This is the fourth and final installment in the series about catering to students with special needs. This section focuses on physical development, which can mean anything from standing, walking, holding a pencil, or feeding oneself. I have personally used both of these tools to help a child learn to stand and walk independently. When I first starting working with him, he couldn't even sit up on his own, and with the help of these tools, he can walk mostly independently (while using the tools) and is getting better at standing without support as well.
Nimbo Rehab Lightweight Posterior Posture Walker
http://www.drivemedical.com/index.php/nimbo-lightweight-gait-trainer-841.html
How it should be introduced to and used by the child in need:
We introduced the Nimbo walker to the child in need firstly by calling it a fun name. We called it his “car” and made cute “vroom” sounds when it was used. This put a positive association with the walker. We started by picking him up and positioning his body and hands where they needed to be to use the walker. We held his hands in place and pushed the walker while singing his “walking song,” while he moved his legs. We praised him any time he tried to move the walker by himself. This walker can be used forwards only, or you can allow the child to walk forwards and backwards. The child in need should be supervised while using the walker to ensure their safety.
How it should be introduced to other children:
Other children should know that the child in need is using the walker to learn how to walk. It is always good to remind the other children that they love to walk and run and play, and the child in need wants to learn how to do all those things as well. I personally avoid using the comparison, “like a baby learning to walk,” because it can make the child in need seem like he is not a peer to the other children.
Goals for the child’s use of technology:
The goal of a walker is to help strengthen the child’s leg muscles and core muscles. We want the walker to strengthen his muscles enough to where the child can walk unassisted if the child’s conditions allow it. The walker is a tool and if it’s possible, we would like the child to eventually walk without it.
How the child’s development will be assessed:
I would assess the child’s development by rating how the child is progressing in their physical development on and off the walker. I would make notes of how long the child can walk using the walker, how their muscles are developing, and what the child can do off the walker. If it seems that the walker is contributing to the child’s increased muscle strength and overall sense of independence, then we would conclude that the walker is helping the child and continue using it as part of the child’s treatment.
Ankle and Foot Orthotics (AFOs)
http://www.cerebralpalsy.org/information/mobility/orthotics
How it should be introduced to and used by the child in need:
I personally have introduced AFOs to a child, and they can be hard to adjust too. I recommend only having the child wear the AFOs for short periods of time at first. We put the AFOs on while the child watched a television show or played on the iPad, and we took them off when the show or game time was done. The child I nannied for would then only wear them during his therapies so he could have increased stability and reduced muscle weakness. We then transitioned to having him wear the AFOs during preschool as well. He learned to be comfortable with the AFOs because they helped him balance better and allowed him to move more independently.
How it should be introduced to other children:
The AFOs are often covered with long pants, but when the child was wearing shorts, we did our best not to draw attention to them. If other children asked about the AFOs, we would tell them that the AFOs were helping him to learn to walk so he can be just like you (other children). Children are very accepting of the AFOs because they like to walk and run and play.
Goals for the child’s use of technology:
Some of the goals for children who use AFOs outlined on the cerebral palsy website include having an increased range of motion, stronger muscles, more endurance, better coordination, and an overall increased sense of independence.
How the child’s development will be assessed:
We can assess how the child’s development is progressing by looking at the overall goals of using AFOs and rating how quickly the child is meeting those goals. I would rate the child’s muscle strength, endurance, etc; before using AFOs, after a week or a month using AFOs, and so on. This will help me keep track of how the AFOs are helping the child in need.
(Picture shows a child I worked with who uses both AFOS and the Nimbo walker with much success. He is able to walk mostly independently as long as someone is close behind him to occasional help him steer. Picture was taken and used with his mother's permission.)
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