Bibas; A Case Study

Bibas is 6 years of age and cared for by his mother, her extended family and friends. ( His mother works) . He has CP and has been fortunate to receive some treatment and equipment in Kathmandu. He has been provided with a plastic floor seat ( no tray or table to 'play at' ) which is not supportive enough and he has out grown, therefore it is really used.

He does not attend school and spends most of his day lying on his back , on the floor or on a wooden bench on the front porch of the house. The people around him involve him as much as they can given their day to day commitments of work, cooking , cleaning and other children to care for .
Durga ( Community Worker) and Bibas. A moment of head control .

Prone lying
One this particular day he enjoyed the changes in position, smiled, laughed and maintained alot of eye contact.
He rarely sees his hands ( in the midline) or takes his hands to his mouth and has no stimuli to reach for or grasp. Bibas is dependent for eating, toileting and all his activities of daily living. It is unlikely that he will ever attend school or be integrated into village life.

He is well cared for by his mother, always clean and in fresh clothes . She appeared to have a good understanding of his disability and was willing to learn new handling/ positioning techniques and how to provide more stimulation for him , although time was an issue considering she needed to work 6 days a week to support him.

He requires a new seating system and a standing frame and practical suggestions for his mother to enhance his functional skills.

Bibas and his mother require regular home visits. Although she can bring him into the centre periodically , carrying him , this will not be sustainable long term as he grows and becomes heavier.