Technology, Disability & Schools
SEAT Center / Illinois State University

Lesson 2: Technology, Disability & Schools

In the 20th century, the role of technology in improving the lives of persons with disabilities has been clearly recognized.  The benefits of technology for persons with disabilities were first recognized in public policy in the 1982 federal publication Technology and Handicapped People.

ADA_logo.gif Nearly 10 years later, in 1990, The Americans with Disabilities Act (ADA) established that access to employment, services and public accommodations through reasonable accommodations is a civil right for persons with disabilities.   Reasonable accommodations included those adaptations and technologies needed to provide the access enjoyed by most Americans to jobs, parks, public buildings, shops, public transportation, hotels, restaurants, entertainment, etc.

But just how "new" is the technology that provides access, assists and supports persons with disabilities? Is such technology only the product of modern 20th century invention?

 

How Did Technology for Persons with Disabilities Develop

A brief "unauthorized" history of technology for persons with disabilities through the ages (with thanks to Cook & Hussey, 1995):

 

Date: The Stone Age

stone age2.jpg

Borg breaks his leg on a hunting expedition. Through holistic medicine, his leg is healed, although Borg has a decided limp. Determined to continue to provide for his clan, Borg selects a fine, stout stick to assist his walking. This advanced design tool made with state-of-the-art materials stuns his family and friends, who smile and grunt.

Many years later, Thona, his now elderly granddaughter, who inherited the inventor gene from Borg, sticks an animal horn in her ear to make voices louder.

 

 

Did You Know? About Braille...

Louis Braille.jpg

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The system of writing and reading used by many blind people was invented almost 200 years ago. While several types of written communication systems were tried during a ten-year period beginning in 1825, the one invented by L. Braille, a blind teenager, was adopted.  Some modifications have been made to it over the years but the Braille code in use today is virtually the same as it was in 1834.

Louis Braille was born January 4, 1809, in a small village near Paris. His father, a leather worker, often used sharp tools in his work. While playing in his father's shop when he was three, Louis injured his eye on an awl. In spite of good care, infection set in and soon left him completely blind.  When Louis grew to school age, he was allowed to sit in the classroom to learn by listening.  Louis was very bright and creative. At age ten, he was sent to the Royal Institution for Blind Youth in Paris. There too, most instruction was oral, but there were a few books in a kind of raised print developed by the school's founder. At that time, the raised letters were made by pressing shaped copper wire onto paper but there was no way for blind people to write for themselves.

A French army captain, Charles Barbier originally created a code of raised dots and dashes as a way to allow soldiers to write and read messages at night without using a light that might give away their positions. He later presented it to the Institution for Blind Youth, hoping that it would be officially adopted there. It was based on phonetics and consisted of groups of twelve dots arranged in two columns of six dots each.  Louis worked with Barbier's basic ideas to develop his own simplified 6-dot system and unveiled the system we know today as Braille in 1824. He based the code on the normal alphabet and reduced the number of dots by half. In 1829, Louis Braille published the first "Braille" book.

 

Sources:  http://www.brailleplus.net/braille-articles/braille-history.htm

and http://www.brailler.com/braillehx.htm

 

Did You Know? About Hearing Aids...

 

 

horn hearing aid.jpg   

"Think hearing aids and the image that pops up in your brain may well be the elderly (usually male) curmudgeon with his enormous ear trumpet. These earliest of hearing aids might well have been used by humanity for millennia; whether skillfully carved from wood, perhaps precious metal for nobles, rich merchants and the like, or fashioned from seashells or animal horns. Wide at one end and narrowing to a small tip at the other, and swung around to be pointed in the right direction these aids must have been seen in all cultures and ages."

Source:  http://www.thehistoryof.net/history-of-hearing-aids.html

 

 

1588 - Some of the first hearing aids are described by Giovanni Battista Porta in Natural Magick. The hearing aids were made of wood and shaped like the ears of animals known to have acute hearing.

1724 - Eustachian tube catheterization is discovered by a Versailles postmaster seeking to cure his own deafness (ouch!).

1878- Emil Berthold first describes myringoplasty, the surgical repair of a perforated tympanic membrane. However, it isn't until 1944 that the procedure gains considerable attention.

Hyperlink to DidYouKnow Activity

  

 

bugle hearing aid.jpg early head phone hearing aid.jpg modern hearing aid c1930.jpg

 

 

Did You Know? About Contact Lenses...

Contact Lenses – New technology? Hardly!

 

Would you believe, way back in 1508, Leonardo Da Vinci sketched and described several forms of contact lenses? Of course, we all know the results of Da Vinci's insatiable curiosity – he was dedicated to discovering the mysteries of nature. That's how he came to create the first record of putting a device on the eye to improve vision. He didn't realize how "visionary" was his idea! 

 

1704 –   A French surgeon, Jean Méry, presented a paper to the French Royal Academy of Sciences, reporting that, by submerging the head of a living cat in water, the irregularities of the surface of the cornea were flattened by the water. [We're not sure how he came up with this idea – and we may not want to know!] His discovery was that the living eye could be neutralized, or corrected, and that is an essential part of optical contact systems.

 

Source: http://www.thehistoryof.net/history-of-contact-lenses-seing our-way-future

 

Hyperlink to DidYouKnow Activity

 

Otto Schott

otto_schott_contact_lens.jpg

 

 

Did You Know? About Other Notable Technology Developments

1855 – Kentucky establishes a printing house for blind people. In 1858, it became American Printing House for the Blind and still exists today.

1863 – civil_war artificial leg.jpg The first suction socket artificial leg is invented. The amount of canon fire and resulting injury during the Civil War created a need for artificial limbs.

1869 – The first American patent for the manual wheelchair is granted.

1877 – Thomas Edison invents the phonograph, making books-on-recording possible

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1913 – The 1st reading machine to read out loud, the "Optophone" Optophone.jpg is built by Dr. Edmund Fournier d'Albe of Birmingham University.

 1955 – Computerized Braille is introduced.

1958 – The first motion picture film is captioned.

1964 – The first laser canelaser-cane.pngis produced for locating and giving feedback on the position of nearby objects and surfaces. In 1971, the first long-term evaluation of laser canes by 8 veterans who were blind began.

 

 

Assistive Technology for Persons with Disabilities

While technology to assist persons with disabilities is clearly not new, the name for the type of technology is a more recent development. In 1988, Public Law 100-407 - The Technology Related Assistance Act was passed to provide assistance for persons with disabilities in obtaining information, training, funding, and technical assistance needed to acquire and use technology. As part of this legislation the term assistive technology was defined to be any "item, piece of equipment, or product system" that was used to "increase, maintain or improve the functional capabilities of individuals with disabilities."

Unlike medical technology, whose purpose is to improve or sustain health through diagnosis, prevention or treatment of a condition that could lead to reduced functioning, the purpose of assistive technology is to directly improve function, or performance, in the activities of life in which the individual engages. As we have learned in a previous lesson, performance can be thought of in terms of the outcomes of the activity, specifically the quality of the activity outcome, the amount (quantity) of the activity outcome, or amount of time it takes to complete the activity. Assistive technology improves the productivity of the individual.

AT_Productivity.jpg

 

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Assistive Technology and Performance Enhancement

To what do we compare the individual's performance to determine whether it is increased or improved, as stated in the AT definition?

We could compare it to the performance of the individual before they used the technology.

With a self-propelled manual wheelchair, a child could get from one class to another independently, which could not be done before. With a hearing aid, an adult could hear more than they could before. With a audio-visual prompting system, a person with cognitive disabilities can do more steps of a complex work task. But the question would still remain, how much improvement is enough?

 

With children who have physical, sensory or cognitive disabilities from birth, we know that they will continue to lag behind their peers in the expected performance on typical tasks in and out of school, even as they continue to develop.

Even after the child learns to use the wheelchair, they might not be able to get from place to place fast enough to change classes within the class break time, or they might not have enough endurance to propel their wheelchair from one end of a large school to another.

As the illustration shows, there is a gap between what they can do and what is expected of them. At younger ages (the vertical line) the gap is smaller but usually increases as they get older.

A child who has difficulty eating, dressing, speaking, writing, or memorizing will never experience less expectation to do these things, only more.

A child or adult with a progressive neurological disease (e.g., muscular dystrophy, multiple sclerosis or ALS) will experience an increasing gap between what they can do and what they need to do as the medical condition progresses over time.

 

 

For children or adults with acquired disabilities (e.g., traumatic brain injury) who had already achieved typical performance, maintaining, rather than improving, performance is the goal.

 

The Compensatory Benefit of Assistive Technology

Assistive technology, like all technology, is a tool and like all tools its purpose is to permit the individual to complete tasks more effectively or efficiently. But AT is a tool designed to provide compensatory benefit specifically to persons with disabilities. To compensate means to nullify, offset or counterbalance the effects of an undesirable influence, in this case, the condition that produces an impairment to functioning or performance - to compensate means to close the gap using technology.

Abnormalities in or damage to the middle ear makes it difficult to hear all parts of normal conversation. A hearing aid compensates for the reduced hearing by increasing the volume of sound going into the ear.

Down Syndrome results in poor muscle tone in the fingers making it difficult to grip a pencil to write legibly. A pencil grip compensates for the lower muscle tone in the fingers by increasing the size of the area to be held.

Traumatic brain injury impairs the individual's ability to remember thoughts short term. A post-it note tablet compensates for memory deficits by making the "to-do" thought continuously visible until the "to-do" is done.

Abnormalities or damage to the optic nerves in the eye make if difficult to read the time on a watch. A talking watch compensates for reduced visual discrimination by substituting hearing acuity for visual acuity.

In the first two examples above, compensation is provided by creating a new tool (a hearing aid, a pencil grip), in another by using an existing tool in a new way (a post-it note) and in another by modifying the tool typically used in the task ( the watch).

 

AT & Teaching. We cannot teach a child with cerebral palsy that affects their whole body to walk independently without assistance or tools. We can teach this child to use an AT tool such as a walker or wheelchair. The AT tool compensates for leg and trunk weaknesses by using the arms for support. However, we do need to teach the child to use the mobility tool before it can provide compensatory benefits.

 

Self-Check Yourself...

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Is an App an AT "Device"?

The legal definition of assistive technology (AT) focuses upon the concept of an AT device being an "item, piece of equipment, or product system." This might have us mistakenly think of AT as separate things, that is, hardware or concrete objects. In 1988, about 25 years ago when the definition was written, there was not an extensive system of easily acquired software applications nor were there small and powerful devices for running them. The Apple IIe "personal computer" had appeared in 1977, but it still required you to type in commands on a blank screen to start anything.

The first Apple Macintosh, or "Mac," computer with a graphical, or icon-based, desktop interface appeared in 1984 offering 2 built in applications, MacWrite and MacPaint. It had 128K of built-in memory (Today, even a child's talking toy has much more memory than this!)

 

  

Computer-based text-to-speech systems were created in the late 1950's using large mainframe computers. The first general, electronic text-to-speech synthesizer was built in 1968 with the first speaking calculator appearing in 1976. Early speech synthesizers for portable computers were boxes that plugged into the computer, rather than Beijing an application that is built into the computer. (And, according to the ad at left, costs about what a high def Kindle Fire would cost today.)

 

 

With a built-in speech synthesizer, some kind of keyboard or touch-key system for entry, and bulky rechargeable batteries,an early, portable voice output communication device was an "item" of technology the size of a briefcase. Combine this with a powered wheelchair, a wired system for controlling devices in the environment like lights, temperature, stereos, and telephones with answering machines and you have a "product system" with many different pieces of AT that might be used by a person with physical disabilities. And a very bulky product system at that - there would hardly have been room for the person in the wheelchair!

Today, software for many applications - communicating, writing by voice, controlling a wheelchair, making phone calls, and controlling the environment might be combined in one device - the laptop computer. Technology convergence was greatly shaped and changed the way we think of AT. Rather than separate devices each having a narrow set of functions, we now have single devices that provide sets of functions that are easily added or downloaded.

 

AT - Is There an App for That?

Source: Ablelink Technologies

So, back when the Tech Act was written, the idea of software applications that could be purchased, delivered, and installed over the Internet to a device the size of a thick tablet of paper was the stuff of science fiction! In fact, the Internet itself did not become commercially, or publicly, available until 1995. While there is currently still plenty of AT hardware, there is also an ever increasing number of software applications that "increase, maintain, or improve the functional capabilities of persons with disabilities."

Today, an "item" and a "product system" range from a toothbrush with a special grip, to a talking watch, to a calculator in a smartphone, to a powered wheelchair for mobility, to an eye-controlled system for answering the phone or turning on the lights, to controlling the computer by voice, to a speech output system for communicating operated by touching the screen on an iPad.

 

So more and more, considering laptops, tablets and other mobile devices, we can answer the AT device question with
"There's an app for that."

 

   

Assistive Technology Services

However, devices, whether hardware, apps, or combinations of the two, are only the tools. There is still the question of how to operate the tool (operational competence), and how to use the tool effectively or efficiently (functional competence), or when and why to choose one tool or another (strategic competence). Moreover, technology that is out there but beyond the knowledge or ability of the person with disabilities to find, acquire, or afford is not useful technology. Believing that it took more than the existence of devices, the Tech Act of 1988 established systems in each state to provide AT services. These services were defined to be:

 The law is still in effect today, having been renewed three times, the most recently in 2004.

Visit the Illinois Assistive Technology project by clicking on this link.

 

Self-Check Yourself...

 

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Law, Culture, and Disability

It is through law that culture and society attempt to ensure rights and access to opportunity to every citizen. Civil rights laws in particular have been enacted to reduce and eliminate discrimination on the basis of race, color, religion, sex, national origin, etc. Just as the civil rights movements of the 1960's led to laws that prohibited discrimination in employment, housing, and public services, the civil rights laws for persons with disabilities have done the same. Discrimination based on race, ethnicity, and skin color is typically based on more overt ignorance, fear, repression, or misguided views of racial domination. Discrimination based on disability is perhaps more subtle. It is based on a misunderstanding or ignorance of the person's needs, perspectives, or abilities, especially when the person is viewed through the lens of "disability." Or it can be based on a misguided sense of obligation to protect those who "suffer" from disabilities

 

Three laws have special significance for technology and people with disabilities:

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1973: Rehabilitation Act / Section 507

The Rehabilitation Act (a.k.a., the Rehab Act), for the first time, prohibited discrimination against persons with disabilities by programs receiving federal funding for education and employment. Section 504 of the Rehab Act specifically extended civil rights to persons with disabilities, both children and adults in employment, education, and other settings. It made reference to "auxiliary aids" (later to become known as assistive technology ) that insures an equal opportunity - "level the playing field". Auxiliary aids, such as special desks, tables, or keyboards, were considered to be "reasonable accommodations". However the Rehab Act had no "teeth" - auxiliary aids could be excluded (not provided) by claiming of lack of funding to pay for them by the agency or organization. And so, not much progress ensued.

1988: Technology-Related Assistance Act

The Technology Related Assistance Act, a.k.a, the Tech Act, recognized the importance of technology in the lives of persons with disabilities and provided funding to states to develop comprehensive service delivery systems for supporting acquisition, evaluation, funding and training related to assistive technology. As already noted , the Tech Act defined assistive technology devices and services for the first time in federal law.

1990: Americans with Disabilities Act

As noted earlier, the Americans with Disabilities Act, commonly known as ADA, is the major civil rights act for people with disabilities that would end discrimination against people with disabilities in employment, services and public accommodations. Discrimination includes not making reasonable accommodations to the known limitations of the person. Prohibits all local, state, and federal agencies from denying persons with disabilities access to any programs and services, including public transportation. Physical access is described in the ADA standards for accessible design. For example, having no ramp or accessible doors in the building denies access to state motor vehicle registration services. Programmatic access includes any policies or procedures which discriminate against persons because of their disabilities. For example, a school district policy that states that no animals are permitted on school buses denies access to transportation services to students with visual impairments who have guide dogs.

 

Self-Check Your Understanding...

Of civil law, disability and AT

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Law, Disability, and School

The needs and rights of students with disabilities and their fa milites are addressed under the Rehab Act and under the ADA. But prohibiting discrimination and denial of access (what not to do) does not provide clear guidelines to schools as to what to do. It takes specific laws that address educational policies, programs, procedures, services, etc. to fully inform schools as to the rights of students and the schools' responsibilities in assuring their rights.

  

1975: Education of All Handicapped Children Act

Education for All Handicapped Children (EAHC) was the first "special education" law and it ensured that all children with disabilities would receive a free appropriate public education (FAPE) in the least restrictive environment (LRE). Prior to this law, schools could exclude a student by claiming that they could not provide programs for students with the most significant disabilities. The EAHC Act mandated that all children ages 6-21 with disabilities could not be excluded from or denied access to a public education. In 1986, the Handicapped Children and Toddlers Act extended public school responsibility for the education to preschool children ages 3-5 years.

1990: Individuals with Disabilities Education Act

In 1990, the EAHC Act was reauthorized (a legislative process that occurs periodically with major laws), renaming it the Individuals with Disabilities Education Act (IDEA). IDEA included two signifiant items that affected technology, students with disabilities, and schools.

  • The IEP team should consider whether the student requires AT when developing any IEP.
  • The definitions of AT devices and AT services from the Tech Act were included in IDEA as part of educational, related or supplementary aids and services.

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AT Device:   Any item, piece of equipment , or product system, whether acquired commercially off the shelf, modified, or customized, that is used to increase, maintain, or improve functional capabilities of children with disabilities (P.L. 100-407, 29 U.S.C. 2201, §3(1))

 

AT Service: Any service that directly assists a child with a disability in the selection, acquisition, or use of an assistive technology device (P.L. 100-407, 29 U.S.C. 2201, §3(1))

1997: IDEA Amendments

In 1997, the IDEA was amended by Congress. Among the changes were two significant modifications affecting assistive technology:

  • It was now mandated that the IEP team must consider whether AT is required by the student when developing the IEP.
  • The law indicates that consideration of whether AT is required involves an AT evaluation.

It had become clear that the earlier use of should did not communicate well enough what the law required. "Should" seemed to have been interpreted as somehow being an option. As a result, the wording of the law was changed to shall. In legal language shall means must - there is no option.

IDEA 1990 did not specify what is meant to consider whether AT was required - it left open to interpretation what it meant for a group professionals and parents to consider whether AT was required. In many cases, consideration was a yes/no check box on the IEP used to document that AT was considered. To provide an explanation of how the determination was made, The 1997 IDEA amendments stated that consideration involved an AT evaluation

 

2004: Individuals with Disabilities Educational Improvement Act

In 2004, the IDEA was reauthorized and renamed the Individuals with Disabilities Educational Improvement Act (IDEIA). This version of IDEA aligned it with the No Child Left Behind (NCLB) Act of 2001, revised requirements for evaluating students with learning disabilities, and stressed measurable student progress in the general education curriculum. IDEIA had two significant changes affecting the use of assistive technology in the schools.

  • It was now mandated that the IEP team must consider whether AT is needed by the student when developing the IEP.

 

 

 

AT: Required v. Needed?

Require would seem to imply that AT is used only if the student cannot otherwise function. Only if the student is ineffective (cannot complete a task, cannot walk unassisted, cannot speak clearly enough to be understood) can AT be used. On the other hand, need seems to imply a less restrictive or strict criterion. If the student is effective but inefficient, need suggests that AT could be used, while require does not.

Example 1: A middle school student (grade 8) who can read textbooks at a 5th grade vocabulary level, but at a much slower rate, with average comprehension might not be provided with AT such as a text-to-speech device under the require criterion. The student can read but not at the level expected for an 8th grade student (text level, rate, and comprehension). Using the need criterion, the student would be provided with the AT because it is needed for the student to acquire and use the information from the 8th grade textbook at the expected level of comprehension (and perhaps even speed of information acquisition).

Example 2: A 4th grader can be pushed by another person to get from class to class or activity to activity, but not always within the typical amount of time.   A powered-wheelchair controlled by the student might not be required because the student can get from place to place (but only with assistance).   A powered wheelchair is needed for the student to "independently" get from place to place and within the time allowed.

It has been suggested that such a lower threshold may confuse educational teams acting under this new wording, but may ultimately increase the number of students using AT devices and services.

 

AT: Not surgically implanted?

Cochlear_implant.jpg IDEIA also addresses the problems of ever increasing development in medical technology. Medical technology is constantly decreasing in size and increasing in power. Such things as cochlear implants, insulin pumps, heart regulating devices, or other devices that assist in eating, breathing, etc. make it possible for children with serious physical, sensory, or health problems to attend school, participate in the classroom, and make educational progress. So, are these AT and does the school bear the cost of providing for surgical implantation and replacement? IDEIA now specifically excludes such surgically implanted devices from the definition of AT devices and from the definition of AT services. However, it does permit services related to checking hearing aids or the external components of surgically implanted devices to determine whether they are turned on and functioning or to provide for maintenance (changing a hearing aid battery).

 

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Technology in the Schools: Instructional v. Assistive Technology

We have already explored the overlap of information and communication technology (ICT) and instructional technology (IT). Much of the IT used in schools today is ICT that has come to school. What is the overlap and what is the difference between IT and AT?

IT supports teaching (planning, preparation, learning, management of data, etc.) whether used during initial teaching or remedial instruction (which is the purpose of special education
instruction). The technology is supplemental to instruction -- the students could learn without it, but IT increases teaching and learning productivity.

 

AT is compensatory. AT allows the student to do tasks which cannot be done at the expected level of performance without the AT. This the compensatory benefit of AT. And, in a school setting, a device or application can be both depending on who is using it and for what.

 

 

 

For example: The calculator. After students learn to do basic computation (addition, subtraction, multiplication, division) the focus of instruction is on solving applied problems using reasoning, strategies, formulas, etc. The calculator focuses all students on math reasoning instead of computation. The typical student is faster with the calculator (more efficient).  However, if the student can still do computation without it, the calculator is IT. For the student with learning or cognitive disabilities, as assistive technology, the calculator compensates for the student's inability to recall "math facts" while focusing on math reasoning (increased effectiveness)It is AT because the student with disabilities cannot do computation without the calculator.

And to be clear, students with disabilities also use IT.

The difference between IT and AT here is in the unique needs of the student, not in the type of disability they have. AT is uniquely matched to the needs of the student. IT is matched to the teaching and learning needs of the teacher and the many students in a classroom.

 

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Of IT v. AT

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Self-check Yourself

Check your understanding of technology, disability, and the schools

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