2004 Conference Proceedings

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Rani Bandaru, MS, OTR, ATP
Matheny School and Hospital
43 Church Lane
East Brunswick, New Jersey 08816-2504
Phone: (732) 319-5316
Fax: (732)297-7583
Email: prbandaru@yahoo.com

Beverly K. Bain, Ed.D, OTR, FAOTA
Matheny School and Hospital
10 Carriage-House Road
Bernardsville New Jersey 07924
Phone: (908) 766-1364

In today's classroom, computers have become an integral part of every student's education. For students at Matheny School and Hospital, who have severe and profound physical disabilities, alternate communication skills, and limited cognitive abilities, computers have made it possible to enhance a student's ability to learn. They help the students interact with their peers and other staff, to develop self-confidence, and to increase their ability to participate in classroom activities.

The use of a collaborative interdisciplinary technology team has increased the efficacy of using computers within the classroom. At Matheny School and Hospital, this interdisciplinary technology team consists of the student, Occupational Therapist, Teacher, Speech & Language Pathologist, and the Computer Technicians. Each member of this team brings a knowledge base, that when put together, provides an optimal learning environment for the student. Initially a school-wide technology plan was developed that included giving technical support services, purchasing equipment, formulating teacher competencies, and assisting teachers in professional development.

The evaluation process begins with the team determining what goals would be important for the student to work on in the classroom. Then formulating what is the best possible way that computers could then help them reach their goals including any necessary adaptive equipment suggestions determined by the Computer Technicial and the Occupational Therapist. The Occupational Therapist then begins their role in first determining whether that student is appropriate to be using switches/alternate access methods to use the computer via a screening form. This switch screening (form #1-given at conference) takes into account some basic cognitive, sensory and motor prerequisite skills which determine whether or not a student is ready to be using switches for any area of assistive technology. Once it has been determined that a student is ready to begin using switches the Matheny Switch Evaluation Instrument (MSEI) (form #2-given at conference) is then completed.

There are many different adaptive access methods and tools that can be trialed with students. They are distinguished by direct and indirect selection. Direct selection involves the use of one step to get to a selection. For example, most people on a day to day basis use direct selection to access their environment because it is easier to use, its faster and it's more consistent. It allows a person at any given time to randomly choose an item from a selection set. Persons with disabilities sometimes require assistive technology devices to assist them in using direct selection. It could be the use of a trackball, keyboard, head pointer or a touch screen. All of these access methods allow the user to directly select their option without going through multiple steps. Generally speaking, direct selection demands that the user require greater physical abilities, but it makes fewer cognitive demands, and places fewer attentional demands on the person. An indirect selection then means that the user has to go through multiple steps in order to reach their final selection. This is typically known as scanning. Persons with disabilities, especially those with severe physical impairments, may use scanning more frequently. There are many different types of scanning patterns (linear, circular, row/column or column/row, group-item, and directed scanning) and scanning methods (automatic, step, and inverse). Through various trials the MSEI identifies the best type of switch that the student can access using the best type of selection method, the optimal location the switch should be placed within and the most advantageous body movements the student uses to activate and release the switch.

Once the switch access site, method, and equipment has been determined, age specific goals in accordance with the student's individualized educational plan (IEP) are formulated with the teacher. The three case studies that will be presented at the conference, will illustrate how the computer was used to reach these goals. The first case study looks at a child who is four years old and has limited physical abilities. This child is able to use a touch screen to learn cause and effect. The second case study will show a 6 years old child who is using the computer to learn to spell his name using an adaptive keyboard. Our last case study will demonstrate a 10-year-old child who is using a modified trackball to learn problem-solving skills. These case studies illustrate a sampling of the many educational goals that can be achieved when an interdisciplinary team collaborates in the educational setting.

Once the evaluation has been completed by the interdisciplinary technology team, an individualized computer profile can be created for use in the classroom. This will ensure consistency and carryover by the team in various environments. The computer profile shows the setup of the computer and student, the type of access, any special adaptive equipment and software, and any precautions for that child.

The planning, evaluation and implementation by an interdisciplinary technology team at Matheny School and Hospital has shown to encourage computer use in the classroom for children with severe physical disabilities. At Matheny School and Hospital, the switch screening, MSEI and the computer profile have proved to be effective evaluation instruments to encourage these severely disabled students to go from being passive pupils to active participants in their education. The planning and implementation involved with the children's education requires on-going involvement from the interdisciplinary team


1. Bain, B.K. & Ledger, D. (1997), Assistive Technology; an interdisciplinary approach. New York: Churchill Livingstone.

2. Cook, A. M., & Hussey, S. M. (1995), Assistive Technologies: principles and practice. St. Louis, MO: Mosby.

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