Vol. 6, No. 4 Summer 1998	Previous Issues Subscribe to AT Messenger Download PDF Viewer
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Study Points to Unmet Technology Needs Among Those with Mental Retardation

The impact of technology on people with disabilities is probably even more profound than that felt by the general population because it opens up avenues for communication, mobility, learning, and self-care that simply could not exist in its absence. As with any technology, however, it takes time for new advances to reach those who might benefit from them. Assistive technology (AT) has proven to be a valuable tool in helping hundreds of thousands of individuals achieve personal goals related to education, employment, recreation, and personal care. Such technologies often decrease dependence on others and allow individuals to become or remain integrated into their chosen communities. Unfortunately, people with mental retardation are often overlooked as potential users of AT. As a result, many individuals with retardation do not have access to the AT devices and services that could assist them in being more independent and productive at home, at school, at work, and in the community.

Since May 1996, a workgroup convened by the Division of Mental Retardation (DMR) has been exploring the assistive technology-related needs of DMR clients. The group has identified several potential approaches to increasing the availability of assistive technology for these individuals. The multifaceted effort includes staff training, increased availability of AT for trial use, thorough assessment of individual needs, and provision of the technology and support services in each case. All involved agreed that a logical first step in this process would be to get some sense of the cost and magnitude of this undertaking. To that end, the Delaware Assistive Technology Initiative (DATI), with funding from the Delaware Developmental Disabilities Planning Council and the Delaware Division of Mental Retardation, conducted an evaluation of the AT-related needs of a sample of DMR's client population.

This project was undertaken to determine the extent to which assistive technologies were being used effectively by DMR clients in their pursuit of their life goals. Screening and evaluation activities considered the individual's program goals, the input of family members and service providers when available, and the individual's wishes and preferences. The process identified dimensions of daily activity that could be enhanced by the application of assistive technology and culminated in device and/or service provision recommendations that would facilitate achievement of positive outcomes.

This short-term, intensive project focused on 50 individuals, randomly selected from each of DMR's program areas. Information was gathered on each individual relative to history, current status, and goals, and then clients and significant others participated in a screening to determine if there were aspects of the individual's education, work, or home and community life that could be supported with AT. Forty of the 50 clients were referred for additional evaluation or consultation following the screening process. Of these 40, 85% were identified as having an immediate need for AT devices and/or services not currently available to them. Another 12.5% were identified as having no unmet needs at the time of evaluation, yet it was anticipated that follow-up would be needed within the year as client circumstances were expected to change.

 

Proportion of sample population with an immediate need for AT devices and services.

Project staff identified device and service needs for each client evaluated. Of the 34 individuals needing some form of AT, over 70% of them (N=24) were in need of augmentative communication supports. Twenty-six percent (N=9) needed technology for mobility. Technologies were also recommended to address sensory, literacy, self-care, and vocational needs. Nine individuals had needs across two functional domains. The table below represents the breakdown of needs by technology type.

Need	# of clients
Communication	24
Literacy	4
Mobility	9
Self-care	4
Sensory	1
Vocational	2

The costs of needed devices and services varied considerably. One individual required modified shoelaces costing $3, and others had communication needs that warranted acquisition of a device and the appropriate services to support its implementation costing several thousands of dollars. A conservative estimate of the costs of meeting the AT device/service needs of the sample population was projected at an average of $1,543 per person.

This per-person cost was then used to estimate the cost of meeting the unmet AT device and service needs of the entire DMR population of 2100 individuals. Applying the per person average cost of $1,543 across the entire caseload, we estimated that it would cost $3,240,300 to meet the unmet device and service needs system-wide. These estimates do not include the cost of screenings and evaluations to assess unmet needs, which we estimated to require an additional $586,300.

Based on the findings of this study, we estimate that there are over 1700 individuals in the DMR system who could benefit from assistive technology devices and services currently unavailable to them. Our cost projections, which include the cost of evaluation as well as the costs for technology acquisition and concomitant service provision, indicate that $3.8 million would be required to meet these needs. These findings were presented at the June 4 meeting of DMR's AT Work Group, and DMR has begun exploring mechanisms to address unmet needs in an efficient and cost-effective manner.