National statistics (Kraus et al, 1996) indicate that 5.6% of children ages 5-13 have major activity limitations. The profile of cognitive capabilities, limitations and needs within the population of children with physical impairments is not known. An example from the literature on cerebral palsy illustrates the limited information available. The leading cause of disability in children is cerebral palsy with an overall prevalence rate of approximately two per 1,000 live births (Nicholson et al., 1992). In this subset of children with motor impairments, there is some knowledge regarding associated cognitive difficulties including estimates of a 30 to 50 percent rate of mental retardation. However, Warschausky (2006) notes the continued sparse literature on cognitive capabilities of children with cerebral palsy and the large variation in findings depending upon the extent to which assessment techniques were modified to meet optimal response modality needs. It appears likely that the use of sub-optimal assessment techniques has contributed to a general underestimate of the capabilities and absence of specific knowledge regarding the potential cognitive needs of children with cerebral palsy – and possibly other groups of children with severe motor impairments.
Successful transition from school to work is quite limited among persons with severe disabilities. Among persons with difficulty with self-care activities, 25.2% are employed; among those needing assistance with self-care, 18.1% are employed and among those who self-rate their disability as severe, only 8% are employed (McNeil, 1993; NOD/Harris, 1994). One factor in these poor employment rates appears to be lack of education and skills, with lower high school graduation rates for students with severe disabilities, 57.4% vs. 82.4% of people without disabilities, and only a 6% college graduation rate, vs. 22.9% of people without disabilities. The earnings trends indicate a lower rate of income growth for people with disabilities, as well (LaPlante et al., 1992). Females with disabilities have a particularly poor outcome (D'Amico & Blackorby, 1992).
We live in a time in which technological advances are occurring at the most rapid rate in history and the fields of rehabilitation engineering and assistive technology are creating applications that range from relatively simple but useful switching devices to complex direct brain interfaces. Advances in the neurosciences and educational psychology have lead to more precise understandings of the nature of learning as well as specific cognitive impairments and learning disabilities. Yet, current practices in cognitive and academic assessment cannot provide accurate and comprehensive information about the capabilities and needs of a significant proportion of students with severe physical, communicative and/or sensory impairments.
The Individuals with Disabilities Education Act amendments of 1997 addressed general curriculum involvement needs of disabled students and shifted the focus of IDEA to improving teaching and learning with a focus on the individualized educational program as a primary tool for enhancing the child's involvement and progress in the general curriculum. The IEP needs to include a statement regarding the child's present levels of educational performance and how the child's disability affects his or her involvement and progress in the general curriculum. In addition, the IEP needs to include statements regarding special education and related services, aides, program modifications and supports that will be provided as a means of attaining specified annual goals including involvement and progress in the general curriculum, participation in extracurricular and nonacademic activities, and education and participation with other children with and without disabilities. Beginning with IDEA-97, there were provisions requiring the participation of children with disabilities in general state district-wide assessments with appropriate accommodations and modifications, if necessary, and alternative assessments for those who could not participate in general assessment programs.
There are significant concerns that IDEA-97 IEP and alternative assessment requirements are being met according to the letter but not the spirit of the law. Specifically, there are concerns that the IEP has devolved into what Kohler (1998) has termed disability-based planning, with little student involvement. Special education teachers have remained the primary educational planners for students with disabilities with limited cooperation or collaboration with other education or community service providers (Wagner, 1993).
Given the tremendous obstacles facing persons with disabilities in obtaining employment, there has been increasing call for a "transitional perspective" (Kohler and Rusch, 1996) on education. Specifically, rather than regarding transitional planning as an "add-on activity," the transitional perspective provides a fundamental basis for education and programming. In this perspective, there is emphasis on addressing early educational needs that set the stage for subsequent transitional planning. Hence, there is the need to develop services that add to the accuracy, breadth and collaborative nature of current assessment protocols for transitional planning. One means of increasing the self-determinative nature of education would be to more accurately identify effective accommodations and resources for students with disabilities. The ACSESS model demonstration sought to:
- Meet national initiatives to find more effective ways of assessing the educational progress of children with special needs.
- Increase awareness of the limitations of traditional assessment instruments in accurately assessing the skills and abilities for children with significant motoric sensory or communicative impairments and address the need to distinguish carefully motoric and cognitive impairments and capabilities.
- Combine the developments of assistive technology, rehabilitation engineering, and computerized and alternate assessment.
- Develop a model that both incorporates the paradigmatic shift in the concept of disability from a deficit-driven model to the role of environmental/cultural factors and creates an essentially collaborative assessment process.
The use of a model that linked developments in rehabilitation engineering and assistive technology with developments in cognitive assessment is expected to provide both more accurate and more comprehensive assessment of capabilities and needs for optimal participation in the general education curriculum. By developing a model-adapted assessment laboratory within an essentially collaborative and empowering context, the ACSESS demonstration model provided information directly related to consumer-driven goals and needs.