Application of assistive technology as intervention strategy addressing needs of children with cerebral palsy has been gaining increasing attention in the recent past in connection with occupational therapy approaches. Research has highlighted that increased independence, effective positioning and engagement for children in activities of daily living (ADLs) can be achieved for children with cerebral palsy with the help of assistive technology. The topic selected for the present portfolio is “Effective positioning, increasing independence and engagement for children with cerebral palsy in ADLs, through Assistive Technology”. The portfolio would be a reflective writing based on evidence that would evaluate my learning on the selected topic related to occupational therapy and assistive technology. The first section of the essay would identify the extent of my prior knowledge and skills in relation to the selected topic. In this section, I would evaluate what I have learnt about the topic through participation in the module. The second section of the essay would be a critical reflection on the material contained in the portfolio in relation to occupational therapy. The last section of the portfolio would be a reflective commentary on the evidences in which I would critique and demonstrate the depth of awareness of the topic. The reflective model to be used for this section would be Borton’s model (Lucas 2012).
Application of advanced technology in the modern world is a common approach, the aim being a better quality of life of human beings, and technology is constantly being utilised in different fields, including medical and health intervention. One novel gift of advanced technology comes in the form of assistive technology, meaning the devices and systems that allow human to carry out activities that are otherwise not possible due to any confounding factors. I have the idea that the basic purpose of assistive technology is to increase the safety and ease of performing tasks and assisting humans to carry out the daily activities of living. These equipment and aids have immense potential to make the lives of human easier and smooth. I understand that occupational therapists use activity analysis to meet the varied demands of clients. As occupational therapists, we are to consider using tools that would promote a better quality of life for the clients and it is crucial in this regard that the tools used matches with the skills of the clients match with the utilisation of the tools. When such tools maintain and increase the functional capabilities of the clients, the definition of assistive technology is met. For facilitating the occupational performance of a client, occupational therapists must modify the tools accordingly. Thus, I believe that there is a need to include provision for assistive technology to support people with disabilities as a natural part of occupational therapy. These would suitably reduce barriers to the function of individuals who need help and assistance for injury or illness (Cook and Polgar 2014).
From my previous studies, I had learnt about how assistive technology could be ideal to addressing challenges faced by children with cerebral palsy. However, the extent to which this might be achieved, and the exact nature of how such technologies help had been unknown to me. Taking part in the present portfolio would help in enhancing my knowledge about the relationship between assistive technology and cerebral palsy. More specifically, I have been gaining deep insight into how assistive technology is beneficial for effective positioning, increasing independence and engagement for children with cerebral palsy in daily activities of living (Mumford and Chau 2016).
Cerebral palsy (CP) in children is characterised by muscle stiffness due to damages to the central nervous system (CNS) at the pre, peri and post natal periods. CP is caused due to maldevelopment of the brain and occurs when the brain is in immature condition. As a result, the motor development of the child is hindered. CP can be identified as a chronic neuromotor dysfunction or infant encephalopathy that is the cause of posture, muscle tone and movement disorders. In occupational therapy practice, the possible application of assistive technology as a form of an intervention addressing physical and mental challenges faced by patients, especially children, is a valuable representation of strategies to promote occupational performance. The tradition of applying assistive technology in occupational therapy dates back to last few decades. Since technological development has the power to control the living conditions of lives of human beings, it poses considerable demand on occupational therapy practice. Addressing needs of children with cerebral palsy has been the focus of occupational therapists in the light of fast evolving technologies. Social inclusion with the help of information and communication technologies has been widely discussed by occupational therapists. Investing in technology that facilitates the inclusion of individuals with different forms of disabilities can possibly be an advantageous approach. Interaction with the outer world, mobility and independence to perform daily activities of living are all promoted for people with cerebral palsy by the use of technology (Heidrich and Bassani 2012).
Cook and Polgar (2014) enlist the wide range of assistive devices that can suitably aid the functioning of children suffering from cerebral palsy. Some of the commonly used devices include closed captioning, digitised speech, word prediction, single latches on laptops, wearable computers, brainwave recognition units and so on. Closed captioning are a textual translation of voice and sounds on television that is helpful for those who have issues with hearing. Digitised speeches are computer-generated speech beneficial for communicating. Word prediction works as speed text entry who are not able to use their hands on the key board. Single latches on laptops can allow individuals to open lids on computer systems easily. Wearable computers are for those who want to carry with him the system without challenges. Brainwave recognition units are advantageous in that an individual can control computer system through thought, without placing their hands. Some of the other assistive devices include pay telephone volume adjustments, automatic doors, sidewalk curb cuts, enlarged bathroom stalls. Pay telephone volume adjustments would allow individuals to use telephones. Sidewalk curb cuts allow them to cross the streets in a wheel chair, while automatic doors would enable them to enter buildings. Enlarged bathroom stalls serve the purpose of transferring individuals in chairs to the toilet (Case-Smith and O’Brien 2014).
Preston et al. (2016) highlighted that computer gaming, and virtual reality can be considered for increasing the participation and engagement of children suffering from cerebral palsy in rehabilitation programs. Customised technologies, for example assistive robotic devices might facilitate the participation of children in functional activities. However, they might be time consuming, apart from being expensive (Rabbitt, Kazdin and Scassellati 2015).
Malik et al. (2016) pinpointed that robotic assistive technology has proved itself worthy of being used in rehabilitation. For people with disabilities, such as cerebral palsy, social assistive robotics (SAR) has potential advantages. Its use can address the challenges brought about by the degenerated cognitive function of the children. One important example of assistive technology is orthotics devices that increase the walking velocity of children. The device acts as a source of driving force that corrects the abnormalities arising in body posture. With the advent of robotic therapies offering suitable treatment options for cerebral palsy, the interaction between human and computers is making a gradual shift towards human-robot interaction (HRI) (Hilderley et al. 2016).
Ryan (2016) states that the variety, complexity and cost of products and services related to assistive technology application for cerebral palsy are still under debate and there lies much speculation about the effectiveness and efficiency of these tools. Positioning devices for children include bath seats, adaptive car seats, wheelchair sitting systems and toileting systems. Adaptive seating interventions encompass both the used device as well as the associated technical and clinical services. The tools allow children to sit freely without the needs of any hand support. They can also successfully control their trunk and head positions as well as the movement of the lower and upper extremities. For maximising the participation of children in daily situations, therapists need to target control of postural alignment, support daily activities of living, manage body structure and function, accommodate preferences of children and enable caregiving support. Implementation of different assistive devices would depend upon evaluation, assessment, customisation and integration of devices with different forms of technologies due to the complexity of nature of each (Novak et al. 2013).
Russo et al. (2009) brought into focus that children suffering from hemiplegic cerebral palsy (HCP) have distinct cognitive and physical limitations that need assistance in the form of orthoses and assistive technology. Upper limb orthoses are the devices who application has to be on an external surface of an extremity known to improve function, correct posture and lead to better positioning. Environmental modifications and portable aids are the two forms in which functional capabilities of individuals can be increased (Cook and Polgar 2014).
The intention of the present essay is to show an understanding of the views and knowledge I have regarding the relation of assistive technologies for children with cerebral palsy and occupational therapy. The discussion appraising the idea of applying assistive technology in occupational therapy would influence my area of practice. Using Borton’s model of reflection, I would highlight my depth of understanding the topic.
After studying the resources used in the portfolio, I have come to the conclusion that children with cerebral palsy might be facing a wide range of difficulties; but with the help of assistive technology, children are able to successfully overcome the challenges. Assistive technology inspires to become more confident, self-sufficient, independent, thereby improving the quality of life. Assistive technologies are known to boost function in children. As a child is able to contribute more to his well-being, self-sufficiency increases. Devices can be custom-made to be aligned with the needs of children. Benefits for using the technologies are multi-faceted. The aids give the children the equipment required for keeping up with the school curricula. Vocabulary, reading ability and comprehension ability are all enhanced when assistive devices are used. For children with cerebral palsy, communicating the emotions might be difficult. With the help of assistive devices, the children can better understand each other and express their feelings. Communication devices also are known to reinforce an effective communication between caregivers and patients. This makes sure that caregivers are better able to interpret feedbacks from the children (Ravneberg and Soderstrom 2017).
Wide application of assistive devices among the community might require multidisciplinary team approach wherein manufacturers, device vendors, caregivers and patients all need to put in their inputs. As an occupational therapist, I would ensure to promote this concept. The fast changing nature of devices implies that occupational therapists need to update their skills and knowledge for staying abreast of the current technologies in the concerned area of practice. Reflecting back to the evidence found, I pinpoint that therapists need to work closely with other professionals for fulfilling the purpose of creating a patient-centric intervention program. Moreover, I learn that practitioners have the requirement to exhibit ethical judgment and exercise care at the time of using emerging technology (Scaffa and Reitz 2013).
As an occupational therapist, I would increase my foundational skills and knowledge for assessing patients and providing them with the suitable assistive technology services. I understand the need for continuing education, and for successful personal and professional development I would carry out continual research on this subject. This needs to be based on my clinical experience. I belive that it is very much important for me to make specific recommendations for the most accurate assistive technology that facilitates functional ability in those who suffer from cerebral palsy. Matching the patient’s environmental context, barriers and preferences with the devices would be a discrete role that I would need to fulfil. This, I know, would lead to the productive outcome for those I would serve. I would make all attempts to become a perfect match between assistive technology and children with cerebral palsy. Given the utmost prominence of leadership in service delivery of assistive technology by occupational therapists, I would make attempts to exhibit leadership and advocacy for my patients for accomplishing valuable outcomes (Dhillon et al. 2010).
From the above analysis, it can be concluded that occupational therapy practitioners must be having a strong understanding of the occupational needs of the children suffering from cerebral palsy, and this understanding coupled with skills to analyse patient’s performance would ultimately lead to better patient outcomes. Therapists must have a perspective that helped in identifying and integrating appropriate assistive technology solutions in lives of children so that they can overcome their barrier. Within the scope of delivery of occupational therapies, application of technology holds immense potential to enhance the mobility, communication, personal control, work and social participation of patients with cerebral palsy. The use of technology would remarkably unlock the potential patients hold, thereby enhancing the performance across their life span. Technology has time and again been considered as a valuable tool using which occupational therapists can guide individuals to move toward in achieving a higher level of independence keeping aside their disability.
References
CASE-SMITH, J. and O’BRIEN, J.C., 2014. Occupational therapy for children and adolescents. Elsevier Health Sciences.
https://books.google.co.in/books?hl=en&lr=&id=0-DsBAAAQBAJ&oi=fnd&pg=PP1&dq=CASE-SMITH,+J.+and+O%27BRIEN,+J.C.,+2014.+Occupational+therapy+for+children+and+adolescents.+Elsevier+Health+Sciences.&ots=NQEIfyoIUK&sig=wLt0QaAwMRzLM5TE1cmDmnUf1JY#v=onepage&q&f=false
COOK, A.M. and POLGAR, J.M., 2014. Assistive technologies: Principles and practice. Elsevier Health Sciences.
DHILLON, S.K., WILKINS, S., LAW, M.C., STEWART, D.A. and TREMBLAY, M., 2010. Advo-cacy in occupational therapy: Exploring clinicians’ reasons and experiences of advoca-cy. Canadian Journal of Occupational Therapy, 77, pp.241-248.
HEIDRICH, R. and BASSANI, P., 2012. Inclusive design-assistive technology for people with cerebral palsy. Work, 41(Supplement 1), pp.4762-4766.
HILDERLEY, A.J., FEHLINGS, D., Lee, G.W. and Wright, F.V., 2016. Comparison of a robotic-assisted gait training program with a program of functional gait training for children with cerebral palsy: design and methods of a two group randomized controlled cross-over trial. SpringerPlus, 5(1), p.1886.
LUCAS, P., 2012, November. Critical reflection. What do we really mean. In 2012 Australian Collaborative Education Network National Conference (p. 163).
MALIK, N.A., HANAPIAH, F.A., RAHMAN, R.A.A. and YUSSOF, H., 2016. Emergence of socially assistive robotics in rehabilitation for children with cerebral palsy: a review. International Journal of Advanced Robotic Systems, vol. 13, no. 3, p.135.
MUMFORD, L. and CHAU, T., 2016. Application of an access technology delivery protocol to two children with cerebral palsy. Disability and Rehabilitation: Assistive Technology, 11(2), pp.166-175.
NOVAK, I., MCINTYRE, S., MORGAN, C., CAMPBELL, L., DARK, L., MORTON, N., STUMBLES, E., WILSON, S.A. and GOLDSMITH, S., 2013. A systematic review of interventions for children with cerebral palsy: state of the evidence. Developmental Medicine & Child Neurology, 55(10), pp.885-910.
PRESTON, N., WEIGHTMAN, A., GALLAGHER, J., LEVESLEY, M., MON-WILLIAMS, M., CLARKE, M. and O’CONNOR, R.J., 2016. A pilot single-blind multicentre randomized controlled trial to evaluate the potential benefits of computer-assisted arm rehabilitation gaming technology on the arm function of children with spastic cerebral palsy. Clinical rehabilitation, vol. 30, no.10, pp.1004-1015.
RABBITT, S.M., KAZDIN, A.E. and SCASSELLATI, B., 2015. Integrating socially assistive robotics into mental healthcare interventions: Applications and recommendations for expanded use. Clinical psychology review, 35, pp.35-46.
RAVNEBERG, B. and SODERSTROM, S., 2017. Disability, Society and Assistive Technology. Taylor & Francis.
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RUSSO, R.N., ATKINS, R., HAAN, E. and CROTTY, M., 2009. Upper limb orthoses and assistive technology utilization in children with hemiplegic cerebral palsy recruited from a population register. Developmental neurorehabilitation, vol. 12, no. 2, pp.92-99.
RYAN, S.E., 2016. Lessons learned from studying the functional impact of adaptive seating interventions for children with cerebral palsy. Developmental Medicine & Child Neurology, vol. 58, no. S4, pp.78-82.
SCAFFA, M.E. and REITZ, S.M., 2013. Occupational therapy community-based practice settings. FA Davis.
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