Biomedical Engineering Reference
In-Depth Information
child and factors intervening in development but also formulate hypotheses about possible
strategies or resources that can help foster their interaction and social participation.
Depending on the type of adaptation, more complex skills may be required. For example,
children with cognitive disorders may have difficulties using tools that demand more
complex movement sequences and more elaborate working memory and planning (Pueyo-
Benito and Vendrell-Gomez 2002; Scherer 2005), such as handling a lever to control a self-
propelling car with only one hand. Strategies like dividing the task into several stages
and encouraging trial-and-error can help in the implementation of more complex AT
resources. Also, getting to know the child's previous experiences with AT can be helpful
when adding and adjusting AT resources (Scherer 2005; Murchland and Parkyn 2010).
In sum, the team's interdisciplinary work, together with the participation of the child's
family, are fundamental to the planning, implementation, assessment, and follow-up of
any assistive solutions for improving the child's performance and quality of life.
12.4 AT Resources Applied to the Daily Life of the Child and Family
The effective use of an AT tool is achieved through its functional application in daily life;
in other words, when it is incorporated into the child's day-to-day routine, altering the
possibilities and manner in which the child can interact in and with the environment
(Lindsay and Tsybina 2011). Two aspects are essential to this process: (1) the active
involvement of the family, which provides ongoing opportunities for practice; and (2) the
effectiveness of the tool for helping the child improve performance in a given task.
Many of the activities in the child's daily life are centered around tasks that are
culturally significant to the family. The more a family values a given resource, the more
opportunities the child will have for practicing and using it (Kellegrew 2000). For example,
some families will encourage their child to evolve in self-care activities, such as going
to the bathroom alone and eating independently without needing the help of others.
The tasks emphasized by the family reflect their beliefs and values about childhood and
impairments, socioeconomic and educational views that influence their daily routines,
and, consequently, the child's participation (or lack of participation) in certain activities.
Depending on cultural values, the use of adaptations in performing daily life tasks can be
either reinforced or ignored by the family (Ripat and Woodgate 2011).
In their interactions with the rehabilitation team, families often signal which tasks
their child shows the most interest in or those they are trying to perform (Hinojosa et al.
2002). The pediatric specialist, on the basis of the team's assessment, aims at adjusting the
rehabilitation goals to the child's potential. By helping the families understand the child's
potential, as well as identify the needs and limitations brought on by the impairment, the
specialist can help them direct their expectations and make changes in the family setting
to maximize the child's development and progress.
The demands brought about by the child's need for assistance cause a number of changes
in the family's daily routine. In addition to the importance of a joint assessment of the child
by the interdisciplinary team, the amount of time that will be spent on the activity is relevant
in the discussion about the team's involvement in training the child and family to use AT
resources. One change includes giving the child as much time as needed (Ostensjo 2003).
The time variable tends to wield a more profound impact in children whose functional
abilities are more compromised or who are slower than independent children (Kellegrew
 
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