At Great Strides We Make Everyday Lives Better
By Christina Swanson
Parenting a child with special needs requires meeting a host of challenges with positive determination, patience and unwavering persistence as the child grows and needs change. Eyes and hearts are opened as family members learn gratitude for everyday things and how simple hygiene and basic tasks, which are normally learned with ease and taken for granted, can be a difficult and pain-staking exercise for a disabled child and a time-intensive ritual for the child’s professional therapists, parents or caregiver.
A big part of Great Stride’s focus is to work as a team with the child, parents and/or caregiver, and teacher outside the classroom to help them learn the skills to be more independent which, in turn, increases the child’s confidence and potential to adapt and learn other skills while freeing-up the parent to meet the other many requirements of their day.
Recently, two Great Strides professional therapists extended their caring reach to teach a student/patient specific tasks by adapting equipment and creating specialized exercises that truly goes above and beyond their duties and speaks volumes to their dedication. Conquering something as seemingly simple as getting in and out of mom’s car and being able to clean oneself after using the toilet, has been a true victory for the child and family alike.
The Bidet Adaption Challenge
Young Brandon Belzer is a Great Strides outpatient who receives both occupational and physical therapy within a close collaborative team approach where his mom, Kimberly Belzer, is highly involved. When Kimberly got the idea to install a bidet on her toilet to relieve her having to be with Brandon every time he used the bathroom, his therapists went to work at teaching Brandon about the many hand and arm movements needed for him to turn the small knob that operated this bidet so he could be self-sufficient.
But Brandon didn’t seem to have the strength or ability to understand the proper way to make the knob turn which set in motion another innovative Great Strides success story thanks to the creative construction of Great Strides Executive Director, Dr. Jon Edenfield, OTD, OTR/L, Brandon’s occupational therapist, Hilda Harrison, and an innovative installation at Brandon’s home by Hilda’s husband, Wayne Powell, who is an engineer. This team looked into ways of adapting the equipment to the skill level of what Brandon could do. In looking for additional products that could change the bidet to have an easy button for Brandon to push instead of turning a knob, there was nothing available on the market. So, Edenfield, Harrison and Powell set to designing adaptive equipment from available parts and combining them together into a final “adaptive” product that’s not available in a store or even yet invented.
Using regular water lines, a lawn sprinkler valve, a low voltage power supply, and a Big Red button type switch, the bidet was adapted, allowing it to bypass the knob operation. This adaptation resulted in a major functional outcome for Brandon who now independently operates his bidet every day using the Big Red switch. Both Kimberly and Brandon are thrilled!
“As special needs parents, we are always trying to make our kids as independent as possible and have them be less vulnerable and dependent on others to perform everyday function which, of course, helps them grow and makes it a lot easier for us as parents,” explained Kimberly. “Now Brandon can go to the bathroom independent without me having to constantly get up and help him. The people at Great Strides are truly amazing in their caring because they know it is really about helping the children. It is a blessing to me that Great Strides is a true partner in helping our children become functional.”
The Entering/Leaving Car Challenge
Another easy to take for granted ability is to be able to get in and out of a car unaided. If you think about it, it’s kind of a complicated motion involving crouching forward, lifting the initial leg, ducking the head, etc.
Brandon’s physical therapist, John Kirkland, initiated a simulated car therapy based on observational gait analysis and Brandon’s known history of visual impairment, increased extensor tone, rigid adherence to routine, aversion to novel tasks and limited verbal and comprehension abilities. It appeared the inability of Brandon to transfer from the parking lot or driveway into his mom’s SUV keyed upon his inability to step up and translate his center of mass forward while in a crouch stance. Kirkland determined that a small portion of this task was challenging for Brandon. However, this part task was essential due to the relatively low head clearance and high floorboard relative to the ground in mom’s SUV. There were also concerns with his ability to pivot into his car seat once he steps into the car.
Kirkland used the principles of over-training, part task training, meaningful rewards, and verbal and tactile cueing with Brandon. He did this by creating a simulated physical situation where he hung a piece of cardboard horizontally from the clinic ceiling to replicate the car ceiling, used a step-up bench that approximated the height of the floorboard of the car and an object on the seat that required him to pivot in order to sit down. The cardboard was painted to match the color of mom’s car and several other objects were used to simulate the bench seat of the car.
Then everything was set for Brandon to practice stepping up under a low ceiling with the bandwidth of reward, cueing, and assistance appropriately withdrawn.
The key was Brandon’s ability to generalize the task to his mom’s car, which he successfully accomplished after only two to three trials. A total success and the cost of the project was a nominal $6.00 but helping make mom’s life easier is – PRICELESS!