Biomedical Engineering Reference
In-Depth Information
At ten months, Michael had not yet attained any motor acquisitions and had no head
control. There was persistence of some archaic movements, such as asymmetrical tonic
neck reflex; placing and parachute were absent. He tried to reach and grasp objects but was
unable to because of movement difficulties.
He currently exhibits regular trunk balance and is in a customized wheelchair that
facilitates positioning and locomotion.
12.6.1.3 Neuropsychological Evaluation
Michael's cognitive development has always been compatible with his chronological age.
At admission, he showed interest in social interaction and exploring objects. His attention
was at the expected level for his age, but his concentration was impaired because of his
involuntary movements. He could recognize familiar faces, persisted in reaching for
objects, and tried to imitate ways of exploring them.
When he was five years three months old, he underwent a cognitive evaluation with the
Columbia Mental Maturity Scale. He scored a total of 42 points, compatible with the 77th
percentile and a maturity level of a six year old.
He currently attends regular school and his scores and performance are compatible with
his age and grade.
12.6.1.4 Communication Strategy
Upon admission, Michael's means of communication were precarious. He had difficulties
controlling the movements involved in gesturing and vocalizing. He communicated his
basic needs by cries, social smiles, and by responding to visual contact. He had good
contextual comprehension, but no conventional forms of expressing communication with
his interlocutors, such as head nods, pointing, or “yes/no” signals.
Today, Michael is capable of independently communicating through alternative
communication systems, although he still requires interlocutors familiar with his commu-
nicative signals.
12.6.1.5 Evaluation of Visual, Auditive, and Perceptive Functions
Michael does not present any associated sensorial deficits or convulsive disorders.
12.6.1.6 Neurorehabilitation Team Approach
The program for stimulating Michael's neurodevelopment at a young age comprised
integrated activities to improve his neck and trunk balance, manual skills, joint attention,
exploration of objects, vocabulary expansion, and conventionalization of nonverbal
communication signals. At that time, the AT resource used was primarily a special
chair that more adequately positioned Michael in a seated position, making it easier for
him to choose and play with toys and sustain visual attention so that he could observe
his surroundings and interact socially. Figure 12.1 shows a special chair that permits
positioning the child in a manner that increases stabilization of the trunk, better visual
contact, and allows him to use the upper limbs to handle toys.
As expected, his cognitive and linguistic development progressed more quickly than
his motor development. Over time, the impact of his involuntary movements made it
impossible for him to walk, speak intelligibly, or write manually.
