Week 7

Question 1

According to the IDEA, what is an assistive tech device?

Answer 1

“Any item, piece of equipment, or product system, whether acquired commercially off the shelf, modified, or customized, that is used to increase, maintain, or improve functional capabilities of a child with
a disability. Exception - the term does NOT include a medical
device that is surgically implanted, or the replacement of such a device

Question 2

According to the IDEA, what is an assistive tech service?

Answer 2

Any service that directly assists the the child with a disability in the selection, acquision, or use of an AT device” Includes evaluation, purchasing/leasing, selecting, designing, fitting, customizing, adapting, maintaining, repairing, collaborating, training

Question 3

Children that are a gross motor function classification 5 will require devices that allows dependent mobility. What are some of these devices?

Answer 3

• Adaptive stroller: seating system comes with a 5 point harness, lateral support, adductor wedge and a headrest with wings. Height can be changed and is limited to young children. 4-5 is the max age
• Wheelchair: have tilt in space capability, usually comes with a chest harness, seatbelt, lateral support or a headrest. Don’t fold well and is heavy

Question 4

What are the characteristics of some of the wheelchairs that a child can self propel?

Answer 4

• Light weight manual wheelchair: does not fold, wheels can pop off to fold the sit down, additional support can be added
• Power wheelchair: can have high low capabilities. Very expensive and heavy. Require a specialized vehicle due to being unable to collapse/fold. Requires a lot of lifestyle changes

Question 5

What are the characteristics of a squiggles stander?

Answer 5

• Can be positioned to accommodate supine or prone
• Highly adjustable
• Lightweight
• Wheeled base

Question 6

What are the characteristics of a rabbit stander?

Answer 6

• Great for children with spina bifida with good upper body control
• Mobile
• New and challenging to e approved by insurance

Question 7

What are the characteristics of the rifton pacer gait trainer/walker?

Answer 7

• Very common
• Wheeled base
• Arm prompt
• Leg straps can be added
• Big, clunky, makes alot of noise and doesn’t turn well
• Not a 1st choice

Question 8

What are the characteristics of the crocodile gait trainer/walker?

Answer 8

• Anterior walker
• Flip down sit
• Commonly used
• Very light weight and maneuverable
• Accessories can be easily added

Question 9

What are the characteristics of the kid gait trainer/walker?

Answer 9

• Stander and gait trainer
• Provides a lot of support
• Wheels on the side
• Allows medial lateral and anterior posterior sway which is present in normal gait

Question 10

What are the goals of assistive tech devices?

Answer 10

• Facilitate participation
• Increase functional independence
• Improve quality of postural control, alignment, and
movement
• Minimize, prevent, or manage impairments, including prevention of secondary impairments.

Question 11

What are the considerations to keep in mind when recommending an assistive tech devices?

Answer 11

• Planning
• Misuse
• Safety
• Financial concerns
• Psychosocial
• Assistive technology versus Rehabilitation technology
(equipment does not = therapy)

Question 12

What are the different types of LE orthotics?

Answer 12

• Arch support
• Supramalleolar orthotics
• AFO
• KAFO/HKAFO (knee ankle foot orthotic/hip knee ankle foot orthotic)
• RGO ( reciprocating gait orthotics)

Question 13

What is the evidence behind the use of an arch support orthoses?

Answer 13

For children who pronate, the arch support is not very helpful

Question 14

What are the characteristics of a supramalleolar orthotics?

Answer 14

• Offers alot of control around the ankle for children with alot of pronation
• Commonly used by children with down syndrome
• Free ankle PF and DF
• Less restrictive than an AFO

Question 15

What are the goals of orthotics?

Answer 15

• Prevent deformity
• Correct soft tissue deformity
• Control undesirable motion
• Allow normal motion
• Protect weak muscles
• Control deviations associated with abnormal muscle tone

Question 16

What are the oral medications used for spasticity?

Answer 16

• Antispasmodics: diazapam, baclofen, dantrium
• Anticonvulsants: Neurontin(most common), lamictal, trileptal, topomax, zonogran
• Anticholinergics: cogentin, sinomet, robonol, chemidrin, aretain. used for uncomfortable body movements

Question 17

What are the injectable medications used for spasticity?

Answer 17

Botulinum toxin (Botox), which prevents the release of AcH from the nerve terminal, which interrupts muscle contraction. Takes a couple of weeks to kick in and wears off in a couple of months. While it is active, work on underlying motion and strength of muscles

Question 18

What are the other medical managements of spasticity?

Answer 18

Intrathecal baclofen pump. Pumps baclofen into the spinal cord to increase inhibition in the motor neuron pools. Fairly invasive, with a high rate of failure and complications

Question 19

What are the types of surgery used for the treatment of spasticity?

Answer 19

• Muscle release to lengthen the muscle
• Selective dorsal rhizotomy. Involves cutting some of the abnormal sensory nerve fibers that come from the muscles into the spinal cord. Goal is to reduce messages from the muscles resulting in a better balance of activities of nerve cells in the spinal cord, hence reduce spasticity. Commonly used in pts with CP