Background: Little research has been conducted to date on the effective uptake of assistive technology for students with cerebral palsy. Available research indicates that these students experience considerable challenges (Copley & Ziviani, 2004, 2007; McMillan, 2008; Raghavendra, Olsson, Sampson, McInerney, & Connell, 2012). With clientcentred and family-centred care widely recognised as a cornerstone for effective assistive technology service provision (Angelo, 2000; Parette & Brotherson, 2004), the current study was undertaken to investigate to what extent such approaches were used by schools when assistive technology assessments and implementation occurred in the classroom. Furthermore, the factors determining the students' capability to access the curriculum to achieve classroom goals were examined. In exploring these issues, this study is the first in Australia to investigate the service provision of high-tech assistive technology in schools for students with cerebral palsy. Methods: This two-phase sequential explanatory mixed methods study was designed to survey and interview all key stakeholders in the assistive technology provision process, in a multiple-case study design. The International Classification of Functioning, Disability and Health (ICF) (World Health Organization, 2001) for Children and Youth (ICF-CY) (World Health Organization, 2007) was used as a framework to describe the facilitators and barriers in assistive technology provision in the classroom. A cross-sectional survey of: parents (n=76), students aged 7-18 years (n=22), occupational therapists (n=33), speech pathologists (n=32), assistive technology consultants (n=4), educators (n=26) and teaching assistants (n=5) was conducted to investigate their experiences of assistive technology service provision and the students' ability to access the curriculum. Furthermore, to evaluate how client-centred and family-centred the service provision was perceived to be, parents completed the Measure of Processes of Care for Caregivers (MPOC-20) (King, King, & Rosenbaum, 2004). School staff and allied health professionals completed the Measure of Processes of Care for Service Providers (MPOC-SP) (Woodside, Rosenbaum, King, & King, 2001); and youth aged 13 years and older completed the Give Youth a Voice (GYV-20). Descriptive and non-parametric statistics were used for data analysis of the survey. Based on the results obtained, semi-structured interviews and focus groups with parents (n=6), their children (n=6), educators (n=6) and allied health professionals (n=15) were conducted to further explore their experiences of service provision and use of assistive technology. These data were analysed using cross-case analysis. Results: This study found that family-centred service and shared decision-making is not yet fully achieved in schools despite being endorsed in early intervention and disability services for over 20 years. When students, their parents, the classroom teacher and a teaching assistant are involved alongside allied health professionals, in the process of selecting and implementing assistive technology in the classroom, successful outcomes are more likely to occur. However, the findings from this study show that classroom teachers are often not involved in the initial stages of the assessment process. For students to access the curriculum it is essential that both allied health professionals and school staff are clear about their roles and set goals with the students and their families. It is also critical for them to be open to learn new skills, have time to meet with other team members, and feel comfortable with implementing the technology. Students' motivation and level of support and training from parents, school staff and allied health professionals played an integral part in the successful use of technology in the classroom. The study also demonstrated that ensuring adequate training and having a dedicated teaching assistant was perceived positively by parents, allied health professionals and school staff. Conclusion: These findings offer directions for service provision, policy development and future research. To increase access to the curriculum, client-centred and family-centred service provision needs to be fully embraced by schools. To enhance the way technology is matched to the student and successfully implemented, classroom teachers need to be fully involved in the whole assistive technology process. Clear policy guidelines on how to access technology equipment and funding are required. For students to be able to show teachers what they know, it is critical that they have someone encouraging them to use their technology in the classroom. These findings have the potential to better provide opportunities for students to access the curriculum and, in doing so, enable them to exercise their right to a meaningful education.
| Date of Award | 2014 |
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| Original language | English |
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