Why does Pediatric VIEW have an Assistive Technology Professional (ATP) as part of the team?
Let’s imagine a quiet Saturday morning in a living room.
Maya & Leo
Maya is a mom who loves story time. She is curled up on the couch with her three‑year‑old son, Leo. They’re reading The Very Hungry Caterpillar for the first time. “On Monday, he ate through one apple, but he was still hungry,” Maya reads, tracing her finger across the words as she says them. She points to the green pear on the page and asks, “Leo, what do you think he’ll eat next?”
Leo leans in and looks at the page, which is full of bright, colorful illustrations. After a quiet moment, he grins. “Pear!” he says with excitement. Maya smiles. Leo proudly reaches for the book, flips the page on his own, and sees two green pears on the next page. His face lights up because he knew his prediction was right. Together they continue through the book, predicting what’s next, turning pages, and discovering what comes next together.
Image 1: This is the first page of The Very Hungry Caterpillar as a predictable flip book.
Moments like these do more than tell a story, and they matter more than we might realize. Long before children learn letters or words, they learn foundational concepts about books. They learn that the pictures and words in a book can convey meaning, and they learn that pages turn to show what comes next. When an adult asks a child to guess what will happen next in a story, the child isn’t just listening to a story. They are active partners in the literacy experience.
But what if the three-year-old has disabilities? What if looking for the pear on the page feels overwhelming? What if reaching to turn the page isn’t a motor skill that the child has developed? Let’s reimagine the same story time for a child with complex needs who uses assistive technology support.
Daniel & Sofia
Daniel settles in for story time with his three‑year‑old daughter, Sofia. Sofia has cortical visual impairment (CVI) and cerebral palsy. Traditional picture books are difficult for Sofia to use because of her vision and motor needs. Typical picture books often have pages with far too much clutter for Sofia. Sofia must work hard to make meaning from the images.
At Sofia’s house, instead of a paper book, Daniel uses an iPad with a digital version of The Very Hungry Caterpillar. The book has been redesigned individually for Sofia by the Pediatric VIEW team as a PowerPoint slideshow. Slide-based instruction (SBI) (Pediatric VIEW, 2020) is one of the many ways that literacy can be adapted for learners with CVI. Each slide shows only one clear image at a time, presented on a backlit screen to support Sofia’s CVI access needs.
“On Monday, he ate through one apple, but he was still hungry,” Daniel reads. He turns to Sofia. “Do you think he’ll eat a different fruit next?” Sofia studies the simple, high‑contrast image in front of her. She pauses, then nods. She reaches, not for the book, but for a bright yellow button next to her that is illuminated by a small light. The button, which is connected to the iPad, allows her to turn pages of the PowerPoint book independently.
The screen changes, and a pear appears. Its most important (i.e., salient) visual features are highlighted in red and presented on a solid black background. Next to the image is the word “pear” shown in Roman Word Bubbling (Roman-Lantzy, 2018). This format makes words easier for Sofia to visually interpret. Sofia beams. Her prediction was right!
Even though the tools look different, the heart of the experience stays the same: Sofia makes a guess, turns the page, and sees the answer for herself. What changes is how she accesses the story — not why they read together. The assistive technology gives her the chance to participate meaningfully and actively in the shared reading experience, just like any other child her age.
Image 2: This is a slide from a PowerPoint book showing a pear with its salient visual features highlighted with no background clutter and the word “pear” shown in Roman Word Bubbling (Roman-Lantzy, 2018).
Image 3: This is a switch that can be connected to an iPad or computer to turn the pages of a digital book.
For many of the children whose access to education is guided by members of the Pediatric VIEW team, assistive technology can open the door for a child with CVI and complex needs. Assistive technology can allow for active, meaningful participation in learning experiences. The story stays the same, but how the child accesses it may look different. The most important visual elements of the book might be shown one page at a time with fewer visual distractions. It might be presented on a backlit screen to make viewing less demanding. The goal of assistive technology is not to change the experience or goal of the activity, but to make the activity accessible.
Assistive Technology & Pediatric Complex Care
Moments like the one described in Sofia’s house do not happen by accident. Creating meaningful access for a child with CVI takes thoughtful planning and an understanding of the following:
- How the child interprets what they see
- The impact of visual impairment on concept development
- Any necessary adaptations or environments needed for the child to interpret visual information
- A child’s communication preferences and needs including how they express choice and feelings
At Pediatric VIEW, the use of assistive technology is focused on creating opportunities for children to actively participate in developmentally appropriate experiences at home and at school. Children with CVI and complex needs deserve the same chances to learn and play as their peers without disabilities. This is why Pediatric VIEW includes an Assistive Technology Professional (ATP) as part of the team. The work of an ATP is focused on ensuring that choices around assistive technology are intentional, meaningful, and built around each child’s strengths and needs.
The ATP certification is a national designation given by the Rehabilitation Engineering and Assistive Technology Society of North America (RESNA), the leading professional organization for assistive technology. To earn the ATP credential, professionals must first document extensive education and thousands of hours of hands-on experience in assistive technology. With training and experience under their belt, they must then pass a rigorous comprehensive exam. Even after becoming certified, ATPs are required to participate in ongoing continuing education to maintain their certification because assistive technology changes quickly. Having an ATP as part of the team ensures that families served by Pediatric VIEW are working with professionals who meet nationally recognized standards for quality, ethics, and expertise.
Image 4: This is the RESNA ATP logo.
The education and experience of an ATP allows them to bring specialized training in understanding how technology, environments, activities, and instructional work together to allow for access. For children with CVI and complex needs, this often means looking beyond traditional definitions of assistive technology and reflecting on the answers to two questions.
What does the child need to be able to do?
What can the child do?
Turning a page independently, making a prediction, showing knowledge, or simply being actively involved in an activity may require thoughtful design and alternative ways of access. An ATP helps ensure that these decisions are individualized, appropriate, and grounded in best practice.
At Pediatric VIEW, assistive technology is used to create inclusion in moments that would be exclusionary without support. The goal of assistive technology is to keep the goal of the experience unchanged while removing barriers that prevent a child with complex needs from participating.
ATP Credential Spotlight: Jonathan Hooper
Jonathan pursued the ATP certification for a variety of reasons. In addition to his love of technology in general, he has seen a pattern emerge related to assistive technology for learners with visual impairment. For learners with visual impairment, technology is often thought of as tools used to provide academic access for learners with visual impairment and no other disabilities. Technology like screen enlargement programs, auditory screen readers, or braille devices are essential tools for those learners. However, assistive technology can open doors for a much larger population of learners – those with complex needs. CVI is the primary cause of severe visual impairment for children in the United States (Good et al., 2001), and most of these learners have additional needs to consider when choosing assistive technology (Blackstone et al., 2021; Blackstone et al., 2022).
Through his work with children with CVI and complex needs, Jonathan observed that access to of daily living was frequently limited not by a child’s ability to think, learn, or engage, but by standard approaches that assumed typical visual access rather than intentionally designing access based on the child’s needs. Throughout his career, Jonathan has been moved by watching how small, intentional changes can dramatically increase a child’s ability to participate independently in activities. Adjusting visual materials, methods, or the adult’s approach to an activity can transform an experience for a child from passive to active.
Earning the ATP is meaningful to Jonathan in many ways. It strengthens his ability to serve the children and families seen by Pediatric VIEW. It also reflects his belief that learners with complex needs deserve adults who continue to learn, refine their practice, and question assumptions in the field. Jonathan views the ATP not as a final achievement, but as part of an ongoing commitment to professional growth.
Citations
Blackstone, S. W., Luo, F., Canchola, J., Wilkinson, K. M., & Roman-Lantzy, C. (2021). Children with cortical visual impairment and complex communication needs: Identifying gaps between needs and current practice. Language, Speech, and Hearing Services in Schools, 52(2), 612–629.
Blackstone, S. W., Luo, F., Barker, R. M., Sevcik, R. A., Romski, M. A., Casella, V., & Roman-Lantzy, C. (2022). Profiles of children with cortical visual impairment who use augmentative and alternative communication: A retrospective examination. American Journal of Speech-Language Pathology, 31, 2707–2721.
Good, W. V., Jan, J. E., DeSa, L., Barkovich, A. J., & Groenveld, M. (2001). Cerebral visual impairment in children. Survey of Ophthalmology, 45(6), 479–509.
Pediatric VIEW. (2020). Slide-based instruction (SBI): A literacy adaptation framework for learners with cortical visual impairment. Pediatric VIEW.
Roman-Lantzy, C. (2018). Cortical visual impairment: Advanced principles. APH Press.
Images of Students Using Tech
