Quelles installations et appareillages pour les jeunes enfants en situation de handicap moteur sévère ? Pour quels objectifs ? Avec quel partenariat ?

The multidisciplinary therapeutic and educational team at the Ramdam Inclusive child care centre welcomes 30% of children with cerebral palsy among able-bodied children in the neighbourhood. The facilities of these young children with severe motor disabilities are essential they aim to preserve their orthopedic capital, to avoid choking spells, and to optimize their functional possibilities (motor, visual, communicational and relational) in their environment, at home as well as at their child care centre. They thus participate in their early social inclusion. From the multifactorial assessment of children's disorders and capacities, their occupations and their environment, to the co-construction of relevant objectives, partnership with the different actors is essential. We will emphasize the importance of this transdisciplinary work (and more specifically between the occupational therapist, the physiotherapist and the orthoprothesist, in close partnership with families and doctors), from the first “foam homemade installations” by the occupational therapist in the Ramdam child-care centre, to the orthopedic equipments made by the orthoprothesist. We will illustrate our constructive approach with some clinical vignettes of young children with severe motor disabilities, with the gradual introduction of facilities depending on the child's evolution, the parents’ requests and their progress in discovering their “different” child, proposals from the multidisciplinary team, while taking into account the specific and personalized goals for each child.