Autism Society of Greater Cleveland

Federal Legislation and Assistive Technology

 

The legislation discussed below outlines the federal government's recognition "...that for all individuals, technology can provide important tools for making the performance of tasks quicker and easier, but for some individuals with disabilities, assistive technology is a necessity that enables them to engage in or perform many tasks." (OSERS NEWS In Print, 2(1), 1989). For more information about any of these laws, contact your State Education Agency, State Developmental Disability Council, State Protection and Advocacy Agency, parent or disability group, or write to NICHCY. In addition, single copies of these laws may be obtained, usually for about $1, by writing to the Superintendent of Documents, U.S. Government Printing Office, Washington, D.C. 20402. Information may also be available by contacting your Congressional Representative.

I. 1986 Amendments to the Rehabilitation Act (P.L. 99-506)
Title I of the Rehabilitation Act authorizes over one billion dollars to the states to provide rehabilitation services including evaluation, counseling, training, placement and rehabilitative technology services to individuals who qualify for vocational rehabilitation services.

The 1986 Amendments require that states receiving funds available under this Act must "describe how rehabilitation engineering services will be provided to assist an increasing number of individuals with handicaps."

The Amendments also include a definition of rehabilitation technology services as "the systematic application of technology, engineering methodologies, or scientific principles to meet needs of individuals with handicaps in areas which include education, rehabilitation, employment, transportation, independent living, and recreation."

The law requires that in assessing an individual's potential for rehabilitation services, rehabilitation engineering services should be explored. In addition, part of the Individual Written Rehabilitation Plan (IWRP) should include, where appropriate, a statement on the benefits of rehabilitation technology services for the individual's rehabilitation goals.

II. Developmental Disabilities Assistance and Bill of Rights Act Amendments of 1987 (P.L. 100-146)
The Developmental Disabilities Assistance and Bill of Rights Act requires that all funded services be aimed at providing opportunities and assistance for persons with developmental disabilities to allow them to "achieve their maximum potential through increased independence, productivity and integration into the community."

The 1987 Amendments require that each state submit an annual report including descriptions of the currently unavailable assistive technology services which could be of benefit to persons with developmental disabilities.

Funds authorized under this Act may be used for planning, advocacy, systems change, and direct services. These direct services may include assistive technology services.

III. Education of the Handicapped Act (P.L. 94-142) and the 1986 Amendments to the Act (P.L. 99-457)
The Education of the Handicapped Act (EHA) requires that states provide a free, appropriate, public education, including related services, for all children with disabilities from ages 5 to 21. The 1986 Amendments to the Act require that states provide special education and related services to children from 3 to 5 years of age no later than the 1991 school year, and establishes a new, voluntary state grant program for providing early intervention services for infants and toddlers with disabilities (ages birth to 2 years).

The law requires that each child receiving special education and related services must have an Individualized Education Program (IEP) or an Individualized Family Services Plan (IFSP, for children birth to ages two), designed to meet their uinique needs. The IEP or IFSP should reflect the assistive technology needs of the child.

Part G of the Act authorizes the Secretary of Education to make grants or enter into agreements with appropriate institutions to advance the use of new technologies, media and materials used in educating students with disabilities.

States differ on the issue of providing assistive technology under the Act. Some states do provide technology-related assistance as part of related services, while other states have made no such provisions.

IV. Elementary and Secondary School Improvement Act of 1987 (P.L. 100-297)
This Act is a consolidation of legislation on programs for elementary and secondary education. A number of the amendments are designed to conform the Act more closely with the Education of the Handicapped Act. This includes the P.L. 99-457 requirement for early intervention services to children between birth and age 2.

The Act allows states to use authorized funds for programs which may include the acquisition of equipment and instructional materials. Funds may additionally be used for training in the use of assistive devices and other specialized equipment.

V. Social Security Act, Budget Reconciliation Act of 1986 (P.L. 99-509)
A. Medicaid. Medicaid funds provide medical services to qualifying individuals. States are required to provide certain basic medical services but can elect to cover other services as well.

Assistive technology devices are covered only if they fit into the Medicaid definition of a prosthetic device. Prosthetic devices are defined as replacement, corrective, or supportive devices prescribed by a physician or other licensed practitioner. Additional covered services include "other diagnostic, screening, preventive and rehabilitative services." This language might be seen as including assistive technology devices and services. States differ greatly in what they will cover in this area. Some states allow Medicaid funds to be used for augmentative communication devices. Other states will not allow funds to be used for equipment they do not consider to be a prosthetic device.

Individuals in active treatment in an Intermediate Care Facility for the Mentally Retarded and other related conditions may be eligible for assistive technology services under Medicaid regulations. Active treatment could include mechanical supports to achieve proper positioning, toilet and bathing facilities, communication aids, and other devices.

B. Maternal and Child Health Services Block Grant (Title V). Maternal and Child Health Services funds may be used by each state for its own priorities. Many services may be funded including: early identification and intervention services, diagnostic and evaluation services, family support services and "medical, surgical, and corrective services." Some states are currently using Maternal and Child Health Services funds for adaptive equipment and assistive devices including wheelchairs for children with disabilities.

VI. Technology-Related Assistance for Individuals with Disabilities Act of 1988 (P.L. 100-407)
Citing the inadequacies of available access, trained personnel, and financing in the area of assistive technology, Congress enacted P.L. 100-407 with the purpose of extending the availability of assistive technology to individuals with disabilities and their families. "

Assistive technology device" is defined by the bill as "any item, piece of equipment, or product system whether acquired off the shelf, modified or customized that is used to increase, maintain, or improve functional capabilities of individuals with disabilities." The broad definition of devices and individuals included under this law gives states great flexibility in the programs to be developed.

Title I provides states with funds to develop a consumer responsive state system of assistive technology services. States receiving funds may develop or carry out any of the following:

  • model delivery systems;
  • state-wide needs assessment;
  • support groups;
  • public awareness programs;
  • training and technical assistance;
  • access to related information;
  • interagency agreements; and
  • other activities necessary for developing, implementing, or evaluating a state-wide service delivery system.

Nine states have successfully competed for funds. Twenty additional states could be added in 1990 with the remainder to be added in 1991.

Title II of P.L. 100-407 authorizes the federal government to perform various activities to assist the states in the development of their service delivery systems. These activities include: a study to be undertaken by the National Council on Disability to identify practices which facilitate or impede financing of assistive technology devices and services; and, a study of the need for a National Information and Programs Referral Network to assist states to respond to technology-related information needs.

In the Fall of 1989, nine states were awarded funding to plan and establish statewide programs of technology-related assistance. These states included: Arkansas, Colorado, Illinois, Kentucky, Maine, Maryland, Minnesota, Nebraska, and Utah. For contact information about these programs in your state, contact the Center for Special Education Technology, or the Association for the Advancement of Rehabilitation Technology (RESNA).

In addition to the state awards, the National Institute on Disability and Rehabilitation Research (NIDRR) awarded a contract to RESNA, an interdisciplinary association for the advancement of rehabilitation and assistive technology, to provide technical assistance and information to States on the development and implementation of a consumer-responsive statewide program of technology-related assistance under this law. For more information, contact RESNA (703) 524-6686.

Understanding and becoming aware of the laws relating to assistive technology can make a significant difference in how, where, and when you gain access to these services. For a listing of any of the groups mentioned in your area, contact NICHCY and ask for a State Resource Sheet.

1996 Note: This overview of the laws is quite out of date. For more current information on the laws

  • Where significant advances have taken place in terms of addressing the needs that children with disabilities may have for assistive technology devices, please contact NICHCY and ask for copies of:
  • News Digest 15: The Education of Children and Youth with Special Needs: What Do the Laws Say?
  • News Digest 21: Questions and Answers about the Individuals with Disabilities Education Act
  • Transition Summary 8: Transition Services in the IEP

Each of these documents provides current information on children's rights to request and obtain assistive technology devices to meet their special needs.

 

Autism Society of Greater Cleveland

Effective Use of Technology With Young Children

Computer technology for young children has only recently been recommended for use in the home and applied on a large-scale in early childhood special education programs. Available technology and information about its use with young children has lagged behind that available to other groups for a variety of reasons, such as: the high cost of hardware, a limited amount of developmentally appropriate software, limited funds to investigate the potential of computers as a teaching tool, lack of skill on the part of professionals in creating a range of response modes, lack of training and skill in computer use by early childhood special educators and parents, and the fear that technology would overshadow the human aspects of early intervention (Berhmann, 1988; Hutinger, 1986).

In the past several years, however, changes have occurred which have made computer technology more accessible to early childhood educators, therapists, parents, and children. Equipment is now more affordable, a wide range of developmentally appropriate software is available, and a variety of response modes have been developed which allow almost any child to access a computer (Burkhart, 1980; Charlebois-Marois, 1985; Goossens & Crain, 1987). Publications and training have made early childhood educators, therapists, and parents more aware of the potential impact computers can have on infants and young children. The appropriate application of technology can assist families and professionals in learning about a child's capabilities. As more educators and therapists have successfully incorporated computer use in their early intervention and preschool programs and as parents begin using computers in their homes, there has been a growing acceptance of the belief that technology can serve to enhance, not supplant, one-to-one interaction with infants and toddlers (Lazzari & Wilds, 1989).

Skills for Interactive Use of Computers

Special educators and therapists using computers in their programs have learned that when some beginning skills are introduced, computers become less complex devices for preschoolers (Rettig, 1987). Introducing these skills can reduce the natural tendency for a young child positioned in front of the computer to bang on the keyboard and possibly become frustrated and lose interest in approaching the computer again or learning that the computer is a toy to react too, not interact with. With this awareness, parents and educators begin to think of the computer as more than a pacifier to keep children quiet. The primary aim should be to allow young children with disabilities access to the assistive technology which will be most appropriate to their needs and to provide for the maximum participation of the young child in social and educational environments. To reach this goal, many skills may be necessary for using this technology effectively. For families and programs with limited funds, these skills can be developed without access to expensive computers or technology devices. The following is a list of some of the beginning skills that should be considered. This list is intended to assist parents, educators, and therapists in adapting the computer's use to the child's current level of skills. Keep in mind that not all children will need total mastery of all of these skills. With some children, these skills can be developed simultaneously with the computer and adult intervention. Each child should be individually assessed to determine the potential benefits of technology.

Motor Skills

  • Range of motion
  • Press and release
  • Reliable and consistent motor movement

 

Visual/Perceptual Skills

  • Visual tracking and scanning
  • Figure ground
  • Form discrimination

Cognitive/Language Skills

  • Cause and effect
  • Attention span (sustained or selective)
  • Object permanence
  • Means/end causality
  • Imitation
  • One-to-one correspondence
  • Intentional behavior (desire to communicate)
  • Symbolic representation (recognize pictures)
  • Reliable yes/no response
  • Receptive understanding of commands
  • Making choices

 

Social/Emotional Skills

  • Initiating and terminating interactions
  • Turn taking and waiting for turn
  • Attending to an object or person
  • Following one-step directions

This list of skills may initially seem overwhelming, unrelated, or overly simple; yet these skills are included in most preschool checklists and taught using other materials. In addition, these skills can be introduced and taught by using simple and inexpensive toys and switches. Toys and switches are concrete objects that are naturally motivating to young children. Many battery operated toys can be used to teach a young child many of these skills, and any toy operated by batteries can be adapted for switch activation. By adapting toys for use to introduce and teach these beginning skills, teachers, therapists, and parents can help a young child prepare to use computers and other assistive technology. Once children have some experiences with toys and switches, they are better prepared to have successful interactions with the computer.

How to Select Battery Operated Toys and Switches

The importance of play for very young children cannot be overemphasized. For children who have a physical disability or who are generally uninterested in manipulative toys, battery operated toys that are adapted to work with single switches can be used. Battery operated toys and switches can be the tools for developing play skills with objects and with peers. They also provide children with physical disabilities increased control over the classroom and home environment (Musselwhite, 1986).

Selecting toys and switches for young preschool-aged children requires that parents, teachers, and therapists consider several important factors. The most important factor is to become an expert. Make a list of your young child's strengths and needs and choose toys which meet your child's requirements. Collect information from parent support groups, toy lending libraries, information centers, manufacturers, and through exchanges with other parents, teachers, therapists, and others. (Additional resources are listed at the end of this NEWS DIGEST.)

When purchasing battery operated toys, it is important to remember that there are different kinds of toys. It is important to consider a variety of battery operated toys that reflect a range of sensory inputs. For example, toys with flashing and multicolored lights provide visual input; tape recorders, musical, and other noisy toys (e.g., animal sounds, sirens) stimulate a young child's auditory senses. Blowing fans and vibrating toys provide tactile and vibro-tactile input. Toys should also provide for a variety of movement patterns: stationary, horizontal, vertical, and circular movement. Examples include a drumming bear, a walking robot, a fireman go-ing up and down a ladder, and small train or car track sets. Toys should be chosen that can be easily incorporated into play routines (Musselwhite, 1986), as well as for their motivation and age appropriateness to the individual child (Greszko, 1988).

As with the purchase of toys, the teacher, therapist, and parent should acquire a variety of switches that can be used with children on different developmental levels and physical skills. Finding an appropriate switch or switches that match the child's physical requirements is extremely important. The child must have a reliable motor movement that can consistently activate the toy. As the child becomes more capable, the more reliable motor movements available to activate switches will provide a means of more efficiently interacting with his or her environment. Recent technology (Greszko, 1988) has provided a variety of mechanisms for these children to activate toys other than simply using a switch activated by a press of the hand. For example, children can use an eye-blink switch or a puff switch to activate a device. Pressure sensitive switches that require only a minimal amount of movement are now on the market. Voice activation of devices is also now possible.

Computer Application

Once children have a variety of experiences with toys and switches, they are often better prepared to have more successful interactions, not reactions, to the computer. A wide variety of appropriate and inexpensive software is now available for preschoolers. Software for microcomputers generally falls along traditional academic and readiness domains and uses color, graphics, animation, sound, and voice synthesis for this population. When introducing computers to very young children with disabilities who have been exposed to the toys and switches noted previously, it is important to minimize the number of new concepts and skills. Most of this software is written for the Apple II series of computers, which is the computer available in most schools. This software can be used with a variety of peripheral devices that are appropriate for preschoolers. The keyboard is very busy, and young children are easily distracted or unable to focus on a limited selection of keys that activate the computer. Commonly available peripheral devices include touch monitors, adapted keyboards and touch pads, voice activation, and switch interfaces. The TouchWindow by Personal Touch is a touch-sensitive screen that is placed over the monitor. This screen allows the child to use direct selection, touching the monitor, to activate the software. Touch pads include the Muppet Learning Keys by Sunburst and the Power Pad by Dunamis. These pads can be modified into single or multiple switches and adapted keyboards. The Muppet Learning Keys, for example, have the alphabet in order, as well as a ruler that illustrates numbers, and a watercolor set for color selection.

Introducing technology to very young children with disabilities is still quite early in its development. While there are many obvious potential benefits to early intervention using this technology, the state of the art is still not sufficiently advanced to enable parents and professionals working with these children to meet their needs easily. However, these children can be trained in many of the skills necessary for successful use of computer and augmentative communication technology without the use of expensive or complicated equipment. Thus, when they are physically and developmentally ready to use available technology, these children will be able to receive the maximum benefits that technology can make in quality of life and the ability to learn and to become as independent as possible.

 

CNN - Computer World

Autistics Offer Unique Computing Skills

(IDG) -- For many of us, the word "autism" evokes frightening images of children shut off from the world, rocking, screaming or banging their heads. And if we think of autistic adults at all, we are likely to picture Dustin Hoffman playing the odd, card-counting "savant" in the 1988 movie Rain Man.

While not inaccurate, those perceptions fail to account for thousands ofautistic adults whose special ways of thinking make them quite well-suited for jobs in programming and computer graphics. Autism often leaves those people with poor social and communication skills while bestowing gifts of extraordinary concentration and creativity.

Unfortunately, for every autistic person who succeeds in the workplace, there are eight or nine who fail.
Why? It's partly bias from employers, although often the bias is unintended. One bright but socially inept autistic programmer says of the job interview, "I set off every warning flag the interviewer's got. He thinks, `Boy, I can't quite place my finger on it, but that guy is really weird."

The Americans with Disabilities Act of 1990 helped produce user-friendly work environments for those with physical impairments. But the special needs of those with mental handicaps aren't well-understood by most employers.

However, it isn't necessary to consult with psychologists and neurologists to understand the conditions under which autistics are most likely to succeed. In interviews for a recent story on computers and autism, I asked a number of autistics what they need to be successful in the workplace.

They say they require employers who understand and respect their social limitations; they need quiet, stable and predictable work environments; and they must be given very clear goals and objectives.
For employers able to offer the right environment, the payoff can be significant. In the words of one autistic programmer, "We can offer dramatically innovative approaches, the ability to focus on a limited number of things for extended periods to a far greater degree than nonautistics and, on occasion, savant-like abilities available from no one else."

Because autism profoundly impairs a person's ability to form emotional attachments and communicate, people sometimes assume autistics lack feelings. But in my interviews with autistics, I found depression and anger often combined with a sort of gallows-humor resignation at the way they are misunderstood, underappreciated and often humiliated.

Temple Grandin, an autistic professor at Colorado State University, credits "mentors" for helping her learn how to jump autism's awesome mental hurdles. She now calls on computer professionals to do the same for bright autistic kids, many of whom otherwise are headed for lives of unemployment.

Grandin tells of a bright autistic boy who recently dropped out of high school because he was bored. ``If someone came along and plopped a Silicon Graphics workstation in front of him and showed him how to use it, he wouldn't be bored anymore,'' she says.

Autistic kids should be doing real programming, not "playing with stupid computer games," Grandin urges.

 

Technology News World
Mind-Reading Computers Could Help Those With Autism

"Would we want computers that can react to our emotions? Such systems do raise ethical issues," said Professor Peter Robinson of the Computer Laboratory at the University of Cambridge. "Imagine a computer that could pick the right emotional moment to try to sell you something."

British and U.S. scientists are developing an "emotionally aware" computer that can gauge an individual's thoughts by analyzing facial expressions. The technology could have practical applications for people with autism, researchers said.

"People express their mental states all the time through facial expressions, vocal nuances and gestures," said Professor Peter Robinson of the Computer Laboratory at the University of Cambridge in London. "We have built this ability into computers to make them emotionally aware."

Theory of the Mind
The ability to determine an individual's mental state based on behavior and then use that information to guide one's actions or predict those of others, is known as the "theory of the mind." This is not a new field. It has been around since the 1970s, but it has recently gained attention in light of the needs of people with autism, who are thought to be "mind-blind." That is, they find it difficult to interpret others' emotions and feelings from facial expressions and other non-verbal cues.

Robinson and his colleague, Rana el Kaliouby from the Media Lab at the Massachusetts Institute of Technology, based their computer program on the latest research in the theory of mind by Simon Baron-Cohen, director of the Autism Research Center at Cambridge. Baron-Cohen's research provided them with a taxonomy of facial expressions and the emotions they represent.

"Machine versus people testing of this system has shown the computer to be as accurate as the top 6 percent of people. But would we want computers that can react to our emotions? Such systems do raise ethical issues," Robinson said. "Imagine a computer that could pick the right emotional moment to try to sell you something."

Autism Applications
There are, however, applications with clear benefits, including an emotional hearing aid to assist people with autism, usability testing for software, feedback for online teaching, and informing the animation of cartoon figures, Robinson noted.

The duo has been working since 2004 on a wearable system that helps people with Autism Spectrum Conditions and Asperger Syndrome with emotional-social understanding and mind reading functions. El Kaliouby is currently implementing the first prototype of the system at MIT's Media Lab.

Stimulating Appropriate Responses
Mary Bellis Waller, Ph.D., a psychotherapist and scientist at the Center for Addiction and Behavior Studies, is cheering on the researchers. Bellis has worked with autistic children and adults in her practice and is encouraged by progressive technologies designed to help autistics live a more normal life.

"Whatever helps autistics develop an awareness and sensitivity -- and appropriate responses -- to emotional cues, should be done," Waller told TechNewsWorld. "And from all the research showing how plastic the brain is, the more anybody -- including autistic people -- practices appropriate responses, the better they get at it, the more natural it becomes to 'act normal.'"

 

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