The young await a brighter future

Child equipment provision has been damned as "too little, too late". However, there is light at the end of the tunnel, says independent occupational therapist Julie Swann

Society places a premium on ensuring that children with disabilities are not only well cared for but also receive special attention to help them develop and learn.

Equipment is vital to this need, as the government's Integrating Community Equipment Services (ICES)' recognises, but the quality of provision has come under attack in recent years.

The Audit Commission report Fully Equipped (2000) found problems with equipment supply(2) and in 2002 a commission review of services for disabled children and their families(3) discovered a "lottery of provision", with services varying from area to area.

These delays, said the commission, were resulting in lost opportunities for development and integration, with "too little provided, too late". It added it was difficult for families to negotiate the system, which was described as "a jigsaw puzzle of services".

The review stated: "Waiting for equipment often meant children had outgrown it by the time it arrived. We found little consideration of agerelated preferences, or of young people's developing sense of self and social awareness."

However, these criticisms acted as a catalyst for change. Now, when thinking how to meet child needs most effectively, therapists are considering a number of factors, including:

• Individual preferences: The child who likes an item is more likely to use it.

• Choice: Products should not only be fit for their purpose, they should also be aesthetically pleasing - a point which is arguably even more important for children (and one which has only in recent years been applied to child equipment).

• Empowerment: Many disabled children and their families have benefited in recent years from the Direct Payments programme. This provides a regular sum of money to service users so that they are able to buy their own equipment and care packages. This increase in consumer independence has also encouraged diversity of providers in the marketplace.

• Access for all by design: The social model of disability(4) states that disability is caused by environments, products and services failing to cater for user needs. If buildings and products were designed for easy access and use, there would be less need for adaptations and assistive items such as tap turners and raised sockets. By making facilities child-friendly we reduce the need for special equipment.

• Technological advances: New technology has introduced a new era of hi-tech products for children with disabilities. They could soon be wearing a computerised patch that will monitor body systems, provide feedback or give simple prompts. This could lead to a "SmartShirt", which is made from a special fabric interwoven with sensors that provide a constant stream of information on vital signs, such as heartbeat, respiration rate, body temperature, insulin levels and blood pressure.

• The internet: The worldwide web is a valuable resource for information on and purchase of equipment. Among the sites that provide very useful advice are the Disabled Living Foundation (www.dLf.org.uk) and Ricability (www.ricability. org.uk). However, it is usually best to try to obtain a personal recommendation for a particular service or item of equipment.

Other changes to improve child disability equipment provision are also taking place. This month sees the launch of an ambassador network by the children's equipment charity Whizz-Kidz, in which young disabled people aged 13 to 25 are encouraged to represent the charity and act as a voice for disabled youth. A junior ambassador network for eight to 12 year olds will also be launched. in June.

The initiatives give designers an opportunity to access children with disabilities and gain their allimportant views on products. So the market in this area - with its potential for life improvement through independent living, choice, empowerment and freedom - has never been more exciting or challenging.

A final point - we often see advertisements in magazines and newspapers for adult disability products such as stairlifts, scooters, high-seated chairs, "special" baths and shower cabinets. So far, however, the youth market appears untouched. A missed opportunity, perhaps?

References:

(1) ' ICES (Integrating Community Equipment Services): What is ICES? http://www.icesdoh.org/cevs-page. asp?page=169.

(2) Audit Commission: Fully Equipped - the provision of equipment to older or disabled people by the NHS and social services in England and Wales: http://www. auditcommission.gov.uk/reports/NATIONALREPORT.asp?CategorylD=&ProdID=B D34429B-F1 B24E50-8A82-7A60A7A45302.

(3) Audit Commission: Fully Equipped 2002 - assisting independence: http://www.auditcommission.gov.uk/ reports/NATIONAL- REPORT. asp?CategorylD=&ProdID=2 103ACC1-7512-46a0-B74C-3D28724585FE.

(4) Oliver M (1990): The Politics of Disablement, Palgrave Macmillan, 1990.

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