Assistive technology is defined as “any item, piece of equipment, software program, or product system that is used to increase, maintain, or improve the functional capabilities of persons with disabilities” (ATIA, http://www.atia.org/at-resources/what-is-at). In this section, I will discuss different types of AT-low, medium, and high-tech-and process for selecting the right device.
Forms of AT
According to the Assistive Technology Industry Association, AT can be in many forms, including:
- low-tech: communication boards made of cardboard or fuzzy felt.
- high-tech: special-purpose computers.
- hardware: prosthetics, mounting systems, and positioning devices.
- computer hardware: special switches, keyboards, and pointing devices.
- computer software: screen readers and communication programs.
- inclusive or specialized learning materials and curriculum aids.
- specialized curricular software.
- electronic devices, wheelchairs, walkers, braces, educational software, power lifts, pencil holders, eye-gaze and head trackers, and much more. (ATIA, http://www.atia.org/at-resources/what-is-at)
I will group all of these forms into three main categories of low-tech, medium-tech, and high-tech.
Low-Tech. Low-tech options of assistive technology require no complex computer systems or chips. Items in this category can involve simple electronic circuit boards, or no electronic components at all. Examples of low-tech options include manual wheelchairs, canes and walkers, pencil grips, some picture exchange communication systems, mounting brackets, and the list goes on.
Medium-Tech. Medium-tech refers to items that consist of more complicated electronic circuit boards and computer processing chips. However, the interfaces are fairly simple and the devices do not contain complex computer operating systems (e.g., Windows, Mac OS). Some picture exchange communication systems, sound amplification and relay devices, and word processing units fall under this category.
High-Tech. High-tech refers to devices with complex circuits and computer processing power. These devices use computer operating systems and may serve more than one function. Personal computers and tablets, motorized wheelchairs, and voice-command home operating systems are some examples of high-tech options.
AT Services. AT services refers to “any service that directly assists a child with with a disability in the selection, acquisition, or use of an assistive technology device” (Georgia Project for Assistive Technology). Devices are essentially worthless without the instruction on how to use them. Therefore, it is imperative that professionals consider ease of use and learning ability/opportunity for each device with every individual.
Many adults and their families do not know how to find support after grade school. School personnel and support/service coordinators need to partner with assistive technology professionals to help select and acquire needed devices and services that extend beyond k-12 education.
Comparing Options. High-tech options might be the instinctive go-to AT option for many professionals. After all, the advanced computer processing gives an individual with disabilities the greatest chance for success; right? Not necessarily. Sometimes, the low-tech option is the best option. Low-tech options are often readily available, thereby costing little to no money for a parent or school. The key to remember when selecting AT devices or services is that the individual’s needs are met, and not what the latest and greatest cool gadget(s) exists for a particular function.
Augmentative and Alternative Communication (AAC)
“Augmentative and alternative communication (AAC) includes all forms of communication (other than oral speech) that are used to express thoughts, needs, wants, and ideas” (American Speech-language and Hearing Association, asha.org/public/speech/disorders/AAC). AAC can be separated into two functions: receptive language and expressive language.
Receptive language AAC devices and services help individuals understand language that is communicated to them. It is not limited to devices or services targeted at improved hearing; rather, it is directed at language understanding as whole.
Expressive language AAC devices target language output. These devices and services help individuals express themselves to others in augmentative (e.g., increase current functioning level) or alternative (e.g., different, substitute) ways.
Like all AT functions, AAC has low, medium and high tech options.
Low-tech. Low tech includes unaided communication systems-such as sign language and body gestures-and aided communication systems-such as a Picture Communication System (e.g., PECS, Gus Communication Symbols). Sign language should be taught using ASL and proper grammar. According to the National Association of the Deaf, sign language needs “to happen [with] the inclusion of Deaf professionals in ASL instruction (for example, using ASLTA certified professionals to teach both special education professionals and students- www.aslta.org) and ensure that the ASL being used is linguistically appropriate, e.g. no made-up signs, or restricting the use to only a few signs” (personal correspondence, September 16, 2016).
Medium-tech. Medium-tech options include communication boards that use electronics to assist with voice output, but do not have high-end computer interfaces or processing chips. Examples of medium-tech AAC devices include GoTalk and ProxTalker. Older generation cell phones could also fit into this category.
High-tech. High-tech options for AAC include iPads, tablets, and personal computers. These are labeled “high-tech” due to the complex computer chips and computer interfaces that enable the software programs to function. Voice output and picture exchange are more advanced in high-tech options with the increase computing power and software. However, more advanced does not always mean better.
Devices and Apps
- Verbal Victor
- Gus Communication Symbols
- Imagine Symbols
- Widget Symbols
Auditory Devices and Services
Auditory devices include items that help with hearing and expressive communication. Hearing is more than receptive language. Hearing involves recognizing environmental sounds, noise and alerts. However, not all auditory devices help a person hear with their ears. Some devices supplement hearing with sight or feeling to achieve the same goal. Auditory devices come in a few categories that will be covered here in brief.
Hearing Aides. Hearing aides have a high degree of variability. There are behind the ear, in the ear, in the canal, completely in the canal and receiver in the canal models. All have their pros and cons. All are tuned to meet the needs of each individual’s audiogram. I will not go in depth with these models, but if you want to learn more, visit mayoclinic.org.
Many over-the-counter hearing devices exist to increase the volume of your surroundings. These devices appear to be great options. They are low cost, do not require expensive evaluations, and–for the most part–perform quite well. However, they are not recommended. Hearing aides are designed to not only help you hear sounds louder but also more clearly and prevent further hearing loss and damage. The over-the-counter devices do not offer you the clarity or the protection quality hearing aides can provide. Talk to an audiologist before making any recommendations or selections of hearing aides.
Assistive Listening Systems. Assistive Listening Systems (ALSs), or Assistive Listening Devices (ALDs), are designed to help an individual focus more on voices and cut down on signal-to-noise ratio (National Association of the Deaf, NAD.org). ALSs come in various types–such as FM, Infrared and Inductive Loop systems. These systems are used to transmit audio from a teacher, instructor or presenter to the listener in a louder and clearer manner. They can be used by individuals with varying degrees of hearing loss, and each has their own pros and cons. For more information and history on ALSs, visit NAD.org or read the book Foundations of Aural Rehabilitation, 3rd Edition by Nancy Tye-Murray.
Low, Medium, & High Tech. Low tech options are limited in this category of assistive technology. Some low tech options include vibrating alarms and light indicators. Many medium and high tech options are expensive and not always covered by insurance companies. Some helpful devices or software are sound amplification devices or applications (e.g., hearing aides, ALSs), and closed captioning on TV programs and Internet videos.For a more complete list, visit the Maryland Assistive Technology Connection Hub.
Many people might assume cochlear implants belong in the category of high tech devices. However, cochlear implants are not always considered as assistive technology by professionals. There are two reasons for this: 1. Cochlear implants are only for individuals with bilateral sensorineural hearing loss, making it extremely limited in availability and benefit. 2. Cochlear implants are not covered under current IDEA mandates for device selection or maintenance by school systems.
Services. A common auditory service is aural rehabilitation. An audiologist or speech-language pathologist helps a person adjust to auditory devices by fine tuning frequencies on aides and helping individuals recognize sounds as words, sounds, or alerts. Other services include real-time transcription, which transcribes speech into written text, word-for-word as the language is spoken. Telecommunication–once an essential communication service–has seen great improvements over the last 20 years. Previously, telecommunication systems such teletypewriting devices were used for phone conversations between the deaf/Deaf/hard-of-hearing and hearing individuals. This has been made obsolete with text messaging and video chatting apps such as FaceTime.
Assistive technology for independent living can be anything from communication to vision to organization and beyond. It is any device or service that allows an individual with disabilities the freedom to function in living environments away from or with limited supported care. This section will focus on AT devices and services that help individuals operate their home environment effectively for various needs. AAC and auditory devices are excluded since they have been discussed in previous sections.
Low-tech. Specialized utensils and dishes can make eating easier for those who have mobility limitations. Ramps and custom tables and counters also offer help in mobility limitations. Canes and extension grabbers/reachers are also low-tech options to help around the house/apartment. Graphic organizers on paper or white boards can help with cleaning, hygiene, budgets and shopping lists.
Medium & High-tech. Many options are available in these areas to help with independent living. Options range from automated systems that control temperature, lights and security to voice or gesture command devices to help with information, shopping, or other household items or tasks. Here are some popular items that I personally recommend:
- Amazon Echo. The Amazon Echo works with a person’s Internet connection and voice to perform a variety of functions. A person can shop for almost anything using Amazon’s e-commerce shop. Previously bought items can be re-ordered with ease. Amazon Echo can also give weather and news updates, perform internet searches, and control household lights and appliances with compatible devices or adapters.
- Philips Hue lights. Philips Hue light bulbs can be controlled via IOS and Android apps, and through voice control by Amazon Echo. The light bulbs can change color for individuals who may be sensitive to bright white light.
- Tablets. Tablets come from various manufacturers and with various operating systems. iPads are popular and come with IOS and the Apple App Store, which contains the greatest number of apps for assistive technology purposes. However, iPads are expensive. Android OS tablets range in price and apps are more limited. Amazon Fire tablets are good choices. They come in a variety of sizes and price points, run off of Android OS, and work with Android and Amazon app stores.
Issues with mobility can be found in the legs, arms, hands and/or neck. Most people associate mobility accessibility with wheelchairs and canes. These are two valuable devices that come in a variety of options. I will briefly discuss these options and expound in some related areas.
Canes & Walkers. Canes are fairly simple. Bases are usually rubberized, or made with a durable material that offers some grip on slick surfaces. Lately, canes have been developed to include a wide base that articulates to bumpy terrain and adds greater stability. Some canes come with a second handle which adds support and stability for sitting down or standing up.
People tend to picture walkers as the basic aluminum, tri-fold devices with tennis balls on the ends that old people push around. While these types of walkers still exist and are used, new models exist that include brakes, fold down seats, and attachable baskets. They fold up easily and can fit in just about any vehicle for transport.
Wheelchairs. Wheelchairs can be very basic and manually operated, or they can motorized with variable speeds and reclining features. Some will not need motorized cars and prefer the option of a manual chair. Others will either need the motorized option or prefer the ease and added options motorized chairs bring.
Aside from manual and power wheelchairs, specialty chairs exist. One such example is designed for basketball. There are also other chairs designed for racing. One company has created a chair that can help individuals lie completely upright or “stand,” thus relieving tension and pressure typically found in sitting all day.
Accessories for wheelchairs are critical and sometimes overlooked. Brackets and trays are needed for eating, reading, or operating a personal tablet/computer outside of the home. Braces and custom headrests are great for easing back pain and allow individuals to sit more upright. Furthermore, not all individuals in wheelchairs will have complete mobility in their arms or hands. Choosing a chair that has comfortable control access is needed.
Services. Operating a wheelchair or walker is not as easy as it may sound. Some individuals will need help learning how to apply brakes, attach baskets and/or fold/unfold a walker. Individuals in wheelchairs may need some help learning how to steer at different speeds, how to navigate through small spaces and door ways, how to back up and how to inch forward to a table. Professionals are needed to help individuals learn controls and maneuvers in order to increase success at independent operation (pro tip: wear closed-toe shoes; your feet will appreciate it).
Websites and Other Resources
Georgia Project for Assistive Technology (www.GPAT.org)
- Run by the Georgia Department of Education. It gives an overview of what assistive technology is, legal mandates and information, IEP information, and on through student success.
Wisconsin Assistive Technology Initiative (www.wati.org)
- Run through the state of Wisconsin. Gives resource material on assistive technology services and devices, as well as AT professionals who give consultations throughout the state.
Maryland Assistive Technology Connection Hub (www.cte.jhu.edu/matchup/)
- This site has assistive technology broken down into many categories and lists various devices for each category. It will also show the relative expense for each device. General information on assistive technology is also available.
Assistive Technology Industry Association (www.ATIA.org)
- Provides webinars and resources on assistive technology. Offers membership for professionals.
American Speech-language and Hearing Association (www.ASHA.org/public/speech/disorders/AAC)
- Gives an overview of AAC devices and services, from the foremost American association.
International Society for Augmentative and Alternative Communication (www.Isaac-online.org/English/home)
- Gives a comprehensive look into AAC devices and services from an international point of view.
National Association of the Deaf (www.NAD.org/resources/technology/assistive-listening/assistive-listening-system-and-devices/)
- Information on assistive listening systems and devices through the eyes of hearing professionals and the Deaf community.
- Information on hearing aids—what they do, types, features, and advice.
Motor & Independent Living
Independent Living Aids, LLC (www.independentliving.com/)
- Catalog of assistive technology devices for various disabilities, impairments and needs.
International Telecommunication Union (www.e-accessibilitytoolkit.org/toolokit/promoting_asssitive_technologies/)
- Gives a search engine and other resources for finding information on assistive technology for independent living and other areas.
Computer/Electronic Accommodations Program (www.cap.mil/Solutions/ProductDisability.aspx?DisabilityID=1)
- Provides information on assistive technology for military and government personnel. Provides assistive technology services and accommodations for disabled military and government employees.
Web Accessibility in Mind (www.webaim.org/articles/motor/assistive)
- Information on assistive technology for motor disabilities and impairments.
Ability 1st Utah (www.ability1stutah.org)
- Private agency serving the people of Utah. Offers assistive technology and job training services.
Roads to Independence (www.roadstoindependence.org)
- Private agency serving the people of Utah. Provides assistive technology services, especially for independent living and employment.
Utah Assistive Technology Foundation (www.uatf.org)
- Run under the Utah Assistive Technology Program. Helps families and individuals receive and use assistive technology devices and services for children and adults.
Utah Assistive Technology Program (www.uatpat.org)
- Run through Utah State University and their Center for Disabilities. Provides information and services on assistive technology for people with disabilities.
Utah Center for Assistive Technology (www.ucat.usor.utah.gov)
- Run by the state of Utah. Provide information and services relating to assistive technology for people with various disabilities and needs.
Utah Parent Center (www.utahparentcenter.org/resources/assistive-technology/)
- Non-profit organization. Helps parents with questions on disability services, including—but not limited to—assistive technology services and devices.
- Chromebooks–Similar in capabilities as a tablet, but with a mechanical keyboard. Cheaper option than an iPad, but you will be limited to Google-based web applications and internet browser.
- iPad/iPad mini–While not for everyone, it does allow for creative interventions through the use of apps.
- Amazon Fire tablet–cheap tablet that can work with books or web applications. Not as good as an iPad, but at $50 it makes for a good start.
- Noise Canceling Headphones–good for those who experience sensory overload in noisy environments.
- Picture books–easy to create and can be used with various EBP, such as Scripting, Social Narratives, and Picture -Exchange Communication System.
- Sunglasses–like noise canceling headphones, these would be good if you work with someone who experiences sensitivity to light. It can also be used to help narrow field of view.
- Bean bag chairs, blankets, and/or pillows–again, great for handling sensory processing issues