educational need versus a medical need? Is there a difference?

• How does one determine when assistive technology rather than human assistance is required to meet educational needs?

• How does one determine when assistive technology must be provided on private school grounds?

• Is the equal access standard of Section 504 and the ADA different from the appropriate standard of IDEA?

Anecdotal information concerning the implementation of assistive technology to individuals in various education sites across the country revealed a long and growing list of reasons for denying access to assistive technology. The list includes inadequate, inaccurate, or nonexistent assessment processes; poorly developed IEPs; inadequate preparation of school-based speech-language pathologists and audiologists; inadequate preparation and support of classroom personnel; deliberate exclusion of technology in the IEP; delays in providing technology; inadequate preparation and training for users; placement on caseloads for training purposes; and tendencies to consider the means (technologies) rather than the ends (student outcomes). The following sections amplify these concerns.

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Future Considerations

As audiologists and speech-language pathologists prepare to deal with assistive technology in the education setting, potential for change in the future must be considered. Professionals may become less involved in direct service, using more support personnel and thereby creating another level of service delivery. “Cross training,” “multiskilled,” “multidisciplinary,” and “transdisciplinary” are necessary terms when considering the need to collaborate with professionals in related fields. Assessments and service delivery may soon be directed through interactive videos and computers. The needs of culturally diverse clientele will become the norm, and there will be a widening gap between specialists and generalists. Assistive technology will be used to help overcome increasingly severe disabilities, and people with disabilities will live longer. Advanced technologies with emerging applications will include graphic interfaces, video conferencing, robotics, the convergence of information technology, advances in software, integrated learning systems, and advances in memory and data storage. Technology trends that are in the more distant future include miniaturization, compressed digitized speech, memory and cognitive aids, increased portability, increased compatibility, intuitive instructional software, and information navigation.

In the future, consumers will become empowered and active in planning their own care, demanding and receiving increased accountability from professionals. Services will be shorter term and integrated into existing programs, with the possible development of international standards of care and training. An added number of services will be provided in the classroom, possibly on a year-round basis, as the number of yearround schools increases. Care will increasingly be home-based, including home-based education (ASHA, 1994a). Given this vision, audiologists and speech-language pathologists must prepare for the use of assistive technology in a changing educational environment.

Committee Recommendations for Future ASHA Activities

1. Develop a comprehensive assistive technology funding module specifically for school-based speech-language pathologists and audiologists. The National Institute on Disability and Rehabilitation Research (NIDRR) could be approached as a possible funding source for this project, and State “Tech Act” projects could be viable collaborators in this endeavor. Topics that should be considered for inclusion are:

   • sources of available funding;

   • tips on how to write funding justifications that document medical necessity; and,

   • profiles of successful funding categories.

2. Consider the feasibility of building a partnership with the Assistive Technology Funding and System Change Project (ATFSCP). The focus of the partnership would allow for cost-effective utilization of resources and nonduplication of effort concerning funding and information dissemination of assistive technology devices and services. The following are examples illustrating the potential focus of this collaborative effort:

   • Develop a funding manual or update an existing document (Morris & Golinker, 1991), with partners sharing the responsibilities. This manual would guide speech-language pathologists and audiologists through various funding streams, with descriptive information regarding the individual sources, as well as outlines and benchmarks that are applicable to the specific funding source. For example, ASHA might produce a segment on the funding of assistive technology in schools; the United Cerebral Palsy Association might produce a similar segment relating to Medicaid/Medicare funding of assistive technology. A segment on private insurance and managed care funding should also be developed.

   • Augment existing efforts of the ATFSCP to organize a clearinghouse aimed at highlighting and sharing success stories that would help to establish an institutional history (funding precedents among funding sources).

   • Consider the possibility of sharing a national 800 number. The ATFSCP already disseminates information relevant to assistive technology funding. ASHA could augment this activity by supplying pertinent information specific to AAC and assistive listening devices.

   • A partnership between ASHA and the National Association of State Directors of Special Education (NASDSE) could develop model assistive technology forms, policies, and procedures for incorporation into the individual education planning and transition planning processes.

3. Develop continuing education programs that include information on funding sources for school-based practitioners. This training might be in the form of video confrences, workshops, brown-bag forums, a 6-week learning activity, or an interactive discussion using electronic communication. Training should include opportunities for hands-on experiences and question and answer segments. This may include updating the Assistive Technology in the Classroom Kit (ASHA, 1992) to include a module focusing specifically on funding.

4. Continue collaborative relationships with the TriAlliance (ASHA, the American Physical Therapy Association [APTA], and the American Occupational Therapy Association [AOTA]). A number of initiatives focus on areas of mutual interest for this Alliance. For example, ASHA, APTA, and AOTA might:

   • Consider entering into partnership with pro-tection and advocacy agencies to produce a curriculum for practitioners in the related therapies. This curriculum should be comprehensive and cover everything from selection to funding. Information on managed care issues is an essential component for all three professional organizations.

   • Direct a concerted effort toward ensuring that the availability of funding information on AAC, assistive listening devices, and other assistive technology devices and systems related to the professions is incorporated into undergraduate and graduate school coursework. In order to ensure that individuals with disabilities are not under-served, speech-language pathologists, audiologists, physical therapists, and occupational therapists must have an adequate working knowledge of funding sources for assistive services and devices. Funding information must receive equal consideration among assessment, solution, utilization, and integration principles.

   • Form a task force, the focus of which would be to explore creative funding collaboratives between Medicaid, special education, early intervention programs, and vocational rehabilitation, and to investigate ways that federal, state, and local funds have been comingled to meet the functional communication and mobility needs of students.

5. ASHA videos should be produced with captioning and all ASHA-sponsored materials should be available in alternate formats (large print, Braille, audio, etc.).

6. ASHA should continue to lead by example. To increase the utilization of appropriate technology, current efforts to integrate and use technology (electronic bulletin boards, listservs, Web sites and chat rooms, telecommunication, distance learning, fax-back, etc.) must be increased and expanded.

7. As a professional association, ASHA must continue to respect the diversity of its members by ensuring that any material communicated via electronic medium is downloaded and made available to members in magazines, journals, reports, etc. When information is printed in journals, magazines, etc., consideration of including references to where and when this information has or will appear in an electronic information system might be helpful. Public and private grants, foundations, and the recently formed ASHA corporate team should be considered as potential funding sources for implementing many of the training and information recommendations.

Federal Legislation

Over the past 23 years, the United States has made a concerted effort to improve the education of students with disabilities. Several laws have been enacted that protect the rights of and provide services for these students. Such legislation has had a significant impact on the way our country educates its students with disabilities, including those with communication disorders. Federal laws have progressively included provisions that require access to appropriate technology-related assistance for all students with disabilities so that they may participate in and benefit from public education programs and activities. Some of the laws (see Appendix B) that have impacted the delivery of assistive technology services and devices to students with communication disorders include:

• Section 504 of the Rehabilitation Act of 1973 (P.L. 93-112);

• Rehabilitation Act Amendments of 1986, 1992, and 1993 (P.L. 99-506, 102-569, and 103-73);

• Individuals With Disabilities Education Act (IDEA) (P.L. 101-476);

• Individuals With Disabilities Education Act (IDEA) Amendments of 1997 (P.L. 105-17);

• Technology-Related Assistance for Individuals With Disabilities Act of 1988 (Tech Act) (P.L. 100-407);

• Technology-Related Assistance for Individuals With Disabilities Act Amendments of 1994 (P.L. 103-218);

• Americans With Disabilities Act of 1990 (ADA) (P.L. 101-336);

• Goals 2000: Educate America Act (Goals 2000) (P.L. 103-85);

• Improving America's Schools Act (P.L. 103-382); and

• Telecommunications Act of 1996 (P.L. 104-104).

Two laws that have had a significant impact on the delivery of assistive technology services and devices to students with disabilities are the Technology-Related Assistance for Individuals with Disabilities Act of 1988 (often referred to as the Tech Act) and its amendments and the Individuals with Disabilities Education Act (commonly referred to as IDEA and its amendments). The Tech Act and its amendments created a system for states to have technology made accessible to persons with disabilities. It defines assistive technology as “…any item, piece of equipment or product system, whether acquired commercially off the shelf, modified, or customized, that is used to increase, maintain, or improve functional capabilities of individuals with disabilities.” [20 U.S.C. Chapter 33, Section 1401 (253)]. This definition is also used in defining assistive technology in IDEA, which is the law that requires that children and young adults with disabilities, from birth through age 21, receive a free, appropriate public education (FAPE), including special education and related services. For infants and toddlers, the IDEA Amendments of 1997 require that a statement of specific early intervention services, which include assistive technology, be included in the Individualized Family Service Plan (IFSP). For older children, the IDEA Amendments of 1997 require the Individualized Education Program (IEP) team to consider whether a child requires assistive technology devices or services in the development of the IEP.

In addition to the Tech Act and IDEA, there are statutes that provide broader protection of the rights of students with disabilities. The Rehabilitation Act of 1973 and its amendments and the Americans with Disabilities Act of 1990 (ADA) are civil rights acts that extend protection to all students with disabilities. These laws require accessibility through reasonable accommodations and the provision of assistive technology services and devices.

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OSEP Policy Interpretations [1]

IDEA and its accompanying regulations are often interpreted differently from state to state and district to district. Therefore, the Department of Education Office of Special Education Programs (OSEP) often provides policy interpretations, guidance, and applications of IDEA's provisions. Many of the documents issued by OSEP that provide guidance and policy interpretations are directly related to the provision of assistive technology services and devices.

Recently, OSEP issued several letters reflecting policy interpretations and guidance that affirm the responsibility of schools to provide assistive technology services and devices, including hearing aids (T. Hehir, personal communication, 1993, 1994, 1995; J. A. Schrag, personal communication, 1990) and permit assistive technology devices purchased by schools to be used at home (J. A. Schrag, personal communication, 1991), as noted in Appendix C. In these interpretations, OSEP states that, when an IEP team meets and determines that a student requires assistive technology to receive FAPE, and the use of such device or service is written into the student's IEP, then the device, according to IDEA, must be provided at no cost to the student, and the device may be taken home if necessary. In another letter providing clarification on a school's liability for a family-owned device (T. Hehir, personal communication, 1994), OSEP determined that in many cases it is reasonable for public agencies to assume liability for family-owned assistive technology devices used by students.

In its policy interpretations, OSEP has clarified that assistive technology devices and services are to be provided to students at no cost if it is written on their IEP in order to meet the requirements of FAPE. However, there has been some confusion among consumers and the professional community concerning IDEA requirements for recommending and providing technology services or devices. IDEA requires the provision of “appropriate” devices and services. In this context, the term “appropriate” does not necessarily equate to the most costly or advanced piece of technology. Therefore, when considering technology services and devices, audiologists and speech-language pathologists must consider features, flexibility, compatibility, the functional needs of the student, and so forth, and then, with supporting documentation, make technology device and service recommendations.

Highlighted in Appendices B and C are the key provisions and policy interpretations of statutes that directly impact on the provision of assistive technology services and devices to students with disabilities. The foundation for the provision of assistive technology services and devices has been laid through federal requirements and policy interpretations. In our efforts to maintain and increase our knowledge base, and to provide appropriate assistive technology services and devices to students with disabilities, audiologists and speech-language pathologists must learn to use these provisions to the advantage of the students they serve.

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Reform Movements

A major reform initiative impacting provision of services to students with disabilities is “inclusion.” Inclusion may be a fairly new word in the everyday vocabulary of speech-language pathologists and audiologists, but the concept has been in existence for 20 years. Although the Education of All Handicapped Children Act (P.L. 94-142) mandated education in the “least restrictive environment,” most states provided services to children with mild disabilities using a traditional “pull-out” approach: that is, pulling students out of the regular classrooms for support services in resource and therapy rooms. Children with more severe disabilities who needed more extensive support were educated in separate classes or schools. Children who could “earn” their way back into the regular education classroom were “mainstreamed” into the classroom for part of the day.

By the mid-1980s, parents, audiologists, speech-language pathologists, and other special education professionals began to more seriously address the concept of the least restrictive environment and began to explore alternative approaches to delivering services. Inclusion as it relates to assistive technology for speech-language pathologists and audiologists means learning to coordinate services among classroom teachers, speech-language pathologists, audiologists, and other professionals. Service delivery models reflecting this approach, such as collaborative consultation and classroom-based services, have gained momentum. ASHA uses the term “inclusive practices” rather than “inclusion” to describe the state of service delivery options available to students with communication disorders. Inclusive practices emphasize serving children and youth in the least restrictive environment, using an array of service delivery options that best meet the individual student's needs (ASHA, 1996a).

Along with inclusion, additional education reform initiatives such as home schooling, charter schools that allow more discretion in the curriculum and management of the school, voucher programs that provide funds for school choice, and site-based management have gained in popularity. These and other education initiatives will most likely mean tighter controls on funding, more localized decision making, and greater challenges in the provision of assistive technology services and devices. There will be increased demand for speech-language pathologists and audiologists to provide assistive technology devices and services to students who will participate in more diverse education systems.

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ASHA Activities, Policies, and Positions

ASHA continually monitors and advocates for legislation, regulations, positions, and policies, ensuring that students with disabilities receive appropriate speech, language, and audiology services, including assistive technology services and devices. ASHA has developed position statements and guidelines relating to the provision of assistive technology devices and services to students. ASHA continually monitors the impact of all proposed changes and works to ensure that provisions for students with communication disorders remain intact or are improved.

ASHA, working with a group of representatives from other major disability organizations, has developed a National Agenda for Achieving Better Results for Children With Disabilities (1994). Formulated in concert with Goals 2000 (Appendix B), the agenda addresses issues such as communication disorders, which may prevent children with disabilities from achieving the National Education Goals. It also suggests strategic activities to resolve these issues. Speech-language pathologists and audiologists should become familiar with the Agenda and its suggestions to help facilitate student achievement of the eight National Education Goals.

The National Joint Committee on Learning Disabilities (NJCLD), of which ASHA is a member, developed a position statement on “full inclusion” in November 1993. The position statement indicates that the NJCLD supports a continuum of service delivery placements and rejects the concept that all students with learning disabilities must be served only in regular education classrooms. NJCLD believes that each student must have an individualized program developed to meet his or her unique needs as required by IDEA (National Joint Committee on Learning Disabilities, 1993). Students with learning disabilities will need a continuum of technology to support their individualized education programs. This concept would include a continuum of technology to support a student's IEP.

In 1994, the ASHA Executive Board requested Special Interest Division 1: Language, Learning and Education, to form a committee to develop a technical report on the concept of inclusion for children and youths with communication disorders and to develop a position paper from this technical report. Based on the work of the Ad Hoc Committee on Inclusion for Students with Communication Disorders, ASHA's position is that “an array of speech, language, and audiology services should be available in education settings to support children and youths with communication disorders” and that “the term ‘inclusive practices’ best represents this philosophy” (ASHA, 1996b).

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Self-Advocacy and Advocacy

Faced with budget cuts, education reform, and changing legislation, audiologists and speech-language pathologists working in the schools must advocate for appropriate and increased professional training and development, opportunities to use a continuum of service delivery models, professional autonomy, and equitable division of the budget. Audiologists and speech-language pathologists have an obligation to themselves as well as to the students and families they serve to be strong advocates within the community. However, to ensure that students with disabilities receive the most appropriate services possible, speech-language pathologists and audiologists must first be knowledgeable and competent within their professions.

Individuals in these professions need to know what resources are available to keep them up-to-date in their field. Information is available through ASHA position statements, guidelines, and technical reports; ASHA staff; ASHA's Special Interest Divisions; allied and related professional organizations (ARPOs); colleagues; other professional, state, and local technology agencies; newsletters and journals; databases; and manufacturers' products information and updates. Another avenue of participation is for speech-language pathologists and audiologists to advocate for strong continuing education programs and provisions in their work settings. This end result can be attained by advocating for:

1. audiology and speech-language pathology-specific, in-service training sessions;

2. funds to attend state, local, and national conferences and meetings; and

3. payments and incentives to return to school.

According to ASHA's Code of Ethics, 1995, Principle of Ethics II, B (ASHA, 1994a) “individuals shall engage in only those aspects of the professions that are within the scope of their competence, considering their level of education, training, and experience.” Therefore, speech-language pathologists and audiologists must understand that whether or not their school system provides appropriate training or support, those who serve students with assistive technology needs must be responsible to acquire the knowledge and experience necessary to become and remain competent in the provision of assistive technology devices and services. If the necessary training is unavailable, professionals should consult with their colleagues who specialize in or are knowledgeable in the field of assistive technology.

Another way to advocate for assistive technology is to ensure that appropriate services, inclusive practices, training, and devices are appropriately included in a student's IFSP, IEP, and ITP. It is important to develop functional goals that integrate the technology services and devices needed for the student to succeed academically and socially. Depending on the student's age and competence level, the student, in many cases, can be a self-advocate and a necessary and useful component in determining and defining assistive technology needs. Along with administrators and other professionals on the team, consumers, including parents, community members, and students themselves, should be a part of any assistive technology effort. Documenting the services and devices needed in the student's IEP and IFSP will leave less room for misinterpretation and miscommunication of the student's needs (see Appendix D). Once services are included in the student's IEP and IFSP, they must be provided.

Additionally, audiologists and speech-language pathologists may become strong advocates, empowering themselves as well as those around them. This end result can be accomplished by educating and enlisting the support of multidisciplinary team members, administrators, parent groups, community groups, and leaders to gain support for and/or to procure assistive technology devices and services.

Audiologists and speech-language pathologists must actively collect data and participate in outcomes and efficacy studies that will support recommendations for and the use and provision of assistive technology devices, systems, and services. Research that supports assessment and intervention protocols and service delivery models and proves social, medical, and educational benefit will go a long way to convince administrators, educators, and parents of the need to fund, integrate, and encourage the use of assistive technology.

In summary, to ensure that audiologists and speech-language pathologists are seen as experts in providing technology services and devices, school-based providers must keep abreast of existing, changing, and emerging legislation, initiatives, and advances in technology. They must also become proactive in state, local, and national efforts to fund and support the use of assistive technology.

Introduction

The Technology-Related Assistance for Individuals with Disabilities Act of 1988 (Tech Act) is the primary acknowledgment in law that assistive technology is a major public policy concern. Bipartisan support for the concept of assistive technology is strong and consistent. Recognizing the unique role assistive technology has had in the lives of more than 56 million Americans, Congress, in an unprecedented action, included standardized language references and definitions of assistive technology devices and services in five separate federal statutes: the Individuals with Disabilities Education Act (IDEA)-Part B and Part H and amendments; the Rehabilitation Act Amendments of 1992; the Tech Act and Amendments of 1994; the Older Americans Act and amendments (P.L. 100-175); and the Developmental Disabilities Bill of Rights of 1993. In support of these statutes, regulations, policy letters, and advisory memos issued by oversight agencies reaffirm the important role of assistive technology in the lives of individuals with disabilities.

Despite the strong statutory foundation for assistive technology, its presence in the lives of individuals with disabilities remains relatively low. In 1993, Congress held a series of hearings regarding the reauthorization of the Tech Act. The following represent some of the major findings from those congressional hearings.

• Technology is a powerful force in the lives of most U.S. residents and enables individuals with disabilities to engage in many tasks.

• Technology can provide tools to make performing tasks quicker and easier.

• Most states have technology-related assistance programs carried out under the Tech Act but, in spite of their efforts, there remains a need to support systems change and advocacy activities in order to assist states to develop and implement responsive, comprehensive, statewide programs of technology-related assistance for individuals with disabilities.

• The efforts of state technology-related assistance programs have produced important results, but there is still a lack of resources to:

  • pay for assistive technology devices and services;

  • fund trained personnel to assist individuals with disabilities to use such devices and services;

  • disseminate information about the availability of assistive technology and its potential to help individuals with disabilities;

  • aggressively reach out to underrepresented and rural populations;

  • identify and fund systems that would ensure the timely acquisition and delivery of assistive technology devices and assistive technology services, particularly with respect to children; and

  • improve coordination among state human services programs and between state human services programs and private programs, particularly as it relates to transition between such programs.

• At the federal level, there is a lack of coordination among agencies that provide or fund the provision of assistive technology devices and service.

Key reasons for the unmet funding may include: insufficient funding levels for these critical devices and services; lack of attention to exploring creative ways of collaborating and sharing resources among funders; and lack of knowledge regarding both the short-term and long-term cost-effectiveness of assistive technology. There appears to be tremendous irony in the funding of assistive technology devices and services. Educators, parents, and others interested in acquiring assistive technology often find themselves in the unfortunate position of competing for funds from other equally necessary and deserving programs.

IDEA and its amendments of 1997 require schools to provide free, appropriate public education (FAPE) in the least restrictive environment (LRE). This portion of the report discusses potential funding partners that educators can access when providing assistive technology devices and services to students; however, the resources included are by no means exhaustive. Also, there is an array of state-specific and local service organizations, fraternal organizations, church groups, and so forth that can assist in meeting the diverse and/or multiple needs of students with disabilities.

The shortage of federal and state funding in education must not inhibit the access to technology needed by America's children. Congressional intent is not to require education to subsidize the total cost of technology designed to enhance the learning environments of children with disabilities. The expectation for funding sources, both public and private, is to collaborate and to share responsibilities for providing these services and devices. This call is repeatedly voiced by our nation's and states' policy makers. Collaborative efforts enhance the ability of each responsible funding source to meet the needs of students with disabilities. The range of funding options from both public and private sources is great and the potential to combine resources from a number of sources is promising. Factors that must be addressed include:

• development of effective, appropriate, and comprehensive ways to meet the functional needs of an individual;

• development of a protocol to determine the most cost-effective way of meeting those needs;

• identification of proven methods of distributing and sharing financial responsibilities; and

• cultivation of a positive attitudinal change that encourages shifts in values of traditional funding sources.

Through the continued and combined efforts of advocates and consumers, state Tech Act projects, educators, parents, and others, a positive shift in efforts toward the funding of assistive technology will occur.

This section focuses on identifying some of the current initiatives and emerging best practices related to the funding and acquisition of assistive technology devices and services. By increasing awareness and building system capacity, more Americans of all ages will be provided with the necessary technology to improve their functional capacities and quality of life. The existence and variety of assistive technology funding options and strategies gives credibility to the belief that funding obstacles can and will be overcome.

A number of individual state programs are referenced; however, the list is not exhaustive. If your home state is not listed as using a particular strategy or initiative, do not assume that little or no activity is occurring in your state. Contact your state's Tech Act Project for more specific and complete information on funding, initiatives, and emerging best practices strategies under way in your area (see Appendix E).

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Current Initiatives