Fig. 21.1
Eve sitting in her height-adjustable working chair doing schoolwork
It is time for break and outdoor play. The assistant asks: “Do you want the crocodile or the Petra?” (running bike). “The crocodile,” Eve answers and hurries out, in the direction of a little ice pond in the end of the school yard (Fig. 21.2). Throughout the break, she slices on the pond along with some other students (Fig. 21.3).
Fig. 21.2
Eve in the “crocodile” on her way to the ice pond
Fig. 21.3
Eve skating in her “crocodile” on the ice pond
Looking at the photo where she is sliding, Eve tells, “I do skating” (articulation unclear, Ida, her friend helps to translate). “How did you do it?” (10 s pauses). “Run, slide, jump, and slide.” “Have you done this before?” “No, (6 s pauses) I love it, it is fun, fun to slide.”
As the students were going to start eating lunch, Eve began to cry. The assistant was not near; the teacher came up to her, but Eve did not succeed in communicating that the dynamic Lycra suit has to be opened. A RollTalk, with speech synthesis, recommended by the OT, had been mounted on her powered wheelchair 1 month ago to support communication, but was not operative.
In the English class, later in the afternoon, all the students were sitting on benches, with the exception of Eve who was standing in her moveable stander (Fig. 21.4). When she looked at the photograph of this situation, she spontaneously says, “It hurts to stand with the orthoses.” “It hurts, but how was it when you were sitting on the floor, as you did throughout ‘The student’s choices activities’?” “It hurts too.” “Is there any time when the orthoses do not trouble you?” “When I sit in the chair.”
Fig. 21.4
Eve standing in her moveable stander in the English class
The Student’s Report
The following guiding questions have been identified in developing possible solutions to management and follow-up of ATD in a school context. These questions are generated from the available literature references and our clinical experiences:
Questions:
1.
What functions might be affected in children with CP according to the ICF framework?
2.
What are important goals for use of ATD in a school context?
3.
What is the evidence for effective use of ATD?
4.
How can the ICF framework be used as a guide for AT interventions?
5.
How can an ATD be an enabler to social participation?
6.
How can OTs work with school staff to make communication more effective for children with problems in producing intelligible speech?
7.
How to involve the child in the implementation of preventive and supportive ATD in school life?
8.
What are the key messages about AT interventions in children with disabilities from this case study?
References
Assistive Technology Act of 1998 (2004) 1998 Pub. L. No. 108–364. § 3, 118 Stat. 1707
Besio S (2002) An Italian research project to study the play of children with motor disabilities; the first year of the activity. Disabil Rehabil 24(1/3):72–79CrossRefPubMed