Can Adaptive Equipment Be Dangerous to a Child?

That was a trick question:  of course it can.  The wrong adaptive equipment can create hazards as well as bad habits that are hard to break.  And it happens all the time now, as parents and patients decide that they know exactly what is needed.  It also happens when they aren’t provided with access to skilled providers.  We are in a crisis in healthcare.  Too many families and too few highly skilled providers that can assess and prescribe DME.


When the adaptive equipment is the wrong piece of DME (durable medical equipment) or used incorrectly, it will almost always damage the development of a child’s independence or make an adult less independent.  This is why a licensed therapist is called in to assess a home and prescribe DME.  Well, that is the way it should be.  There are a lot fewer providers out there that do home-based care.  Facilities cannot replicate the home, and so the DME used in a clinic often doesn’t fit or function in a home they way that it did in a rehab unit or a clinic.  If a therapist has never done a home visit with any patient in their entire career (yes, that is entirely possible!), they have to rely on their guesses and prescribe the DME that they believe will at least fit into the patient’s bathroom.

Home bathrooms are impressively variable. As variable as our patients.  Getting the fit right for a growing child or an adult patient with a progressive disorder is not easy.  But being in the actual bathroom can be essential to saving patients time and money.  Often, parents believe their kid will “grow into” the DME they own.  Adults hope that their loved one will make enough progress that they will learn to use awkward DME.  Or that they won’t decline further.


This makes no sense.  None.  The chance of the stars aligning in the future for a good outcome isn’t as good as the chance of an accident happening soon or the child/adult becoming confused or frustrated.  Good DME is the kind that works right now and has the ability to keep doing its job for a while into the future.  But getting things right in the present is the most important thing.  It always will be.

We don’t take many chances in treatment.  We always think about risk assessment, and we choose to place safety above just about everything else.  This goes double for bathrooms.  There is so much at stake:  safety, independence, dignity, and more.  Getting the right DME for the toilet can improve someone’s life right away.  That is what builds future independence:  Success today.

When you can easily use the toilet and don’t need as much (or any!) help to do so, it builds confidence and self-esteem.  Those two things are so valuable that it is worth getting a skilled therapist to help you!!


Is your child on the spectrum?  I wrote a book for you!  Read The Practical guide to Toilet Training the Autistic Child  to learn more about how to potty train your autistic child right the first time (or fix the mistakes you make in round 1!)


I can’t come into your home if you don’t live in my region of the country, but you can contact me to help guide your conversations with your local providers!  With the right information and knowing what questions to ask, you will be empowered to make the right choices with confidence.  Contact me and set up a consultation session today!!


By Cathy Collyer

I am a licensed occupational therapist, licensed massage therapist, and certified CBT-i sleep coach in private practice in the NYC area. I have over 25 years of professional experience in adult and pediatric treatment. It has been a joy to help people of all ages improve their ability to grow and thrive! Occupational therapists are focused on enhancing a client's functioning in everyday life. We are practical healthcare providers, interested in teaching, adapting actions and environments, and building a client's useful skills for living their best life, regardless of their challenges. I am the author of five books, including "Staying In The Room: Managing Medical And Dental Care When You Have DID" and "The Practical Guide To Toilet Training the Autistic Child". I lecture on many subjects, including sleep, trauma, and development. Contact me to learn more about how I can help you achieve YOUR goals!

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