REHABILITATION COUNSELORS’ PERCEPTIONS OF IMPORTANCE AND
COMPETENCE OF ASSISTIVE TECHNOLOGY
By
Hung Jen Kuo

A DISSERTATION
Submitted to
Michigan State University
in partial fulfillment of the requirements
for the degree of
Rehabilitation Counselor Education – Doctor of Philosophy
2013

	
  

	
  

	
  

ABSTRACT
REHABILITATION COUNSELORS’ PERCEPTIONS OF IMPORTANCE AND
COMPETENCE OF ASSISTIVE TECHNOLOGY
By
Hung Jen Kuo
Assistive technology (AT) has been identified as one of the most effective interventions
for rehabilitation purposes of individuals with disabilities. Due to the positive potentials,
assistive technology has attracted tremendous attention among the rehabilitation counselors
during the past decades. As a result, numerous AT devices have been created and research has
been conducted attempting to improve quality of lives of individuals with disabilities. While
many successful rehabilitation stories were revealed by AT assisted individuals, the
implementation of AT does not always equal to successes. In fact, the high AT abandon rate has
been a critical issue for the rehabilitation counselors. One of the identified reasons for the high
AT abandon rate is the mismatch between the person and the device. In order to increase
successful rate and decrease the possibility of mismatch, training specifically designed for
building rehabilitation counselors’ AT skills is needed. However, despite the recognition of AT
training needs, very few master level rehabilitation counseling programs offer stand-alone AT
classes to their students. Reasons for the missing of designated AT training include the lack of
time, financial resource and manpower among these programs. Therefore, in order to design the
AT training with the constraints these programs have, it is crucial to learn what the most
important AT knowledge and skills are for the rehabilitation counselors.
As a response to the current issue, this study focused on exploring current certified
rehabilitation counselors’ (CRC) perception of importance and competence in relation to their
AT knowledge and skills. A sample of 242 CRCs was randomly drawn from the database of

	
  

	
  

	
  

Commission on Rehabilitation Counselor Certification (CRCC). An Internet-based instrument
was utilized as means for data collection. The quantitative design of this study yielded several
statistical analyses.
Results showed that AT was consistently considered one of the most important skills that
rehabilitation counselors should have. However, although AT was considered to be important,
rehabilitation counselors in general did not perceive competent to provide such services. The
finding was alarming and demonstrated that more AT trainings were needed. In addition, for
both perceived importance and perceived competence scales, significant differences were found
between AT skill areas (understanding AT, using AT, and making AT decision), which provided
insights of what AT skills should be prioritized when designing curriculum. Specific AT skills,
which the participants rated important and less competent, were also identified for future training
references.
Data generated from this study can be used to inform current practitioners, rehabilitation
counselor training programs, and future research directions. Limitations and implications were
also discussed.

	
  

	
  

Copyright by
HUNG JEN KUO
2013

	
  

	
  

	
  

	
  

ACKNOWLEDGEMENTS

First, I want to thank God for giving me much more than I deserve. All glory belongs to
God. It is the blessing, love, and protection from God that make everything possible.
I would like to express my gratitude to my family. I want to thank my beautiful and smart
wife, Yu-Hwai, for her endless support, understanding, and patience. Without her encouragement
and wisdom, I cannot even make through the chapter one of this dissertation. I also want to
express my appreciation to my father and mother, Ta-Yang and Husn-Chu. While I may have
doubt about myself, they always have faith in me. I would like to thank my sister, Wen-Lin, for
being a wonderful sister who takes care of me all the time. It is a privilege to be her brother, and
I always know that.
I am also appreciative of my dissertation committee, Dr. Kosciulek, Dr. Leahy, Dr. Sung,
and Dr. Roseth. Without their guidance, none of these is possible. Dr. Kosciulek has been my
advisor since 2005 when I first entered the master program of rehabilitation counseling. He has
been a great mentor who allows me to explore my career goals and provides support when
needed. In addition, during the past four years of my doctoral study, Dr. Leahy has offered me
tremendous opportunity to grow. I want to express my sincere appreciation to Dr. Leahy for
always leave his door open for me. Dr. Sung has been my “go-to person” whenever I have
teaching and research questions. I really owe her a big thank you. Lastly, Dr. Roseth has
significantly strengthened my logistic thinking and research skill. I really appreciate his input on
my dissertation and kind words.

	
  

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TABLE OF CONTENTS

LIST OF TABLES ....................................................................................................................... viii
LIST OF FIGURES ....................................................................................................................... ix
CHAPTER ONE: INTRODUCTION ......................................................................................... 1
Statement of the Problem ............................................................................................................ 2
Purpose of the Study ................................................................................................................... 4
Definition of Terms..................................................................................................................... 5
CHAPTER TWO: LITERATURE REVIEW ............................................................................ 7
Definition of Assistive Technology ............................................................................................ 7
AT Benefits ................................................................................................................................. 9
Education..............................................................................................................................9
Employment........................................................................................................................10
Social Inclusion..................................................................................................................12
Challenges of Assistive Technology ......................................................................................... 17
Assistive Technology in Rehabilitation Counseling ................................................................. 19
Current Education Provision ..................................................................................................... 24
Theoretical Framework ............................................................................................................. 26
	
  
ATD Decision-Making And Device Selection....................................................................29	
  
Perceived Importance and Competence .................................................................................... 30
Summary ................................................................................................................................... 33
CHAPTER THREE: METHOD ............................................................................................... 35
Research Questions ................................................................................................................... 35
Participants................................................................................................................................ 36
Sample Size............................................................................................................................... 37
Instrumentation/Variables ......................................................................................................... 37
Reliability and Validity ............................................................................................................. 41
Procedure .................................................................................................................................. 41
Data Analysis ............................................................................................................................ 43
CHAPTER FOUR: RESULT .................................................................................................... 46
Response Rate ........................................................................................................................... 46
Missing Data and Data Screening ............................................................................................. 47
Demographics and Characteristics ............................................................................................ 48
Exploratory Factor Analysis ..................................................................................................... 49
Descriptive Statistics................................................................................................................. 52
Univariate Analysis of variance (ANOVA) .............................................................................. 55
Multiple Regression Analysis ................................................................................................... 57
	
  

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Clustering Technique ................................................................................................................ 59
Qualitative data ......................................................................................................................... 62
CHAPTER FIVE: DISCUSSION.............................................................................................. 64
ATPRC Instrument ................................................................................................................... 64
AT Skills ................................................................................................................................... 65
AT importance .......................................................................................................................... 66
AT Competence ........................................................................................................................ 69
Training Needs .......................................................................................................................... 71
Limitations of the Study............................................................................................................ 72
Implications of the Study .......................................................................................................... 74
Implication for Practice..................................................................................................... 74
Implication for Education and Training............................................................................ 75
Implication for Future Research........................................................................................ 77
Conclusions ............................................................................................................................... 78
APPENDICES .............................................................................................................................. 80
APPENDIX A: Special Education Teacher Preparation Survey .............................................. 81
APPENDIX B: Assistive Technology Perception For Rehabilitation Counselors ................... 82
APPENDIX C: Informed Consent ............................................................................................ 86
REFERENCES ............................................................................................................................. 88

	
  

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LIST OF TABLES

Table 1: Comparison of Sample and Overall CRC Demographic Characteristics ............... 49
Table 2: Factor Loadings For Perceived Importance Scale With Varimax Rotation ........... 50
Table 3: Perceived Importance Scale Summary ................................................................... 53
Table 4: Perceived Competence Scale Summary ................................................................. 54
Table 5: One-Way Anova For Perceived Importance And Perceived Competence On Three
Factors With Greenhouse-Geisser Correction Used ............................................................. 55
Table 6: Post Hoc Analyses On Three Factors ..................................................................... 57
Table 7: Multiple Regression Model For Perceived Competence ........................................ 59

	
  

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LIST OF FIGURES

Figure 1: Framework for modeling the selection of assistive technology devices........... 27

	
  

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CHAPTER ONE: INTRODUCTION
Assistive technology (AT) has received much attention among rehabilitation
professionals during the past several decades. One of the most important reasons for the growth
of AT in rehabilitation professions is its value on enhancing physical capacity, increasing
independent living, promoting self-image, and improving overall quality of life (Day, Jutai, &
Campbell, 2002; Scherer, Sax, & Glueckauf, 2005; Viney, 2003). Due to its promising
rehabilitation effects, rehabilitation professionals such as occupational therapists, physical
therapists, special education teachers, and rehabilitation counselors have devoted tremendous
energy to study how AT can be helpful to the individuals with disabilities. As an example,
Bryant and Bryant (2003) found positive vocational rehabilitation outcomes to be associated with
assistive technology usage among people with visual and hearing impairments. Similar results
were also suggested by Schonbrun and Kampfe (2004) for a traumatic brain injury population.
While the potential benefits AT can bring to individuals with disabilities are encouraging,
there are also challenges. In fact, the intervention and implementation of AT does not guarantee
successful rehabilitation outcomes. As Phillips and Zhao (1993) noted, approximately 30 percent
of AT users tend to abandon their AT devices. Cushman and Scherer (1996) also suggested that
almost one-third of AT users will abandon their devices within the first three months of
implementations. The high abandon rate is especially alarming because of two: (a) the cost of AT
implementation does not equal to the rehabilitation gain, and (b) the mismatch between the
person and the device could potentially harm both the practitioner and the client’s trust in AT,
and hence, question the effectiveness of it in the future. In order to alleviate such issue, it is
critical for rehabilitation practitioners to effectively assist their clients in choosing the most
appropriate AT devices.
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Statement of the Problem
Due to the benefits and the positive influence on individuals with disabilities’ lives,
rehabilitation researchers devote more energy to explore AT knowledge and skills. However,
despite the recognition of the importance of AT, education and training specifically focused on
assistive technology may not be well enough developed. Chan, Leahy, Saunders, Tarvydas,
Ferrin, and Lee (2003) conducted a study, in which they focused on identifying the most
important skill sets to current certified rehabilitation counselors (CRCs) and how well they
perceive themselves prepared in these skill areas. Among different skill areas being identified,
accommodations/rehabilitation engineering services and assistive technology are two areas
considered to be important by most CRCs. Specifically, 83% of the participants in this study
perceived accommodation and rehabilitation engineering services as important, and 86%
perceived assistive technology as important. While their perceptions of importance on both skills
are high, their perceptions of preparedness are much lower. Specifically, they were 67% and
68% respectfully. In fact, that was not the only study that revealed the lack of AT education
among rehabilitation counselors. Riemer-Reiss (2003) conducted a study that focused on
comparing current rehabilitation counselors’ perceptions of AT competence and their actual AT
service provision. The result of this study suggested that although majority of the rehabilitation
counselors reported they received some level of AT education (range from 1 hour to 15 hours) in
the past, they still expressed the need and the desire for additional AT trainings. This really
suggested that most rehabilitation counselors considered that the AT education they received was
not sufficient for the quality service provision. Further, Reimer-Reiss emphasized the strong and
positive correlation between the amount of AT education these individuals received and the
amount of assistive technology service they provided. In other words, practitioners who received

	
  

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more training on AT skills were more likely to provide AT services. Reimer-Reiss concluded his
study with the suggestion that in order to empower clients with disabilities and improve quality
of their lives, rehabilitation counselors should continue and update their learning of AT
knowledge and skills.
In respond to AT education needs, Estrada-Hernandez, Wheaton, Dawson and Krispinsky
(2007) devoted their effort to explore how AT knowledge and skills were trained in master level
of rehabilitation counseling programs. In the study, they developed a survey and obtained data
from 88 current Council on Rehabilitation Education (CORE) accredited rehabilitation
counseling programs. The results of the study showed that majority of the rehabilitation
counseling programs considered assistive technology to be an important skill and that it should
be included in professional preparation courses. Further, they pointed out that despite AT was
identified by most programs to be an important skill to have, however, most master rehabilitation
counseling programs did not offer any stand-alone AT class. Instead, most of them merely
infused AT materials into other classes. For example, the AT concept and knowledge were only
introduced in one or two class sessions of the rehabilitation counseling foundation class. In
addition, although most master programs anticipated that AT would be more and more important
to the field, they did not expect any change in curriculum designs in the near future. While
reasons such as lack of time, financial supports and manpower could all contribute to the missing
of stand-alone assistive technology courses, there might be reasons beyond these. As Noll,
Owens, Smith, and Schwanke (2006) noted, what AT knowledge and skills are important to the
future rehabilitation counselors is still blurry. In order to develop AT education for rehabilitation
counselor preparation programs, it is crucial for researchers to identify what AT skills are the
most relevant and necessary to the rehabilitation counselors.

	
  

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Purpose of the Study
Several studies were conducted examining the benefits that AT can provide for
individuals with disabilities (Day, Jutai, & Campbell, 2002; Viney, 2003; Riemer-Reiss, 2003).
These studies also raised important questions regarding how to train the future rehabilitation
counselors. As many researchers noted, education addressed rehabilitation counselors’ AT
knowledge and skills needs to be strengthened and expanded. (Estrada-Hernandez et al., 2003;
Sherer, Sax, & Glueckauf, 2005). While many emphasized the insufficient AT training among
rehabilitation counselors, not many addressed specifically what AT skills should be trained.
As a response to the gap of the current rehabilitation literature, this study attempted to
shift attention from professional training programs to current rehabilitation practitioners. It is
through the investigation of current service providers, the most important and relevant AT
knowledge and skills could be identified. Specifically, the focus of this study was to explore
Certified Rehabilitation Counselors’ (CRCs) perception of the importance and the competency in
AT services they provided. The research questions of interest in this study were as follows:
1. How important do CRCs perceive for assistive technology skills in rehabilitation
counseling practice?
a. Is there a difference in perceived importance across three different factors (i.e.,
understanding AT, using AT, and making AT decision) among assistive
technology skills?
b. Do CRCs’ backgrounds (e.g., gender, years of practice, practice setting,
disability) associate with perceived assistive technology importance?
2. How competent do CRCs perceive themselves in providing assistive technology services?

	
  

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a. Is there a difference in perceived competence among three assistive technology
factors (i.e., understanding AT, using AT, and making AT decision)?
b. Do CRCs’ backgrounds (i.e., gender, years of practice, practice setting, disability)
associate with their perceived assistive technology competence?
3. How do CRCs perceived importance differ from perceived competence in assistive
technology skills?
a. Are there differences between CRCs perceived importance and perceived
competence across three AT factors?
4. What can be improved in relation to assistive technology service provision?
Definition of Terms
Rehabilitation counselor. A practitioner with a master’s degree who assists persons with
physical, mental, developmental, cognitive, and emotional disabilities to achieve their personal,
career, and independent living goals in the most integrated setting possible through the
application of the counseling process. Techniques and modalities used by rehabilitation
counselors may include, but are not limited to: (a) assessment and appraisal; (b) diagnosis and
treatment planning; (c) career (vocational) counseling; (d) individual and group counseling
treatment interventions focused on facilitating adjustments to the medical and psychosocial
impact of disability; (e) case management, referral, and service coordination; (f) program
evaluation and research; (g) interventions to remove environmental, employment, and attitudinal
barriers; (h) consultation services among multiple parties and regulatory systems; (i) job analysis,
job development, and placement services, including assistance with employment and job
accommodations; and (j) the provision of consultation about and access to rehabilitation
technology (Scope of Practice for Rehabilitation Counseling, 2007).

	
  

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Certified Rehabilitation Counselor. Rehabilitation counselors who have been certified
by the Commission on Rehabilitation Counselor Certification (CRCC) as having at least an
acceptable minimum level of knowledge and skills to practice as a professional in rehabilitation
counseling.
Assistive technology. Assistive technology device' means any item, piece of equipment,
or product system, whether acquired commercially off the shelf, modified, or customized, that is
used to increase, maintain, or improve functional capabilities of a child with a disability
(Assistive Technology Act, 1998).
Competency. The specific knowledge and skills required of rehabilitation counselors to
provide effective services to the client in relation to a third party, be it an individual, group, or
organization

	
  

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CHAPTER TWO: LITERATURE REVIEW
The purpose of the study is to investigate current Certified Rehabilitation Counselors’
(CRC) (a) perceived importance of assistive technology (AT) skills and knowledge, and (b)
perceived level of competence in providing AT services to their clients. To develop the research
plan, a thorough examination of the literature is necessary. A series of definitions, benefits, and
challenges of AT were discussed, and the role of AT in rehabilitation counseling was examined
in order to demonstrate the need of continuous training in AT knowledge and skills. A theoretical
framework was provided as a fundamental basis of the research. Lastly, since this study
attempted to identify training needs on the basis of comparing perceived importance and
perceived competence, the motivational theory was included in the literature review session.
Definition of Assistive Technology
The term assistive technology (AT) was initially introduced in the Technology Related
Assistance for Individuals With Disabilities Act of 1988 (P.L. 100-407). However, its definition
was not clearly developed until 1998, when the Assistive Technology Act was passed. AT was
defined as “any item, piece of equipment, or product system, whether acquired commercially off
the shelf, modified, or customized, that is used to increase, maintain, or improve functional
capabilities of individuals with disabilities” (Scherer, 2000). AT is a broad concept that includes
any product that facilitates users with disabilities in functioning in activities of daily living
(ADLs), thus enhancing the quality of their lives (QOL) (Dell, Newton & Petroff, 2008).
Therefore, regardless of hardware devices or software applications and high tech or low tech, if
they can achieve the purpose of empowering persons with disabilities, they are examples of AT.
There are more than 26,000 AT products available nowadays for individuals with needs
to select. Scherer (2002) provided a list that categorized AT products into five groups on the

	
  

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basis of their functionalities: (a) recreation, (b) sensory aid, (c) communication, (d) personal care,
and (e) mobility. In detail, recreation AT devices are products which increase integration of
social activities, team sports, and other forms of indoor and outdoor recreation for individuals
with disabilities. Examples of recreational AT devices include sport wheelchairs and hand-cycles.
Sensory disability AT refers to devices that provide individuals with visual or hearing assistance.
Examples of this category include Braille printers, screen readers, and hearing aids.
Communication AT refers to devices that facilitate individuals with disabilities in receiving and
sending messages verbally or in written form. Examples of this category include video relay
system, captioned television and computer dictation systems. Personal care AT refers to devices
that increase the independence of individuals with disabilities in fundamental areas such as
grooming, bathing, dressing, and eating. Examples of this category include reachers, commode
chairs, and electronic toothbrushes. Mobility AT refers to devices that provide extra support for
individuals with disabilities in moving around in the environment. Examples of this category
include powered wheelchairs, walkers, and crutches.
In addition to devices, AT also refers to services individuals with disabilities receive from
rehabilitation service providers to meet their accommodation needs. According to Individuals
with Disabilities Education Act (IDEA, 1997), AT service is defined as “ any service that
directly assists an individual with a disability in the selection, acquisition, or use of an assistive
technology device.” Therefore, the comprehensive AT service involves service providers’ AT
knowledge, skills in selecting AT, and their abilities in communicating with users with
disabilities. As Scherer, Jutai, Fuhrer, Demers and Deruyter (2007) mentioned, AT intervention
really requires extensive interactions between service providers and users of AT devices. In other

	
  

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words, successful implementation of AT intervention is only possible when there is a
combination of the right AT products and effective AT services.
AT Benefits
Efforts have been devoted to understanding what advantages individuals with disabilities
can benefit from by the use of AT. Evidence suggests that AT not only directly and indirectly
enhances opportunities for individuals with disabilities (Edyburn, 2003; Langton & Ramseur,
2001), but it also substantially improves the quality of their lives (Burgstahler, 2003; Agree &
Freedman, 2011). In order to understand better how AT can impact rehabilitation plans of
individuals with disabilities, a systematic review of the literature is necessary. The following
section discusses the impacts of AT in terms of education, employment, and social inclusion.
Education. During the past decades, efforts have been devoted by governments as well
as rehabilitation professionals to promote ideas of de-institutionalization and social inclusion for
individuals with disabilities. As a result, the number of students with disabilities in regular
classrooms has been increasing for the past few years (Hasselbring & Glaser, 2000; Nelson,
2006). While the increasing integration of students with disabilities in regular schools is
encouraging, there are still challenges. For example, students with disabilities might not have
equal access to all educational resources, despite the law mandates otherwise (Smith & Jones,
1999). Fortunately, supports provided by AT allow these students to obtain the extra assistance
they need and thus enhance their equal opportunity (Alsalem, 2010; Curtis, 2005; Angelo, 1997;
Male, 1994; Rudnick, 1997).
One of the identified benefits of implementing AT in education settings is enhancing
students’ learning experience. For example, the infusion of computer technology in curriculum
designs has significantly increased learning opportunities for students with special needs

	
  

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(Hasselbring & Bausch, 2005). Specifically, Hasselbring and Bausch demonstrated that students’
reading and comprehension abilities could be significantly enhanced with the use of screen
reader software. Similarly, Bransford, Vye, Kinzer and Risko (1990) claimed that the inclusion
of multimedia in learning materials would deepen students’ conceptual understandings.
Multimedia provides multiple cues that stimulate students’ vision and audio senses, consequently
strengthening students’ learning and prolonging their memory of learned knowledge. In an
overview of research, Raskind and Higgins (1998) concluded that it is effective to utilize AT to
improve the reading and writing skills of children with learning disabilities.
In addition to learning enhancements, AT has also been identified as useful in increasing
students’ learning motivation. As Hetzroni and Shrieber (2004) noted, AT increases interaction
opportunities between students, teachers, and curriculums. As a result, students can be
encouraged to participate actively in class activities. Similarly, Owston and Wideman (1997)
also suggested that the use of computer technology significantly alleviates students’ frustration in
learning, and hence increases their motivation in responding to teachers’ instructions.
Employment. One of the most important functions of rehabilitation counselors is to
assist individuals with disabilities to find and retain employment opportunities (McMahon, 2009;
Chan, Leahy, Saunders, Tarvydas, Ferrin & Lee, 2003). Therefore, extensive efforts have been
devoted to understanding and promoting employment situations for individuals with disabilities.
However, while there have been some successes (e.g., supported employment, job development
strategies, specialized placement, and follow-along assistance) in promoting employment rates,
challenges are still there for individuals with disabilities to compete in job markets and be treated
equally to people without a disability. In fact, the disparity of the employment rate between
people with and without a disability is still significant. According to the U.S. Bureau of Labor’s

	
  

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statistics (2012), the employment rate for people with disabilities was as low as 17.8% in
contrast to 63.5% for those without a disability. Similarly, the United State Department of Labor
(2012) has shown that the unemployment rate of people with disabilities is almost twice as high
as those without a disability. Causes and possible interventions have been studied intensively in
recent years in order to improve the low employment rate. Among different foci, accommodation
implementations (i.e., assistive technology) have been identified as one of the most promising
and effective interventions that could improve the employment situation (Dong, MacDonaldWilson & Fabian, 2010; Roessler, Rumrill & Fitzgerald, 2004). As Hedrick, Pape, Heinemann,
Ruddell & Reis (2006) noted, AT is particularly beneficial to individuals with disabilities
because of its capacity to decrease environment barriers, promote independence, and invite
integration.
On how AT devices facilitate individuals with disabilities in job-related performance,
Zeitzer (1991) provided examples such as computers that “read” typed material automatically to
the person as feedback, machines that “speak” text for individuals with visual impairments or
learning disabilities, and machines that “hear” and “understand” person’s speech or
conversations. McNaughton and Bryen (2002) showed the same in their review of multiple
studies on how augmentative and alternative communication (AAC) has evidently increased the
employment success for employers with disabilities. Similarly, in a review of the recent assistive
technology literature, Sauer, Parks and Heyn (2010) found that devices such as the cuing system
are very effective for supporting the job performance of people with cognitive disabilities. Sauer
et al. further explained that the cuing system provides visual as well as vocal prompting signals
that help on cognitive tasks such as memorizing and recalling.

	
  

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As AT evolves, more options will be available for individuals with disabilities. The
variety of AT options creates the possibility of customization for the individual user. As an
example, for different purposes, the individual might need high or low tech, general or specific
functions and single or multi-purpose AT. These advancements not only increase the
applicability of AT to different situations, but also lower the costs of implementation. As Sauer
et al. (2010) noted, devices such as Personal Digital Assistants (PDA) and smartphones are
designed to handle more and more tasks; however, the costs of those devices are less and less.
Consequently, cost effectiveness has become one of the most appealing reasons why AT is so
popular in recent years.
Social inclusion. As mentioned above, AT may have positive impact on the education
and employment statuses of individuals with disabilities. Whereas the possibility created by AT
is already encouraging, the benefits of AT are beyond just education and employment. As an
example, AT have the capacity to create even more social inclusion. In fact, AT have proved to
be especially beneficial for individuals with disabilities in aspects such as transportation,
accessibility, and recreation.
Transportation has been recognized as an important indicator of being independent.
Apparently, transportation can affect every kind of social participation. As identified by Gray,
Gould and Bickenbach (2003), without successful means of transportation, individuals with
disabilities cannot actively participate in employment and community activities. Therefore,
transportation should not be overlooked when considering individuals’ independent living and
the quality of their lives. Unfortunately, despite the awareness that transportation is a critical
element for integration, barriers to transportation still exist and are prevalent to individuals with
disabilities. A study conducted by Fitzgerald, Songer, Rotko and Karg (2007) reported that

	
  

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approximately one third of wheelchair users experienced some level of difficulty when using
transportation. With the recognition that transportation barriers really hinder employment
possibilities, rehabilitation outcomes and social participation, efforts have been devoted to
exploring these barriers and studying possible solutions.
AT is one of the most frequently mentioned solutions for overcoming transportation
barriers and increasing accessibility. In fact, the use of AT among wheelchair users and their
transportation accommodations have been extensively studied during past decades (Brinkey,
Savoie, Hurvitz, & Flannagan, 2009; Evcil, 2009; Fitzgerald et al., 2007; Frost, van Roosmalen,
Bertocci, & Cross, 2012; Owens & Simonds, 2010; Scheider, Manary, Hobson, & Bertocci,
2008). Most of these studies not only identified the potential benefits of using AT (e.g., powered
wheelchairs), but also made suggestions for future AT designs that can promote users’ mobility
as well as safety. Beside wheelchair AT, there are also studies that have been conducted to learn
how AT can improve transportation situations for people with different disabilities. As an
example, Blenkhorn and Evans (1997) introduced a low cost AT solution for individuals with
visual impairments. They explained that a handheld device with the capacity to send omnidirectional radio signals could detect what are nearby the user and hence send vocal signals to
inform the user where he/she is. As an implication, they suggested that the device could
significantly promote independent traveling for individuals with visual impairments.
Similar to transportation, accessibility enhancements have been intensively studied and
explored in the AT literature. Among different foci, AT that promotes physical accessibility and
virtual accessibility has gained the most attention from researchers and experts.
Regarding physical accessibilities, researchers have focused on environmental barriers
and how AT can successfully circumvent these difficulties. As an example, Vasiliadis and

	
  

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Angelidis (2005) noted that environmental barriers are prevalent which significantly affect
individuals with disabilities in accessing public services. These barriers should be carefully
measured and solved in order to create an integrated environment for everyone. They further
introduced and described technology devices that could successfully improve these situations. A
smart card, as an example mentioned by Vasiliadis and Angelidis, is a phone card tailored to the
user. When the user inserts the smart card in public phone system, the phone would recognize the
user and tailor the service to him/she. These tailored services include pre-defined volume, sound
quality, font sizes, and preferred languages. In addition, they also mentioned the technology for
functions of voice recognition and noise cancellation. These technology devices are really
beneficial for individuals with hearing impairment and visual impairments. Another AT which
helps in promoting accessible environment was proposed by Ikonen-Graafmans and Graafmans
(2003). They introduced a barrier-free suburb in Finland which would be impossible without the
use of AT. They explained that the use of assistive technology devices not only improved the
mobility situation for individuals with disabilities, but also made accessing public services easier
for them. In the suburb, AT was utilized for automatic windows and doors, customized elevators,
and supporting rails. This AT enabled individuals with mobility concerns to travel around the
environment independently. In addition, according to Ikonen-Graafmans and Graafmans, daily
chores such as disposing garbage, were also made easier for wheelchair users by the use of
multiple technology solutions. With help from the use of assistive technology and universal
design, the suburb won the golden Helios-prize from the European Union. Although this was just
a case that happened in a small suburb of Finland, it showed the benefit AT can bring to
individuals with disabilities.

	
  

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Virtual accessibility is another advantage which could be achieved by the use of AT.
Virtual services such as the Internet or the World Wide Web (WWW) have been among most
participated in daily activities for most people nowadays. However, despite the nature of the
Internet service as highly customizable, not all websites are designed or prepared to be fully
accessible for individuals with disabilities. For example, screen readers for individuals with
visual impairment might not be able to capture picture information if the picture on the website is
not accompanied by explanation texts. Dazzling special effects from certain websites might
cause further confusions for individual with cognitive impairments. The difficulty of finding
desired information (e.g., how many pages does the person need to go through in order to find
the right information) on the Internet might affect individuals’ frustration levels. Due to these
situations, the enhancement of web accessibility has been emphasized and studied considerably
in the AT and rehabilitation literature in the past years. In fact, the journal, Disability and
Rehabilitation: Assistive Technology, used a special issue to specifically discuss web
accessibility research in 2009. Several important considerations and elements were identified for
designing accessible websites, for examples, web adaptability, which focuses on flexibility of the
website in order to fit every user’s need and browsing habit (Kelly, Nevile, Sloan, Fanou, Ellison,
& Herrod, 2009); website design standards and protocols, which detail the necessary elements in
developing accessible websites (Bigham, Brudvik, Leung, & Ladner, 2009; Obrenovic, 2009);
and website accessibility evaluations, which provide measurable standards for websites’
accessibility (Vigo, Brajnik, Arrue, & Abascal, 2009; Watanabe, 2009). While Internet
accessibility for individuals with disabilities is still a new territory that needs more effort, AT has
the potential to create more accessible web browsing environments for them.

	
  

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Another social inclusion benefit that could be gained by the use of AT is promoting the
participation of recreational activities among individuals with disabilities. As Guttmann (1976)
mentioned, recreational activities such as sports are the most natural remedial exercises for
individuals with rehabilitation needs. Guttmann further explained that with adequate exercises,
individuals could improve their strength, speed, coordination, and endurance. Similarly, Brittain
(2012) also claimed that sport contests such as the Paralympic games could significantly improve
the psychological and physical wellbeing of individuals with disabilities. Due to the positive
outcomes of sport activities, researchers have devoted efforts to explore the means of promoting
sport participation for the disability population. Among possible solutions, AT is one that
consistently provides flexibilities and supports for individuals with disabilities to participate in
various sports activities. As an example, De Groot et al. (2003) introduced a new wheelchair
design specifically for users to have higher quality performances in basketball games. They
articulated that the new design provides advantages such as light weight, rolling resistance, and
footrest stability. In addition, the advancement of wheelchair technology allows more
customizations, and hence lowers cost on tailor made wheelchairs. Another recreational activity,
gaming, has also been also emphasized in the AT literature for the past few years. For instance,
Puret, Archambault, Monmarché, and Slimane (2006) introduced a new game generating system
that facilitates children with disabilities’ learning through playing games. Similarly, Shimizu,
Yoneda, Minagawa, Ohnishi, and Uchiyama (1999) unveiled an AT system that can provide
extra cues for blind children to have better spatial awareness. As Shimizu et al. mentioned, this
system helped children in games such as tic-tac-toe.
For the past few decades, promoting and advocating a fairer environment for individuals
with disabilities have been the center of emphases in the literature across different rehabilitation

	
  

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disciplines. Although there are no simple answers for these challenges, AT sheds light on the
path to the goal. In fact, as evidence shows, AT has provided not only extra physical support for
users, but also psychological empowerment. In short, AT is powerful and helpful for individuals
with disabilities in every aspect of their lives. Hence, continuous research and development of
the AT should be addressed and emphasized. At the same time, it is also rehabilitation
practitioners’ responsibility to be competent in providing AT services.
Challenges of Assistive Technology
Although it is well recognized that AT has positive impacts on the everyday lives of
people with disabilities, the implementation of AT does not guarantee successful rehabilitation
outcomes. In reality, mismatches between the individual and the AT device are frequently seen
scenario in rehabilitation cases. As a result, these mismatched devices are often abandoned or
discarded. In a study conducted by Phillips and Zhao (1993), two hundred and twenty-seven
users of AT devices were surveyed to understand their experience of using AT. The result
showed that among the participants, 29.3% of them completely abandoned their AT by the time
of the study. This situation was especially more robust in the case of mobility devices. As
Phillips and Zhao (1993) pointed out, mobility aids were the highest abandoned tools compared
to other categories. Similar abandoned situations were also found in Cushman and Scherer's
(1996) study. Cushman and Scherer reported that one hundred and twenty-eight AT approaches
were prescribed to forty-seven participants with mixed diagnoses. Three months after the AT
prescriptions, only eighty-six devices were still in use among participants. In other words, the
abandonment was as high as 32.8 in percentage. This high rate is particular alarming because (a)
the expenses of AT were wasted without positive outcomes, and (b) users abandoned their AT as

	
  

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a result of frustrations from using them, which in turn affects their impression of the
effectiveness of AT in the future.
Given high abandonment issue of the AT devices, it is crucial for rehabilitation
professionals to understand possible reasons and how to alleviate such situations. As BrownTriolo (2003) stated, most research concerning AT use and abandonment has focused on factors
such as the cost of devices, the physical skills necessary for use, demographics, and device
reliability and safety. While some of the identified factors are limitations of AT, others are
related to rehabilitation services. For instance, Phillips and Zhao (1993) pointed out four factors
predicting the abandonment of the AT devices by users with disabilities. These four factors
include (a) lack of consideration of user opinion in selection, (b) easy device procurement, (c)
poor device performance, and (d) change in user’s needs or priorities. Among these factors, (b)
and (c) concern the availability and affordability of AT devices. These two factors really require
rehabilitation technology engineers and researchers to continue their efforts on inventing and
developing better AT devices to meet the needs of individuals with disabilities. On the other
hand, factors (a) and (d) are related to rehabilitation service planning and delivery. In order to
raise the successful rate of matching persons with AT devices, rehabilitation professionals should
be competent in providing AT information and professional suggestions for making appropriate
AT selections. As for the service planning, good communications between clients and
rehabilitation professionals will strengthen the rehabilitation plans. Therefore, the AT selected
after careful discussions between practitioners and clients should be able to meet and
accommodate clients’ dynamic needs even after a period of time. As a matter of fact, the number
of abandonment of AT could be reduced simply with close collaboration between practitioners
and individuals with disabilities. For example, in the study conducted by Bates, Spencer, Young,

	
  

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and Rintala (1993), they found that the perceived stigma of the accommodations would affect
individual’s decision to abandon them. When an AT is implemented, the user needs to adjust
himself/herself to accept the accommodation not only physically but also emotionally. Bates et al.
(1993) mentioned it is the emotional adaptation that takes longer time than the physical
adaptation. They further suggested that practitioners should recognize client’s emotional desires
and communicate with them to smoothen the implementation process of the accommodation.
To sum up, although AT has been identified to be powerful and efficient in improving the
quality of lives of individuals with disabilities, the successful outcome is not a guarantee. In fact,
no matter what the challenges are for AT itself or the users, researchers and practitioners play an
important role in understanding and coordinating the person and the AT device. It is through
careful communications and meticulous plans between the practitioners and the clients that the
successful rate of AT could be raised. As a result, as frontline service providers, rehabilitation
practitioners are responsible for being competent to provide AT services.
Assistive Technology in Rehabilitation Counseling
As with many other rehabilitation professionals, such as occupational therapists, physical
therapists, and special education teachers, rehabilitation counselors work with individuals with
disabilities to promote the quality of their lives. Among various services rehabilitation
counselors provide, accommodation has been identified as one of the most important
interventions which substantially affect rehabilitation outcomes (De Groot et al., 2003). Langton
and Ramseur (2001) argued that assistive technology, as a major example of accommodations,
should be emphasized among rehabilitation counseling professionals. The following section
demonstrates the importance of AT in the profession of rehabilitation counseling from the
perspectives of (a) regulatory organizations and (b) the literature’s suggestions.

	
  

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Regulatory organizations. Two of the most important regulatory organizations concerning
rehabilitation counselors are the Council on Rehabilitation Education (CORE) and the
Commission on Rehabilitation Counselor Certification (CRCC). CORE (2012) is a specialized
accreditation organization that is recognized by the Council for Higher Education Accreditation
(CHEA), and it is a member of the Association of Specialized and Professional Accreditors
(ASPA). CORE’s mission is to accredit graduate programs that provide professional
rehabilitation counselor preparation. Currently, there are 95 master rehabilitation education
programs that have received accreditations from CORE (2012). In order for a program to receive
accreditation, its curriculum must be assessed by the Standards for Rehabilitation Counselor
Education Programs. These standards detail the knowledge and skills that should be included in
professional preparation programs. Among the standards that stress different knowledge domains,
AT is emphasized in several areas. For example, under the knowledge domain, C4.2.b,
rehabilitation counselors should be able to apply the techniques of job modification/restructuring
and the use of assistive devices to facilitate the placement of people with disabilities. Under
C4.11.a, rehabilitation counselors should be able to identify and describe assistive technology
resources available to individuals with a disability for independent living and employment.
Under C9.4.a, rehabilitation counselors should be able to determine the need for assistive
technology and the appropriate intervention resources, and C9.4.b points out that rehabilitation
counselors should be able to support the evaluation of assistive technology needs as they relate to
rehabilitation services. Similarly, knowledge domain C10.15 lists the assistive technology and
accommodation competencies rehabilitation counselors should have. This is consistent with what
Chan et al. (2003) found in their study, in which they suggested that rehabilitation counselors
should be competent in providing assistive technology services.

	
  

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Another important regulatory organization for rehabilitation counselors is the
Commission on Rehabilitation Counselor Certification (CRCC). CRCC’s mission is to set the
standard for quality rehabilitation counseling services in the United States and Canada (CRCC,
2012). Therefore, while CORE sets standards for professional preparation programs, CRCC sets
standards for qualified individuals to become certified rehabilitation counselors (CRCs).
Currently, there are more than 35,000 rehabilitation counselors who have received certification
from the CRCC. Specific to standards, CRCC sets ten knowledge domains that certified
rehabilitation counselors should be competent with. These domains include (a) assessment and
appraisal; (b) diagnosis and treatment planning; (c) career (vocational) counseling; (d) individual
and group counseling treatment interventions focused on facilitating adjustments to the medical
and psychosocial impact of disability; (e) case management, referral, and service coordination; (f)
program evaluation and research; (g) interventions to remove environmental, employment, and
attitudinal barriers; (h) consultation services among multiple parties and regulatory systems; (i)
job analysis, job development, and placement services, including assistance with employment
and job accommodations; and (j) the provision of consultation about and access to rehabilitation
technology (CRCC, 2012). It is clear that rehabilitation technology is one of the most important
areas that rehabilitation counselors should be familiar and competent with. In addition, CRCC’s
professional code of ethics also reveals that it is rehabilitation counselors’ responsibility to be
able to provide services associated with assistive technology. For example, since January 1st
2010, CRCC has modified ten areas in its professional code of ethics. Section J, as one of the
major changes, explicitly requires rehabilitation counselors to be competent with the use of
advance technologies. Specifically, under section J.12.a, rehabilitation counselors are held
responsible for determining that clients are functionally and linguistically capable of using the

	
  

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application and that the technology is appropriate for the needs of clients when technology
assisted services are used to increase accessibility. Section J.4 and section G.4 both indicate that
rehabilitation counselors are responsible for competency in providing technology-assisted
assessments.
Literature. Assistive technology and its application have been mentioned in the literature
of rehabilitation counseling for many years. Although rehabilitation counselors have had mixed
perceptions toward the use of technology in service delivery systems, they have generally agreed
that assistive technology does improve the clients’ quality of life (Barros-Bailey, Benshoff, &
Fischer, 2009). As Barros-Bailey et al. mentioned, rehabilitation technology is perceived as both
threat and opportunity. In their study, a number of current rehabilitation counselors expressed
concern that the emphasis on rehabilitation technology would significantly shrink the attention
given to the individual client, and would therefore harm the relationship between the counselor
and the client. However, the majority of the participating rehabilitation counselors (61%) believe
that assistive technology would improve the capacity and the opportunities for their clients. As a
result, although with mixed perceptions toward AT, Barros-Bailey and her colleagues concluded
that AT education should be included in rehabilitation counselor training curriculums.
Similarly, Noll, Owens, Smith, and Schwanke, (2006) conducted a study on rehabilitation
counselors in the state of Wisconsin. The interest of the study concerned how rehabilitation
counselors considered themselves as a role in providing AT services. One hundred and eighty
five rehabilitation counselors from the Wisconsin Division of Vocational Rehabilitation
participated the study. Noll et al. found that in general, rehabilitation counselors considered AT
as cost-effective interventions that could largely enhance employment opportunities for their
clients. In addition, although rehabilitation counselors recognized their role as AT service

	
  

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providers, they did not have complete confidence in services such as determine the AT solution,
identify clients’ AT needs, and provide consumers AT information. Noll et al. (2006) concluded
their study with the suggestion that AT education should be recognized and included in the
future rehabilitation counselor preparation programs.
Scherer, Sax, and Glueckauf (2005) authored an article with the title “Activities and
Participation: The Need To Include Assistive Technology In Rehabilitation Counselor
Education”. In the article, Scherer et al. utilized International Classification of Functioning,
Disability and Health (ICF) model from World Health Organization (WHO) to illustrate the
importance of AT in promoting quality of lives of individuals with disabilities. Beside all the
potential positive outcomes that could be gained by the use of the AT, they also pointed out the
“underutilize” issue among rehabilitation professionals. Some reasons for underutilization of AT
could be attributed to misunderstanding of AT to be only “high-tech” or high cost solutions and
the lack of training among rehabilitation counselors in relation to their AT knowledge and skills.
As a conclusion, Scherer and her colleagues suggested that rehabilitation counselors should
receive more AT education training with the emphases on understanding AT and coordinating
services.
To sum up, AT has been a very effective and promising intervention that provides
additional supports for individuals with disabilities in their rehabilitation process. However, if
rehabilitation counselors are not fully prepared to provide quality AT services to their clients, the
effectiveness of such intervention will be limited. As the regulatory organizations (e.g., CRCC
and CORE) specify, it is rehabilitation counselors’ professional and ethical responsibility to
update their AT knowledge and skills continuously. Similarly, the rehabilitation literature has

	
  

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suggested that the AT education should be emphasized in the rehabilitation counselors
preparation programs.
Current Education Provision
As identified above, the AT knowledge and skills are crucial for rehabilitation counselors
to assist their clients effectively in rehabilitation processes. Education needs are also identified
through the review of the past literature. The next task is to understand how the AT trainings are
offered currently in rehabilitation counselor preparation programs.
Estrada-Hernandez, Wheaton, Dawson, and Krispinsky (2007) conducted a study to
explore how the AT education were offered in the master level of rehabilitation counseling
programs. A total number of eighty-eight rehabilitation counseling programs which have
received the accreditation through the CORE were surveyed on their AT education offerings.
Estrada-Hernandez et al. reported that of all programs which responded (47 programs), there are
only 36% of the schools offer at least one AT course. In addition, among these 47 programs, only
nine schools list AT as a required couse. The low rate on offering AT education is really
alarming considering ATs have been identified as a very important intervention and scope of
practice for rehabilitation counselors. According to Estrada-Hernandez et al. (2007), another
concern which worth more attentions is that the majority of the rehabilitation counseling
programs only infuse AT training into other classes such as medical aspect of disability, job
placement and development, and rehabilitation assessment. While it is sometimes appropriate
and necessary to infuse AT topics into the classes such as ethics class, solely depends on infusion
of the class might not be sufficient for the purpose of the training. In fact, the depth and width of
the AT knowledge and skills are beyond material infusions can offer. The same suggestion was
also made by Scherer et al. (2005). Scherer and her colleagues noted that depends on the

	
  

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individual rehabilitation counseling program’s curriculum designs, some invite guest lectures to
disseminate AT knowledge as a part of the other classes, some create instructional module to
teach AT, and still some develop the specific class for AT trainings. Although different
curriculum designs provide flexibility to the program, some programs might suffer from
insufficient trainings in both the breadth and depth of the AT education.
As Estrada-Hernandez et al. (2007) noted, one of the reasons for the rare dedicated AT
class in some rehabilitation counseling programs can be attributed to the limited resource they
have. Specifically, the time constraint, financial support, and personnel needed to develop a
standalone AT class are not fully available for most of the rehabilitation counseling programs.
As a result, most rehabilitation counselor training programs choose to infuse AT knowledge and
skills into other classes as mentioned above. While the infusion means is useful for future
practitioners to gain more AT skills, the selection of material becomes an important decision for
these rehabilitation counseling programs to make. Because the lack of resource most
rehabilitation counseling programs have, they have to decide what to be included and what to be
excluded from the required curriculum. In fact, given the limited resource, only the most relevant
materials could be used to train future rehabilitation counselors.
Given the resource limitation, it is important to understand what are the most relevant AT
skills to the rehabilitation counselors so that the infusion of the training could be more effective
and efficient. Therefore, the intention of this study is to understand what are the most important
AT skills from the perspective of current rehabilitation counselors. Specifically, the foci will be
addressed on rehabilitation counselors’ perception of importance and competence in providing
AT services. By comparing and contrasting perceived importance and competence, it will

	
  

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provide valuable information of what the most frequent used AT skills are for the rehabilitation
counselors. In addition, AT skills that need the most enhancements could also be identified.
Theoretical Framework
Various AT models have been proposed to facilitate rehabilitation practitioners providing
AT services. For example, Cook and Hussey (1995) developed the Human Activity Assistive
Technology (HAAT) model that addresses the properties of the client and the tasks in AT
planning. Similarly, Zabala (1995) introduced the Student Environment Tasks Tools (SETT)
model that emphasizes the harmony of the student’s ability, the environment, and the technology.
While these models are very useful in service planning, they do not address the properties of the
rehabilitation practitioners. In fact, the ability and the skill of the service providers should not be
overlooked. Therefore, in order to understand the importance of the rehabilitation practitioners in
AT service delivery, a model with the emphasis on the service provider is needed.
Assistive Technology Device (ATD) selection framework is identified to provide basis
for the current study (See Figure 1 below).

	
  

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Assistive Technology Device Selection Framework
ATD	
  Decision-­‐Making	
  
and	
  Device	
  Selection	
  

Personal	
  Factors	
  

Ÿ Resource:	
  	
  
	
  Family/Friends	
  and	
  	
  	
  
	
  significant	
  others	
  
Ÿ Financial	
  
Knowledge	
  and	
  
information	
  
Expectations	
  
Personal	
  Preferences	
  
and	
  priorities	
  

	
  

	
  
	
  

Consumer	
  

Assessment	
  of	
  
Functional	
  ATD	
  Need	
  
(Objective	
  Need)	
  

	
  

	
  
	
  

	
  

Provider	
  

Assessment	
  of	
  ATD	
  
Predisposition	
  
(Subjective	
  Need)	
  

	
  
	
  

	
  

Environmental	
  Factors:	
  Cultural	
  &	
  Financial	
  Priorities,	
  Legislation	
  &	
  Policy,	
  Attitudes	
  
of	
  Key	
  Others.	
  
Figure 1. Framework for Modeling The Selection of Assistive Technology Devices.
According to Scherer et al. (2007), the ATD selection framework involves two major
“players” in the process: (a) the consumer of the assistive technology devices, and (b) the service
provider. To fit the context of the current study, the consumer would be considered as the client
with a disability and the service provider would be considered as the rehabilitation counselor. As
identified, the process of selecting appropriate ATDs for individuals with disabilities is a product
of close communication and collaboration between these two roles. Both the client and the
rehabilitation counselor have their own personal factors. These personal factors include
individuals’ resources, levels of knowledge, expectations, references, and priorities. Personal
factors could be strengths and also could be constraints. The second factor, ATD decision-

	
  

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making and device selection, is a result of the interaction between the client and the
rehabilitation counselor. One last key factor affecting the ATD selection is the environmental
factor. The details of personal factors, ATD decision-making and device selection, and
environmental factors are introduced as below.
Personal factors. Personal factors involve four major elements which include (a)
resource/financial, (b) knowledge and information, (c) expectations, and (d) personal preferences
and priorities. For the client, resource and financial factors represent supports he/she can obtain
to purchase or implement the AT device. For example, the financial constraint can be a
significant limitation when selecting appropriate AT device. In addition, whether resources such
as insurance funding and loan programs are available for the client also could affect the AT
selection outcome. For the rehabilitation service provider, the resource/financial factor represents
whether the practitioner can find additional funding to support his/her client’s AT decision.
Knowledge and information represent both the client and the rehabilitation practitioner’s
awareness and recognition of AT that is available on the market. It is especially important for
rehabilitation practitioners to be knowledgeable of the variety of AT devices since it is unlikely
for them to help their clients implementing the devices they do not even know exist. This is
consistent with Riemer-Reiss’ (2003) finding in which he suggested that the rehabilitation
practitioners tend to provide more AT services if they feel competent in using such AT devices.
Therefore, knowledge of AT as well as competency of using such devices are identified as one
important indicator by the ATD selection model. Both the client and service provider’s
expectation would affect the ATD selection as well. The expectation mainly focuses on the
functionality of the AT. In other words, what the goals are to be achieved by the use of ATD is
the main concern. Through the communications between the client and the rehabilitation service

	
  

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provider, the expectation toward the AT could be positive and realistic. One last personal factor
is the personal preferences and priorities. As identified, there are more than 26,000 AT devices
available nowadays. Some of them overlap on functions. While the variety of selection increases
flexibilities, it also creates complexities. As a consequence, it is critical for the service provider
to implement AT that satisfies client’s physical needs as well as emotional and psychological
desires.
ATD Decision-Making And Device Selection. As the step before ATD is purchased and
implemented, it involves the collaboration and communication between the client and the
rehabilitation service provider. Two factors affecting the final decision are assessment of
functional ATD need (objective need) and assessment of ATD predisposition (subjective need).
The objective assessment addresses the client’s functional capacities and limitations (e.g., the
client cannot lift more than 20 lbs. independently). The subjective assessment describes the
psychological desires of the client (e.g., the client desires to work independently on the job
which includes lifting goods more than 20 lbs. in weight). As the client has better vision toward
his/her functional needs, he/she would also have better ideas of what AT is needed. On the other
hand, if the client does not understand his/her needs and desires, the ATD selecting process
would not be effective and could harm the decision-making process. Therefore, it is very
important for the rehabilitation service providers to facilitate their clients’ decision-making by
having effective discussion with their clients on objective goals and subjective desires.
Environmental factors. As depicted in Figure 1, the environmental factors really involve
the consideration of culture and financial priorities, legislation and policy, and attitudes of key
others. The rehabilitation service providers have to be aware of their clients’ culture and
financial backgrounds in order to successfully match them with ATDs. For instance, the client

	
  

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cannot afford certain ATDs or the client comes from a place that internet service is not fully
accessible. In addition, the rehabilitation service providers also have to understand the legislation
of policy that could potentially affect the ATD selection. For instance, the company in which the
client works might have its own accommodation policies. Lastly, the attitudes of key others
might also influence the ATD selection outcome. For example, the client from a family that has
biases against accommodations might affect the ATD selecting outcome.
Perceived Importance and Competence
The relationships between an individual’s ability beliefs (i.e., perceived competence),
subjective values (i.e., perceived importance), and expectancies for success have been studied for
decades in the psychology literature. Specifically, motivation theorists focus on studying (a) how
individuals’ ability beliefs and values form and change overtime (Wigfield Eccles, Suk Yoon,
Harold, Arbreton, Freedman-Doan & Blumenfeld, 1997), and (b) how they affect individuals’
activity performances and choices (Wigfield & Eccles, 2000). While both are important for
understanding an individual’s learning motivation and performance, the latter is particular
relevant to the present study. In order to better understand their implications, perceived
competence and perceived importance need be examined individually and jointly.
Perceived competence. The positive association between an individual’s perceived
competence and his/her subsequent performance has been identified. For instance, in the domain
of mathematics, Meece, Wigfield and Eccles (1990) report that children’s ability belief is a
strong predictor of their actual performance. In other words, children who perceive more
competent in mathematics tend to perform better in mathematics as well. While this example
seems to only apply to children with younger age, researchers have provided evidence supporting
the opposite (Bandura, 1994; Wigfield et al, 1997). In fact, Wigfield et al. suggest that the same

	
  

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effect can be seen across different age groups: competence beliefs of children, adolescents, and
adults are all positively associated with their achievement performances, amount of effort
devoted to the given tasks, and senses of self-worth. Therefore, age does not make any difference
in predicting an individual’s performance on the basis of his/her perceived competence.
Another important contribution of the finding which links perceived competence to actual
performance is when the measure of the skills is not directly achievable. For example, one focus
of the present study is to learn rehabilitation counselors’ competence in providing assistive
technology services. The direct measurement of rehabilitation counselors’ mastery of such skill
seems to be ideal and straightforward, whereas there is no simple way to do so due to the
complexity of the AT service itself. Therefore, the investigation of perceived competence
becomes a useful and logistic way for the purpose. In fact, the method using perceived
competence to map the actual competence has been validated in the context of vocational
rehabilitation professionals and the assistive technology: Riemer-Reiss (2003) investigates
vocational rehabilitation professionals’ perception of AT competence and their actual provisions
of the service, in which they finds positive associations between these two. Therefore, using
perceived competence to identify actual competence would be a reasonable, and in some cases,
the only means to achieve the purpose.
Perceived importance. Just as perceived competence, motivation psychologists have also
devoted significant efforts on studying the relationship between perceived importance, outcome
expectancy, and activity choice. For instance, as early as fifty years ago, Atkinson (1964) has
attempted to define attainment value and its relationship with performances. In Atkinson’s theory,
the value a person attaches on a task will determine his/her achievement motivation on the task.
Thus, if an individual perceives an activity to be important, he/she will try to perform better as

	
  

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well. Eccles, Adler, Futterman, Goff, Kaczala, Meece, and Midgley (1983) further suggested that
attainment value has broader influences. In fact, the literature indicates that the perceived
importance on a task not only determine an individual’s positive performance, but also have a
positive association with one’s learning motivation on the given task. Eccles et al. (1983) uses an
example to illustrate the idea: if a student thinks of himself as “smart” and perceives a certain
course (e.g., math) as intellectually challenging subject, he will try to perform better in the
subject because it will enhance the self-concept. Further, it is because the belief that the “smart”
student should take the “smart” course, he will choose to learn more from the subject. This is
correspond to what Wigfield and Eccles (2000) suggest, in which they report that children tend
to take more classes in relation to subjects which they perceive as more important.
Comparing perceived competence and perceived importance. As indicated, it is important
to explore perceived competence and perceived importance separately because each of them has
different implications on the person’s learning and performance of the given skill. On the other
hand, it is also important to study the difference and similarity of the perceived competence and
importance. In fact, the technique that compares and contrasts perceived competence and
perceived importance has been used in social science for decades. This technique is especially
useful for identifying training needs of a given professional. The idea is to identify those skills
that the sample rates the highest perceived importance and the least perceived competence at the
same time. When such a skill is identified, it represents that the skill is regarded as important
whereas most people do not feel competent with, and consequently, more training will be needed.
This technique has been used in the field of rehabilitation counseling for years. For examples:
Berven (1979) uses the technique to identify training needs for state agency rehabilitation
counselors, Chan, Leahy, Saunders, Ferrin, and Lee (2003) attempt to explore training needs for

	
  

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certified rehabilitation counselors (CRC) comparing these two, and Zanskas (2007) and Austin
(2012) use the same idea to find educators’ needs in training new rehabilitation practitioners.
Since it is one of the main foci of the present study to explore what the most important training
needs are for the CRC concerning their assistive technology skills, the same technique which
comparing perceived competence and importance is utilized. The specific analysis method is
discussed in chapter three.
Summary
Assistive technology has been identified as an important and effective intervention for the
rehabilitation counselors to promote clients’ quality of life. While the positive effect of AT is
really encouraging, the implementation of AT does not guarantee successful outcome. As a
matter of fact, there are still challenges. As one of the major challenges, the high AT abandon
rate indicates the problem of mismatch between individuals with disabilities and AT devices.
The lack of AT training among current rehabilitation counselors could be one of the reasons
responsible for the low successful rate. As identified by the rehabilitation literature, professional
AT training and continuous education are needed for the rehabilitation service providers in order
to provide quality AT services.
However, while the AT education needs are apparent for every rehabilitation counselor, it
is not an easy task to achieve. In fact, due to the resource limitation and manpower constraint, the
majority of rehabilitation counselor preparation programs choose to infuse AT knowledge and
skill training in classes such as assessment, medical aspect of disability, and ethics. Although the
infusion of knowledge and skills invites the advantages of saving time and cost, the amount and
quality of the AT training might not be sufficient. Therefore, it is very important to identify what
are the most relevant and necessary skills for rehabilitation counselors to have for providing

	
  

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quality AT services. The current study will attempt to answer this question by investigating
current rehabilitation counselors for their perceptions regarding AT services.
Scherer et al.’s (1997) ATD selection framework was used to provide fundamental basis
for the current study. As illustrated in the model, in order to provide quality AT services and
facilitate decision-making process, rehabilitation counselors are responsible to acquire AT
knowledge and help AT decision-making.

	
  

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CHAPTER THREE: METHOD
Due to the purpose of the study, a quantitative design was selected. The study utilized
Internet-based instruments to investigate the assistive technology competency and importance
perceptions of current Certified Rehabilitation Counselors. The quantitative data was used to
conduct descriptive as well as ex post facto analyses. It was anticipated that findings of this study
would inform CRCs and rehabilitation educators regarding assistive technology skill training
needs and priorities. The qualitative data had provided references for future educational ideas.
This chapter addresses research questions, participants, instruments, variables, demographic
information, procedures, research design, data analysis, and the limitations of the study.
Research Questions
This study focused on exploring Certified Rehabilitation Counselors’ assistive
technology knowledge and skill. Specifically, the emphasis was on CRCs’ perception of the
importance and the competency in providing AT services. The research questions of interest in
this study were as follows:
1. How important do CRCs perceive for assistive technology skills in rehabilitation
counseling practice?
a. Is there a difference in perceived importance across three different factors (i.e.,
understanding AT, using AT, and making AT decision) among assistive
technology skills?
b. Do CRCs’ backgrounds (e.g., gender, years of practice, practice setting,
disability) associate with perceived assistive technology importance?
2. How competent do CRCs perceive themselves in providing assistive technology services?

	
  

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a. Is there a difference in perceived competence among three assistive technology
factors (i.e., understanding AT, using AT, and making AT decision)?
b. Do CRCs’ backgrounds (i.e., gender, years of practice, practice setting, disability)
associate with their perceived assistive technology competence?
3. How do CRCs perceived importance differ from perceived competence in assistive
technology skills?
a. Are there differences between CRCs perceived importance and perceived
competence across three AT factors?
4. What can be improved in relation to assistive technology service provision?
Participants
The population of interest in the proposed study was Certified Rehabilitation Counselors
(CRCs). According to Commission on Rehabilitation Counselor Certification (CRCC, 2012),
there are currently approximately 16,000 CRCs across the United State. CRCs were chosen to be
the population of interest in this study because CRCs received professional trainings from
rehabilitation counseling programs and have passed the national certification examination.
Therefore, CRCs represent skillful and qualified professionals who can provide quality
rehabilitation counseling services. In addition, CRCs perform their jobs in different employment
settings such as private/public agencies, for profit/non-profit organization, and in different states.
The diverse nature of CRCs was particularly useful for this study because these demographic
data could be used to investigate whether different settings would yield different results of
perceived importance and perceived competence related to AT.

	
  

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Sample Size
Prior to the sampling process, an appropriate sample size had to be determined. Several
techniques were considered for the sample size determination. First, since multiple regression
analysis was chosen to answer research questions (i.e., “are there differences in perceived
importance across three assistive technology factors relative to CRC demographic characteristics”
and “are there differences in perceived competence across three assistive technology factors
relative to CRC demographic characteristics”), an a priori power analysis was conducted. For
such calculation, 12 predictors (please see data analysis section) were identified, power was set
as .80, and alpha was set as .05. In addition, according to Cohen (1988), a medium effect size (f
= .15) was used. The analysis yielded an appropriate sample size of 127. In addition to power
analysis, item-participant ratio is also considered. As Costello and Osborne (2005) argued, itemparticipant ratio for the survey study is reasonable at 10:1. Since there were 18 items in the
ATPRC, the target number for sample size was approximately 180. In comparison of the a priori
power analysis and subject to item ratio suggestion, the researcher decided to use the more
conservative 180 as target sample size for the current study.
Instrumentation/Variables
In review of the assistive technology and rehabilitation counseling literature, there were
no instruments identified that directly measure rehabilitation counselor perceptions of the
importance and their competence in performing assistive technology tasks. However, an
instrument to assess the assistive technology knowledge and skills of special education teachers
was developed by Michaels and McDermott (2003). For the purpose of this study, the researcher
adopted the survey, Special Education Teacher Preparation Survey – Assistive Technology
Integration (SETPS). However, for the purpose of this study, some modifications of SETPS were

	
  

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necessary. The new survey, Assistive Technology Perception for Rehabilitation Counselors
(ATPRC), was then developed to fit the context of the rehabilitation counseling discipline and
CRCs. In specific to modifications made, there were incidental changes such as word
substitutions. For instances, the SETPS has items, “use a variety of AT hardware devices and
software applications to support students’ individual needs”, “use AT, the internet and other
media to actively engage students in research and independent learning”, and “facilitate
student/family involvement and collaboration in AT decision-making”, and the ATPRC has
modified items such as “use a variety of AT hardware devices and software applications to
support clients’ individual needs”, “use AT, the internet and other media to actively engage
clients”, and “facilitate client/family involvement and collaboration in AT decision-making”.
Therefore, “student” was changed to “client”. Other modifications such as “use AT to increase
access to the general education curriculum” was modified to “use AT to increase access to
rehabilitation services”, and “use AT to promote access within school, community, and leisure
environments” was modified to “use AT to promote access within services, community and
leisure environment. For further comparison, the SETPS (Appendix A) and the ATPRC
(Appendix B) are included at the end of this document.
Although the instrument was only modified incidentally to fit the context of rehabilitation
counseling, the potential influence of the changes should be appraised. As a cautious step to
ensure the instrument, ATPRC, has its reliability, face validity, clarity, and appropriateness in
wording, a group of rehabilitation counseling doctoral students was asked to pilot the instrument.
Specifically, these individuals were asked to provide professional opinion on instrument’s (a)
content, (b) clarity, (c) appropriateness, and (d) appearance. The ATPRC was again revised
according to the suggestions these individuals made. For instances, item one, “define AT and

	
  

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describe its potential impact on the lives of persons with disabilities”, was change to “ability to
define AT and describe its potential impact on the lives of persons with disabilities” to prevent
participants’ confusion on how to answer the question; for item ten, “use differential
rehabilitation plans to infuse assistive technology into services”, the word “differential” was
eliminated to prevent misunderstanding. The final version of the ATPRC is included in
Appendix B.
The Assistive Technology Perception for Rehabilitation Counselors (ATPRC) consisted
of three sections: demographic information, quantitative survey and exploratory open-ended
questions. The demographic section was designed to gather basic information of participants
such as gender, age, years of practice, job title, ethnicity and the highest education level. The
second section, quantitative survey, included two sets of the same 18 items. Items were designed
on the basis of 7-point Likert scale. The first set of questions was designed to investigate
participants’ perceived importance in understanding AT, using AT and making AT decisions.
Therefore, the 7-point scale ranged from Not Important At All (1) to Extremely Important (7).
The second set of questions was designed to explore participants’ perception of their competency
in understanding AT, using AT, and making AT decisions. The 7-point scale ranged from Not At
All Prepared (1) to Extremely Prepared (7). The last section of the survey consisted of two openended questions designed to investigate participants’ willingness and preferred means of
receiving additional assistive technology related training.
The instrument was designed to measure one construct (i.e., domain), Assistive
Technology Skills. Consistent with original survey created by Michaels and McDermott (2003),
factors associated with assistive technology skills in this study referred to competencies in: (a)
understanding of AT, (b) using AT, and (c) making AT decisions. Although these factors were

	
  

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initially identified by National Council for Accreditation of Teacher Education (NCATE, 1997)
for special education teachers, they were consistent with the likely application, use, and
understanding of AT in a rehabilitation counseling context. For example, Sax (2002) reported
that rehabilitation counselors should be able to identify the benefits of using of AT, assess clients’
needs through a person centered approach, coordinate within an interdisciplinary team, complete
research on possible AT options, and make recommendations for modifications to assist an
individual in access to work, education, recreation, or social activities. These skills identified by
Sax (2002) were identical with those identified by NCATE (1997). Therefore, the three-factor
construct was also utilized for the present study.
In specific to three factors, the first factor, understanding AT, pertains to knowledge of
AT, fundamental AT skills and awareness of how AT could potential impact clients’ quality of
lives. Examples of survey questions include “Describe the impact of AT legislation and policy
on service delivery”, and “Describe the potential use and benefits of AT in employment,
community, and leisure environments”. A total of six items are included for the understanding
AT factor.
The second factor, using AT, pertains to rehabilitation counselors’ competencies in
practical experiences such as familiarity with hardware AT devices as well as software
applications. Examples of survey questions include “Use AT to increase access to rehabilitation
services”, and “Use AT, the internet and other media to actively engage clients”. Six items were
included in this factor.
The third factor, making AT decisions, pertains to rehabilitation counselors’ skills in
providing professional AT advice, coordinating resources, planning and implementing AT
interventions, and monitoring the use of AT. Example questions include “Facilitate

	
  

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clients/families’ involvement and collaboration in AT decision-making”, and “Serve as a
resource for AT information, consultation and technical assistance to colleagues and families”. A
total of six items were included in this factor.
Reliability and Validity
According to Michaels and McDermott (2003), SETPS has established well internal
reliabilities. In specific, the internal reliability figures (i.e., Cronbach’s alpha) of perceived
importance construct are .93, .95 and .95 for understanding AT, using AT and making AT
decisions, respectively. Internal reliability figures of perceived competence construct are .91, .90
and .92 for understanding AT, using AT and making AT decisions, respectively. According to
Nunally (1978), the reliabilities should be considered acceptable.
In relation to validity, Michael and McDermott (2003) established SETPS’s validity by (a)
reviewing AT literatures and (b) consulting experts of AT and survey development. In specific, a
literature review provided a foundation of the instrument development that allowed appropriate
content to be included in the first draft of the SETPS. Upon the completion of first draft of the
SETPS, it was sent to experts of AT and survey development for consultation. Experts were
asked to provide professional opinion on instrument’s (a) content, (b) clarity, (c) appropriateness,
and (d) appearance. The final version of SETPS was a result of a series of modifications and
revisions on the basis of experts’ professional suggestion. Hence, social validity, content validity,
and face validity were grounded in the instrument’s design.
Procedure
Approval for the use of human subjects in research was obtained from the Michigan State
University Institutional Review Board (IRB) prior to the initiation of data collection. Following
receipt of approval from IRB, a submittal letter and the current study proposal was sent to the
	
  

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Council on Rehabilitation Counselor Certification (CRCC) research committee for approval of
the study. CRCC provided a list of e-mail addresses using method of convenience, nonprobability sampling (Trochim, 2006). Based on reviews of similar studies conducted in the
context of rehabilitation counselors (Zanskas, 2007; Austin, 2012) and research on Internet based
surveys (Cook, Heath, & Thompson, 2000), the expected response rate for the current study was
approximately 20%. Hence, in order to enlist an adequate number of participants (n=180),
approximately 900 email addresses were requested from the CRCC.
E-mails was sent to each potential participant through the list provided by the CRCC. A
consent form (see Appendix C), invitation to participate in the study, and the link to the online
survey were included in the e-mail. Specifically, each participant was presented with informed
consent form which explained that the purpose of the study was to understand current CRCs’
perceptions of importance and competence in regard to AT knowledge and skills, and preferred
means of receiving AT-related training. In addition, informed consent also included statements
that notify participants that participation in the study was completely voluntary and was
anonymous. Participants were prompted to read the consent form.
The initial invitations were sent out through e-mail. One week after the initial e-mail was
sent, a second email was sent to remind those who have not yet responded. A third and final
reminder e-mail was sent again one week after the second reminder email was sent.
In specific to the data collection process, the study utilized online automated survey
instrument “Qualtrics” to collect information from participants. Although demographic data was
also collected for purposes of data analyses, no identifiable personal information was included in
the survey. The raw data of individual responses to the survey was kept on Qualtrics and secured
and protected utilizing Secure-HTTP system.

	
  

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Data Analysis
The quantitative research design of this study was an Internet-based ex post facto survey
design where a series of descriptive statistics, exploratory factor analysis (EFA), one-way
univariate analysis of variance (ANOVA), multiple regression analysis, and paired t-tests were
utilized to interpret results and answer research questions. The data was downloaded from
Qualtrics’ database and imported into Statistical Package for Social Science 20.0 (SPSS) for Mac.
The initial step involved data cleansing processes that included importing data, naming variables,
and checking accuracy and examining missing data.
Descriptive statistics, frequencies, and percentages were used to report demographic
information (e.g., gender, ethnicity/race, years of practice, and employment settings) of
participants. The EFA was not chosen as a method to answer research question, instead, EFA
was used to test if items on the ATPRC measure theoretical construct of interests. In addition,
EFA also provided information to determine if the items could be better explained by fewer
factors that held common item interrelationships and significant loadings (Raykov &
Marcoulides, 2008).
To answer research questions 1, 2, and 3, quantitative data was used to process analyses
such as descriptive statistics, frequency tables and percentages. These data was obtained on 7point Likert scales and was handled as interval scales to interpret findings and answer research
questions. The purpose of the analyses was to provide general information of data distribution. In
specific to data analyses, descriptive statistics of CRCs’ perception of importance and
competence were generated and reported.
To answer research questions 1a and 2a, a one-way univariate analysis of variance
(ANOVA) was utilized. 1a and 2a’s major concern was to understand whether there were

	
  

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differences between factors within perceived importance and competence. Therefore, one-way
ANOVA utilized F-test to determine whether there was an overall significant difference between
three factors. Further, within each construct of perceived importance and perceived competence,
three one-by-one comparisons (i.e., understanding AT versus using AT, understanding AT
versus making AT decision, and using AT versus making AT decision) were performed to
inform researcher if one factor was significantly different (two-sided) from the other.
To answer research question 1b and 2b, multiple regression analysis was used. Question
1b and 2b’s concern was to understand whether there were significant associations between
participants’ demographic characteristics and their perceptions of AT importance and
competence. Therefore, the initial step of this analysis involved the conversion of demographic
information. Specifically, each demographic data such as gender, ethnicity/race (i.e., white, black,
and others), employment settings (the original data will be categorized into five groups:
education unit, public sector, private-for-profit, private-non-profit, and others), disability, AT
experience and AT training received was converted into one or more dichotomous variables. As
a result, ten dummy variables were created. In addition, age and years of practice were
considered as continuous variables. As a result, a total of 12 explanatory variables were included
in the multiple regression analyses. Scores on perceived importance and perceived competence
were used as dependent variables according to the research question. Consequently, two multiple
regression analyses were performed to test if each demographic information significantly
contribute to the variance. R2 was obtained to determine if the model has a good fit.
To answer research question 3a, a cluster technique was used. The purpose of this
analysis was to understand if there is a significant difference between perceived importance and
perceived competence. Three factors (i.e., understanding AT, using AT, and making AT

	
  

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decisions) were analyzed separately to inform the researcher which factor has the most disparity
between perceived importance and perceived competence.
To answer research question 4, the qualitative information was summarized and reported.
Due to the exploratory nature of the design, no predetermined theme was used. Upon the
completion of data collection, the investigator proceeded to review through participants’ answers
gathered from two open-ended questions. Answers were presented genuinely to the investigator
without any modification in an Excel spreadsheet. The most frequently mentioned terms were
selected for further process. Subsequently, these frequently mentioned terms were categorized
into groups for further interpretations.

	
  

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CHAPTER FOUR: RESULT
The purpose of the present study was to explore CRCs’ perceived importance as well as
perceived competence in relation to their assistive technology skills. A series of statistical
analyses including exploratory factor analysis (EFA), one-way univariate analysis of variance
(ANOVA), multiple regression analysis, and cluster technique analysis were conducted.
Specifically, the EFA was conducted to determine whether the instrument and items measure the
assistive technology construct as proposed in this study. The one-way ANOVA was conducted
to investigate whether differences exist between factors among perceived importance and
competence. Multiple regression analysis was used to identify associations between participants’
demographic characteristics and their perceived importance and competence. Lastly, the cluster
technique analysis was conducted to compare perceived importance and perceived competence
on specific AT skills.
This chapter addresses the characteristics of participants, the process of screening data,
EFA results, and statistical analyses conducted to investigate the four research questions. The
Statistical Package for Social Science 20.0 (SPSS) for Mac was used for all analyses.
Response Rate
A total of 1051 CRC email addresses were acquired from the CRCC. Of 1051 emails sent
to these potential participants, 56 could not be delivered due to invalid or discontinued addresses.
As a result, 995 valid emails were counted and sent. Of these 995 potential participants, 242
entries were valid (please see below) and recorded by the Qualtrics online survey system
yielding a response rate of 24.3%.

	
  

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Missing Data and Data Screening
Since the online survey system (i.e., Qualtrics) was set to prevent participants from
proceeding any further in the survey if they miss any question, there were no missing data found
in the data set. However, there were eight individuals who ended their participation before the
completion of the survey. Five of these eight left the survey while filling the demographic
section, and three of them left the survey during the second section (i.e., perceived importance
section). These eight entries were deleted from the data set. As a result, the final dataset used for
conducting analysis was 242 participants.
As Osborne and Overbay (2004) noted that although reasons for statistical outliers might
not be the same, all could be a potential threat to the integrity of a data set, and thus negatively
impact statistical analyses and the subsequent interpretations. Therefore, before any statistical
analysis was conducted, the raw data for the present study was subject to a data screening
process. The SPSS boxplot and stem-and-leaf were chosen to screen univariate outliers. In order
to process the outlier screening, several steps were used. First, the sum of each of the three
factors within perceived importance and perceived competence was computed. Since each factor
contains six items, and each item ranges from 1 to 7 points (i.e., for perceived importance, 1
represents not at all important and 7 represents extremely important; for perceived competence, 1
represents not at all competent and 7 represents extremely competent), the score range of each
factor is from 6 to 42. Following the same procedure, six sums were obtained for each participant
(sums of perceived importance: understanding, using and decision making, and sums of
perceived competence: understanding, using and decision making). After obtaining these six
sums, boxplot and stem-and-leaf analyses were performed. Outliers in this case would mean
those scores of participants who rate all items either low or high (i.e., all 1s or 7s). After the

	
  

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analysis, five outliers were identified. The investigator proceeded to review these five
participants’ raw data and found that one of these five answered high (i.e., 6s or 7s) across all
items while the rest answered low (i.e., 1s or 2s) across all items. These five entries were then
excluded from further data analyses. Therefore, the complete data was lowered to 237
participants in total.
Demographics and Characteristics
Of the 237 certified rehabilitation counselors who responded to the survey, 73.4% (n=174)
were female, and 26.6% (n=63) were male. Regarding age, 8.9% (n=21) were under 30 of age,
15.2% (n=36) were age between 30 to 39, 24.8% (n=59) were age between 40 to 49, 30.0%
(n=71) were age between 50 to 59, and 21.1% (n=50) were age over 60. Regarding participant
race/ethnicity, 83.5% (n=198) were White, 7.2% (n=17) were Black/African American, and
9.3% (n=22) were others. Regarding employment settings, 35.9% (n=85) of the participants
reported to work in state/provincial rehabilitation agency, 11.4% (n=27) in private for profit
rehabilitation agency, 7.6% (n=18) in a college/university, 6.3% (n=15) in a private not-forprofit rehabilitation agency, 4.6% (n=11) in K-12 school, 4.6% (n=11) in mental health
center/psychiatric facility, and 29.5% (n=70) work in other settings. In relation to years of
practice, 13.5% (n=32) had equal or less than 5 years experience, 20.3% (n=48) 6 – 10 years
experience, 18.5% (n=44) 11 – 15 years experience, 12.7% (n=30) 16 – 20 years practice, 7.6%
(n=18) 21 – 25 years experience, and 27.4 (n=65) more than 25 years of practice experience.
Regarding level of education, 92.4% (n=219) have a master degree, 5.5% (n=13) have a Ph. D
degree, and 2.1 (n=5) have other level of education. A total of 25.7% (n=61) participants report
to have a disability and 74.3% (n=176) reported to not have a disability. A total of 58.2% (n=138)
of participants reported to have used at least one AT device in the past, and 41.8% (n=99)

	
  

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reported that they had never used an AT device. A total of 65.4%(n=155) of the participants
reported to have received AT training and 34.6% (n=82) reported that they had never AT training.
In order to verify the equivalence between the sample drawn for this study and the overall
CRC population, the demographics characteristics of the population were obtained from the
CRCC to demonstrate the comparison. The data was obtained on May 21, 2013. Table 1 shows
the comparisons between the sample data in the current study and the overall CRC population.
Table 1
Comparison of Sample and Overall CRC Demographic Characteristics
Variable
Gender
Male
Female
Age
<30
30-39
40-49
50-59
>60
Ethnicity/Race
White
Black/African American
Hispanic/Latino
Others
Years of practice
0-4
5-9
10-14
15-19
20-24
25+

Sample

Population

26.9%
73.1%

26.77%
73.19%

8.7%
15.3%
24.3%
30.6%
21.1%

6.64%
18.84%
22.07%
26.51%
25.87%

83.9%
7%
2.5%
6.6%

79.11%
10.16%
4.15%
6.58%

11.6%
21.5%
10.7%
16.1%
8.7%
31.4%

26.63%
15.98%
8.17%
11.16%
10.43%
18.12%

Exploratory Factor Analysis
The Assistive Technology Perception – Rehabilitation Counselor (ATPRC) instrument
was a modified version of Special Education Teacher Preparation Survey (SETPS). Although the

	
  

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modifications were primarily wording changes and can be considered minor, as a conservative
approach, an EFA was conducted to determine whether the ATPRC measured the theoretical
constructs of interest. Specifically, principle components analysis was used to verify if items
included in ATPRC could be explained by the proposed (i.e., understanding AT, using AT, and
making AT decision) factors. Items included in the perceived importance rating were selected for
the EFA analysis. As a result, 18 items from perceived importance were included in the EFA to
determine interrelationships between these items. It was anticipated that the subsequent statistical
analyses used to answer research questions would be based on the results of the EFA.
The principle components method was selected for the factor analysis. In order to
increase the interpretability of the finding, the varimax rotation was utilized for maximizing item
loadings on identified factors. The Kaiser-Meyer-Olkin (KMO) measure of adequacy of sample
size for the factor analysis yielded a result of KMO= .93, which according to Field (2013) is
considered very good. With the respect to Bartlett’s test of sphericity, the analysis yielded a
2

result of χ (153)= 2811.94, p < .001. Therefore, the factor analysis is appropriate for the study
data (Field, 2013). With the requirement of Kaiser’s eigenvalue greater or equal to 1, three
factors were extracted. Specifically, factor loadings for the three factors after the varimax
rotation were 4.43, 4.13, and 3.24. The percentages of variance explained were 24.7%, 22.9%,
and 18.0% respectfully (total variance = 65.6%). Table 2 shows the specific factor loadings (with
loading greater than .400) on perceived importance scale with varimax rotation.
Table 2
Factor Loadings For Perceived Importance Scale With Varimax Rotation
Item# Item description
1 Ability to define AT and describe its potential
impact on the lives of persons with disabilities.

	
  

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Factor 1

Factor 2

Factor 3
.758

	
  

	
  

	
  

Table 2 (Cont’d)
2 Describe the transdisciplinary nature of AT
.806
planning and application.
3 Describe a variety of AT devices and their
.644
potential uses with individuals with
disabilities.
4 Describe the impact of AT legislation and
.575
.555
policy on service delivery.
5 Describe the potential use and benefits of AT
.433
.503
in community and leisure environments.
6 Describe strategies for determining AT
.550
.565
funding potential and establishing AT funding
eligibility.
7 Use a variety of AT hardware devices and
.468
.431
software applications to support clients’
individual needs.
8 Use AT to increase access to rehabilitation
.671
services.
9 Use computer-based instruction, software
.789
programs and other media to aid all clients.
10 Use rehabilitation plans to infuse assistive
.613
technology into services.
11 Use AT, the internet and other media to
.765
actively engage clients.
12 Use AT to promote access within services,
.715
community and leisure environments.
13 Implement AT interventions using a process of .553
.546
assessment, self-reflection and impact
evaluation.
14 Serve as a member of a transdisciplinary team
.763
conducting AT assessments.
15 Collaborate with other members of a team to
.745
determine AT needs and implement AT
supports.
16 Serve as a resource for AT information,
.717
consultation and technical assistance to
colleagues and families.
17 Facilitate clients/families’ involvement and
.521
.617
collaboration in AT decision-making.
18 Facilitate the selection of AT solutions based
.583
.537
on clients’ needs and preferences.
Note: factor loadings for each factor appear in boldface. N=237. Factor 1= using AT, factor 2=
making AT decision, and 3= understanding AT.

	
  

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Three items (#4, #13 and #18) from the perceived importance scale were excluded from
further statistical analyses due to cross loading across factors. As a conservative approach, the
reliability analyses (i.e., Cronbach’s Alpha) were conducted to ensure the quality of instrument’s
integrity after the exclusion of these items. As a result, the internal reliability for each factor
remained reasonably high (Cronbach’s Alpha = .838, .891, and .861 respectively for
understanding AT, using AT, and making AT decision factors). The internal reliability for the
perceived importance scale as a whole after the exclusion the three items yielded a Cronbach’s
Alpha of .933. Therefore, these three items were excluded.
Descriptive Statistics
Descriptive statistics were used to answer two major research questions: (1) how
important do CRCs perceive for assistive technology skills in rehabilitation counseling practice,
(2) how competent do CRCs perceive themselves in providing assistive technology services, and
(3) how do CRCs perceived importance differ from perceived competence in assistive
technology skills?
Regarding the perceived importance scale, participants rated using AT as the most
important skill with the mean of 5.52 (SD = .98). Among six using AT questions, item #8 (i.e.,
use AT to increase access to rehabilitation services) was rated the highest with a mean of 5.69
(SD = 1.18), while item #9 (i.e., use computer-based instruction, software programs and other
media to aid all clients) was rated lowest with a mean of 5.39 (SD = 1.30). Of 15 items included
in the ATPRC instrument perceived importance scale, all items were rated higher than neutral
point (i.e., with a mean score greater than 4), which represented that rehabilitation counselors
participated in this study considered these skills were important. The specific mean score and
standard deviation for all 18 items can be found in Table 3.

	
  

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Table 3
Perceived Importance Scale Summary
Factor/Item
Understanding AT
Ability to define AT and describe its potential impact on the lives of
persons with disabilities.
Describe the transdisciplinary nature of AT planning and application.
Describe a variety of AT devices and their potential uses with
individuals with disabilities.
Describe the potential use and benefits of AT in community and
leisure environments.
Describe strategies for determining AT funding potential and
establishing AT funding eligibility.

M
5.40

SD
0.95

5.70
5.08

1.07
1.34

5.68

1.11

5.41

1.22

5.12

1.34

Using AT
Use a variety of AT hardware devices and software applications to
support clients’ individual needs.
Use AT to increase access to rehabilitation services.
Use computer-based instruction, software programs and other media to
aid all clients.
Use rehabilitation plans to infuse assistive technology into services.
Use AT, the internet and other media to actively engage clients.
Use AT to promote access within services, community and leisure
environments.

5.52

0.98

5.45
5.69

1.27
1.18

5.39
5.57
5.52

1.30
1.21
1.19

5.51

1.15

Making AT decision
Serve as a member of a transdisciplinary team conducting AT
assessments.
Collaborate with other members of a team to determine AT needs and
implement AT supports.
Serve as a resource for AT information, consultation and technical
assistance to colleagues and families.
Facilitate clients/families’ involvement and collaboration in AT
decision-making.

4.87

1.19

4.45

1.51

5.16

1.37

4.72

1.43

5.16

1.34

Regarding the perceived competence scale, participants rated using AT as the most
competent skill with the mean of 4.04 (SD = 1.38). Among the six using AT questions, item #11
(i.e., use AT, the internet and other media to actively engage clients) was rated the highest with a
mean of 4.34 (SD = 1.52), while item #7 (i.e., use a variety of AT hardware devices and software
applications to support clients’ individual needs) was rated lowest with a mean of 3.66 (SD =

	
  

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1.69). Of 15 items included in the ATPRC instrument perceived competence scale, 10 items (i.e.,
#2, #3, #5, #6, #7, #9, #11, #12, #16, and #17) were rated with a mean below 4, which
represented that participants did not feel competent in such skill areas, while 5 items (#1, #8, #10,
#11, and #14) were rated with a mean greater than 4, which indicated that participants felt
competent in these skill areas. The specific mean score and standard deviation for all 18 items
can be found in Table 4.
Table 4
Perceived competence scale summary
Factor/Item
Understanding AT
Ability to define AT and describe its potential impact on the lives of
persons with disabilities.
Describe the transdisciplinary nature of AT planning and application.
Describe a variety of AT devices and their potential uses with
individuals with disabilities.
Describe the potential use and benefits of AT in community and
leisure environments.
Describe strategies for determining AT funding potential and
establishing AT funding eligibility.

M
3.79

SD
1.40

4.27
3.73

1.53
1.52

3.93

1.59

3.92

1.52

3.12

1.71

Using AT
Use a variety of AT hardware devices and software applications to
support clients’ individual needs.
Use AT to increase access to rehabilitation services.
Use computer-based instruction, software programs and other media to
aid all clients.
Use rehabilitation plans to infuse assistive technology into services.
Use AT, the internet and other media to actively engage clients.
Use AT to promote access within services, community and leisure
environments.

4.04

1.38

3.66
4.02

1.67
1.63

3.92
4.33
4.34

1.56
1.61
1.52

3.97

1.52

Making AT decision
Serve as a member of a transdisciplinary team conducting AT
assessments.
Collaborate with other members of a team to determine AT needs and
implement AT supports.
Serve as a resource for AT information, consultation and technical
assistance to colleagues and families.

3.74

1.52

3.49

1.67

4.10

1.63

3.44

1.71

	
  

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Table 4 (Cont’d)
Facilitate clients/families’ involvement and collaboration in AT
decision-making.

3.95

1.69

Univariate Analysis of variance (ANOVA)
One-way repeated measure univariate analysis of variance was used to answer two
primary research questions: (1a) Is there a difference in perceived importance across three
different factors among assistive technology skills? and (2a) Is there a difference in CRC
perceived competence among three assistive technology factors? Since there were different
numbers of items within each of the three factors (understanding AT, using AT, and making AT
decision), it was necessary to compute a mean score for each factor before the ANOVA
procedures. For the perceived importance scale, mean scores for the three factors were 5.40 (SD
= 0.95), 5.52 (SD = 0.98), and 4.87 (SD = 1.19) respectively. For the perceived competence scale,
the mean scores for the three factors were 3.79 (SD = 1.40), 4.04 (SD = 1.38), and 3.74 (SD =
1.52) respectively. Upon obtaining the mean scores of each factor, one-way repeated measure
ANOVA was processed with three factors set as independent variable and their mean scores set
as dependent variables. This procedure was used twice for perceived importance and perceived
competence scales. The results of F-test can be found in Table 5.
Table 5
One-way ANOVA for perceived importance and perceived competence on three factors with
Greenhouse-Geisser correction used
Type III
Factor
Sum of Squares
DF
F
Sig.
Perceived Importance
56.600
1.85
79.532
.000
Perceived Competence
12.041
1.91
16.857
.000
Note: since both results for the Mauchly’s test of sphericity were significant for the perceived
importance and perceived competence scale, the Greehouse-Geisser (1959) correction was used
for conservative interpretations.

	
  

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Since both results of Mauchly’s test of Sphericity were significant (p < .05), the
Greenhouse-Geisser correction was used to have a better interpretation on F-test (Field, 2013).
Consequently, perceived importance scale yielded a significant result with F (1.85, 236) = 79.53,
p < .05, and perceived competence scale also yielded a significant result with F (1.85, 236) =
16.86, p < .05.
Since the one-way repeated measure ANOVA yielded significant results, the post hoc
analysis was appropriate for further investigation, which would determine if there were
differences between the three factors. As suggested by Field (2013), the Bonferroni adjustment
was used as a conservative approach to prevent false rejection of null hypothesis. Table 6 shows
results of the post hoc analyses conducted on mean comparisons of three factors within perceived
importance and perceived competence scales. Regarding the perceived importance scale, there
were three significant results: (a) understanding AT was rated significantly lower than using AT
(MD = .122, SE = .047, p = .029), (b) understanding AT was rated significantly higher than
making AT decision (MD = .528, SE = .061, p = .000), and (c) using AT was rated significantly
higher than making AT decision (MD = .650, SE = .056, p = .000). Therefore, using AT was
rated the highest, which was followed by understating AT, while making AT decision was rated
the lowest. In relation to the perceived competence scale, there were two significant results: (a)
understanding AT was rated significantly lower than using AT (MD = -.247, SE = .049, p
= .000), and (b) using AT was rated significantly higher than making AT decision (MD = .298,
SE = .058, p = .000. Understanding AT and making AT decision did not have any difference
statistically (MD = .051, SE = .058, p =1.000).

	
  

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Table 6
Post Hoc Analyses On Three Factors
Perceived Importance
Factor
Understanding AT – Using AT
Using AT – Making AT Decision
Understanding AT – Making AT Deicison

Mean Difference
-.122
.650
.528

Std. of Error
.047
.056
.061

Sig.
.029
.000
.000

Perceived Competence
Factor
Understanding AT – Using AT
Using AT – Making AT Decision
Understanding AT – Making AT Deicison

Mean Difference
-.247
.298
.051

Std. of Error
.049
.058
.058

Sig.
.000
.000
1.000

Note: Bonferroni adjustment was used for conservative result.
Multiple Regression Analysis
General linear model multiple regression analysis was used to investigate research
questions: (1b) Do CRCs’ backgrounds (e.g., gender, years of practice, practice setting, disability)
associate with perceived assistive technology importance, and (2b) Do CRCs’ backgrounds (i.e.,
gender, years of practice, practice setting, disability) associate with their perceived assistive
technology competence? Demographic data (i.e., gender, age, ethnicity, year of practice, practice
setting, disability, AT experience, and AT training received) were used as independent variables
(i.e., predictors), and scores of perceived importance and perceived competence were set to be
the dependent variables (i.e., outcomes). In addition, in order to proceed the regression analysis,
six categorical variables (gender, ethnicity, practice setting, disability, AT experience, and AT
training received) were transformed into one or more dichotomous variables. Specifically, one
dummy variable for each variable such as gender, disability, AT experience, and AT training
received was created. Ethnicity data (i.e., white, black/African American, and others) were
transformed into two dichotomous variables, and practice settings (i.e., public, private, and
others) were transformed into two dichotomous variables. Years of practice and age were

	
  

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included in the model as continuous variables. Since no specific order for predictors were
identified, the forced entry method was used to perform the regression analysis (Field, 2013).
Two linear models (perceived importance and perceived competence) were created.
Regarding the linear model performed on perceived importance scale, there was no
multicollinearity detected. Specifically, as indicated by the correlation matrix of the predictor
variables, the highest correlation was -0.721, which was considered appropriate for linear
regression analysis (Field, 2013). In addition, predictors’ indexes of variance inflation factor
(VIF) ranged from 1.07 to 2.25, which was also considered appropriate (Bowerman & O’Connell,
1990). Therefore, multiple regression analysis was conducted, and yielded an insignificant model
2

which R = .054, F (10, 226) = 1.288, p = .238. Due to the insignificant result from the model,
no further identification of individual predictors was conducted.
Regarding the linear model performed on the perceived competence scale, there was also
no multicollinearity detected. The model was, therefore, conducted with a significant result
which R2 = .168, F (10, 226) = 5.763, p = .000. The total variance explained by the model was
20.3%. Due to the significant model, individual predictors were further investigated for statistical
significance. Among different 10 predictors included in the model, two (i.e., AT experience and
AT training received) were identified with slopes that significantly contributed to the model.
Specifically, AT experience had a significant result with B = 5.10, t (237) = 2.03, p = .044, and
AT training received also had a significant result with B = 15.60, t (237) = 5.94, p = .000. Table
7 shows the details of the predictors in relation to the regression model.

	
  

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Table 7
Multiple Regression Model For Perceived Competence
Variable
Gender

B

SE

β

t

Sig.

3.314

2.896

0.073

1.144

0.254

Age

-0.069

0.144

-0.041

-0.483

0.630

Years of Practice

-0.100

0.162

-0.055

-0.616

0.539

Work Setting
Public
Private

2.081
-1.239

2.772
3.496

0.050
-0.023

0.751
-0.354

0.454
0.723

Ethnicity/Race
White
Black/African American

3.320
1.624

4.301
6.035

0.061
0.021

0.772
0.269

0.441
0.788

Disability

3.671

2.923

0.080

1.256

0.211

AT Experience

5.101

2.513

0.125

2.030

0.044

15.600

2.628

0.368

5.936

0.000

Male

AT Training Received
2

Note: R = .168, F (10, 226) = 5.763, p = .000 for the model.
Clustering Technique
A clustering technique was administered to investigate research question: (3a) are there
differences between CRCs perceived importance and perceived competence across three AT
factors? The clustering technique has been used in the rehabilitation literature (Berven, 1979;
Chan et al., 2003; Austin, 2012) for years to identify training needs by comparing participants’
perceived importance and perceived competence. Specifically, it is through the comparison of
the professional skills which participants rate with high importance and low competence that the
training needs are identified.

	
  

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In order to conduct the clustering technique, few steps were needed. First, the frequency
of high importance rating from the participants was calculated for each of the 15 items included
in the ATPRC perceive important scale. In this study, since 7-point Likert scale was used, ratings
equal or above 5 (i.e., 5 = quite importance, 6 = very important, and 7 = extremely important)
were considered “high importance”. For example, skill item “describe a variety of AT devices
and their potential uses with individuals with disabilities” had the highest frequency of high
importance ratings by the participants, which 85% of participants rated such skill with a 5 or
above. The item, “use AT to increase access to rehabilitation services”, was the second highest
rated skills which 84% of participants gave a rating of 5 or above. Same raking procedure was
taken until the order of the 15 skills was identified.
Same ranking procedure was performed for all 15 items included in perceived
competence scale as well. However, due to the intention of the design, the ranking target was
shifted to address items with the “limited competence” in the perceived competence scale. Since
7-point Likert scale was used, items rated below 4 (i.e., 3 = somewhat competent, 2 = slightly
competent, and 1 = not at all competent) were considered “limited competence”. As a result, 15
items were ranked in order base on participants’ rating with the least competence. For example,
the item “describe strategies for determining AT funding potential and establishing AT funding
eligibility” was rated with the least competence which 62% of participants gave a rating of 3 or
less. The item, “serve as a resource for AT information, consultation and technical assistance to
colleagues and families”, received a second lowest competence rating which 54% of participants
rated with a 3 or less. Same raking procedure was taken until the order of the 15 skills was
identified.

	
  

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Upon the completion of sequencing the orders of perceived importance and perceived
competence items, the definitions of “high importance” and “limited competence” were decided.
Specifically, items at or above the median were designated to be “high importance” and “limited
competence”. As a result, for the total sample, the median percentage for “high importance”
items was 78%, and the median percentage for “limited competence” items was 41%. As a
technique used by several studies (Berven, 1979; Chan et al., 2003; Austin, 2012) to increase the
breadth of findings, the median for both scales was arbitrarily lowered to 77% and 37%,
respectively. The high priority AT training needs were identified as an area in which the given
items fell above the median on both perceived importance and perceived competence scales.
Table 8 shows skill areas, which were identified as AT training needs base on clustering
technique. Two items identified in “understanding AT” were “describe a variety of AT devices
and their potential uses with individuals with disabilities”, and “describe the potential use and
benefits of AT in community and leisure environments”. Four items identified in “using AT”
were “use a variety of AT hardware devices and software applications to support clients’
individual needs”, “use AT to increase access to rehabilitation services”, “use computer-based
instruction, software programs and other media to aid all clients”, and “use AT to promote access
within services, community and leisure environments”. No item was identified in “making AT
decision”.
Table 8
High Priority Assistive Technology Training Needs
Skill Areas
Understanding AT
Describe a variety of AT devices and their
potential uses with individuals with
disabilities

	
  

High importance
(%)

Limited Competence
(%)

85%

43%

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Table 8 (Cont’d)
Describe the potential use and benefits of
AT in community and leisure environments

78%

42%

80%

49%

Use AT to increase access to rehabilitation
services

84%

39%

Use computer-based instruction, software
programs and other media to aid all clients

77%

41%

Use AT to promote access within services,
community and leisure environments

81%

37%

Using AT
Use a variety of AT hardware devices and
software applications to support clients’
individual needs

Making AT Decisions
N/A
Qualitative data
Two open-ended questions were asked at the end of the survey to answer the research
question: (4) what can be improved in relation to assistive technology service provision? Due to
the exploratory nature of this aspect of the study, no predetermined themes or specific qualitative
analyses were used for coding. Information was collected and the most frequently mentioned
themes were identified and reported. As a result, the seven most frequently mentioned themes
were identified in relation to how to improve rehabilitation counselors’ AT competence. First,
the training should expose rehabilitation counselors as much as possible to different and new
technology devices. For example, participants stated “it would be helpful to see new and
different types of technology available now”, “I would love to learn latest and greatest
innovations in AT”, “I enjoy the opportunity to try out new devices and equipment”, and
“Knowledge of the variety of technology, new products and techniques and uses”. Second, the
	
  

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training should include information to access AT funding. For example, participants reported the
following: “it is important to have knowledge of potential funding sources and how to access
them”, “how to obtain funding”, “who pays for it and how much it costs”, and “funding sources
and strategies for identifying and securing comparable benefits”. Third, the training should
include information on AT consultation resources. For example, participants stated “a list of
resources that I can consult when I have clients with different needs”, “I'd like to see some
websites, for instance, with informational descriptions of technologies-matched to the each type
of disability”, and “Who to call when I need help”. Fourth, training should include how to
properly assess clients AT needs. For example, participants stated: “it is important to know about
resources for assessment”, “assessment, how to choose hardware/equipment”, and “assessment
to assist in the proper selection of AT based on client needs”. Fifth, training should include
rehabilitation counselors’ competence in describing pros and cons of specific devices. For
examples, participants stated “the cost/benefit of the use of technology devices”, “Information
about strengths vs. weaknesses of product options”, and “benefits and disadvantages could be
best presented to the client in question”. Sixth, training should emphasize hands-on AT
experience. For example, participants stated “better hands on training and ability to actually use
the technology”, “training should include demos and hands-on use of the equipment”, and “I
would want hands on demonstrations”. Seventh, training should emphasize the importance of
receiving feedback from clients using AT. For example, participants stated “learn from patients
of how the devices have changed their lives”, and “counselors should follow up on client’s use of
AT”.

	
  

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CHAPTER FIVE: DISCUSSION
In order to investigate research questions regarding CRCs’ assistive technology skills and
the future training needs, a quantitative design was utilized. The data collected via an Internetbased survey system (i.e., Qualtrics) was analyzed using SPSS 20.0 for Mac. In this chapter, an
analysis of these statistical results, and a discussion of these findings are provided. In addition,
limitations, which address the generalizability of the findings, are indicated. Finally, implications
for practitioners, educators, and future research are discussed.
ATPRC Instrument
The instrument utilized in the present study, ATPRC, was a modified version of SETPS,
which was used to evaluate special education teachers’ perceptions of assistive technology skills.
While the AT services provided by special education teachers and rehabilitation counselors are
likely similar, the adoption of the instrument from the special education literature still raised
concerns. In addition, instrument validation was needed since the validity of original SETPS was
based on expert opinion and the related literature (i.e., expert validity). Hence, the exploratory
factor analysis was conducted. As the results indicate, three factors (understanding AT, using AT,
and making AT decision) were identified and differentiated from each other in the domain of AT
skills, which corresponded to the original design of SETPS. Although three items were excluded
(i.e., one from understanding AT and two from making AT decision) from the final version of
the ATPRC, the reliability of the whole instrument remained high (Cronbach’s Alpha = .933).
Therefore, the ATPRC can be considered as a reliable instrument in exploring rehabilitation
counselors’ AT perceptions and the subsequent statistical analyses based on the ATPRC can also
be considered appropriate.

	
  

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AT Skills
Although AT has been identified as an effective rehabilitation strategy, the
underutilization situation remains high. In addition, even among those clients who receive AT
implementations initially, they tend to abandon their AT devices within the first three months
(Phillips & Zhao, 1993; Cushman & Scherer, 1996). Such a situation not only limits the potential
AT benefit but also causes extra financial burden to rehabilitation agencies. One of the
suggestions made to improve the situation is to provide more training for service providers
(Scherer et al., 2005). In fact, as specified in the assistive technology device selection model
(Scherer et al., 2007), service providers are key persons to ensure the effective match between
individuals with disabilities and the AT devices. Therefore, the professional training of
rehabilitation service providers is vital. The need for AT training is clear, however, what content
should be included in the training remains unclear.
Before providing the needed AT training, it is important to understand what AT skills are.
The EFA result of the present study may have shed some light on the topic. Specifically, three
themes were identified among the 15 items included in the present study. They are defined as
understanding AT, using AT, and making AT decision. “Understanding AT” pertains to
knowledge of AT, fundamental AT skills and awareness of how AT could potential impact
clients’ quality of lives. “Using AT” pertains to rehabilitation counselors’ competencies in
practical experiences such as familiarity with hardware AT devices as well as software
applications. “Making AT decision” pertains to rehabilitation counselors’ skills in providing
professional AT advice, coordinating resources, planning and implementing AT interventions,
and monitoring the use of AT.

	
  

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AT importance
As suggested by Scherer (2002), assistive technology refers to two components: assistive
technology devices and assistive technology services. While AT devices seem relatively clear in
concept, which pertains to “any item, piece of equipment, or product system, whether acquired
commercially off the shelf, modified, or customized, that is used to increase, maintain, or
improve functional capabilities of a child with a disability” (Assistive Technology Act, 1998),
the meaning and the breadth of AT services, on the other hand, can be vague. In fact, although it
is ideal to have interdisciplinary collaborations between professionals such as a physician,
rehabilitation engineer, occupational therapist, physical therapist, special education teacher, and
rehabilitation counselor when providing comprehensive AT services, rarely does such a
rehabilitation team form to serve the individuals with disabilities. As a result, AT service relies
heavily on single service providers or a single agency. Such a situation not only increases the
chance of mismatch between clients and the AT devices, but also confuses rehabilitation
professionals regarding what their roles are in providing AT services.
The same question was raised among the profession of rehabilitation counseling as well.
For instance, a decade ago, Chan et al. (2003) suggested that assistive technology was one of the
most important skills that rehabilitation counselors should have. Specifically, among 631
participants they included in the study, 83% rated “assistive technology” important and 84%
rated “accommodation and rehabilitation engineering services” important. Chan et al. further
suggested that although competence level of assistive technology among rehabilitation
counselors might not be as high, the importance of AT skills seemed to be certain. However, six
years later, McMahon (2009) argued that rehabilitation counselors should only devote their
efforts on disability issues, case management, short-term counseling and vocational related

	
  

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services. He also emphasized that services such assistive technology should be provided by other
professionals. The argument of whether assistive technology should be part of the professional
scopes of practice for the rehabilitation counselor remains unanswered.
A decade after Chan et al.’s study, the present study detected similar findings. Among the
237 participants included in this study, as the descriptive statistics showed (Table 3),
understanding AT received an average rating of 5.40 (with a 7-point Likert scale rating above 4
considered as important), using AT received an average rating of 5.52, and making AT decision
received an average rating of 4.87. In addition, all five items included in the “understanding AT”
factor received average ratings above 4.0, which the highest average rating was 5.70 (i.e., ability
to define AT and describe its potential impact on the lives of persons with disabilities) and the
lowest average rating was 5.08 (i.e., describe the transdisciplinary nature of AT planning and
application). All six items included in the “using AT” factor received average ratings above 4.0
as well, which the highest average rating was 5.69 (i.e., use AT to increase access to
rehabilitation services), and the lowest average rating was 5.39 (i.e., use computer-based
instruction, software programs and other media to aid all clients). All four items included in the
“making AT decision” factor also received average ratings above 4.0, which the highest rating
was 5.16 (i.e., facilitate clients/families’ involvement and collaboration in AT decision-making)
and the lowest average rating was 4.45 (i.e., serve as a member of a transdisciplinary team
conducting AT assessments). In sum, all 15 items included in the perceived importance scale of
the ATPRC were rated “important”. Such data provided evidence that a decade after Chan et al.
(2003), AT was still widely recognized as an important skill to have by rehabilitation counselors.
Upon the recognition that AT was very important to the field of rehabilitation counseling,
this study attempted to gain better insight on which specific AT skill was more important to

	
  

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rehabilitation counselors. The one-way ANOVA was used to determine whether there was
difference among three AT factors. As Table 5 showed, the F-test yielded a significant result
conducted on three factors in the perceived importance scale, which indicated that there was
significant difference between these factors. The post hoc was then conducted to test for the
detail difference. As shown in Table 6, three significant results were obtained. Specifically,
participants rated using AT as the most important AT skill, followed by understanding AT, and
the least important was making AT decision. Since a major function of rehabilitation counselors
is to promote clients’ career outcomes, independent living, and quality of life, interventions that
can directly benefit clients in these objectives should attract the most attention. Therefore, it is
logical that using AT was rated the highest among AT skills. In addition, there are currently
more than 26,000 assistive technology devices available on the market. If rehabilitation
counselors are unaware of what devices are available and how to use these devices, how can they
effectively assist their clients in choosing the right ones?
A surprising finding of the analysis was that “understanding AT” was rated higher than
“making AT decision”. Rehabilitation counselors are trained to communicate with clients and to
facilitate them in making life decisions. As such, one would intuitively assume that rehabilitation
counselors would value decision-making more than others. However, the data suggested the
opposite. One possible explanation was that the AT intervention outcome was significantly
influenced by legislation, policies, and available funding sources. In other words, rehabilitation
counselors’ understanding of service eligibility, feasible programs, and available financial
support are vital for effectiveness of AT interventions. An ability to make effective AT-related
decisions is only possible when his/her rehabilitation counselor has good AT knowledge.
Therefore, understanding AT was rated higher than making AT decision.

	
  

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AT Competence
While items in the AT importance scale were generally rated high in this study, the items
in the AT competence scale were rated much lower. Specifically, the understanding AT factor
received an average rating of 3.79 (with a 7-point Likert scale, ratings below 4 were considered
not competent), the using AT factor received an average rating of 4.04, and the making AT
decision factor received an average rating of 3.74. The results indicated that rehabilitation
counselors included in this study did not consider themselves as competent in providing AT
services. This is especially alarming when compared to their perception of AT importance,
which suggested that rehabilitation counselors realize the importance of AT for their clients,
however, they might not be prepared to offer such services. In fact, two possible consequences
might occur: (a) rehabilitation counselors provide AT services of less than desired quality, which
in turn, results, in part, in clients’ high AT abandonment, and (b) rehabilitation counselors avoid
providing AT service, which results in clients’ underutilizing AT devices. As indicated by the
literature, rehabilitation professional consider the high AT abandonment (Phillips & Zhao, 1993;
Cushman & Scherer, 1996) and underutilization of AT (Scherer, 2002) issues as critical.
Therefore, in order to improve the situation, it is important and necessary to infuse more AT
training in rehabilitation counselor preparation programs.
Table 5 showed that a significant difference was found between three factors in the
perceived competence scale. Subsequently, a post hoc analysis was conducted to determine the
relationship between three factors. As shown in Table 6, two significant results were obtained.
Specifically, using AT was rated the highest among three and had significant differences when
compared to understanding AT and making AT decision. When comparing understanding AT to
making AT decision, there was no significant difference found. This finding suggested that

	
  

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despite that rehabilitation counselors in general reported to be less competent in AT, they had
relatively better ideas of how to actually use AT devices. This finding provides useful
information for an AT training priority for rehabilitation counselors. For example, a large portion
of rehabilitation counselor’s job is to determine eligibility, secure useful funding, and facilitate
clients’ decision-making. If the rehabilitation counselors are not competent in providing these
services, the benefit of AT interventions could be limited. Therefore, although the ability to use
AT devices is important, it is also important to enhance knowledge of AT and AT decisionmaking.
Lastly, the regression analysis conducted on the perceived competence scale yielded a
significant result. As Table 7 showed, significant positive relationships were found in
participants’ AT experience and AT training received. This finding suggested two implications.
First, it represented that participants who had past AT experience were positively associated with
their perceived competence level. While such a finding is intuitive, it reveals the importance of
exposing rehabilitation counselors to available AT devices. Second, a positive association was
also found between rehabilitation counselors’ AT training and their perceived competence level.
The result provided evidence and echoed findings indicated by Riemer-Reiss (2003) and Noll et
al. (2006), in which they suggested that additional AT training can improve rehabilitation
counselors’ AT competence level and, in turn, they might choose to provide more AT service in
the future. As Estrada-Hernandez et al. (2007) noted, there are currently very few masters level
classes designated to strengthen rehabilitation counselors’ AT competence. While there are
several constraints causing the lack of the AT training, the finding in the present study provide
incentive for rehabilitation counselor training programs to infuse more time and energy into
promoting such training.

	
  

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Training Needs
One goal of this study was to identify the most needed rehabilitation counselor AT skills.
A clustering technique was used to serve the purpose by comparing participants’ perceived
importance and perceived competence. As a result, six items met the selection requirement. As
shown in Table 8, two items from understanding AT and four items from using AT were
identified to be the most needed training areas. There was no item from making AT decision
identified.
Two items identified as the most needed training areas in “understanding AT” were
“describe a variety of AT devices and their potential uses with individuals with disabilities”, and
“describe the potential use and benefits of AT in community and leisure environments”. In order
to facilitate choosing a variety of AT devices, rehabilitation counselors have to understand and
be able to discuss potential benefit of the devices with their clients. However, there are new AT
devices created to improve quality of life of individuals with disabilities everyday. It becomes a
difficult but necessary task for rehabilitation counselors to keep their AT knowledge up-to-date.
While traditional in-class training is important and useful, it is also beneficial if there are
resources such as websites and workshops that keep rehabilitation counselors informed regarding
new AT devices. Furthermore, the results also revealed that the use of AT devices in leisure
environments or for recreation purposes has been overlooked. While AT for vocational
rehabilitation is important, AT for recreational purposes such as sport and entertainment should
also be emphasized.
Four items identified as the most needed training areas in “using AT” were “use a variety
of AT hardware devices and software applications to support clients’ individual needs”, “use AT
to increase access to rehabilitation services”, “use computer-based instruction, software

	
  

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programs and other media to aid all clients”, and “use AT to promote access within services,
community and leisure environments”. It was apparent that rehabilitation counselors perceived a
great need of training regarding their computer skill and software knowledge. While hardware
AT devices help a significant amount of individuals with physical challenges, accommodations
such as computer software programs can provide extra assistance for individuals with intellectual
and cognitive impairments. In addition, it is important to note that rehabilitation counselors
perceived the need to use AT for promoting service accessibility. Lastly, the result again
revealed the importance of rehabilitation counselors’ knowledge in assisting clients with
selecting AT devices not only in the vocational context but also in places such as leisure
environments. The findings provoke considering whether rehabilitation counselor preparation
programs should more thoroughly address the importance of clients’ leisure activities.
The qualitative data collected by the current study also yielded important training ideas
for the rehabilitation counseling programs to take into considerations when designing curriculum.
As indicated, seven major training areas in relation to AT skills should be emphasized: (a) new
and innovative AT devices, (b) AT funding, (c) AT consultation and referral, (d) AT assessment,
(e) ability to describe specific AT’s strengths and weaknesses, (f) hands-on experience, and (g)
ability to communicate with clients regarding their feedback of using AT. While the exploratory
nature of the qualitative data in this study might limit its generalizability, it should provide
insight for future research as well future training directions.
Limitations of the Study
Due to the research design of this study, which relied on a self-report questionnaire,
participants’ bias was difficult to avoid and should be carefully assessed when interpreting the
findings. As Heppner et al. (1999) noted, participants may answer items more socially acceptably

	
  

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or tend to answer in ways that correspond to the researcher’s expectations. In addition, response
patterns, which participants tend to answer items in the middle of a Likert scale, should not be
overlooked. Another possible limitation is the low response rate (24.3%). Although the response
rate is not considered uncommon comparing to those of similar studies such as 22.7% for Austin
(2012), 12% for Coduti (2009), and 29.2% for Zanskas (2007), caution is still needed when
interpreting and generalizing the findings. To demonstrate equivalence, the comparison between
the sample drawn for this study and the overall CRC population was presented in Table 1.
Moreover, since the study utilized an Internet based survey system, participants needed to have a
certain level of computer skill in order to complete the survey. Therefore, careful consideration is
needed whether there was systemic difference between participants who completed the survey
and those who did not.
Another possible limitation is that the ATPRC was a revised version of SETPS. SETPS
was initially designed to evaluate special education teachers’ AT perceptions. Therefore, in order
to use the instrument to measure perceptions of rehabilitation counselors, item wording was
changed to fit the context. Although changes from SETPS to ATPRC were incidental (i.e.,
“student” change to “client”), whether the revision changed the core conceptual nature of the
instrument is unknown.
An addition limitation of the study is the validity of the instrument. As noted, the ATPRC
was a revision of SETPS. The validity of SETPS relied on experts’ opinion and the related
literature. There was no systematic validity measurement found for the SETPS. Therefore, the
ATPRC inherited the same validity concerns as with the SETPS. As a conservative approach,
factor analysis and reliability Cronbach’s alpha tests were conducted in this study. As the results
showed, three factors were identified and internal reliability of the instrument was high (α

	
  

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= .933). Although these analyses provided validity and reliability evidence, a more thorough
analysis is needed to further justify the integrity of the instrument.
Implications of the Study
The results found in this study have implications for current practitioners, educators, and
future research.
Implications for Practice. It is clear that AT has become one of the most important
skills that rehabilitation counselors should have in order to effectively serve their clients. A
decade ago, Chan et al. (2003) suggested that AT skills should be emphasized. This study echoed
the same suggestion. Findings of the current study provide evidence that AT continues to be a
skill that rehabilitation counselors should devote more energy in learning. As suggested by
Scherer (2002), new and the more innovative AT devices are created everyday. If rehabilitation
counselors do not keep their knowledge up-to-date, they will be unable to effectively assist their
clients with identifying and securing the appropriate technology. Moreover, as indicated by the
results, understanding AT (e.g., legislation, policies, and available funding) and making AT
decision (e.g., assisting clients and family in choosing AT devices) were two areas in which
rehabilitation counselors perceived they were less competent. While these areas are not directly
related to AT devices, they are essential in dealing with issues such as AT underutilization, the
mismatch between person and technology, and high AT abandonment. For instance, the inability
to secure available funding for clients might limit clients’ opportunity in purchasing the right AT
devices.
One interesting phenomenon found in the open-ended questions of this study was that a
number of participants expressed the desire to learn where can they receive AT consultation. As
the role of the rehabilitation counselor keeps growing and expanding, it is almost impossible for

	
  

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them to master every service provided. Therefore, referral and consultation resources become a
useful means for obtaining addition assistance. Currently, there are many online resources
available for AT consultation. For example, the Job Accommodation Network (JAN:
http://askjan.org) and AbleData (http://abledata.com) provide ideas for employment related
accommodations and the recreational use of AT devices. Such information is instrumental when
exploring possible AT solution with clients. However, as many participants pointed out, this type
of information is underutilized. Therefore, it is crucial rehabilitation counselors to become
familiar with such resources as such. A few ways such as subscribing to newsletters from
websites (e.g., JAN), joining AT professional organizations (e.g., Rehabilitation Engineering and
Assistive Technology Society of North American (RESNA)), participating in AT workshops,
and attending AT sessions at conferences may be particularly effective in acquiring more AT
information and skill.
Implications for Education and Training. As indicated by the findings in this study,
AT skill is important to rehabilitation counselors. However, as Estrada-Hernandez et al. (2007)
and Scherer et al. (2004) indicated, there are currently very few rehabilitation counseling training
programs actually require students to take a course in AT. This is particularly alarming because it
suggests that rehabilitation counselors provide AT services for which they are not well-prepared
to do. This study provides reference and incentive for current rehabilitation counselor
preparation programs to include AT when considering curriculum development and revision
plans.
While implementing comprehensive AT training may not be impossible for most
rehabilitation counselor training programs due to financial constraint and time limitations, this
study provided ideas for the prioritization of specific AT skill training. For example, the findings

	
  

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of this study suggest that rehabilitation counselors did not feel competent in AT related
knowledge such as the legislation, policies, and available funding programs. Therefore, future
AT training specifically addressing these areas should be a high priority. In addition,
rehabilitation counselors did not feel competent in facilitating client AT decision-making. A
number of rehabilitation counselors expressed the lack of ability in communicating with clients
regarding strengths and weaknesses of specific AT devices. While decision-making processes
involve various factors, one necessary step for the rehabilitation counselor is to inform clients
about potential benefits and possible side effects of each available option. If rehabilitation
counselors do not have such knowledge about AT devices, they likely will not be able to
facilitate client AT decision making. Therefore, it is not hard to understand why the
rehabilitation counselors in this study did not feel competent in making AT decision with their
clients. As an implication for future training programs, the information of specific AT
characteristics should be introduced.
Another implication of the current study stems from the identification of training needs,
which were identified by the clustering technique. Based on the results, three major areas should
be emphasized for future AT trainings: First, the training should include learning about hardware
devices as well as software proficiency. It is a trend that computer technology will be utilized
more and more in the future. Software applications specifically designed for special needs such
as screen readers, voice dictation, and electronic reminder should be introduced. Second, training
should also include AT devices that increase the accessibility of rehabilitation services. Although
a majority of AT devices may be used as a means to improve client employability, it is worth
noting that AT can also improve the rehabilitation service delivery. Third, training should

	
  

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increase rehabilitation counselors’ awareness of recreational AT devices. Therefore, future AT
training should extend its territory and include devices for recreational purposes.
Lastly, the open-ended questions of this study also yielded useful data for AT training
considerations. Few areas were identified. First, practical experience should be emphasized. For
instance, rehabilitation counselors should be familiar with the most innovative AT devices, and
be able to describe their strengths and weaknesses. Second, rehabilitation counselors’ ability to
facilitate decision-making should be emphasized. For instance, rehabilitation counselors should
be able to perform adequate assessments, which target users’ experience before and after
implementations of AT devices. Finally, the importance of consultation skills should also be
stressed. For instance, rehabilitation counselors should be aware of other AT resources (e.g.,
funding resources and AT device vendors), which they can consult with when they have
questions.
Implications for Future Research. The need for further research is apparent due to the
limitation and findings of the current study. First, the ATPRC was a revision of SETPS. An
instrument that specifically measures rehabilitation counselors’ AT competence is needed. Given
that very few studies have been conducted to gain an understanding of rehabilitation counselors’
AT skills, there is limit knowledge of rehabilitation counselor AT competency. As a result, the
validity of the instrument used in this study relied heavily on expert opinion. It would be
beneficial to utilize this study as a foundation to create an instrument with wider and deeper
understanding of rehabilitation counselor AT skills.
Second, although the technique which uses the comparison between perceived
importance and perceived importance to inform training needs is common to the rehabilitation
literature, it is worth of further investigation regarding what they really mean and how they

	
  

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interrelate to each other. In fact, while it might seem easy to gather a person’s value on a given
area by collecting his/her perceived importance data, there might not be a simple way to evaluate
his/her actual competence level. The question is whether the information gathered from the
perceived competence scale reflects the real competence level? For instance, does rehabilitation
counselors with more experience perceive their competence level more accurately than others
with less experience? The sample drawn for this study composed of 31.4% of participants with
more than 25 years of experience. Whether the overwhelming amount of more experienced
CRCs included in this study deviated the statistical results remains unanswered. Therefore, future
research is needed to clarify what the perceived importance and perceived competence really
mean and how they can be affected by participants’ backgrounds.
Lastly, Estrada-Hernandez et al. (2007) studied how AT education was provided in
rehabilitation counseling programs, in which he and his colleagues found that the trainings were
not sufficient. In fact, most programs choose not to have a separate AT course but rather infuse
AT knowledge into other courses. Therefore, it is important to choose which AT materials
should be included in a master’s degree rehabilitation counseling training program. This study
provided ideas for what can be implemented or infused in coursework. Future research is needed
to evaluate whether such suggestion made by this study improve rehabilitation counselor AT
competence as well as the quality of AT service they provide.
Conclusions
The findings of this study are useful and complement previous studies which emphasized
the AT training needs for rehabilitation counselors. Results showed that AT was consistently one
of the most important skills that rehabilitation counselors should have when providing services to
their clients. In addition, although AT was considered to be important to their clients,

	
  

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rehabilitation counselors in general did not perceive themselves competent to provide such
services. This is alarming because rehabilitation counselors can only choose not to provide such
services or to provide less quality services. In either case, the rehabilitation outcomes of their
clients may be compromised. Therefore, one important finding of this study is the confirmation
that there is a need to include AT training in rehabilitation counselor preparation programs. The
results of this study can also be used to inform education programs regarding the AT skills that
should be prioritized when designing curriculum. Although it may be difficult to include all
aspects of AT skills in mainstream rehabilitation counseling trainings, several important areas
were suggested.

	
  

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APPENDICES

	
  

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APPENDIX A
SPECIAL EDUCATION TEACHER PREPARATION SURVEY
IMPORTANCE
1=not important at all
2
3
4
5
6
7=extremely critical

CURRENT ATTAINMENT LEVEL
1=no level of attainment
2
3
4
5
6
7=extremely attained

1. Ability to define AT and describe its potential impact on the lives of persons with
disabilities.
2. Describe the transdisciplinary nature of AT planning and application.
3. Describe a variety of AT devices and their potential uses with students with disabilities.
4. Describe the impact of AT legislation and policy on service delivery.
5. Describe the potential use and benefits of AT in school, community and leisure
environments.
6. Describe strategies for determining AT funding potential and establishing AT funding
eligibility.
7. Use a variety of AT hardware devices and software applications to support students’
individual needs.
8. Use AT to increase access to general education curriculum for all students.
9. Use computer-based instruction, educational software programs and other media to aid all
students.
10. Use differentiated lesson plans to infuse instructional assistive technology into
curriculum.
11. Use AT, the Internet and other media to actively engage students in research and
independent learning.
12. Use AT to promote access within school, community and leisure environments.
13. Implement AT interventions using a process of assessment, self-reflection and impact
evaluation.
14. Serve as a member of a transdisciplinary team conducting AT assessments.
15. Collaborate with other members of a team to determine AT needs and implement AT
supports.
16. Serve as a resource for AT information, consultation and technical assistance to
colleagues and families.
17. Facilitate student/familie involvement and collaboration in AT decision-making.
18. Facilitate the selection of AT solutions based on student/family needs and preferences.

	
  

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APPENDIX B
ASSISTIVE TECHNOLOGY PERCEPTION FOR REHABILITATION COUNSELORS
INSTRUCTIONS FOR COMPLETING THIS INVENTORY
This inventory presents a list of assistive technology skills that can be used to facilitate
clients with rehabilitation needs. For each item, you will be asked to rate its importance for
practice and how competent you perceive yourself in applying these skills.
IMPORTANCE: IMPORTANCE OF AT SKILLS AND KNOWLEDGE.
SCALE FOR PERCEIVED IMPORTANCE
1=not at all important
2=slightly important
3=somewhat important
4=important
5=quite important
6=very important
7=extremely important
COMPETENCE: THE ABILITY TO PROVIDE AT SERVICES TO CLIENTS.
SCALE FOR PERCEIVED COMPETENCE
1=not at all competent
2=slightly competent
3=somewhat competent
4= competent
5=quite competent
6=very competent
7=extremely competent

	
  

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PART I
Demographic Information (7 questions):
1. Gender:
a. Male
b. Female
2. Age:________
3. Race/Ethnicity (check only one)
a. American Indian or Alaskan Native
b. Asian (including Chinese, Filipino, Japanese, Korean, Vietnamese)
c. Asian Indian
d. Black or African American.
e. Hispanic, Latino, or Spanish Origin alone
f. Native Hawaiian or Other Pacific Islander
g. White
h. Other Race
i. Two or More Races
4. Employment setting:
a. Center for Individuals with
b. Private Not-For-Profit Rehabilitation
Developmental Disabilities
c. College or University
d. Retired
e. Corporate Environment
f. State/Provincial Rehabilitation Agency
g. Corrections Facility
h. Student
i. Independent Living Facility
j. Unemployed
k. Insurance Company
l. Veterans Benefits Administration (VBA)
m. K-12 School
n. Veterans Health Administration (VHA)
o. Medical Center or
p. Workers’ Compensation Setting
Rehabilitation Hospital
q. Mental Health
r. Private For-Profit Rehabilitation
Center/Psychiatric Facility
s. Other-Specify:_______________________
5. Years of practice: _________
6. Level of Education:
a. Master
b. Ph. D
c. Others
7. Do you have a disability:
a. Yes
b. No
8. Have you used an assistive technology device:
a. Yes
b. No
9. Have you received AT trainings?
a. Yes
b. No

	
  

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PART II
Assistive Technology Skills Rating
For each item, rate its importance and how competent you perceive yourself in applying these
skills.
SCALE FOR PERCEIVED
IMPORTANCE
1=not at all important
2=slightly important
3=somewhat important
4=important
5=quite important
6=very important
7=extremely important

SCALE FOR PERCEIVED
COMPETENCE
1=not at all competent
2=slightly competent
3=somewhat competent
4= competent
5=quite competent
6=very competent
7=extremely competent

19. Ability to define AT and describe its potential impact on the lives of persons with
disabilities.
20. Describe the transdisciplinary nature of AT planning and application.
21. Describe a variety of AT devices and their potential uses with individuals with
disabilities.
22. Describe the impact of AT legislation and policy on service delivery.
23. Describe the potential use and benefits of AT in community and leisure environments.
24. Describe strategies for determining AT funding potential and establishing AT funding
eligibility.
25. Use a variety of AT hardware devices and software applications to support clients’
individual needs.
26. Use AT to increase access to rehabilitation services.
27. Use computer-based instruction, software programs and other media to aid all clients.
28. Use rehabilitation plans to infuse assistive technology into services.
29. Use AT, the internet and other media to actively engage clients.
30. Use AT to promote access within services, community and leisure environments.
31. Implement AT interventions using a process of assessment, self-reflection and impact
evaluation.
32. Serve as a member of a transdisciplinary team conducting AT assessments.
33. Collaborate with other members of a team to determine AT needs and implement AT
supports.
34. Serve as a resource for AT information, consultation and technical assistance to
colleagues and families.
35. Facilitate clients/families’ involvement and collaboration in AT decision-making.
36. Facilitate the selection of AT solutions based on clients’ needs and preferences.

	
  

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PART III
Open-ended Questions
1. As identified by the rehabilitation literature, the high assistive technology abandonment
has been a serious concern of rehabilitation service providers. In your opinion, what can
service providers do to improve such a situation?

2. If assistive technology continuing education were available to you, what knowledge or
skills should be included in such a training?

	
  

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APPENDIX C
INFORMED CONSENT

INFORMED CONSENT
1. PURPOSE OF RESEARCH:
You are being asked to participate as a research participant in this internet-based survey study of
rehabilitation counselors’ perceptions of assistive technology skills. You have been selected as a
participant in this study because you have been identified as a certified rehabilitation counselor
(CRC). Your participation in this study will take about 10 - 15 minutes of your time.
2. WHAT YOU WILL DO:
All that will be required of you is that you take the time to complete this internet-based survey.
There are three parts and a total of 50 questions to answer. You can save your selected answers
by pushing the next button. In addition, you have the option to save your responses and log out
and return to the survey where you left off. However, you will be unable to go back and change
your answers once you have submitted them since no identifying information will be included
with your responses.
3. POTENTIAL BENEFITS:
Your participation in this study may generate data useful for better understanding rehabilitation
counselors’ perceptions of assistive technology knowledge and skills. Further, it is anticipated
that the findings from this study have the potential to both inform and enhance the clinical
training curricula of master’s rehabilitation counseling programs.
4. POTENTIAL RISKS:
There are no foreseeable risks associated by participating in this study.
5. PRIVACY AND CONFIDENTIALITY:
The data for this project will be kept confidential. All data will be collected on the web using the
web-survey service program, Survey Monkey. Access to Survey Monkey will be password
protected. Only the researchers will have access to the password to Survey Monkey needed to
access the data. The researchers will maintain your privacy throughout the research process by
ensuring you are automatically assigned a Case ID number that remains blind to the researchers.
No identifying information will be stored with the data. The only identifying information will be
your email address that is linked to your survey on Survey Monkey and will be used only for
sending email reminders to you to complete this survey. All the data will be imported and stored
on one of the researcher’s personal computer and software programs where data will be entered
	
  

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and stored for data analysis. The personal computer used and data files created will be password
protected to ensure protection of all participant data. Only the researchers and Michigan State
University Institutional Review Board will have access to the data. The results of this study may
be published or presented at professional meetings, but the identities of all research participants
will remain anonymous.
6. YOUR RIGHTS TO PARTICIPATE, SAY NO, OR WITHDRAWAL:
Participation in this research project is completely voluntary. You have the right to say no. You
may change your mind at any time and withdraw. There are no consequences of withdrawal or
incomplete participation. You may choose not to answer specific questions or to stop
participating at any time.
7. COSTS AND COMPENSATION FOR BEING IN THE STUDY:
There are no costs to you to participate in this study other than the value you place on your time.
You will not receive money or any other form of compensation for participating in this study.
If you have any questions about this study, such as scientific issues, how to do any part of it, or
prefer an alternative method for taking this survey (e.g., by phone or hard copy), please contact
the researcher, Hung Jen Kuo, Michigan State University, 457 Erickson Hall, East Lansing, MI
48824, kuohungj@msu.edu, 517-402-2187.
If you have any questions and concerns about your role and rights as a research participant, you
can also contact responsible project investigator, Dr. John Kosciulek, at 517-353-9443, or e-mail
jkosciul@msu.edu. If you would like to obtain information or offer input, or would like to
register a complaint about this research study, you may also contact, anonymously if you wish,
the Michigan State University Human Research Protection Program at 517-355-2180, FAX 517432-4503, or e-mail irb@msu.edu, or regular mail at: 408 West Circle Drive Room 207 Olds
Hall, MSU, East Lansing, MI 48824.
By clicking the “NEXT” button below, it means that you voluntarily agree to participate in this
research study.
*Please print a copy of this form to keep before proceeding.*
THANK YOU

	
  

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REFERENCES

	
  

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