RESNA 27th International Annual Confence
The Role of Assistive Technology in Cognitive Testing of Students with Severe Disabilities
The Adapted Collaborative Strategies for Evaluating Student's Strengths or ACSESS project was recently funded by the US Department of Education to address current deficiencies in cognitive assessments for the educational purposes of children with severe communicative, motor, and/or sensory disabilities. The ACSESS Project combines the work of neuropsychologists and rehabilitation engineers to develop a new standard that will provide assessors with affordable assistive technology devices and will allow for comprehensive and accurate cognitive assessments, regardless of the severity of a child's disability. The project goals are realizable due to the availability of affordable, standard assistive technology products. Development of a model system, based on student evaluations and feedback received from relevant stakeholders, is currently in progress.
ACSESS, cognitive assessment, neuropsychology
For a child with a disability, assessment of cognitive ability is a central issue in determining that child's Individualized Education Plan (IEP). There is, however, a valid concern that these standard assessments do not allow children with severe and multiple impairments to fully display their cognitive skills and thus proper accommodations for their education cannot and are not properly being identified (1).
The US Department of Education, Office of Special Education and Rehabilitation Services funded the Adapted Collaborative Strategies for Evaluating Student's Strengths (ACSESS) Project, a collaborative project involving The University of Michigan, Washtenaw Intermediate School District, Western Michigan University, and the United Cerebral Palsy Association of Michigan (1). The ACSESS Project's focus is on an all-inclusive and accurate assessment of students' abilities through the use of the latest advancements in rehabilitation engineering and assistive technologies (1). This technology is being used to allow students to fully display their cognitive abilities. This project also focuses on including the child and the parents in any and all decisions surrounding the child's IEP (1). The goal of the ACSESS Project is to create a standardized method for cognitive testing where those administering the test will be able to provide the child with the necessary assistive technologies to participate, based on the severity of the child's disability. This method, complete with all of the assistive technology devices needed to properly assess most students, regardless of the severity of their disability, is oriented towards using standardized assistive technologies in order to ensure its availability to schools at a reasonable cost.
Although the focus of the ACSESS project is neuropsychological cognitive assessment of students with severe disabilities, rehabilitation engineers play a vital role in the success of the project. This type of assessment requires the ability of the child to make a definitive choice. The University of Michigan Rehabilitation Engineering Program (UMREP) developed a lab complete with assistive technology devices necessary for reliable choice making. As the student evaluation phase of the project continues, rehabilitation engineers involved will be evaluating the assistive technology used in these assessments with the goal of assembling a standard kit for distribution to schools containing low cost assistive technology devices that can be used to properly administer assessments. Rehabilitation engineers will also take on an active role in aiding schools without assistive technology experts to use these devices for proper evaluation.
Can a new model of adapted protocols and procedures utilizing proper and cost effective advancements in assistive technology devices be developed that will more thoroughly and accurately test the cognitive abilities of children with severe communicative, motor, or sensory disabilities to identify effective accommodations and resources necessary for a well rounded education (1)?
The ACSESS project will proceed in six phases over the course of four years consisting of:
Phases 1 and 2 are complete and Phase 3 is currently underway. In Phase 1, five groups provided feedback on the needs of students with severe disabilities regarding cognitive evaluation. One group, consisting of students with disabilities as well as their parents and guardians, provided feedback via questionnaires. The other four groups, consisting of school psychologists, teacher consultants/educational specialists, assistive technology staff and transition planning staff, all participated in focus groups where they provided feedback with regards to how assessments can be changed to more accurately assess students with severe disabilities.
Phase 2 has been initiated with the creation of an ACAL at the University of Michigan C.S. Mott Children's Hospital. The University of Michigan Rehabilitation Engineering Program (UMREP) designed, ordered and set up the equipment for the ACAL based in part on Phase 1 results. This equipment included assistive technology devices such as computing hardware and software, access switches, pointing devices, switch activated toys, and other devices that provide needed options for cognitive evaluation of students with severe disabilities. These devices were purchased with two factors in mind, effectiveness and cost. Purchased devices were chosen to provide necessary access options for these assessments and at the same time satisfy criteria as standard assistive technology devices that could be purchased at relatively low cost by a school.
The ACSESS project is currently in Phase 3, which will continue through the third year of the project. Students ages 5 to 21 with severe communicative, motor, and sensory disabilities have been and will continue to be evaluated in environments such as the University of Michigan hospital, school, and home by project rehabilitation engineers and psychologists using the technology available from the ACAL. Also, during this phase, the UMREP will be evaluating the effectiveness of the assistive technology used. Phase 4, Model Demonstration Refinement, is now underway concurrent with Phase 3, Model Demonstration Evaluation. As evaluations of students occur, the model is refined based on experiences and outcomes. Phases 5 and 6 will occur predominantly in the final year of the project and will involve creating the final model for alternative cognitive testing, training those that will be assessing children in its use, and putting the model to practice.
At this point results have been obtained from Phase 1, Survey of Needs in Assessments. After analyzing the responses, several concerns became obvious:
These results are valuable opinions that will be taken into account in the development of the new assessment model. Results from the ongoing cognitive evaluations of students with severe disabilities using the assistive technology available in the ACAL are not yet available.
Although still in its early stages, the ACSESS Project has exposed a significant problem in the current cognitive assessment of children with severe disabilities and has garnered some helpful opinions on how these assessments can be changed. Successful attainment of ACSESS project goals includes a new model for cognitive assessments composed of a readily available compilation of assistive technology products and techniques for evaluating severely and multiply impaired students for cognitive abilities that a school can purchase at a reasonable cost. This goal is attainable due to the availability of off-the-shelf assistive technology products at affordable prices.
James R. Stachowiak, M.S.E
University of Michigan Rehabilitation Engineering Program
1C335 University of Michigan Hospital
1500 E. Medical Center Dr.,
Ann Arbor, MI 48109-0032
734-936-7170, fax: 734-936-7515,