When designing assistive devices for children with disabilities, designers mostly consider technical and functional aspects and overlook factors that affect their usage from children’s perspective. Therefore, in most cases, assistive devices do not fully meet the needs of the children and may create a negative effect on children’s well-being. To explore the opinion’s of children using 3D printed hand prosthetics in Country-Xx, individual generative sessions were conducted with four children with limb deficiency. Generative tools are used to engage children and encourage them to express themselves in relation to prosthesis use. The main aim was to investigate how children provide design relevant information that may help designers to achieve improved assistive devices that support children’s physical, emotional and social wellbeing. Children’s feedback related to prosthetic usage categorized under two topics; expectations of children for prosthesis use and children’s priority expectation for the prosthesis. The findings are argued to be useful and usable by NGOs, product designers and design researchers who work with children with disabilities.

Objectives: The study aims to develop an understanding of the views of children and adolescents, parents, and professionals on upper limb prosthetic devices to develop and improve device design. Previous research has found that children are dissatisfied with prostheses but has relied heavily on parent proxy reports and quantitative measures (such as questionnaires) to explore their views.

Methods: Thirty-four participants (eight children aged 8–15 years with upper limb difference, nine parents, eight prosthetists, and nine occupational therapists) contributed to the development of new devices through the BRIDGE methodology of participatory design, using focus groups and interviews.

Results: The study identified areas for improving prostheses from the perspective of children and adolescents, developed prototypes based on these and gained feedback on the prototypes from the children and other stakeholders (parents and professionals) of paediatric upper limb prostheses. Future device development needs to focus on ease of use, versatility, appearance, and safety.

Conclusions: This study has demonstrated that children and adolescents can and should be involved as equal partners in the development of daily living equipment and that rapid prototyping (three-dimensional printing or additive manufacturing), used within a participatory design framework, can be a useful tool for facilitating this.

We have developed a prototype middle-ear hearing implant which uses a multilayer piezoelectric actuator. In this series of experiments the actuator was attached to the medial wall of the attic so that it makes contact with the body of the incus. Initial in vitro evaluation has been carried out using a laser vibrometer (Polytec CLV) to measure stapes velocity. Stapes displacement is calculated by mathematical integration. The device used in this way is particularly effective at transmitting high frequency sound to the stapes. When switched off the actuator impairs the transmission of sound to the ossicular chain at low frequencies, but this effect is only 7 dB at most. The stapes displacements resulting from the action of the implant have a linear relationship with the voltages used to drive the system. The high capacitance of the present actuator means that its power requirements are higher than that of other comparable devices. An optimal method of coupling the device to the incus has yet to be identified.

The authors describe the adaptation of a Montgomery T-tube laryngo-tracheal stent to incorporate an uncuffed fenestrated Shiley tracheostomy tube in the management of a complex case of subglottic stenosis. The combined ‘ trache-stent’ provided a secure, unobstructed airway and optimal phonation. The presence of a removable inner tube facilitated cleaning and reduced patient anxiety regarding the perceived risks of stent obstruction with dried secretions.

The combined ‘ trache-stent’ was upsized at four weeks with minimal evidence of local granulation formation. The device was removed entirely six weeks later after direct laryngoscopy reconfirmed the above findings. Almost two years later the patient retains a good voice and airway using a simple fenestrated tracheostomy tube and speaking valve. The subglottic area is stable and the patient has returned to full-time employment.

The uncertain results of aryepiglottopexy in our personal experience led us to develop, for patients with aspirations associated with the risk of severe pneumonitis, three types of intralaryngeal endoprostheses (ILEP) under the systematic cover of a tracheostomy. From September 1997 to May 1999, seven protheses were implanted in six patients. It was not possible to restore the full range of laryngeal functions, i.e. deglutition, phonation and respiration. However, our results, that were obtained with an intracricoidal prothesis closed at its upper end or equipped with a phonatory valve, are quite encouraging, even more so when in association with early alimentary re-education and support continuation of our trial. These ILEPs are simple to place, well tolerated, efficacious in preventing deglutition pneumonitis and easy to remove. Furthermore, the reversibility of this bloodless procedure facilitates the monitoring of a possible recovery of the laryngeal functions.

This paper demonstrates the need for a cosmetic device as a necessary adjunct to long-term tracheostomy care. Such devices are not available, at present, from tracheostomy tube manufacturers. The cosmetic tracheostomy cover plate is based on a silver Negus tracheostomy tube, to which the silver chain and cover plate (locket) are attached. The result, for the patient who tried it, was excellent.

In the recent past there has been a significant expansion in the range of paediatric tracheostomy tubes available. This has mainly been in response to clinicians' requests. This article reviews those now available and the situations in which they are useful. A sizing chart is included for easy reference.