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Students offer mobility, independence to special needs children

Sarah Wakefield Rosser
Posted 12/30/15

ORANGE PARK – James Bujold reaches up and gives Heather Billiot a fist bump after engaging with her over what appears to be a simple string of Mardi Gras beads, however, for the five-year-old, the …

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Students offer mobility, independence to special needs children


ORANGE PARK – James Bujold reaches up and gives Heather Billiot a fist bump after engaging with her over what appears to be a simple string of Mardi Gras beads, however, for the five-year-old, the beads play a key role in improving his life.

Billiot, an occupational therapist with Brooks Rehabilitation, placed the beads around the joystick of Bujold’s modified red Power Wheels car to pull the joystick forward. Bujold’s mother Karen stands behind the car and gently pushes her son’s right elbow forward to demonstrate the physical movements he needs to get the car moving on his own.

“I can pull [the beads] and give him an idea of the cause and effect so he can move forward,” Billiot said. “For him, it’s a cause and effect thing. We push it forward and it goes forward. When he pulls it backwards, it goes backwards. We want him to learn that on his own eventually.”

Bujold was one of nine special needs children in the greater Jacksonville area who recently received a modified toy car courtesy of engineering and physical therapy students from the University of North Florida’s Adaptive Toy Project. In its second year, the program helps children develop independence, as well as cognitive and motor skills required for solving daily problems.

After his Dec. 23 therapy session at Brooks Rehabilitation’s Orange Park center, Bujold took the Spiderman-themed car home to continue building new motor and mobility skills. Born with a genetic disorder that causes him to be fully dependent his parents, Jim and Karen Bujold, the child will continue to increase upper extremity function, reaching, grabbing and grasping to make daily living activities such as eating and getting dressed easier.

“We’re working a lot on core strength because for him, it’s one of the most important things,” Billiot said. “Sometimes he doesn’t want to do it, so we improvise.”

James Bujold participates in three-week long sessions in suit therapy, a form of therapy using a network of bungees to correctly align and strengthen his body, two to three times each year in Orlando in addition to continual physical and occupational therapy. Suit therapy sessions cost the Bujold’s, who both teach at Clay County’s Tynes Elementary School, $35,000 out of pocket each year.

The combination of occupational and physical therapy aims to make the five-year-old independent and autonomous.

“We want to get him to be as independent as we can because that will help the family, too,” Billiot said. “As he gets bigger, he’s going to be harder to handle. Let’s say when they go to dress him, it’ll be easier if they can pick him up or have him stand while they manipulate things so it’ll be easier on them in the long run and also it gives him a little more independence to do things on his own.”

“Just sitting took years,” said Kelly Delaney, a pediatric physical therapist, who also works with the child. “He learned to sit up by rolling onto his side and from there sitting up. Motivation is the key thing for him. He’s a faces person. There’s research that kids with special needs do have that long processing time that they need to figure something out. That’s one of the awesome things about this project…because it’s not out of the ordinary to put a two or three year old in a wheelchair to start that power mobility earlier.”

Delaney submitted James’ name to be a part of the UNF project because she recognized that learning to drive the car will increase independence and allow him to play and interact with his younger brother Jacob Bujold, who is three.

“That’s why the car is so great,” Delaney said. “It gives him the mobility his parents can’t give him. It’s more controlled by him. Once he gets the hang of it, he can go from one side of the room to the other.”

Although James Bujold’s therapy session focused on the cause and effect, his parents also learned how to help their son by placing extra pads along his left side and behind his back.

“I think he might need more padding in the back, he just doesn’t want to push forward,” said Jim Bujold, who teaches fourth grade. “Hopefully he’ll start chasing Jacob.”

Students in the graduate physical therapy program at UNF joined forces with students in the engineering department to modify Power Wheels toy cars of various sizes after James Cole Galloway, Ph.D. from the University of Delaware gave a presentation at UNF about a mobility program called “Go Baby Go.” The program Galloway helped develop provides children with severe mobility issues, such as cerebral palsy or genetic disorders, the opportunity to learn cognitive and motor skills by operating the simple vehicle thus increasing the chance to improve in social skills by being around others.

Foam pool noodles, foam pieces, microcontrollers, and stop switches among other things were added to various cars depending on each child’s specific needs and physical size. Once the child outgrows the Power Wheels car, it will be reused and modified for another child to use at home or in therapy.

Third year graduate physical therapy student Kevin Dolan worked with the Bujold family and assessed James’ mobility needs before meeting with his student team at UNF.

“We wanted to make it easy to use so we made a joystick that was simple to push it forward and backward. We needed something to make it safe and structurally sound to give him proper posture and to encourage him to reach forward to operate the controls. We added cushions to move him forward to give core stability and to try to keep his legs together for proper posture,” Dolan said.

Under the instruction of UNF electrical engineering professor in the college of computing, engineering and construction Juan Aceros Ph.D., mechanical and electrical engineering students modified the steering system, the seatbelt mechanism, axial components and the seat structure that resulted in dramatic improvements in accessibility for James Bujold. Aceros said that it was important for his students to not only complete the project but to make a difference in the community.

“One important aspect is for the students to experience the potential that they have as engineers,” Aceros said. “They can make a significant difference in people’s lives. In this course, we see this change in the students through the semester, they gain a sense of citizenship and a better understanding of their role in society.”

The Adaptive Toy Project also requires physical therapy and engineering students to work together, thus preparing them further for professional life after graduation.

“In the course the students develop hands-on technical skills, but by interacting with [doctor of physical therapy] students they learn to communicate complex ideas across multiple disciplines,” Aceros said. “They also learn to appreciate how other disciplines approach problem solving and gain skills in working in interprofessional teams.”

Learning to operate the car could take months, but once James Bujold masters the joystick, Billiot said his car could be modified again.

“James doesn’t grow very fast so James is going to be in that car for a while,” Billiot said. “As he gets more control, there is potential that maybe we could do something else to the car so it’s harder to use and will challenge him more. We could add something such as a steering wheel.”

Karen Bujold said the car will be a welcome addition to his ongoing therapy and she was curious to see how her sons would interact with each other at home.

“It’s awesome to see him be able to play like a normal child and to be able to have this cool car and be able to work it,” Karen Bujold said. “With regular pedals, he wouldn’t be able to do that.”