Assistive Technology as Part C Service

Assistive technology devices and services should be considered for all children enrolled in Connecticut’s Birth to Three System. Every child referred to the Connecticut Birth to Three System must receive a comprehensive, multidisciplinary evaluation of his or her unique strengths and needs to determine eligibility and to plan for early intervention (EI) services appropriate to meet those needs, including the need for assistive technology. 

Assistive technology, which includes devices and services, is one of the services required under Part C of the Individuals with Disabilities Education Act (IDEA) of 2004. Children may not be excluded from consideration for assistive technology for any reason (e.g., type of disability, age, cost, lowered expectations, or administrative concerns).

Parent Rights

Parents are an integral part of the process for determining the needs of their child, including the need for assistive technology. Parental participation is vital for the assessment, selection, implementation, and maintenance associated with their child’s use of assistive technology. Parents must give consent to the evaluation of their child. They must be included as part of the team that develops the Individual Family Service Plan. If the family and the early intervention team do not agree on the proposed assistive technology, the family may share its concerns with the Birth to Three program through many informal steps. However, if informal steps do not satisfy the concerns, a family can take other, more formal steps, including a written complaint, mediation, and/or a hearing (Connecticut Birth to Three System, 2011).

Definition of Assistive Technology Devices and Services

Assistive technology in the Individuals with Disabilities Education Act includes both assistive technology devices and assistive technology services.

Assistive technology devices covered under IDEA

An assistive technology device means 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 a child with a disability (IDEA 2004, Sec.602(1)A; 34CFR §.300.5).

Assistive technology devices not covered under IDEA

• Devices provided to meet the medical, daily living, or life-sustaining needs of a child.
• Devices that are not specifically designed to increase, maintain, or improve the functional capabilities of a child with a disability.
• A device that is surgically implanted, or the replacement of such device.

Equipment that is not specifically designed to increase, maintain, or improve the functional capabilities of a child, such as car seat or bath chair, and does not meet the definition of AT under IDEA, may still be needed by a child and his or her family. It is the responsibility of the child’s service coordinator to coordinate with medical and health providers as well as to assist the family in locating services and devices outside of the Birth to Three System when needed. For example, the family may need a bath seat to help with the bathing routine and to ensure the safety of the child. The bath seat, however, may not contribute toward increasing, maintaining, or improving the functional capabilities of the child. If the family indicates that obtaining a bath seat is a family priority, the service coordinator should assist the family in obtaining a bath seat through other resources.

Assistive technology services means any service that directly assists a child with a disability in the selection, acquisition, or use of an assistive technology device. Assistive technology services include:

• evaluation of the needs of such child, including a functional evaluation of the child in the child’s customary environment; 
• purchasing, leasing, or otherwise providing for the acquisition of assistive technology devices by such child; 
• selecting, designing, fitting, customizing, adapting, applying, maintaining, repairing, or replacing assistive technology devices; 
• coordinating and using other therapies, interventions, or services with assistive technology devices, such as those associated with existing education and rehabilitation plans and programs; 
• training of child and family; and  
• training or technical assistance for professionals (including individuals providing education and rehabilitation services), employers, or other individuals who provide services to, employ, or are otherwise substantially involved in the major life functions of such child (IDEA 2004).

Continuum of Assistive Technology Devices

The complexity and specificity of AT devices proceed along a hierarchy. AT options along the continuum of AT devices ranging from no-tech to high-tech should be considered (Tots ’n Tech Research Institute, 2009).

• NO-TECH Universally designed devices that would be used with all children, with and without disabilities, at a particular age (e.g., booster seat, suction bowl, safety plugs in outlets) (Thomas Jefferson University, 2011). A no-tech device may not be considered AT under Connecticut Birth to Three unless it is something unique and specific to the child’s disability and not something commonly used by most parents. Early intervention providers can help parents select and procure such devices when needed and, if they think it is justifiable as an AT device, may purchase such devices if under $250 or may submit request for reimbursement to the Birth to Three System for devices costing $250 or more. 
• LOW-TECH Differentiated adaptations and assistive technology that enable children to do something they cannot do and may not be able to do for a while (e.g., loops attached to puzzle pieces, picture communication systems board, rolled towels or foam to enhance sitting posture) (Thomas Jefferson University, 2011). 
• MODERATE-TECH Battery-operated or simple electronic devices or adaptations. (e.g., switch-activated toys, cordless remote control to activate appliance/light). 
• HIGH-TECH Specialized individual adaptations and assistive technology that would allow a child to do something he or she cannot do otherwise (e.g., gait trainer walker, computerized augmentative communication device, wheelchair, hearing aids) (Thomas Jefferson University, 2011). 

Types of Assistive Technology Devices

Assistive technology devices range from the creative use of existing resources in the child’s environment (e.g., household items) to the most sophisticated and cutting-edge high technology. Many types of AT are available to address needs in all areas of development: cognitive, physical, communication, social/emotional, and adaptive. 

• Adaptive/self-care (e.g., elastic waist pants, suction bowl, bath mitt). 
• Communication (e.g., picture communication boards, single or multiple message devices with switches or more complex augmentative and alternative communication devices). 
• Mobility (e.g., self-propelled wheelchairs with seating/safety adaptations, therapeutic walkers, curb cuts). 
• Positioning (e.g., positioning pillows or pads, standing aids). 
• Sensory enhancers for hearing and vision (e.g., toys with sound or vibrating mechanism, large picture books, hearing aids or other forms of amplification) 
• Socialization/play (e.g., Velcro mitt to catch a tennis ball, paper clips separating pages for ease of turning, a ball designed with openings for ease of holding, knobbed crayon, standing devices for peer height interactions). 
• Cognition (e.g., switch-adapted toys, touch-screen computers, software).

Determining whether a piece of equipment meets the definition of assistive technology under Part C of IDEA must occur on an individual basis and be based on the child’s needs, the family’s concerns, and the IFSP outcomes. Some devices might be therapeutic or make caring for the child easier or safer but do not contribute to enhancing or maintaining the child’s functional capabilities. Consequently, these may not be AT but may be appropriate to acquire these devices through other medical channels.