With your extensive knowledge (compared to any one else in your school) about AT, you have been asked to assist a multidisciplinary team in identifying appropriate assistive technology for Karen, a young lady with mental retardation. Karen has limited communication abilities and uses problem behaviors (aggression) to influence the actions of others (gain, or maintain attention). Her parents would like to see Karen more involved with her age peers, but her problem behavior bar her access to these peers. The team thinks that assistive technology, specifically communication devices, may help her communicate better and this, in turn, will reduce her need to use aggressive responses to get other people's attention.

The Student:
Karen is an 8-year-old child with Down's syndrome. Her parents report that she is a very happy child, sometimes too much so. She will hug everyone, including strangers. Karen attends your elementary school and her parents are very interested in having her attend a regular 3rd grade class. They feel that her time in the self-contained classroom is not productive. Karen, they say, needs social skills more than academics. She is not getting any training in social skills and her parents feel that this is the key to her successful integration into the workforce. Karen has very limited communication abilities. She is able to speak but her utterances are limited to short, 2-4 word phrases. When engaged in a conversation, Karen will typically remain attentive for short periods of time, then tune out or begin talking to an imaginary friend. Her reading, writing, and math skills are very limited. Karen's parents are very supportive and willing to do anything to help her. They support her desire to be "just like everyone else."

Interviews: (Mr. Watermeyer - Self-Contained)

I: "Can you tell me about what you think the assistive technology will do for Karen?"
W: "Well, I really would like to see Karen communicate better. As you have seen in her evaluation, she is limited in her expressive language skills. Karen will not use sentences and she is often left with gesturing to get her point across. When the listener does not understand Karen, she will just repeat herself. Often, when she is asked a question, Karen will respond with "It's only fun.” I think this is her way of dealing with communication that she does not understand. You know, just shut it out by saying anything.

I: "I understand that Karen also engages in problem behaviors. Can you tell me a little about that."

W: "Yes. Karen displays several types of problem behaviors. She will use the "sh.." word -- no trouble there with articulation, yell, hit other students, throw a tantrum, and generally not comply with many of my directions. I should mention that I am not the only person this occurs with."

I: "What do you think causes these problem behaviors?"
W: "I think that attention is the base cause. Karen always gets attention when she does any of these behaviors. But, come to think of it, Karen often uses problems when she is not clear in her communication interactions. I will see her get frustrated then fly off the handle and hit someone or scream. She also uses the "sh.." word when she is around friends who are not disabled. Karen will often start the conversation off by cursing. It seems that every time she wants to be involved in the conversation, she will curse more. Boy it gets other people's attention, but it does not lend itself to a detailed or long-term conversation. I just don't know what to do about it. "Karen is also very sensitive around her ears. She will not allow you to touch them nor will she wear headphones. When she talks on the phone, she places the phone on her throat rather than her ear." "One additional thing to be aware of is that she is very tentative in her motor skills. Karen will refuse to go out of the door unless someone guides her out. She seems to always stop when the floor changes colors or at the border of a room (in the doorway). Karen is very unstable in most gross motor activities and will fall often when engaged in P.E. activities. She will cruise along the hallway using the wall for support.

(Mrs. White - 3rd grade teacher)

I: "Can you tell me about your concerns for Karen?"

W: "I am very concerned with her being placed in my class. She is so low academically. It is my understanding that Karen can recognize 3 sight words (come, car, house), can write the first two letters of her name, and can identify the number 1. She is not able to write the letters of the alphabet and will doodle, acting like she is writing. Karen can count to 5 orally, but cannot pick out 5 objects. She can identify a penny but does not know the value of any other coins (i.e., a penny is the same as a $20 bill). I am worried that I will not be able to teach her -- or, if I do, the other students will not get the education they need.

I: "Anything else?"
W: "Well, yes. I am concerned about her limited attention span. In talking with her psychologist, I heard that her attention span is very short. He stated that it was probably measured in negative numbers (smiling). I know that this will be a challenge to my room."

The Setting:

Karen attends the local elementary school. The self-contained class has 12 students with varying degrees of mental retardation. The teacher, Mr. Watermeyer, is very sophisticated and uses computers throughout the school day. He is familiar with a variety of assistive devices and does not feel ill at ease with learning new technology. The regular classroom teacher, Mrs. White, is similarly comfortable with using technology. She took several courses in college and has attended numerous district in-services. She has not, however, used assistive devices and is a little apprehensive about the possibility of needing to learn something so new behavior.