title: An access technology delivery protocol for children with severe and multiple disabilities: a case demonstration.
abstract: OBJECTIVE
  This study applied response efficiency theory to create the Access Technology Delivery Protocol (ATDP), a child and family-centred collaborative approach to the implementation of access technologies.
  
  
  METHODS
  We conducted a descriptive, mixed methods case study to demonstrate the ATDP method with a 12-year-old boy with no reliable means of access to an external device. Evaluations of response efficiency, satisfaction, goal attainment, technology use and participation were made after 8 and 16 weeks of training with a custom smile-based access technology.
  
  
  RESULTS
  At the 16 week mark, the new access technology offered better response quality; teacher satisfaction was high; average technology usage was 3-4 times per week for up to 1 h each time; switch sensitivity and specificity reached 78% and 64%, respectively, and participation scores increased by 38%.
  
  
  CONCLUSIONS
  This case supports further development and testing of the ATDP with additional children with multiple or severe disabilities.
authors.affiliation: Bloorview Research Institute , Toronto, ON , Canada .
authors.forename: Leslie
authors.initials: L
authors.lastname: Mumford
authors.forename: Rachel
authors.initials: R
authors.lastname: Lam
authors.forename: Virginia
authors.initials: V
authors.lastname: Wright
authors.forename: Tom
authors.initials: T
authors.lastname: Chau
mesh_terms: D000465:Algorithms; D002648:Child; D003142:Communication; D003143:Communication Devices for People with Disabilities; D002658:Developmental Disabilities / Q000534:rehabilitation*; D006233:Persons with Disabilities; D004867:Equipment Design; D006801:Humans; D008297:Male; D009123:Muscle Hypotonia / Q000534:rehabilitation*; D009788:Occupational Therapy; D010363:Pattern Recognition, Automated; D012656:Self-Help Devices; D012815:Signal Processing, Computer-Assisted; D011795:Surveys and Questionnaires
keywords: Access technology; assessment; assistive technology; communication; provision; service delivery