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MassMATCH Quarterly News: Winter 2015

In This Edition:

Open House Announces REquipment Expansion!

REquipment logo: Choose to Reuse your DME.

It's official! REquipment--the durable medical equipment (DME) reuse program--is now serving central Massachusetts. On October 22nd, the Department of Developmental Services (DDS) and the Massachusetts Rehabilitation Commission (MRC) hosted an open house in Worcester to celebrate the new REquipment Center at 325 Clark Street. Now residents beyond Greater Boston can obtain no-cost refurbished wheelchairs, ramps, shower chairs, rollators, adapted strollers and other gently-used DME.

The facility is a hub for receiving and refurbishing donated equipment in central Massachusetts (and is not open to the public). The space has been in the works for three years, and was carefully designed to co-locate a regional Assistive Technology (AT) Center serving DDS clients and a DME reuse center serving anyone. "The co-location made practical sense," remarks Karen Langley, EOHHS Director of Assistive Technology and Community Support Programs. "And the partnership should serve as a model for how state agencies can work together, share resources and provide essential services to more people."

Indeed, REquipment's expansion would not have been possible without both MRC and DDS's in-kind and financial support. In Worcester, DDS is sharing both space and a skilled AT technician to provide refurbishment, storage and transportation services. MRC provides a van for device transport serving both programs.

A woman in a suit addresses a crowd holding a mike.

Department of Developmental Disabilities (DDS) Commissioner Elin Howe addresses an audience of over 75 attendees at the REquipment Center ribbon-cutting celebration. Seated behind her are HHS Secretary John Polanowicz and MRC Commissioner Charles Carr.

REquipment is also a unique public/private sector partnership. The Boston Home received pilot funding in 2013 from the Carl and Ruth Shapiro Family Foundation plus additional support from MRC and Spaulding Hospital. Now in its second year, REquipment program partners also include The Boston Foundation, the Massachusetts Department of Public Health as well as DDS.

REquipment's refurbishment and transportation services set it apart from other equipment exchange programs. Craigslist and GetATStuff.com depend on residents exchanging items "as is" and directly with one another. Individuals who need durable medical equipment, however, often do not have the capacity to transport these items, never mind sanitize and repair them. REquipment is able to pick up donated DME and deliver reassigned items within Greater Boston and central Massachusetts.

A man stands next to a wheel chair on a table with tools mounted behind.

AT Technician Jim Smith with a refurbished manual wheelchair in the new Worcester center. Smith splits his time between REquipment and the DDS AT Center.

"The central Mass expansion was very essential to reaching new donors and more individuals who use DME," remarks REquipment Program Manager Randi Sargent. She notes that during the first nine months of operations, REquipment collected and refurbished 85 devices and reassigned 44. However, since the opening of the Worcester center--and thanks largely to an article about the open house in the Worcester Telegram--the program has received an additional 50+ referrals, leading to the donation of 40 items from central Massachusetts in two months alone. "That article had a lot of legs!" Sargent observes. "People are still referring to it when they call."

REquipment's DME assists individuals of all ages to stay independent, get to school or work, or leave costly facilities and move back to their home communities. The program accepts donations of only gently-used equipment, including lifts, rollators, scooters, standing frames, shower chairs and portable ramps, in addition to power and manual wheel chairs (see Donating Your DME for more information). Individuals seeking DME can browse what is available at DMErequipment.org and place a request online (or by calling, toll-free, 1-866-224-6156).

"The plan is to eventually expand statewide," explains Sargent. "But we don't yet have the funding. Hopefully events like the open house will raise the awareness with legislators and potential funders that we need to keep this momentum going."

Man in speaking with a microphone.

State Representative Bruce Ayers addresses the crowd at the open house. His words give reason for encouragement: "Today I am eager to listen and learn, and bring back to the State House how to expand this program."

PARCC Accessibility Update!

PARCC logo

In November, the 3rd edition of the PARCC Accessibility Features and Accommodations Manual was released with updates to PARCC's approach to accessibility for students with disabilities. PARCC is one of two federally-funded state consortia creating general assessments aligned to the new Common Core State Standards (CCSS). Massachusetts has adopted the Common Core State Standards and this year more than half of all Massachusetts school districts will transition from MCAS to the new computer-based PARCC assessment. Educators and families will need to get to know what is required of their students with disabilities and how best to support effective access to this "next generation" assessment.

As a digital assessment, PARCC has promised to be more accessible to students with disabilities than traditional paper and pencil tests (although a paper version is an available accommodation). PARCC's online platform offers built-in tools and access features, such as captioning of video and ASL, as well as individualized accommodations and customization (for an overview read "The PARCC Assessment and Assistive Technology: What Do IEP Teams Need to Know?" from our spring edition). It is important that families and educators understand what is offered by the assessment platform and familiarize their students with access options and PARCC features well ahead of test-taking time. For students accustomed to using their own assistive technologies, this process is particularly necessary.

New in the 3rd edition is this language: "Students may use a range of assistive technologies on the PARCC assessments, including devices that are compatible with the PARCC online testing platform, and those that are used externally (i.e. on a separate computer)." The manual's web page indicates the AT Guidelines will be available in winter 2014 (in addition to a PARCC Technical Assistance Bulletin: "PARCC Assessments and Students with Visual Impairment, Including Blindness"). The guidelines are eagerly anticipated by many educators and advocates in the field. Guidance for how to test AT devices and software for use with PARCC and TestNAV 8 (the platform the test uses) through an "infrastructure trial" is anticipated.

For readers familiar with PARCC and its accessibility features and accommodations policies, below is a summary of additional changes made to the 3rd edition (based on an email from Tamara Reavis, PARCC Senior Adviser on Accessibility and Equity).

Presentation accommodation updates include:

  • Large-print edition and paper-based edition accommodations, and an Appendix A for additional guidance.
  • All available modes for text-to-speech for ELA/literacy (including text-to-speech, screen reader only, ASL video, human reader, or human signer).
  • Clarified language for text-to-speech accommodation for ELA/literacy.
  • Allows a human signer for test directions.
  • Allows a student to read the assessment aloud to themselves.

Response accommodation updates include:

  • Added a braille writer accommodation.
  • Added a calculator accommodation for the calculator sections of the mathematics assessments.
  • Revised calculator accommodation for the non-calculator sections of the mathematics assessments based on PARCC blueprints.
  • Provided all available modes for scribing for each content area (including speech-to-text, human scribe, human signer, and external assistive technology device).
  • Clarified that word prediction will be done via an external device.

Additional accessibility-related changes include:

  1. New and revised language added on the Personal Needs Profile (p.19-20)
  2. Clarified information on the accessibility features available to all students (p.22-26):
    • Added a low contrast option for “color contrast (background/font color)”
    • Added browser magnification limits for “magnification/ enlargement device”
    • Noted that spell check is available through an external device.
    • Provided all available modes for text-to-speech for mathematics (including text-to-speech, human reader, or human signer).
  3. Combined Sections three and four to streamline the document, and added/clarified a number of accommodations (p. 27-48)
    • Accommodations for English Language Learners now include:
    • Provided all available modes for speech-to-text for mathematics (speech-to-text or human scribe).
    • Added ten highest incidence languages across PARCC states for translation of general test administrator directions.
    • Added online, paper-based, and large print translation of the mathematics assessments as an accommodation (at state discretion, approved by the Governing Board in 2013).
    • Added text-to-speech and/or human reader in Spanish or other languages as needed for the mathematics assessments (at state discretion, approved by the Governing Board in 2013)

Accommodation updates for English Language Learners:

  • Provided all available modes for speech-to-text for mathematics (speech-to-text or human scribe).
  • Added ten highest incidence languages across PARCC states for translation of general test administrator directions.
  • Added online, paper-based, and large print translation of the mathematics assessments as an accommodation (at state discretion, approved by the Governing Board in 2013).
  • Added text-to-speech and/or human reader in Spanish or other languages as needed for the mathematics assessments (at state discretion, approved by the Governing Board in 2013)Streamlined the final section (originally Section 5 and now Section 4) for clarity (p. 49-67).

Also check out PARCC's Lessons Learned Report (PDF) gleaned from the assessment field tests.

AT Implications in Recent ADA Guidance to Public Schools

Schools must comply with the Americans with Disabilities Act (ADA)'s "effective communication" access requirement and understand when it is different from IDEA's Free and Appropriate Public Education (FAPE) standard

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Referencing recent legal cases, the US Department of Education and the Justice Department (DOJ) have jointly published new guidance for schools, educators and parents. The guidance clarifies when the ADA's Title II "effective communication" requirement differs from the standards set by the Individuals with Disabilities Education Act (IDEA) and Section 504 of the Rehab Act.

Under IDEA, public schools and charters must provide a Free and Appropriate Public Education (FAPE) as called for by a student's Individual Education Plan (IEP). FAPE is also a way to satisfy Section 504's program access requirements. Until now, the ADA has come into play for Pre K-12 schools mostly for building access standards only.

However, the DOE and DOJ have recently clarified the ADA's Title II requirement that students with disabilities have "effective communication" access to existing school programs. (Unlike  IDEA, the ADA does not provide for the creation of educational programs, only access to existing programs.) In some cases the ADA may require student services not obligated under the IDEA.  In other instances, complying with IDEA meets the requirements of both laws.

There are important AT implications for providing "effective communication" access under the ADA. "Communication" under Title II includes various forms of information exchange, including reading, writing, listening and speaking. "Effective communication" can require technology support instead of human support because technology  can allow a student to complete tasks independently. It might also, for example, require CART services instead of peer note taking because "effective communication" can be a higher standard than the "appropriate" standard in FAPE. The ADA also requires "primary consideration" be given to the auxiliary aid or service requested by the student with a disability.

The guidance requires careful consideration and study. Review:

The Right Switch for Brianna


See, Touch, and Try: Assistive Technology Regional Centers.

Brianna is a beautiful girl with expressive brown eyes who is loved by her whole school community. Last spring, AT Regional Center Co-coordinator Kristi Peak-Oliveira, CCC-SLP, was contacted by Brianna’s middle school for assistance with her speech-generating device. Brianna needed help accessing her Dynavox Maestro. Equally important, the school needed help accessing Brianna.

Brianna, Kristi learned, lives with quadriplegia due to a trampoline accident six years earlier. She has limited movement of her head, neck and shoulders and is not able to use her voice. Kristi had many questions about Brianna, but school personnel apologized. Her full story just wasn’t available.

Kristi did learn, however, that Brianna resides in a nursing facility with, sadly, no contact from her family. Indeed, school staff explained they wanted to help her communicate--not only to expand her schooling--but to help her recover emotionally. Brianna needed a way to ask questions, they emphasized, and to talk about what had happened.

Brianna’s device, the Maestro, allows users to select symbols and/or letters from a large display to compose and speak synthetic or recorded messages. A different provider had originally conducted an evaluation and recommended the Maestro for use with a mechanical switch. However the access method had never worked for Brianna. As result, her primary form of communication was still smiling for “yes” and pushing her arms forward for “no”—and she did so with exuberance!

Indeed, there is something special about Brianna that is felt by her whole community; without words she connects with others easily. Kristi felt it. In the middle school cafeteria, she observed staff and classmates light up to greet her. “At lunch all kinds of kids were laughing and coming to sit down next to her. One girl came over and noticed her head had fallen forward and then repositioned her to her headrest! It was obvious the kids and teachers loved her.”

The Dynavox, Kristi saw, could potentially provide Brianna with more expressive communication, but her motor and visual impairments would make using it a challenge. Navigating the display with a finger or a joystick was not an option. Brianna needed the device to scan each button, highlighting choices one at a time until she could make a well-timed selection. Most challenging would be finding a switch she could use to trigger what she wanted to say. While Brianna could push her arms forward, she could not pull them back to release a mechanical switch.

The AT Regional Center’s Short-Term Device Loan program, however, is designed to solve problems like Brianna’s. The Short-Term Device Loan program allows individuals, families, and professionals to see and try out a range of device options before making a purchase. On inventory in Boston, for example, are mechanical switches, sensor switches and proximity switches; each may be borrowed for up to four weeks at a time.

Since Brianna has the most control over her facial muscles, Kristi began by loaning her the Enablemart Sensor Switch Kit and a very simple AAC device, the AbleNet Step-by-Step. The switch kit contains disks that can be placed on muscles such as the cheek or eyebrow. The Step-by-Step has a one button display that would help Brianna get started.

School staff soon found, however, that applying sensors to Brianna’s face meant she could not smile without triggering messages on the Step-by-Step (and not smiling was not an option!) So, next, Kristi loaned them the SCATIR proximity switch. The SCATIR is activated by breaking an infrared beam.

SCATIR switch

The trick, Kristi says, was figuring out how to mount the switch so Brianna could blink her eyes to trigger it. The SCATIR comes with options for using the infrared switch on a gooseneck mount; and there is a separate piece that can be placed on eye glass frames. Although the gooseneck did not work, Kristi had a pair of old wire eye glass frames to try. The frames were a little big, but Brianna was able to activate the switch with eye blinks. Brianna was on her way!

Finding Brianna the right switch took trial and error and the ability to borrow equipment for an extended period of time. Allowing the school to try out different switches in different environments and configurations was essential. The school had already purchased a mechanical switch and could not afford another mistake, exactly what the AT Regional Center is designed to prevent.

Happily, Brianna took to the SCATIR switch. Indeed, her final request for Kristi and her school team (accomplished through responses to yes/no questions) was for a pair of pink eye glass frames to personalize her look!

These days Brianna works in spurts, as learning to use AAC is hard work. Her teachers reward her with High School Musical and Zac Efron (her favorite!) With the help of the AT Regional Center, they are getting to know her better.

Peapod.Com Settles with the Justice Department

The Internet grocer must be accessible by September 30th, 2015!

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On November 17th, Peapod.com and its parent company, Ahold USA, entered a settlement agreement with the Justice Department over alleged violations of the Americans with Disabilities Act (ADA). Under the agreement, Peapod must ensure users with disabilities "are able to fully and equally enjoy the various goods, services, facilities and accommodations provided through www.peapod.com" (DOJ Press Release).

This is good news! Peapod is a leading Internet grocer serving twelve states in the Midwest and on the East Coast as well as the District of Columbia. Yet its website and mobile applications have not been accessible for many users with disabilities including individuals who are blind or have low vision, individuals who are deaf or hard of hearing, and individuals who have physical disabilities that impact the ability to use a mouse. The agreement requires Peapod to ensure its site is compliant with Web Content Accessibility Guidelines (WCAG) 2.0 by September 30th, 2015. The site, for example, must be navigable with a keyboard, provide captioning of video and be useable with assistive technologies such as screen readers and refreshable Braille displays. The deadline for Peapod's mobile applications is earlier: March 31, 2015!

In addition, the agreement calls for Peapod to provide a toll free telephone number to assist Peapod.com visitors who experience accessibility difficulties (due within 90 days... late February).

Stay tuned! Visitors and users will be invited to provide accessibility feedback.

Read the full settlement agreement (PDF)

New Resource: ToyBox Tools!

Hasbro and the Autism Project provide a website for making the most out of playtime

Hasbro Toybox Tools logo

Here's a new resource to know about just in time for the holidays! Toybox Tools is dedicated to making play accessible. Hasbro and the Autism project have collaborated with teachers and occupational therapists to learn how classic Hasbro toys (Play-Doh, Playskool, Mr. Potato Head, etc.) are being deployed in the field to support children who learn and play differently.

The site provides tools for use with Hasbro toys: instructional videos, printable materials, and play-mats "designed to help families, caregivers and teachers unlock the power of play and to make play more fun and enjoyable at a child’s own pace."

Check it out at toyboxtools.com!

GetATStuff Highlights

Get A.T. Stuff logo: Assistive Technology Exchange in New England and New York. Shows recycling arrows around the states.

The Assistive Technology Exchange in New England is now the Assistive Technology Exchange in New England AND New York! GetATStuff has welcomed New York as a new state partner which means access to more equipment from and for more people! GetATStuff is the "Craig's List" for AT. Currently there are hundreds of items posted as for sale or free.

As of this writing, GetATStuff highlights include:

  • 4 Vision-related items, including a new BrailleNote Apex BT 32 Cell notetaker for $4,396 in Montague, MA.
  • 1 Hearing-related item: a Superprint 4425 TTY for $410 OBO in Rochester, NH.
  • 2 Speech Communication-related items, including Dynavox Eyemax eyegaze device for $300 in Wilbraham, MA.
  • 65 Mobility, Seating, and Positioning related items, including a Shoprider Sprinter XL 4 Wheels Delux Scooter for Free in Haverhill, MA.
  • 63 Daily Living related items, including a Snug Seat Pilot special needs high-back booster seat for $40 in Whitinsville, MA.
  • 15 Environmental Adaptation related items, including a Brooks Stair Lift for Best Offer in South Burlington, VT.
  • 7 Transportation and Vehicle Modification related items, including a hydraulic pushbutton lift for $500 in Levant, ME.
  • 4 Computer-related items, including a Footime foot mouse with programmable peddle for $99 OBO in Rochester, NH.

Go to GetATStuff to search items by category or geography or to list what you need. Looking for a wheelchair? Scooter? Rollator? Or other gently-used durable medical equipment? Be sure to check out REquipment!

Learn about additional AT reuse sites.