Biomedical Engineering Reference
In-Depth Information
During Zoey's transitional IEP meeting, her occupational and physical therapist from
her early childhood intervention (ECI) program met with the school educational team
[special education (SE) teacher, school administration, diagnostician, occupational thera-
pist (OT), physical therapist (PT), and speech and language pathologist (SLP)] to discuss
her current strengths, needs, and plans for education. Zoey's current level of performance
and participation in the home is described as follows:
Zoey is an attentive young girl and motivated to learn. She has a very supportive family
and a good relationship with the health professionals she has worked with. She is able
to sustain attention and learns best through visual model/representation versus kinetic
learning because of her physical impairments. Zoey has paralysis in both her upper and
lower extremities (severe motor impairment) and relies on primitive reflexes to illicit
motor movement. She is able to sit supported in her wheelchair, and the therapists have
been working on finding the best access position for her so she can control her environ-
ment and engage in tasks. She has tried using a wobble switch with upper extremity
reflexive movements (arm reaching out to hit the switch), but she then moves her head
away from the visual field. Her therapists are working on increasing her head control
because they feel eye movement may be the best option for access as she gets older. Her
vision acuity/convergence is mild impairment, but it is corrected with glasses. She is
able to use track using visual scan and sustain attention visually. Zoey is delayed in
language; however, her receptive skills are more intact (mild impairment) compared
with her expressive (complete impairment) language skills. She demonstrates interest
in engaging in interactions and likes to be in the middle of the action.
Her occupational and physical ECI therapists discussed the current AT that they have been
using in the home setting, which includes a manual wheelchair with adapted seating and
a mounted switch to access her toys during her playtime. She loves music and is engaged
in computer-based learning tasks that use music as a positive reward. She has tried some
built-up handles, but she seems to do better with a universal cuff when using materials.
Zoey's parent's main concern is her communication. They feel that she would be able to
engage more independently if she could talk. The team has tried a mid-tech AAC with step
scanning using a head switch; however, she still had limited endurance with head control
and movement at that time. The team felt she was able to navigate through a dynamic
screen and the static screen was limiting to her. Zoey is in the stage of novice user moving
toward transitional user at the age 36 months through five years of age. As she becomes
more independent, she moves into a power user stage with success at 10 years of age. This
case will look at Zoey at the age of 36 months and then at ten years using her AT in the
educational setting (Table 7.1).
7.6.2 Second Case Study: John
John is a young man with athetoid cerebral palsy. He attended his local mainstream pri-
mary school for seven years, then moved to a mainstream secondary college and progressed
then to third-level education. The case study introduces John at age 7 and a novice user of
technology. The case study jumps to when John is a young man of 17 and a power user
of technology. Power and novice users refer to a study of students transitioning from the
second to third level education conducted by Craddock (2006). Three discernable groups of
students emerged from the study distinguishable by the type of technology they used, how
they used it, and how satisfied and comfortable they were with it. They were typified as the
novice and power users with students progressing between the two stages characterized as
