ACPOC - The Association of Children's Prosthetic-Orthotic Clinics Founded in 1978

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Fitting a Toddler with a Myoelectric Arm

This single case report focuses on the functional outcome of fitting a toddler with a myoelectric prosthesis. A 16month-old boy with a congenital right below elbow limb deficiency was a sporadic wearer of a passive mitten and his mother was determined to obtain a myoelectric arm even if she had to travel half-way around the country with very limited financial resources. He was evaluated by our clinic team and we decided to fit him with a myoelectric. We were pleasantly surprised at how quickly he learned to control the one site (cookie cruncher) electrode and how well he began to incorporate the prosthesis into daily activities. This positive experience has encouraged us to reexamine the pros and cons of fitting toddlers with a myoelectric arm.

Although a myoelectric is not the appropriate arm for all young children, it must be considered as a viable prosthetic option. Criticisms of fitting the very young child with a myoelectric are that you are really fitting the parents and these arms are too expensive for the function they provide. We believe there are three good reasons to fit young children: 1) the function of the myoelectric is comparable to the hook, although each has advantages for specific activities; 2) the cosmetic appearance of the hand "seems" to enhance body image; 3) parental acceptance of the prosthesis facilitates wearing and increased use.

This single case report indicates that it is possible to achieve good functional results on a toddler. This was accomplished despite minimal training time and limited on-site follow-up due to a combination of factors such as a highly cooperative family, an organized clinic team, a well-fitting prosthesis and frequent communication. Myoelectrics should be considered as part of the standard prosthetic options for children; however, constraints such as cost, professional expertise, and family compliance need to be assessed for each child.

University of Washington, Division of Occupational Therapy, UWMC, RJ-30, Seattle, WA 98195