For 2-year-old Bella, a play table built by a Columbia Occupational Therapy student is more than just a platform to play with her favorite toy.
It is an integral part of her treatment that allows her to be a child at the same time.
Bella has extensive hypotonia (weakness) and has difficulty standing upright for long periods of time. “Having a custom table is really helpful for Bella. She doesn’t have to struggle to stabilize her body and can use her hands to play with her toys,” says Bella’s dad. , says Arun Her Viswanath. “She loves to explore and this table should help her develop her basic skills.”
The play table is one of several devices and pieces of furniture created in the last few fall months by students of the Bagueros Physicians and Surgeons Occupational Therapy Program in Colombia for young clients with severe disabilities. As part of the new course, students will learn how to design and build assistive and adaptive equipment using sturdy cardboard, glue, and some decorative decals.
There is a great need for customized devices for young people with disabilities. “In many cases, children with disabilities get adaptive or assistive devices at school, but they cannot take them out of school to do their homework or to sit and position themselves correctly at home. Their families may not be able to afford to buy one for home use, or there is nothing available on the market that addresses the child’s specific needs,” said the rehabilitation and regenerative medicine specialist who teaches the course. Assistant Professor Rochelle Mendonca, Ph.D. “We wanted to close this gap and give children the resources they need to succeed at home and in school.”
Through this course, students will learn how to create custom devices from low-cost materials that address specific treatment goals for children with disabilities.
This course is part of a national movement founded by Alex Truesdell, a teacher of children with multiple disabilities. He began making adaptations more than 20 years before her and won a MacArthur Fellowship for her work. Mendonca first learned about the exercise a few years ago when she attended a training workshop for local occupational therapists hosted by Truesdell.
“Learning to build adaptive instruments using cardboard is a great way for occupational therapists to address the needs of people who do not have access to the necessary equipment and tools to promote independence and participation. says Mendonca. “Cardboard can be used to create devices that promote play, leisure activities, and family involvement – goals that are typically not achievable with insurance or commercial devices.”
Mendonca launched a course to give Columbia OT students hands-on experience building supportive and adaptive devices for people with disabilities in their community.
Mendonka worked with SKIP of NY, a nonprofit that connects children with disabilities to medical services and equipment, to select seven children and young adults between the ages of 18 months and 26 to assist them. I needed tools. During the first few weeks, students met with families, caregivers and Colombian occupational therapists to learn about the client’s needs.
After that, 55 students in all rolled up their sleeves and got to work building the device.
Help each child reach their treatment goals
To reach Bella’s occupational therapy goals, occupational therapy students Ginger Pojednick and Amy Lopez knew they needed to start with a sturdy bench. and postural control, and reaching for the little things,” says Lopez. This means that the bench must support Bella’s weight when she leans over it.
Ready-made tables and benches were not suitable due to other considerations, such as Bella’s frequent rocking back and forth and her limited ability to reach for things while feeling safe.
Rugged, 3-ply cardboard is the perfect material for designing custom adaptive devices. It is inexpensive, strong, and easy for students to handle. “One of our goals for him is to keep the device low cost,” he says Mendonca. “Assistive and adaptive equipment can cost $500 to $10,000 on the market. Everything we made cost him less than $100 in materials.”
Lopez and Pojednic designed and built a small bench and removable lap tray for doing activities and playing with toys. The tray has small cutouts with soft padding that provide a snug fit when Bella is reaching for her toy, but prevent injury when rocking. Paint and colored plastic Her tape decorated and protected the furniture, and two students personalized Bella’s bench by drawing her name in flowing letters.
However, when Bella attended a mid-semester fitting, the students noticed a problem.
“When she sat on the bench, we found it was about 6 inches too tall for her, so we had to redo almost all the measurements and redesign the seat to fit,” says Pojednic. says Mr.
These are not one-size-fits-all products, says Mendonca. Before we get to the final product, we need to see the patient work on the first iteration, so we can perfect the device. ”
On December 12th, Bella and other clients came to Colombia to receive and test the finished device.
“It was really nice to see everything working out. We got to see Bella do exactly what we envisioned,” says Pojednic. “It was a lot of work, but the results show that simple adjustments to a person’s environment can really make a difference,” adds Lopez.
Devices provided to other clients included custom phone holders, outreach desks, and comfortable wedges for lying down while watching TV.
Children grow, change, and their needs change. “We will have all families check in in the next few months so that we can make adjustments as needed,” Mendonca says.
Mendonka plans to double the number of families it serves next year.