Imagine!’s Assistive Technology Laboratory

Part of Imagine!’s goal for its SmartHomes project is to raise awareness of the incredible opportunities that exist for using technology to serve those with a variety of disabilities, and to increase access to technology for those with disabilities. We are hoping to create an Assistive Technology Laboratory to help meet those goals. We’re not there yet, but we’re working on it! More information on the why, what, and how of the laboratory is below.

Imagine!’s Assistive Technology Laboratory (AT Lab) will be a new headquarters for helping individual consumers identify, obtain, and learn to use the specific assistive technology devices that will allow them to reach their full potential.

The capacity of assistive technology (AT) devices to expand the functional capabilities of people with disabilities is widely accepted. The United States Assistive Technology Act of 2004 (Pub. L. No. 108-364) recognizes an "assistive technology device" as "any item, piece of equipment, or product system, whether acquired commercially, modified or customized, that is used to increase, maintain, or improve functional capabilities of individuals with disabilities." Numerous reports and entire journals, such as Technology and Disability, demonstrate the benefits of various assistive technology devices for people of all ages, with a variety of disabilities, and in a variety of settings, from the home environment, to the classroom, to the workplace.

However, people with disabilities in Imagine!’s service area are not routinely evaluated in order to determine whether any AT devices might be useful to them unless their families request and pay for such an evaluation. Even in the best of circumstances, these evaluations are brief and intensive. While it may meet the needs of (for example) a communicative, blind adult of typical intelligence, this system is inadequate for many of the individuals in Imagine!’s service population. Nonetheless, the resulting documents typically determine what devices may be funded by private or public insurance for five years or more. In addition, the process of securing such funding and obtaining and learning to use the recommended devices is complex.

For years, Imagine! staff members have been helping individual consumers find and use technologies that allow them to live richer and more independent lives. Some of these individuals have con-ditions that result in paralysis – including, for example, Cerebral Palsy, Bilateral Congenital Hip Dysplasia, spina bifida, multiple sclerosis, and Guillain-Barre Syndrome.

Imagine! estimates that approximately 80 adults will be served during the AT Lab’s initial year of operation, and that 10 - 15 of these individuals will be individuals with paralysis-related disabilities. For these individuals, augmentative and alternative communication (AAC) devices are often the key to increased independence and enhanced well-being. Not only do they allow non-verbal individuals with developmental disabilities to communicate with their care providers, family members, and friends with greater clarity, depth, and ease, but they also can also be programmed to allow individuals with paralysis to activate switches on electronic devices. AAC devices have allowed some of the SmartHome residents to turn their lights on and off, open and close the blinds in their bedrooms, and independently select videos or television programs – for the first time in their lives.

Imagine! consumers are the primary stakeholders in the AT Lab project. During this initial phase of the AT Lab, participants will be selected from a pool of clients who are perceived by case managers, direct care staff, and personal and professional caregivers as those most likely to benefit from an assistive technology device.

As mentioned above, Imagine! works collaboratively with an extensive network of organizations and individuals who provide care and opportunities for people with developmental disabilities. In addition to ongoing case management services, Imagine! staff members in every department work with the community-based organizations, businesses, and government entities that are able to pro-vide the best support to clients. For example, the SmartHomes are being developed, constructed, and equipped in collaboration with a wide variety of partners, offering the chance for real-world application and testing. Examples of these partners are AbleLink Technologies, a Colorado Springs-based business whose mission is to change lives with cognitive support technologies, and the University of Colorado’s College of Engineering and Applied Science, whose students are creating tools to help residents accomplish a wider variety of tasks independently. Imagine! anticipates that such collaborations will be established in relation to the AT Lab as well.

Imagine! will rely on professional evaluators to conduct some of the formal evaluations and produce evaluation reports and/or prescriptions for individual clients. However, Imagine! has found that evaluators are very committed to identifying and recommending devices to assist people with disabilities. The shortcoming of the existing system for people with developmental disabilities is the structure of the evaluation – brief and intense, with little time for someone with cognitive limitations to acquire any needed skills and no time for exploration of untapped potential. Fortunately, Imagine! has an excellent working relationship with Assistive Technology Partners, the area’s leading provider of professional evaluations and the area’s leading resource for information on funding for AT devices.

Funding for two computers and touch screens has been secured. In March 2011, this basic equipment was acquired and installed in the AT Lab. Timing of subsequent steps depends in part on the availability of additional private funding for the project; however, it is likely that during April, May, and June, Imagine!’s Director of Information Technology and Technology Architect will refine the selection of tools and protocols for assessing the needs and capabilities of participants and create a database for storing information on AT devices, structured to facilitate matching consumers with optimal devices. If sufficient additional funding is secured, Imagine! will launch the AT Lab during July and August 2011. This will involve hiring the AT Lab Coordinator, ordering equipment, and installing and testing all technologies. During September, the Coordinator will enter data about AT devices into the database.

Beginning in October, 2011 and continuing through June, 2012, Imagine! will assess the needs and capabilities of individual consumers with multiple disabilities, help clients gain familiarity with a selection of technologies to determine which devices would best meet their needs, and provide training and support to clients and to family members who care for them.

The goal of Imagine!'s AT Lab is to help people with developmental disabilities or a combination of developmental and physical disabilities to achieve their full potential through assistive technology devices. Imagine! will meet this goal by accomplishing the following three objectives: 1) developing a means of assessing consumer functionality; 2) identifying consumers who can benefit from AT devices; and 3) assisting these consumers in acquiring and using AT devices that match their needs and capabilities. AT Lab participants will benefit from the in-depth assessment, the introduction to various devices outside the evaluation setting, accurately-paced training on how to use the devices, and support as they become accustomed to the devices they obtain. Imagine! expects that program participants, including those living with various forms of paralysis, will demonstrate an increased ability to communicate, increased mobility, increased control over the home and/or work environment, and/or an increased ability to perform daily tasks without assistance. Their family members will also benefit from training and support related to the AT devices.

Imagine!’s Technology Architect, Occupational Therapists, Speech Therapists, and other staff members worked together to determine which residential clients might derive the most benefit from living in Imagine!’s SmartHomes. No single existing assessment instrument or protocol was ade-quate for this purpose, so the staff began to develop a new, cross-disability assessment tool, which includes aspects of the Supports Intensity Scale developed by the American Association on Intellec-tual and Developmental Disabilities along with cognitive criteria (e.g., the ability to distinguish be-tween colors or symbols) necessary for the operation of various technological devices. This tool, along with an accompanying, evolving protocol, provide a procedural foundation for the AT Lab.

Imagine! will evaluate the success of the AT Lab by administering pre- and post-tests of consumer functionality using a refined version of this cross-disability assessment tool. Imagine! will know that the AT Lab has been successful if at least 64 (80%) of the participants who completed the pro-gram during the project’s initial year demonstrate abilities increased by at least 50% in at least one area of functional capability when re-assessed while using the recommended AT device. Imagine! will use the results of its evaluation of the AT Lab to improve the project design and (if the ex-pected outcomes are achieved) to help other organizations serving people with developmental dis-abilities or similar populations to establish their own assistive technology programs.

Imagine! will undertake the following activities to accomplish the goals and objectives listed above:

• Refining tools and establishing methods for assessing clients’ needs and capabilities;

• Developing a database of AT devices; • Assessing the needs and capabilities of individuals with developmental disabilities or a combi-nation of developmental and physical disabilities;

• Determining which AT devices will best meet the needs of those clients who can benefit from the devices;

• Conducting (or making referrals for) formal evaluations resulting in reports or prescriptions for particular AT devices;

• Providing training and support to clients and to family members who care for them.