Assistive Technology for Young Children with Special Needs

1. INTRODUCTION

For most people, technology makes things easier. For people with disabilities, technology
makes things possible.
—Mary Pat Radabaugh

- Children with disabilities experience different forms of exclusion, which may cut them off from
health, education and social services, and limit their participation in family, community and
society.
- Supportive services and technology can enable children with disabilities to take their place in
society and contribute to their family and community.
- Assistive technology includes products and related services that improve the functioning of
people with disabilities.
- Assistive technology can enhance the quality of life of both children and their families.

2. CHILDREN WITH DISABILITIES

Who Are Children With Disabilities?

- According to the CRPD, children with disabilities includes children “who have long-term
physical, mental, intellectual or sensory impairments which in interaction with various barriers
may hinder their full and effective participation in society on an equal basis with others”.

What Barriers Do Children With Disabilities Experience?

- Children with disabilities face extreme disparities and daunting challenges to the enjoyment of
academic, social, and community participation in low and middle income countries.
- An environment with barriers and without enablers restricts a child’s potential; other more
enabling environments increase the opportunities.
- Society may hinder a child’s potential because it creates barriers (for example, negative
attitudes or inaccessible buildings) or it does not provide enablers (for example, unavailability
of assistive technology).

3. ASSISTIVE TECHNOLOGY FOR CHILDREN

What Is Assistive Technology?

- Assistive technology is used as an umbrella term for both assistive products and related
services. Assistive products are also known as assistive devices.
What Are The Benefits Of Assistive Technology?

- When appropriate to the user and the user’s environment, assistive technology is a powerful
tool to increase independence and improve participation
- Assistive technology supports children to access and enjoy their rights; do things they value;
and bridges disparities between children with and without disabilities.
- Assistive technology reduces costs when it supports early childhood development and
educational achievement, and avoids repetition of learning missed due to educational barriers.
- Providing assistive technology to children as early as possible will facilitate their development
and prevent secondary conditions such as deformities.

What Are The Needs For Assistive Technology?

The global need for assistive technology for children has not yet been adequately quantified.
Estimates indicate that about 0.5% of a population need prosthetic or orthotic devices, about
1% need a wheelchair, and about 3% need a hearing aid. These needs vary between countries
as well as between regions within a country due to factors such as variations in age distribution
and prevalence of various impairments. In developing countries, up to 0.6% of children have
hearing impairments within the neonatal period. However, hearing aids are not always an
appropriate solution.

WHO estimates that only 5-15% of assistive technology needs are met in many developing
countries. In fact, more than 97% of those that would benefit from using a hearing aid do not
have one. Studies in Malawi and Namibia indicate that more than 80% of those who need
assistive technology do not have it. A study in Afghanistan reported that children were less
likely than adults to access assistive technology indicating that their unmet needs are even
greater.

What Rights Do Children Have To Assistive Technology?

Access to assistive technology is regarded as a precondition for achieving equal opportunities,

enjoying human rights and living in dignity. CRPD Article 32 calls for international cooperation
among governments, international and regional organizations and civil society, in particular
organizations of people with disabilities, while CRC Article 23 calls for information exchange
between governments. Failure to provide assistive technology results in rights violations.

Assistive technology is frequently mentioned in the CRPD. Articles 4, 9, 20, 21, 24, 26, 29 and 32
of the CRPD make explicit mention of specific aspects of assistive technology, and an additional
17 articles require measures which may include assistive technology. For example, Article 24 of
the CRPD recognizes the right of children with disabilities to education.

What Are The Barriers To Assistive Technology?

As indicated earlier, disability is the outcome of the interaction between a child with an
impairment and an environment with barriers that hinder his or her participation on an equal
basis with others. Assistive technology can reduce or eliminate such barriers. However,
obtaining such technology is not always possible due to product and service related barriers.

LACK OF AWARENESS
Many people with disabilities and their families have limited awareness of assistive products
and services. This makes it difficult for children and their families to know what assistive
technologies are available or suitable and how they can be beneficial.

LACK OF GOVERNANCE INCLUDING LEGISLATION, POLICIES AND NATIONAL

PROGRAMMES
The 2005 ‘Global survey on government action on the implementation of the Standard Rules on
the Equalization of Opportunities for Persons with Disabilities’ found that of the 114 responding
countries 50% had not passed relevant legislation and 48% did not have policies in place
relating to the provision of assistive technology. This indicates that for many States the
provision of assistive technology is a relatively low area of priority.

LACK OF SERVICES
Assistive technology services are often in short supply and located far away from where
children with disabilities live. In the above mentioned global survey, 53% of the 114 responding
countries had not initiated programmes relating to the provision of assistive technology. Non-
governmental organizations rarely have the financial means or capacity to develop countrywide
sustainable service delivery systems. With limited geographical coverage, their services often
focus on specific types of assistive technology or disabilities. In addition to reduced financial
means, it is culturally impossible for girls in certain regions to access assistive technology when
services are staffed only by male personnel.

LACK OF PRODUCTS
In many countries, there is no production of assistive products—or production occurs on a
small scale. It is small not only in terms of quantity, but also in terms of the range of types,
models and sizes of the products. Limited access to the materials and equipment needed to
produce assistive products can hamper production. Market-related factors can also limit
production. Limited awareness of assistive technology or purchasing capacity leads to a limited
demand. This results in few incentives to engage in production. Local production may not be
cost-effective where local markets are small. Moreover, duty and import taxes associated with
assistive technology can discourage local businesses to import materials, equipment or assistive
products. Although a wide range of types of assistive products are available globally, they are
not available everywhere, and all designs are not appropriate in all settings.

INACCESSIBLE ENVIRONMENTS
Physically or cognitively inaccessible environments act as barriers to assistive technology. For
example, inaccessible transport systems or service centres prevent children from having easy
access to the services and products they need. Physical barriers include stairs or poor lighting,
while cognitive barriers include texts that are not clear or symbols that are difficult to
understand. Further, regardless of the cost or availability of a wheelchair, a child will not be
able to use it in an inaccessible house, road or school. Barriers are often exacerbated during
natural disasters and conflicts.

LACK OF HUMAN RESOURCES

Another barrier to assistive technology is a lack of personnel properly trained in manufacturing
or adapting products, or delivering services. Many countries report inadequate numbers of
rehabilitation personnel .

FINANCIAL BARRIERS
The costs of purchasing, maintaining and replacing assistive products, and associated services
and traveling costs constitute a major barrier. Costs can be especially prohibitive in the case of
children, as they need their assistive products replaced or adjusted as they grow. In the global
survey among 114 countries, 36% had not allocated financial resources for developing and
supplying assistive technology.

Improved training opportunities, availability of quality products, and increased availability of

services are very important.

What Principle Should Guide The Provision Of Assistive Technology?

Assistive technology for children needs to be appropriate for them.They should be available,
obtainable, maintainable and the service sustained in the country at the most economical and
affordable price.

AVAILABILITY
Services and products are available in sufficient as close as possible to children's community.

ACCESSIBILITY
Services and products are accessible to every child who needs them.Their delivery should be
equitable. Accessibility includes physical and cognitive.

AFFORDABILITY
Services and products are affordable to the family of every child who needs them.

ADAPTABILITY
Services and products are adapted and modified to ensure they are appropriate to the needs
and requirements of individual children.They need to accommodate differences in terms of
individual factors as well as environmental factors. In addition, physical changes of children as
they grow and develop need to be accommodated.

ACCEPTABILITY
Services and products are acceptable to children and their families. This is facilitated by
involving them in the provision process and by considering their needs, preferences and
expectation.

QUALITY
Product quality can be measured through applicable technical standard or guidelines in terms
of strength, durability, capacity, safety and Specific services qualities can be measured in terms
of compliance with staff training requirements and service guidelines, while over all quality of
services can be measured in terms of outcomes, user satisfaction and quality of life.

4. CONCLUSION AND NEXT STEPS

National governments have primary responsibility to ensure that person with disabilities can
access assistive products, international cooperation in the area of assistive technology can also
be a critical catalyst. The main aim of this UNICEF-WHO discussion paper is to provide an
understanding of the need for and benefits of assistive technology to children with disabilities.

ESTIMATE NEEDS AND MAP RESOURCES

Estimating children's needs for assistive technology and mapping available resources are a
prerequisites for planning equitable resources.

ADOPT LEGISLATION, POLICIES AND STRATEGIES

These documents also need to address issues of physical and cognitive accessibility to assistive
products and services, as well as to outdoor environment and facilities.

PROVIDE FUNDING AND INCREASE AFFORDABILITY

Ensuring effective implementation of policies requires budgeting and allocation of necessary
funding.Assistive technology for children needs to be identified and made available at an
affordable price.

SET UP ASSISTIVE TECHNOLOGY SERVICE PROVISION

Each country needs to set up assistive technology services that are accessible to children and
capable of responding to identify needs in their specific contexts.Equitable provision of assistive
technology calls for national approaches . Although applied service may vary between user
groups and geographic areas.

SUPPLY PRODUCTS
Assistive products of appropriate quality and sufficient quantities need to be supplied to
assistive technology services.
TRAIN PERSONNEL
Decision makers and personnel at all levels require appropriate training to effectively develop
and implement all aspects of a system for the provision of assistive technology to children.

ESTABLISH PARTNERSHIP
The development of partnerships among stakeholders supports national efforts, coordination
and collaboration, andhelps prevent duplication.