Including AT, AT Reuse and Emergency Preparedness in Pre-Service Training Amy Goldman, Temple University and Sara Sack, University of Kansas January 27, 2012 ATIA - Orlando

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Roadmap for this session 1.Are YOU ready?? Personal preparedness for ALL college students. 2.Personal preparedness for people with disabilities who use AT. How might the Pass It On Center and/or your state’s AT Act program help? 3. Identify relevant requirements in the Codes of Ethics, Scope of Practice covering members of professional associations, as it relates to responsibilities regarding emergency preparedness. 3

Why AT and Emergency Preparedness in Pre- service Training? All of us are responsible for being prepared! (AT providers can’t help others if they themselves are impacted) AT is key to the independence of people with disabilities Access to AT - and therefore, independence - may be lost as a result of emergencies (e.g. house fire) and disasters (e.g. large scale flooding) Many of the AT-related professions articulate professional responsibilities in emergency preparedness, and pre-service professionals should be aware of those obligations AT service providers have great opportunities to discuss individual preparedness – and they may be the only ones who have the conversation!

Strategy One: Make it “personal” Discuss the overall importance of being ready for disasters and emergencies. Have any of the students been affected by emergency or disaster? How? Did this affect any of the “tools” they use for living, working, or going to school – their car, computer, etc.? What did they learn? Do the students have a “go kit” in the dorm? At home? What has their college done to “get ready”? For what hazards? App: Campus Safety; Where is the information? 5

“Getting Ready” Considerations for AT Users Have a comprehensive listing of all AT used at home, at school, or at work Register products. Maintain current records of the devices and related peripherals: manufacturer /vendor contact information; make; model; serial number; payment source Tag devices and peripherals with identifying information Have key operating instructions available (e.g. using a power chair in manual mode) Keep current evaluation reports, prescriptions, and product information in a place (off site?) with other key health-related information 6

Strategy Two: Understanding public systems This may already be a part of the curriculum! Define assistive technology devices and services Discuss how AT is within the scope of practice of the profession Review how public systems (e.g. education; vocational rehabilitation) may have responsibility for the provision of (payment for) AT devices and services Provide scenarios that address emergencies/disasters that may impact access to AT devices and services; how might the impact be mitigated? How can the professional assist in planning? 7

Assistive Technology AT device: any item, piece of equipment, or product system, whether acquired commercially off the shelf, modified, or customized, that is used to increase, maintain or improve the functional capabilities of individuals with disabilities AT service: any service that directly assists an individual with a disability in the selection, acquisition, or use of an assistive technology device (evaluation, purchasing, selecting/designing or adapting, coordination of device use or services, device training, or expanding the availability of AT)

Education IDEA Part C, IDEA – infants and toddlers AT can be provided as an integral part of a child’s special education, as a related service to special education, or as a supplementary aid or service to special education (34 CFR ). AT devices and services as “considered” (special factors) and as indicated, subsequently specified in the IEP. AT may also be part of a “504 plan”

What can we include in pre-service education? Address the consideration of AT and the obligation of the school district to provide AT (including IDEA Parts B and C, as well as Section 504) Address personal emergency preparedness and individual responsibilities within transition activities Include emergency/disaster scenarios for discussion Target: pre-service practitioners in the schools (e.g. educators, special educators, speech- language pathologists, OTs)

Education: What if… A fire in school has compromised the electronics of the elevator that Max uses, as specified in his 504 plan. The elevator will probably be out of use for up to two months. Mary’s scanner, part of her Kurzweil 3000 system, was lost in a fire that completely destroyed her family’s home. She depends on this system to complete her homework. Mitzi’s adapted stroller, purchased by Medicaid as a specified in her IFSP, was totaled when her dad wrecked his car. Marlene’s computer adaptations, available to her in the high school computer lab, are significantly damaged by a flood that affected half of the lab. Mark no longer has access to the CCTV he needs, after his junior high was closed on account of structural damage resulting from a recent earthquake. Maddie’s school is about to re-open after the hurricane. However, the SLP who knew about her SGD evacuated to a nearby state and is probably not returning.

Education: What if… The disaster/emergency happens at school? Is there a plan? In the case of emergency or disaster, does the school still have the obligation to provide? Who pays for a replacement device? Is there insurance (school; homeowner’s) or other assistance (FEMA) What happens while you are figuring it out, or obtaining the replacement device? What is the “short-term” fix? Who is responsible for making this happen? How can we plan?

Rehabilitation Act Purpose of the Rehabilitation Act is to empower persons with disabilities to maximize employment, economic self-sufficiency, independence and inclusion and integration into society. Title I of the Rehabilitation Act is to provide a comprehensive, coordinated, effective, efficient, and accountable program that is designed to assess, plan, develop, and provide vocational rehabilitation (VR) services for individuals with disabilities, consistent with their strengths, resources, priorities, concerns, abilities, capabilities, and informed choice, so that they may prepare for and engage in gainful employment.

Employment Rehabilitation technology or the systematic application of technologies to meet the needs of and address barriers confronted by individuals with disabilities in areas which include education, rehabilitation, employment, transportation, independent living, and recreation. The term includes rehabilitation engineering, assistive technology devices and services. The AT Act of 1998 definition of AT devices and services is incorporated into the assessment for determining eligibility and VR needs and on the individualized plan for employment (IPE).

Employment: What if… Leo’s computer and printer, provided with partial funding from VR to support his telework, were destroyed when a lightening strike hit his home. Leanne uses a power chair. After an electrical main was damaged, her office building was evacuated and closed for 3 days. The firemen carried her down 8 flights of stairs, but her wheelchair remained in the building. Lawrence left his Braille notetaker in his house which is now uninhabitable due to flooding. He completely depends upon his notetaker to do his job. Lincoln’s hearing aids, funded by VR, were lost in the process of evacuating. He depends upon them at work. Luckily, Lisbeth was at work when the tornado demolished her home. However, her wheelchair battery charger was in the house.

Employment: What if… Does the employer have the obligation to provide? Does VR have the obligation to provide? Who pays for a replacement device (or component)? Is there insurance (from the employer, homeowner’s) or other assistance (Red Cross? FEMA?) What happens to the individual’s ability to return to work while you are figuring it out, or obtaining the replacement device? What is the “short-term” fix? Who is responsible for making this happen? How can we plan? (What is the AT provider’s role?)

What can we include in pre-service education? Address the consideration of AT and the obligation of the employer to provide AT Address the consideration of AT and the obligation of the vocational rehabilitation “system” to provide AT Include emergency/disaster scenarios for discussion Target: pre-service rehabilitation counselors, all (future employers!)

Strategy Three: Professional Responsibilities Does the national association refer to emergency preparedness and the role of the professional in a position paper? Scope of practice? Code of Ethics? Have students search those documents for references and report back. If there are no references: how can students, professionals, and consumers work to assure considerations of the role of professionals in emergency preparedness and response? 18

American Speech-language Hearing Association (ASHA) Audiologists and SLPs have emerging roles in emergency preparedness. They may be responsible for educating the first- response teams or emergency-care providers and for assisting with the development of emergency or disaster preparedness plans. Audiologists can educate first-responders and providers about communicating with individuals who are deaf or hard of hearing and about the likelihood of ear trauma, temporary or permanent hearing loss, and tinnitus among victims on the scene of blast-related incidents. SLPs can educate first-responders and health care providers about the communication needs of persons who rely on augmentative and alternative communication systems and individuals with intellectual disabilities, dementia, traumatic brain injury, and speech and language impairments. Nunez, Beamer, Deussing,Paul & Aulbach,

American Occupational Therapy Association (AOTA Disaster Preparedness Concept Paper, 2005) OTs can assist individuals and communities in coping with disaster situations and in returning to optimal occupational performance (Rosenfeld, 1982; 1989) In disaster situations the focus of OT is to facilitate engagement in occupation in order to support participation in adaptive disaster recovery and resumption of valued life roles and activities (AOTA, 2002) Working together with the client, OTs can plan and implement interventions that enable people to reestablish balance in daily life in activities of daily living, work, leisure, and social participation OTs need to be knowledgeable about how national, state, and local governments and private agencies involved in disaster management are organized, and how to gain entry into these systems Knowledge of available resources and understanding of local plans for responding is critical if the therapist is to facilitate rapid humanitarian responses.

Strategy Four: Find other unique opportunities within the curriculum Examine existing curricula for opportunities to embed emergency preparedness issues in topics such as transition, universal design, public health, counseling, independent living, disability studies, advocacy, etc. 21

Example (for SLPs): Vocabulary Vocabulary selection is part of the pre-service curriculum related to augmentative and alternative communication (AAC) Vocabulary related to emergencies/disasters should be part of the “adult vocabulary” Evidence-based sample vocabulary available at Growing availability of no- or low-cost “apps” to enhance communication, may be available to emergency responders as well as to people with complex communication needs (“i” am ready; Presentation by A. Goldman, ATIA 2011 Chicago or 2012 Orlando) 22

Strategy Five: Provide resources Assistive Technology Act programs in each state/territory ( Device lending (to make a decision, as well as for interim use while funding/replacement is pending) Device demonstrations (to make a decision) Alternate financing programs (including but not limited to cash loan programs) **Reutilization programs (open-ended loan; refurbish; exchange; see 23

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DISCLAIMER This work is supported under five-year cooperative agreement #H235V awarded by the U.S. Department of Education, Office of Special Education and Rehabilitative Services, and is administered by the Pass It On Center of the Georgia Department of Labor – Tools for Life. However, the contents of this publication do not necessarily represent the policy or opinions of the Department of Education, or the Georgia Department of Labor, and the reader should not assume endorsements of this document by the Federal government or the Georgia Department of Labor. Pass It On Center - AT Reuse Strand 25

Thank you for attending this session 26 CEUs More Info at: For ACVREP, AOTA and ASHA CEUs, hand in completed Attendance Forms to REGISTRATION DESK at the end of the conference. For general CEUs, apply online with The AAC Institute: Session Evaluation Please help us improve the quality of our conference by completing your session evaluation form. Completed evaluation forms should be submitted as you exit or to staff at the registration desk. Handouts Handouts are available at the general ATIA conference site as well as in the “knowledge base” of the Pass It On Center. Handout link remains live for 3 months after the conference ends.

15th Biennial Conference of the International Society for Augmentative and Alternative Communication ISAAC 2012 July 28-August 4, 2012 Registration open now!

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