This 2-year study examined how assistive technologies are used in educational programs for children who have significant multiple disabilities. Naturalistic inquiry incorporated qualitative collection procedures including observations, videotapes of children, and questionnaires and interviews with teachers and parents. Three groups of children were studied. The children had used technology applications in early intervention programs or received technology assessments and follow up as part of related projects. Case studies were developed on 14 children who had from 2 to 10 years experience with assistive technology when the study began. Findings indicated that assistive technology has positive effects on children's development even when they have significant disabilities and their technology experiences are inconsistent. Generally, children were able to use technology tools to accomplish tasks they would not otherwise have been able to do because of the severity of their disabilities. Improvement in social and emotional development was also related to technology use. Additionally, parents and service providers perceived that using assistive technology produced positive effects on the children's academic skills. Obstacles in obtaining, implementing, and maintaining access to assistive technology are noted, including problems of funding, personnel training, and collaboration among staff and between staff and families. Appendices include site descriptions and questionnaires. (Contains 68 references.) (DB)