We met Ariel in the summer of 2015. His school Occupational Therapist (OT) mentioned he needed assistance stabilizing his neck and arms while sitting in the classroom chair. So, with the help of a couple of ADA interns and volunteers, and the collaboration of Ariel’s Physical Therapist, OT, Teacher, and paraprofessionals we were able to figure this out!
Stabilizing the Neck
Ariel sits with his neck hyper-extended most of the time. Since he has a degenerative disorder, having a soft customized support that can be adjusted over time was very important.
We custom-made a removable neck insert with soft pillows that will provide enough support to his neck to keep it in a neutral position. It took us 2 – 3 trips to the school to figure out the right shape and materials, but the outcome was inexpensive and very successful.
The second request was for arm guards. Ariel tends to keep his arms out to the side and unsupported most of the time. This position causes stress on shoulders, prevents him from focusing on his work, and can risk injury when going through doors or just being in a classroom with people and furniture around him.
We started by making mock-up guards in cardboard, which angled in from the sides. When we finished, we realized the shape was not good. They obstructed his range of motion too much and blocked his vision. So we changed the shape to straight guards, but the next day they were taken off the chair because Ariel wasn’t comfortable with them and they still blocked his view. Ariel’s teacher and the paraprofessionals in the classroom wondered if we could make guards that could pivot or be removable so that he could reach out to the sides for certain activities – such as pointing to the SMART Board in the classroom.
So, this took us to a 3rd and finally very successful prototype. His new arm guards are made out of plywood and clear plastic. When we brought them to the school we realized they could be used for different activities and in different ways: both arm guard down for studying and playing with toys; one guard up so that he can point to the SMART Board; or he could have both arms up when needing a break. He did not fight them as much as the previous prototypes, probably because they are see-through. He also seems to like the fact that they go up and down.
Both adaptations are helping Ariel to improve posture and alignment of neck and arms, reduce stress on neck and shoulders, and keep his arms safe from bumping into hard surfaces or other people. He also can better focus on work, be more hands-on at school, and manipulate toys independently. ADA learned a lot during this process as we tried different designs and materials, but these two projects would not have been as successful if it hadn’t been for the input that the entire team gave us: his therapists, his teacher, and the paraprofessionals in the classroom. This ended up being a successful project due to such a great collaborative process.