Brief # 51 – Technology
A Review of Current Assistive Technology Policy in the United States
By M.J. Conaway
June 25, 2021
In the United States, there are several Federal laws that address technology accessibility for people with disabilities, including the American with Disabilities Act, the Telecommunications Act and Section 508 of the Rehabilitation Act. The U.S. Access Board develops accessibility standards for the various technologies covered by the laws, which have been incorporated into the procurement regulations of the Federal government.
Assistive technology (AT) provides devices that help people with disabilities engage in activities of daily living. Examples of assistive technology include communication boards, wheelchairs, and word prediction software. AT facilitates greater independence by allowing people with disabilities to accomplish tasks in all facets of everyday life that would otherwise be difficult or impossible.
There are myriad gaps in various areas relevant to policy development. This includes: identifying evidence useful for policy making; using existing data within policy; generating policy development in an inclusive way; evaluating existing policy according to social inclusion criteria, and; implementing policy, and its monitoring and evaluation by an appropriate range of stakeholders. Too often policymakers in the healthcare sector are totally unfamiliar with disability, impairment or assistive technology issues. Therefore, these officials are unaware of some of the policy challenges in this area .
Generally, the first steps in creating inclusive policy for assistive technology are to connect different communities with an interest in assistive technology; to encourage sharing experiences and best practices, and to simply become aware of the constellation of stakeholders from academia, government, self-advocacy, and various nonprofit organizations. Stakeholders who are often overlooked in these processes generally include self-advocates; Native peoples in areas where their inclusion is often marginalized; rural and/or inner-city people in poorly resourced settings, and; people with intellectual disabilities  for whom assistive technology may be particularly beneficial for community living .
In the scholarly literature, three types of policy gaps have been identified: 1) a Policy Awareness Gap, where policymakers knew little about disability-specific policy instruments (e.g., ADA), and disability representatives knew little about the policy instruments used in mainstream development; 2) a Policy Process Gap, in which there was consultation with disability advocacy organizations, but the final deliverables rarely reflects their primary concerns, and; 3) a Policy Implementation and Monitoring Gap, in which there is a lack of explicit criteria for monitoring and evaluation with respect disability specific concerns.
Engaging in policy often requires understanding the triggers for policy change. While Federal law and the U.S. Access Board can set the context for a discussion on assistive technology policy; such mechanisms by themselves are generally insufficient to propel various Federal agencies, such as the Centers for Medicare And Medicaid Services (CMS) towards policy change. The crux of the matter is to fashion an argument that hooks the attention of government and policymakers. Especially persuasive would be data indicating the socioeconomic benefits and impact of assistive technology. The widespread fragmentation of service delivery, which is often siloed and inviscid with many specialists in the supply chain, is a very expensive way to provide assistive technology. Such fragmentation sorely lacks in equity and distributive justice. Thus, arguments addressing the need for improved efficiency in the delivery system for AT would be helpful. However, policy is often most influenced by financial consequences. Hence, the socioeconomic case for assistive technology must be emphasized by different stakeholders to drive improvements in U.S. assistive technology delivery systems.