Case Study on Bradley's Challenges of Living With Cerebral Palsy

Introduction

People with cerebral palsy encounter numerous challenges in their day to day lives. Some of the common problems affecting the cerebral palsy individuals occur due to communication and motor dysfunction disorders. Such disorders are usually associated with non-progressive damage in the brain, which occurs in their early life. Cerebral palsy is also associated with communication problems and cognitive development. This paper examines Bradley's case study, a boy aged six with spastic quadriplegic cerebral palsy.

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• Bradley's Characteristics Relevant in Identifying Appropriate Assistive Technology
• Bradley has a challenge in opening doors at home without the assistance of a family member
• Bradley also has a verbal communication problem and a limited hand function
• Fortunately, Bradley does not seem to have a mental disability
• He is outgoing and finds it quite appealing to spend time with his two older siblings
• He has a personal desire to learn the use of technology devices as he is always interested in watching his brother play computer games on his Xbox
• Bradley's inability to effectively use a mouse or keyboard practically excludes him from practically engaging in social or play activities in school
• The Environmental Factors Relevant for Bradley in Identifying the Appropriate Assistive Technology
• First, Bradley is privileged to use an electric wheelchair for his movement
• Back home, he has started using a picture board to communicate during meal times
• His older brother has a technological device (Xbox) that he can use to play computer games
• The school is equipped with computers that other students use for social and learning activities
• Bradley's mother Anne, his elder sister and brother, assist him back home
• In school, his teacher is quite supportive and also the other students
• Bradley attends Occupational Therapy weekly and has also started a once in a while fortnight Speech Therapy sessions at his school
• He cannot effectively use a mouse or keyboard like other students; hence, excluded in engaging in computer-based activities
• Back home, he gets frustrated when he cannot communicate something else that is not on his picture board
• Other students find it quite challenging in understanding him
• The Tasks Bradley Is Trying To Achieve That May Be Addressed Through Assistive Technology
• To improve his verbal communication, Bradley utilizes a picture board, and his frustration, once he cannot communicate anything else not in the board, necessitates the use of alternative devices like an electronic device with a voice
• Bradley can also be provided with hand-assisted tools that he can use while opening doors
• For his difficult verbal communication, and for the other students to understand him, an alternative communication system can help out such as communication board, a book or even an electronic device

The Assistive Technologies That May Be Implemented for Bradley

Assistive technology represents an inclusive word for a system or an approach that permits an individual to perform a specific activity that may be complicated to accomplish or that which simplifies the manner an activity is completed (Marino, 2006). Assistive technology is mainly made up of both low-tech and high-tech tools, which all might be used for Bradley's situation. Some of the low-tech technologies comprise adapted kits like the sign language, picture boards and walkers. High-tech techniques include the electronic communication equipment, AAC digitized speech (Augmentative and Alternative Communication), powered wheelchairs, micro switches among others (Zabala, 2005).

Literature Review

Assistive technology is meant to help those with disabilities overcome their conditions and engage in some of the crucial phases of life. According to (Frantz, 2019) "Assistive Technology is an area of knowledge, with interdisciplinary characteristics, which includes products, resources, methodologies, strategies, practices and services that intent to promote functionality related to activity and participation of people with disabilities or reduced mobility, aiming at their autonomy, independence, quality of life and social inclusion". Assistive technology uses Alternative and Augmentative Communication to give a student an expanded communication opportunity to contribute in social exchanges. AAC comprises a set of methodological and technical procedures meant for people with oral communication difficulties.

According to Karlsson (2014), many of the students with cerebral palsy have difficulties in performing activities which have an impact on their participation in school activities. Many students hence apply a mixture of technologies in bridging the gap between their physical ill health and activity needs and accessing the school curriculum. In bridging this gap, those students need to make use of assistive technology to help them achieve what they would otherwise not have realized. Additionally, as more efforts are put to increase students' participation in school, the majority of the disabled students experience insufficient collaborations and communications between health professionals and school staff. Improving students' involvement in school and creating a supportive environment for disabled students calls for the incorporation of assistive technology. According to Karlsson (2014). "The education system often does not have formal mechanisms for assistive technology support. The support and training of individual educators to increase their knowledge and expertise in the use of assistive technology are critical for a successful experience." In ensuring support to the disabled children, family centred care is a form of assistive technology that is used in collaboratively providing interventions as it establishes a collaborative relationship between the kids and their parents.

Family-centred assistive services involve both participatory and relational components, both of which need to be included in for an efficient intervention (Taherian, 2017). The relational component involves those processes associated with excellent clinical skills while the participatory element involves the flexible, individualized, those which meet family priorities and concerns.

A study by Marino et al. (2006) states that "a first step in improving AT services for students with high incidence disabilities in understanding the salient factors that hamper IEP teams' abilities to make appropriate decisions." The assistive technologies are meant to encourage the functional competences of the disabled kids. The assistive technologies offer the children with the much-needed assistance to use in writing, reading and finishing calculations unconventionally. Moreover, assistive technologies are useful for the following set of functions: Sustaining life, promoting communication, improving environmental interaction, protection from body injuries, increasing mobility and participation in recreational activities (Marino et al., 2006). It is also essential to identify the best assistive technology for a given child. Whatever is termed as assistive technology for a student may not apply to another.

Normally, education is considered as one of the essential areas in the life of a child while assistive technology functions as a top innovation in their education process which accelerates learner involvement (Marino et al., 2006). However, the capacity for utilizing the high-tech equipment, the students need to have a combination of physical and cognitive skills; a feature valuing alternate access preferences like switches, substitutes to the keyboard or even the mouse (Zabala, 2005). High-tech equipment have a challenge in their assessment and implementation. The equipment creates strains on the persons using them, not forgetting that they need expert skills and an excellent knowledge for supporting the practice (Ikuta et al., 2012).

Recommendations for Appropriate Assistive Technology

Bradley, who has cerebral palsy, also uses a wheelchair, and has limited hand functionality and has difficulties in verbal communication. One of the best assistive technologies for Bradley would be the Tibii Mobile. The Tibii mobile is an accessibility device made of an eye control element that when fixed to tablets, laptops or notebooks will allow Bradley to control the software with his eye movements. Tibii mobile will also allow Bradley to communicate through symbols or texts that produce recorded or synthesized speech for face-to-face communication. The eye-controlled device makes it possible for Bradley to transport a book and supplement his involuntary hand movements. The approach substitutes the mouse and keyboard as the interface system, and hence Bradley can have the ability to control a PC and have be able to communicate and engage in activities, including playing music and games. With the Tibii mobile device, Bradley can communicate and engage in several activities regardless of his disabilities. Though being of great help, this type of assistive technology has a limitation. According to (Borgestig et al., 2016), "eye gaze devices are unsuitable due to there being too many involuntary movements in children with cerebral palsy." Bradley's performance capacity in controlling the AT device will depend on his capacity to control the movements of his eyes and the capability to understand the interaction and task with the computer.

Bradley could also use the AAC assistive technology tool which is based on iconographic symbols and communication boards. Bradley use of AAC will help him overcome his oral communication problem. Using this AT, Bradley will be able to choose the desired symbol after which the symbol is voiced then "added to the upper life side of the software interface" (Ramirez et al, 2016). The AAC software makes use of approaches that facilitate the choice of symbols. The symbols that are commonly used appear first, such as greetings and people. The tool will help improve the communication speed for Bradley. Symbols suggestion is on the basis of the preceding usage and is also dependent on the therapist's settings on the device. The pictures used in this tool have oral descriptions which, according to Ramirez (2016), "this is very important because CP individuals have difficulties keeping attention on what happens on the computer screen." Though this type of assistive technology is much useful, its major limitation is that it requires programming, an aspect that may make it unreliable.

Conclusion

The paper combines the case study and literature, to evaluate and implement assistive technology among young children with Cerebral Palsy like Bradley. In helping Bradley overcome his disabilities, it is also recommendable to involve him with professional therapists in diverse areas of knowledge. The involvement will help Bradley attend the different stages of assistive technology which include being evaluated to identify his needs and skills; obtain the relevant prescription; get monitored so that his needs are identified for modification of the chosen set of technologies.

References

Ikuta, S., Nemoto, F., Endo, E., Kaiami, S., Fukushima, K., & Ezoe, T. (2012, March). Handmade Teaching Materials and School Activities with New Dot-codes Handling Multimedia. In Society for Information Technology & Teacher Education International Conference (pp. 3649-3654). Association for the Advancement of Computing in Education (AACE). Retrieved May 27, 2019, from https://www.learntechlib.org/primary/p/40166/.

Karlsson, P. A. M. (2014). Assistive technology in the classroom for students with cerebral palsy: The team approach, the number one key to making it successful(Doctoral dissertation, University of Western Sydney (Australia)). Retrieved on May 26, 2019, from https://re...