What to Expect During an Assistive Technology Evaluation

OVERVIEW

People often arrive at an assistive technology evaluation without a clear picture of what will happen. That uncertainty can make the process harder than it needs to be, particularly for families and for people who have not been through it before.

This article describes what evaluations commonly involve. Practice varies considerably by setting, profession, funding source, and the questions being asked, so this is a general picture rather than a standard procedure. Your own evaluation may be organized differently, may take more or fewer sessions, and may involve different people.

WHY SOMEONE MAY SEEK AN EVALUATION

Common reasons include a task that has become difficult or impossible, a device that is not working as expected, a change in abilities or circumstances, a new environment such as a new school, job, or home, equipment that no longer fits, a funding source requiring documentation before it will consider a request, or simply not knowing what options exist.

An evaluation is also reasonable when several things have been tried without success, or when the barrier is unclear. Sometimes the most useful outcome is a clearer understanding of what the actual problem is.

WHO MAY BE INVOLVED

Depending on the setting and the questions, an evaluation may involve an occupational therapist, physical therapist, speech language pathologist, teacher of students with visual impairments, teacher of the deaf and hard of hearing, special educator, assistive technology specialist, rehabilitation engineer, or a professional certified by RESNA as an Assistive Technology Professional. Suppliers and manufacturer representatives are sometimes present for equipment demonstration.

Family members, support people, educators, and coworkers frequently take part, because they know how tasks actually go day to day. The person being evaluated is central, and their preferences carry real weight.

INTAKE AND BACKGROUND INFORMATION

Most evaluations begin with gathering background. This commonly covers relevant history, current abilities and difficulties, what technology is already being used and how well it works, what has been tried before, the environments involved, daily routine, and the goals that matter to the person.

Some of this may be collected by form or by phone before the first session. Bringing existing reports, current equipment, and a list of what you want to achieve tends to make this stage more productive.

IDENTIFYING FUNCTIONAL TASKS AND BARRIERS

Evaluations generally focus on tasks rather than diagnoses. The practical question is what the person is trying to do, where, and what specifically breaks down.

This distinction matters. Writing is a broad goal. Producing legible notes fast enough to keep up in a lecture is a task with identifiable barriers. The more specific the task, the more useful the evaluation.

This part of the process often reveals that the barrier is not where people assumed. Difficulty using a communication device may turn out to be a positioning issue. Difficulty reading may turn out to involve fatigue rather than acuity.

OBSERVATION

Observation is watching the person do the task, ideally in the setting where it normally happens. That may be a classroom, workplace, or home, or it may be a simulated version in a clinic or center.

Observation frequently surfaces details that do not come up in conversation, including how long a task takes, how much effort it requires, where fatigue appears, what workarounds the person already uses, and how the environment affects performance.

TRIALS AND COMPARISONS

Trying options is usually the core of an evaluation. This may mean comparing two access methods, adjusting a setting and re measuring, or trialing a device over a longer period in the person's own environment.

Trials vary in length. Some comparisons happen within a single session. Others require loan equipment used over days or weeks. State Assistive Technology Act programs, coordinated nationally through the AT3 Center, frequently offer device demonstration and short term device loan that can support this.

Longer trials in the real environment give better information than short in clinic trials, though they are not always possible within the time or equipment available.

ENVIRONMENTS AND SETTINGS

A good evaluation looks at every environment where the technology needs to work. A device that performs well in one place can fail in another because of noise, lighting, network restrictions, furniture, transport, or who is available to help.

If the technology needs to move between environments, that introduces its own requirements, including portability, mounting, charging, and whether the necessary software is permitted on institutional networks.

THE PERSON'S PREFERENCE

Preference is not a tiebreaker applied at the end. Devices selected without meaningful involvement of the person who will use them are more likely to end up unused, which is discussed in Why Assistive Technology Gets Abandoned and How to Reduce Device Nonuse.

Appearance, how a device feels to use, how conspicuous it is, and whether someone is willing to use it in front of other people are legitimate factors. An evaluator who takes those seriously is doing the job properly.

RECOMMENDATIONS

Recommendations usually describe what is suggested and why, often including features rather than only product names, because features are what transfer if a specific product becomes unavailable.

Recommendations may also address access method, mounting and positioning, training, setup and configuration, support arrangements, and what to reassess and when. They may include more than one option, or a staged approach that begins with something simpler.

A recommendation is not a guarantee that equipment will be provided or funded. That depends on the relevant system and its rules.

DOCUMENTATION AND REPORTS

Most evaluations produce written documentation. Depth varies with purpose. A report supporting a funding request generally needs considerably more detail than a note recording that a simple tool was tried and worked.

Reports commonly record background, what was observed, what was trialed and what happened, the reasoning behind recommendations, and next steps. Ask when the report will be ready, who will receive it, and how to request corrections if something is inaccurate.

TRAINING AND FOLLOW UP

Training is part of making technology work, not an optional extra. It may cover the person, family members, educators, or coworkers, and it often needs to happen more than once.

Follow up matters just as much. A check in after a period of use catches problems while they are still fixable, and confirms whether the technology is doing what it was meant to do. Where follow up is not automatically arranged, it is worth asking who to contact and when a review will happen.

FUNDING IS USUALLY A SEPARATE PROCESS

This point causes frequent confusion. An evaluation identifies what may help. Whether equipment is then funded is generally a separate decision made by a separate body, under its own rules and timelines.

An evaluation report may be required as part of a funding request, and a well documented report can support one, but a recommendation does not obligate any program to provide equipment. Payment for the evaluation itself is also separate, and whether it is covered depends on the setting, the provider, and the payer.

Funding Assistive Technology and Assistive Technology Funding Systems describe funding pathways at a general level. Nothing here states what will be covered for any individual.

HOW SETTINGS DIFFER

Schools. Assistive technology is addressed through the special education process. Under the Individuals with Disabilities Education Act, the IEP team must consider whether a child needs assistive technology devices and services, and devices and services the team determines are necessary for a free appropriate public education are provided by the public agency responsible for the child's education at no cost to families. Decisions are team decisions. Education, IDEA and IEPs covers this, and Assistive Technology Consideration, Assessment, and Evaluation explains how the terms differ.

Postsecondary education. The IDEA framework does not apply, and an IEP does not transfer to college. Students generally request accommodations from the institution's disability or accessibility services office through a separate eligibility based process. Assistive Technology for College and Postsecondary Education covers this.

Workplace. Accommodations are generally handled through the employer under the Americans with Disabilities Act. An external evaluation may inform the process, but the employer runs it. Employment and Workplace Accommodations covers this.

Health care and rehabilitation. Evaluation may involve licensed clinicians and other qualified assistive technology professionals, with documentation and funding requirements depending on the relevant plan or program, including requirements for equipment funded as durable medical equipment.

Home and community. State Assistive Technology Act programs, independent living centers, and community organizations may offer demonstration, loan, information, and referral. Services vary by state.

PREPARING FOR AN EVALUATION

Practical preparation that tends to help includes writing down the specific tasks that are difficult and what happens when they go wrong, bringing current equipment and accessories, bringing relevant reports, noting what has already been tried and why it did not work, thinking about which environments matter, involving someone who sees the daily routine, and being clear about what you want to be able to do.

It is also reasonable to ask in advance how long the evaluation will take, how many sessions are expected, who will be present, whether trials are available, when a report will be produced, and whether there is a cost.

WHAT AN EVALUATION IS NOT

An evaluation is not a guarantee of equipment, funding, or a particular outcome. It is not a test that a person passes or fails. It is not a one time event, since needs change and reassessment is normal.

It is also not the same thing as buying a device. The value is in identifying the right match, which sometimes means concluding that a simpler or lower cost option is the better answer.

RELATED ASSISTIVETECHNOLOGY.ORG RESOURCES

For the general framework behind matching a person, a task, an environment, and an access method, see AT Assessment and Selection. For how the terminology differs across systems, see Assistive Technology Consideration, Assessment, and Evaluation. For reducing the risk that technology goes unused, see Why Assistive Technology Gets Abandoned and How to Reduce Device Nonuse. For school processes, see Education, IDEA and IEPs. For funding pathways, see Funding Assistive Technology.

AUTHORITATIVE RESOURCES

• Individuals with Disabilities Education Act, 34 CFR 300.324(a)(2)(v), for the assistive technology consideration requirement in the IEP process

• U.S. Department of Education, Assistive Technology Devices and Services for Children With Disabilities Under the IDEA, for federal guidance on assistive technology in schools

• Quality Indicators for Assistive Technology, for indicator areas covering assessment, implementation, and evaluation of effectiveness

• RESNA, Assistive Technology Professional certification, for information about the ATP credential

• AT3 Center, National Assistive Technology Act Technical Assistance Center, for state assistive technology programs, demonstration, and device loan

ABOUT THIS ARTICLE

This article is provided for general educational purposes and is maintained by Accessibility Clinic, Inc. Evaluation practice varies by setting, profession, state, and funding source, and this article does not describe the process used by any specific provider or program. It does not constitute medical, legal, or educational advice, and it does not constitute an individualized assistive technology evaluation. For an individualized evaluation, see AssistiveTechnologyEvaluations.org.