Assistive technology is any type of device that makes it easier for a child with a disability or impairment to perform a task that might otherwise be difficult or impossible. Nemours’ Clinical Assistive Technology Services (CATS) provides evaluations and recommendations for children with a variety of communication, learning, and mobility needs.
Our team is comprised of experts from several fields, including speech and language pathology, occupational therapy, and rehabilitation engineering services (specialists who use the principals of engineering to design or adapt assistive devices). This allows us to consider your child’s needs from many different perspectives. For example, if your child has a visual, fine motor, or sensory processing difficulty that may influence his or her ability to successfully use one type of communication system, we will then consider other alternatives or modifications.
Although the majority of services are conducted on an outpatient basis at the Alfred I. duPont Hospital for Children, we also provide on-site services in schools and other facilities when needed. We offer complete specialized assessments, as well as individual therapy and training, consultation with your child’s other therapists and educators, and assistance with the set-up and customization of any technological aids. Our goal is to supplement, not replace, your child’s natural speech and writing to the greatest extent possible.
Teamwork is essential in this process, and we actively seek to build a strong collaboration between children, parents and family members, community-based therapists and teachers, and our clinic staff. Together we can facilitate your child’s most effective use of his or her skills and technologies in every setting.
Augmentative Communication
One important service we provide for children with profound communication challenges is what’s called an augmentative communication evaluation. Skilled examiners observe your child's speech, language, and communication skills as well any visual, motor, positioning, and mobility difficulties that may influence his or her ability to communicate.
The evaluation includes considering and trying out a range of devices that assist communication. Parents, teachers, and therapists are encouraged to attend evaluations whenever possible in order to make our evaluation and plan more complete. Their participation also facilitates implementation of recommendations into the child's functional environment.
Commercially available augmentative communication devices and supplementary assistive technology can be found for children of all ages, disabilities, and cognitive levels, including:
- Young children, emerging communicators, and children with physical impairments who are just beginning to learn how to move in such a way as to actively participate in their physical and social worlds
- Socially and pragmatically (“pragmatics” refers to skills having to do with the social use of language) impaired communicators and children with acquired or developmental cognitive challenges
- Communicators who require flexible and generative language expression There are also many different types of communication systems we may be able to recommend, such as:
- unaided systems (word approximations, gestures, and sign language)
- low-tech devices (picture communication books and displays, picture schedules, and manual language signs)
- high-tech devices (speech-generating devices)
All of our outpatient therapy treatment plans are individualized to your child’s receptive and expressive language skills, needs, and goals. Hands-on trials and follow-up training helps match your child’s personal strengths and weaknesses with the tools and strategies that best support his or her language and communication independence.
Family education and support is always a critical component in our plan. In order to optimize your child’s communication potential, it is essential that families are able to carry over techniques learned in therapy and implement them in their child’s home, school, and community environment.
Computer-Assisted Writing and Learning Services
Our team is also pleased to offer evaluations for computer access and computer-assisted writing and learning. Children who have cerebral palsy, fine motor and visual-motor impairments, learning disabilities, auditory processing disorders, Asperger syndrome, and other disorders may all benefit from these types of tools.
A computer access evaluation examines your child's language, reading, spelling, and communication skills along with his or her visual, motor positioning, and mobility functions. Evaluations include vital hands-on trials of equipment. Our goal is to determine if assistive technology is required, and if so, which specific products may help to functionally improve your child’s literacy skills and support his or her learning.
As a service of our Speech and Language Pathology department, this evaluation also considers whether a child’s writing and/or reading comprehension difficulties might be related to language organization or processing weaknesses. As with our augmentative communication evaluations, other therapists and educational representatives (particularly occupational therapists and school curriculum experts) may also attend to provide a well-rounded view of your child's unique strengths and challenges and offer recommendations about what types of assistive technology might best build on these strengths.
We also consider the setting in which your child learns. For example, is computer technology already available in the classroom? If so, is it Mac- or PC-based? This helps us to determine whether portable or desktop computer technology might be most effective, and which specific modifications (including standard or specialized hardware, software, and adaptations) will help your child meet his or her reading and writing goals.
Follow-Up Services
The Clinical Assistive Technology Services (CATS) offers a variety of services as follow-up to complete evaluations in order to help children, parents, and community-based therapists and educators implement recommendations from our evaluations. Just as evaluations are conducted in our hospital-based clinic or as on-site services in schools and other facilities, some follow-up services can be scheduled in a child’s school or day care center when necessary. Follow-up services may include:
- assistance with procuring funding for speech-generating devices (this includes providing additional documentation if families wish to appeal initial denials of coverage for devices through health insurance plans)
- outpatient therapy in our clinic with individualized treatment plans and family education
- assistance and instruction with set-up and customization of a child’s speech-generating device or specialized computer software
- consultation and in-service training programs for school and family teams in which we provide proven techniques for integrating augmentative communication and assistive technology into your child’s curriculum and learning experiences, functional activities, and day-to-day family life
Wheelchair Clinic
The Wheelchair Clinic at the Nemours/Alfred I. duPont Hospital for Children offers a team approach to the evaluation and recommendation of seating and mobility equipment for children from birth to age 18. The wheelchair clinic team is comprised of a rehabilitation engineer, a physical therapist, an occupational therapist, and a rehab technician, and the wheelchair vendor. Families are invited to bring along anyone involved in the care of their child, especially their child’s physical and occupational therapists.
Our multidisciplinary team is up-to-date on the latest advances in seating and positioning technology. Our professionals are experts in helping find the solution that best fits your child’s needs. One of our main goals is to promote independence and better functioning within the home, school, and community environments.
What you can expect at an appointment with us:
- a thorough evaluation of your child’s mobility and positioning needs
- recommendations for the most appropriate equipment to meet those needs
- collaboration with your orthopedic surgeon or pediatric physiatrist
- documentation that will be provided to the wheelchair vendor and submitted to your insurance company for the authorization of the recommended equipment
- assistance with insurance appeals, if necessary
- the fitting of your child’s wheelchair and seating system upon delivery to assure that the recommended equipment is providing the expected outcome
Additional services provided by our Wheelchair Clinic include pressure mapping, custom molded seating, trials of various power seating systems, and trials of alternative drive controls. Supplemental assistive and adaptive technologies may also be recommended.