Running head: Assistive device

Assistive Technology Device

Lauren Hoppe
Touro University Nevada

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Occupational Profile

Aden is a 4 year old boy with Osteogenisis Imperfecta (OI) who lives in a two story
home with his mother, father and two year old sister. He loves singing and dancing and has a
karaoke machine so he can belt out his favorite songs. He also has a guitar, drum and piano he
regularly plays to accompany his vocalizing. He enjoys playing basketball with his miniature
basketball hoop in the backyard as well as riding his bike around the yard. Another favorite
pastime of his is racing his toy cars around the house. He is social boy, never wants to be left out
of anything and enjoys being the center of attention. He loves playing with his little sister, when
she isnt trying to steal his toys and tries his hardest to keep up with his older cousins. He
currently attends preschool for three hours every morning, five days a week.
Aden was diagnosed with OI when he was born and since then has broken his right femur
three times, his left femur three times, fractured his left tibia once, and fractured his skull once.
When he breaks his femur he is placed in a hip spica cast for 6-8 weeks and then usually wears a
splint on his leg for another one to two weeks. To increase bone his bone stability Aden
underwent osteopathic surgery to have his first rod placed in his right femur in December of
2011 followed by a second rod placed in his left femur in February. In August 2012 telescoping
rods replaced his previous rod in his left leg and in May 2013 his right rod was also replaced by a
telescoping rod to allow bone growth.
He is a strong, determined little boy who has had to relearn how to walk each time he
breaks his leg. When his femur is casted in a hip spica cast Adens mobility is greatly affected
and he must rely heavily on his mom and dad to help him play and move around. When he was
two years old he was fitted with for a wheel chair and easily learned how to maneuver it. This
greatly impacted his daily life as he no longer had to rely as heavily on mom and dad to move

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him from room to room. He could use his wheelchair at Sunday school and preschool to keep up
with the other children in the classroom. However his play was still limited to the height of the
wheelchair. He also cannot transfer in and out of the chair independently. When sitting in the
wheelchair with the cast he is also semi reclined which hinders his reaching forward for table top
play.
Diagnosis
OI, also known as brittle bone disease, is a genetic disorder which is characterized by
fragile bones that are easily broken. It is caused by a genetic mutation occurring on type 1
collagen gens but can also cause a mutation of the cartilage-associated proteins. OI can range in
severity from only mild fractures to severe and frequent fractures. The OI is classified based on
the mode of inheritance, clinical pictures and information from x-rays. Common characteristics
of OI are short stature, weak tissues, fragile skin, muscle weakness, loose joints, easy bruising,
frequent nose bleeds, hearing loss, higher incidence of asthma and curvature of the spine. Life
expectancy is not affected in people with mild to moderate symptoms but may be shortened for
those with more severe cases.
There is currently no cure for this disease but treatments include minimizing fractures or
breaks and increasing mobility and independent functioning. Treatments include physical
therapy, occupational therapy, casts, splints, braces, orthopedic surgery, medications to increase
bone strength and mobility devices such as wheelchairs, walkers and canes.
Aden has type three/four, moderate/severe OI, he is short in stature, has some muscle
weakness, is easily fatigued and experiences frequent nose bleeds. He receives infusions of
Reclast to strengthen the bones and decrease the occurrence of fractures.
Clients Need for Device

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Adens primary occupation is play and when he suffers from a broken bone this can be
extremely impacted. When he is casted it severely limits his mobility and creates a barrier for
participation in play activities. Due to the hip spica cast Aden is limited in playing positions. He
usually is either lying in supine or seated in his wheelchair or another chair. Even these positions
confine him because he must rely on others to move him. There are also few toys available for
children to use in supine or table top. This causes limitations in Adens play activities and also
puts a greater burden on his caregivers. When his leg is casted he can no longer walk, but is still
able to crawl by using his arms to pull his leg behind him. Crawling allows him to remain mobile
but also places his ankle in a compromising position, because of the position of the cast his ankle
becomes everted, which has caused problems when the cast is removed and he begins walking
again. Other than his wheelchair, or being carried by caregivers, crawling is his only independent
means of transportation when playing on the floor. The ankle positioning caused by crawling
will continue to become exacerbated if he continues to crawl when casted.
Many childrens toys are made to be played with while the child is on the floor and this is
where most children play with their toys and because of his age and determination it is difficult
to prevent him from crawling.
Adaptive Device
To increase Adens ability to play I decided to make a scoot around, this is a scooter
type device that Aden can lay on in prone and play with is toys on the floor. This device consists
of four wheels attached to a base for him to lay on that allows Aden to use his arms to propel him
forward or backwards and increase his mobility speed. The device also has a swivel function
that permits rotation of the entire device. The top of the scooter is padded and covered in vinyl

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fabric to give more comfort when laying on it. The scooter is also equipped with two stoppers,
one in front and one in back to prevent the device from tipping as the child crawls on top.
The device was made from a mobile computer unit stand, a piece of particle board, a lazy
susan mechanism, padding, Styrofoam, vinyl, bump stops from a car and four wheels. I tried to
use materials I already had or found from family and friends who were no longer using the
materials. I only had to purchase the foam padding, lazy susan turn table device and the vinyl
covering. All other materials were found around the home or reused from old furniture.
It took several attempts to get the base of the device just right. Originally, I used a
wooden circular base cut from and old desk and mounted old wheels from an office chair. This
would have worked but when added to the platform it was too tall for Aden to reach the floor
with his arms. After searching many home improvement stores and looking through old
furniture for an alternative, I finally found an old rolling computer CPU stand. This stand had a
metal base with four wheels attached. I then had the top of the metal frame cut away leaving only
the bottom part and four wheels, which were then attached to the lazy susan mechanism and the
platform.
The platform was measured and cut down to fit the length of Adens body. The front and
sides where cut away to leave room for his arms to reach the floor comfortably and the back part
was left wide to support his lower body and cast.
The next challenge was creating an incline to support his extensor muscles while in
prone. Originally, I wanted a more significant incline to allow for enough support so he would
not fatigue so quickly, the problem with this was due to his short stature the incline had to be
significantly decreased so he could lay prone and reach the floor with his arms to propel the
scooter. The final design used a slight incline with the stryofoam and a small amount of padding

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for support and comfort. It was then covered with blue vinyl, which is the color Aden chose for
his scooter.
After having Aden test the scooter, I noticed it tipping due the placement of the wheels
and his body weight on the board. This tipping also scared Aden when he was climbing on the
scooter. I then added anti tippers made from suspension bump stoppers on cars to the front and
back of the platform.
Another issue I discovered was the scooter was too hard to roll on carpet. A simple fix is
laying a plastic mat on the carpet near his toy box, if he wanted to play in the carpeted area, or
his toys could be moved to the hard wood floor allowing him to propel himself around and play
with his toys.
Future Fabrication Recommendations
The device was created and tested when Aden was not in a cast and therefore may not fit
him perfectly when he will have his hip spica cast on. The measurements used for the width of
the platform where estimated with input from his mother on how wide it should be to allow
enough support for his cast. When he has his cast on, padding may need to be devised to help
support his lower extremities, but I will not know what kind of supports will be needed until he
is casted again. At that time I can assess his needs and add padding as needed.
Another thing I would adjust if I were to make this again is work on lowering the entire
scooter closer to the ground so that I could increase the incline on the platform. I could maybe do
this by trying to find wheels that had a shorter attachment point. I tried using smaller wheels, but
found that the smaller the wheels the harder it was to roll the scooter. Therefore I would like to
keep the diameter of the wheel the same and to decrease the attachment point in hopes of
lowering the platform to the ground.

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It was also difficult to cut the foam padding at an incline and to get it even on both sides
so to get an even incline I would go to a professional or find a tool that could better cut the foam
into the correct incline. The vinyl was also difficult to put on because of the ankles on the
platform and to make it look more professional I would also take this to a place that specialized
in vinyl coverings.
Literature Review
The reason for developing the scoot around was to increase Adens participation in play
based activities when his mobility became limited. Play is such an important part of childhood, is
his primary occupation and is what helps him to grow, learn and continue to develop.
Play has been shown to be a major contributor to a childs cognitive, physical and
emotional growth. In fact play is so important to a childs development that is has been
recognized by the United Nations High Commission for Human Rights as a right of every child
(Lillard et al., 2013). In a study done by Lillard et al. (2013) the focus was specifically on
pretend play and its impact on a childs development. The researchers classified pretend play as
being non-literal or using their imagination to project an alternative representation to the present.
This type of play can be done in groups with other children or alone. The research showed
pretend play can help to develop abstract thought, increase creativity, and if done in a group
setting can increase social skills and social participation (Lillard et al., 2013).
Play is an integral part of a childs life but can be limited if the child becomes immobile
due to a physical impairment. A child can be restricted to the type and amount of play due to the
childs level of mobility and environment. Children with disabilities should have opportunities
to use an array of mobility options to facilitate their participation in activities that are meaningful
to them (Wiart, 2011). Aden has a wheelchair that can allow him to travel around the house or at

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preschool and now with the scoot around he will be able to freely move around close to the floor
to manipulate his toys. Mobility can give a child a sense of freedom and independence that will
allow them to go where they want and participate in activities they couldnt do by themselves.
Mobility is also important because children learn and develop best when they are able to
interact with their environment and others. Immobility can pose a problem for a child who has a
physical impairment. The child no longer has the freedom to roam around in their environment
and must rely on others to help with play activities which can limit many areas of development.
Increasing a childs mobility leads to skills that are developed through movement within the
environment including; problem solving, as they figure out how to manipulate toys or other
objects, eye-hand coordination is developed as they reach and pull things around them, and
communication is improved as the child learns to interact with others within their environment.
Because Aden is only four years old he is still learning how to interact with his
environment and continues to require exploration of his environment to enhance his
development. With this device he will have the ability to move about in a prone position close to
the floor where all his toys are located, providing him free range to play and independence
(Baldwin, Euteneur, Anderson, 2004).
Rationale for Device
As mentioned earlier, play is a crucial part of a childs development and mobility greatly
influences a childs ability to play and interact with their environment. This device will help
Aden have the mobility to play freely on the floor and propel himself wherever he would like to
go. It will also increase his independence because he will not have to rely on someone moving
him if he wants to play with another toy.

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This device will also take all pressure off his ankle caused by the cast while he was
crawling. With the scooter his ankles will be off the ground and will be allowed to rest in an
uncompromising position.
Comparable Items
There are many other types of play scooters on the market most are small, square, plastic
scooters used primarily for play. They usually have four wheels on each corner that allows for
motion in all directions. There is also a scooter made by Fun and Function that allows is a longer
padded scooter that a child can sit on or lay in prone. Although these are great scooters for
children to play on they would not be long enough to support Adens cast and keep his legs and
ankles off of the ground.
Conclusion
Overall, I believe this device turned out great and was beyond my expectations. Aden
enjoys playing with it even though he is not casted right now and I believe when he suffers from
another break that it will be very beneficial to have. The building of the device was an interesting
experience that took patience and being able to adapt when things were not turning out the way
you expected them too. When I see Aden playing on the scooter and using it to play with his toys
it makes all the hard work and effort pay off. I am excited to get the device back to him so that he
can continue to play with it and get used to it so when he is in a cast he will know how to use it
and it will be an easy for him to use.

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References
Baldwin, J. L., Euteneur, S., & Anderson, K. (2004). Making the Case for Mobility: Enhancing
Overall Developmental Skills of Students with Physical Impairments. Physical
Disabilities: Education And Related Services, 23(1), 33-41. Retrieved
from

http://files.eric.ed.gov/fulltext/EJ842013.pdf

Lillard, A. S., Lerner, M. D., Hopkins, E. J., Dore, R. A., Smith, E. D., & Palmquist, C. M.
(2013). The impact of pretend play on children's development: A review of the evidence.
Psychological Bulletin, 139(1), 1-34. doi:10.1037/a0029321
Wiart, L. (2011). Exploring Mobility Options for Children with Physical Disabilities: A Focus on
Powered Mobility. Physical & Occupational Therapy In Pediatrics, 31(1), 16-18. DOI:
10.3109/01942638.2011.532452

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Appendix
Table A1: Cost Analysis
Item
Nylon covering
Padding
Styrofoam
Lazy Susan Mechanism
Wheels with Base
Particle Board
Bump Stoppers
Thread and Needle

Cost
$4.99
$10.89
$7.89
$4.29
$0.00
$0.00
$0.00
$0.00
Total Cost = $31.06

Purchased/ Retrieved
From
Hancock Fabrics
Hancock Fabrics
Hancock Fabrics
Home Depot
Recycled
Recycled
Recycled
Previously Owned

Table A2: Comparable Devices

Soft Tummy Scooter form Fun and Function
Cost: $59.99

Retrieved from http://funandfunction.com/tummyscooterboard.html m

12 Yellow Scooter Board From Fun and

Function
Cost: $16.99

Retrieved from http://funandfunction.com/12-scooterboard.html

Companion Sports Wood Scooter From

Amazon
Cost: $ 24.81

Retrieved fromhttp://www.amazon.com/Champion-SportsWood-Scooter-12-Inch/dp/B000KA2UQW

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Figure A1
The Scoot Around

Figure A2
Bottom of the Scoot Around

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Figure A3
Aden on the Scoot Around

Figure A4
Aden playing on Scoot Around

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Figure A5
Aden playing his guitar in his wheel chair

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