ADAPTIVE DESIGN...Making Therapy Equipment Out Of Cardboard- NYC Class

Back Row: Alex (founder), Susan (our Teacher), Me
Front Row: Meg

I had the wonderful privilege a few weeks ago of attending a class I have been wanting to take since January of this year. While I was attending a class on NDT (Neuro Developmental Treatment) for Pediatrics I learned about a technique called APT (Appropriate Paper Based Technology) in which you use cardboard & paper to make therapy equipment & everyday items like tables, chairs, bowls, etc. It was developed in developing countries originally but since has been adapted to be used here in the states as well. Here is the states they use trip-fold cardboard. After much research & talking to people in the UK and Canada I learned about Adaptive Design in NYC who teaches a course. I also went online & purchased the original APT book to read prior to going to the class. I highly recommend this book if you work in developing countries & think APT would be of benefit to the work you do.

Well my adventure to NYC started with me being a little nervous...I have never been to NYC...I am a country girl & don't do cities...I was staying with people I had never met (but they were relatives of a friend)...I took the MegaBus for the first time...etc. Right from the start God was all over the trip guiding me, protecting me, and blessing me. The following is what I wrote the first day after my bus trip into NYC...

"Feeling incredibly blessed and standing in awe of God & how he works! Bus was pretty empty and was able spread out and even sit with my feet up first 3/4 of trip. Then I met an amazing women Amanda on the second half of my bus trip. What triggered our conversation. My Joni Erickson book "Beyond Suffering". We sat next to each other the last 2 hours and was able to share Haiti and have wonderful conversations!!! Then she hugely blessed me by walking me through the subway and got me on the right train!!! Me being so not city would have been so lost & overwhelmed without her. The people I am staying with are so nice & had great conversations. Now waiting for meg to get in and our class adventures start tomorrow"
smile emotic Mezi Jezi!!

Me and Amanda

It was such a blessing to have my friend Meg who will be coming to Haiti at the end of June to spend a few days at the Miriam Center as a vision trip for possibly brining students from Indiana State University down in the future.

Day 1- Cardboard Basics In Adaptive Design

Learning Objectives: Understand a child’s unique equipment needs. Participants use hand tools and single-layer cardboard to create a mock-up of a user-specific seat insert and practice writing a justification for the adaptation.

I learned so much day 1. We got to see many different items you can make out of cardboard & paper and then learned some techniques. Below are a few pictures of different Items you can make from cardboard

In the morning we made a small box our of cardboard the then in the afternoon we were given a case study of a kid and had to make an adapted seat insert for his chair to improve his positioning which would ultimately improve his functional ability to participate more fully in his every day activities. There was a lot more math involved than I thought but it was so much fun! I can't wait to take the techniques I learned back to Haiti & teach the nationals.

Top pictures is the first item we made which was a box
The bottom pictures are example of how to make a quick but sturdy foot stool/support

In Haiti since we do not have trip-fold cardboard I learned how to make my own & this was my practice attempt

This was our case study and our adapted seat insert we created

Meg and I got lost in the subway on our way home the first day but I guess that is all part of the adventure & the result of not being a city person & having very little sense of direction ;-) We were blessed by the people we were staying with. They took us on a driving tour around the city pointing out the highlights & landmarks and then took us out for a wonderful Italian Dinner.

Day 2- Making Adaptive Equipment Work

In addition to Learning Objectives listed in the Day 1 Course, participants will understand the step-by-step process of creating customized adaptations, from assessment to delivery of final item. Participants learn to make a basic adaptation--a footrest, easel, or monitor stand--while delineating the process of revising the IEP or service plan, in order to list, justify, and ensure the provision of customized adaptive equipment.

We started of the morning learning how and practicing with each piece of equipment including: Band Saw, Jig Saw, Power Drill, 3in circular saw, Sandar. 

 Then we got to pick a project seen around the room and design it. Meg picked a slant board and I picked an IPAD holder/slant board. We spent the rest of the day drawing up plans & creating our projects. All that is left by the end of the day for both of us was painting them & then placing a finishing coat of Laquer on them.

In the Evening Meg and I were blessed to get to go out to dinner with the family we were staying with and to meet their kids and some of their close friends. It was delicious food and great fellowship!!!!

Day 3- Adaptive Devices Made To Fit

In addition to the Learning Objectives listed in the Day 1 and Day 2 courses, participants create and test devices for specific children, write justifications, and explore adaptations created for individual needs in academics, ADLs, communication, music, and art.

One of the really nice things about this class was that it was customized to Meg and I based on what we wanted to do and learn. The last day you typically get to build a full size item that you could take home and use with a child. Since I will be going to Haiti & want to teach the nationals to do it we made a variety of little mock-up models of various therapy equipment items and also traced full size patterns onto butcher paper so I could take the models & patterns back to Haiti to train with. We also got to see even more variety of items you can make out of cardboard.

In the afternoon I got to talk to a couple different people who work at Adaptive Design as I vision planned how I was going to use what I was learning in Haiti and how I would be able to fund a project like this. So what is my vision...what do I hope to do with what I learned at this class...why did I take it?

As many of you know getting therapy equipment into Haiti is difficult and very expensive. The equipment often breaks within a short amount of time because it is not made to stand up to such rough, rugged conditions. When I originally heard about this class I knew it would be a great way to add to the creativity of making equipment in Haiti which we have been doing for the last few years making adapted Hatian ductape chairs and PVC pipe walkers/standers.

My goal is to take what I learned back to Haiti. First training my therapy staff how to make the equipment. Secondly training some of the outreach children's fathers who are off work but have a background in construction to make do this technique & make equipment for their own children & children in the outreach program. Thirdly I would like to do educational trainings for the Rehab Tech graduates & current students so they will have a knowledge base to do this work while they are in the field. Fourthly I hope to get this technique imbedded into all therapy curriculum throughout Haiti because I think it is a great way to use resources in Haiti that are usually wasted to make a specialized piece of equipment that has life changing capabilities of providing a child with the ability to more fully engage in their everyday life and environment.

Check out Adaptive Design Website by CLICKING HERE

Day 4 was my travel day back to Pittsburgh. I was beyond blessed that My MegaBus friend Amanda Brashermet mer me for dinner the night before and then got up early to come help me maneuver the subway system to my bus stop to head back to Pitt. I am standing in Awe of how God works. God brought Amanda and I together in an unlikely way. Sisters in Christ! We have had so many wonderful Godly conversations the last few days!!! Hopefully I will see her in Pittsburgh one more time before I head back to Haiti. She has been such an encouragement to me.

I am also standing in Awe of how God brought Meg into my life...One of her students at ISU found my blog. She asked Meg who is the fieldwork coordinator if she could go to Haiti. Meg after looking into it decided to apply for a grant to try to get funding to take a vision trip to Haiti to see if it would be a possibility to partner with the Miriam Center to possibly take ISU students for fieldwork or be a good place where they could bring students on a spring break service learning trip. Our friendship started through email & phone calls as I helped provide her with information for writing her grant proposal. This led to me going to Nashville to the National AOTA convention where I stayed with Meg for the week...which turned into me talking her into going to NYC to this class and Meg coming into Haiti in June... God is always at work!