Assistive Technology -- Making It Work For People On The Job By Robert R. Williams _________________________________________________________________ This article is reprinted from the A.T. Quarterly, Volume 1, Number 2 (1990). Employment prospects are extremely bleak for most people with disabilities in the U.S. A 1986 poll by Louis Harris showed that fully two-thirds of all working-age Americans with disabilities still do not work in our country. In fact, Harris and his associates believe that "not working is perhaps the truest definition of what it means to be disabled" (Harris, 1986). But, there is ample reason to believe that things may soon be looking up for current and prospective employees with disabilities in the 9 to 5 work day world. The passage of the Americans with Disabilities Act (ADA) will surely eliminate much of the prejudice and environmental barriers which have prevented so many people from working in the past. In a slightly different way, assistive technology is already fast at work, chipping away at many of the same stereotypes and hurdles. Thanks to increasing public awareness, even some traditional naysayers now stand in awe of the powerful, key role assistive technology can play in enabling individuals with the most severe disabilities to work in ways never thought possible before. For example, assistive technology in the form of a Touch Talker, a word processor and a TV teleprompter is enabling Jim Prentice to manage an extensive database of statistical information for Westinghouse in Pittsburgh, Pennsylvania. More recently, a voice activated Computer Assisted Drawing (CAD) device has given new hope to Larry McAfee, who five years ago became severely disabled in a motorcycle accident, of resuming a promising engineering career. Last summer McAfee won a case in the Georgia Supreme Court to switch off his ventilator with a specially crafted device of his design. Now, technology of a different sort is holding out promise to him of exerting a new kind of control in life: that of leading a self-initiated lifestyle, making choices and living by their consequences. In my own case, a package of assistive devices including a Touch Talker, a slightly modified Macintosh computer, a voice activated phone and a fax machine holds just as great a promise of enabling me to influence federal policy for all Americans with disabilities in ways still unimaginable to most people. In reality, though, as great as this promise is, it has yet to come to full fruition. Why? Because as with anything new, innovative and relatively complex, there have been glitches, snags, compatibility problems and corresponding delays in getting this series of devices to really work alongside of me to make me my productive best. The overall experience has been frustrating, draining and often downright maddening for all concerned. That does not mean that it has not been worth it or that a lot of good will not ultimately come out of it. But, what it does mean is that for all the good that it can do to assist people to be productive and get the job done, assistive technology should never be seen as a magic solution. That is because making assistive technology work for individuals with severe disabilities on the job takes a great deal of hard work in and of itself. More than this, though, making technology work for people on the job must start with a commitment. That is, the person with a disability and his or her current or prospective employer must agree to work and problem-solve together. Each must commit to invest whatever time, creative energy, cooperation and financial resources it takes to find the best way assistive technology can be put to work for the individual on his or her actual job. Absent such a commitment, it is likely that the right assistive technology solution or job modification never will be found. In fact, minus a working commitment on the part of both the employee and their employer, the very best and latest in assistive devices purchased for the individual may wind up on someone else's bookshelf rather than on the person's desk being used where it belongs. An assistive device which just sits and gathers dust on a shelf is much more than a waste of valuable time, energy and resources. In a very real sense, it represents a great many dreams deferred for all concerned as well. Practically no assistive device should ever sit idle or unused. But to avoid this will require that the employee with a severe disability, his or her employer, and others involved in designing or offering job supports, commit to working together to: 1. Ensure that both the employer and employee play an informed role in assessing and selecting the right assistive device to enable the individual to perform the right job. 2. Deliver the assistive technology to whom, when and where it is needed. A device which arrives two to three weeks after someone starts work or one which cannot be put to immediate practical use is likely to be put on the shelf. 3. Actually show rather than just tell the employee and employer how a particular device can produce real on the job results. If a picture is worth 1,000 words, an actual demonstration of what a device or given technology "can do" is worth at least ten times that much. 4. Recognize the time and effort it has taken for the person who is not a current user of AT to get this far in life without the benefit of such aids or devices. Never denigrate that individual for "choosing" to use an "antiquated" manual communication board. It only will bring out the seven year old in all of us and memories of being told that if only we'd press our tongue more tightly against our teeth, we could say the word "TALK" ourselves and thus not have to rely on that "funny board." 5. Recognize, too, that persons with severe disabilities have probably spent years being their own best rehabilitation technologists. The tools and methods they have developed over the years may not be as "high tech" as some approaches. But, in many (though clearly not all) instances, these self-designed measures may make the individual just as effective and productive on the job as any other which could be thought up by an entire bevy of rehabilitation technologists. 6. Respect the fact that someone who has invested a lifetime in coming up with their own ways and means of getting through life in a fairly hostile world is apt to be extremely stubborn out of necessity. People with cerebral palsy are often chastised for relying on associated movements caused by changes in muscle tone to do things independently. Yet, if we are not shown another way to do the same thing, we will likely continue on as before. Similarly, telling rather than actually showing an employee with a severe disability how assistive technology can make their life and work easier will likely not be enough to yield the intended results. 7. Point fingers at unsolved problems and their potential solutions rather than at one another. Assistive technology holds out a great many promises for people with disabilities and their employers. But it is no panacea. Problems--some quite thorny and complicated--are bound to arise. When they do, resist the temptation to assign blame, problem-solve instead. 8. Do not expect the employee to necessarily experience a great deal of overnight results, success or personal satisfaction in using a new assistive device. Learning to use a device (just like learning to use a computer) can be time consuming and frustrating. It also can temporarily take away from your productivity when you want to be your most productive. 9. Realize that some of the most powerful lessons we can gain in life come as a result of learning by doing. Others have stressed the importance of introducing preschoolers to the practical everyday uses and wonders of assistive technology as a sure fire way of getting them hooked on it as soon as possible. Employees with severe disabilities need to be given the same range of opportunities to learn about assistive technology while doing and being productive at what they paid (increasingly good money) to do. 10. And, finally, always remember to KISS (Keep It Simple and Straightforward) as much as possible. That is, Keep It as Simple and Straightforward as much as possible. The fewer dangling cords, intertwined interfaces, compatibility hang-ups and other potential glitches that an assistive technology user has to deal with on a daily basis, the more likely he or she will be to use a particular device. Following these ten steps will not be enough to entirely address all the issues which will inevitably arise out of all our efforts to bring needed assistive technology to people with severe disabilities at their workplaces. But it is hoped that doing so may help us to both clarify and work through a great many of the critical challenges which lay ahead. A slightly different version of this article appears in the Summer, 1990 UCPA Networker. ---------- Assistive Technology And People With Disabilities: Separating Fact From Fiction Robert R. Williams _________________________________________________________________ This article is reprinted from the A.T. Quarterly, Volume 2, Number 5 (1991). As with anything new and exciting, a great many misconceptions still surround assistive technology: what is it, what isn't it, when can it do something, what can it do, what can't it do, who can benefit from using it, where is it available? The following is an attempt to begin to separate fact from fiction in this regard. Myth: ASSISTIVE TECHNOLOGY IS MAGIC. IT IS A CURE-ALL THAT CAN SOLVE ALL OF THE PROBLEMS FACED BY INDIVIDUALS WITH DISABILITIES. Fact: Assistive technology is neither magic nor a panacea. But, assistive devices certainly can be powerful tools which people with disabilities of all ages and varying backgrounds can use to successfully meet head on everyday life challenges. Assistive technology alone will never completely eliminate the added difficulties and challenges which comes with having a disability in our society. Increasingly, though, it is becoming one of our most effective allies and change agents for doing so. Myth: ASSISTIVE TECHNOLOGY IS FANCY GADGETRY AND A MERE LUXURY. Fact: For someone with a disability who relies upon assistive technology to perform a critical function or achieve a desired goal in life, it is not just fancy gadgetry or a luxury. Rather, assistive devices of all kinds are very much life necessities for those who use them. Just because a device makes performing a task easier or more convenient for an individual to do, does not make it a luxury item no matter what the cost. Seventy-five to eighty years ago, telephones and cars were seen as novelties - play things for the rich and well-to-do. In just a short period, though, phones and cars were scattered throughout the American landscape and seen as modern day necessities. Just three to five years ago personal computers and fax machines were also a rarity and now have become a required part of practically every office and business in the U.S. Telecommunication devices for people who are deaf (TDDs), voice-recognition devices, augmentative communication devices, lightweight wheelchairs and other technology solutions for those with disabilities of all ages must eventually be seen in the same light: not as luxuries but, rather, as necessities for everyday living. Myth: ALL ASSISTIVE TECHNOLOGY IS HIGH TECH AND EXPENSIVE. Fact: While some assistive devices are both expensive and sophisticated, devices may also include most anything that helps people in their daily lives: hearing aids; wheelchairs; adapted bathrooms and showers, or work equipment; hand controls and lifts added to vans or cars; switches for using computers and other appliances; and, electronic devices that can be used to speak whatever is on your mind. Not all of these devices cost a lot of money nor are they all high tech. Myth: ONLY PERSONS WITH CERTAIN TYPES OF DISABILITIES FIND ASSISTIVE TECHNOLOGY USEFUL. Fact: The needs for specific types of assistive technology varies widely from one person to the next. But individuals of all ages, varying abilities and needs can benefit from having increased access to A.T. devices and services which enable them to lead more self-directed, productive and satisfying lifestyles. By tailoring technology solutions to meet the real life challenges of real life individuals, assistive technology can capitalize on the interests and capabilities of persons with even the most severe disabilities. Myth: PERSONS WITH DISABILITIES WANT THE LATEST, MOST EXPENSIVE ASSISTIVE DEVICE. Fact: When it comes to obtaining technology for their own use, people with disabilities are like any other customer or consumer. Typically, such individuals are not especially interested in trying to keep up with the Joneses next door by buying the latest or most expensive piece of assistive technology on the market. Rather, what people are really interested in is acquiring A.T. which will be both easy and reliable: assistive technology which will assist them to get things done in life in the quickest and most convenient way possible. Myth: PEOPLE WITH DISABILITIES AND THEIR FAMILIES ALREADY KNOW ALL THERE IS TO KNOW ABOUT ASSISTIVE TECHNOLOGY. Fact: The good news is that many individuals with disabilities and their families now know a great deal more about assistive technology and its potential to improve their lives than ever before. In spite of this, though, efforts to increase awareness concerning A.T. have failed to reach many others. Outreach and awareness efforts, therefore, clearly must continue and, in fact, should be an ongoing effort. Myth: PROFESSIONALS ARE THE BEST SOURCE OF INFORMATION OR ASSISTANCE. Fact: Professionals are certainly a source of information and assistance on assistive technology for persons with disabilities and their families. However, unlike in the past, disability professionals need not be regarded as having an exclusive monopoly in this regard. As just noted, many persons with disabilities and their families now know at least as much about A.T. as professionals who may or may not have life experiences in using or relying upon A.T. on a daily basis. This represents a rich source of information, moral support and assistance which individuals and families need to be encouraged to tap into and contribute back into as well. Myth: THE ONLY REAL THING THAT PEOPLE WITH DISABILITIES AND FAMILIES WANT FROM AN ASSISTIVE TECHNOLOGY SERVICE SYSTEM IS TO "PURCHASE TECHNOLOGY." Fact: Increasingly, those with disabilities and their families will be looking to the A.T. service system, including the A.T. systems change project in their state, to help finance various assistive devices. But, it would be a mistake to view the sole role of any A.T. service delivery system as simply that of a "Daddy Deep Pockets" for assistive technology. Most people prefer to do business with a reputable bank than with a fly by night financier because they know that they can expect a greater quality and variety of services from the bank. Similarly, most individuals with disabilities and families have higher expectations of their state's A.T. service system as well. Purchasing or arranging for the financing of assistive devices is just one of many significant challenges which must be met. A.T. users and families also expect services that are: convenient, prompt, provide choices, courteous and provide reliable goods and maintenance efforts. In short, everything you might expect to get at your neighborhood bank. These are just a few of the myths that we hear on a regular basis. Others exist. From time to time, in subsequent issues of A.T. Quarterly, we will debunk other myths frequently heard. ---------- Assistive Technology Exceeding All Expectations By Robert R. Williams, Commissioner Administration On Developmental Disabilities, Administration For Children and Families U.S. Department of Health and Human Services _________________________________________________________________ This article is reprinted from the A.T. Quarterly, Volume 5, Number 2 & 3, (1994) Editor's Note: Mr. Williams was appointed by President Clinton to his present position in August 1993. Prior to his appointment, he worked as a policy associate with the United Cerebral Palsy Association's Governmental Activities Department. The following speech was delivered as a keynote address at the opening ceremony of RESNA's Annual Conference in Nashville, Tennessee on June 18, 1994. I want to begin by saying how personally proud and pleased I am to be back at the RESNA Conference - and to have been selected to address you tonight. My father is a fine craftsman whose craft is wood-making. I, too, like to think of myself as a craftsperson of sorts. I consider my primary craft neither politics nor policy but that of writing. And I spent some of the most enjoyable and productive years practicing and fine tuning that cherished craft by writing and editing RESNA's A.T. Quarterly newsletter as well as chumming around with the likes of Nell Bailey, Karen Franklin, Judy Brewer and Dianne Coleman, among others, in the Tech Act states and with families like the Guzzos of Indiana. This includes an increasing number of assistive technology advocates who come out of the developmental disabilities network, like Marv Fifield, Dianne Bryen, and Joan Bergman. So it is good to see so many old friends and to have this chance to meet many new ones. It is great to be back in Nashville as well. I seem to make my way back to this city every couple of years. And, almost by accident, each time I come here I end up learning a great deal more about assistive technology. About its power! About its potential! And, perhaps most of all, about its dreams deferred: about how much work you and I still have left to do to close the gap between its promise and everyday reality. As most of you know, the device I use is aptly called a Liberator (see box at the end of this article for a description). However, it was not until I gave the keynote at the national People First Conference in Nashville in 1991 that I realized how truly liberating such assistive technology can be - not just for individuals with disabilities, but in a political sense and for our nation as a whole. For once I had a roomful of 900 people, all chanting in unison, with me and my device: WE HAVE POWER! WE HAVE POWER IN OUR HEARTS! WE HAVE POWER IN OUR VOICES! It was only then that I came to really understand the deep transformational properties of this thing we call assistive technology! It was here in Nashville a year later, ironically following an assistive technology systems change conference, that I learned an equally critical, yet bittersweet lesson about assistive technology - its potential and its dreams deferred. I met a woman, a contemporary of mine named Kathy, who has cerebral palsy and who at the time was living in Clover Bottom, an institution a short way from here. As soon as my wife Helen and I met her, Kathy pointed to the symbols for "I want to go" on her communication board. Not wanting to jump to conclusions, we asked staff what she meant by this, and they replied that Kathy wanted out - out of Clover Bottom - forever. When we first met, I talked to Kathy using my manual communication board, and she took a keen interest in it. Later, as we were leaving, I spoke to her using my Liberator. It was then we learned of her interest in obtaining a similar device. When I told her that the law said she should get what she needs, Kathy cried inconsolably - and with good reason. For Kathy is very much like many others we all know: The greatest crippler she faces is not her disabilities, but othersþ severe ignorance and profound underestimation of her abilities. Having access to supports like personal assistance and assistive technology is critical. In fact, for individuals like Kathy and myself, it's often the only thing that can begin to tear down the age-old walls of myths and stereotypes regarding people with disabilities. The good news for Kathy is that she moved out of Clover Bottom and into a group home, which, while not perfect, is a beginning. Kathy, the last I heard though, still has not gotten the communication device, nor any of the ongoing support and training she would need to learn how to use it. Like millions of other Americans with significant disabilities, Kathy has a strange attraction to proverbial monkey wrenches and, what I call, plain inertia. The inertia is not hers but is systems inertia þ the lack of urgency and sustained efforts on the rest of our parts. We all talk a good game about the power and the potential of assistive technology. And it is all very true. But I am increasingly seeing, both as an individual and as a federal executive responsible for leading a national network committed to systems change, that where the real rubber meets the information highway is in transforming that power and potential into everyday realities in people's lives! Creating true access to assistive technology means much more than creating access to devices - to hardware and software. Much more significantly, it means building in training; building in ongoing support; and building in opportunities for self-instruction and troubleshooting, both for the individual relying on the device and his or her partners or assistants. This is especially true for the kind of technologies I rely on most but it is also true for a great many other assistive devices and technology solutions being used in school and work situations in particular. Now that I run a $109 million dollar federal agency, I have a great many more challenges to address in this regard. However, unlike the vast majority of Americans with significant disabilities and their families, I also have a great many more resources and accommodations to organize and deploy as I see fit. Just two weeks ago, for instance, I got a new custom-made desk. It can be raised and lowered with the push of a button and is designed to enable me to stand part of the day while working, thus reducing my chances for both fatigue and other possible secondary disabilities. Some might see this as a luxury. I think not. My staff reports that the only down side to it is that as my lung capacity increases, my bark will be louder than ever. I hope that will make my occasional bite pale in comparison. Increasingly, I am also relying on this Liberator, not just for communication but as my principal management tool. With it, I am able to access my computer, e-mail, and Internet. The reason I am able to do this is the ongoing support I can draw on. I have a staff person, Ron Filewich. Usually, Ron doesnþt travel with me. But, as luck would have it, Helen could not come with me on this trip, so I drafted Ron to come in her place, and it is good that he did. It is good that he is being exposed to everything this conference has to offer. One of the best management decisions I made early on at the Administration on Developmental Disabilities was to have Ron be my troubleshooter on technology. And, on average, he now spends over a third of his time troubleshooting, developing macros, and making sure everything is backed up, not just with respect to the Liberator but with regard to the LAN and Internet as well. He, in turn, has an entire network, inside and outside of government, backing him up as well. He is there to anticipate problems and solve glitches as soon as they occur because, frankly, I cannot afford slow downs or to be non-productive þ not for five minutes, a half hour, nor, certainly, an entire day. More important, America can no longer afford it either. America can no longer afford to have a few exceptions to the rules, like myself, hanging around. Right now there is really just a relatively small number of us who are exceptions to some extremely important rules - exceptions in that we have had access not simply to assistive technology but to the training and, most important, to the ongoing support we need to make it work, not just to improve our own lives but to make a critical difference in the lives of our families, communities, and our nation. The challenge that you and I face, therefore, is not to come up with a few more exceptions but to change the rules of the game entirely. As President Clinton says, America cannot afford to waste any of its citizens. What does this mean in practice? It means figuring out the best ways to get ongoing technology training, assistance, and support to individuals. It means educating individuals and their families of their rights under IDEA and the most recent rehabilitation amendments - and making these laws work for people. It also means a great deal more: doing a great deal differently from what we typically have done in the past þ reaching out and reaching beyond the traditional ways of thinking about and responding to the challenges and opportunities presented by disability in the twenty-first century. The disability community must work with those of us in the Clinton Administration to infuse universal access as a pivotal element in the National Information Infrastructure. We must work to infuse access to assistive devices and technology solutions and the ongoing training and support it takes to master their power as a central practicing tenet in each and every one of President Clinton's major new investment initiatives - in Head Start, in Health Reform and Personal Assistance, in National Service, in Goals 2000, in the School to Work initiative, in Welfare Reform, and in the Empowerment Zones. By seizing on and influencing these ventures, you and I have an opportunity, and the obligation, of a lifetime. Our nation simply can no longer afford, either in the rawest human or economic terms, to continue to spend between two and three hundred billion dollars a year keeping Americans with disabilities economically disenfranchised and, for the most part, needlessly dependent. There is a better way, and that way begins with working with young Americans, both those with and without disabilities, and especially with those who are left out and left behind - those at the very margins of the American community. It begins with preparing an increasing number of these young men and women to come together to form what might be called a National Human Support Infrastructure - a Human Support Infrastructure which would offer individuals with significant disabilities of every age and background ready access to the same kind of ongoing training, technology support, and troubleshooting which I now take full advantage of myself. As President Clinton, Labor Secretary Robert Reich, and others point out, access to communication and telecommunications technology will increasingly become a necessary prerequisite. A prerequisite for learning, for working, and simply, for living, in twenty-first century America. This will be true for all Americans. But, I think, it will be particularly true for two groups above all else: those with disabilities and other young Americans on the margins. There is a powerful connection to be made here. You can be certain that we in the Administration on Developmental Disabilities and elsewhere throughout the Administration will be working to make that vital link occur! I challenge you to work with us to do the same! _________________________________________________________________ The A.T. Quarterly was a newsletter developed by the RESNA TA Project under a contract with the National Institute on Disability and Rehabilitation Research (NIDRR), U.S. Department of Education (ED). The content, however, does not necessarily reflect the position or policy of NIDRR/ED and no official endorsement of the material should be inferred