Assistive Technology

Assistive technology (AT) can dramatically affect the success of your special needs family member.

AT can give students equal access to curriculum, the work environment, or any other environment that use government funding.  Assistive Technology includes devices that are used by individuals in order to perform functions that might otherwise be difficult or impossible.

The AT can compensate for the impairments of the disability, increase classroom participation, foster independence, improve learning and working, assist in communication, and help the individual become successful in multiple aspect of life. In the school environment, assistive technology accomplishes these goals by allowing students with many types of disabilities to see, hear, read, write, and communicate.  In fact, assistive technology often provides the student with the only access to the general curriculum.

People who use AT products and services may have difficulty speaking, typing, writing, remembering, pointing, seeing, hearing, learning, walking, breathing, etc.  Everyone uses assistive technology.  We may not think that the things we use on a daily basis to make our life a little bit easier, like alarm clocks, planners, computers, talk to text software, canes, automatic windows and doors, lined paper, stools or chairs, the list could go on and on.  An individual with special needs may rely on AT devices to perform tasks and be more independent, enriching their life.

AT devices are protected under the law. This means that if there is need for an individual, then the use of the devices cannot be denied.  The Individuals with Disabilities Education Act or IDEA is the federal special education law that addresses services for children with disabilities, set into law in 1975. IDEA requires that states provide a free appropriate public education for children with disabilities, including related services. This law requires schools to provide necessary assistive technology devices and services to help children with disabilities receive an appropriate education. To that end, every child with a disability must be considered for assistive technology.

Section 504 of the rehab act protects qualified individuals with a disability in the US from discrimination in any program or activity receiving FEDERAL FINANCIAL ASSISTANCE—for instance: government offices, banks, educational institutions, hospitals and clinics, etc. So, if money can be traced back to the federal government through grants, loans, tax breaks, and the like. then this law is applicable.

When selecting AT devices, evaluating the product or device is critical.  The goal is to help or improve function, access or ability, not hinder or impede it.  Following the steps below can help us narrow in on the selection process.

Consider: Look at what tools are available and how they may restrict or support skills by doing a skills assessment. With an assessment, we are looking at the easiest or simplest way to solve the problem without distracting others or causing more difficulty for the individual, teachers, or other students.

Consult: After the needs are figured out, ask other people about the AT devices they use. Don’t be afraid to seek out professionals for advice.  Check out websites, blogs, and forums for advice on different devices.  Ask for examples of how the device helps, the limitations one might encounter, and pros and cons of the device.

Conclude:  Once a decision has been made about what is appropriate and what will meet the needs, it then is necessary to purchase, make, or obtain the AT and begin using it.  When we make a decision on AT devices, we must keep in mind that the needs may change, a person’s ability may outgrow the device, or that we might need to reevaluate.

Building in some flexibility when selecting the device can save time and money in the future.  For instance, if a person struggles to turn pages of a book, then an e-reader would be more appropriate.  However, if the person is unable to use a mouse and keyboard as well, then selecting a device that is internet capable may be a better option.  Before you purchase the device, try it out.  Each state has a National Assistive Technology center. Often, families can try out devices or other AT items prior to purchasing.  Below are a few links:

History of Quality Indicators for Assistive Tehcnology

State Tech ACT Projects

Early Childhood Technical Assistance Center

National Center for Technology Innovation

Things to remember about Assistive Technology:

  • AT levels the playing field by providing access
  • Each person requires different types of AT
  • One size does not fit all
  • AT does not have to be expensive
  • AT can change based on the needs, development, and milestones reached by the individual
  • AT is protected by law

“Working Together with Military Families of Individuals with DisAbilities!”

 

Q & A Transportation and Private Schools

I have enrolled my child in a private school in our town.

Q: She is also receiving special education services at our local district. We have been discussing if the District is responsible for providing transportation from my home to the private school. What are your thoughts?

A: We have Washington Administrative Codes (WAC 392-172A-04045: http://apps.leg.wa.gov/WAC/default.aspx?cite=392-172A-04045) that address that particular issue.

If it is necessary for the student to benefit from or participate in the services provided by a parentally placed private school, students eligible for special education services must be provided transportation.

This includes:

From the student’s private school or the student’s home to a site OTHER than the private school.

From the district school to the private school or the students’ home, depending on the time of the service.  For instance, if the student received the special education service at the end of the school day then transportation would be provided home.

Districts are not required to provide transportation from the student’s home to the private school.

Hope this helps!

 

Q&A – Should the Whole Team be Present for an IEP?

Amending the Individualized Education Program (IEP)

Q: My son’s special education teacher informed me she wants to have a meeting to amend his Individualized Education Program (IEP). It is not time for his annual review, but he has met some goals and objectives and she would like to change them. Do you think this is a good idea, and can we do this without the whole team?

A: Absolutely!  If you and the district agree with the changes and write an amendment that would be perfectly acceptable.  Again, both parties must agree and the full IEP Team should be informed – even if they’re not present.  Make sure you get a copy for your records and congratulations on your son’s progress.

 

Hospital to Home

Without a doubt, one of the most stressful situations you can face as a parent is the hospitalization of your child.

Whether it is a planned stay, like a surgery, or an unplanned event, parents are bombarded with a huge number of shifts in their day-to-day life and priorities. Parents are also expected to step in and provide a lot of the care a child receives in the hospital once they are back home and that can be extremely overwhelming. While the purpose of this article is for families with a child who is medically fragile or has a life-threatening diagnosis, it is also meant to offer ideas for the unexpected and planned hospitalizations that can occur in all our families. Hospitalization and Emergency Room (ER) visits for many families with a child who is medically fragile or has life-threatening diagnosis is an ever-present possibility. The hope is to provide some tool kit examples and some ideas to ease the transition back home.

As a parent who has spent a lot of time in ERs, Intensive care units, and the medical floor during hospital stays, I have found that I was better prepared for what was going on and the transition back home when I asked questions and shared what home was like with the doctors, nurses, and therapists. I also found that the hospital social workers were my best friends when it came to asking about support for me as a parent. Even before you talk with the discharge planner check in with the social workers. They often have information about support groups, outside therapists/home help, vouchers, and financial supports that you don’t have the time to think about while your child is hospitalized.

Building relationships and the supports for you with the staff caring for your child can help ease some of the overwhelming confusion.  Especially when there is an extended medical emergency or complex surgery with a long recovery. Keep a small notebook to write down and track what doctors and nurses do, and record the answers to your questions when you ask them. If you have a smart phone, there are multiple apps for this on both iPhone and android platforms. Most important of all is making sure you take time for you and self-care.  This is often the hardest part and frequently we know it’s what we need to do and focus on other pressing priorities.  Remember, when you take time to renew it helps you be there for your family. While your child is hospitalized, the nurses are there to take care of them, so find ways to re-charge. Take breaks and find quiet time for yourself because once you get back home you are often the nurse and parent.

Vital links for your family and your child:

This first link is from the Agency for Healthcare Research and Quality (AHRQ) and takes you to a website that gives some good basic information and links to checklists. After clicking on the link below this text, go to the middle of the page. There will be a link to the “Be Prepared to Go Home Checklist and Booklet” is a good general tool to use. https://www.ahrq.gov/professionals/systems/hospital/engagingfamilies/strategy4/index.html

The second link for a Neonatal Intensive Care Unit (NICU) babies or Pediatric Intensive Care Unit (PICU) babies and is really targeted to supporting parents of infants. https://www.ahrq.gov/professionals/systems/hospital/nicu_toolkit/nicu-packet.html

The last link is a great way for families of children with complex medical needs to prepare ahead of time just in case. This link is for the Family Voices collaborative care notebook template that has places for all of the information that goes with the care of your child. This tool can be used to provide information to the hospital and ER. Some families have used the child sheets or the emergency information sheets as a one pager to take with them to the ER or for extended hospitalization. This sheet provides the multiple doctors and staff that you see with consistent accurate information. There are also schedules that a child might need in their care and they can be used to record care needs in the home. http://www.fv-ncfpp.org/files/5813/0721/3621/Care_Notebook_-_entry_enabled1_reduced.pdf

These tools have been a great help in supporting my family with multiple hospitalizations and it is my hope they will be useful for you too!

 

Home for the Holidays: The Gift of Positive Behavior Support

The holiday season is upon us!

Good food, family gatherings, festive decorations, changing seasonal weather and a break from school may provide you and your family with peace, hope and joy.   If your child struggles with changes in routines, different food items on the menu, overstimulating environments, long periods of unstructured activities or sensory issues that make long pants, socks, gloves, coats and hats feel like shards of glass against their skin, you may not find too much merriment in the coming weeks.

But it doesn’t have to be that way. All behaviors serve a purpose – they are a way for the child to solve a problem. Without the appropriate social skills our kids will do what is necessary to have their needs met in the quickest way possible. However, if we can predict problem behaviors, we can prevent them.

Set your child (and family) up for holiday success by thinking ahead about the types of routines and situations that might be challenging and then craft a plan to prevent problem behaviors or intervene early before they escalate. The first step is to create a best guess statement as a way to better understand the relationship between the behavior and the child’s environment. This summary should include a description of the behavior, what happens before and after the behavior, circumstances that set the stage and what seems to be the purpose.

Here is an example of a best guess statement:

At Grandma’s holiday gathering when someone tells my child to try a food she doesn’t like, tries to force a “please or thank you”, or scold her inappropriate behavior (what happens before), she will cry and yell loudly (a description of the behavior). When she does this, others leave her alone (what happens after). She is more likely to do this when she is tired, hungry or in a new or unpredictable situation (sets the stage). We think she engages in these behaviors to avoid unpleasant people, food or situations (purpose).

To create your own best guess statement, replace the underlined words with descriptions about your child’s behavior and surrounding circumstances. Once you have a good guess about what causes and maintains the behavior under certain circumstances (e.g., crowded or overstimulating environment, being rushed, being told they can’t have or do something they want, different expectations, demands, exhaustion, hunger) you can come up with a plan and potentially avoid a worst case scenario.

When determining the purpose or function of behavior carefully think about what typically happens (what others say or do) after the behavior occurs. Does the child get something or get out of something?  This could include seeking or avoiding attention (from adults or peers), an activity, a tangible (a toy or other object), or sensory stimulation. The behavior may be inappropriate but the reason for it usually is not.  Most of the time there is an obvious reason for misbehavior once we take a few moments to break it down into these different components.

Make a list and check it twice: prevention is key

Many behaviors can be prevented using simple proactive strategies – we underestimate the power of prevention. Using the best guess statement from above, here is an example of a list of some different strategies to prevent or reduce the intensity, frequency or duration of the behavior.

make sure she is well rested and has eaten before going to grandma’s house

bring some food to grandma’s that she likes and would recognize on her plate in case the new food isn’t appealing

extend family expectations (respectful, responsible, safe) to other settings such as Grandma’s – teach what each looks like during difficult activities (e.g., during the gift exchange respectful looks like saying thank you or smiling at the person who gave you the gift).

  • allow her to bring a comfort item (toy, book, blanket)
  • teach a signal she can show to indicate a need to take a break
  • create a social story about family gatherings and review on a regular basis
  • rehearse going to grandmas, practice the specific routines (meal time, opening gifts, playing with cousins)
  • arrive early to allow her to get comfortable before the house gets crowded
  • create a visual schedule of the events – let her cross off as each occurs

Your brainstormed list may look different than this one – but there may be similar themes. Next, select the strategies that are easiest to implement have the highest probability of working. An essential prevention strategy is teaching your child what to do instead of displaying the problem behavior. This other behavior is often referred to as the replacement behavior. The replacement behavior must achieve the same results just as quickly as the problem behavior. For example, if you teach your child a signal to let you know that she needs a break then you must ensure she gets a break as immediately as she would if she were to scream and cry. Responding quickly to the replacement behavior will strengthen it and make the other behavior no longer useful. Teaching involves demonstrating the behavior, providing many opportunities to practice, and letting the child know they did it correctly (the same way you might teach them to ride a bike or learn their colors).

All is calm: intervene early at the first sign of trouble

Be ready to prompt appropriate behavior, redirect, or offer a calming activity as soon as you notice early signs of agitation or frustration. Pre-correction is a strategy to use when you anticipate a problem behavior by prompting what they should do instead. For example, if you notice your child getting frustrated you can say, “remember, you can give me the peace signal if you need a break.” A simple redirect to another activity or topic can decrease chances that the problem behavior will escalate. Handing your child a comfort item or showing empathy can also help alleviate anxiety.

Raise the praise: giving effective positive feedback

Praise expected behavior so your child is encouraged to continue using appropriate behavior. Normally a 5:1 positive to negative ratio is an acceptable rate, however you might want to consider increasing the praise during difficult routines. Provide frequent, genuine, and specific praise. For example, you could say, “you did a nice job sharing that toy with your cousin!”

Do you hear what I hear? Responding to escalating problem behavior

Not all challenging behaviors can be prevented. A child’s ability to control their emotions can often be overestimated by adults. When a child is experiencing significant distress, they are less likely to be able to process what is going on around them — including following what may seem like simple instructions. If, despite your best efforts, the behavior escalates, plan a graceful exit and remove your child from what is causing or maintaining their behavior.  Wait for your child to be calm before addressing the issue. Learn from what worked and didn’t work and adjust your strategies next time.

Believe

What might seem fun and relaxing to adults, could be overwhelming and upsetting to children.  Children are more likely to exhibit the behavior that will most quickly get their needs met, regardless of the social appropriateness. Acting-out is typically a symptom of an underlying issue – it’s important to get to the root of the problem for long-term positive results. Prevention strategies and intervening early can be very effective – yet often underutilized. Think ahead to what can be changed in the environment to eliminate, modify or neutralize anything that might trigger a problem behavior. Support the positive behavior by teaching and reinforcing expected behavior. Ensure consistency and predictability. These small changes can make a big impact this holiday season and beyond.

Resources:

Center on the Social and Emotional Foundations for Early Learning (CSEFEL) Parent Training Modules: http://csefel.vanderbilt.edu/resources/training_parent.html#workbook

Durand, V.M. (2011). Optimistic parenting: Hope and help for you and your challenging child. Baltimore: MD: Paul H. Brookes.