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Professional Credentialing and Assistive Technology.

What Parents Need to Know

When I bring my car in for repairs, I assume the mechanic has the training to do the job right An incorrect assumption may lead to a lot of wasted time and money! When your child needs assistive technology services and equipment, you want the best. But how can you be assured that you are getting qualified help?

Assistive technology services and equipment are provided by a wide variety of people with an even wider variety of educational backgrounds and experience. I have known wheelchair suppliers whose only previous work experience was at the local fast food restaurant before they began telling consumers that they provide seating evaluations! So how do you know who was flipping hamburgers two weeks ago and who is a leader in their field? Assistive Technology Credentials can help.

What is an Assistive Technology Credential?

The Rehabilitation Engineering and Assistive Technology Society of North America (RESNA) has developed the only credential program for service providers in the area of assistive technology. Two separate certifications are offered: Assistive Technology Practioner (ATP) and Assistive Technology Supplier (ATS). ATPs generally provide assistive technology evaluation, training, and education. ATPs often have a background in occupational therapy, physical therapy, speech-language pathology, engineering, or education. Assistive Technology Suppliers are suppliers who are involved in the sale and service of commercially available assistive technology equipment.

The areas of assistive technology addressed in the RESNA program include: positioning, wheeled mobility, computer access, work-site accommodation, augmentative and alternative communication (AAC), and electronic aids to daily living (EADLs)--also known as environmental controls). The examination focuses on appropriate evaluation, training, implementation, service delivery, and ethics.

Several other organizations offer assistive technology courses that provide a certificate of completion. This is very different than the RESNA credentialing process. To earn the RESNA credential, the applicant must meet minimum eligibility requirements (education and experience) to qualify to sit for a written examination. The applicant must then sit for a comprehensive examination. Upon passing this exam, the applicant must agree to abide by the standard of practice, to which all credentialed service providers are held accountable. The candidate is then granted the ATP or ATS credential and may then use these initials after his or her name.

Those people who have passed both examinations are dual certified as both an ATP and an ATS. The ATP or ATS must also meet continuing education requirements to be re-certified, to ensure continued competence. RESNA is currently developing a certification program in rehabilitation engineering and rehabilitation engineering technology. The first exam will be administered in 2001. The cost of the examination is $500. The various courses that provide continuing education units towards re-certification range from flee to several hundred dollars. Finally, being re-certified costs an additional $75.

Why should I seek an ATP or ATS to help me with assistive technology?

The certification is designed to increase consumer satisfaction and provide a consumer safeguard. This is particularly important in the area of assistive technology, since the educational backgrounds and level of experience vary so much between both providers and suppliers. While working with an ATP or ATS does not guarantee satisfaction, certification demonstrates the service provider's commitment to the field and baseline foundation knowledge. Just as a certified master plumber is not guaranteed to unclog your drain, he or she should be more competent than your uncle Harry.

Jimmy(*) is 13 years old and has Duchenne muscular dystrophy. He went to a physical therapist at a local clinic to be evaluated for power mobility, as he was no longer able to push his manual wheelchair by himself The therapist recommended a scooter. Jimmy was able to try one out in the clinic and did quite well. Unfortunately, within a year, Jimmy was no longer able to drive the scooter. His arms were too weak to hold the handlebars and squeeze the triggers to move the scooter. He needed more supportive seating, which the scooter could not accommodate. When the physical therapist then recommended a power wheelchair, it was denied because the scooter was less than one year old. With the knowledge base and experience required to be certified, an ATP would have known to recommend not only a power wheelchair, but one that could be retrofitted with a power tilt system (to provide pressure relief and comfort as Jimmy's condition worsened) and that could support more than one way of driving (in case he could no longer control a joystick).

How do I find an ATP or ATS in my area?

The RESNA Web site has a list of all ATPs and ATSs by state. You can also contact the RESNA national office (see Resources for information). Not every ATP or ATS works with all types of assistive technology. Some ATSs only work with wheelchairs for adults. Some ATPs may only work with computers and communication devices in the school. Central to the RESNA Standards of Practice is for a service provider to refer to others when a client's need is outside the ATP's or ATS's area of competency. A local credentialed service provider can direct you to the most appropriate person if your needs are outside of his or her practice area.

What if my funding source will not cover services from that person?

Contact your funding source and let them know about the certification process or encourage them to contact RESNA for more information. Using an ATP for evaluation helps to ensure an appropriate equipment recommendation, the first time, thus saving money in the long run for the funding source. Using an ATS to supply the equipment helps to ensure appropriate equipment provision and service.

Sally(*) is 13, and her insurance company paid for three new wheelchair seats in three years. Now Sally's doctor says she needs yet another one. Looking for a way to change the situation, the insurance company referred Sally to an ATP, hoping that this certification would lead to a better and longer-lasting recommendation. A comprehensive evaluation was performed and a new seating system was recommended. This time, however, the seat has already lasted three years and is still meeting Sally's needs with adjustments for growth.

Are ATP services available in my child's school?

More and more school-based professionals are pursuing the ATP certification. You can check with your school district to see if these services are available. School-based services require not only determining the most appropriate modifications, such as an alternative computer mouse, but also appropriate implementation, working with the entire educational team. An ATP should be aware of the needs of the student and the environment of use, as well as the technology options which may meet the need.

Rosie,(*) 8, has a metabolic disorder which effects her fine motor skills. Rosie is unable to write, and using the standard keyboard and mouse is difficult for her. However, she is quite verbal. Her teacher recommended that the family purchase a voice-recognition program. The family did so and were excited to think how much this would help Rosie in the classroom and at home. As a comprehensive evaluation was not done, no (me realized:

* the program was not compatible with any of the school's computers;

* Rosie could not use the program in the middle of her class without distracting her classmates;

* the family needed training in how to use the program; and

* Rosie was too young to effectively use this complex system.

An ATP could have provided an evaluation for appropriate solutions and assisted with implementation.

What happens if I receive poor service from an ATP or ATS?

The certification process is run by the Professional Standards Board (PSB) of RESNA. This Board monitors the entire certification process, including complaints. If you have concerns about the service or equipment you were provided, you can contact the PSB through the RESNA office.

Why should providers or suppliers of assistive technology consider certification?

Certification has many advantages for a provider or supplier of assistive technology. These include referrals, reimbursement, and employment. Many ATPs/ATSs have noted an increase in their referrals as consumers are seeking out qualified services. Some funding sources will only pay for evaluations or training services if these are provided by an ATP. The same is true for equipment. Some funding sources will only purchase from a company who has certified staff. Finally, this certification is an excellent item on a resume, providing external support of your commitment to the field and your mastery of the foundation knowledge needed to provide client-centered service delivery.

Joanne,(*) 15, needed a new seating system. After an evaluation with an ATP (an occupational therapist), a custom-molded system was recommended. Joanne's insurance would only use Supplier A to provide this equipment. Supplier A did not make this particular type of seating system. The therapist contacted the insurance and told them Supplier B made the required system and asked for permission to use this company. The insurance company refused on the basis that this was only the therapist's opinion. The therapist then went on to explain that Supplier B had several ATSs on staff certified by an outside agency as being competent. The insurance used Supplier B.

I provide wheelchairs. Why should I have to pass a test that covers all those other areas of assistive technology?

Assistive technology has a lot of cross-over. Persons exploring the use of technology to achieve their goals are whole people, often with multiple functional needs. Service providers need to be aware of the whole picture. Work with a team and refer to others as the needs of the person indicate.

Communication devices can be used as an alternative computer keyboard. The computer can be used to control devices in the environment. A power wheelchair can be interfaced electronically with other assistive technology, so that the same switch used to make a right turn can control scanning on a communication device. That same communication device needs to be mounted properly on the wheelchair. With all this cross-over, anyone providing assistive technology services and equipment needs to at least be familiar with the big picture.

Paul,(*) 17, has cerebral palsy. He uses a power wheelchair, power tilt system, communication device, computer, and electronic aid to daily living (a central control for electronic devices, like TV and radio). However, he can only use four switches. Through interfacing, he can drive with three switches and use the fourth as a reset. The reset switch chooses his operating mode--driving, tilting, or accessing his communication device. His communication device is interfaced to a computer to allow computer access. His communication device is also interfaced to the electronic aid to daily living, allowing him control of his TV and radio. This complicated set-up required competent evaluation by a provider and competent interfacing of the equipment by a supplier. In this case, both were certified.

Certification is not a guarantee of optimal recommendations, equipment, and implementation. The RESNA credential, like many other voluntary, professional credentials, provides consumers with external, objective assurance that a provider or supplier has met certain requirements in base knowledge and in experience.

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(*) Although names have been changed to protect anonymity, these represent actual cases.

Michelle L. Lange, OTR, ABDA, is Clinical Director of the Assistive Technology Clinics of The Children's Hospital of Denver. She is Member at Large of the RESNA Board of Directors. She is the Editor of the Technology Quarterly for the American Occupational Therapy Association.
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Title Annotation:What Parents Need to Know
Author:Lange, Michelle L.
Publication:The Exceptional Parent
Geographic Code:1USA
Date:Nov 1, 2000
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