University of Reno Different Equipment for Students with Disabilities Discussions

This discussion is about the use of equipment in educational settings, for special needs students. Please respond to each student discussion. I have also loaded each chapter in case you need it.

(Discussion #1).Side-Lying Equipment:1. I chose side-lying equipment because it’s a great way to ensure adaptive positioning that allows the student to engage in midline activities, which allows them to use or work their arms and hands. Side-lying equipment can prevent or improve spinal curvatures (eg. scoliosis), helps to align the vertebrae, assists in stretching out muscular tightness, especially on the concave side, and promotes asymmetrical and midline posture, which decreases the effects of ATNR, asymmetrical tonic neck reflex. The choices of equipment are easy to use, self-explanatory, can be made by an individual, and are affordable. Students who have physical disabilities may find it very difficult to engage their muscles to bring their arms and hands to their midline area while sitting or lying flat on their back positions. Using side-lying equipment, side-lying mats, pillows, rolled towels or blankets, sandbags, upholstered furniture, and homemade and/or a commercial side-lyer equipment, (Heller; Chapter 6, figure 6-1, pg. 128), students will be able to utilize their arms and hands. A student will be able to easily move their hand to reach for switches/items with the help of gravity. This allows the student to communicate and have some independence that they otherwise would not have in a sitting or back-lying position. 2. The decision for a student to use side-lying equipment is based on a team decision, parent(s), teachers, support staff, and physical/occupational therapists should be involved to determine if the student would benefit from this type of equipment. The first step is initiated by the physical or occupational therapist, as he/she should instruct/teach any and all staff members who work with the student on how to position the student correctly in regards to the appropriate alignment for each body part and each side the student will be lying on. Not only should the therapist go over proper placement for the students’ head, trunk, arms, and legs, they need to determine how long the student will lie on each side. The regime should be tracked and monitored, as to not have the student lie too long on any given side or utilize the side-lying equipment for too long of a duration, which could have a negative effect. Therapists also need to train all staff members who work with the student on the proper set-up of any materials/equipment used. Side-lying positions allow students the opportunity to engage in fine motor skills where they can transfer items/objects from hand to hand, however, when changing objects staff needs to be aware of perceptual changes that may differ depending on the student and the objects used. 3. The setup and design of the side-lying equipment would also be a team decision with guided instruction from the physical/occupational therapist. Each student will need to have individualized equipment as no student/person is the same and the design needs to be implemented to incorporate enough space, opportunity for movement with items/objects, ability to see/hear staff and peers, and if possible be similar to the equipment and set up in their home. This maximizes movement and increases fine motor skills, which helps with muscle and coordination development and maintenance. 4. The advantages to using side-lying equipment are:

• • Promotes a symmetrical and midline posture of the body
  • Decreases the effects of ATNR (asymmetrical tonic neck reflex- “…primitive reflex that babies exhibit and is part of the development of muscle tone, consistent one-sided movements with their body, and even proper hand-eye coordination”. (https://www.healthline.com/health/baby/atnr-reflex#definition (Links to an external site.))
  • Can prevent or improve spinal curvatures (e.g. scoliosis)
  • Helps to stretch out muscular tightness in concave side curvatures
  • Improves fine motor skills
  • Allows for communication (use of a switch device/music/play with objects/etc.)
  • Helps with hand-to-hand object engagement
  • Improves coordination
  • It may be more comfortable and relaxing for the student
  • Affordable

  The disadvantages to using side-lying equipment are:

  • The student may not be able to express if they’re uncomfortable or if something hurts (e.g. a specific body part or muscle)
  • If the student is left too long on one side it may negatively impact his/her muscles, willingness to participate, and could lead to sores (If excessive time is spent in one position.)
  • Improper use of the equipment
  • Equipment environment is not conducive to student engagement with peers and staff
  • Not utilizing or introducing new objects for the student to improve in his/her fine motor skills
  • Not introducing new ways to communicate where the student becomes disengaged or lacks participation.
  • (Discussion #2) Crutches
  • How easy or difficult do you think it is to use the equipment? The difficulty of the equipment would depend on the severity of the individual. Since crutches allow for more independence, it would be used for an individual who has stronger arms and who’s lower extremities aren’t as impacted. Since this piece of equipment allows for more independence, it would be important to have the appropriate training so the individual is able to use the equipment in all situations. The most difficult part about using this piece of equipment would be the training since the individual would have to learn how to walk, sit down, stand up, maneuver tight spaces/corners and ascend/descend stairs in a safe manner. It is a lot of movement that needs to be learn because the individual will be able to navigate through more environments than an individual who has a walker or a wheelchair. After the appropriate training this piece of equipment will be pretty easy to use. Not to mention those who have had broken legs or lower limb surgery have all been given a crash course on crutch usage, this shows the ease of use, though training is necessary if this is to be a long term solution. What general guidelines would you follow in using this particular piece of equipment (under the guidance of a therapist, of course)?The first guideline would be that it needs to be a team decision. This would include the parents, teachers and physical therapist. This team would get together and collect data on the impact of an individuals mobility. If the student has weaker arms, this would not be recommended since the individual will rely on their upper body to hold them up. If the individual has extreme jerky and random movements, this also would not be recommended since the individual will need to use the equipment for balance and these movement could impede their balance. In order to be used the individual will need to have as little help possible and will need to have the energy work the equipment for extended periods of time. Usage should be monitored since the rubber tips can wear down and as the child grows they will need their crutches adjusted for height. How would an instructional setting (classroom or home – depending upon age of child) have to be set up to accommodate use of this piece of equipment and allow the child the greatest amount of ability and interaction with peers, siblings, family, etc. (who depends upon setting)?The greatest part about this piece of equipment is that it takes up very little space and can be used in all types of environments. The only thing that would be necessary is that obstacles would need to be far enough apart for the individual to be able to walk through while using their crutches. It would also be wise to not have any obstacle such as cords that can trip the individual or have their crutch get caught. Instructionally it would be good for the individual to have space to roam around so they can practice walking with the equipment, places to sit so they can practice sitting and standing with the equipment, corners or tight spaces so they can practice maneuvering and stairs so they can practice ascending and descending. It would be the job of the teacher or family to create an environment in which the individual is able to navigate. What are the potential advantages and disadvantages of using the piece of equipment?The advantages are that this piece of equipment allows for the greatest amount of independence when it comes to mobility. The size of the equipment is small so it is easy to transport or to place somewhere when not in use. It allows the individual to navigate many environments such as buildings, stairs and outdoors. The disadvantages are that it takes a lot of practice to be proficient in using this equipment. It takes energy to hold oneself up for an extended period of time and other equipment may need to be considered if the individual is up for an extended period of time. This is also only for individuals who have strong command of their arm strength and control, which limits the population with mobility needs who can use it. The device is also dependent on height which means as the individual grows they will need to have their equipment adjusted or replaced.

  (Discussion#3)

  PRONE/SUPINE STANDERS

  These standers seem relatively easy to use but it’s important that the student is supported at the proper joints with straps and blocks. Students cannot support their own weight, but through support of feet, knees, hips and chest can use the stander for positioning support. In a prone stander, students’ weight is on the stomach/front. In supine stander, the support is on the back. The prone stander can be pushed up to a high table or counter to facilitate interaction/work. The supine stander comes with a detachable tray for support. Because both standers typically come with locking casters/wheels, they can be moved around the instructional environment much like a wheelchair. If the room was set up for wheelchair use, then the stander would be accommodated. It allows for more peer/family interaction as you can be at eye level with standing peers/family and this helps with being “noticed” rather than sitting in a wheelchair.

  Advantages of the stander are it doesn’t take much more space than a wheelchair. The two types support supine and prone positions so more students can use them. The change from sitting to standing position can prevent pressure sores and change circulation patterns. Pressure points can also be a disadvantage and need to be monitored closely. The student can only be in the stander for maximum of 30 minutes, so scheduling in the instructional setting for transfer will have to be accounted for.

  (Discussion #4) The device I’m focusing on are Walkers, which are mentioned in Heller’s Chapter 7 Mobility. Walkers are generally used with individuals that have the “ability to bear weight on [their] legs, stand supported and take steps only while supported.” (Heller, pg 153). There are a wide variety of walkers out there for different supports and needs. “A typical walker provides support in front of the student, with hand grips for holding onto the walker on either side of the top of the frame. A walker may have four rubber tips on each of its legs, requiring the student to pick the walker up and move it forward after every step.” (Heller, pg 153.)

  1. How easy or difficult do you think it is to use the equipment? This is dependent on the student and how the walker fits their mobility needs. Walkers are used for support to help the individual to navigate their environment without becoming exhausted if walking without supports. The difficulties can come with the environment. If in the school, are the hallways and classrooms navigable? Is the school single or multi-story or multi-level? Stairs can be a hinderance to using a walker. Are tables and desks spaced apart for easy traveling or does the individual need to take detours to reach different areas which could be tiring? If in the hallways, especially during transition times, can the walker be safely used if the hallways are crowded?
  2. What general guidelines would you follow in using this particular piece of equipment (under the guidance of a therapist, of course)? The general guidelines for using a walker would be is how does the staff safely support the student? Does the staff walk behind, beside, or in front of the walker? How much guidance does the student need to navigate their environment? Just a hand to help steer in a steady line, not run into walls, turn corners, or go through doorways? Also, if the student needs supports such as straps, hand grips, or positioning devices such a pelvic supports or saddles, how are they used? Such as how long are the straps used for, how tight do they have to be? Also, the therapist can show how tall or short the walker has to be adjusted for the student so safely grasp the walker to use it. Also, the therapist will have to train the staff and student how to safely get in and out of the walker.
  3. How would an instructional setting (classroom or home – depending upon age of child) have to be set up to accommodate use of this piece of equipment and allow the child the greatest amount of ability and interaction with peers, siblings, family, etc. (who depends upon setting)? As I said in question one, the environment needs to be accessible for the use of a walker. A crowded environment with desks and tables and chairs can make it hard to safely navigate the environment. It also might tire out the individual making it hard for them to do their classroom activities or socialize with their peers if they’re tired or not have enough time to do anything because of how long it talks to walk around. If there are different levels, both at school and home, are the ramps or easy ways to navigate steps or stairs or a different floor levels. So wide open paths, ramps if needed can be utilized. Also, if navigating hallways, depending on the school’s population, a student might be excused from class early to safely to to another classroom without having to contend with crowds. Maybe other family members or other students could be on hand to assist and help the individual safely navigate their environment.
  4. What are the potential advantages and disadvantages of using the piece of equipment? The advantages of using the walker is that it can give mobility and independence to the individual using it, that they can explore their environment and engage with others around them. Another advantage is they they can use their bodies, help develop and grow by using and moving around instead of being immobile. The disadvantages could be that it could be tiring, there is a risk of body harm from falling or bumping into things or not being able to access buildings or areas in their environment that isn’t equipped for use of walkers.