Assistive Technology For People With Disabilities 2nd Edition
Assistive Technology For People With Disabilities 2nd Edition
Assistive Technology For People With Disabilities 2nd Edition
Assistive Technology
for People with Disabilities
Diane Pedrotty Bryant
The University of Texas at Austin
Brian R. Bryant
Psycho-Educational Services
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10 9 8 7 6 5 4 3 2 1
This textbook is intended to provide readers with a wide range of information about assistive
technology adaptations with an emphasis on devices and services. Assistive technology (AT) is
an area that is characterized by rapid development and innovation as a result of work done by re-
searchers, engineers, educators, users and families, therapists, and rehabilitation specialists to in-
form and provide better and more promising devices to meet the needs of technology users. We
know more than ever about the benefits of assistive technology to enhance the lives of individu-
als with disabilities to promote independence, access, and equity.
• We included a case study in Chapter 3 to help the reader learn about the application of the
assessment process to the identification and evaluation of assistive technology devices for
individual users.
• We added newer concepts such as universal design, information about the Independent
Living Movement, information about efficacy, and vocabulary.
FEATURES
There are several noteworthy features that are intended to enrich the content and assist readers in
learning about assistive technology adaptations. First, we have included instructional features
such as Objectives, Making Connections, Scenario Applications, and Discussion Questions to
help readers think about the content before and after reading each chapter. Second, we have in-
cluded Personal Perspectives that highlight the viewpoints of individuals who use technology,
have children who use technology, provide professional development, and/or serve as advocates
for assistive technology. We think this feature helps to personalize the information presented in
the chapters and illustrate the impact of assistive technology on the lives of individuals who ben-
efit most. Third, we have included updated pictures of devices and URLs to help readers go on-
line to see and read about new technologies. We think providing URLs is a good way to help
readers stay apprised of current and new technologies. We hope these features will promote read-
er activity and connections with the content.
mobility, communication, and access to the information pervasive in our society—these are basic
life requirements. We provide a chapter that focuses on assistive technology during the school
years because of the importance of ensuring that all students have access to the curriculum and
that teachers examine ways to make instruction more meaningful for learning. Finally, we con-
clude the book with a chapter on independent living. We think this represents a good culminating
chapter that focuses on how assistive technology is applicable across all environments. We hope
you enjoy the book!
ACKNOWLEDGMENTS
When we started revising our book on assistive technology, we were struck by the considerable
amount of “new technologies” that have emerged for all consumers and more specifically for in-
dividuals with disabilities. One of the biggest challenges with this revision was to identify con-
tent that would not be outdated immediately. We hope that we have captured the “big ideas” in
assistive technology and that the examples we provided will illustrate the ideas successfully.
Throughout this book, you will read Personal Perspectives and references to a number of our col-
leagues whom we have met and worked with over the years. Their perspectives, we believe, en-
rich the content of this text, because they speak to the issues, challenges, and “new technologies”
from their vantage point, whether an educator, a parent, a researcher, and most importantly as a
user of AT. We acknowledge and thank our Personal Perspective authors: Diana Carl, Anne
Corn, Lewis Golinker, Mike Haynes, Tony “Mac” McGregor, Robin Lock, Peg Nosek, Bonnie
O’Reilly, Mark O’Reilly, Penny Reed, Sam, and Jamie Judd-Wall. We believe that the reflections
offered in the Personal Perspectives will help readers understand the application of assistive
technology from different viewpoints.
We also acknowledge our coauthors in several of the chapters. Their assistance in revising
the content is deeply appreciated, and their work strengthens the book. We thank Guliz Kraft,
Robin Lock, and Minyi Shih. In addition, we recognize Joy Zabala, Tricia Legler, and Marshall
Raskind, three friends, who have taught us much about assistive technology from their profes-
sional and personal experiences working with AT users and their families. Much of what we
know has come from working closely with these three professionals.
We also express our appreciation to our editor, Ann Davis, and Penny Burleson, editorial
assistant, for their assistance, support, and patience. We acknowledge and thank our reviewers,
whose insight and helpful feedback strengthened the content of this book. They offered many
thoughtful comments, suggestions, and feedback that addressed the areas that required attention
in this revision. We are deeply indebted to them for their time and expertise. Thank you to Emily
C. Bouck, Purdue University; Kristy K. Ehlers, Oklahoma State University; Linda Mechling,
University of North Carolina—Wilmington; and James Stachowiak, University of Iowa. We
hope that the combined efforts of all we have mentioned have made this book an informative and
pleasant reading experience for you.
Finally, we would like to acknowledge the students and parents with whom we have
worked over the years. They are the people who are most affected by AT’s promise. They have
taught us much over the years, and we hope that, for them, AT eventually fulfills its potential as
a tool for accessibility and full participation in all of life’s activities.
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CONTENTS
ix
x Contents
Casters 94
Hand Rims 95
Other Features 95
Seating and Positioning Issues 95
• Personal Perspective 4.2 95
Other Seating and Positioning Issues 101
Summary 101 • Scenario Applications 102
• For Discussion 103 • References 103
Telecommunication 139
Telephones 139
Internet Access 140
Listening and Print Access 141
Listening Aids 141
• Personal Perspective 6.2 142
Print Aids 145
Summary 149 • Scenario Applications 149
• For Discussion 150 • References 151
Chapter at a Glance
ACCESS AND INDEPENDENCE
• Personal Perspective 1.1
ASSISTIVE TECHNOLOGY DEFINED
HISTORICAL OVERVIEW OF ASSISTIVE TECHNOLOGY
• Personal Perspective 1.2
MULTIDISCIPLINARY NATURE OF ASSISTIVE TECHNOLOGY SERVICE PROVISION
Objectives
1. Examine definitions of key assistive technology terms.
2. Demonstrate knowledge concerning the history of assistive technology.
3. Identify key professionals involved in assistive technology service delivery.
MAKING CONNECTIONS
Think about how inventions have changed people’s lives over the past 100 years. Some inventions,
such as automobiles, computers, the Internet, microwaves, televisions, refrigerators, and airplanes,
have dramatically altered our way of life. Others, such as remote control units and electric devices,
ATMs, and digital networks, have certainly made our lives easier on a daily basis. Now, think about
people you know with disabilities that could be developmental, acquired, or part of the aging
process. What special needs do these people have, and what devices do they use to access various
environmental contexts? Think about inventions that make things possible for people with disabili-
ties—for example, think about an aging grandparent who might use a remote control to turn on the
lights because of difficulty with standing and walking. Consider the ramifications to access and
independence if those inventions did not exist for people with disabilities. Now, recall legislation that
has been passed to help secure people’s civil rights. How might these laws apply to people with dis-
abilities? What laws are specifically designed for people with disabilities?
1
2 Chapter 1 • Introduction to Assistive Technology Devices and Services
In this chapter, we provide background information that sets the stage for the central themes (i.e.,
access and independence) that run throughout this text. In this chapter, we (a) introduce and dis-
cuss the concepts of access and independence; (b) define assistive technology (more specifically,
AT device, AT service, and instructional technology); (c) provide a historical overview of AT
development; and (d) discuss the multidisciplinary nature of AT service delivery.
would have severe and profound disabilities. She was being fed by tube and the doctors did not
anticipate that she would be able to suck a bottle or that we would be able to care for her at
home. We were asked to plan our next step and decide whether we would take her home or
place her in an institution. After considerable reflection and discussions with our doctors, family,
and friends, my husband and I decided that we would never know if we could care for her at
home unless we tried. That decision was made some 37 years ago and was the best decision of
our lives. During her first year, every cold would send her back to the hospital so we could not
take her out in public and had to screen everyone’s health that came over to the house. Today,
Dana uses a power wheelchair for mobility; she has cerebral palsy, seizures, and her right arm
doesn’t work well for her. However, what one will quickly discover is that her speech is not
involved; and when you talk with her, you will find out she does not consider herself “disabled.”
She does not like to be defined by her disability or categorized as disabled. Dana is very much a
self-confident individual with her own mind. One of Dana’s primary characteristics is that she is
quite social and makes friends easily. She has physical challenges but actually lives a physically
active and independent lifestyle. Swimming is her passion and her outlet from the wheelchair.
Year round she swims about 30 to 50 laps usually six days a week. Many people that we meet,
particularly at the health club, say that Dana has been an inspiration to them and they often nick-
name her the “Energizer Bunny.”
After 30 years in special education, I retired from Region 4. I continue to serve on national,
state, and local advisory boards and frequently present at conferences. As a consultant, I have been
contracting with the Center for Applied Special Technology (CAST) and working as the Special
Project Coordinator of the AIM [Accessible Instructional Materials] Consortium. I am a founding
member of the Quality Indicators in Assistive Technology (QIAT) Consortium and have served on the
QIAT Leadership Team for the past 10 years. Recently, I have been working with the National
Assistive Technology Technical Assistance Project at RESNA [Rehabilitation Engineering and Assistive
Technology Society of North America] to develop quality indicators for service provision for the
Assistive Technology Act state programs. As it turns out, I am not really retired, just repurposed.
You have worked in assistive technology for much of your career. What
changes have you seen that can be directly attributed to legislation?
The most profound changes in AT have occurred as a result of the Individuals with Disabilities
Education Act (IDEA) and its subsequent reauthorizations. My colleagues and I often talk about
the “legal evolution of access.” From the passage of the Education for All Handicapped Children
Act (EHA), Public Law 94-142, in 1975 to the present, public schools have been responsible for
providing each student with a disability a free, appropriate public education (FAPE). In 1975, EHA
provided “access to schools,” as prior to that time, many children with disabilities were not per-
mitted to attend schools. In 1990, EHA was reauthorized as the Individuals with Disabilities
Education Act (IDEA). At that time, although students with disabilities routinely attended school,
they were mostly educated in separate classrooms and facilities. IDEA (1990) provided “access to
classrooms” as it required students with disabilities to be educated with their general education
peers. By the reauthorization of IDEA in 1997, Congress was dissatisfied with the limited aca-
demic progress of students with disabilities. Although students were largely being educated in
the same schools and same classrooms as their peers without disabilities, their educational pro-
grams were designed specifically to meet their individual needs and generally were not correlated
with the general education curriculum. Therefore, IDEA (1997) emphasized “access to the gen-
eral education curriculum,” which may necessitate AT devices and services. As the perception
of what constitutes FAPE continues to evolve, in the reauthorization of IDEA in 2004, emphasis
was placed on “access to instructional materials.” This emphasis provides students who are
unable to read or use information through the use of traditional print materials with accessible
instructional materials appropriate to their individual needs. IDEA (2004) includes requirements
for state and local educational agencies to ensure that, when needed, textbooks and related core
instructional materials are provided to students with print disabilities in specialized formats in a
timely manner. The four specialized formats are Braille, audio, large print, and digital text. In most
instances, assistive technologies are needed for students to be able to use the materials in the
specialized formats. For example, digital text can be used on the computer with various reading
programs that allow the student to manipulate features and functions such as text size, text and
background colors, text-to-speech, and learning supports.
As we look forward to the future for today’s students with disabilities, we can be greatly
encouraged by the opportunities available to them through access to the schools, the classrooms,
the general education curriculum, and instructional materials. I am hopeful that Congress will
continue to provide legislation that strengthens the rights of students with disabilities to the same
education the other students receive and the provision of quality AT devices and services that are
needed to support them.
What are the most critical issues that will be faced by AT providers
in the near future?
Accountability continues to be a critical issue. Educators are increasingly being held accountable
to ensure that all students are learning. How to effectively include students with disabilities in the
Chapter 1 • Introduction to Assistive Technology Devices and Services 5
accountability system continues to be a challenge. Many states limit the allowable accommoda-
tions that can be used on the tests, and frequently AT is not allowed. It is often perceived as being
an unfair advantage. The definition of an accommodation is that it does not invalidate the nature
of the task or the construct that is being measured. It stands to reason that if the AT is truly an
accommodation, then its use should be allowed.
Another issue focuses on when AT is included in the IEP [Individualized Education Program],
the effectiveness of its use must be evaluated on a trial basis before adoption is recommended.
Prior to the use of an AT device, the team supporting that student will need to determine how
they will know if the trial is successful. Then, with clearly defined roles and responsibilities, the
team members will want to collect implementation data.
Yet another issue relates to the increasing national emphasis on universal design and uni-
versal design for learning, which may blur the lines between what is instructional technology
(used in general education) and AT (specifically required for a special education student). As class-
rooms increasingly incorporate universally designed technology, many of the features needed to
support learning will be available to all with the result that more students, who would otherwise
struggle and go through a cycle of failure, are successful at the outset and fewer will be referred
to special education services. It is important to remember that universally designed technology
meets the needs of many but does not meet the needs of all. There will continue to be a need for
AT for the specific needs of some of the students. For example, a student who is blind may need
a Braille note-taker with a refreshable Braille display, which would not be included in the class-
room technology infrastructure.
Finally, the connection between AT and the Response to Intervention (RtI) initiative, which
was spurred by IDEA (2004) as a means for identifying students with learning disabilities, remains
relatively unexplored and a challenging issue for educators. The critical question that needs to be
addressed by national, state, and local education agencies is the role of AT in the RtI process,
which includes prevention and intervention practices.
I see increasing reason to believe that the view formed some time
back as to the origin of the Makonde bush is the correct one. I have
no doubt that it is not a natural product, but the result of human
occupation. Those parts of the high country where man—as a very
slight amount of practice enables the eye to perceive at once—has not
yet penetrated with axe and hoe, are still occupied by a splendid
timber forest quite able to sustain a comparison with our mixed
forests in Germany. But wherever man has once built his hut or tilled
his field, this horrible bush springs up. Every phase of this process
may be seen in the course of a couple of hours’ walk along the main
road. From the bush to right or left, one hears the sound of the axe—
not from one spot only, but from several directions at once. A few
steps further on, we can see what is taking place. The brush has been
cut down and piled up in heaps to the height of a yard or more,
between which the trunks of the large trees stand up like the last
pillars of a magnificent ruined building. These, too, present a
melancholy spectacle: the destructive Makonde have ringed them—
cut a broad strip of bark all round to ensure their dying off—and also
piled up pyramids of brush round them. Father and son, mother and
son-in-law, are chopping away perseveringly in the background—too
busy, almost, to look round at the white stranger, who usually excites
so much interest. If you pass by the same place a week later, the piles
of brushwood have disappeared and a thick layer of ashes has taken
the place of the green forest. The large trees stretch their
smouldering trunks and branches in dumb accusation to heaven—if
they have not already fallen and been more or less reduced to ashes,
perhaps only showing as a white stripe on the dark ground.
This work of destruction is carried out by the Makonde alike on the
virgin forest and on the bush which has sprung up on sites already
cultivated and deserted. In the second case they are saved the trouble
of burning the large trees, these being entirely absent in the
secondary bush.
After burning this piece of forest ground and loosening it with the
hoe, the native sows his corn and plants his vegetables. All over the
country, he goes in for bed-culture, which requires, and, in fact,
receives, the most careful attention. Weeds are nowhere tolerated in
the south of German East Africa. The crops may fail on the plains,
where droughts are frequent, but never on the plateau with its
abundant rains and heavy dews. Its fortunate inhabitants even have
the satisfaction of seeing the proud Wayao and Wamakua working
for them as labourers, driven by hunger to serve where they were
accustomed to rule.
But the light, sandy soil is soon exhausted, and would yield no
harvest the second year if cultivated twice running. This fact has
been familiar to the native for ages; consequently he provides in
time, and, while his crop is growing, prepares the next plot with axe
and firebrand. Next year he plants this with his various crops and
lets the first piece lie fallow. For a short time it remains waste and
desolate; then nature steps in to repair the destruction wrought by
man; a thousand new growths spring out of the exhausted soil, and
even the old stumps put forth fresh shoots. Next year the new growth
is up to one’s knees, and in a few years more it is that terrible,
impenetrable bush, which maintains its position till the black
occupier of the land has made the round of all the available sites and
come back to his starting point.
The Makonde are, body and soul, so to speak, one with this bush.
According to my Yao informants, indeed, their name means nothing
else but “bush people.” Their own tradition says that they have been
settled up here for a very long time, but to my surprise they laid great
stress on an original immigration. Their old homes were in the
south-east, near Mikindani and the mouth of the Rovuma, whence
their peaceful forefathers were driven by the continual raids of the
Sakalavas from Madagascar and the warlike Shirazis[47] of the coast,
to take refuge on the almost inaccessible plateau. I have studied
African ethnology for twenty years, but the fact that changes of
population in this apparently quiet and peaceable corner of the earth
could have been occasioned by outside enterprises taking place on
the high seas, was completely new to me. It is, no doubt, however,
correct.
The charming tribal legend of the Makonde—besides informing us
of other interesting matters—explains why they have to live in the
thickest of the bush and a long way from the edge of the plateau,
instead of making their permanent homes beside the purling brooks
and springs of the low country.
“The place where the tribe originated is Mahuta, on the southern
side of the plateau towards the Rovuma, where of old time there was
nothing but thick bush. Out of this bush came a man who never
washed himself or shaved his head, and who ate and drank but little.
He went out and made a human figure from the wood of a tree
growing in the open country, which he took home to his abode in the
bush and there set it upright. In the night this image came to life and
was a woman. The man and woman went down together to the
Rovuma to wash themselves. Here the woman gave birth to a still-
born child. They left that place and passed over the high land into the
valley of the Mbemkuru, where the woman had another child, which
was also born dead. Then they returned to the high bush country of
Mahuta, where the third child was born, which lived and grew up. In
course of time, the couple had many more children, and called
themselves Wamatanda. These were the ancestral stock of the
Makonde, also called Wamakonde,[48] i.e., aborigines. Their
forefather, the man from the bush, gave his children the command to
bury their dead upright, in memory of the mother of their race who
was cut out of wood and awoke to life when standing upright. He also
warned them against settling in the valleys and near large streams,
for sickness and death dwelt there. They were to make it a rule to
have their huts at least an hour’s walk from the nearest watering-
place; then their children would thrive and escape illness.”
The explanation of the name Makonde given by my informants is
somewhat different from that contained in the above legend, which I
extract from a little book (small, but packed with information), by
Pater Adams, entitled Lindi und sein Hinterland. Otherwise, my
results agree exactly with the statements of the legend. Washing?
Hapana—there is no such thing. Why should they do so? As it is, the
supply of water scarcely suffices for cooking and drinking; other
people do not wash, so why should the Makonde distinguish himself
by such needless eccentricity? As for shaving the head, the short,
woolly crop scarcely needs it,[49] so the second ancestral precept is
likewise easy enough to follow. Beyond this, however, there is
nothing ridiculous in the ancestor’s advice. I have obtained from
various local artists a fairly large number of figures carved in wood,
ranging from fifteen to twenty-three inches in height, and
representing women belonging to the great group of the Mavia,
Makonde, and Matambwe tribes. The carving is remarkably well
done and renders the female type with great accuracy, especially the
keloid ornamentation, to be described later on. As to the object and
meaning of their works the sculptors either could or (more probably)
would tell me nothing, and I was forced to content myself with the
scanty information vouchsafed by one man, who said that the figures
were merely intended to represent the nembo—the artificial
deformations of pelele, ear-discs, and keloids. The legend recorded
by Pater Adams places these figures in a new light. They must surely
be more than mere dolls; and we may even venture to assume that
they are—though the majority of present-day Makonde are probably
unaware of the fact—representations of the tribal ancestress.
The references in the legend to the descent from Mahuta to the
Rovuma, and to a journey across the highlands into the Mbekuru
valley, undoubtedly indicate the previous history of the tribe, the
travels of the ancestral pair typifying the migrations of their
descendants. The descent to the neighbouring Rovuma valley, with
its extraordinary fertility and great abundance of game, is intelligible
at a glance—but the crossing of the Lukuledi depression, the ascent
to the Rondo Plateau and the descent to the Mbemkuru, also lie
within the bounds of probability, for all these districts have exactly
the same character as the extreme south. Now, however, comes a
point of especial interest for our bacteriological age. The primitive
Makonde did not enjoy their lives in the marshy river-valleys.
Disease raged among them, and many died. It was only after they
had returned to their original home near Mahuta, that the health
conditions of these people improved. We are very apt to think of the
African as a stupid person whose ignorance of nature is only equalled
by his fear of it, and who looks on all mishaps as caused by evil
spirits and malignant natural powers. It is much more correct to
assume in this case that the people very early learnt to distinguish
districts infested with malaria from those where it is absent.
This knowledge is crystallized in the
ancestral warning against settling in the
valleys and near the great waters, the
dwelling-places of disease and death. At the
same time, for security against the hostile
Mavia south of the Rovuma, it was enacted
that every settlement must be not less than a
certain distance from the southern edge of the
plateau. Such in fact is their mode of life at the
present day. It is not such a bad one, and
certainly they are both safer and more
comfortable than the Makua, the recent
intruders from the south, who have made USUAL METHOD OF
good their footing on the western edge of the CLOSING HUT-DOOR
plateau, extending over a fairly wide belt of
country. Neither Makua nor Makonde show in their dwellings
anything of the size and comeliness of the Yao houses in the plain,
especially at Masasi, Chingulungulu and Zuza’s. Jumbe Chauro, a
Makonde hamlet not far from Newala, on the road to Mahuta, is the
most important settlement of the tribe I have yet seen, and has fairly
spacious huts. But how slovenly is their construction compared with
the palatial residences of the elephant-hunters living in the plain.
The roofs are still more untidy than in the general run of huts during
the dry season, the walls show here and there the scanty beginnings
or the lamentable remains of the mud plastering, and the interior is a
veritable dog-kennel; dirt, dust and disorder everywhere. A few huts
only show any attempt at division into rooms, and this consists
merely of very roughly-made bamboo partitions. In one point alone
have I noticed any indication of progress—in the method of fastening
the door. Houses all over the south are secured in a simple but
ingenious manner. The door consists of a set of stout pieces of wood
or bamboo, tied with bark-string to two cross-pieces, and moving in
two grooves round one of the door-posts, so as to open inwards. If
the owner wishes to leave home, he takes two logs as thick as a man’s
upper arm and about a yard long. One of these is placed obliquely
against the middle of the door from the inside, so as to form an angle
of from 60° to 75° with the ground. He then places the second piece
horizontally across the first, pressing it downward with all his might.
It is kept in place by two strong posts planted in the ground a few
inches inside the door. This fastening is absolutely safe, but of course
cannot be applied to both doors at once, otherwise how could the
owner leave or enter his house? I have not yet succeeded in finding
out how the back door is fastened.