Assistive TechnologyTECHNOLOGICAL ADVANCES LEAVE MANY BEHIND: Children with disabilities. Technological advances and innovations in computer software have opened the door to various ways educators can teach their students, as well ways in which their students can learn. It is not unusual in today’s world for a classroom to be equipped with upgraded computer systems and educational technology to facilitate the learning process. Children in elementary school are already becoming Internet savvy, while other technological advances allow two classes on opposite sides of the world to interactively learn together. However, like with any advance or upgrade, there are always those who are left behind. Many of these technological advances that facilitate the learning process are designed for the masses and those that do not fit into that category are often left out. Children with disabilities, physical or mental, are often the ones that are unaccounted for. According to a report by the World Health Organization, only 10 to 12 percent of children are afflicted with disabilities, which in most cases, is why technology is not fitted to their needs. According to a 2002 release by the Office of Special Education Programs, in the past 10 years, the percentage of students with disabilities served in schools and classes with their non-disabled peers has gradually increased. Approximately 96 percent of students with disabilities, ages 6-11, receive their education in regular education classrooms. The 1997 Reauthorization of the Individuals with Disabilities Education Act calls for providing access to the general education curriculum in order to improve outcome for all students (according to atto.buffalo.edu). However, it is the access to the technology within schools which roadblock children with disabilities. According to a 2001 study by the National Center for Educational Statistics, over 76 percent of American students use a computer at school, while Internet access in public schools has increased to 78 percent. So how can a child with disabilities keep up with non-disabled peers in an educational setting? The answer: Assistive technology. The Assistive Training Online Project defines assistive technology as the tools and strategies that act to liberate the use of technology for all students as well as to provide new ways to “assist” interactions and learning. In a 1994 report titled, “Assessing Special Needs” author R.B Lewis defined A.T. as a way “to augment abilities and bypass or compensate for a disability.” Basically, assistive technology is anything that makes reading, writing, communicating, and moving a little easier for a person with disabilities. An example of assistive technology is adapted wheelchairs. Children with cerebral palsy often have many physical limitations, including limited motion/muscle tone in their hands and arms, paralysis from the waist down and sometimes a combination of these disabilities. An adapted wheelchair may have its directional controls on the head rest, rather than on the arm rest. This enables children with difficulties in moving their arms or controlling their arm movements to move their wheelchair by simply pushing their head back or from side to side on their head rest. Another type of adapted wheelchair offers mobility for even those with major disabilities. For a person who cannot use their head to maneuver their wheelchair, wheelchairs can be fitted with blow tubes, where the user can blow into the tube, which in turn moves their wheelchair in a designated direction. Mobility in children with disabilities is the first step toward integrating them into classrooms with their own peers.
HOW DOES ASSISTIVE TECHNOLOGY WORK?
Advances in assistive technology have allowed many children with disabilities to stay ahead of the learning curve. However, determining the assistive technology needs of a child depends on the child’s disability.
One of the most basic, but most effective pieces of assistive technology equipment is known as a “plate switch.” A plate switch is an interface that helps a child with low muscle tone compensate for their lack of function. A plate switch has the same basic function as a mouse for a computer. However, children with disabilities/ low muscle tone in their arms have difficulties placing their hand on a mouse, as well as successfully clicking the mouse on a designated area. Software, in addition to the plate switch, is often used with younger children to help them develop the cognitive skill of cause and effect. For instance, at United Cerebral Palsy in Roosevelt, New York, Tommy is a 4-year-old with quadra-palegia cerebral palsy. This means that his cerebral palsy affects both his arms and legs. Also, the muscle tone in his right arm far surpasses the muscle tone in his left arm, thus making it much more difficult for him to use his left hand, let alone lift his left arm. So in an attempt strengthen the tone in his left arm and help him develop basic cause and effect skills, Tommy sits with his occupational therapist in front of a computer screen with a plate switch. The computer game they play is simple. With his left hand, he presses the plate switch, which is the same as clicking a mouse, and a digital boom box appears on the screen and plays a song. Interestingly enough, when he presses the switch with his right hand, he presses it repeatedly, without any realization of the affect of him pressing the switch. To Tommy, continually pressing the switch without realizing the consequence of it is more than enough fun. However, when his occupational therapist holds his right hand down and he is forced to use his left hand to press the switch, he focuses more intently to move his left hand and press the switch. After pressing the switch with his left hand, Tommy notices that a song is played after he presses the switch. This is the cognitive skill of cause and effect that can be developed in young children through the usage of plate switches. The next step beyond plate switches is linear scanning. This also uses a switch, but is used not only to develop cause and effect skills. Linear scanning is very simple. In a computer game, several letters appear in rows on the screen. Then, a target scans slowly across the rows and the student not only has to build words, but time his/her responses with the switch, so that the target lands on the letter they need to spell the correct word. This helps the child develop timing and accuracy as well as offer them a fun way to learn spelling. The most advanced form of scanning is cross-scanning. It encompasses the same concept of linear scanning, but rather than the mouse/switch scanning across one line, it scans in different directions, similar to a tic-tac-toe board. For the most part, cross-scanning is used for the children to play games that in most circumstances, they wouldn’t be able to play, but more importantly, cross-scanning is used to help children with speech impediments. Assistive technology experts at DynaVox Systems, LLC created a portable communication device they named a DynaMyte. The DynaMyte “provides a way for students with communicative disabilities to initiate, respond and converse.” The way the DynaMyte works is through cross-scanning. The target scans a sequence of picture symbols and the child selects which symbols they want and in what order. Once the order of symbols is complete, the computer “says” the sentence constructed by the child. Cross-scanning and DynaMyte’s are a huge step towards having children with disabilities being in the same classroom as their peers without disabilities. Now children with disabilities, especially those with speech disabilities, have the opportunity to be part of the class and not left behind because they can’t express their thoughts and feelings.
TECHNOLOGY THAT INTEGRATES LEARING:
Developing cognitive skills in small children is only one aspect that assistive technology targets. Many older kids with cerebral palsy have the cognitive level to spell out on a computer, but don’t have use of their hands to type or have the ability to speak clearly. So companies like RJ Cooper and Associates and Judy Lynn Software, who specialize in creating assistive equipment for people with disabilities, developed what they call an adapted joystick. The adapted joystick can be used for children and adults with various levels of disabilities. Take Jess for example. Jess is 16-years-old and has athetoid cerebral palsy. Athetoid cerebral palsy is a disorder that affects the muscle tone in her extremities. The muscle tone in her body fluctuates from time to time which makes it difficult for her to control her movements and motor skills. Her occupational therapist Erin uses the adapted joystick with Jen for several reasons. One reason is so Jess can play computer games and have fun in regular activities that children without disabilities get to have. Secondly, the use of the adapted joystick helps Jess control her involuntary muscle movements and focus her strengths. The adapted joystick gives her more surface area to grab on to and the speed on the joystick is lowered, so if her arm jerks to the right unexpectedly, the joystick arrow does not go flying in that direction as well. One of the exercises I observed Jess and her therapist Erin work on the computer with was a virtual puzzle. Though there were only five to six pieces, Jess’ job was to pick the puzzle pieces and assemble them into a picture. Though this may seem as a fairly easy task, it is quite daunting for a person who does not have full control of their hands and arms. The adapted joystick gives Jess the focus, relaxed, slow pace she needs to click on the pieces she wants and place them into their correct slot in the puzzle. Not only does the use of the adapted joystick help her physically, it also motivates her to know that with a little help, she can participate in the games that other children play, as well as do it on her own…which is a key part to her assimilating into the “regular” society. Another student at UCP Roosevelt, Mikhail, is 17-years-old and has spastic-quad cerebral palsy. His cerebral palsy affects all four of his limbs and since he has spastic cerebral palsy, it means he has very high muscle tone. High muscle tone makes Mikhail’s body very stiff and even stiffer when he gets excited or attempts to talk. His CP also inhibits him from talking. The adapted joystick is used with Mikhail in a similar fashion Jess used it. Since his CP affects his movements, the bottom of the joystick is lined with Velcro which attaches to the side the Mikhail’s chair. The Velcro is needed because of Mikhail’s spastic movements; he’s prone to knocking the joystick off his wheelchair tray table. Jessica, the assistive technology computer specialist at UCP Roosevelt, works with Mikhail on “speaking.” The computer program Jessica uses with him has a variety of pictures on the screen (ie. “I got dressed”, “Read a book”). She then asks Mikhail questions like, “What did you do this morning?” With the joystick, Mikhail can direct the joystick and pick a particular picture on the screen. He will continue to pick pictures until he creates a segment, or better yet a sentence. Once the sentence is complete, all he has to do is hit the joystick button and his sentence is read aloud by the program. Assistive technology has improved the lifestyle and learning atmosphere for Mikhail and many other children with disabilities, however there is still more to be done. Prices for assistive technology equipment are often high and facilities like United Cerebral Palsy cannot afford a lot of the equipment that their children need. With lower prices and new technology being created everyday, hopefully the segregation of children with disabilities and their peers in classrooms will become a distant memory.
The Time is Now: Assistive Technology Opens the Door for Those Locked Out Tyler silently sits in front of the big screen television in
his bedroom. It's his free time now. He’s already
seen his school tutor, his occupational therapist and his speech
therapist, and that was all in one day. Tired from a full day of school, treatments and everyday wear-and-tear on his body, he cracks a smile while watching his favorite basketball team: the Philadelphia 76ers. He doesn’t talk much, but when he does, he talks in short breaths because his cerebral palsy not only forced him into a wheelchair, but impaired his hands and speech. Born with cerebral palsy in 1993, Tyler will never be able to speak “normally,” feed himself dinner or walk, even after undergoing nine surgeries to repair muscle disorders in his hips, legs and groin. So he sits, content with what he’s watching, but inside, his everyday struggle weighs on him. “You don’t know how frustrating it is to be me,” Tyler said.
However, Dylan must play his Xbox alone. The hand-held controller Dylan uses is the default Xbox controller and with Tyler’s cerebral palsy affecting the use of his hands (his CP forces his hands to stay in a fist form); he can’t grip and balance the controller in his hands. So as usual, Tyler watches his brother play, unable to participate in the fun and unable to do the same things his twin brother does. If Tyler wants to change rooms and watch television in the living room, he has to call for someone to turn on his wheelchair and then move the powered wheelchair by touching his head to the sensors on his head rest. A daunting and energy consuming task, and after a long day of class and treatments, he’d rather just stay put. Tyler’s story is just one of many stories of children with disabilities in this country. Motivating children with disabilities with software and equipment designed for children without disabilities is a dead-end street, just ask Elliot Pludwinski, a software developer who has a daughter with disabilities and faced the same difficult task of motivating his child to do just about anything. Pludwinski’s daughter is 18-years-old, but her brain level is of a one-year-old child. Elliot could not find any software on the market that could motivate his daughter, so since he was a computer programmer, he decided to design software for his daughter on his own. He attempted to build the software on DOS, but at the time, there were not any interfaces for IBM compatible machines. However, the roadblocks he encountered did not slow his determination. Elliot had a friend at Dell Computers and together, they sat down and created one of the first ever plate switches. This was 13 years ago and Elliot has been creating assistive technology ever since. But none of this would have been possible without his daughter, Judy Lynn, whom he named his company after. Judy Lynn Software is one of the largest manufacturers of assistive technology in the country and has created software unlike anything in the assistive technology market. Everything Judy Lynn sells comes straight from the mind of Elliot Pludwinski. His top selling software is a virtual boom box program where plate switches help children with disabilities control all levels of an MP3 player. Though he makes a decent buck by selling his software to mostly school districts, there is an underlying reason why Elliot continues to produce top of the line assistive software. “First off, it’s rewarding. Over here (at Judy Lynn Software) there’s so much creativity, creating animation and you’re seeing children who really benefit by it,” Pludwinski said. In addition, seeing first hand what his assistive technology has done for his own family, helping other families motivate their child with a disability is a reward in itself. “It’s amazing when a parent says to you nothing ever motivated my child, but you’re giving my child a chance to open up. That is the main reason why I do it,” Pludwinski said. Though they may have the same goal in mind as Judy Lynn Software, assistive technology company R.J. Cooper and Associates started their journey into helping people with disabilities 23 years ago. R.J. Cooper studied electrical engineering at the University of Utah, but did not have the desire to spend the rest of his life being a “techy” for some computer company. “I wanted to use that educational background I got at college to help humanity,” Cooper said. “So I came up with the concept of using computers with people with disabilities. Plus, only 20 to 30 people in the world were using this technology.” So Cooper took advantage of the opportunity to create an income for him and his family, while at the same time making an impact on people around the globe. Unlike Elliot Pludwinski though, Cooper does not come up with ideas for software on his own. He meets with occupational therapists, speech pathologists and parents from around the country to gather ideas and information on what people with disabilities need. He then either works with the parent or the therapist through an interactive process, designs the software, gives it to them free, then sells it on his website. Besides the money and the fact it was “better than joining the peace corps,” the response Cooper gets from his customers is enough to satisfy him. “I get emails at least once a day from someone telling me that something I did made a difference in their kid’s or wife’s life. That’s a big thing to get those emails, it makes me feel really good,” Cooper said. Occupational therapist at United Cerebral Palsy in Roosevelt, New York Erin Finneran has had first-hand experience with assistive technology and the positive effects it has on her students with disabilities. When she first began working as an occupational therapist, she had a student who used a small round switch plate by her knee to access her DynaVox. However, since the student had what OT’s call an “extensor thrust,” which means when the student gets excited, the student’s muscles tense up, and the student would knock the plate switch off her wheel chair. Erin decided to move the switch to the student’s lap tray on her wheelchair, which allowed for the student to press the switch with less effort and with more accuracy. “This child went from not participating in the classroom because she couldn’t communicate to teachers asking her questions. Now she was able to participate and show us how cognitively aware she is and participate in learning,” Erin said. Occupational therapist at UCP Diana Forcina had similar success with students using assistive technology. She described working with a student with significant physical and cognitive limitations. The student required ventilator support and had very little volitional movement (ie. head movement). Using a universal switch mount, the child was able to access a switch using her head to turn towards the switch to access using her cheek. “Although the movement she needed to access the switch was not consistent, it was very rewarding to see a child with so many physical limitations being able to access a computer independently,” Forcina said. “It’s stories like this that make you realize how using the computer is such an amazing way for individuals with special needs to access their environment.” Forcina said that working on basic switch activation skills provides a solid foundation for higher-level communication skills. Some children, she said progress to working on different choice programs using two different switches to prepare them to access communication devices. Though there are numerous success stories involving people with disabilities and assistive technology, not many schools and parents with children with disabilities can afford the steep prices some of these companies charge. Switches and assistive software are priced moderately, mostly in the $100-$200 range. However, additions to powered wheelchairs and more advanced technology can cost up to $3,000. Considering the technology that is available on the market today, there are still assistive technology products that have yet to be designed. Assistive technology computer specialist at UCP Roosevelt Jessica Jean-Charles said she looks forward to seeing a speak-and-spell computer program created that could decipher distorted speech into words on a screen. Occupational therapist Erin Finneran hopes to see wheelchair simulation software created, which would help OT’s decide what is best for the child and their mobility skills. RJ Cooper is working on developing an alternate game controller so people with disabilities can be involved in playing Xbox as well as use a cell phone through voice activation. Cooper’s design for a game controller was inspired by an alternative controller he found on the market, then he modified it so it can be used by a person with disabilities. “I use products made for the mainstream market then modify it for the assistive technology market. It helps keep my prices down,” Cooper said. With this in mind, it won’t be too long before Tyler can join in with his brother Dylan playing whatever Xbox game he chooses. Children like Tyler and Dylan often are left out when technology developers are developing software for the masses. But now, with the help of RJ Cooper and Judy Lynn Software, Tyler and Dylan will be given the same chances and opportunities to learn, play and just have fun like any other kid. |
His twin brother Dylan, who has a lesser form of cerebral palsy, comes into their bedroom. He too is in a wheelchair, but has full range of motion in his right hand and has normal speaking capabilities. Dylan can feed himself and maneuver his power chair with the joystick on the right armrest of his powered wheelchair. He turns the Sixers game off and turns on his Xbox, rearing to continue his Madden 2007 season. 
