68 chapter 7
Step 3: After the physical exam, again observe how the child moves or walks. Try to relate
her particular way of moving and walking with your physical findings (such as weakness
of certain muscles, contractures, and leg length). (For an example, see p. 70.)
Step 4: Based on your observations and tests, try to figure out what kind of exercises,
aids, or assistance might help the child most. Consider the advantages of different
possibilities: benefit, cost, comfort, appearance, availability of materials, and whether the
child is likely to use the aid you make. Ask the child and parents for their opinions and
suggestions.
Step 5: Before making a final brace or aid to fit the child, if possible test to see
how well it may work by using a temporary aid or old brace from another child. For
example,
If a
child’s
ankle
bends
over
to the
outside
like
this. . .
. . . a lift
on the
outer side
of the sole
like this,
may help
to keep
the foot
straighter.
But before nailing
and glueing in the lift,
quickly make a trial
one of cardboard or
something else and
fasten it temporarily
to the sandal or shoe
with tape or string.
Then have the child
walk.
tape
Note: For a few children, a lift like this will
help. For many it will not.
Ask the child what she thinks.
Step 6: After the child, her parents, and you have decided what kind of brace or aid might
work best, take the necessary measurements and make the brace or aid. When making it,
once again it is wise to put it together temporarily so that you can make adjustments before
you rivet, glue, or nail it into its final form. (See p. 540.)
Step 7: Have the child try the brace
or aid for a few days to get used
to it and to see how well it works.
Ask the child and parents if it seems
to help. Does it hurt? Are there any
problems? How could it be improved?
Is there something that might work
better? Make what adjustments
are necessary. But remember that
no brace or aid is likely to meet the
needs of a child perfectly. Do the best
you can.
Disabled village Children
Mari and Chelo making a child’s brace