Title: When remediation is not enough
1When remediation is not enough
- Technology for Younger Learnerswith Learning
Disabilities - Presenters
- Kristen OHare, Nipissing Student
- Elaine Beckett-Albert, Nipissing Student
- Mark Giddens, Adaptive Technology Technician
- Mike Walker, Learning Strategist
- Presented to Michelann Parrs AQ class, March 2003
2Presentation Outcomes
- Create a context for this presentation
- Why need we accommodate students with LDs?
- Accommodation, Modification Remediation
- Describe living and learning with a LD
- Student stories meet Kristen and Elaine
- Social, emotional and academic aspects of LDs
- Describe learning disabilities from IP
perspective - A new definition from the LDAO
- Impact on diagnosis and accommodation
- Describe how YOU can help your students succeed
- Conditions and strategies for success
- Briefly review technology for students w/LDS
- The Big Three
- Other Tools
3Our Context the Premise
- Our Desire - we want all of our students to be
able to master the Three Rs and to develop
normally physically, mentally and emotionally. - The Reality approximately 9.4 of our
elementary and secondary students are
exceptional (MET, 1997). - The Result - many of our students will not read,
write or perform other academic tasks
efficiently, despite our best effort and intense
remediation.
4Some Stats . . .
- learning disabilities impact the lives of
approximately 10 of the population - approximately 4 of Ontarios school aged
population is formally identified with LDs - of Ontarios identified exceptional population
- approx. 48 of elementary students are LD
- approx. 54 of secondary students are LD
- 25 to 30 of those with LDs have AD/HD
- 75 to 80 of those with AD/HD have LDs
Sources Weber and Bennett, Special Education in
Ontario Schools, Fourth Edition and LDAC
National, Spring 2000
5Consequently
- In order for many of these exceptional students
to be successful their - skills must be remediated and/or
- learning either modified or accommodated
- Remediation may be needed for the student to
- overcome performance deficits (reading, writing,
speech, motor) - consolidate skills for future learning
- Modification may be needed for the student to
- experience academic success
- maintain motivation to learn
- Accommodation may be needed for the student to
- maintain grade level standards
- broaden future learning opportunities
6However
- Modifications are not an option at the
post-secondary level. - Nor are modifications eligible for high school
credit. - Therefore, accommodation for severe disabilities
may become more challenging and solutions, by
necessity, more sophisticated. - Technology has provided many new tools which may
be used to accommodate students with LDs.
7Remediation
- Should
- provide direct intervention and instruction
- build skills in areas of deficit
- teach strategies to cope in areas of deficit
- But may involve
- withdrawal creating gaps in class learning
- constant repetition and extra work leading to
frustration and fatigue - low-level material leading to low self-esteem
- stigmatization (retard room) leading to
emotional and behavioural issues
8Modifications
- Should
- change curriculum outcomes
- lessen expectations
- make work easier
- shorten assignments
- But
- can lead to learned helplessness
- may be ineligible for high school credits
- do not exist at college/university level
9Accommodations
- Should
- meet learning outcomes/objectives
- keep expectations at grade level
- allow for similar work
- allow for alternative presentation of info,
assignment completion, test taking - Can or Are
- build self-esteem
- eligible for high school credits
- available at colleges and universities
10Meet Kristen
- a student witha Visual Processing Disability
11Meet me and my bisadility
12Why cant you read this?
- Nigissinq Univeristg in North GaG miqht de
detite, dut it is gugging with dotential. - It specialises in training today to be the
teachers students of of tomorrow. - Set among mature, the tool offers a beautiful few
for mutants while they are in mass or while they
are sat launch indoors. - Is this clearer?
13Average StudentAptitude vs. Achievement- normal
scatter (normal differences)
14Student with a LD (Reading)Aptitude vs.
Achievement significant differences
15My Profile - Visual LD (Dyslexia) Aptitude,
Achievement Info Processing
16Welcome to elementary school
- Learning with dyslexia and dysgraphia
- She has great ideas for stories but must take the
time to recheck her work for careless mistakes in
spelling and sentence structure. (Gr. 4 teacher)
17My elementary school experience
- How I was perceived
- - the lucky one
- How I performed
- - the remedial accommodations
- How I learned
- - accommodations at home
- How I was identified as LD (grade 4)
18My Elementary Years
- My school experience
- Never trying hard enough
- She tends to try to guess what is written instead
of slowing down and trying to discriminate the
different sounds. (Gr. 5 teacher) - Having no free time
- Krissy has used the tape recorder and the
computer to help improve her spelling skills.
The weekly test results with the class are very
positive. (Gr. 6 teacher)
19My Elementary Years
- My school experience
- Walls of frustration
- Getting the right answer
- Always being alone
- All day, every day
- she finds written work a real chore. Her
grammar, spelling and handwriting are still weak
however, many errors could be avoided if she were
to take the time to recheck her work carefully.
(Gr. 5 teacher)
20My high school experience
- I was cured!! (not but de-identified)
- How I was perceived
- I thought you were smart?
- How I performed
- the exam accommodations
- How I learned
- accommodations at home
21My learning context then...
- Previous assessment (wasnt shared with Kristen)
- weakness in
- letter word identification
- reading comp
- writing skills
- diagnosis - specific learning disability
- Previous accommodation
- progress monitored
- Spec Ed assistance
- removed from regular French program
- periodically removed from regular class for
remediation
22My university experience
- Has the perception changed?
- deafness
- How I perform
- the exam accommodations
- How I learn
- using my learning strengths
- accommodations for learning
23My learning context now
- New assessment greater self-knowledge
- 4 page to 20 page assessment
- Im now part of the IEP process (shut out before)
- Access to Resources
- Special Needs, LOP, Assistive Devices Tech
Learning Strategist - Increased self-confidence
- ability to explain self-advocate
- More efficient learning
- reading, writing, organization test-taking
24In addition, I now know
- new assessment information
- poor visual memory
- visual tracking problems including reversals
- poor visual decoding
- poor phonetic decoding (phoneme/grapheme
awareness) - auditory memory is weak although this is my
strongest learning modality
25Current Accommodations
- Kurzweil 3000 (text to speech)
- Dragon Naturally Speaking (speech to text)
- textHELP Read Write (editing reads back,
dyslexic spell checker, homophone checker) - Pocket PC keyboard organization, note taking
in class reading - Study carrels in library
- Exams above tools and extra time if necessary
26Life Today
- Im not broken
- Self-advocate
- Purse full of technology
- DONT or CANT or NOT ABLE are not words I use
- Work Free money any one?
- Advocate for others who dont have a voice
27Meet Elaine
- a student with
- Working Memory Deficit
28What is Working Memory?
29WM has been compared to
- A computer with limited RAM (one too many
programs and the computer stalls) - A chalkboard (info is erased before more can be
written down) - A measuring cup (fill it with info but it will
start to spill out when more is poured in) - An average persons WM is like riding a bike with
large wheels but my WM is like riding a bike with
very small wheels. I cant go as fast and I use
more energy and tire more quickly.
30The Memory System
- Where does Working Memory fit in?
31Memory System
Weiten, W. (1998) Psychology themes and
variations, fourth edition. Pacific Grove
Brooks/Cole Publishing Company.
32Sensory Memory
- Sensory input is the information we receive from
our eyes, ears, nose, and hands. - When sensory input is attended to it enters
working memory from sensory memory.
33Sensory Working Memory
- Working memory has to block out other sensory
input to attend to the specific stimuli.(
i.e.blocking ears, turning off radio, testing
environment) - Blocking out uses some of the Working Memorys
capacity
34Working Short-term Memoryincludes
- a rehearsal loop or (short term memory) has, on
average, a limited capacity of 7 chunks. - If information is rehearsed long enough it is
organized into long term memory.
35Working Short-term Memoryincludes
- a visuo-spatial sketch pad holds and manipulates
mental images (visual image of a word or number)
36Working Short-term Memoryincludes
- an executive function handles a limited amount of
information while manipulating it (hold 56 and 17
while subtracting 17 from 56)
37Long-term Memory
- Very simply, rehearsal is needed to retrieve a
list of words from long term memory. - The more rehearsal the easier it is to retrieve.
38Working Memory Learning Disabilities
39WM and learning to read
- Consider the process as a child
- I read a sentence and come to a word that is
unfamiliar - I must decode (sound out) the word and in doing
so - I lose the context of the sentence, so I reread
- I come to the same unfamiliar word, my memory
fails me and I begin the process again.
40Working Memory Deficit
- Holding some information is possible until
- Holding and manipulating occurs then the process
fails - Holding the image of the word failed
- Therefore, elaborate rehearsal was not achieved
so long term memory retrieval failed or was never
really engaged
41Working Memory Deficits
- These failures will happen to all young children
learning to read because learning to read is so
demanding on working memory however, - Children with working memory deficits have
extreme difficulties and need to be accommodated - Average child reads their first novel at age 8.
I was 14.
42Working Memory Deficits
- People with working memory deficits have great
potential. - It is like an athlete confined to a wheel chair.
The potential is still there but part of the
system has made the implementation more
difficult. - I need you to believe in the potential of people
with learning disabilities.
43How WM deficit affects my life
- The elementary school years were humiliating for
me. - High school was better because I mastered reading
even though it was at a slow pace, but writing
was painful. - There are so many rules for spelling, punctuation
grammar that I have never been able to process
them efficiently enough to depend on them when I
need them.
44How WM deficit affects my life
- I worked extremely hard in high school and got
As and Bs, but my health suffered - I finished college with As
- I rarely finished a test in high school or
college. - Currently I still cant trust my working memory
to get by on tests so I compensate by being very
prepared
45WM and Me
- I must study very hard and self-test to be in
complete control. - This is an attempt to keep anxiety low (anxiety
also taxes WM) to avoid overload from too much
information - This control is physically draining and effects
my health
46Parent of a Child with L.D.
- My child has a Non-verbal L.D.
- very strong verbal skills
- weak visual and spatial skills
- affects coordination of gross and fine motor
skills - affects the ability to organize
- affects understanding facial and body language
- depends on working memory to compensate for
non-verbal weakness which overloads WM - similar characteristics as my deficit in learning
but at a lesser extent
47Working Memory
- Has a powerful role
- If you can understand and respect the role of
working memory in the learning process, you will
be an effective teacher for children with
learning disabilities and also the average child. - Quiet time and extra time are a must during the
learning process
48Parent of a Child with L.D.in the school system
- A good experience (but this rare)
- Grade 1- excellent teacher picked up the signs
(identification process began) - Parent open to hearing their child is L.D. (rare
or school system is not open to parents concerns) - Grade 2- psychological assessment
- Grade 3- Learning Skills classroom (quiet
setting, consistent skilled teacher, with smart
kids just like him) - early help was extremely beneficial he did not
get discouraged and still likes learning and
school
49Child with L.D. in School System
- Grade 4 - integrated into a regular class with no
difficulties. - Now he gets As and Bs.
- anxiety is a problem
- depends heavily on rules in social situations and
doesn't adapt well to the dynamics of social
interactions - may fail to pick up social cues
- but considering how far he has come, I am so so
very pleased
50A brief overview . . .
- What is a Learning Disability?
- Ministry of Education definition
51A learning disorder
- evident in both academic and social situations
that involves one or more of the processes
necessary for the proper use of spoken language
or the symbols of communication, and that is
characterized by a condition that
52- a) is not primarily the result of
- impairment of vision
- impairment of hearing
- physical disability
- developmental disability
- primary emotional disturbance
- cultural difference and
53- b) results in a significant discrepancy between
academic achievement and assessed intellectual
ability, with deficits in one or more of the
following - receptive language (listening, reading)
- language processing (thinking, conceptualizing,
integrating) - expressive language (talking, spelling, writing)
- mathematical computations
54- c) may be associated with one or more conditions
diagnosed as - a perceptual handicap
- a brain injury
- minimal brain dysfunction
- dyslexia
- developmental aphasia.
55What is a Learning Disability?
- A new definition
- from the LDAO
56In brief "Learning Disabilities"
- refers to a variety of disorders that affect the
acquisition, retention, understanding,
organization or use of verbal and/or non-verbal
information.
57These disorders
- result from impairments in one or more
psychological processes related to learning in
combination with otherwise average abilities
essential for thinking and reasoning.
58These psychological processes are
- phonological processing
- memory and attention
- processing speed
- language processing
- perceptual-motor processing
- visual-spatial processing
- executive functions (e.g., planning, monitoring
and metacognitive abilities)
59Learning disabilities
- range in severity and invariably interfere with
the acquisition and use of one or more of the
following important skills
60These skills are
- oral language (e.g., listening, speaking,
understanding) - reading (e.g., decoding, comprehension)
- written language (e.g., spelling, written
expression) - mathematics (e.g., computation, problem solving)
- organizational skills
- social perception
- social interaction
61What a LD is Not!
- IT IS NOT
- low intelligence/an intellectual disability
- mental illness/emotional disturbance
- autism
- visual or auditory acuity problems
- laziness/lack of motivation
- a way to avoid other issues
- a physical handicap
- the result of a poor academic background
62A Learning Disability is an Information
Processing Impairment
- It is like having too many bridges out as well as
too many overlapping pathways along the
information highways of the brain. - Dale R. Jordan
- U. of Arkansas
63A Simple Model of Learning Information
Processing
- Attention
- Sensory Input
- Decoding
- Processing
- May include Storage
- and/or Retrieval processes
- Encoding
- Physical Output
64Where can IP break down? Dr. Allyson G.
Harrison, Queens University
- 1. Frontal lobe functioning deficits
- - abstract and conceptual thinking
- 2. Memory impairment
- - Short term memory
- - Working memory-mental blackboard dynamic
process - - Long term memory
- - Storage vs retrieval issues
- 3. Sequencing deficits (visual or auditory)
65Breakdown continues Dr. Allyson G. Harrison,
Queens University
- 4. Speed of information processing
- 5. Attention
- - Selective (cannot choose/focus)
- - Sustained (cannot maintain)
- - Divided (cannot shift/hyperfocus)
- 6. Narrow processing style - cant
simultaneously attend to process multiple
aspects of a stimulus field
66Still breaking down Dr. Allyson G. Harrison,
Queens University
- 7. Poor scanning resolution-miss relevant data
- 8. Right hemisphere dysfunction good at details
but not global picture. Gets lost in details,
easily overloaded. Cant make sense of
holistically presented information. Poor ability
to interpret visual cues. - 9. Faulty output mechanism - interferes with
demonstration of adequate information processing.
67As a result, learners with LDs may have
- Difficulty with Alphabet/Penmanship
- Problems Expressing what is Known and Understood
- Problems in Personal Organization
- Difficulty in Copying/Note-Making
- Problems in Arithmetic
- Problems in Reading
- Slow Work Speed
- Problems with Time and Sequence
- Confusion in Spelling
68For you visual learners
What does an LD look like? LDs from an
Information Processing perspective.
69Traditional Aptitude vs. AchievementAverage
Student
70Traditional Aptitude vs. Achievement Student
with a LD
71Aptitude, Achievement Info Processing Visual
(Dyslexia)
72Aptitude, Achievement Info Processing Auditory
(CAPD)
73Non-verbal LDWAIS Profile
74The Criteria
- identification is NOT diagnosis
- diagnosis must be made by a psychologist
- based on a discrepancy between ability (as
measured by IQ) and academic achievement and/or
information processing - students at the post-secondary level MUST have a
recent assessment with a valid diagnostic
statement in order to get academic accommodation
75So how might an LD affect a Learner?
- A Couple of Examples . . .
76Cant you read this?
- Myle arn in gdisa bi LI tyma kesit dif Ficu
ltform eto re Adi tslo wsm edo wnwh eniha veto re
AdmYte xtbo Ok sbu twhe nius Eboo kso Nta peo rco
mpu Teri zedsc ree nrea Din gsof twa Reto lis
tent Om yte xtbo ok sith elp sal Ot.
77Cant you see this?
- Cant you see the Dalmatian?
78Social Emotional Aspects of a Learning
Disability
- From Introducing Learning Disabilities to
Postsecondary Educators - The Meighen Centre for Learning Assistance and
Research, Mount Allison University
79What does a Learning Disability feel like?
80Possible Academic Problems
- silent reading/reading aloud
- writing/spelling
- learning languages/math
- expressing what is known and understood
- having to re-do school work at home
- having no time off since everything takes longer
- dropping out
81Possible Social/Emotional Problems
- feeling dumb, stupid, embarrassed, frustrated,
anxious, lonely, isolated - being called stupid, lazy being put down by
teachers, friends, and even parents - feeling nobody understands
- feeling need of help
- fearing rejection failure
- always having to cover up, act a role
82Possible Career/Vocational Problems
- lack of basic skills
- lack of social skills
- Its never cured, It never goes away
- having to cover up
- never feeling adequate
- low expectations
- jobs dont last
83Tough Facts from LDAC
- 35 of students identified with learning
disabilities drop out of high school. - 50 of adolescent suicides had previously been
diagnosed as having learning problems. - Volumes of research have shown that 30 to 70 of
young offenders have experienced learning
problems.
Statistics on Learning Disabilities. LDAC,
October 2001. Source Online http//www.ldac-taac
.ca/english/indepth/bkground/stats01.htm
84What About the Kids?3 Tales from the Trenches
- Adam (grade 4) reading disability (pre. board)
- reading at grade 1 level, highly frustrated
resistant to learning - resistant to resource, so accommodated in the
classroom - up two levels, completed grade level work,
independent research project, class leader - end of the year comment to John
- now in Grade 5 back in resource, same phonics
workbooks, etc. shut down - teachers, perhaps afraid of technology, but have
also bought into the myth that if students learn
differently, they wont make it in the real
world
85What About the Kids?3 Tales from the Trenches
- Eve (grade 4) gifted with an LD
- worked very hard but no significant
ability/achievement discrepancy so parents paid
for assessment - performing just below grade level
- works harder than all of her classmates
- remediation every night thru Oxford LC
- principal wont allow identification IEP
monitoring - recently caught cheating in spelling in French
- I wanted to get them right just once.
- should she be allowed to experience success?
- strategy Report Card accommodating her
learning disability according to the
psychological assessment
86What About the Kids?3 Tales from the Trenches
- Ruth (grade 4) not yet diagnosed
- problems with math
- probably non-verbal LD problems with drawing,
visual/spatial awareness, awkward, late reader - goes to Kumon Math every night
- nightly math sheet (10 20 min) may take 2 hours
with parents help - teacher warned not to rock the boat (not to ID)
- so teacher removed classroom accommodation
resulting failure allowed teacher to contact
parents parents influential in community and
parent council - letters flew testing has begun shook up
resource team 5 kids will now benefit from 1st
math program
87What you can do . . .
- How can a classroom/ resource teacher support a
student with a learning disability?
88Be a GREAT teacher
- Use multi-modal teaching techniques, offer valid
performance and evaluation alternatives, and - remember . . .
89We Learn... William Glasser
- 10 of what we read
- 20 of what we hear
- 30 of what we see
- 50 of what we both see and hear
- 70 of what is discussed with others
- 80 of what we experience personally
- 95 of what we teach someone else
90Or Simply
- Tell me and I will forget
- Show me and I may remember
- Involve me and I will understand
- Ancient Chinese proverb
91Teach Academic/Learning Skills Topics from
UNIV1011
- How We Learn
- Learning Styles
- Time Management
- Active Listening Notetaking
- Active Reading
- Writing Strategies
- Critical Creative Thinking
- Test Taking Evaluation
- Attitude Motivation
- Self-Determination Self-Advocacy
- Teamwork Rapport
- Energy Stress
- Health Wellness
92What you can do . . .
- Provide Access to Curriculum and Accommodation
93Follow the principles of UIDHeli Wynne
- Universal Instructional Design
- . . . curriculum is accessible to all students,
regardless of their learning style or the
presence of learning and/or other disabilities. - or . . .
94Universal Design for Learning (CAST description)
- UDL shifts old assumptions about teaching and
learning in four fundamental ways - Source online Center for Applied Special
Technology (CAST) www.cast.org/udl/
95UDL basic concepts (CAST)
- Students with disabilities fall along a continuum
of learner differences rather than constituting a
separate category - Teacher adjustments for learner differences
should occur for all students, not just those
with disabilities
96UDL basic concepts (CAST)
- Curriculum materials should be varied and diverse
including digital and online resources, rather
than centering on a single textbook - Instead of remediating students so that they can
learn from a set curriculum, curriculum should be
made flexible to accommodate learner differences
97For more about UDL see
- CASTs Universal Design for Learning site
- http//www.cast.org/udl/
- Online textbook
- Teaching Every Student in the Digital Age
Universal Design for Learning. David H. Rose
Anne Meyer ASCD, 2002 - www.cast.org/teachingeverystudent/ideas/tes/
98More about accommodating individual student
differences
- PBS documentary, Misunderstood Minds
- http//www.pbs.org/wgbh/misunderstoodminds/intro.h
tml - Check out the work of Dr. Mel Levine
- His organizations website
- www.allkindsofminds.orq
- A Mind at a Time, Chapter 1
- http//www.allkindsofminds.org/bookExcerpts/aMinda
tATime.aspx
99Paul Gerber onwhat you can do . . .
- Promote success through teaching
- self-advocacy
- self-awareness
- self-knowledge
- Dr. Paul Gerber, Pathways 2002
100Characteristics of Successful Adults with LDs
- Gerber, Ginsberg, and Reiff. Learning to
Achieve Suggestions from Adults with Learning
Disabilities. Journal on Postsecondary Education
and Disability.Source online www.ahead.org/publi
cations/JPED/jped10-1-b.html
101Their findings (n71)
- The driving factor underlying the success of the
entire sample was an effort to gain control of
their lives. - Attaining control involved both internal
decisions and external manifestations.
102Control
- The issue of control is of special significance
to individuals with learning disabilities. - For many, a significant effect of learning
disabilities was a sense of a taking away of
control.
103Control
- Especially in the school-age years, most
respondents felt that they were not in charge of
their lives - instead, because they learned differently, they
were consigned to special programs or told, in a
variety of ways, that that they did not measure
up to expectations
104Gaining control
- a significant pattern was a high degree of
preparation that the adults used to be ready to
face any possible situation. - A number remarked that they could not afford to
be caught off-guard and consequently put forth
extraordinary effort to predict all permutations
of any situation.
105Attaining control involved
- Internal Decisions
- Desire
- Goal Orientations (realistic in goal setting
process) - Reframing (of the learning disability experience)
- External Manifestations
- Persistence
- Learned Creativity
- Goodness of Fit (between abilities and work
environment) - Social Ecologies (use assistance of helpful,
supportive people)
106Predictors of Success in Adults with LD
- IQ or Achievement scores are at best MINOR
predictors of success in adults with LD - Six other factors were far BETTER PREDICTORS
(Raskind et al, 1999) - Dr. Marc Wilchesky, York University
- Pathways 2002
107Predictors of Success in Adults with LD
- Self-awareness
- Proactivity
- Perseverance
- Goal Setting
- Emotional Stability
- Social Support Systems
- Raskind et al, 1999
108So in review, you can
- Raise self-esteem by staying positive -- you may
be the adult who makes a difference - Include the student in the process
- Allow the student both access to and control over
his/her learning environment - Focus on strengths accommodate for weaknesses
- Teach learning strategies
- Use technological aids/software
- Encourage/teach social skills
- Offer positive, realistic feedback
- Fight for funding, assessment technology
109More Info . . .
- On learning disabilities
- www.schwablearning.org
- www.ldonline.org
- www.ldpride.net
- www.ldao.on.ca
- www.ldrc.ca
- http//specialed.about.com/cs/learningdisabled
- Activities to help understand processing deficits
- http//www.pbs.org/wgbh/misunderstoodminds/
- Mikes Learning Resources site
- www.nipissingu.ca/faculty/mikew/resource
110Questions?
111Technology for Students with Learning Disabilities
- Tools to help accommodate for information
processing deficits
112What Can Students with LDs Expect?
- Typical accommodations available to students with
learning disabilities at the post-secondary level
113Test/Exam Accommodation
- Common
- extra time
- spell checker
- use of a computer
- distraction-free environment
- leniency towards spelling grammar
- Less Common
- reader
- scribe
- e-reader
- voice dictation
114Classroom/Lecture Accommodation
- Common
- tape recorder
- note-sharer/taker
- use of overheads/ visual organizer
- Alpha-Smart/lap-top computer/Pocket PC
- Less Common
- FM system
- wait time when called upon
- lecture notes on reserve/on web
- lecture outline in advance
115Personal Study Accommodation
- master notebook
- organizer
- talking spell checker
- texts on tape
- tape/digital recorder
- computer
- scanner
- e-reader/e-texts
- voice dictation
- reduced course load
- study buddy
- study carrels
- mentor
- academic skills
- peer tutor
- professional tutor
- technology training
- learning strategy training based on LD assessment
116BSWD Bursary for Students With Disabilities
- This year up to 10, 000
- Tied to OSAP eligibility
- For disability-related educational expenses
assessments, computers assistive software,
adaptive devices, tutoring, therapy, ergonomic
devices, etc. - NOT for tuition, books, residence, etc.