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How Assistive Technology Services Can Go Awry

Examine a summary of the lessons learned during a case study that identified problems that can occur when planning, developing, implementing, and evaluating assistive technology services for a specific student.

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In 1997, the Individuals with Disabilities Education Act (IDEA) mandated that the assistive technology needs of all students who receive special education or related service as part of an Individualized Education Program (IEP) be considered during the planning of their IEPs. Although many school districts throughout the United States had been delivering assistive technology services prior to 1997, many others were not prepared to do so when the assistive technology mandates became effective.

To examine how school districts were approaching the delivery of assistive technology services prior to the implementation of the 1997 mandates, a case study was conducted on a student who had multiple physical disabilities that seemed to warrant the consideration of assistive technology. Numerous problems were identified in the planning, implementation, and evaluation of assistive technology services for the student. This report summarizes the primary problems that were identified. A more complete version of the case study appears elsewhere (Bell, Rylance, Bliss, & Blackhurst, 2000).

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We studied "Madelaine", a middle school student (6th grader) with Mobius syndrome, whose legs end just above the knee and whose left arm ends just below the elbow joint. At the time of the study, she was performing at an average level on achievement tests in reading and below average on math. She performed well in primary school, but her grades in social studies and science deteriorated when she moved to middle school.

Her full inclusion plan was revised so that she would receive special education resource services for one period each day. She is very independent, but was slow in performing written tasks because her handwriting is very poor. Peer transcribers were often used to assist in the preparation of written work. A plan was needed to teach her how to use a computer.

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Findings and Evidence

Following is a summary of the major findings and the evidence that supports each one. The findings are reported in the sequence in which they were identified during the case study.

FINDING: Timing of Assistive Technology Decision Making

Assistive technology evaluations and recommendations should be made in a timely manner.


The IEP team requested an assistive technology evaluation for Madelaine at the end of fourth grade. Nothing was done over the summer. The IEP team made a second formal recommendation in November. By the following June an evaluation was completed. In the following February the IEP Team met with the evaluator to decide on a device to aid in keyboarding. A chording keyboard was obtained by late Spring.[A chording keyboard is an assistive device that enables a person to operate a computer keyboard with one hand.] It took nearly two years to arrive at a potential solution.

FINDING: Assistive Technology Selection Criteria

The characteristics of devices should be matched to the physical abilities of students when decisions are made about the selection of assistive technologies.


When the chording keyboard arrived it was found that it was too large and the keys were too far apart for Madelaine to operate it. A rehabilitation engineer had to fabricate a keyboard emulator to make it functional.

FINDING: Assistive Technology Staff Development

Training about the use of assistive devices should be provided to people who interact with students who are using such devices.


Teachers reported that they didn’t know how to use the chording keyboard and how to teach Madelaine how to use it.

FINDING: Assistive Technology Monitoring

A system for monitoring the implementation of assistive technology services should be developed and maintained.


A consultant was employed to provide training in the use of the chording keyboard. When queried about their training, teachers and parents reported that no training on the use of the device had ever been conducted.

FINDING: Assistive Technology Equipment Compatibility

Prior to purchase, verification should be obtained that assistive devices are compatible with existing equipment.


Madelaine’s parents were anxious to take the chording keyboard home over the summer so that she could practice using it on their home computer. It was incompatible with that computer and remained on the shelf during the summer.

FINDING: Communication about Assistive Technology

A system should be established and maintained to ensure that relevant information about a student’s assistive technologies is communicated to new personnel who will be working with that student.


When Madelaine returned to school in the Fall, she left the chording keyboard at home. Her new teachers were unaware of its existence.

FINDING: Assistive Technology Follow-up

Recommendations for the use of assistive technology should be followed up to ensure that the recommendations are implemented.


A film crew was scheduled to videotape Madelaine using the chording keyboard as part of a public relations program on special education and assistive technology. It was then found that Madelaine was not using the device. The assistive technology specialist reported that it was assumed that she was using it on a regular basis.

FINDING: Assistive Technology Selection Criteria

Personal perceptions of students should be taken into consideration when making decisions about assistive technologies.


Madelaine refused to use the chording keyboard, because, according to her, "It made me look different than the other kids."

FINDING: Assistive Technology Decision Making

When making decisions about assistive technology for an individual student, lower-tech solutions should be explored before higher-tech solutions. When options are available, preference should be given to less-obtrusive solutions.


The assistive technology evaluation report listed several options that could be explored to facilitate Madelaine’s keyboarding. In addition to the use of a chording keyboard, the use of a software program for one-handed keyboarding was included. The chording keyboard device was chosen instead of the lower-tech, and less obtrusive, software option.

Madelaine learned how to use the "sticky-key" software system that permitted one-hand operation of keyboard operations that required simultaneous pressing of multiple keys. She learned how to efficiently use the keyboard and, in fact, won an award for her performance in her computer class.

FINDING: Interdisciplinary Collaboration

Communication should be maintained among the various professionals who are providing services to students using assistive technologies.


Regular classroom teachers were unaware of some of the manifestations of Madelaine’s disability. They were not informed by the special education teacher that students with Mobius Syndrome cannot smile; and they mistook that for a lack of affect on her part. In addition, they were unaware of her modus operandi for using her artificial legs and her wheelchair. Furthermore, they were completely uninformed about the chording keyboard. Other than the assistive technology evaluation report, there was no communication between the person who had conducted the evaluation and those who made decisions about the selection of options from the report when Madelaine’s IEP was developed.

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In reflecting about this case study, it seemed to the investigators that almost everything related to assistive technology that could have gone wrong did go wrong:

  • An inordinate period of time elapsed from the referral until action occurred;
  • Decisions about the selection of technology did not include the preferences of the student involved;
  • A high-tech device was selected, when low-tech solutions would have sufficed;
  • Assessment recommendations were ignored;
  • When the device arrived, it was the wrong size;
  • The device was incompatible with equipment at home;
  • There was lack of monitoring of use;
  • Teachers were not trained in the use of the device;
  • There was no communication about the device was provided to teachers when the student made a transition to a higher grade level; and
  • There was a lack of follow-up to determine the status of the use of the device and its effectiveness.

There were errors of omission and commission on the part of numerous personnel who were involved in the case.

Fortunately, this case was not representative of typical practice in the school district. It did point out the need, however, for policies, procedures, and guidelines related to the delivery of assistive technology services in the district.

There also are rather obvious implications for the actual practices of school administrators (e.g., policy making), operation of IEP Teams (e.g., decision making), working with parents (e.g., training), collaboration among special and general educators (e.g., communication), and the role of those responsible for assistive technology services (e.g., training, monitoring, and evaluating). Virtually every instance which resulted in less than best practice could have been prevented if appropriate policies and procedures were in place and implemented properly.

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In 1999, a follow-up study was conducted on Madelaine. Her father had been transferred to another state and she was enrolled in a school district that provided excellent special education and assistive technology services. The principal of her school was a former special education teacher, who took a particular interest in her.

When she left her prior school she was in the process of being referred for a potential learning disability in math. An assessment was done in her new school and she was assigned the services of a math resource teacher. Within one school year, she was performing at grade level in math and the services of the resource teacher were no longer needed. Her academic achievement in other subjects also was satisfactory.

Madelaine became very proficient in using a computer, operating the keyboard with one hand. She spent considerable time surfing the Web. She was particularly involved with a variety of online chat rooms and indicated that she liked them because she could interact with people without worrying about their perceptions about her disabilities.

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Bell, J. K., Rylance, B. Bliss, T., & Blackhurst, A. E. (2000). Madelaine never smiles. In T. Bliss & J. Mazur (Eds.) Elementary teachers in the midst of reform: The common thread cases. Upper Saddle River, NJ: Prentice Hall Simon and Shuster.

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Credits and Disclaimers

How Assistive Technology Services Can Go Awry (© 1999) was authored by Jennifer K. Bell and A. Edward Blackhurst. At the time this research was conducted, Bell was Project Director, and Blackhurst was Principal Investigator of the University of Kentucky Assistive Technology (UKAT) Project in the Department of Special Education and Rehabilitation Counseling at the University of Kentucky. This report may be duplicated and circulated for noncommercial purposed, provided this credit is included.

The research conducted for this report was supported by the University of Kentucky and Grant No. H180U50025, Examination of the Effectiveness of a Functional Approach to the Delivery of Assistive Technology Services in Schools, from the Division of Innovation and Development, Office of Special Education Programs, U. S. Department of Education. The conclusions and implications reported herein do not necessarily reflect the official positions of the funding agencies.

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