The Clinic Team Designs a Hand for an Infant

MARY D. BARBER, OTR**Washington, D.C.

Meshing of age-appropriate function and acceptable appearance in a terminal device for an infant has been recognized as a need by our clinic. Members of our clinic team have attempted to meet this need by working from individual areas of expertise. The social worker, recognizing the need for acceptable appearance and a grief process that occurs within the family both at birth and at initial fitting, would fit with a cosmetic hand initially and later with a functional terminal device (hook, CAPP or hand). The prosthetist would opt for a functional hand of simple design reparable with stock items. The occupational therapist would fit as young as possible with a soft, washable device designed with age-appropriate function in mind (i.e., establishing bilaterality, weight-bearing and gross prehension).

We have compromised with two cosmetically acceptable hands. One is for a non-walking infant (6-18 mos.) and the other is a cable-activated hand (18 mos.-4 yrs.). Both prototypes are of solid silicone and fit standard wrist units. Parental interest in this project is greater than anticipated. The impetus for the development of these terminal devices has moved from the social worker to the local Parents of Amputee Children group which is finding resources to help with design and construction.

**Juvenile Amputee Clinic, Handicapped Children's Services, 19th and Massachusetts Avenue, S.E., Washington, DC 20003