When I was 13 my parents took me to the orthodontist to get braces. At that time, the most effective technique consisted of horse bridle-like machine that I was supposed to wear overnight and for at least 6 hours during the day. This meant I was supposed to go to school wearing the bridle. I never did. Fortunately, it seems I had soft mandibular bones and the overnight hours were enough. 

I couldn’t help but to remember this experience while reading about the use of assistive devices by children with physical disabilities. Although I don’t mean to compare my 13-year-old anxiety about braces to the challenges faced by children with disabilities, my experience helped me put into context the process that children with disabilities often experience when using assistive devices.

Assistive devices, such as wheel chairs, walkers, computers, etc,  have been used by children with physical disabilities for decades. These devices have significantly increased daily functioning in these children, and as technology continues to improve, so will the use of advanced assistive devices. In an article published in the journal Child: Care, Health and Development, a team from the university of Leeds in the UK explored the perceptions of assistive devices as reported directly by school children with cerebral palsy living in Taiwan. This descriptive/qualitative study included 15 children between 7 and 15 years. The authors used semi-structured interviews to examine the children’s views of their devices, such as factors that contribute to device use as well as factors that limit their use. The authors explained how previous studies have mostly been conducted with adults, and those involving children are usually based on parental reports largely ignoring the children’s own views of their devices.

The results:

The authors identified 4 global factors that contributed to enthusiasm for the device (use and acceptance):

  1. A desire to overcome physical limitations
  2. An identification with the role of ‘student’ and a need to fulfill such role better.
  3. A desire to increase peer socialization and school participation.
  4. A perception of others’ acceptance of the device.

The authors also found a number of factors that contributed to lower use and poor acceptance of the device.

  1. Becoming the center of attention (in a negative way)
  2. Being teased and verbally abused by peers
  3. Viewing the device as an explicit reminder of their disabilities

An important contribution of this study is the presentation of the children’s own perception of their devices, and particularly the identification of factors that hamper device utilization and acceptance, which could have clinical implications. For example, it was not surprising that others’ acceptance of the device, unwanted attention, and teasing/abuse, were important factors that affect children’s negative conceptualization of their device use. We could argue that to some degree, these  3 factors are related to behaviors by  “others”,  and therefore, appropriate school programs to educate peers on how to interact with children using assistive devices may significantly improve the experience of using such devices by children with disabilities.
The reference: Huang, I., Sugden, D., & Beveridge, S. (2009). Assistive devices and cerebral palsy: the use of assistive devices at school by children with cerebral palsy Child: Care, Health and Development DOI: 10.1111/j.1365-2214.2009.00968.xResearchBlogging.org

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