Making all the right moves
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New SDC program gets wheelchair-bound clients up and about
 From The Sonoma Index-Tribune, May 10, 2002 edition:
By Pamela Gibson
Gerald was a young child when a debilitating illness took away the use of his legs. For years he scooted around on carpets before learning to use a wheelchair to get from one room to the next.
Today Gerald walks again with a big grin on his face and obvious pride in his accomplishment.
Gerald is one of 44 clients at Sonoma Developmental Center who is involved in a program that is giving people new hope.
Project MOVE - Mobility Opportunities Via Education - is the brainchild of Linda Bidabe, a Bakersfield special education teacher who developed a program to help children and adults with severe disabilities acquire greater independence of movement.
The simple program teaches three things: how to sit, how to stand, and how to walk. The focus is on making everyday life easier for both the client and the caregivers.
When a child is born, parents look forward to incremental phases of development - rolling over, sitting up, crawling, standing, and finally, taking those first steps.
But does this successive approach make sense for an adult who may have missed these steps? This is the concept Project MOVE challenges.
"In the past, therapy focused on getting the disabled individual to go through the same incremental learning steps as a normal person," said John Litzenberg, a MOVE Site Trainer at the center. "Sometimes severely disabled individuals can't roll over or crawl but, with assistance, can go on to later phases, such as standing or walking."
"It can take up to 2,000 tries to learn a new skill," added Tracy Farmer, another MOVE Site Trainer. "If it takes that long, why teach them to crawl when they don't need it?"
The first step in the process is assessment.
"A team of people who know the individual best determine if he (or she) is a good candidate for the program," said Farmer. "These are his (or her) parents, physical therapist, occupational therapist and anyone else who provides care."
If a person has no medical limitations and wants to be part of the program, the next step is to assess his or her capabilities. Does the client have an instinct to stand and, if so, how much weight can he or she bear?
"The assessment is a 'top down' approach, rather than a developmental approach," said Litzenberg. "We look at what they can do and go from there."
Once these determinations are made, the individual may be fitted with a device which bears some of his or her weight, generally on the forearms, while allowing the user's feet to propel it in a standing position. This is called a gait trainer, a steel contraption which has small wheels.
There are other forms of the device - a dynamic stander, which has larger wheels, and some that look like standard walkers. They provide support while the user goes forward, backward or makes turns.
The first gait trainer was made by MOVE founder Bidabe in the 1980s using an old granny walker, duct tape, broom handles, and car tires. Today's sleek contraptions are adjustable, strong and expensive, running more than $1,000 apiece.
Not every device is used for walking. Special chairs are available to position a person so they learn to lean forward. Others support a person laterally, putting him or her in the correct position to eat and do functional tasks.
Not everyone needs a device to be successful in the program.
"Some techniques don't use equipment," said John Kliegl, SDC MOVE Site Trainer and teacher. "Using the MOVE philosophy we can teach people to stand up with balance or to improve their eating position on their own. The equipment serves as support. It makes it safer for them."
The goal is to make the clients as independent as possible, so they can be mobile and as functional as they are capable of becoming.
"For me it's been huge to see the positive affects of this program," said Doug Brewer, another MOVE Site Trainer. "Even if a person doesn't gain complete independence, they show a remarkable change."
The change is not only in their mobility level but also in their social level.
"Those who are now standing are improving their communication skills," said Brewer. "They can look you in the eye.
"One man, who is 70 years old, never walked until we implemented this program," said Kliegl. "He used bars and rails to lower himself into a chair. The gait trainer actually improved his body alignment to give him the mobility he wanted. Today he has a lot of confidence and goes around telling everyone, 'Look, I'm walking'."
"One of the greatest challenges is overcoming their fear," added Kliegl. "Gerald, for example, was afraid to use his legs. He hadn't used them in years. We worked with him, gaining his confidence, and now he walks back and forth and around the campus in his trainer. He can almost do without a wheelchair."
There are seven MOVE Site Trainers currently on staff. Several received training directly from Bidabe and have learned to train others.
The program is now used in more than 1,000 sites internationally with training materials in 10 languages. Headquarters for MOVE International is in Bakersfield, and today it is overseen by the Kern County Superintendent of Schools.
The program was introduced into the Sonoma Developmental Center curriculum in 1995. Large manuals describing philosophy, use of equipment and training techniques are distributed throughout the center for reference. As clients are deemed ready, they can enter the program at any time.
While making a difference in the lives of those served by SDC, the staff emphasizes it is not a cure.
"We're improving the quality of life for the individual," said Farmer.
They are also providing new hope to those who care for them.
"We have a client who was in a car accident at the age of 16. The one thing he told his mother he wanted, above all else, was to walk again. Without this program, he would still be in his bed," said Farmer. "His mother has new hope. Her perspective on how his life will progress has completely changed. She is now looking ahead, not back."
It has also brought new energy and joy to the trainers.
"It gives me real hope to see people like Gerald who are showing improvement," said Kligl. "And also joy to see the big smiles on the faces of the people who are benefiting. It makes me laugh every day."
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