Advancements of technologies in the areas of mobility, hearing and vision, communication, and daily living for people with intellectual and developmental disabilities has the potential to greatly enhance independence and self-determination. Previous research, however, suggests that there is a technological divide with regard to the use of such technologies by people with intellectual and developmental disabilities when compared with the use reported by the general public. To provide current information with regard to technology use by people with intellectual and developmental disabilities by examining the technology needs, use, and barriers to such use experienced by 180 adults with intellectual and developmental disabilities, we used QuestNet, a self-directed computer survey program. Results suggest that although there has been progress in technology acquisition and use by people with intellectual and developmental disabilities, an underutilization of technologies across the population remains.
Today, technology use permeates virtually every dimension of the human experience: physical, social, emotional, spiritual, occupational, and intellectual (Antón, Silberglitt, & Schneider, 2001) and has changed the way people function in society. Not all people, however, have the opportunities or resources available to obtain and successfully utilize new and developing technologies. Further, technological advancements occur at such a rapid rate that even people who use technology often cannot keep up with technological innovations and advancements. This phenomenon has contributed to the emergence of a technological divide (Burns, 2008), referring to the disparity between people who have access to and subsequently use technology and people who do not. More often than not, people with intellectual and developmental disabilities end up on the side of the divide with others who do not have access to or use technology (Wehmeyer, 1995).
Research shows that increased technology use positively impacts quality of life for people with intellectual and developmental disabilities (Wehmeyer, Smith, Palmer, Davies, & Stock, 2004). Parette (1991) outlined three potential benefits of technology for people with intellectual and developmental disabilities: “(a) the facilitation and automation of therapeutic regimens and educational activities; (b) the provision, restoration, or extension of a person's physical abilities; and (c) the provision of opportunities for greater participation in the mainstream society” (p. 165). Unfortunately, research also shows that technology is appreciably underutilized by people with intellectual and developmental disabilities (The Arc, 1993; Happestad, 2007; Kling & Wilcox, 2010; Wehmeyer, 1995, 1998, 1999). Wehmeyer (1998) surveyed family members of people with intellectual disability about their son or daughter's technology use and found that in the majority of device areas (e.g., mobility, hearing and vision, communication), the number of people with intellectual and developmental disabilities who needed a device outnumbered those who were identified as already using such a device. Contributing factors to underutilization of technology devices by people with intellectual disability included: (a) cost of device, (b) lack of information about device, (c) difficulties in obtaining an assessment, and (d) inadequate training to use the device.
Another barrier to technology use by people with intellectual and developmental disabilities involves the ways in which technology is designed. Despite an emphasis on incorporating universal design features, device design features remain obstacles to their use by people in this population (Mitchandi, 2003; Wehmeyer, Palmer, Smith, Davies, & Stock, 2008). Such barriers may be physical or cognitive. An example is cell phone use. In 2010, the Pew Research Center reported that cell phone ownership across the nation had grown and that people were now using their phones for more than just communication. Compared with data collected in 2009, cell phone users were more likely to use their mobile phones for taking pictures, sending or receiving texts, accessing the Internet, playing games, sending or receiving e-mail, recording video, playing music, and sending and receiving instant messages (Smith, 2010). The proliferation of uses for a single device, however, typically introduces additional complexity. Bryen, Carey, Friedman, and Taylor (2007) found that cell phone use by people with intellectual and developmental disabilities was 27% compared with over 60% of the general population (at the time the study was conducted). Bryen and colleagues found that a significant barrier to cell phone use by adults with intellectual and developmental disabilities involved physical features of phones, such as the small size of the buttons needed to operate most cell phones. Other aspects of design are difficult for users with intellectual and developmental disabilities because of cognitive complexity or confusing design; for example, in many cases one pushes an “End” button to turn the phone both on and off. Most cell phone users can relate to the cognitive complexity of such devices when trying to do tasks such as changing ring tones or retrieving messages; however people with intellectual and developmental disabilities may be challenged by this design feature.
The lack of universal design features and cognitive complexity seriously limit the use of a wide array of technologies by people with intellectual and developmental disabilities. Wehmeyer and colleagues (2004) examined the impact of technology use by people with intellectual and developmental disabilities using Carroll's (1993) first-order domains of cognitive abilities (language, reasoning, memory and learning, visual perception, auditory reception, idea production, cognitive speed, and knowledge and achievement). Within each of Carroll's domains, Wehmeyer and colleagues examined research on utilization and concluded that, in most cases, it is the lack of cognitive access and the failure of devices to incorporate universal design features that acted as barriers to their functional use in the areas of communication, mobility, activities of daily living, environmental control, community integration, education, employment, and sports and recreation.
Recently, Wehmeyer and colleageus (2008) conducted a meta-analysis of single-subject design studies evaluating the use of technology by people with intellectual disability, including an examination of the degree to which the devices examined incorporated features of universal design. By and large, there were few, if any, mentions of universal design features with regard to these evaluation studies. Only flexible use was reported in any particularly high number of studies (26.5%), with every other design feature identified in fewer than 10% of studies.
There has, however, been progress with regard to federal policy and research pertaining to the use of technology by people with intellectual and developmental disabilities across multiple categories. Federal legislation, such as The Silberglitt of 1998 and its subsequent reauthorizations, the Individuals with Disabilities Education Improvement Act of 2004, and the Workforce Investment Act of 1998, focuses attention on the acquisition, training, and use of technology for children and adults with intellectual and developmental disabilities. The Silberglitt of 1998 as amended (P.L. 108-364), often referred to as the Tech Act, funds 56 United States and territories to improve awareness and use of assistive technology to all people with disabilities across the lifespan. In fiscal year 2008, statewide activities performed under the Tech Act programs provided information and assistance to 252,647 indivduals; trained 62,344 professionals, users, and family members; and loaned 53,438 devices (National Information System for Assistive Technology, 2010).
For students, IDEA 2004 requires that developers of all Individualized Education Programs (IEPs) consider assistive technology needs (20 U.S.C. 1414(d)(3)(B)(v)). Quinn, Behrmann, Mastropieri, and Chung (2009) utilized the National Assistive Technology Research Institute's Status of Assistive Technology Use Survey to evaluate the use of assistive technology by students receiving special education services. Of the 682 students surveyed, those with multiple disabilities in self-contained classrooms used assistive technology most frequently. Although limitations due to sampling methodology were cited, the authors were able to identify trends in technlogy use when compared to national statistics of students receiving special education services.
As students transition into adulthood, the Workforce Investment Act of 1998 seeks to coordinate and improve employment outcomes through One-Stop Career Centers that are universally accessible and includes access to technology (Timmons, Boeltzig, Fesko, Cohen, & Hammer, 2007). This act also notes that through the vocational process technology should be considered in job planning, training, and retention. In a review of the literature on assistive technology in the workplace completed over the past 30 years, Sauer, Parks, and Heyn (2010) found positive outcomes for people with cognitive disabilities—including higher rates of accuracy and task completion, generlization of skills, and increased independence—as a result of assistive technology interventions.
It is not within our scope here to comprehensivley review the literature pertaining to application of all new and emerging technologies and people with intellectual and developmental disabilities; however, it might be helpful to provide examples of several recent developments in the application of technology to several functional and life domains. In the area of mobility, Lancioni and colleagues (2008) examined the outcomes of 26 studies in which treadmills were used with body weight supports (Accivatti, Harro, & Bothner, 2006; Dannemiller, Heriza, Burtner, & Gutierrez, 2005; DeJong, Stuberg, & Spady, 2005; Sanders, Begnoche, & Pitetti, 2005) or walkers with microswitches and contingent stimulation (Lancioni et al., 2005; 2007) to increase locomotor behavior of children with intellectual and developmental disabilities and found that, overall, children experienced positive results in locomotor behaviors based on the two approaches. In addition to treadmills and walkers with microswitches, virtual reality has also been used as a mechanism to assess and train children and adults with intellectual and developmental disabilities to use powered wheelchairs. Studies demonstrate marked improvements in skill acquisition when initially introducing people to new mobility devices (Erren-Wolters, Dijk, DeKort, IJzerman, & Jannink, 2007; Harrison, Derwent, Enticknap, Rose & Attree, 2002; Hasdai, Jessel, & Weiss, 1997).
In daily living areas, environmental controls and community integration of technological advancements, such as personal robots as nurses and caregivers, has emerged as a method for increasing independence and decreasing reliance on supplemental staffing (Braddock, Rizzolo, Thompson, & Bell, 2004; Dario, Guglieitmelli, Laschi, & Teti, 1999). Also, Lotan, Yalon-Chamovitz, and Weiss (2009) demonstrated marked improvement in physical fitness as a result of a 5- to 6-week program using mainstream virtual reality systems, such as Sony Play Station.
Finally, electronic and information technologies, such as personal digital assistants and computers, have demonstrated improved outcomes when utilized by people with intellectual and developmental disabilities. Computers and personal digital assistants (PDAs) have been shown to be successfully used by people in this population as supports for a variety of tasks across multiple environments, including emergent literacy (Davies, Stock, King, Woodard, & Wehmeyer, 2008; Hetzroni & Schanin, 2002); improving vocational, transition, and employment skills (Lancioni, Van den Hof, Furniss, O'Reilly, & Cunha, 1999; Riffel et al., 2005; Stock, Davies, Davies, & Wehmeyer, 2006; Wehmeyer et al., 2008); promoting living skills (Davies, Stock, & Wehmeyer, 2002; Standen & Brown, 2005; Standen, Brown, & Cromby, 2002; Tam, Man, Chan, Sze, & Wong, 2005); and providing means for communication (Schlosser & Sigafoos, 2006; Wilkinson & Hennig, 2007), including accessible cell phone use (Stock, Davies, Wehmeyer, & Palmer, 2008).
Given the advancements in the application and availability of technology since prior technology use surveys were conducted, it is important to re-examine the technology-based experiences of people with intellectual and developmental disabiliies and to determine what, if any, changes have occurred in technology use by this population and what barriers remain to such utilization. Further, unlike previous studies pertaining to the use of technology and barriers thereof, in the present study we sought to gather such information directly from people with intellectual and developmental disability through the use of a cognitively accessible, Internet-based, multimedia self-report survey system. Information solicited included (a) device use; (b) assessment procedures; (c) knowledge of available devices; (d) training; (e) device cost; (f) on-going support; and (e) barriers to technology use in the areas of mobility, vision, and/or hearing; computer use; communication; and independent living.
Participants were 180 youth or adults identified as having intellectual or developmental disabilities recruited through the self-advocacy network, described subsequently. Participants were grouped into four age ranges: 17 and younger, 18 to 21, 22 to 39, and 40+. Thirty-two percent of participants were 21 years old or younger, and 68% were above 22 years of age. Males outnumbered females (ns = 94 and 86, respectively) in nearly every age group except for those who were 40 years and older, which included 35 women and 26 men. The majority of the participants indicated that they lived at home (n = 112, 62.2% of the sample), 53 lived alone in their own home or apartment (29.4%), and 15 lived in a group or nursing home (8.3%). Female participants reported that 59.3% were employed, whereas only 46.8% of male participants were employed (see Table 1).
Following survey construction activities, described below, we recruited participants via direct contact with disability advocacy and self-advocacy organizations nationwide. The Self-Advocate Coalition of Kansas, a statewide self-advocacy organization, served as a primary contact for project staff with regard to survey design, implementation, and participant recruitment. Coalition leaders recruited participants by several means, including information distributed at local self-advocacy meetings and the annual state conference; e-mails sent to self-advocacy listservs; and through the national self-advocacy association, Self-Advocates Becoming Empowered, and at their national conference. As we discuss in the Limitations section, this is a convenience sample; therefore, issues such as response rate could not be determined nor were we able to obtain demographic data other than that reported here.
The online survey program, called QuestNet, supports the online collection of data using multiple means to present questions and provide answers and has the flexibility to be used in different ways. Within the QuestNet survey template, respondents are presented one question at a time that can be answered directly by choosing from several icon-driven options. The question is formatted in large font sizes, with the option of clicking an icon depicting the image of an ear so the person can hear the question read aloud. Auditory and visual cues are also provided to enable respondents with intellectual and developmental disabilities to navigate through the survey. Such features include providing an auditory description of the function of any icon if the person held the cursor over that icon (e.g., “Press this button if you want to exit the survey”); hiding specific functions until they are appropriately used (e.g., the next question icon would not appear until an answer had been checked); providing large radial check boxes in which to click; giving verbal directions for responding to each item; and using pictorial representations of each button's function as the icon (e.g., an ear for hearing the item or response read aloud, a red stop sign for exiting).
In a pilot study of the system, Stock, Davies, and Wehmeyer (2004) found the QuestNet system to be more reliable than a traditional written survey format. They also found that users preferred the QuestNet system as opposed to pencil and paper because it provided people with disabilities a greater level of independence and allowed them to progress through the material at their own pace.
Upon completion of the survey, respondents received a certificate thanking them for their full participation. The QuestNet site provided information for technical assistance, and respondents were given any support needed to complete the survey. Out of the 180 participants, 42.2% (n = 76) indicated that they had someone helping them to fill out the survey, perhaps to provide initial acess to the survey and/or to explain the items.
We designed survey questions under the guidance of a total design method proposed by Dillman (2000) and based items on a previous survey designed and used by Wehmeyer (1995, 1999), with modifications to make the survey more user-friendly for people with intellectual and developmental disabilities. The survey was originally designed as a parent-report survey. Wehmeyer (1995) conducted an extensive review of the literature pertaining to technology use by people with intellectual disability. That search did not identify an extant survey, and project staff constructed a survey based on techology use in multiple domains, including mobility, hearing and vision, communication, home adaptation, environmental control, and independent living as well as computer use. This version of the survey was pilot tested with 80 respondents (Wehmeyer, 1995) and revised accordingly; this was the version used by Wehmeyer (1998, 1999).
We updated the items from Wehmeyer (1995) survey to account for advancements in technology in the intervening years and then reworded them from a parent-report to a self-report version. There were 11 questions soliciting demographic information followed by a series of questions to which participants responded related to five domains in which technology is frequently used, including for mobility, hearing or vision, communication, and independent living. The survey also contained questions about computer use. Respondents were asked about the use of electronic and information technology, such as e-mail, digital cameras, cellular telephones, or PDAs. Finally, we included a question about computer or technology training. Each section (four domains plus the computer use section) contained questions about whether the respondent used technology as a support in that domain. If the person did use technology, respondents were given follow-up questions about which devices were used; what training was available and who provided that training; what problems they experienced using the device and, if problems existed, what supports were in place to address those problems; and what maintenance issues existed. If the respondent answered no to the question as to whether he or she used technology as a support in the domain area, then a follow-up question concerned whether they thought that they might benefit from technology support in that area. If the respondent answered no to this query, he or she was directed to go to the next domain area. If the respondent answered yes, he or she was directed to an additional five questions pertaining to what device might be useful and what barriers existed to limit such access at the moment, including cost, knowledge about the device, assessment, or device complexity.
The electronic and information technology section consisted of five questions covering whether the person with intellectual or developmental disabilities used e-mail, a digital camera, a cellular or mobile phone, or a PDA. Representatives from the Kansas self-advocacy group, The Arc of the United States, and AbleLink Technologies (who developed QuestNet) reviewed the survey multiple times and provided feedback. We then finalized the survey and uploaded items into the QuestNet format.
Table 2 provides the number and percentage of respondents who reported some difficulty related to a device-specific area (mobility, hearing and vision, communication, and daily living); the current use of technology in each of the four device-specific areas; and the perceived need of a device in a specific area if the person did not currently have a device. Participants responded to multiple device-purpose areas, if applicable to their situation. Results indicated that 67.2% (n = 121) of respondents experienced difficulties in one or more of the domains detailed in the survey. Overall, respondents identified the use of 120 devices, and 57 respondents indicated a need for a device, across all device-purpose areas, but did not currently have such a device. In addition to difficulties, use, and need, we asked respondents whether they had trouble with learning and memory, as technology has been shown to address these challenges (LoPresti, Bodine, & Lewis, 2008). Forty-seven percent (n = 85) reported trouble in learning new things, and 47% (n = 84) reported problems remembering what they had learned.
To determine device-specific need, we asked participants to respond to the need for multiple devices in the same device-purpose area (e.g., a participant could respond to the need for both a wheelchair and a walker within the mobility domain). The most frequently used device area was mobility (23.3%), and the most frequently identified device used for mobility was a wheelchair (81%, n = 34). Seventeen respondents reported that they used some other mobility device. With regard to hearing and vision difficulties, 23 respondents indicated they used a technology device other than glasses to help them see or hear. Of the 23 respondents, 7 used a text reader; 9 used an adapted computer keyboard; 8 used a hearing aid; and 10 used another unspecified device to help them hear or see. When asked about communication, 13 respondents reported that they needed a device to help them talk or communicate. The most frequently used communication device was one that allowed the person to type in words (66.7%, n = 18). The 13 respondents who did not have but indicated a need for a communication device identified three: a communication system that provides synthesized speech (n = 12), a picture or word board (n = 11), and a computer and keyboard (n = 11).
Finally, 47 respondents indicated difficulty in the daily living device purpose area. This type of difficulty was identified by those who reported physical challenges with their hands. Next, 28 individuals indicated that they used daily living devices to help around their home. Similarly, 28 individuals reported a need for a daily living device. The most frequently reported device was a switch to help turn things on and off (64.3%, n = 18). However, 22 respondents reported that they could benefit from other daily living devices beyond a voice activation device, an eating device, or a switch to turn things on and off.
Barriers to Device Use
Table 3 presents the number of barriers identified for each device-specific area and the total number of times a given barrier was documented for respondents who indicated a need for a device-specific area and for current device users. The most frequently identified barrier for the former respondents was cost (n = 47) followed by assessment (n = 39). The most frequently identified barrier for current users was the occurrence of their technology breaking (n = 67). Mobility devices were cited most frequently as breaking, but when respondents were asked whether they had someone who could assist them if their device breaks, 37 of the 42 respondents with a mobility device responded yes. In addition to the frequency of a device breaking, 53 respondents identified assistance in using their devices as a frequent barrier to use. The complexity of the device (n = 9) and knowledge of how to use a currently owned device (n = 32) were the least cited barriers to technology use. In the areas of communication and daily living, the number of respondents indicating that they did not know what device they needed (ns = 8 and 17, respectively) was greater than the number of respondents who knew what device they needed in these areas (ns = 5 and 11, respectively).
Computer Use and Barriers
Table 4 presents data with regard to use of and barriers pertaining to use of computer technologies. We analyzed the barriers according to current users and nonusers who identified a need for a computer. Overall, 90.6% (n = 163) of respondents reported using computers; 9.4% (n = 17) did not use computers at home, school, or work. Of the 17 people who reported that they did not use a computer, 64.7% (n = 11) reported that they needed a computer for home, school, or work. The most frequently cited barrier for current users was lack of support using the computer when faced with a problem (85.8%, n = 139), while maintenance was cited as the second most frequent barrier (56.4%; n = 92) to computer use. Approximately 50% of respondents (n = 81) indicated the cost of programs and software as a barrier to computer use, and 42.9% (n = 70) reported general problems with the computer as a barrier.
When respondents who did not use a computer but indicated a need listed the barriers to computer use, they cited lack of assistance using a computer as the greatest barrier (81.1%, n = 9). Cost was the second most frequently identified barrier (63.3%; n = 7) for this group, whereas computer complexity and computer knowledge (knowing how to make a computer work) were reported equally as barriers to computer use (45.5%; n = 5).
Table 5 reports the percentage of computer-specific use for current users and nonusers who identified a computer need. Current users reported searching the Internet or World Wide Web as the most frequent reason for their computer use; nonusers identified playing games as the most frequent reason for wanting to use a computer. Respondents who were computer users reported that writing and sending e-mail messages were also prevalent activities when they used the computer. Similarly, nonusers reported e-mail and writing as motives for desiring a computer. Finally, current users identified budgeting as the least frequent reason for computer use, and nonusers identified searching the Internet as the least frequent reason they wanted a computer. Nonusers were not asked whether they would use a computer for work.
Electronic and Information Technologies
Participants were asked four additional questions related to their use of (a) e-mail, (b) digital cameras, (c) cell phones, and (d) pocket computers or PDAs. Sixty-six percent of respondents (n = 142) indicated that they currently had an e-mail account; 34.7% (n = 75), a digital camera; 44.9% (n = 97), a cell phone; and 13.9% (n = 30), a pocket computer or PDA.
Training and Support
Table 5 provides information regarding the person who first trained respondents on the use of their currently owned devices as well as people who currently provided support for each device. We organized results by device-purpose areas. Computer users were added to the table under the information device purpose. It is important to note that respondents in this category did not report who was currently providing support. Family members constituted the largest group providing training for computer use and for hearing and vision devices. Support staff and teachers provided the largest percentage of trainers for mobility and communication devices. Support staff and teachers also represented a large proportion of people providing training for hearing and vision devices. In the daily living device-purpose area, respondents mainly reported that no one trained them to use their current device (42.9%). Overall, family members as a group provided the greatest amount of initial training for device use; staff and teachers were second on the list of initial trainers.
Across all categories except hearing and vision, respondents reported that they did not have a support person to help them use their device. When support was offered, family members provided the most support (42.9%) for daily living devices. On the other hand, family members provided the least amount of support for respondents using hearing and vision devices (13.0%). When support was provided for using communication devices, family members provided the greatest amount of support (29.2%), whereas staff and teachers provided the greatest level of support for hearing and vision devices (43.5%).
Our purpose in conducting this study was to gather information from people with intellectual and developmental disabilities with regard to their self-perceived technology use, needs, and barriers. The QuestNet survey system provided users with multiple representations of relevant questions (i.e., pictures, text, and audio recordings) and applied error minimization techniques to improve reliability and enable and support respondents with intellectual and developmental disabilities to report their experiences with technology.
Before discussing these results, we need to consider the limitations to the study and their implications for interpreting these data and generalizing the study results to the broader population of people with intellectual and developmental disabilities. First, the sample size (N = 180) was limited, and the nature of the data collection (e.g., computer-based) introduced potential bias in the sample. That is, because the survey was conducted online, it is reasonable to assume that the participants are more likely to use technology than are the general population of people with intellectual and developmental disabilities, and, as such, our findings most likely represent a more positive picture than is reality. Exacerbating this issue is that participants were recruitied who were involved with self-advocacy organizations, and this is a population that is probably more likely to use technology than are people with intellectual and developmental disabilities in the general population. Thus, results should be interpreted with caution and likely represent a best-case scenario. Another limitation to the findings is the process by which participants were recruited. Project staff worked collaboratively with a state self-advocacy organization to identify potential respondents, both within the state and througout the national self-advocacy network. This included sending out invitations through self-advocacy meetings, listservs, and at state and national meetings. There is, therefore, no way to determine such issues as response rate and nonresponse bias, though we are presuming that there is a bias in that the respondents may well be heavier technology users than the general population of people with intellectual disability. Finally, we have opted to frame this discussion in the context of previous findings about technology utilization. These previous findings, though, were from parent report surveys. We recognize that we cannot necessarily equate self- and proxy-report measures but believe that it is helpful, nonetheless, to examine the current findings in light of previous findings.
Device Use and Need
Previous studies have shown that people with intellectual and developmental disabilities underutilize technology. Wehmeyer (1995, 1998) found that the percentage of people who needed devices outnumbered those who were currently using devices across all domains except mobility and communication. Although the results of the current study suggest that more adults with intellectual and developmental disabilities are using assistive technologies, there remains an overall underutilization of devices across functional life domains.
The current study results demonstrate that respondents indicating their use of a device in any of the device-purpose areas (mobility, hearing and vision, communication, and daily living) outnumbered those who indicated a need for a device in the same device-purpose area but did not have a device readily available. The one exception to this trend emerged in the area of daily living, where the number of respondents who indicated a need for a device equaled the number of respondents who identified the use of a device. Across domain-purpose areas, we found that 120 respondents reported use of any domain-specific device, whereas 57 respondents indicated they did not currently use, but needed a device.
On the other hand, when the number of respondents who indicated experiencing difficulties in device-purpose areas was compared with respondents who indicated a need or use of a device, we found that the total number of respondents who indicated the need or use of a device was fewer than the total number of respondents who indicated experiencing difficulties in a given functional area. In the areas of hearing and vision and communication, fewer than one-half of the respondents who indicated experiencing a difficulty actually used a device. Further analyses indicated that across all device-purpose areas, 40.2% of respondents indicated experiencing a difficulty in a functional area but did not report either the use or need of a device, suggesting that the number of respondents reporting the need for a device could potentially be underreported and technology even more underutilized by the population than responses would indicate.
The previous survey Wehmeyer (1998) identified mobility devices, communication devices, environmental control/daily living devices, and technologies that allowed for home adaptations as the most frequently used device-purpose areas, in that order. In the current study we found mobility devices to be the most frequently identified device-purpose area, daily living (most similar to environmental control/daily living devices in previous studies) as the second most frequently identified, and communication as the third most frequently identified. Like Wehmeyer (1998) we identified daily living as the most frequently cited device-purpose area for which technology was needed and communication as the second most frequently cited area of need.
Barriers to Use
Again, the results of our study mirror those of past studies concerning barriers associated with technology use by people with intellectual and developmental disabilities. Like past studies, the top barriers continue to be cost, assessment, and information. Depending on the study year, however, these barriers exchange position within the hierarchy. In Wehmeyer's 1995 study, cost and information were reported by parents and caretakers of people with intellectual and developmental disabilies as the greatest areas of need. When Wehmeyer (1998) examined barriers reported on behalf of adults with intellectual and developmental disabilities, information regarding devices was the most frequently reported barrier, followed by cost and then assessment. In 1999, Wehmeyer examined use and barriers of assistive technology by students with intellectual and developmental disabilities. Similarly, the top three barriers emerged again, this time: (a) cost, (b) information, and (c) assessment. In the current study, we found that cost was identified as the most frequently cited barrier followed by assessment and then identification or information about potential devices. Wehmeyer (1995) suggested that there is a relationship between assessment availability and device availability. This finding was supported in the current study, in which we discovered that over one-half of the respondents who identified a need for a device within a device-purpose area also reported a need for an assessment in that area. By examining the trends across a decade of technology advancements and support developments, it appears that people with disabilities continue to face many of the same challenges to availability and use of technology.
In the present study we also examined barriers to technology use reported by people who were technology users in any given device-purpose area. In each category except for daily living, the device breaking and assistance using the device were reported as the greatest barriers to use. In addition to the need for assistance using a device, individuals using daily living devices reported that knowledge on how to use their own home living device was a barrier. Overall, it is evident that barriers to technology use by this population are multifaceted and emerge in phases—those prior to and those following ownership. Thus, support for technology must also be comprehensive, systemic, and inclusive of on-going supports to avoid device abandonment.
Computer Use and Barriers
Results were encouraging as they pertained to computer use by people with intellectual and developmental disabilies. However, caution should be used when interpreting the data because of the nature of the self-report systems for which computers were used. Ninety-one percent of respondents in the study indicated that they had a computer at home, work, or school. This was a significant increase of 35% from the results in Wehmeyer's (1995) study. Also encouraging were results from the percentages of respondents who reported they could benefit from a computer (63.7%) compared with 38% from Wehmeyer (1998).
Of those respondents who currently used a computer at home, work, or school, the majority reported that they used it to access the Internet. Conversely, individuals who were not using a computer but identified that they could benefit from its use indicated playing games as the most frequent reason for using a computer. In past studies, recreation and leisure have been identified as primary reasons for computer use by those people with intellectual and developmental disabilities who could benefit from but lack access to such technology.
Finally, we examined barriers to computer use. The top two barriers related to computer use by those who did not have a computer but identified perceived benefit were tech support (81.1%) and cost (63.6%). In the Wehmeyer (1998) study, cost, training, and complexity were the most frequently cited barriers. When computer users in the present study were asked to identify barriers to use, they recognized tech support (85.8%) and maintenance (56.4%) as the top two barriers.
With regard to questions related to respondents use of (a) an e-mail account, (b) a digital camera, (c) a cell phone, or (d) a pocket computer or PDA, we found a positive trend: 142 respondents (78.9%) indicated that they had an e-mail address. Although computers were more reliably used to play video games, e-mail appears to be a primary mode of communication for our sample. Digital cameras, which were used by fewer respondents (n = 75, 41.7%), are beginning to be utilized for reasons other than leisure (e.g., augmentative and alternative communication devices); as these technologies emerge, it is possible that we will see a surge in their use across disciplines. In this study, 66% of respondents used cell phones; national polls suggest that 69% of the general public use cell phones (Nysteadt, 2006), signifying that people with intellectual and developmental disabilities are using cell phones as frequently as those in the the general public. Finally, pocket computers or PDAs were used least as compared with the other advanced technologies (n = 30, 16.7%). These results are intriguing because there have been several studies in which researchers examined the positive outcomes (e.g., improved independence and productivity) related to the use of PDAs by people with intellectual and developmental disabilities (Bergman, 2002; Davies et al., 2002; Lancioni, O'Reilly, Seedhouse, Furniss, & Cunha, 2000). These results provide further evidence that there is a dire need for dissemination of information regarding the use and benefits of devices such as PDAs and financial supports to acquire them.
Training and Support
Family members were reported most frequently as providing training for computer use (30.7%), and staff and or teachers acted as initial trainers for the device-purpose areas of mobility (31%) and communication (40.7%). Initial training was shared equally by family and staff and/or teachers for hearing and vision devices (34.8%), and “no one” was cited most frequently as initial trainers for daily living devices.
In the three device-specific areas most frequently cited as used by respondents with intellectual and developmental disabilities (i.e., mobility, daily living, and communication), staff and teachers were identified most frequently as providing the initial training. However, when we examined the current supports for these devices, respondents most frequently reported that no one was providing support in these areas. When support was provided in these areas, family members were the ones identified as providing current support. These results suggest that although staff and teachers introduce and initially train individuals with intellectual and developmental disabilities to use devices, families overwhelmingly are responsible for ongoing support, which they may or may not be qualified to provide. With the knowledge gained by these results, we suggest that device system training should include not only the potential user but also an integral family member to ensure ongoing success.
Implications for Policy and Practice
It is evident that although much work has been done over the past decade to increase the availability, training, and retention of technology for people with intellectual and developmental disabilities, barriers still remain that prevent technology use. We address implications for policy and practice through the lens of the three federal policies (The Silberglitt of 1998, the Individuals with Disabilities Education Improvement Act of 2004, and the Workforce Investment Act of 1998) discussed previously.
First, it is important to note that several studies have demonstrated that people with intellectual and developmental disabilities are capable of reliably reporting about their feelings and daily activities (Booth & Booth, 1996; Douma, Marielle, Dekker, Verhulst, & Koot, 2006; Esbensen, Seltzer, Greenberg, & Benson, 2005; Hartley & MacLean, 2006; Mactavish, Mahon, & Lutfiyya, 2000; McVilly, Burton-Smith, & Davidson, 2000) and that proxy reports offer misleading information regarding individuals with intellectual and developmental disabilities (Burnett, 1989; Epstein, Hall, Tongnetti, Son, & Conant; 1989; Jenkinson, Copeland, Drivas, Scoon, & Yap, 1992; McVilly et al., 2000; Sigelman, Budd, Spanhel, & Schoenrock, 1981; Stancliffe, 1995; Wehmeyer & Metzler, 1995). This is not to ignore the fact that there are situations in which proxy reports are necessary to gather pertinent information (Ruddick & Oliver, 2005). To address this conflict, prior to seeking proxy reports, professionals must establish a “conscious presumption of credibility” (Mactavish et al. 2000, p. 225) of self-reports along with the development of multifaceted measurement designs that address the diverse support needs of these individuals. Thus, in the evaluation and administration of supports for technology used in state assistive technology centers, schools, and one-stop career centers, professionals must utilize person-centered approaches (Mirza & Gammel, 2009).
The National Information System for Assistive Technology reported that in fiscal year 2008, 4,459 family members were trained through the state assistive technology centers; however, on the basis of our results it is evident that family member are the first resource for support using technology devices; thus, policies and practices aimed at training families must be improved and implemented across the lifespan, including the training of direct-care professionals.
Finally, the National Educational Technology Plan (2010) outlines the necessity for technology use by our students to “prepare them to be productive members of a globally competitve workforce” (p. 7) through recommendations in five areas: learning, assessment, teaching, infrastructure, and productivity. To advance outcomes in these essential areas, professionals in one-stop career centers must adopt and advance these recommendations to make the transition to the workplace effective and seamless for people with intellectual and developmental disabilities.
Future researchers examining the use of technology by people with intellectual and developmental disabilities should expand the national data related to technologically saavy and novice users. They should focus on self-assessments to identify personal goals and outomes for people across the lifespan. It is also essential to explore technology use and barriers in the workforce to better prepare students and employees to become contributing members of their communities.
This study replicates findings from previous studies that technology is underutilized by people with intellectual and developmental disabilities but also documents that progress has been made in the decade since the last major survey was conducted. It is particularly promising that computer use has increased substantially during this time and that people with intellectual and developmental disabilities are using newer electronic and information technologies, such as cell phones. On the other hand, many of the same barriers to utilization remain, including cost and training, and there appears to be a relatively high percentage of people with intellectual and developmental disabilities who either report that (a) they could benefit from a device in some area of their lives but do not have access to such technology or (b) they have difficulties in a particular functional area but do not believe technology can address such difficulties.
Editor-in-charge: Steven J. Taylor
Emily Shea Tanis, MEd (e-mail: firstname.lastname@example.org), Instructor, Coleman Institute for Cognitive Disabilities, University of Colorado, Boulder, CO 80301. Susan Palmer, PhD, Research Associate Professor, and Michael Wehmeyer, PhD, Professor of Special Education; Director, Kansas University Center on Developmental Disabilities, Senior Scientist Beach Center on DisabilityDepartment of Special Education, University of Kansas, Lawrence, KS 66045. Daniel K. Davies, President, and Steven E. Stock, Vice-President, AbleLink Technologies, Colorado Springs, CO 80903. Kathy Lobb, Self Advocate, Self-Advocate Coalition of Kansas, Lawrence, KS 66046-4079. Barbara Bishop, Executive Director, The Arc of Douglas County, Lawrence, KS 66046-4079.