Biomedical Engineering Reference
In-Depth Information
2000). The time spent on each activity should be evaluated to avoid excessive efforts by the
child (Ostensjo 2003). The team should also be aware of the impact that time may have on
the family's perception of the child's performance. They may feel anxious or concerned
watching the child take too long to perform a task or use a given AT tool. It is important to
help the family understand the challenges that the child is facing, as well as the resources
that can help facilitate the child's performance; this may help family members feel more
at ease. They can see that the child is using time more efficiently, even if it takes longer.
Furthermore, the child will play a more active role when the activities are planned around
the family's daily routines at home (Ketelaar et al. 2001). The situations that the child faces
can also change depending on the setting. For example, at home the child may have more
time to carry out a task than at school. In this sense, strategies need to change to ensure
greater participation in activities, such as taking bite-size foods to school that do not require
cutting, thereby reducing the amount of time needed for lunch and snack time.
Often, an AT tool may end up in disuse by the child and family because it lacks significance
for their particular routine and setting. For example, when the team fails to work in
conjunction with the family in the implementation of an AT tool, there is the risk that it
will not be effective. This can occur because it is not directed toward the family's needs and
environment, even if the device itself would have brought important benefits to the child. It
is important to investigate how the AT tools are seen by the child, how the family perceives
them, and how they can become part of the child's and the family's social context (Skär 2002).
The pediatric specialist should be attentive to the child's real potential and capacity for
executing a given task so that the most effective assistance can be offered to the whole
family (e.g., guiding the participation of others in the activity or introducing adaptations,
when necessary). This type of intervention can most positively impact the quality of life of
the child and family.
12.5 AT and Learning
The application of AT resources involves a learning process that grows as the child's skill at
using the tools evolves. The use of a device implies the development of a functional ability
that encompasses planning and executing organized movements through which the child
achieves an objective or function. The capacity for developing a skill is, in part, determined
by biological potential. Nevertheless, the development or reorganization of functional brain
systems is promoted by social demands and depends on the lifestyle, beliefs, and values of
each culture in accordance with the possibilities of the child's morphological substrate and
chances for practice (Leontiev 1978; Vygotsky 1984, 1991). In other words, certain functional
skills that evolve through the use of AT tools are achieved or honed according to the child's
capacity and opportunity to develop them (McNaughton et al. 2008).
For example, the ability to use an alternative communication interface is achieved through the
ability to control certain bodily movements or after attaining a level of cognitive development.
However, it also depends on the child's chances to learn and improve the way in which the tool
is used. What at first may appear to be a difficult or uncoordinated movement that demands a
lot of time and effort can, with practice and incentive, become easier and more effective.
For example, the strategies used by the family for communicating or managing mealtimes
(e.g., how they initiate and conduct conversations or how they encourage the child to eat) can
significantly contribute to the development and improvement of skills that will gradually
