This document discusses assistive technologies that can help children with disabilities. It defines assistive technology and outlines its benefits, such as increasing independence and participation. Examples of assistive technologies are provided, including mobility devices, seating and positioning aids, prosthetics, and communication aids. The document also discusses challenges, evaluation processes, and how assistive technology can help support development in children with various conditions such as cerebral palsy. Case studies are presented to illustrate how specific assistive technologies can help children with different types of disabilities or congenital conditions.

1. Assistive technologies for pediatric
rehabilitation
Poly Ghosh
Workshop Manager(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. • 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

4. 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

5. 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.

6. Why AT is important in child
• The psychological development of children is very dependent on their
environmental interactions and their successful integration into peer groups.
• The level of energy, natural curiosity, and adaptability of children allow most
children to achieve a mainstream education and lifestyle.
• Many of the skills learned in life begin in infancy:
• AT can help infants and toddlers with disabilities learn many of these crucial
developmental skills.
• With assistive technology they can often learn the same things that peers without
disabilities learn at the same age, only in a different way.
• Communication skills at this age are especially important since most of what an
infant or toddler learns is through interacting with other people.
• This is especially true with family members and other primary caregivers.
• The earlier a child is taught to use an AT device, the more easily the child will learn
to accept and use it.

7. Way to evaluate an infant or toddler for an
AT device or services?
• A multi-disciplinary team will do an AT evaluation.
• Early intervention progrmme
• The evaluation is usually done in the environment where the child spends the most
time.
• For infants and toddlers, this may be the family home or a childcare setting.
• When the evaluation is finished, the evaluator will recommend any devices or
services that will help the child reach the expected outcomes.
• Any devices recommended should be easy for the family and other caregivers to
use.
• An important part of the evaluation : child’s strengths and abilities.
• For example, if an infant with cerebral palsy can only wiggle her left foot, then
being able to wiggle that foot is considered a strength. Any AT device should build
on this strength. In this case, a switch could be positioned so that every time the
infant wiggled her foot a music box would play. Creativity is a must when thinking
about AT for children who have significant impairments! Parents and other primary
caretakers are great resources.

8. 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

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

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

11. 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.

12. 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.

13. 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.

14. Orthosis
Lower extremity
orthosis

15. Lower extremity
orthosis

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

18. Upper extremity orthosis

19. Stick & crutches

20. Walker

21. Wheelchair
• Manual wheelchair
• Powered wheelchair

22. 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.

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

24. Adaptive equipments for ADL
• Attaching larger grips to
zippers and buttons, making it
easier to get dressed
• Displaying simple picture
instructions for daily routines
(such as washing hands) at
home (e.g., above the sink in
the bathroom)
• bowls with suction cups to
provide increased stability for
young children

25. Social Skills and Behavior
• Reviewing video models
of other children
successfully waiting their
turn or listening in order to
teach a desired behavior
• A visual choice board of
different calming activities
a child can use when they
are feeling upset
• Using a child-friendly
timer to alleviate anxiety
and create smoother
transitions between
activities

26. Sensory

27. Literacy Skills

28. Computers access

29. Problems to use AT in child
• Weight factor
• Growth
• Cognitive function
• Adaptibility

30. Different disease/ conditions/diagnosis
that causes disability
1. Cerebral palsy
2. Delayed developmental milestone
3. Congenital malformation/anomaly
4. Amputions
5. Down syndrome
6. Erbs palsy
7. CTEV

31. Delayed developmental milestone
• All developmental milestone become delayed
• Can have different causes
• Causing impairment from physical to
phychological

33. Congenital anomalies/ malformation

34. Congenital anomalies/malformation

35. Functionality & outcome depends on
• The child is a continuously changing patient in whom body size,
limitations, and physical potential mimic the age-appropriate
developmental advances expected in able-bodied children.
• The support and participation of the patient’s family, technologic advances,
and the practitioner’s skill and experience all contribute to the prosthetic
fitting outcome.

36. AT needed
• Any kind of prosthetics & orthotics devices for mobility
• For lower limb, main aim is to make child mobile
• For upper limb, main aim to integrate into different learning
activities, playing, study and other activities of daily living

37. Lower limb prosthesis

38. Upper limb deficiency
1. First passive prosthesis
• It provides length extension and support on the missing side to aid with
sitting balance, reaching forward while sitting, prone play, crawling,
and pulling to a standing position
• 2. First active prosthesis :- cognitively ready and is walking and no
• longer requires arm extension for balance

39. Upper limb deficiency

42. Quadrilateral amputations

43. Adaptive equipments

44. Case no 1:
• The child is having congenital transpelvic
amputation
• main aim to make the child mobile.
• Prosthetic intervention has been given
• Other functions are normal
• Make him walk by prosthesis and increase
his self confidence and social integration and
match with developmental skill as compared
with same age child

45. Case 2
• Congenital
absence of Rt side
femur & LT side
tibia

46. Case 3
• Congenital
absence of femur
partial

47. Erbs palsy

48. Down syndrome

49. 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.

50. • Photo curtsey: Google.com
• Photos from Prosthetics & Orthotics, National institute for locomotor
disabilities.