Assistive technology (AT) includes devices and services used to enhance abilities and participation of children with disabilities, while reducing limitations that may arise from impairments of body functions and structures. These children often have limitations that prevent them from performing activities in the same manner as their peers. The limitations are attributable to neuromotor or musculoskeletal impairments, including muscle contractures, skeletal deformities, and inadequate balance and control of muscle groups that affect children’s ability to produce the movement necessary to perform specific skills and activities. Physical therapists, as members of an intervention team, may recommend AT in the areas of positioning, mobility, and communication to prevent or decrease the influence of neuromotor or musculoskeletal impairments. Historically, professionals in rehabilitation and educational environments have used AT to support therapeutic intervention.
With continued advancement of technology and legislation in the United States addressing the provision of AT during the past 30 years, options for devices are more readily available. Although therapists and families may still use handmade devices fabricated from low-cost materials, other options are now commercially available and the emergence of 3D printing technology has created new possibilities for device fabrication (Lunsford, Grindle, Salatin, & Dicianno, 2016). Physical therapists, along with parents and other service providers, can evaluate a child’s need for AT devices and services and make appropriate recommendations to meet those needs (Cook & Polgar, 2015). This chapter describes the laws and processes used to meet the AT needs of children, and the role physical therapists play in the selection, acquisition, and implementation of AT, with a focus on positioning and mobility, augmentative communication, and other technologies.
Assistive Technology Legislation
Many laws in the United States address AT and provide a legislative framework designed to ensure that children with disabilities receive the AT they need. These laws are summarized in Table 17.1 and in Chapter 1.
TABLE 17.1Federal Laws Related to Assistive Technology (AT) ||Download (.pdf) TABLE 17.1 Federal Laws Related to Assistive Technology (AT)
|The Rehabilitation Act of 1973 (as amended through PL 114-95) ||Individuals With Disabilities Education Improvement Act and Amendments of 2004 (IDEA) (PL 108-446) and Its Precursors ||Assistive Technology Act of 2004 (formerly [PL 108-364] known as the Technology Related Assistance Act) ||Americans With Disabilities (ADA) Amendments Act of 2008 (PL 110-325) |
Protects civil rights of people with disabilities from discrimination in programs or activities that receive federal financial assistance.
Definitions of disability are broader than those defined by IDEA.
Some children qualify for services under this definition, although not meeting eligibility criteria of IDEA.
AT devices and/or services may be considered reasonable accommodation when needed by children to access and participate in their public education.