A Multi-Tiered Approach to Assistive Technology from the gr…

Dec 22/Jan 23 Closing The Gap Solutions - Collaborating With Augmentative and Alternative Communication (AAC) Users Gains A New Perspective To Best Support Clients By Lydia Dawley

accessibility & UDL

A Multi-Tiered Approach to Assistive Technology from the Ground Up Summary : Mesa Public Schools adopted a tiered approach to assistive technology (AT), inspired by the Multi-Tiered Sys- tems of Support (MTSS) Framework to expand access to assistive technology (AT) for their 8,900 special education students. In their model, Tier 1 consists of universal tools like Core Boards, GRID 3, Read&Write, Windows Dictation, and Google Keep. These tools were made available to all students to promote inclusivity. Since implementing Tier 1 tools, their district has seen a 300% increase in AT support requests. This surge reflects not only growing awareness but also a significant shift in the dis- trict's culture toward embracing technology to support students.

When Zoie, a 4th grader with limited motor abilities, was in- troduced to voice-controlled technology, it wasn’t just about giving her access to a device—it was about unlocking her po- tential in the classroom. Assistive technology is a powerful tool that can unlock access and potential for so many students. With a department of only two specialists, the demand for assistive technology was overwhelming. However, rather than seeing it as a challenge, we saw it as an opportunity to build a scalable, sustainable system. We needed to figure out how to serve ap- proximately 8,900 students with. However, if we stuck with an expert model (at a caseload of approximately 50 students) we

would need somewhere around 140 specialists. We needed to find a different way to increase access and build capacity on a large scale. A tiered approach was the answer that we were searching for. LAYING THE FOUNDATION: THE TIERED APPROACH The concept of tiered support originated in public health in the 1960s and later gained traction in education through the Multi-Tiered Systems of Support (MTSS) framework. We used the concepts of a tiered support system and applied it to assistive technology.

BECKY WOOLLEY , C-SLPA, ATP, and Assistive Technology Facilitator at Mesa Public Schools, has been a member of the AT department for 4 years. Before joining the AT department, Becky worked as an SLPA in public school settings for approximately 10 years. Becky is currently a member of the Arizona Speech-Language Hearing Association AAC committee.

SAMANTHA HAGNESS , M.S., CCC-SLP and Assistive Technology Specialist at Mesa Public Schools, has been a member of the AT department for 3 years. Prior to joining the AT Department, Samantha worked as an SLP in public schools for 10 years. Samantha is an active member of Arizona’s Speech-Language-Hearing Association and currently serves on the AAC committee.

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Searchable video tutorials empowered staff to learn at their own pace. The result? Staff members began embracing Tier 1 tools. Our AT Department utilizes a ticket system. When staff members want to check out a readily available tool, collaborate, or request support, they complete a Google Form. Since implementing Tier 1 tools, our district has seen a 300% increase in AT support re- quests over the past 3 school years. This surge reflects not only growing awareness but also a significant shift in the district's culture toward embracing technology to support students. Teachers became our champions in the classroom. Instead of seeing AT as an 'extra' service, they began viewing it as an inte- gral part of the learning process. This shift was key to integrating the tools effectively, ensuring they became a natural part of stu- dents' routines. TIER 2: CUSTOMIZING FOR SPECIFIC NEEDS Not all students’ needs can be met by universal tools. Tier 2 interventions involve modifications to Tier 1 tools, such as ad- justing reading speeds in Read&Write or providing headsets for Windows Dictation. These small adaptations can sometimes significantly improve the tools' effectiveness for individual stu- dents. Let’s take a look at how some of the tools can be modified to provide the required features.

Our target was clear: to ensure all special education students had access to essential AT tools. Specifically, we focused on tools designed to support communication, reading, writing, and ex- ecutive functioning skills. The tiered approach provided a struc- tured way to deliver these supports efficiently and equitably. TIER 1: UNIVERSAL TOOLS FOR ALL In our model, tier 1 tools form the universal toolkit. These are readily available tools that are accessible to all students. They provide foundational support and often promote inclusivity and accessibility across the broader student population. CORE BOARDS : Found in preschool and self-contained special education classrooms, playgrounds, and cafeterias, these low-tech communication tools align closely with the high-tech AAC devices used by many students. GRID 3: Smartbox’s software provides customizable sym- bol-based communication supports, empowering teachers to seamlessly integrate communication tools into class- room routines. READ&WRITE (free version): Through Read&Write’s ex- tension, students have access to reliable, web-based text- to-speech. WINDOWS DICTATION: Built-in speech-to-text is available to any student with a 1:1 device, fostering independence and accessibility across general and special education set- tings.

Tool

Possible Modifications

An Example of the Story Interface

Core Boards

One way to reduce the visual com- plexity of the core boards is to print a copy in grayscale and then cut out the icons being targeted. By doing so, the targeted icons stand out without losing access to the remaining words Targeted vocabulary can also be highlighted by using wet-erase markers, Wikistix, and painter's tape. Within GRID 3, any page can be printed to create a visual. This al- lows the core boards to be quickly modified and printed for students. Students can choose the voice that is easiest for them to listen to. A voice that sounds more natural to them can make the text feel more engaging and enhance un- derstanding. The reading speed can be adjust- ed to support processing.

GOOGLE KEEP: A digital organizational system that sup- ports students’ executive functioning skills.

The introduction of Tier 1 tools caused a ripple effect. Assis- tive technology awareness increased, technology integration became a more natural part of learning environments, and class- room cultures were transformed. NAVIGATING CHALLENGES IN TIER 1 IMPLEMENTATION Our journey was not without obstacles. Initial attempts to disseminate information through required, lecture-style train- ing sessions were ineffective. It became clear that adult learners thrive on involvement, relevance, and immediate application. By incorporating adult learning principles, we were able to shift to designing more successful learning experiences: Virtual user groups allowed for self-directed, problem-cen- tered exploration of tools. Hands-on demonstrations and group discussions provid- ed immediate application opportunities and fostered collabora- tion.

GRID 3

Read&Write (free)

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Windows Dictation

Noisy classrooms can be a barrier for students using voice typing. A headset equipped with a boom mic can help . Key bumps can be added to the “Windows” and “h” keys if students require a visual/tactile reminder for how to turn dictation on and off. Students can use the voice train- ing wizard to train their computer to better understand them. Color coding can be used within Google Keep to help students find, sort, and prioritize information . Labels can be created to keep the digital notes organized and help students visually structure their time and responsibilities Checkboxes can be included to help keep track of upcoming versus completed tasks by mini- mizing distractions and increasing structure .

TIERS WITHIN TIERS Even within tier 3, we use multiple layers of support. For our students using AAC devices, we use a Specific Language Sys- tem First approach developed by Chris Bugaj, where an iPad with TouchChat WordPower 60 Basic is our first tier within tier 3. Some students may need slight modifications or adjustments (e.g., keyguards, different vocabulary sets, a Spanish toggle), which we consider our tier 2 within tier 3. Other students need a completely specialized system to provide them with the nec- essary features. For example, a student may need an eye-gaze camera or a system with high-contrast icons. This is our tier 3 within tier 3 Using this model, the number of district-provided high-tech augmentative and alternative communication (AAC) devices has increased by over 90%. Today, we have 689 students using robust AAC systems because, currently, they are not able to con- sistently say what they want to say when and how they want to say it. 689 is a number worth celebrating! OVERCOMING TIER 3 CHALLENGES One of the most effective strategies we employed to address challenges in implementing Tier 3 assistive technology (AT) was the development of comprehensive implementation plans. Research shows that people are 42% more likely to achieve a goal when they write it down (Matthews, 2015). The plans not only helped clarify objectives but also kept all team members aligned, avoiding the need to start over at the beginning of each school year. Each implementation plan includes a space to consider and document the following:

Google Keep

TIER 3: INDIVIDUALIZED SOLUTIONS When students require more specialized support, we turn to Tier 3. This involves using frameworks like SETT (Student, Envi- ronment, Task, Tools) to match features to student needs and exploring highly customized solutions. Tier 3 tools can be just about anything. If we look to the defi- nition of assistive technology provided by IDEA, it is defined as “any item.” The student, their environment, and the tasks they need to complete will help the team determine which tools to try and which services to provide. Oftentimes, the student will need a system of tools and support to access their education. Zoie is a 4th-grade student with a physical disability that impacts her fine and gross motor abilities. She does not have functional use of her hands and needed alternative access to use a computer. After trying various options like eye-gaze and voice control, Zoie’s IEP team decided to use an iPad as her 1:1 device instead of a laptop. That decision was driven by the fea- ture-matching process and Zoie's preference. Zoie prefers using the voice control feature on an iPad as her access method. Our district has iPads available for students, but our Tier 1 academic device is a laptop. In this case, a laptop wasn’t the right tool. Zoie needed a Tier 3 system. Zoie's general education teacher and related service providers were a wonderful support. They were already familiar with voice typing, so the idea of voice control on an iPad wasn’t foreign and did not require extensive training. This is an example of how a universal toolkit supports students who need specialized solutions.

• The tools being used • Video tutorials • What will be modeled • Additional training required for team members • Daily tasks • On-going management • Trial data • Progress monitoring • Obstacles/barriers and solutions to try

Collaboration with other departments proved critical. Re- member. We are a department of two specialists, so we needed to enlist the help of staff. Instructional coaches, education tech- nology trainers, speech-language pathologists, occupational therapists, physical therapists, teachers, administrators, and in- structional assistants all played a part in rolling out tiered sup- ports. WILDFLOWERS: UNPLANNED SUCCESSES As we implemented the tiered approach, we discovered un- expected benefits. These unplanned successes were significant.

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Let’s look at some of the stories of wildflowers we have gathered along the way. Inclusive Environments: Tier 1 tools created more inclusive en- vironments for all students, not just those with IEPs or 504 plans. When students are given choices in their learning, we move to a more inclusive educational design. Let’s look at an example. Zoie was a student who did not like to stand out or feel dif- ferent. Due to this, she was very hesitant to try eye-gaze or voice control. Introducing Tier 1 tools to her entire 4th-grade classroom made all the difference. She saw how her peers thought voice typing was incredibly cool and felt comfortable trying voice con- trol on an iPad. She needed a shift in the classroom culture to use assistive technology. That shift happened during one 40-minute technology lesson. Every student was given access to speech-to- text and text-to-speech. Once every student had access to those tools, using assistive technology felt “normal.” Increased Use: Staff began independently integrating AT into their classrooms. With training and built-in support, more staff were considering how they could modify tools to fit the needs of their students. A great example is when Zoie’s teacher requested a different type of headset for Zoie. He wanted to make sure Zoie had a re- liable headset with a good microphone that would specifically pick up her voice and not her peers. As voice control would be Zoie’s main access method for digital materials, she needed a good headset, and her general education teacher thought about that. He was considering AT implementation. He saw how voice typing worked for all his students and wanted to help eliminate barriers for Zoie. Increased Access: Let’s take a look at another student exam- ple to see how using a tiered approach made a difference and increased their access. From the moment we walked into the shop at Westwood High School, we were impressed. The teacher agreed to have the Assistive Technology Department present a problem to his Robotics Club to see if they could come up with a solution. The students immediately got to work, asking questions and sketch- ing out ideas. Before we knew it, they had made 3D-printed keyguards for our latest communication devices. Just like that, hundreds of students were able to access communication more reliably. Fast forward six months, we were working with David, a stu- dent who had so much to say but was limited by his fine motor skills when he used his communication device. We tried our best to customize a stylus for him, but it simply was not good enough. There was nothing sold commercially that had the features we were looking for. We weren’t surprised that his classes were able to create a sty- lus, but we were completely blown away when we first saw the pictures of all of their creations. David’s new challenge was that he had his pick of over 20 customized handgrips- each design

was unique and creative. Improved Confidence: Another benefit of using a tiered sup- port was that student confidence increased. When students gain independence and can participate alongside their peers, it can increase their confidence. Stella (fictitious name) was characterized as a shy student by her classroom teacher. That was shocking to her parents, who knew her to be outgoing. Junior high was a new setting, and Stella was struggling. She had a reading disability, and her school work was becoming increasingly difficult. The compensa- tory strategies she relied on in elementary school, like listening carefully to her teachers, paying attention to her peers, and ask- ing her teachers to read things out loud for her, weren’t cutting it now that she was getting older. She was starting to feel like she wasn’t “good” at school. Stella’s IEP team realized that she need- ed AT tools to increase her independence. She was provided with a free text-to-speech tool for her computer, and it made all the difference. Decoding grade-level text was still challenging at times, but it didn’t prevent her from participating in class with in- dependence. Stella’s attitude about herself as a learner changed. Stella’s team didn’t collaborate with the AT department. They didn’t need to. They were familiar with text-to-speech and knew they could try it with her. Stella represents a growing number of students in our district who are enjoying increased indepen- dence and confidence as IEP teams become more comfortable and aware of assistive technology. A JOURNEY WORTH TAKING Applying a tiered approach to assistive technology has been a challenging but rewarding journey. By addressing obstacles with research-based strategies and celebrating the “wildflowers” that emerged along the way, we are fostering a district-wide culture of accessibility and inclusion. While there is still work to be done, the path we’ve paved demonstrates that a structured, tiered ap- proach can transform how schools deliver assistive technology, ensuring that every student has the tools they need to succeed.

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