Assistive Technology for Students with TBI
- What is assistive technology?
- What is unique about designing and evaluating assistive technology for students with brain injury
- What areas of cognition have the highest needs for assistive technology after a brain injury?
- What is effective assistive technology for students with brain injury?
- Six tips for teaching students how to use assistive technology
- Seven types of assistive technology equipment
Assistive technology (AT) is any piece of equipment or product system–acquired commercially, off the shelf, modified, or customized–used to increase, maintain, or improve the functional capabilities of an individual with a disability.
- Assistive Technology Act of 1998
- IDEA Amendments of 1997, 20USC 1401 (1), Sec. 300.5
Students with brain injury can have unique assistive technology needs. Some assistive technology ideas are specifically designed for students with brain injury; other technologies can be used following proper assessment of student needs.
The needs of students with brain injury can change dramatically, especially during the first two to three years following the injury. Unfortunately, cognitive skills and memory often take a long time to heal and may remain areas of challenge for students with TBI. The student with brain injury may not recognize the need for assistive technology or other forms of intervention.
Assistive technology needs to be strategically taught to the students and practiced in the environment where it will be used. As with any assistive technology, most students may depend heavily on people in the environment at first. Then the student should be taught to take more and more control of the technology over time, if possible.
In a survey, 95% of clinicians who work with people who have had brain injuries reported that people with brain injury needed assistive technology to support organization and memory skills. Most clients (53%) believed that assistive technology was needed for help with attention and concentration; 48% of clients wanted assistive technology for speed and efficiency, 45% for self evaluation, and 30% to help with interpersonal behaviors.
Hart, T. O'Neil-Pirozzi, Morita C, ( 2003) Clinician expectations for portable electronic devices as cognitive-behavioural orthoses in traumatic brain injury rehabilitation.Brain Injury, 17(5), May 2003 , pages 401 - 411.
For students with brain injury (as well as other students), effective assistive technology tends to have the following characteristics:
- It has meaning to the student using it.
- It is minimally intrusive. It is not overly cumbersome or unwieldy and does not intrude too much on the student's life, e.g., does not prevent the student from interacting with others.
- Effective assistive technology provides assistance without unnecessary control on the student's day-to-day activities.
- It requires skills the student has. The student is not overwhelmed by the device or strategy and has the background to use it easily.
- The most effective assistive technology is universally accessible or at least accessible to a majority of other people.
- The assistive technology doesn't make the individuals using it feel different or that they stand out when using it.
- Assistive technology is most successful when it looks normal or stylish to the student.
- The assistive technology has built in prompting, which can decrease over time as the student's independence increases.
- The assistive technology is supported by the environment; people around the student understand how to use the technology and can help the student when needed.
Kirsch, N.L., Shenton, M., Spirl, E., Rowan, J., Simpson, R., Schreckenghost, D., LoPresti, E.F. (2004). Web-based assistive technology interventions for cognitive impairments after traumatic brain injury: A selective review and two case studies.Rehabilitation Psychology, 49(3), 200-212
- Use the simplest, least expensive and most usable system that will fill the need.
- Develop routines around the use of the technology and teach the student the routines over time.
- Provide support for the student, but fade the support to prevent dependence on the external support system and environment.
- Teach the system to other people in the student's environment.
- Review the assistive technology on a regular basis to ensure it continues to meet the changing needs of the individual and that the student is moving toward less dependence on people in the environment.
- Involve the student in the selection of the system and in the planning for training and support when appropriate.
- Off-the-shelf marketed products, such as planners, cell phones, etc.
- Modified off-the-shelf products, such as a cell phone with a program that reads the screen aloud or a light attached to a timer to help someone wake up in the morning.
- Specialized assistive technology commercial products, such as specialized keyboards that provide the user fewer choices and a larger target for making key choices.
- Modified assistive technology commercial products, such as a magnified screen on a computer or a specialized communication device built onto the tray of a wheelchair.
- Simplified products, such as a cell phone with fewer choices or a keyboard with fewer keys.
- Products with added functionality, such as a cane with a sensing device for people with limited visual acuity.
- Customized product, such as a chair built specifically for a particular user.
Dawe, M., (2006).Desperately seeking simplicity: how young adults with cognitive disabilities and their families adopt assistive technologies.From the proceedings of the Conference on Human Factors in Computing Systems (2006). Montreal, Quebec, CA