As a part the activities with Tonio’s class, we asked the children what they thought some of the problems or obstacles might be that make it difficult for Tonio to take part fully and happily in school. The children identified the following difficulties.

• Getting from his home to the school is hard. The trail is steep and rough. Tonio’s grandmother has to walk with him and provide support.

• For this reason, Tonio goes to school only in the mornings. It’s too tiring, both for him and his grandmother, to also come in the afternoon, when it is often brutally hot.

• To get into the schoolhouse, the two steep flights of steps are a major barrier and hazard especially since there are no railings.

• The steps are also a big obstacle to Tonio’s participation on the playground during recess. Tonio can’t manage the steps safely alone and is embarrassed to ask for help.

“What actions might we take to overcome these difficulties?” we asked the children. They had a lot of ideas.

One girl suggested that families who had cars could take turns driving Tonio to and from school every day. The teacher pointed out that while this was a good idea, it was probably too idealistic.

A boy suggested, “At least we could help level out the rough areas of the trail.” Everyone thought that was a good idea.

As for the steep flights of steps to get to the school, some children suggested putting up railings. Others thought it would be better building ramps.

We discussed these various alternatives with the children and the teacher, and as best we could with Tonio, whose shy responses were limited to a muffled “Si” or “No.”

Taking into consideration the boy’s physical condition, the anticipated course of his muscular dystrophy, and his therapeutic needs, we finally came up with a plan of action and assistive equipment, which included the following.