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Module
Objectives
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Describe
through a case study a young boy's process of dealing with
amobility impairment.
Trace
his progress in school and outline next steps needed.
Discuss
the physical history of the condition and the social
support that has been received.
Explain
the insurance coverage and medical care received by the
family as well as early intervention treatment.
Summarize
mobility and functional assessments while in the EI program.
Review
the rationale behind and reactions to the use of a power
chair.
Conclude
with lessons learned. |
Meet Tony
Tony
is a second grader in his local public school. That may not
be a big deal for most seven year old boys. But for Tony, it
is
a really big deal. He is a young man with a medical diagnosis
of
Cerebral Palsy. His speech is a little difficult to understand,
initially, but he is right on grade level for both receptive
and expressive speech. What makes Tony’s journey to the
second grade so remarkable is how he gets to and around school.
He is
a power wheelchair user. He wows the other kids with his speed
and skill when driving his chair, but most importantly he can
go where he wants, when he wants (with a hall pass!), without
needing
assistance from anyone else for his mobility – just like
all the other kids in his class.
Tony always
did want to “motor” by
himself. He was initially seen by a therapy team in an Early
Intervention (EI) Program when
he was about 2 years old. At that time, he verbalized his desire
to walk and move around his environment. The EI team ordered
Ankle Foot Orthoses - AFO’s (foot braces) due to his consistent
pattern of standing on his toes ,with poor alignment of his knees
and ankles.
The AFOs provided better support to his feet and improved his
lower extremity alignment. The EI team then tried a standing
frame in
the classroom for upright activities; he liked it, but wanted
to be more
mobile.
When he was
about 3 years old, attending the same program, Tony learned (by
himself) that if he flipped over a cube chair
(small
square chair),
pulled to stand, he could go across the room, turn around,
and “walk” with
his friends by and pushing the little chair along the carpet.
Following Tony’s
lead, the EI team tried a gait trainer, (like
the Rifton Pacer or Mulholland Walkabout
or Snug Seat Pony
and others listed at http://www.usatechguide.org) which he loved
and mostly pushed backwards to go somewhere quickly. He would
go
forward with
much prompting and made this into a game with the therapists or
teachers, quickly reverting to pushing backward with much giggling.
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