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Download Tech Assessment Checklist in RTF (61K)

Student Name _______________________ Date of assessment _____________

Person Completing Checklist _______________________ Position ______________________

During this assessment, informal measures were utilized to evaluate the student's ability to access print, produce written communication, access the computer and use various assistive technologies. Some of the information requested may be obtained from the Learning Media Assessment, the Clinical Low Vision Evaluation or the Functional Low Vision Evaluation.

Accessing Print

Regular Print

When accessing printed information, the

_____ Student is able to read regular print materials at _____ inches without adaptations.

_____ Student is able to read regular print materials with adaptations.

_____ using prescribed glasses or contacts

_____ materials enlarged on photocopying machine - Specify (i.e. 130%, 3 times) __________ Student is able to read regular print materials with or without adaptations for _____ min before experiencing either visual or physical fatigue.

Large Print

When accessing large print with prescribed optical aid (if appropriate) the student is able to read

72 point print at approximately _____ inches.
60 point print at approximately _____ inches.
48 point print at approximately _____ inches.
36 point print at approximately _____ inches.
30 point print at approximately _____ inches.
24 point print at approximately _____ inches.
18 point print at approximately _____ inches.
14 point print at approximately _____ inches.
12 point print at approximately _____ inches.

Student's font preference ___ Arial, ___ Antique Olive, ___ Tahoma, ____ Verdana

Student's preferred point size without prescribed optical aids.

___ 14 ___ 18 ___ 24 ___ 30 ___ 36 ___ 48 ___ 60 ___ 72

Optical Aids

When accessing printed materials with the use of an optical aid, the student is able to use

_____ glasses _____ contact lens

_____ hand held/stand magnifier, power _____

_____ telescope, power ________

Closed Circuit TeleVision (CCTV)

_____ inch graphic _____ inch text on a _____ inch monitor at approximately 13 inches

polarity preference: _____ dark on light _____ light on dark

color combination preference (if available) ______________________________

Use of CCTV controls - The student is able to:

_____ adjust size of image.

_____ focus image.

_____ independently use X/Y table for viewing materials with friction brake and margin stops adjusted by examiner.

_____ write name and a short sentence legibly on regular writing paper.

_____ write name and a short sentence legibly on bold line paper.

read approximately _____ wpm orally when the friction brake and margin stops are adjusted properly by the examiner.

_____ read the sentence he/she wrote on regular writing paper.

_____ read the sentence he/she wrote on bold line paper.

Use of the VisAbility program with optical scanner connected to computer

preferred magnification ____ for viewing at approximately 13-16 inches

polarity preference: _____ dark on light _____ light on dark

color combination preference _________________________________________

Use of VisAbility features - The student was able to:

_____ select menu items and tools from the toolbar with the mouse.

_____ navigate around the magnified image with the mouse.

_____ read text in the panning/review mode with a speed setting of _____.

Non-Optical Aids

When accessing information through the use of non-optical aids, the

_____ student reads materials produced with felt tip pen on bold line paper.

_____ student prefers ___ incandescent lighting, ___ flourescent lighting ___ window lighting.

_____ student experiences glare problems from ___ overhead lighting ___ window lighting

_____ student prefers less lighting than currently available.

_____ student prefers to have materials placed on a reading stand or copy holder.

Braille and Tactile

When accessing information through braille and tactile graphics, the

_____ student is able to use simple tactile graphics.

_____ student is able to read materials in braille. Attach results of formal/informal Braille Assessments conducted by TVI.

_____ student's oral braille reading rate is _____ wpm

_____ student is able to read braille on an electronic/refreshable braille display.

Auditory

When accessing printed information auditorally, the

_____ student is able to demonstrate comprehension by answering simple questions & relating details about a passage when it is read to him/her.

_____ student is able to paraphrase information presented orally (sentence or story.)

_____ student is able to write, type, or braille what he/she heard (sentence dictation) without having it repeated more than twice.

_____ student is able to put tape in and remove tape from player/recorder.

_____ student is able to activate play, pause, stop, fast forward and rewind functions (please underline those demonstrated.)

_____ student is able to understand and comprehend compressed or "fast" speech.

_____ student is able to manipulate variable speed and pitch controls.

Reading Rates

(This is an optional section used when needed to demonstrate to the student, parents, teachers or administrators the benefits of using adaptations when reading.)

When reading printed information, the

student is able to read _____ wpm orally when provided with 12 point materials.

student is able to read _____ wpm orally when provided with materials in the optimum size for viewing at 10 -13 inches (_____ point print.)

student is able to read _____ wpm orally when using a CCTV.

student is able to read _____ wpm orally when using VisAbility.

student is able to read _____ wpm orally when provided with materials in braille.

student is able to read _____ wpm orally when provided with recorded materials.

Other

When using a large print calculator, the

_____ student is able to see _____ inch numerals displayed on a large print calculator.

_____ student is able to accurately manipulate keys on a large print calculator.

student is able to perform basic functions ___ with, ___ without instruction.

When using a talking calculator, the

_____ student is able to understand synthesized speech produced by a talking calculator.

_____ student is able to accurately manipulate keys on a talking calculator.

student is able to perform basic functions ___ with, ___ without instruction.

When using a talking dictionary, the

_____ student is able to understand synthesized speech produced by a talking dictionary.

_____ student is able to accurately manipulate keys on a talking dictionary.

student is able to perform basic functions ___ with, ___ without instruction.

When accessing information presented on black board or overhead projector, the student reported that he/she

_____ sits close enough to read board.
_____ gets a copy from the teacher
_____ gets a copy from other students.
_____ uses a hand held or spectacle mounted telescope
_____ has information read aloud to student and
_____ writes information on paper
_____ types information into computer or portable note taker.
_____ brailles on braille writer
_____ records on tape recorder.
_____ Other, please specify ________________________________________________

Are these options working adequately? ___ yes ___ no Explain briefly: ______________

________________________________________________________________________

Producing Written Communication

When using standard writing tools, the

_____ student's manuscript writing is legible.
_____ student's cursive writing is legible.
_____ student's spacing is intact.
_____ student's writing is labored and difficult.
_____ student is able to write _____ wpm from ___ dictation, ___ copy.
_____ student is able to read his/her own writing.
_____ student is able to sign his/her name legibly in cursive ___ with, ___ without a signature guide.

When writing with the following adaptation the student's _____ manuscript, _____ cursive writing is legible.

_____ a screen board _____ bold line paper
_____ raised line paper _____ a felt tip pen
_____ a white board and erasable marker
_____ Other modifications _________________________________________

When using a braille writing device, the

_____ student is able to use a manual braille writer to emboss characters, words and sentences at ___ wpm from ___ dictation, ___ copy.

_____ student is able to use the slate & stylus to emboss characters, words and sentences at ___ wpm from ___ dictation, ___ copy.

_____ student is able to use the MountBatten brailler to emboss characters, words and sentences at ___ wpm from ___ dictation, ___ copy.

_____ student is able to use a portable note taking device such as the Braille 'n Speak to enter characters, words and sentences at ___ wpm from ___ dictation, ___ copy.

When using an electronic writing device, (computer, portable note taker) the

_____ student is able to write characters, words and sentences.

_____ student is able to perform basic functions ___ with, ___ without instruction from the examiner.

Comments: _________________________________________________________________

_____________________________________________________________________________

_____________________________________________________________________________

Computer Access

Visual

When accessing electronic information on a stand alone computer or in the computer lab, the

_____ student is able to read menus and other system text items on a _____ inch monitor at approximately _____ inches.

student was able to read bold _____ point print in an ___ Arial, ___ Antique Olive, ___ Tahoma, ___ Verdana font displayed on a _____ inch monitor at approximately 13 inches.

student is able to see information on the standard computer monitor with

_____ screen magnification hardware (Compu-Lenz) at approximately ____ inches.
_____ flexible arm monitor stand at approximately _____ inches.
_____ screen enhancements provided with computer operating system
_____ WIN 95/98 High Contrast
_____ WIN 95/98 Large
_____ WIN 95/98 Extra Large
_____ screen magnification software with _____ magnification

When accessing the computer through the use of screen magnification software, the

_____ student is able to read 12 point print enlarged to _____x magnification at a viewing distance of approximately 13 inches.

_____ student expressed a polarity preference for; _____ dark on light, _____ light on dark.

_____ student is able to locate and select menu items, buttons and icons with the mouse/pointing device.

_____ student is able to navigate around the magnified image with the mouse/pointing device.

student ___ is, ___ is not able to maintain orientation when navigating around the screen.

_____ student is able to read text in the panning/review mode with a speed setting of _____.

_____ student expressed a viewing mode preference. Specify ___________________________

_____ Student is unable to access the computer visually.

Auditory

When accessing computer based information auditorally, the

_____ student is able to understand synthesized speech produced by

Software synthesizer

_____ Kids Time Deluxe _____ Write Outloud _____ Other

_____ Flextalk _____ TrueVoice

_____ Dectalk Access 32 _____ Eloquence

Hardware synthesizer

_____ Braille/Type 'n Speak _____ Double Talk _____ Other

_____ Accent SA _____ Dectalk

_____ student is able to execute navigation commands with instruction.

Tactile

When accessing computer based information tactually, the

_____ student is able to read braille text displayed on an electronic refreshable braille display.

_____ student is able to execute navigation commands with instruction.

_____ student is able to enter text through the braille keyboard.

Input Devices

Keyboard Use

_____ The student is able to use a standard keyboard without adaptation.
_____ The student is able to locate and identify alphanumeric keys.
_____ The student is able to locate and identify function keys.
_____ The student is able to activate two keys simultaneously.
_____ The student does not demonstrate excessive miss-hits or key repeats.
_____ The student uses good mechanics when typing. (Posture, wrist elevation, etc.)
_____ The student types with ___ fingers of right hand and ___ fingers of left hand.
_____ The student demonstrates keyboard awareness (has a general knowledge of the key locations).
_____ The student is able to touch type while looking at his/her hands.
_____ The student is able to touch type without looking at his/her hands.
_____ The student is able to utilize a standard computer keyboard with adaptations. (Seek assistance from occupational and physical therapist as needed.)

_____ zoom caps _____ keyguard _____ finger guard/pointer

_____ keylatch _____ wrist/arm support _____ head pointer

_____ moisture guard _____ tactile locator dots _____ mouthstick

_____ other Specify _____________________________________________________

The student is able to utilize a standard computer keyboard with the following keyboard utilities. (Seek assistance from general technology specialist, OT or PT to complete this section.)

__ sticky keys __ repeat keys __ slow keys __ toggle keys __ mouse keys _____

_____ The student is not able to utilize a standard keyboard with or without adaptations. (If checked, refer student for a Computer Access Evaluation.)

Use of a Pointing Device

_____ The student is able to navigate the desktop with the standard mouse/trackball.

_____ The student is able to maintain the mouse position while clicking/double-clicking.

_____ The student is able to maintain eye contact with the screen while navigating the desktop.

_____ The student is able to access pull-down menus with the standard mouse.

_____ The student is not able to use a standard mouse. (If checked, please request a Computer Access Evaluation.)

Additional Assessment Information: _________________________________________________
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Recommendations for Assistive Technology

Based on the results of this assessment, the following recommendations are made regarding assistive technology to support this student's educational objectives.

Accessing Printed Materials (Students with visual impairments will use a combination of strategies to access printed information. Some will be appropriate for short reading assignments and others will be necessary for longer passages.)

Check all that apply

_____ Student should use regular print materials for
_____ short reading assignments.
_____ most reading assignments.

_____ Student should use regular print materials with optical aids.
_____ glasses/contact lenses
_____ hand held magnifier
_____ stand magnifier

_____ Student should use materials written with felt tip pen on bold line paper.

_____ Student should use regular print materials enlarged on a photocopying machine.

_____ Student should use large print books.

_____ Student should use regular print materials scanned into a computer, edited and printed out in ______ point print.

_____ Student should use regular print materials with CCTV (Closed Circuit TeleVision).

_____ Student should use regular print materials with the VisAbility program.

_____ Student should use materials in braille.

_____ Student should use recorded materials.

_____ Student should use a computer assisted reading system such as Kurzweil 1000, Open Book, etc.

_____ Student should use a ___ basic, ___ scientific calculator with at least 1/2" numeral display.

_____ Student should use a ___ basic, ___ scientific talking calculator.

_____ Student should use calculator program on computer.

_____ Student should use a large print dictionary with at least 18 point print.

_____ Student should use dictionary/thesaurus program on computer.

_____ Student should use a talking dictionary

_____ Student should use crayons and a screen board to develop basic tactile skills using tactile graphics.

_____ Student should use tactile graphics to access maps, charts, diagrams, etc.

Comments: ____________________________________________________________________

______________________________________________________________________________

Producing Written Communication (Students with visual impairments will use a combination of strategies to produce written communication. Some will be appropriate for short writing assignments and others will be necessary for longer assignments.)

Check all that apply

_____ Student should use pen/pencil and paper

_____ for short writing assignments.

_____ for most writing assignments.

_____ Student should use felt tip pen and bold line paper.

_____ Student should use bold line graph paper for math.

_____ Student should use crayons and a screen board for beginning handwriting.

_____ Student should use a white board with erasable markers.

_____ Student should use a computer with the word processing software most commonly used in the student's school.

_____ Student should use computer with form filling software such as VisAbility.

_____ Student should use manual braille writer.

_____ Student should use manual braille writer with extended keys.

_____ Student should use a unimanual braille writer.

_____ Student should use slate & stylus.

_____ Student should use an electronic braille writer. Specify: __________________________

_____ Student should use portable word processor (Braille 'n Speak/Type 'n Speak, etc.)

Comments: ____________________________________________________________________

______________________________________________________________________________

Computer Access

Input Method

_____ Student should use a standard keyboard.

_____ Student should develop/improve keyboarding skills.

_____ Student should use a standard keyboard with adaptations. Specify __________________

_____ Student should use an alternative keyboard. Specify _____________________________

_____ Student should use a standard pointing device like a mouse or trackball.

_____ Student should use an alternate point device. Specify ____________________________

_____ Student should have access to a copy holder that allows printed materials to be positioned at a comfortable viewing distance.

Output Mode

_____ Student should use a standard computer monitor - Optimal size: ___________________

_____ Student should use a standard computer monitor with hardware adaptations

_____ adjustable monitor arm _____ Compu Lens

_____ Student should use screen magnification software

_____ CloseView _____ inLARGE _____ WIN xxx Accessibility enlargement

_____ Dedicated screen magnification software - Specify ________________________

_____ Student should use a talking word processor. Specify ___________________________

_____ Student should use a speech synthesizer/sound card and screen reading software. Specify

________________________________________________________________________

_____ Student should use an electronic braille display. Specify _________________________

Additional Hardware & Software

Student should be provided with access to the following hardware & software;

_____ Macintosh computer system with

___ Mb memory ___ hard drive ___ CD drive ___ modem

_____ IBM compatible computer system with

___ Mb memory ___ hard drive ___ CD drive ___ modem

_____ Optical Scanner ___ Printer

_____ Word processor used in student's school ___ Internet access

_____ CD Encyclopedia ___ Dictionary ___ Atlas

_____ Other: -_________________________________________________________________

Equipment needed to produce materials for student in appropriate format.

_____ Mac or IBM compatible computer system

_____ Optical scanner _____ OCR software

_____ Word processing software _____ Inkjet or laser printer

_____ braille translating software _____ braille embosser/printer

_____ Tactile graphics production equipment, specify _________________________________

Additional comments/recommendations: ____________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

The recommendations made above do not all have to be implemented immediately. The suggestions are designed for a 2 - 3 year plan in which the student masters certain skills and is provided access to additional technologies that can facilitate his/her educational program. During that time, new technologies will become available that will enhance his/her ability to maximize his/her educational potential. The specific devices recommended may no longer be the most appropriate, but the assistance that they provide will continue to be a need for this student.

_____________________________________   ____________________________________
Assessment Completed by (Signature)             Position

This document was developed by This email address is being protected from spambots. You need JavaScript enabled to view it., American Foundation for the Blind, (100 Peachtree Street, Suite 620, Atlanta, GA 30303) Permission to photocopy is granted for non-commercial purposes if this credit is retained.