By Tod Jones
When you think of personal independence, it is often in a hypothetical way, more of a “big picture” approach to life and its challenges—something along the lines of obtaining freedom from job constraints (How do I get this person off my back?), or financial constraints (How can I pay the bills?), or maybe emotional constraints (see job constraints).
Steven Shores thinks of independence in a much simpler way. To him, personal independence means freedom from physical constraints, such as “How can a child with minimal hand function use his computer? How can I make it easier for a teenager with cerebral palsy to style her hair? How can I give a child with limited motor skills the ability to interact with his world?”
Shores is an occupational therapist who specializes in assistive technology in the Children’s Therapy Unit (CTU) at Good Samaritan Hospital in Puyallup, Wash. He helps create links between children with special needs and the equipment they must use to be more functional and independent.
Assistive technology is something we’re probably all familiar with, in one respect or another, from public architecture (ramps and lifts) to motorized wheelchairs.
But there is an endless array of assistive devices for helping with tasks many of us would likely take for granted: personal grooming, interacting with a computer, reading a book, playing a musical instrument, or just playing with toys.
“Therapists have a huge selection of commercially available equipment options, such as motorized wheelchairs, adaptive switches and control systems, self-care aids, and exercise equipment,” explains Shores, who began working at CTU in 1991 and is a part-time instructor in the occupational therapy department at UPS. However, he says, the one-size-fits-all approach doesn’t always work. “Some equipment is just too generic. Many products are over-designed and too complicated to adjust or use. Each child has unique needs and unique challenges. That’s where we come in.”
What Shores and his fellow therapists at CTU do is take that existing equipment and further enhance (or in some cases simplify) its function, or create something entirely new. This may involve “positioning,” which means devising a variety of supportive pads, straps or handles to better align or stabilize the child’s body position when using their walker, wheelchair, or tricycle. Or it may involve the use of adaptive switches, something that Shores says he has developed a local reputation for designing. “Because of physical limitations, some children need switches they can operate with their hands, or their feet, or their head,” he says.
Pulling together both the positioning and adaptive switch elements in a particularly exciting way, has been the Kars for Kids program.
Originally developed by the Puyallup Valley Lions Club and currently sponsored by CTU/Good Samaritan Hospital, Kars for Kids involves the custom adaptation of battery operated toy ride-on vehicles for children receiving ongoing outpatient therapy at CTU.
The toy car’s electric circuitry is modified so that the child can power and steer the vehicle with any type of adaptive switch. “Some children use their hands to power and steer the vehicles, while other children use methods such as head movement, chin movement, finger movement, or voice,” says Shores, a self-described “tinkerer” who uses his previous interest in engineering along with his occupational therapy degree in his work. Custom seating systems are also fabricated and installed in the vehicles to provide the child with adequate sitting stability. The vehicles are then loaned to the children for as long as they can benefit from their use.
“Frequently, the development of basic skills required for powered mobility are delayed until the child receives his or her first power wheelchair,” says Shores, who has presented workshops on assistive technology throughout the U.S., Canada, and China. “The Kars for Kids program provides the child opportunities to experience powered mobility at an earlier age.”
To these children, their customized vehicles are dream machines. In them, they can travel down the road to independence. This can have an enormous impact on a child’s development, says Shores. “Each adapted vehicle allows the child to interact with others and the environment in a way that can develop necessary cognitive and physical skills prior to possible use of a power wheelchair,” he says.
It’s a lot of fun for the kids, too. The smiles on their faces are absolutely huge. You might say, “unrestrained.”