Skip to Content RESNA Catalyst Project - providing technical assistance to AT Act entities

TAP Bulletin - February 1999


USE OF ASSISTIVE TECHNOLOGY INCREASES AMONG INFANTS AND TODDLERS

The number of very young children using assistive technology (AT) has increased dramatically over the past four years. Currently, more than 177,000 infants and toddlers receive services under Part C (formerly Part H) of the Individuals with Disabilities Education Act (IDEA). Of these, 9,274 children, birth to 2 years old, receive assistive technology devices and services.

The federal government tracks AT services through its annual state data collection activities. In 1992, 5,861 infants and toddlers received AT devices and services. In 1993, the number of children increased to 6,678, and by 1994, the number had risen to 7,352. In 1995, there were 9,274 children receiving AT devices and services. These figures represent a 58% increase in children receiving services and devices during the four-year period. The increase cannot be attributed to a rise in the total Part C population, which increased only 24% during the same time period. (See Table 1.)

The increase may be owing in part to the activities of State Tech Act Projects, which have been active in promoting the use of assistive technology for the very young and have worked to build the capacity of the states to provide assistive technology services under Part C.

Services to infants and toddlers with disabilities were mandated under IDEA in 1986. However, states were allowed to phase in these services over a number of years, with full implementation by 1994. Besides assistive technology devices and services, states provide a variety of other services to children birth to 2 years old, such as special education; physical therapy; nutrition services; audiology; nursing services; speech-language pathology; family training, counseling and home visits; and vision services.

Table 1. Increase in Assistive Technology Devices and Services for Infants and Toddlers

Year

Birth to 2 Population Receiving Any Early Intervention Services

Birth to 2 Population Receiving AT Devices and Services

1992

143,392

5,861

1993

154,065

6,678

1994

165,253

7,352

1995

177,734

9,274

Increase in AT Services to Very Young

Data from 38 states show an increase in the number of infants and toddlers who received services and devices from 1992 to 1995. Ten states show a decrease in the number of children provided devices and services, and 8 states show no change in the number of children receiving AT. Table 2 provides data for each state.

Some states show consistent steady growth in the number of very young children receiving services, such as Kansas, Ohio, Texas, and West Virginia. Other states show a tremendous gain in numbers of children over the last two years, primarily because of phased-in implementation of Part C. Until 1994, some states were still phasing in implementation of services and were not necessarily providing all services delineated under Part C.

However, several cautions must be noted when reviewing these data. Early data collection efforts, particularly in 1992 and 1993, were incomplete because some states had not elected to implement Part C provisions fully. Data have also been subject

to changes in reporting procedures by several states. Some states were not able to gather unduplicated counts of infants and toddlers, particularly in 1992 and 1993. Thus some states have wide fluctuations in their yearly totals, such as in Oregon and New Jersey.

Some states changed what assistive technology devices were actually counted. For example, Arkansas added developmental toys to the list of devices that were counted under the assistive technology category. Other states were not able to report data on assistive technology devices and services and are only now making changes to their data systems, such as New Hampshire and Massachusetts.

Variety of Assistive Technology Devices Used

Infants and toddlers use a variety of assistive technology devices. Battery-operated toys are often adapted with easy-to-access switches that allow a very young child to control the actions of the toy. These adapted toys help the child learn the basic concept of cause and effect. Seating and positioning systems provide support and guide the growth of a child's body. They also allow the child to move about in his or her environment. Computers and alternate access aids, such as large key pads and touch screens, can help children use software that develops communication, perceptual skills, fine motor skills, and many other skills.

Several sources are available for acquiring assistive technology devices for infants and toddlers. Devices may be purchased through Medicaid's early periodic screening, diagnostic, and treatment (EPSDT) program; through the child's individualized family service plan (IFSP) under IDEA; and through private insurance. Parents also may purchase devices directly or use monetary donations from various nonprofit sources. Parents may borrow money from financial loan programs being established around the country to buy assistive technology devices.

In addition, devices may be borrowed from local and state equipment loan programs. Devices are loaned for a period of time and then returned as the child grows out of the device or the device is no longer needed.

Tech Act Projects Encourage Use of AT

Tech Act projects have actively encouraged the use of assistive technology by very young children. They have increased awareness among parents and professionals about assistive technology and they have opened up access to devices and services.

For example, the Assistive Technology for Kansans Project, in collaboration with the Kansas Infant-Toddler Service, established an equipment loan program that serves very young children. Parents can borrow devices for a six-month trial. At the end of that time, families are assisted in finding funding for the equipment they want to continue to use. Or, if no other child is waiting for the equipment, the family may keep it for a longer loan period.

Clinicians are also allowed to borrow devices to conduct child assessments and allow the family to try out a device before purchase. This program has been so popular that the catalog of equipment to loan is now on a web page so borrowers may request devices electronically. The Tech Act project offers regional training on assistive technology subjects. Topics are determined by requests from families and local infant-toddler providers.

The Kansas Tech Act project collaborated with the state's Infant-Toddler Services to establish clear policies and procedures to ensure that very young children in the state receive proper assistive technology evaluations. Approximately 100 infants and toddlers receive evaluations, training, and equipment annually.

The West Virginia Assistive Technology System (WVATS) has concentrated on a number of initiatives that have promoted a greater use of assistive technology in the state for infants and toddlers. The project fostered the development of a pilot equipment loan program, similar to the one in Kansas but on a smaller scale, so that devices can be borrowed for use and returned when the child no longer needs them or grows out of them. WVATS has worked with the state's early intervention services to develop a state certification for early interven-tionists that includes competencies in assistive technology as a requirement. This step will ensure that early interventionists in the state have the knowledge and skills needed to use assistive technology with the very young in their programs.

With other state agencies, WVATS cosponsors a yearly hands-on summer camp that features assistive technology. Camp Gizmo, as it is called, is for young children, ages birth to 5, and the team of family members, educators, and clinicians who work with each child. Approximately 50 parents and professionals attend each year. At the camp, team members develop knowledge and strategies that they will be able to use in their home communities. Workshops are conducted on augmentative communication, positioning and mobility, computer adaptations, funding, and advocacy issues. Workshop participants have the opportunity to make low-cost adaptations tailored to their children's needs and take the devices home with them.

Summary

The total number of children receiving assistive technology devices and services nationwide is perhaps the most significant number to study when looking at Part C provision of those devices and services and the impact the law is having on very young children.

Data collection is being refined. States have been challenged in their work to design an interagency

data collection system that captures accurate counts

of infants and toddlers receiving services. As states refine and standardize their systems, individual state data will become more useful for comparative studies. Also, since a 3-year interval exists between data collection at the state level and reporting efforts at the federal level, outcomes of efforts by Tech Act projects and other state agencies may not be seen in data tables for several years.

Thus these data provide only a starting point to examine state response to the need for assistive technology devices and services of infants and toddlers.

 

References

U.S. Department of Education. (1995). Implemen-tation of the Individuals with Disabilities Education Act, seventeenth annual report to Congress. Washington, DC: Author.

U.S. Department of Education. (1996). Implemen-tation of the Individuals with Disabilities Education Act, eighteenth annual report to Congress. Washington, DC: Author.

U.S. Department of Education. (1997). Implemen-tation of the Individuals with Disabilities Education Act, nineteenth annual report to Congress. Washington, DC: Author.

U.S. Department of Education. (1998). Implemen-tation of the Individuals with Disabilities Education Act, twentieth annual report to Congress. Washington, DC: Author.

Table 2. Infants and Toddlers Receiving Services under IDEA


The RESNA Technical Assistance Project, Grant #H224A50006, is an activity funded by the National Institute on Disability and Rehabilitation Research (NIDRR), U.S. Department of Education (ED), under the Technology-Related Assistance for Individuals with Disabilities Act of 1988, as amended. The information contained herein does not necessarily reflect the position or policy of NIDRR/ED or RESNA and no official endorsement of the materials should be inferred.