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PART 3 WORKING IN THE SHOP: Rehabilitation Aids and Procedures 571 CHAPTER 62Developmental AidsIn this chapter we look at the design details of aids for lying, sitting, standing, balance, use of hands, and communication. Aids for walking are in Chapter 63. Whether or not a particular child needs an aid, and what kind of aid she needs, must always be carefully and repeatedly evaluated. An aid that helps a child at one level of development may actually hold her back at another. When considering aids, we suggest you first read the chapters on child development, those covering the particular disability of the child, and Chapter 56.
Lying aidsLying face down is a good position for a child to begin to develop control of the head, shoulders, arms, and hands, and also to stretch muscles in the hips, knees, and shoulders. However, some children have difficulty in this position. For example: 
A 'wedge' or slanting support is often helpful. The height depends on the needs of the particular child.
Wedges can be made with:
572
Some children are able to control their shoulders, arms, and hands better when lying on one side.  A side-lying frame may be helpful for some children with severe cerebral palsy. Try cushions or padded blocks of different shapes until you find what works best. Use straps only if clearly needed to keep a good position. Also see lying frames for straightening hip flexion contractures (Page 81 and 86), and lying frames with wheels (Page 618 and 619). ADJUSTABLE BEDS This design from the Centre for the Rehabilitation of the Paralysed in Bangladesh adjusts easily from an upper position to a lower position.
These metal beds and wheelchairs are welded together by paraplegic workers. For the 'coconut fiber' mattresses they use, see Page 199. ADJUSTABLE BACK SUPPORT CLAMP  Supporting a severely paralyzed person so he lies on his side can be difficult. Pillows easily move or slip. This simple clamp helps solve the problem. It was designed and made by disabled workers at the Centre for the Rehabilitation of the Paralysed, Dacca, Bangladesh (see Page 518).
573 Sitting Aids A wide variety of early sitting aids are included in the chapter on cerebral palsy (see Page 97 and 98). Special seating adaptations for chairs and wheelchairs are in Chapter 65. Here we include a few more ideas:
OTHER IDEAS FOR HOLDING LEGS APART from Don Caston and AHRTAG  from other parts of this book  Page 5, 416 Page 5 Page 7 Page 81, 97 Page 98 Page 609 Page 329  For more ideas on adapted seating, see Chapters 9, 35,and 65. Also, see scooters and walkers with roll seats, Page 98. 574 Standing aids (See also Page 99, 312, and 500.)Many children who have problems with balance or control for standing may benefit from standing or playing in a 'standing aid'. Even for the child who may never stand or walk on her own, being held in a standing position with weight on her legs helps circulation and bone growth and strength. STANDING BOARD Sometimes a child who does not have enough control or strength to hold his head up when lying. can hold his head up better when sitting or standing.   A simple standing board can help hold the child in a stable position. This one leans against a table.  LEANING BOARD
BACK-BOARD This can be used to gradually bring a child to a standing position. It is especially useful for older children who get dizzy if stood up straight too quickly. This can happen after a spinal cord injury or a long, severe illness. The child can be stood up gradually and for longer each day.  STAND-IN TABLE  OTHER IDEAS  575 STANDING FRAMES  These are mainly for a child with contractures or painful joints who has difficulty standing straight. The child can gradually be straightened up.
STANDING-AND-WALKING FRAME This is a useful aid to begin standing and walking, for children paralyzed or severely affected below the waist (paraplegia, Spina bifida, diplegic cerebral palsy).
STANDING-WALKING BRACE   This has the same use as the standing-walking frame above, but is especially useful for children who need to learn how to walk before they are fitted for braces with a hip band or body brace. 576 Aids for balancing and body control Activities for improving balance are discussed on Page 105, 311, and 312. Here we bring together a few of the aids for balancing that are shown in different parts of this book, together with a few new ones. BALANCE BOARDS    BALANCE BEAMS
To improve balance also see swings, rocking horses and merry-go-rounds.  Page 420 and 421  Page 422  Page 425 577 Other aids Many aids not yet described in PART 3 have been described in other parts of this book. Here is a brief summary of some of these to give you basic ideas and tell you where to look. We also give a few ideas of aids not shown before. EATING AND DRINKING AIDS
TOILETING AIDS
HOLDING AND REACHING AIDS (Also see Page 6, 223, 230, 335, 336, 431, and 507.)
SPIRAL HOLDING AID
REACHING TOOL  ALL-PURPOSE TOOL  WRITING AIDS (Also see Page 189, 223, 230, and 501.)
578 COMMUNICATION AIDS (Also see "Blindness" Page 253 to 254 and "Deafness" Page 259 to 275.)  Page 288 and 501.    See Page 641. PHYSICAL EXAMINATION, MEASURING AND RECORDING AIDS INSTRUMENT FOR LEVELING HIPS  Cut 2 pieces of thin plywood like this. Fasten them together so that they slide back and forth.  To use, close instrument around child's waist and push down against hip bones. Then raise or lower shorter leg until the instrument is level.  aid for measuring leg length difference (Page 34 and 549)
FOOT CONTRACTURE PREVENTION AIDS Also see Chapter 59, "Correcting Joint Contractures," and Chapter 58, ''Braces".
EXERCISE AIDS
Go back to the CONTENTS Disabled Village Children A guide for community health workers, rehabilitation workers, and families by David Werner Published by The Hesperian Foundation P.O. Box 11577 Berkeley, CA 94712-2577 Copyright © 1987 by the Hesperian Foundation 2nd edition, 5th printing February 1999 |
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