The seminar on May 23 was followed by two regional “learning by doing” workshops in which participants had the experience of making simple assistive equipment for disabled children. Two rehab workers from Los Pipitos had taken part in a similar workshop I had facilitated in Medellin, Colombia, in 2004 and had been eager that I conduct such workshops in Nicaragua.

To allow broader attendance, the two workshops were held at opposite ends of the country. The first was held in Jinotepe, to the south of Managua. The second took place in Condega, near Estelí, close to the Honduran border. Each workshop was conducted in a learning center for disabled children run by the local branch of Los Pipitos.

Guiding Principles

The process is as important as the product. These short (2-day) workshops have 3 pragmatic learning-by-doing objectives:

  1. Demystification: We can do it ourselves! Theworkshop provides an opportunity for persons involved in the care and rehabilitation of disabled children to have hands-on experience, first in evaluating the needs and wishes of the child and family, and then in designing and constructing simple, low-cost aids, using local materials.

  2. Inclusion: We can do it together! The child and family must be included in the problem-solving process. The workshop encourages close partnership, or collaboration, between providers and recipients. Professionals and rehab workers work together with family members and the child herself or himself in determining needs and possibilities, and in planning, designing and creating appropriate assistive equipment.

  3. Flexibility: We can adapt! By first visiting the child’s home, observing the living situation, and exploring needs and possibilities with the child and family, all learn that assistive equipment must be adapted to the specific needs of the child and the local environment.

Small is Beautiful

It is best that each workshop have at most 30 participants. More makes full participation difficult. But, as it happens, usually far more persons show up. In Jinotepe there were more than 50 participants, and in Condega more than 70, counting the disabled children and their family members involved.

Guidelines for Conducting a 2-day Device-Making Workshop

To follow is an outline for the type of two-day learning-by-doing workshop that I (David Werner) have facilitated in Nicaragua and many other countries. I provide this outline for two reasons. First, organizations that ask me to conduct such workshops in the future can use it to prepare appropriately. Second, I hope some programs can use these guidelines for planning their own workshops, without need of my presence. (The goal of any leader or facilitator should be to make oneself unnecessary as quickly as possible.) In brief, the 2 days of the workshop are planned as follows:

The first day starts off by learning about principles and approaches to making low-cost aids adapted to a disabled child’s specific needs, and then involves small group visits to the homes of pre-selected disabled children to evaluate their possibilities and plan for making an appropriate aid.

The second day involves collectively making the aids, in small groups, for and with the children and their families. It ends with demonstration of their use, and evaluation.

Outline of the Workshop Activities

Day 1: Preparation, Methodology, and Home Visits

Morning: Preparations

  • Discussion of procedure & goals for the 2 day workshop (1/2 hr.)

  • Presentation methods for evaluating the needs and possibilities of specific disabled children, and for making appropriate assistive devices (2 hours, with use of PowerPoint slides)

  • Preparation for afternoon visits (1/2 hour):

    • Participants divide into small groups, each with 4 to 5 persons.

    • Each group is given a copy of Disabled Village Children and Nothing About Us Without Us, and perhaps other resources. Ideally these can be distributed in advance.

    • Each group needs to have:

      • paper for taking notes and making drawings

      • pencils with erasers (for preliminary sketches)

      • measuring tape

      • poster paper

    • Transportation and procedures explained for home visits

Lunch (maximum 1 hour - or less to allow more time for visits)

Afternoon: Home Visits

  • Travel time & home visit: about 2 hours.

  • Each small group will travel to the home of a disabled child.

  • Important considerations in preparing for the home visits:

    • These visits must be carefully arranged in advance, choosing families and with children who are likely to respond well to a group of concerned strangers.

    • A family member must be willing to spend the whole next day participating in the hands-on workshop.

    • The visits should be to homes of poor families with disabled children with significant unmet needs.

    • The different children selected should have a range of different disabilities needing different simple assistive devices (ones that can be made in a single day).

    • Some children selected should be mentally alert and able to express their wishes, and if possible, to participate actively in building their own assistive device.

During the home visit participants, together with family members and the child herself, explore the child’s needs and possibilities. The child should be central to this process. Every effort should be made to gain the child’s confidence and listen respectfully to her desires. Even children who can’t speak often have ways to communicate their likes and dislikes, and these should be heeded. The families’ concerns, wishes, and ideas should also be central to the process.

  • The learning group (including family and child) considers possibilities for an assistive device that might help the child do something she wants, or that helps the family better manage the child.

  • To get ideas for possible aids and designs, the participants can look in their books and show pictures to the parents and the child.

  • When a likely aid—or combination of aids—is mutually decided upon, the group draws sketches and takes measurements.

  • When one or more aids are decided upon and sketches drawn, the group copies the drawing on poster paper for next day presentation.

  • Before leaving, the group makes sure the child and at least one family member agree to attend the day-long workshop the following day, and that arrangements for transportation are firmed up.

Day 2: The Workshop: Making Assistive Equipment For and With Each Child

  • The workshop, if possible, is held in a community rehab center, carpentry shop, or other facility where assistive equipment is made or repaired. (A community shop run by disabled persons is ideal.)

  • The workshop is attended by up to 30 enrolled participants, plus each of the disabled children with a family member who were visited the day before. The family member and child are urged to be participating members of each group, with full involvement of planning, building, and evaluating the aids.

  • Because workshops last all day (up to 8 hours), provisions must be made for children to play, eat and nap—as well as participate.

Timetable for the 2nd Day (the Device-Building Day)

Opening plenary. (1-1 1⁄2 hours) Each group presents the evaluation of the child’s needs, wishes, and possibilities, and displays the poster with the designs for one or more assistive devices. All participants including family members and children are invited to make suggestions.

  • Small group activity. Production of the aids (5-6 hours)

  • Final plenary. Presentation and evaluation (1 hour) Each group presents the aid or aids it has made, and the child and family member demonstrate how they use it. The audience makes constructive observations and applauds the successes (or at least the efforts).

  • Closure and congratulations (15 minutes)

  • Be sure follow up is planned for devices that still need work.

Cautions and Advice for Making Aids

Before beginning the construction of the devices, participants should be precautioned:

  • When making an assistive device, first put it together in provisional form, so you can test it with the child and make needed changes. Use screws. Or if you use nails, leave the heads out a bit so you can pull them out easily to make changes. Don’t use glue until you’re sure everything is just right.

  • Don’t paint or upholster the aid until after it has been well tested by the child and everything appears to work well (often several days of trial are needed). In the workshop it is better to give more time to getting the aid to function just right. Making it pretty may also be important but can come later.

  • In making the aid, try to pace the work so that construction is completed in plenty of time to allow for repeated testing and modifications.

  • Try to divide up the tasks so that everyone in the group, including the family member and, as much as possible, the child, keep active.

Plans for Follow-up

It is important that follow-up is arranged to assure the completion of any aids that are still incomplete or need rework or modification. Every effort should be made that the assistive device actually serves its purpose and the child and family like it. Follow-up is essential.

Successes and Challenges of the Nicaragua Workshops

Nearly everyone agreed that the workshops were a great success. The final, pragmatic measure of success is if the aids helped the children do things better, and many did.

This is not to say that all the assistive devices turned out well. Some of them worked remarkably well. Others were more or less OK but needed improvements. And a few had major problems. But people can learn as much or more from their mistakes as their successes. Indeed, at the start of the workshop it was pointed out that to make assistive equipment for a specific child is often a process of trial and error. We shouldn’t expect that everything will turn out just right the first time. Even when something turns out well, there is always room for improvement.

An indisputable achievement of the Pipitos workshops was the enthusiasm, hard work, and full involvement of all the participants. One goal of the workshop was to get rehab workers, family members and the disabled children themselves working together, both in sharing of ideas, and in production of the aids. To a large extent, this happened. It was wonderful to see all the interaction and cooperation. Mothers of the disabled children pitched in eagerly. And two of the fathers, experienced in working with wood and making things, took the lead in creating the aids for their own children, as well as generously assisting other groups.

The active participation of disabled helpers and local crafts-persons was, to me, one of the delightful features of the workshops. In Jinotepe, where the Pipitos Learning Center has a carpentry shop, three mentally handicapped young apprentice carpenters helped our workshop participants who were making assistive devices with wood. Since there were no electric cutting or sanding tools, everything had to be done by hand, and this slowed down work a lot. Fortunately, the disabled young men had incredible stamina and good will, especially on that blistering tropical day. Without their enthusiastic help, some assistive devices would never have been completed.

On the afternoon of the first day, one of the young mentally handicapped carpentry apprentices who was most helpful had an epileptic seizure. For several minutes he lay twitching on the floor, while people gently protected him from injuring himself. However, the next day in the workshop the same lad was working away at full tilt. So everyone looked at his strengths, not his weaknesses.

Melvin, who has muscular dystrophy, helped design his footrest. Here (L) he traces a cardboard pattern for the side pieces onto plywood. Completed, he sits proudly in his improved chair.


On our way to Condega, we visited the “Centro Juvenil” in Estelí, a huge new complex of spacious buildings for the skills training of disabled youth, financed by the European Union and others. There, we met Melvin, an 11 year old boy with muscular dystrophy. Melvin’s big wheelchair had no footrests.

Because footrests are important for comfort and to prevent foot-drop contractures, we invited Melvin to the workshop the next day, where he could help make his footrests. A local carpentry instructor offered to take him, and was good to his word. In the workshop he and a carpenter with polio pitched in enthusiastically wherever they were needed (see below).