Assistive Technology Use with the Birth to Three Population: A Rural Perspective

Rural Special Education Quarterly, Winter 2009 by Keramidas, Cathy Galyon, Collins, Belva C

Abstract

Previous research found infants and toddlers, age birth to three, capable of using assistive technology (AT), and the Federal Government mandates that AT be considered when a team creates an Individualized Family Service Plan (IFSP). Although this is an ideal time to introduce and begin AT use, practitioners use little AT with this population. Rural states have unique challenges to AT use. Through interviews, practitioners in West Virginia shared their experiences with AT use with this young population. Although there are barriers, one practitioner summed up the consensus of the group. "I think that excellence of service can and in many cases is being provided in West Virginia despite the fact that it is very rural."

The United States Federal Government has acknowledged the importance of assistive technology (AT) in meeting goals for infants and toddlers. The 1997 reauthorization of the Individuals with Disabilities Education Act (IDEA) was the first law that mandated AT and AT services be considered when developing an IFSP This law defined AT as:

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 the functional capabilities of children with disabilities," and AT services are defined as "any service that directly assists an individual with a disability in the selection, acquisition, or use of an AT device (Individuals with Disabilities Education Act of 1997).

The Human Functioning Model developed by Melichar (1978) regarded the strengths and weaknesses of the individual to determine the individual's AT needs. The AT is not determined by the disability, but by the need.

The Division for Early Childhood (DEC), a division of the Council for Exceptional Children, published best practice guidelines on using AT with very young children including using AT to foster independence and using AT to increase participation in routines in natural settings, such as at home and at preschool (Sandali, McLean, 8c Smith, 2000). The National Association for the Education of Young Children (NAEYC) has taken die following position: "[Assistive Technology] requires thoughtful integration into the early childhood curriculum or it may fall far short of its promise. Educators must match the technology to each student's unique special needs, learning styles, and individual preferences" (NAEYC, 1996).

Many studies show that infants and toddlers can use AT. Two early studies (Brinker 8c Lewis, 1982; Dunst, Cushing, 8c Vance, 1985) found that infants under 12 months understood cause and effect, a necessary skill to use AT. Numerous studies in the 1980s and 1990s have shown children under age 3 could use a variety of AT, such as prosthetic hands (Cook, Liu, 8c Hoseit, 1990; Krebs, Lembeck, 8c Fishman, 1988; Meredith, Uellendahl, 8c Keagy, 1993); power mobility devices (Butler, Okamoto, 8c McKay, 1983, 1984; Jones, McEwen, 8c Hansen, 2003; Nilsson 8c Nyberg, 1999;); augmentative and alternative communication (AAC) (Cumley 8c Swanson, 1999; Foreman 8c Crews, 1998); and switches to operate toys (Daniels, Sparling, Reilly, 8c Humphry, 1995; Ferrier, Fell, Mooraj, Delta, 8c Moscoe, 1996; Sullivan 8c Lewis, 2000). Only three studies, (McEwen, 8c Hansen, 2003; Sullivan 8c Lewis, 2000; Wilcox, Guimond, Campbell, 8c Moore, 2006) researched AT use with die birth to 3 population in the 2000s.

Although laws are in place and national organizations have set guidelines, AT use with children in the birth to 3 population is low. In December 2001, 246,988 children, ages birth to 3 years (2.11% of the estimated total population) in the United States received early intervention services (U.S. Department of Education. Office of Special Education Programs, 2003). Data showed that 9,325 (3.78%) of the infants and toddlers receiving early intervention services during die 2001-2002 school year had AT and/or AT services documented on their IFSP (U.S. Department of Education Office of Special Education Programs, 2003). The types of AT, implementation of AT, and AT efficiency with this age group were not documented. Since many of these young children have significant delays, the percentage of children in this population using AT should be much higher.

Though little published research exists on assistive technology implementation in rural areas, there appear to be unique issues in regard to assistive technology training. Gitlow and Sanford (2003) surveyed practitioners in Maine and found that a majority of respondents would not drive over 1 hour for AT training. In rural states, this could be a problem. Another study (Beicastro, 2004) found that rural areas needed more access to AT. Although these studies have significance for rural areas, neither of these studies focused on the subject of AT use with infants and toddlers.

The purpose of this investigation was to determine barriers that influence AT use with children receiving birth to 3 services in a rural state. Eight participants that responded to a previous survey volunteered to discuss what they knew of AT policy in the state and what challenges they faced in implementing AT with this age group. The data are presented and discussed along with future directions for research with this population.