Effectiveness of Assistive Technology

Evaluation of AT effectiveness is a dynamic, responsive, ongoing process. Measuring effectiveness occurs over time. The pursuit and implementation of optimal AT should continue throughout the child’s enrollment in Birth to Three. 

This process requires answering the questions:

• What is working? 
• What is not? 
• Why? 
• What needs to be changed?

The best device will not work if the child does not use it. Reasons may include: 

• It is not enabling the child’s participation in routines and activities. 
• It may be one of many assistive devices for the child and difficult to embed into daily routines. 
• It may be overwhelming for the family and caregivers. 
• There may be insufficient physical space to accommodate using the devices. 
• “…parents or caregivers may not be adequately trained on how to use the technology” (Illinois Early Intervention Assistive Technology Guidelines, 2007).

The adults who will be assuming responsibility to record information about the child’s responses to the AT should be clearly determined. Team members should understand what information is to be gathered, who is to provide it, in what form, how often, and for what period. The Birth to Three professional responsible for the AT services coordinates collection of this information and interpretation of changes. Assessing AT effectiveness should occur informally during routine early intervention visits as well as formally at IFSP reviews. 

Evaluation of effectiveness includes measuring changes in the child’s performance related to his or her functional outcomes. The expected changes may be quantitative in nature. Examples include the distance that a child walked with the walker, how many new pictures the child has used weekly to communicate, and/or the amount of food the child scooped independently. Change can also be measured qualitatively. Examples include the erectness of the child’s posture using the seating device during circle time, the accuracy of pointing to small pictures on a communication board, and/or the efficiency with which the child can put on shoes with Velcro fasteners in the morning. 

Service providers can collect this information in various ways:

• verbal feedback and/or written notes; 
• simple data-keeping chart (prepared by the child’s interventionist); 
• clinical measurements (e.g., amount of movement, distance walked, clarity of speech); and/or 
• observing the child using the AT. 

The formal analysis of this collected information may result in changes to implementation of AT and/or changes to AT devices. There may be a recommendation to the IFSP team, at a review, to engage the consultation of a specialist or to schedule a formal assistive technology assessment, if one has not been completed previously.