South Warwickshire Foundation Trust

I have been using the Cosmo switches to complete a number of different intervention sessions with pupils across the schools. This has included using them to help develop the following – hand dominance, development of shoulder stability, development of finger isolation, development of crossing midline, development using both hands together (Bilateral). The Cosmo switches have been used to develop the underlying skills needed to help promote the development of feeding skills with cutlery, development of communication systems (Aided Language Displays and Augmentative and Alternative Communication Devices)

The activities have included using the apps provided by Cosmo to support the motivation of using hands. The apps included where Exploration, Fireworks, Improvisation, My Voice, Turn Taking, Storytelling and Colour matching. These apps have been used with the pupils while they have been in their specialist seating or on the working on the floor/carpets.

The Occupational Therapy Technical Instructor (OTTI) used the Cosmo devices to help develop the use of both hands for individual pupils and to encourage them to cross their midline. All the pupils that have been worked with have a diagnosis of Cerebral Palsy, affected on their lower body and arms. The aim was to use the Cosmo devices across a range of special schools with different ages to help show progression.

The Cosmo was first used with the children/young persons on their initial treatment sessions as explorative devices, to allow them to see the cause and effect properties. The devices were then set to specific programs to help to work towards the set goals by the Occupational Therapist (OT), such as encouraging them to use both hands for bilateral skills and crossing the midline skills. The sessions were set for 1 hour for each child/young person. The devices were used for a period of 30 minutes to help develop their use of the devices. Prior to using the devices, there was use of different activities, such as theraputty to help warm up their hands. The apps were used to help encourage the use of different hands, the devices were placed on either side of the child/young person and was encourage to use the opposite hand to reach over to help incorporate those skills.

The children/young people were motivated by the devices, they all appeared to reach towards the devices, and would bring the devices towards themselves. The one pupil would use a number of the cosmo switches to reach and coordinate their hands towards the switches. A younger individual would laugh at the sound apps, and would bring the switch to their chest and hold it with arms in the midline.

The challenge I found was that because I only attend the intervention sessions during short periods it was a challenge to work with schools to be able to come and use them in school. This made it difficult to ensure consistent use and to collaborate with staff effectively.

Having the training prior to using the apps was very helpful in being sure how to accurately use them to them at the best and most optimum manner. Having the professionals to contact and having visual and auditory aids to support this has also help to develop knowledge around their use. Showing the staff in schools worked really well in developing their knowledge of the Cosmo switches and then having them purchase their own sets.