This document discusses assistive technology (AT) for pediatric rehabilitation. It defines AT as any product or equipment that is adapted or designed to improve functioning for people with disabilities. The principles of AT provision are availability, accessibility, affordability, adaptability and acceptability. AT can increase independence, participation and functioning for children with disabilities. Examples of common pediatric conditions requiring AT include cerebral palsy, spina bifida, traumatic brain injury and muscular diseases. Rehabilitation professionals play an important role in evaluating patients' needs and recommending appropriate AT. Common types of AT discussed include positioning devices, mobility aids, prosthetics/orthotics and adaptive equipment.

1. Adaptive & assistive
technologies for pediatric
rehabilitation Poly Ghosh
M.Sc (P & O)
NILD, Kolkata

2. What is AT?
• Assistive technology is used as an umbrella
term for both assistive products and related
services. Assistive products are also known as
assistive devices.
• As per ICF: “assistive products and
technology as any product, instrument,
equipment or technology adapted or specially
designed for improving the functioning of a
person with a disability”.
• ISO: defines assistive products more broadly
as any product, especially produced or
generally available, that is used by or for
persons with disability: for participation; to
protect, support, train, measure or substitute
for body functions/structures and activities;
or to prevent impairments, activity limitations
or participation restrictions

3. Principles to guide the provision of
assistive technology?
Availability Accessibility Affordability Adaptability Acceptability Quality

4. • Increase independence
• improve participation
• Children become mobile, communicate effectively, see and hear better,
• Participate more fully in learning activities
• Bridges disparities between children with & without disabilities
• access to and participation in educational, social and recreational
opportunities;
• empowers greater physical and mental function and improved self-esteem;
• reduces costs for educational services and individual supports
• Positive socioeconomic effect
Benefits of AT

5. Challenges of AT
• Potential for an increase in frustration & anxiety
• Ineffective
• “One size does not fit all”
• Technology overload
• Training is more than 1 time
• Carryover may not occur
• Repairs

6. Needs of AT
• 0.5% of a population need prosthetic or orthotic devices, about 1% need a
wheelchair, and about 3% need a hearing aid
• In situations of crisis and emergency, children with disabilities suffer from
a triple disadvantage: they experience the same impact as others, they are
less able to cope with deterioration of the environment, and responses to
their needs are postponed or disregarded (53). To reduce the impact of
crisis and emergencies, children may need assistive technology to be
alerted or to escape a danger before it strikes, or to be able to carry out
activities of daily living important to their survival and health.

7. Pediatric condition required AT
• CP
• Spina bifida
• Traumatic brain injury
• Spinal cord injury
• Neuromascular disease

8. Role of rehabilitation & AT
• Physicians play a critical role as they will evaluate the
patient’s current medical and mental status, identify
precautions and areas to evaluate.
• Physicians need to be aware that AT is an option and
referral sources
• Rehabilitation Therapists bring diverse perspectives and
specialty for evaluating a patients’AT needs.
• Rehabilitation Team provides Education about AT
• Examples of Interdisciplinary approach
: Adaptive Sports Clinic
:Wheeled Mobility Clinic
: Assistive Technology Clinic

9. AT evaluation process
• Patient Goals
• Patient Background
• Developmental milestone
• observation
• School aged & adolescent
patient
• Growth
• Neuromuscular assessment
• Musculoskeletal assessment
• Sensory examination
• Functional evaluation
• Previous/Existing AT Devices
• Body Systems & Structures
• Activity
• Environment
• Outcome Measures
• Patient Education
• Impression/Recommendations
• Plan

11. Assistive technology
• Mobility aids
• Seating & positioning aids
• Prosthetics & Orthotics
• Communication Aids
• Computer Access Aids
• Daily Living Aids
• Education and Learning Aids
• Vision and Reading Aids
• Environmental Aids
• Hearing and Listening Aids
• Recreations & Leisure aids

12. Positioning
• Sitting
• Standing
Mobility
• Orthosis
• Sticks & crutches
• Walkers
• Wheelchairs

13. Positioning devices
• Allow active movement,
• Provide body support,
• Improve circulation and
bone health,
• Prevent soft tissue
contractures,
• Improve communication,
• cognitive and personal
social development.

14. Sitting devices
• Sitting support many
body functions.
Maintained sitting is a
goal achieved by most
typical infants before 1
year age. There are
also significant social
benefits.
Pc: google.com
Corner seat
CP CHAIR

15. Standing
• The standing posture is
the foundation for many
functional activities. Also
can promote circulation,
bone mineral density,
vertical access and social
interaction with others.
parapodium
MODIFIED
STANDER

16. Mobility
• Mobility is defined as the ability
to move in one’s environment
with ease and without restriction.
Problems with walking, rolling
over in bed or transitioning
positions are examples of
mobility limitations.

17. Orthosis
Lower extremity
orthosis
HIP
ABDUCTION
BRACE
Ankle foot
orthosis

18. Lower extremity
orthosis
Knee ankle
foot orthosis

19. Knee
orthosis

20. Upper extremity problems
• Involuntary movements
• Incoordinated movements
• Muscle tone problems
• Lack of sensation
• Lack of motor difficulties
• Grasping difficulties

21. Upper extremity orthosis

22. Stick & crutches
B/L AXILLARY
CRUTHES

23. Walker

24. Wheelchair
• Manual wheelchair
• Powered wheelchair

25. Adaptive equipments
• Adaptive equipment is any device that helps increase
the functional capabilities of people with disabilities.
• Adaptive equipments, :
 Improve the function.
 Provide functional independence.
 Facilitate, develop and maintain a specific function.
 Increase;
 the control over the environment of the person.
 independence.
 motivation.

26. • Adaptive equipment / equipment is used for
positioning, mobility, participation in daily
living activities and interaction with various
media.

27. References
• Dell AG, Newton DA, Petroff JG. Assistive Technology in
the Classroom:Enhancing the School Experiences of
Students with Disabilities. 2nd ed. Boston, MA: Pearson
Education Inc; 2012.
• George Mason University. Assistive technology initiative.
Equityand diversity services.
http://ati.gmu.edu/what_ati.cfm. Accessed July 11, 2013.
• Copley J, Ziviani J. Barriers to the use of assistive
technology for children with multiple disbilities. Occup
Ther Inter. 2004;11(4):229–243.
• Angelo DH. Impact of augmentative and alternative
communication devices on families. Augmentative Alt
Commn. 2000;16:37–47.