Consumer-Based Approaches Used in the Development of an Adaptive Toileting System for Children with Positioning Problems

Abstract

A research and development project was initiated to address concerns that existing commercial toileting systems are generally cumbersome to use, costly, and do not effectively support children in the best biomechanical and physiological position for independent toileting. Others have found that “homemade” adaptations are often necessary to improve the fit of these systems. To address these problems, a research and development project wasinitiated to develop a better toileting system. A multiphase research project involving a series of focus groups with parents, therapists, and other rehabilitation professionals (phase 1), classroom trials to evaluate a fitting prototype (phase 2), and home trials of a functional version (phase 3) was undertaken in the design of a better toileting system. Consumer feedback from these trials was used to develop a commercial version.¹ This paper reviews each phase of the design process and discusses how consumer perspectives and clinical feedback were integrated into the design of the final product. In addition, features of the final product are described.

Key Words:

• Toileting
• assistive devices
• consumer-based research
• cerebral palsy
• self care

Additional information

Notes on contributors

Dianna Fong Lee

Michael Lepp, PT, is in private practice, Associate Instructor of the Upledger Institute, and Clinical Instructor, Case Western Reserve University School of Dentistry, Cleveland, OH.

Marie McKenzie, MS, OTR, is in private practice. She was Coordinator of Occupational Therapy at Scottish Rite Hospital at the time of this study.

Heather Miller, MS, OTR/L, is currently employed by Madison County Educational Service Center, providing therapy services to the county's pre-schools. This research was completed in partial fulfillment of the requirements of an MS degree at Ohio State University.

Linda Viscardis, BA, is Team Leader and Community Development Worker, Peterborough Family Enrichment Centre. She is Co-Founder of P.R.O.S.P.E.C.T.S., a support and advocacy group for families who have children with special needs.

Debra Stewart, BSc, OT(C), is Occupational Therapist, Erinoak, Serving Young People with Physical Disabilities, Mississauga, ON, and Clinical Lecturer, School of Rehabilitation Science, McMaster University.

Janette McDougall, MA, was Project Coordinator

Kip Husted, BEd, was a parent representative on the study team.

Aviva Yochman, MA, OTR, was a student in the School of Occupational Therapy, Faculty of Medicine, The Hebrew University of Jerusalem, Israel at the time of this study.

Imelda Burgman, MA OTR/L BCP, completed her MA in Movement Sciences at Teachers College, Columbia University, and was an Occupational Therapist at The Shield Institute, Bronx, NY. She is currently Lecturer, Habilitation, School of Community Health, Faculty of Health Studies, Charles Sturt University, Albury, N.S.W., Australia.

Barbara J. Steva, OTWL, BCP, is Occupational Therapist, University of New England Community Occupational Therapy Clinic, Saco, ME. She was Director of Occupational Therapy and Therapeutic Recreation, Franciscan Children's Hospital and Rehabilitation Center, Boston, MA, when this work was completed.