The field of Assistive Technology (AT) is both relatively new, first being defined in federal law in 1997 in the Individuals with Disabilities in Education Act (IDEA) and yet is older than recorded history, with the use of mobility aides made from sticks to use as crutches or canes.
AT is a broad category of devices and services, designed to support an individual with a disability to live, work, play and learn in their most integrated setting. The number of AT devices is limitless, as it can include anything that is designed specifically for an individual with a disability, adapted or modified, or purchased directly off the shelf that supports an individual with a disability in being more independent in performing a task. AT devices can be something helpful for a person without a disability, but for a person with a disability, may be the only tool or strategy that allows someone to perform a task. A simple example of this is a jar opener. For a person without a disability, this makes it easier to open a jar, but for some people with a disability, having a jar opener as a tool is the only way that individual can open a jar independently.
AT devices can be simple or complex. They can be available through a specialized marketplace or may be available from a local big box store. With this range of tools, how do we know how to support the selection of the right tool at the right time so that someone with a disability can perform a task important to them?
With the focus on person-centered planning, it is critical that the selection of AT for an individual have the needs and desires of the individual with a disability as the central focus of a decision making process. It is critical that a framework to help focus on the needs of an individual be central to the discussion. A model frequently used in education is the SETT Framework, first described by Joy Zabala Ed.D. in the 1990s. It is important to understand the differences between a framework and a process. A framework is a broad structure which allows room for multiple processes to be implemented. A process is a more concrete tool which allows information to emerge that are specific to the individual. The SETT Framework is appropriate for consideration of AT for all service providers. It becomes the task of the service provider to determine an appropriate process, which will be focused on specific supports based on the level of service they provide. An example of this specific process is the Manual for Consideration of Assistive Technology, which is a publication of the Minnesota Department of Education. This manual includes specific tools which support an IEP team in both following the SETT Framework and in digging deeper into specific supports for a student with a disability.
The SETT Framework is a person-centered framework that will support the discussion of the needs for assistive technology. While it was originally designed to support the consideration of a student receiving special education services in determining the need for AT, the framework can be used to support the selection of interventions to support the ability to complete a task. Because this is a framework that was developed for students receiving special education services, the original concepts involve educational tasks and environments. We will discuss situations including schools, work, and independent living for Minnesotans of many ages.
It is important to think about how the needs and abilities of students or individuals with disabilities and the features of assistive technology tools are well-matched, so that the right tool or service is provided at the right time to help with completion of a task or activity.
It is critical to think about all environments in which someone is expected to be in. If we are considering supporting someone in a work setting, we will examine the work place environments, but we also need to consider if they have the ability to get up, get dressed and leave the house independently? If not, we need to look at the home environments as well.
While it is appropriate and central to focus on the Someone and match tools to the someone's needs and disabilities. Although many teams are becoming increasingly aware that it is important to think about the environments and the tasks that are required in those environments, remember to take more than a cursory glance at those areas. The questions about the environments need to be as detailed as possible, never just "the 4th grade classroom" or "the office." (for example). There is SO MUCH more to each of the environments than that! How many other people are there?? What is the physical layout? How much support is available from and to family members, co-workers or staff? What materials and equipment are being used by others? Are there physical access issues? What services are being provided? What are the attitudes and expectations of others in the environments? AND, certainly, no one does not LIVE in the 4th grade classroom or the office.
What about other school environments like the cafeteria and the playground? What about home environments in which someone may need to use technology? What about community environments in which someone may need to also need to use the technologies?
SETT – an acronym for Student, Environments, Tasks, and Tools was developed to help collaborative school-based teams create Student-centered, Environmentally useful, and Tasks-focused Tool systems. However, with minor adjustments, it has proven useful at all levels of service provision, from early intervention through adult services. In the original SETT Framework, the S relates to Student. We will instead use that S to talk about Someone with a disability, who wants to perform a task with greater independence.
Using the SETT Framework will help a discussion in which many persons can participate actively and with confidence in assistive technology decision making and service delivery. A key factor of the SETT Framework in a person centered plan is the involvement of the individual in expressing her own dreams, ideas, goals, strengths and needs. All team members work collaboratively to create an atmosphere in which the information, skills, observations, and thoughts of individuals, families, and professionals are all valued and respected. Collaborative team members seek to build a shared vision of what technology might be needed and how it will be used, by first building a common understanding of someone with a disability, the environments, and the tasks. The questions and comments below are intended to guide discussion. As these questions are explored, other questions arise. Conversation continues until there is consensus that there is enough shared knowledge to make an informed, reasonable decision that can be supported by data.
When thinking about the Someone, four small questions may yield reams of data: What does she need to be able to do that is difficult or impossible to do independently at this time? What are their special needs that contribute to these concerns? What are the current abilities related to these concerns? What are her interests? The questions are intentionally broad, so that they do not preclude anyone or any possible solutions at the outset.
When considering what someone needs to be able to do, it is fine to be global. "Talk" or "write" or "move about" may be appropriate at this point, though some elaboration is desirable. Later, in the Tasks section, these issues will be explored more deeply, as it would be useless to pursue "talking" if "about what?" could not be defined. The primary goal of this question is to invite active, nonjudgmental sharing to begin to establish consensus among group members about what is really important for this someone to be able to do. The question about someone's special needs is designed to generate conversation about the barriers which keep this someone from doing whatever needs to be able to be done.
When exploring current abilities, it is important to keep in mind that, no matter how great the needs, everyone has abilities which can be built upon and enhanced – not necessarily replaced.
The tasks are the actual activities that take place in the environments that will enable the someone to achieve their goals and be an active participant in the daily life surrounding them – for adults, the tasks may be vocational or have some other focus. Tasks are different than the needs that have been discussed.
Tasks are what is actually HAPPENING – the specifics of the functional demands for each particular environment. An example of a functional area of concern might be "reading" and the goal might be to read of grade level". But, when it comes to tasks, no teacher ever says, "Alright class, it's time to read on grade level." The tasks are EXACTLY what a person will need to do IN THE SPCEIFIC ENVIRONMENTS to learn to read on grade level. The reason this is important is that, although goals may be similar from environment to environments, there may be quite a wide range of tasks that will take place to help an individual reach their goals.
The following example provides insight into the importance of exploring specific environments and tasks before attempting to select tools:
There are two clients of the workforce center with the same disability who have written productivity issues caused by the same fine motor issue that impedes their ability to hold a pencil securely over a period of time. If discussion focused only on the disability and the tools, it could be concluded that the same tools would be required for each someone. However, what if one of these clients had a master's degree in engineering who needed to draw schematics and the other was a junior in high school who needed to fill in a bubble sheet? Clearly the written productivity TASKS are immensely different for these individuals. In the first case, we might consider use of a forearm stabilizer, and in the second case, use of an alternative answer sheet might be an appropriate option.
Finally, the SETT Framework addresses the area where most people would like to begin. The SETT Framework, leads teams to the main question, "What needs to be included when developing a system of assistive technology tools for someone with these needs and abilities, doing these tasks in these environments?" All other questions merely gather and organize the information that is needed to arrive at answers to this question. It is hoped that a team using the SETT Framework to arrive at this point, does so with a clearer understanding of what tools should be sought. What a difference to begin seeking tools with a clear idea of who is going to use them, where, and for what!
In the SETT Framework, tools included devices, services and strategies – everything that is needed to help someone succeed. They are "no tech" strategies as well as low tech and high tech devices and supports. They are systems of tools working in combination to assist someone in moving forward. More often than we would like to think – even when ongoing training has been provided – a laptop computer may fail to meet expectations because there is no extension cord available when the battery runs low. In a well-thought-out system, the extension cord would have been included.
It is expected that the SETT Framework will be useful during all phases of assistive technology service delivery, from device selection through use and evaluation of effectiveness. With that in mind, it is important to revisit the SETT Framework information periodically to determine if the information that is guiding decision-making and implementation is accurate, up to date, and clearly reflects the shared knowledge of all involved.