Assistive Technology: A Positive Approach?

Assistive technology is one of the most tangible and accessible, but sadly enough, not always the most obvious of Positive Approaches. To better appreciate how naturally assistive technology fits into Positive Approaches, both as a philosophy and as an application, consider the purpose of assistive technology. The Technology-Related Assistance for Individuals with Disabilities Act Amendments of 1994 (P.L. 103-218), collectively known as “the Tech Act,” states that assistive technology devices and services can help people with disabilities to:

a) have greater control over their own lives;

b) participate in, and contribute more fully, in activities in their homes, schools, and work environments, and in their communities;

c) interact to a greater extent with people who do not have disabilities; and

d) otherwise benefit from opportunities that are taken for granted by people who do not have disabilities. (P.L. 102-218, 29 USC 2201)

When you help people help themselves, when you assist a person in finding tools or devices that aid her in being more self-reliant and less dependent upon others, you help create a situation where that person feels more in control and less helpless. What could be more positive?

When reviewing the continuum of positive approach supports (Barol, 1996) that impact upon a person's well being and self esteem, assistive technology fits into each of the supports as though it were custom-made.

The Environment. Do you have control in your home? Can you reach items on high shelves or in the back of the closet? Can you get in and out of your bed or shower without assistance? Do you have to wait for someone else to do those things for you? How frustrated or angry do you feel when your body does not cooperate with your mind and spirit? Most of us have experienced loss of control at some point in our lives. Fortunately, such occasions are usually temporary. When they are not, we ask someone to help; we try to contrive a technique, to rig up some gadget or device, or simply modify the environment to compensate for what we need. We look for an appropriate alternative-a Positive Approach to compensate for some functional limitation that cannot be "fixed" itself.

This same Positive Approach should also be considered for a person who has a developmental disability, especially an individual with challenging behaviors. Simply creating a “friendly environment” can be the first step in helping the person gain (or regain) control of his life. That friendly environment can include a reacher for a woman who cannot get to a high shelf. It can include grab bars or a shower chair for the man who cannot get into or out of a tub without support. These assistive devices are not necessarily "high tech"- nor are they necessarily expensive. What they need to be is available to and functional for a particular person in his or her own setting.

Communication. Historically, communication is probably the most widely discussed area in the fields of challenging behavior and assistive technology. Sometimes we simply, truly miss what the person is saying, or trying to say. Just about anyone who has supported a person with challenging behaviors has asked herself: "What is he trying to tell me with this behavior?" Those who work with persons who do not use typical spoken communication often try to find an alternate or additional technique for communication. When a successful technique (or device) is found for the person who has challenging behaviors but does not speak, it is an enormous breakthrough. However, despite good intentions, we sometimes forget that communication is something that happens all the time, day and night. Does the individual have the opportunity to express preferences? To make choices? Do we make sure that the person has access to and actually is encouraged to use that alternative or augmentative device at home, at work, and during leisure? Do we make sure that everyone who supports the person knows how to use the technique or device? Frustration and accompanying expressions of frustration, are almost inevitable if we fail to facilitate the use of the technique or device in all communication settings.

Assessment. Ongoing assessment is a "given" when supporting a person with developmental disabilities, especially when that individual has challenging behaviors. We must continually assess whether or not the individual is responding as expected to his environment, her physical state, his emotional life, or her current medication. If not, we look at whether changes in any part of the person's life could or should occur. When we are supporting a person who uses assistive technology, we ask the same questions. Does the communication device meet the person's needs? Does the person want or need something more sophisticated or less cumbersome? Are there environmental controls or devices which the person can now benefit from that he may have not needed in the past? Are there possible new assistive technology solutions that may not have been available previously? Has the environment changed? If so, what is the impact? Assessment is an ongoing activity simply because people and circumstances change. Assistive technology can allow a person to gain or regain control over events in his or her life and thereby reduce the potential for frustration and its manifestations.

Hanging in There. Change is inevitable. Today's stellar work or "best practice" can be tomorrow's average work. A commercial for an investment company talks about "measuring success one investor at a time." We can take that advertisement quite literally when supporting people with challenging behaviors. We invest in one person at a time-the whole person-and look at what he or she wants and needs to feel in control of his or her life. The answer may be a person to talk to or an assistive communication device to help that individual communicate. It probably won't happen overnight. It will require commitment and patience on the part of the person and his or her support team. But the investment is worth it.

Most people would fully agree with the Congressional findings supporting the 1997 reauthorization of the "Tech Act" presented in the beginning of this article. However, many providers and advocates still do not fully appreciate assistive technology as a Positive Approach for people with mental retardation or other developmental disabilities. The purpose of this article is to begin to highlight the role of various assistive technology devices and service in improving the lives of children and adults with mental retardation.

Benefits of Assistive Technology for Children and Adults With Disabilities

Clearly assistive technology has made a difference in the lives of many children and adults with disabilities. In 1993, the National Council on Disability conducted a 19-month survey to better determine the cost/benefits of assistive technology devices and services. The following are some of this study's findings:

• Almost three-quarters of school age children with disabilities were able to remain in a regular classroom and 45% were able to reduce school related services.

• Sixty-two percent of working-age persons were able to reduce dependence on family members, 58% were able to reduce dependence on paid assistance, and 37% were able to increase earnings.

• Eighty percent of elderly persons studied were able to reduce dependence on others, half were able to reduce dependence on paid persons, and half were able to avoid entering a nursing home.

• Almost one-third of assistive technology users indicated that their family saved money, averaging around $1,110 per month, with assistive technology. At the same time, one-quarter of the users indicated that they experienced additional equipment related expenses that averaged around $287 per month.

• Of the 42 users of assistive technology who reported having paid jobs, 92% reported that the assistive technology enabled them to work faster or better, 83% indicated that they earned more money, 81% reported working more hours, and 67% reported that the equipment had enabled them to obtain employment. 15% indicated that the equipment enabled them to keep their jobs.

• When asked to estimate the impact of equipment on their quality of life, assistive technology users reported that without the equipment, their quality of life on a scale of 1 to 10 was about 3; as a result of the equipment, it jumped to approximately 8.4 points (National Council on Disability, 1993, 1-2).

The results of this study certainly underscore Williams's (1991) position-that assistive technology is liberating not just for the individual with a disability but indeed for America as a whole. Let us now turn to the use, needs, and experiences of Pennsylvanians with disabilities.

Assistive Technology and the Lives of Pennsylvanians With Disabilities

In 1994, Pennsylvania's Initiative on Assistive Technology (PIAT) - Pennsylvania's "Tech Act" Program - conducted a statewide consumer survey. More than 1,000 surveys were disseminated; 372 (51% person with a disability, 15% a parent or family member, 22% a friend or representative, and 11% other) were completed and returned to PIAT. Of the respondents, 72% were adults with disabilities and 44% had a developmental disability.

When asked, "During the past two years, how has assistive technology equipment or services helped you?" the following responses were obtained:

Assistive technology has helped me:

Be included in school --- 38%
Be included in the community --- 56%
Become more independent --- 72%
Get a job --- 23%
Get a better job --- 14%
Decrease reliance on personal assistant --- 52%
Increase quality of life --- 75%

Based on this data, assistive technology is certainly a Positive Approach for many Pennsylvanians with disabilities. Assistive technology devices used and/or needed by these 361 Pennsylvanians included:

Assistive Technology Device for --- Used By --- Needed By

Communication (electronic or manual boards) - Used by 32%; Needed by 10%

Mobility (wheelchairs, walkers, crutches) - Used by 74%; Needed by 4%

Hearing or seeing (hearing aids, reading machines) - Used by 30%; Needed by 11%

Writing/reading (books on tape, computers) - Used by 38%; Needed by 17%

Doing things at home (switches, adapted appliances) - Used by 35%; Needed by 22%

Recreation (remote controls, adapted equipment) - Used by 32%; Needed by 22%

Personal Care (adapted toilets, shower bars) - Used by 54%; Needed by 14%

Transportation (modified cars, bus lifts, ramps) - Used by 60%; Needed by 10%

Help do a job (adapted work equipment) - Used by 33%; Needed by 17%

Help with school (tape recorders, computers) - Used by 36%; Needed by 14%

1) Assistive technology has had a positive impact on the lives of Pennsylvanians with disabilities. It has enhanced quality of life (75%), allowed greater independence (72%), and resulted in more inclusion in the community (56%).

2) While a large percentage of people have obtained assistive technology that is helpful to them, 68% of those responding to the survey still do not have the assistive technology that they need.

3) There are two main reasons for not having the needed assistive technology: (1) expense and (2) difficulty in determining what specific technology is needed.

Barol, B.I. (Summer 1996) An Overview. The Pennsylvania Journal on Positive Approaches, 1.

National Council on Disability (1993) Study on the Financing of Assistive Technology Devices and Services for Individuals with Disabilities: A Report to the President and the Congress of the United States. Washington, DC, National Council on Disability.

PIAT (1995) A Preliminary Report on Assistive Technology: Use, Needs and Experiences of Pennsylvanians With Disabilities, Unpublished paper, Institute on Disabilities/UAP, Temple University.

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

Williams, B. (1991) Testimony before the House Education and Labor Subcommittee on Select Education. Santa Fe, NM.

The Pennsylvania Journal on Positive Approaches is published by the Pennsylvania Office of Mental Retardation (OMR) Statewide Training Initiative through Temple University, Institute on Disabilities, University Affiliated Program and Contract Consultants, Inc., 105 Old York Road, New Cumberland, PA 17070. For subscription information, please contact Contract Consultants, Inc. at [717] 774 - 5455. Copyright © 1997 OMR/CCI. All rights reserved.

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