Environmental Integration

Question 1

Describe how motivation and effort affect educational assistive technology (AT) usage.

Answer 1

The effects of motivation are seen in a user’s engagement in a learning task. When users are motivated, they have an investment in the learning process. It affects their cognitive, behavioral, and emotional engagement in the activity. Motivation has also been shown to be an important psychosocial factor in the use of assistive technology (AT). If a user is unsuccessful with the technology, the clinician must look at whether the task is motivating enough for the user to put forth the effort to use the technology. This motivation-effort relationship is referred to as Baker’s Basic Ergonomic Equation. The equation is represented as follows:
The motivation of AT user to purse and complete a task
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Physical effort + cognitive load + time load + linguistic effort = successful or unsuccessful AT use
The effort required to use AT can sometimes outweigh the benefits and rely on the supports of an adult or peer. A child who could get a need formulate a message using an AAC device. The challenge for clinicians is to increase motivation and reduce effort for the AT users.

Question 2

Describe how usage of assistive technology affects access to employment and independent living.

Answer 2

Statistics indicate that the percent of people with disabilities age 16 to 64 who are employed is between 35% and 55%. The advances in technologies, education of individuals with disabilities, and government policy should expand the employment of individuals with disabilities; however, that is not the case. The effects of unemployment for individuals with disabilities is sobering - having a job means that individuals have ways to support themselves. Employment is critically important for citizens to accomplish their life goals, pay their bills, and secure their futures. Employment also allows individuals with disabilities to have some control over their lives and live as independently as possible. Assistive technology devices and services can make it possible for individuals with disabilities to work, participate in the community, live independently, attend school, and enjoy social activities. Appropriate assistive technology helps people with disabilities overcome or compensate for societal limitations and limitations caused by the disability. Increasing opportunities for participation using assistive technology benefits everyone including employers, family members, and everyone who interacts with users of technology.

Question 3

Identify issues with integration of the Student, Environment, Task, and Tools Framework (SETT)

Answer 3

The use of the SETT Framework is critical for collaboration among the educational team. The collaboration is important, not only because of the effects on the outcome of the student but because the entire educational team must be willing to implement the agreed-upon decisions. Difficulties with fidelity of implementation of assistive technology solutions can lead to poor outcomes and device abandonment. Inclusive models of education have allowed many students who have been isolated in separate settings to be educated among their peers, but this also leads to difficulties in meeting the diverse needs of students. Many problems with integration can be solved using universal design for learning principles. Students can choose from flexible methods of learnings, using flexible tools in ways that best support their learning profiles. The need for specialized assistive technology tools is reduced, and all students participate equally in the learning process.

Question 4

Explain how using the human, activity, assistive technology (HAAT) model can determine infrastructure barriers for individuals with disabilities.

Answer 4

The effects of impairments pose a certain degree of difficulty to disabled people, but infrastructure barriers and social attitudes can impact individuals more than the disability itself. Infrastructure is critical to social functioning for all people, but when a certain group of people is at risk of exclusion, and health. Because of infrastructure barriers, individuals in the excluded group are unable to participate and contribute to society. The human, activity, assistive technology (HAAT) model process informs the “contexts” of an individual’s life, not just the environment. It encourages the clinician to look beyond the physical and environmental aspects that affect an individual to societal variables that are disabling. It is not the individuals impairment that is disabling but rather the societal constructs that are disabling. As an example, architectural designs that benefit only individuals who can independently walk in an upright position. Other variables include attitudinal barriers, funding inadequacies, stereotypes, policy barriers, and any other social structure that marginalizes a group of individuals.

Question 5

Explain the relationships among educational, therapeutic, and assistive technology goals for a student who uses assistive technology.

Answer 5

Assistive technology support is typically specific to a student’s educational goals and not used for the general, overall benefit of the student in his or her educational program. Said another way, assistive technology is a compensatory rather than remedial, meant to compensate for a functional issue (sensory, motor, visual, hearing, cognition, or psychological) that impedes the student’s ability to access the curriculum. Without the use of assistive technology, the student would be unable to complete the necessary tasks or goals. In many instances a student will also require some amount of work on remedial skills to receive the full benefit of assistive technology. This can be educational, such as continuing support in reading strategies even though the student benefits from text reading software to access grade-level material. The student can also receive therapies, such as speech articulation therapy along with the use augmentative communication, or occupational therapy to improve handwriting while benefitting from assistive technology for keyboarding.

Question 6

Explain how short- and long-term assistive technology (AT) supports are needed for individuals.

Answer 6

Up to one-third of all assistive technology (AT) accommodations are abandoned. AT discontinuation is sometimes related to changes in the individual’s condition, the skill level, or the demands of the task. The selection of AT systems should be designed to allow flexibility for the user so that the AT accommodation works for short- and long-term needs. The AT solution should not be fixed but should allow for changes in how the user wishes to participate in activities. The changes individuals experience can be short term, such as fatigue, muscular stiffness, or illness, or long term, such as a degenerative disease. The allocation of supports can also change with the individuals skill level. As they become more skilled using the assistive device, they may need the device to provide more technical support or less support. For instance, as an individual’s proficiency with the augmentative communication device improves, he or she may need additional vocabular or access methods changed. Task demands might also change over time. For instance, as a student gets older, the length and complexity of written assignments increase. The prewriting accommodations might need to support these more extensive projects.

Question 7

Describe some policy barriers that cause limited access to assistive technology solutions.

Answer 7

Assistive technologies have the potential to help people with disabilities become employed or return to work, complete daily living tasks, meet educational needs, and access community, social, and recreational activities. However, there are many nontechnical barriers that cause the promise of assistive technology solutions to go unfulfilled. There is a lack of awareness on the part of many individuals in the disability community regarding available assistive technologies. Information on assistive technologies needs to be cultivated in teacher preservice programs, consumer advocacy programs, and other programs for nurses, doctors, and related service specialists. There is also limited expertise in the assessment, recommendation, implementation, and use of assistive devices and services. There are no standardized assessments for determining assistive technology supports, and the practitioner needs to know how to lead the client in determining the tasks he or she hopes to accomplish. From this information, the practitioner needs to design assessments and trials to meet the client’s needs. The practitioner also needs to understand how a client’s sensory, cognitive, physical, neuromotor, musculoskeletal, and neurological needs and environmental conditions can be served by assistive technology support.

Question 8

Explain how the Student, Environment, Task, and Tools (SETT) framework can help unify a team and facilitate a client-centered approach.

Answer 8

The school-based teams that help students with disabilities can have many professionals who provide expertise in specific areas of the student’s profile. The professionals who assess and support students include psychologists, education specialists, behavioral specialists, physical therapists, nurses, occupational therapists, adapted physical education specialists, general education teachers, speech and language therapists, the family or caregivers, and the student. Each person on the team brings a unique view of the student’s capabilities and needs, but many school-based assessments focus on areas of deficit. The Student, Environment, Task, and Tools Framework (SETT) is a unifying process that helps teams gather the pertinent information about the student and environmental factors that affect the student and facilitates the identification of student strengths. These areas of strength can facilitate the tasks the student needs to accomplish. The SETT Framework helps the team focus on using the student’s strengths and reducing environmental barriers.

Question 9

Describe why an appropriate assistive technology solution should benefit a client in multiple enviornments.

Answer 9

Assistive technology and environmental supports are interdependent. If the client cannot use an assistive device in one of his or her customary environments, then the device is of no benefit. A client can receive appropriate assistive technology devices and supports, but the environment can still be inaccessible or difficult for the client to access. Some studies not that up to one-third of wheelchair users encounter accessibility issues outside of the home. One-quarter of individuals with disabilities encounter inaccessible buildings in the community. Barriers include lack of signage, narrow aisles, inoperable elevators, and inaccessible bathrooms. Community transportation barriers are often reported by individuals with disabilities. These barriers include difficulties traveling to transportation hubs, limited accessible transportation options, and limited schedules on public transportation. These barriers highlight the need to look beyond the needs of the individual and the technology to find supports that many changes to barriers in the environment.

Question 10

Explain how the human, activity, assistive technology (HAAT) model for a mobility assessment might need to be revisited when the context changes.

Answer 10

An individual with mobility needs will use a mobility device, whether it is a power wheelchair, manual wheelchair, or scooter in many different environments and, possibly, for many different contexts. The settings can include home, workplace, school, and community. One method to validate effective seating and mobility intervention is using the human, activity, assistive technology (HAAT) model to verify whether the person is provided the right technology for the right purpose. The match is reflected in the usability of the wheelchair to accomplish a level of mobility integrity in a given environment. The difficulty the individual and clinician experiences is when the environments and contexts of the individual change, leaving the individual with usability difficulties. As an example, a student’s mobility device might have worked in a classroom setting with desk, but he or she is unable to participate in lab activities around a high table. The clinician will need to revisit the HAAT model when the individual’s environments change.