Assistive Technology s1

Assistive Technology

Intervention Worksheet

Student: ______Age/Grade: ______

Evaluator: ______

Other Information: ______

Write the name of the device, such as IPad or BrailleNote, being trialed for up to 6 weeks (or less when possible). After the 6 weeks, a team decision should be made as to whether the school district will purchase the device. At the end of the 6-week trial, the device should be returned to the Assistive Device Center.

Name of Device ______

Use the table below to keep data regarding use of the device. More than one date/score column is provided so that you may use the chart for data collections at the beginning, middle, and end of the trial.

This intervention assessment is general in nature. Specific skill development goals may be written and rubrics for assessment may be developed upon purchase of equipment by the local education agency.

Feel free to change the information to meet the needs of your particular situation.

Use the information generated from the worksheet to write a recommendations report regarding the assistive technology being trialed.

I = independent

V = verbal cue(s)

p = physical assist(s)

F = possible future use

N = not applicable at this time

Skill/Concept / Date
Score / Date
Score / Date
Score
1. Use fine motor skills to navigate and manipulate device.
2. Demonstrate motivation and willingness to use device to meet goals.
3. Student is able to determine, request, or make adjustment to settings as needed.
4. Student cares for device appropriately (does not drop, stores in backpack, etc).
5. Use device for reading
_____ braille
_____ print (indicate preference)
____Auditory
6. Complete written tasks using device:
______using braille (refreshable display)
______using on-screen keyboard
______using qwerty keyboard
______using dictation
______Hand writing
______Fill out test or worksheet
______Other______
7. Send and receive e-mail.
8. Use Internet.
9. Keep track of assignments (calendar).
10. Communicate with others appropriately (such as through Skype or face time, other).
11. Download and/or access books.
_____Bookshare _____ Learning Ally
_____ IBooks _____BARD
_____ Read items such as hard copy textbooks, worksheets, tests, etc. (close viewing).
_____Other______
12. Look up words with dictionary/thesaurus
13. Use device for appropriate leisure activities (listening to music, etc).
14. Use educational apps as needed (such as math apps, CVI apps, etc).
15. Use GPS for navigation.
16. View teacher display (such as white board) using device.
17. Charge (hook and unhook from AC power, know when) as appropriate.
18. Communicate with others regarding device (what device can and cannot be used for, etc).
20. Use phone or texting as appropriate.
21. Other
22. Other
Total Independent Score
Comments

Think about…

1. Did the device provide adaquate accessibility options for the student? Explain.

______

2. Did the student show improvement during the trial of this device? Give narrative to describe your observations and results of data.

______

3. Do you believe continued improvement could be made if student had this device permanently? Explain.

______

4. What training would be necessary for student to make full use of this product? How could this training realistically be provided? Who would give instruction?

______

5. What would staff needs regarding training would assist the student to take complete advantage of this product. Write details as possible.

______

6. Considering the above data, what would your next steps be? Why? Outline the data that helped in your decision making if possible.

______

7. Will this device “grow with” the student? Based on the data, your observations, ect. Explain.

______

8. What is your plan to communicate results to team members?

______

Rosa Mauer 11/30/2012