Final Design Renders

Based on all of my research from the past year, my final design concept consists of three separate pieces designed to be used individually as well as a unit. There are three different stages that they assist with, focusing on a consistent physical development process in both children with hypotonia and with hypertonia.

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Screen Shot 2015-05-17 at 12.32.27 PMFurther renders of the final design concept:

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This thesis project is an ongoing development and I will continue my exploration and design process to modify the final outcome if necessary.

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Final Photoshoot

When I finally finished my final full scale model, one of my three final designs, it was time to have some professional photographs taken. I wanted the photographs to be of a baby sitting aside the product to give a better sense of scale and context. Luckily, I have an incredible friend who lives nearby with the most adorable one year old baby in the world and she allowed me to have her pose with my model. I think that the photographs came out really great and make it feel less like a prototype and more like a real product. Here are some of the photos:

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Final Model Making

After testing my first attempt at a full scale model during my latest observation session and seeing how incorrect the scale was, I created a second full scale model and went about adjusting both the size and form accordingly. I created a larger surface area so that the child could fit comfortably on both sides of the form by adding a few inches to both the length and width. I also made both ends a little bit thicker so that there would be more of the product touching the ground. This would ensure that it would more stable and safe when the child uses it at home.

I brought this second model to be tested for scale with another child. She is about 10 months old so her age falls right into the range of my user group. After bringing the second foam model to her home and even having her both interact with it and lay on top of it, it once again became aware to me that the scale was still incorrect. Although she was able to fit on top of it, I needed to increase the scale even further to make sure that it would be ergonomic for children both smaller than her and slightly larger. Seeing it in a real-life context definitely helped me understand the adjustments that were necessary to complete my design.

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Since I was unable to create a full scale, functioning prototype, I realized I needed to find a way to show all of the important elements that my product would have if it were being manufactured. This meant that I needed to create either one model or a set of models to communicate scale, material, and how the three final designs would look as a unit. After thinking about how to do this in a clear and minimal manner, I finally knew how it would be accomplished.

To show how the product would look in its final size, I continued to create a full scale, detailed model for one of the three designs. This model would represent both scale and form, giving others the chance to better see how it would be placed in the home environment. I used the same process as my previous two models, gluing together stacked layers of pink foam that was cut using the CNC router and carefully sanding it into its final form. I then used SolidWorks to create the textures that I wanted to add and 3D printed them on the studio’s Makerbot. I designed the piece to have both cone and bump textures that vary on either end on both sides. After printing four different sets of textures, I carefully sanded them, glued them on to the form and spackled all of the imperfections so there would be an overall clean, smooth finish.

This led to the next stage, which was to coat the entire piece with a product called foam coat. Foam coat, used in the set design industry to create life-like props to be used on stage, creates a plastic-like shell once it is painted on in multiple coats and set to dry. Once it was dry, I carefully sanded it to have a smooth a finish as possible. This was followed with multiple coats of primer, sanded in between applications, and two coats of spray paint.

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To depict all three models together, making them each in full scale was unnecessary. Instead, I used both Autodesk Fusion360 and SolidWorks to create CAD models for all three designs. I scaled them all down to 1/4 scale models and proceeded to 3D print them using the Makerbot. I assembled the forms and finished them by sanding, priming and painting them. Each one was painted a different color using the color palatte that I chose for my final designs. After researching the positive sensory effects that color can have on children with abnormal muscle tone, I chose bright, modern colors that would be both fun and visually appealing. Although the models are not as large as they would be in real life, seeing them all together in three dimensions gives a much better sense of how they would be used both individually and as a unit.

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Lastly, I needed to figure out an approach to depict the final material. The model, made of foam and an exterior shell-like material called foam coat, does not communicate what the product would feel like if it were manufactured as a product for children. Although I was able to give it a silicone-like finish visually, the textures and overall surface are very rigid and non-inviting for a child to interact with it. I decided that what I needed to do was create a set of silicone-molded textured forms to communicate the real-life material.

I purchased a set of textured plastic balls for children to use for my texture and material samples. I ended up cutting each one in half in order to use as the basis for my molds. After multiple attempts at creating plaster molds, I tried to create a mold using silicone caulking. I attached the textured halves to a sheet of glass and used a mix of dishwashing soap and water to slowly layer the caulking onto the textured exterior of the forms. After creating two full layers and letting them dry, I attempted to break the forms out of the silicone mold. However, it turned out that there was not nearly enough release agent applied before adding the silicone so it was impossible to break them free from the mold.

The simplest way I could find to get a clean silicone copy of the textured halves was to simply flip them inside-out and fill them will silicone. I flipped them all this way, applied plenty of release agent to the inside, and carefully filled them with a two-part silicone mixture. After letting them dry and solidify for 24 hours, I was able them from the textured plastic halves, leaving me with very clean silicone textured forms to use as my material and texture references.

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The textured forms are able to be touched and held, communicating how different textured surfaces would feel in the material of a final product. The silicone is rigid yet somewhat soft, as well as non-porous and easy to clean, making it a perfect candidate for a product in which a child would be interacting with quite often. The soft quality makes it inviting and comfortable while the rigidity adds an element of structure and safety to the product.

Observation/Shadowing & Product Scale Testing

On February 5th, I was able to shadow PT on two physical therapy visits with Child A and Child B once again. Having a period of one month in between these two visits allowed me to see even further progress that they have made over a short period of time. These were my observations:

Child A – 15 months old; low muscle tone

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PT spent the beginning of this physical therapy session working with Child A to stay in a hands and knees position. Instead of this being his usual way of moving around, he uses his head to scoot across the carpet while he lies on his back. In this position, he also arches his back and pushes off of the ground to gain movement. PT works with him on lifting upright on his arms and stomach so that it will transition into him moving around on his hands and knees as opposed to the position he currently prefers. She helps support him while she has him slowly move forward on his hands and knees.

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PT places a mirror underneath Child A and holds him in the same hands and knees position that he was in before. Looking down at his reflection, Child A is interested enough to push upright in order to see his face, helping him stay held up on both of his outstretched arms for a longer period of time than usual. He enjoys looking at his own reflection but he needs to be a little further away from it to see it, so this helps keep him from laying down flat on top of it. In addition to the support that she is giving him with her own hands, PT has wrapped a “super wrap” around his hip and upper thigh area. It is a stretchy, bandage-like fabric wrap that holds his legs together and helps him stay a little more rigid.

Child B – 2 years (+ a few months) old; high muscle tone

2-5-15acopyPT started the therapy session by taking out a product called Theratogs and carefully putting it on Child B. Theratogs, designed by a physical therapist for children with neuromotor issues, is a garment that physically aids the child when it is worn. It comes in different parts so that it is easy to put on and remove, as well as so that it can be used on the areas of the body that require it most.

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PT uses the medical device with Child B since it keeps him grounded, which allows him to be more patient during the physical therapy session. He is able to work for a longer period of time and it helps increase his stability throughout the session. It also helps him with his hip rotation alignment when he is put in to a kneeling position.

Product Scale Testing. 

In addition to just observing this session, I was also able to bring my first full-scale foam prototype of the first of the three final designs to test it for scale. The model was created the same way my previous scaled model was made; I designed the form on CAD, split it into stackable layers using Autodesk 123D Make, then used the CNC router to cut the shapes out of 1″ thick sheets of pink foam. I stacked the piecess together using spray adhesive then proceeded to carve and sand it into its final form.

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Child A, who is 28.5″ tall, is the perfect age and size to use as a scale reference for the model, so I brought it to the physical therapy session for him to interact with. Once I placed it next to him, I immediately saw that the model was a lot smaller than I had anticipated it to be. Although I was still happy with the form, I knew that there were a few modifications that were to come so that the scale could be perfected towards its user.

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The first modification to the full scale piece was that the thicker end, which is the end that the child’s head would be leaning on, needed to be widened. This would create a larger surface area that would be resting on the floor, increasing the design’s stability and making it sturdier and safer for a child to interact with. In addition, the entire piece need to be both lengthened and widened so that it could accommodate a child. Seeing it not only in full scale, but also next to a child in the age range of my user group, allowed me to gain a better sense of scale.

One great part of seeing Child A interact with the foam model was when he started crawling around it and playing with it. He was interested in its inviting, curvy form and continuously grabbed on to it. This made me see that although it is designed based on a specific developmental stage, its minimal form allows it to be used beyond that for different purposes during playtime.

Deciding on Final Forms

I began this stage of form sketching by making a list of the key developmental stages that my design will be focusing on. The benchmarks that made up this list were: lying down while lifting arms outright, ‘tummy time’, sitting upright, balancing, crawling, creeping, and moving objects. The three pieces that compile my overall design will each be designed around a couple of these stages. However, they will have additional uses as well so that they will not have a limited usage time and as the child develops he/she will use them in different ways through exploration.

In addition, each one of the three pieces advance in movement from one to the next. As the child progresses physically, the pieces somewhat follow along in a sense as their own movement is increased. It is a subtle way for the design to grow alongside the child who is using them as they reach their milestones.

Going through the stages of development I am focusing on, I made a list of necessary and optional components that each position would require for support. For lying down while working on arm strength, the child will need head support and upper back support. Support that is optional would be underneath the entire body, underneath the arms, and slightly underneath the knees. For ‘tummy-time’, necessary support would be underneath the child’s chest as well as underneath the arms. Support that might be helpful but is not necessarily required would include a front curve to hang the arms over, underneath the entire body, as well as around the body. For sitting upright, back support and support behind the neck area would be required. Optional support includes under the leg support and surrounding support. Based on these components, I sketched basic forms that would accomplish all of the above in three separate pieces. These sketches, along with all of the research that I have done up until this point, have led to my three final form choices:

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(This diagram shows basic sketches for all three of the following design explanations, starting from the left side.)

Three Final Form Design Explanations:

1. First Design. 

This first form focuses on helping the child with arm lifting and ‘tummy time,’ both of which are stages in which the child has limited mobility in most of their body. These stages are an important area of focus since they are the foundation of all other developmental stages. The minimal form, meant to be used on both sides, has curves designed for specific positions. The specific placement of varying textures will initiate further movement in the child’s arms and legs. Ideally, the finished product would be made of a soft yet rigid material that will increase the child’s comfort by giving in slightly to their body weight while still supporting them off the floor.

2. Second Design.

This second design focuses on the developmental stages of sitting upright, balancing and learning to climb on and off objects. All of these involve the child learning to keep their upper body upright as well as maintaining that upright position stably for a period of time. The form has specific curves and thicknesses that are designed to be multi-purpose in function. Placed in one direction, it can be used to improve the child’s sitting position. A 90-degree back rest initiates the child to sit with proper posture comfortably. Textures are placed in specific areas for sensory stimulation and motivation for reaching outward.

When it is flipped upright, the design is used as a rocker. It is designed to be low enough for the child to place their feet on the floor while sitting on it and a bumpy texture serves as stoppers on the underside to prevent the piece from rocking too much. This rocking motion will increase the child’s balancing ability through play, further advancing on their physical advancement as well as their motor skills. Another possible addition is that the form will be filled with sand. This could serve as a base support that will shift where it is needed when the piece is moved from one position to the next.

3. Third Design.

This last design focuses on more advanced stages of mobility, including crawling, creeping and moving objects. These are the stages in which the child has gained enough mobility to begin moving about their surrounding environment. They are also the stages when the child is playing more independently than before, allowing the parent to observe their child’s progress as opposed to having the child rely on them for help. This piece has no set position; it is meant to rotate in order to move with the child.

The child is able to crawl through and feel the different textures lining the interior surface of the form. They can push the lightweight piece in order to work on arm strengthening as well as to chase after it, increasing their ability to both crawl and creep. Keeping the child’s interest with a unique form that is able to move will help them advance on these movements without having to think about what they are doing. They can also lie inside and reach around to grasp different areas and feel through the gaps, which will help increase their fine motor skills.

All three of these pieces are meant to be used both individually and as a unit. They were designed with specific functions in mind, yet their ambiguous forms allow their usages to extend further than those intended purposes, giving them a longer lifespan than other similar products currently on the market.

Follow-Up Observation/Shadowing Session

On January 6th, I had the opportunity to shadow PT on two physical therapy visits with two different boys. I had already shadowed these two boys twice in September, so having a few months in between visits allowed me to really see the progress that they have made with her. These were my observations:

Child A – 14 months old; low muscle tone

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At this point, Child A is now able to sit upright unsupported, which is a huge step forward from where he was just a few months ago. He can also reach for objects while sitting upright and even bang two objects together. Once in a while he gets back into a side-lying position, so PT slowly aids him as he pushes to lift back into an upright position. When he plays upright with a toy, Child A mainly uses his left hand to play while he uses his right hand to stabilize himself to stay sitting up.

A big challenge that PT is dealing with now is getting him to move onto his stomach. She shakes a small toy near him that makes subtle noises, such as a plastic maraca or a ball with a smaller ball inside. When he hears and sees it, he slowly moves towards it by reaching his arms outward while lying on his back. From his left side, Child A does not need much support to sit upright when he is lying on the floor. He has to work a lot harder reaching up from his right side.

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PT holds up a plastic ring stacking toy while he is sitting upright. She has him reach towards it and pull off the rings one at a time, then has him put them each back one by one. Child A puts on and takes off each one that PT tells him to and stays sitting upright the entire time. After this activity, she puts Child A on her lap while she sits on a floor mat. She places his legs in a 90 degree position and gently keeps them in this position with his feet planted firmly on the ground. As she holds him in this position, PT uses her other hand to place toys in front of him so that he reaches forward and grasps the toys with his hands.

Seeing this progress from the first session I observed really made an impact on me. It showed me that with enough time, patience and attention, children with hypotonia can progress at a steady pace and advance physically over time.

Child B – 2 years (+ a few months) old; high muscle tone

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PT holds him and tells him to carefully lean forward into a hands and knees position. He leans forward slowly so that his hands are touching the ground and she carefully lifts him back up. They proceed to do this activity multiple times so that Child B gets used to it.

After this, PT puts Child B’s orthotics on, followed by his sneakers. The orthotics give him added support in the ankle and knee areas. Having a more stable base helps keep the rest of him stable. She then places a weight around his left ankle before trying to get him to walk across the room. He walks across the room towards an iPad playing a favorite song of his while she stabilizes him and slowly guides him there. Once he reaches his goal, Child B sits down on the floor and PT adds a weight to his right ankle. With both weights on, he is aided back across the room and goes into sitting position once again when he gets to the iPad. PT does this exercise multiple times with him, going from one end of the room to the other.

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PT pointed out that Child B works more with his right side during every activity. If he pushes off the ground, he always uses his right side as support since it is currently his dominant side. PT is working with him to use his left side too in order to strengthen it so that he has no dominant side and uses both of them equally. Getting rid of this current dominance will help him use both sides during activities.

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PT carefully sets him into his walker. He holds on to both sides and walks without the support of PT, but uses the walker to help him. He is able to walk out a fairly long distance on his own. He does not tire easily and pushes himself to keep moving forward for a fairly long time.

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Throughout this entire time he has been looking around and taking in his surroundings. As he gets tired, Child B’s legs get less stable and the bottom of his feet are no longer planted firmly on the ground. He uses the walker to hold most of his weight towards the end of his walk. Once he starts fatiguing it is difficult for him to stand up straight. PT makes sure to take short breaks while walking once he gets tired. She continues to give him encouragement and support, telling him that he is doing a great job. She also makes sure that he is holding up his weight with not only his right hand, but his left one as well.

Once again, I was grateful to be able to see theses stages of progress with my own eyes. It showed me that although it might be difficult at times, these children want to progress physically for themselves but do not know how to do so on their. The help of a PT and development tools makes an extremely noticeable difference and I am hoping that my design will have the opportunity to aid in these milestones as well.

Progress is What Matters Most

Meeting with my Advisor: PT

Although I have been jumping ahead to researching materials and textures, I had to take a step back and focus on the actual form of what I will be designing. I had a meeting with PT to review the main developmental stages I will be focusing on and to find out how to go about designing the specific curves based on the necessary physical positions.

I had already narrowed down the age range I am focusing on, which is the 6 month to 14/15 month age range. Within this time, most of the physical development that takes place includes ‘tummy time’, sitting, crawling, creeping, balancing, climbing to get on and off of things, kneeling on objects and even walking. I had some trouble differentiating crawling and creeping until PT showed me the difference. Crawling is when the child pulls himself forward on his stomach, using his hands and legs to pull his body forward. Creeping is when the child moves into a quadruped position, moving forward on both hands and knees in order to move forward.

When working with a child, PT told me that there are overall guidelines for where the child should be at developmentally. However, it really goes according to the schedule of each individual child. When asking her what stage the child should be at during each age range, she told me that there is no set answer. Instead of forcing a child to be at a specific place at a specific time, physical therapists promote stages of progress. As long as there is progress occurring, that is what matters most. Therefore, there is no set developmental timeline for children with abnormal muscle tone. There are just stages that should follow one another and my design will help further this progression.

As a physical therapist, PT says that even when a child gains a skill, one must look at the way it is done. If the physical positioning is incorrect, it will put unnecessary pressure on the child’s joints. In addition, skipping over developmental stages will effect those that follow. A good, strong and stable core is key; the more stable you are there, the more control you have away from the body.

One very important position is known as ‘crossing midline’, which is when the child transitions from their hand and knees and then back into the sitting position. The child is moving off of their center line of axis in order to rotate, which is a big struggle since children tend to get stuck in a frontal position. It is a great transitional position in the earlier developmental stages to enhance their bilateral coordination, which is when they learn to use both sides of their body equally. If there is a dominant side that the child uses, a physical therapist will encourage the use of the other side as well so the dominance is balanced out.

CrossingMidlineCrossing midline develops the child’s hip muscles, core muscles, arm strength and visual tracking. For a child to keep their head midline, to weight bear on one hand and to reach out with the other hand is incredibly difficult for them. In addition, children who are still developing physically often keep their legs straight out in front of them. It anchors them for stability since it is a very broad base that is holding them upright. Once their legs are up in a crossed position, there is less surface area for support and a large bulk of their weight is placed on their bottom.

Learning about specific positions during the developmental process helps me understand the importance of each one individually and how they transition into the next positions. It is also incredibly useful learning about them from PT since she will sit next to me and demonstrate the positions step by step. Seeing them acted out physically allows me to understand them much more than I do by just viewing images on the internet.