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Policy & Guidance


From Wisconsin Department of Health and Family Services Birth to 3 Program

State of Wisconsin Foundations Bulletin #3
ASSISTIVE TECHNOLOGY SERVICES AND ASSISTIVE TECHNOLOGY DEVICES AND BIRTH TO 3 PROGRAMS

March 1995

Assistive technology devices and services are an early intervention service under the Birth to 3 Program. Assistive technology services and devices are defined as follows:

Assistive technology service means: evaluating the needs of a child with a disability for an assistive technology device, 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 for children with disabilities; 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 or technical assistance for a child with disabilities or, if appropriate, the family of a child with disabilities, in the use of an assistive technology device; and training or technical assistance for professionals, including individuals providing education or rehabilitation services, employers, and other individuals who provide services to or are otherwise substantially involved in the major life functions of children with disabilities. [HSS 90.03(2m) and 90.11(4)(a)]

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 the functional capabilities of children with disabilities. [HSS 90.03(2) and 90.11(4)(a)]

Assistive technology services and assistive technology devices will be considered early intervention services when they also meet the following definition:

Early intervention services means services provided under public supervision that are designed to meet the special developmental needs of an eligible child and the needs of the child's family related to the child's development and selected in collaboration with the parent.
[HSS 90.03(16)]

The following bulletin will clarify issues regarding the provision of assistive technology services and assistive technology devices. This bulletin discusses:

1. How does assistive technology benefit young children with developmental delays or disabilities?

Assistive technology devices and services help children overcome barriers to their participation and learning as they explore the world through discovery and experience. Mobility devices assist children in motor development and allow for greater independence. Cognitive and communication skills improve as children utilize computers and selected software as a way to access information and communicate what they have learned. Hearing aids and FM systems allow children to receive information about their environment. The use of technology makes it easier for children to actively take part in home and community activities that increase the opportunity to meet friends.

Young children learn through play. Through play children develop motor, sensory, cognitive and social skills. Some children need toys that are adapted so that they can participate in age-appropriate activities. Adapted toys and other assistive technology devices and services are used by early intervention professionals, parents and other care givers to motivate children and assist them in their developmental progress. For example, a piece of Velcro may be added to the bottom of a bowl to assist a child in eating more independently, a foam wedge may be used to assist in positioning a child so that he or she may attend to an activity, or a child who is non-speaking may use an augmentative communication device to produce spoken output.

2. What are some of the resources that may be used to obtain assistive technology services and devices?

There are a number of sources available for obtaining funds to purchase assistive technology services and assistive technology devices. Programs and families may also borrow, rent, or lease devices from an assistive technology lending library or program. These sources include:

Private insurance may fund assistive technology assessments and devices. Parents must give consent before private insurance may be used for services or devices related to the child's special developmental needs.

Medical Assistance (MA) is a joint Federal/State program to provide physical and related health care services to persons with disabilities. There are a variety of ways to access MA. Some children are eligible based on income. Other children are eligible based on their medical or developmental needs. Medical Assistance will fund assistive technology when a child's need has been appropriately assessed and the service and/or device is documented as medically necessary. The MA provider handbook describes what is covered and how to request it.

HealthCheck is a preventative health program for anyone under the age of 21 who has a valid Wisconsin Medical Assistance (MA) card. HealthCheck may fund medical needs, beyond the basic MA services, identified through a HealthCheck screening. For more information about this program, call 1-800-722-2295.

Children with Special Health Care Needs (CSHCN) is a state-wide program that provides consultation and reimbursement for certain medical services to children who have physical disabilities or chronic illnesses, from birth to age 21. Private insurance may be billed and there are income requirements for this program. For more information, call 1-800-441-4576 or (608) 266-3886.

The Wisconsin Assistive Technology Initiative has a Used Equipment Marketplace (UEM), lending libraries, and access to donated computer equipment. Assistive Technology Consultants are located at the CESAs throughout the state. For more information, call Penny Reed at (800) 565-8135. To borrow from the lending library or use the UEM, call WATI lending library (800) 991-5576.

WisTech includes a network of specialists located in the seven Independent Living Centers. The specialists can provide information and referrals, lend devices, and help identify financial resources. A list of the Independent Living Centers is attached. The WisTech state office can be reached at (608) 267-6720.

Foundations, organizations and other community resources such as private donations, Kiwanis Clubs, Lions Clubs, the Veterans Administration, United Cerebral Palsy and United Way may provide funding to a Birth to 3 Program or directly to the family. Efforts to raise public awareness of the Birth to 3 Program and the benefits of early intervention may assist programs in developing or accessing these funding sources.

ABC for Health provides advocacy and benefits counseling through parent consultants located within each of the state's five public health regions. They can provide assistance in applying for benefits from the following public benefit programs: Medical Assistance, SSI, Healthy Start, Family Support, Children with Special Health Care Needs, Community Options, and Katie Beckett, as well as information on maximizing the use of private insurance and assisting families when insurance is not covering items that appear to be covered under their policy. For the names of regional benefits consultants, call ABC for Health at (608) 251-2323.

3. What is the process for assessing a child's assistive technology needs?

Throughout a child's evaluation and assessment, the early intervention team (EI team) should be alert to the child's potential need for assistive technology services and/or devices. During the assessment of a child's physical development, an EI team member may determine that a particular size or style of chair might better support the child. Information from previous evaluations might indicate the need for a specific assistive technology device. The child's family may share information about adaptations they have developed to support their child's participation in family activities. While observing the child, members of the EI team should be able to identify barriers that may be limiting the child's participation and independence in home and other settings.

Some children with complex or challenging needs may require additional assessment. The EI team might benefit from assistance or consultation from professionals with specific expertise in the area of assistive technology or from access to a variety of assistive technology devices. In some instances it may be necessary to arrange for a separate assistive technology assessment.

4. What type of training or experience should early intervention professionals and families have in the area of assistive technology?

Members of the EI team who assess the need for, plan for, or provide a child with assistive technology devices or services should be knowledgeable about the particular delay or disability of the child, the range of assistive technology services and devices available and how to utilize these services and/or devices to support the child's developmental progress. When a child has significant challenges, specially trained staff knowledgeable about assessment and specific equipment or adaptations might be needed. Depending on the needs of the child, professionals such as an augmentative communication specialist, an occupational therapist with a specialization in assistive technology, or a rehabilitation engineer may need to be a part of the EI team.

5. What if the program does not have the expertise needed to evaluate a child's assistive technology needs or to provide other assistive technology services?

Birth to 3 Programs need to have access to professionals who are able to assess a child's simple or complex assistive technology needs and provide ongoing assistive technology services. If this expertise does not exist among a program's early intervention staff, programs may need to contract with community assistive technology professionals such as an augmentative communication specialist, occupational therapist, or a rehabilitation engineer to provide this expertise.

Birth to 3 Programs and providers who want more information regarding the location of professionals with expertise in assessing young children's assistive technology needs, and resources for pursuing training or other assistive technology services can contact:

6. How does the IFSP team document a child's need for assistive technology?

The IFSP is the key to documenting the need for and utilization of assistive technology as part of a child's early intervention program. On the IFSP, a description of the child's present level of development might indicate abilities such as "Tom communicates by pointing to objects," or "Tom has a good appetite, and he needs assistance to eat independently." The list of the family's concerns, priorities and resources might indicate the family's desire to work with early intervention staff in utilizing specific assistive technology devices or services to support their son in the areas of communication and self help. The IFSP outcomes might include such statements as, "Tom will tell others when he is hungry or thirsty," or "Tom will feed himself." The list of early intervention services would include the specific assistive technology services and/or assistive technology devices (in the above examples, picture boards, adapted spoon and adapted bowl) that will be provided to assist the child in achieving the IFSP outcomes.

7. Who is responsible for assuring that a child's assistive technology needs are met?

County Birth to 3 Programs are responsible for providing assistive technology when the IFSP team determines that the assistive technology device or service is needed to support the child's special developmental needs and to assist the child in meeting specific IFSP outcomes.

If the IFSP team determines that the assistive technology being considered is not needed to support the child's special developmental needs identified within the IFSP, the assistive technology may still be listed on the IFSP as "other services." In this situation, the service coordinator could assist the family in obtaining the assistive technology, but the Birth to 3 Program would not be responsible for paying for the assistive technology service and/or assistive technology device. For example, while an air conditioner may be needed by the child, it is not considered an early intervention service because it is a service designed to meet the child's medical needs rather than the child's special developmental needs.

8. When HSS 90.11(4)(i)2 describes occupational therapy services, in part, as "adaption of the environment," does this mean that Birth to 3 Programs are responsible for such things as widening doors in homes to make them wheelchair accessible?

The phrase "adaptation to the environment" refers to activities such as providing equipment, materials, or devices or changing the child's position to facilitate the child's interaction and participation in activities within the environment. It does not mean physical adaptation of the home.

9. When a child utilizes an assistive technology device within his or her Birth to 3 Program, will that device stay with the child as he/she transitions from the program?

The ownership of an assistive technology device will be decided on an individual basis. When a device has been purchased by the program to assist a child in achieving specific IFSP outcomes, it belongs to the program. When the device no longer meets the needs of the child or when the child transitions from the Birth to 3 Program, the program may decide to use the device to support another child. When the child is transitioning from the program and continues to need/benefit from the device, the program may choose to allow the child to continue to use the device. This option may be especially appropriate when the device has been specially fitted or designed for the child and would not likely be of use to any other child.

When a family uses their own private funds or third party funding to purchase an assistive technology device, the device is the property of the family. Unless the family indicates otherwise, the device will remain with the child as he or she transitions from the Birth to 3 Program.