
Speech and Language Pathologist Emily Waler uses a modified switch toy that allows patient Isabella Yoder to play with a bubble maker.
When physical therapy assistant Rosanna Koehler joined the volunteer group TWIG #13 (Together with Important Goals) in 2016 she did so with a few things in mind.
“I already knew a number of ladies in the TWIG group from my neighborhood,” she said. “The social aspect of getting to know them better was obviously a draw, but so was their mission.”
For a number of years Rosanna attended TWIG #13’s fundraising events and she knew one of the recent beneficiaries of the funds was the Brandon T. Clark Fund in the hospital’s rehabilitation department.
“Knowing this group was raising money that benefited patients I care for appealed to me,” she said.

Members of TWIG #13 present a check for $8,000 to the hospital’s foundation department staff, Brian Hollingsworth (at left), senior major gifts officer, and Stephanie Weber (at right), special projects coordinator. TWIG members are (left to right in center) Kate Huisinga, Lisa Stewart, Kathy Johnson, Tina Lee, Christi Phillip, Kersten Swartz and Rosanna Koehler. To date, the group has donated nearly $41,000 to Akron Children’s.
As the group’s fundraisers evolved and continued to raise tens of thousands of dollars, Rosanna encouraged the rehab team to look for ways the funds could be stretched to benefit even more patients and fulfill unmet needs in the department. That’s how the department’s switch toy lending library came to be.
“We primarily use the library to assist with our Augmentative Alternative Communication (AAC) Program,” said Emily Waler, speech language pathologist. “The switch toys are used to encourage children who didn’t previously understand or have access to switches for play. The opportunity to take home switches and toys gives patients the chance to learn the cause/effect relationship of hitting the switch and causing the toy (and eventually a high-tech communication device) to be activated.”
The library is composed of specialized switches, mounting systems and switch-modified toys. The switches and mountings are the most expensive items in the library, but without them children would not be able to access the toys in the least restrictive and energy efficient manner.

Isabella uses a switch to allow her to communicate through a communication device
“Children who benefit most are those with very complex bodies, who cannot use their hands and fingers to activate battery operated toys,” said Lindsay Ripple, occupational therapist. “These kids use other body parts such as a leg to kick or shoulder to hit a specialized switch when they shrug. Some of the children who have benefited from the library use a head switch to activate the toys.”
Library toys are incorporated into a child’s therapeutic plan and can be borrowed for 4-6 weeks. Currently, toys are only available for loan to outpatients working with the AAC team. Consisting of 5 speech therapists and 3 occupational therapists, the team has a wish list of toys based on current patient needs.
“The expensive switches and switch mounting equipment are very specific to the complex needs of each child and can vary in cost from $50 to $500,” Lindsay said.
The department works closely with Medina-based non-profit, RePlay for Kids, that switch modifies toys for free and donates them for use in treatment sessions; however, some are now included in the toy lending library.
“RePlay hosts 2-3 workshops annually where families learn to switch modify their own toys,” said Lindsay. “At these workshops each family receives the education to complete the modification and a kit with the equipment needed to make 10 toys, free of charge.”

TWIG member Lisa Stewart learns how to use a switch to make a toy light up and move.
Some of the devices featured in the toy lending library include bubble blowers, musical and light up toys, personal fans, nerf guns, gear toys, animal toys, Groot, Captain America and a paint spinner.
“We have 2 Powerlink systems that are used for plug-in items such as lights, a radio, kitchen appliances, etc.,” said Emily. “The appliance or light plugs into the Powerlink, which the switch also plugs into, allowing the child to turn the appliance or light on/off with the mounted switch.”
Lindsay says the benefits to families are numerous.
“The items borrowed are not easily funded by insurance, so having access to trial them prior to buying is very helpful,” she said. “Practicing switch access at home allows the patient to develop a motor pathway for the muscles needed to access the switch consistently, similar to the process of learning to type. The movement becomes rote with increased exposure to use. Having daily use versus an hour per week in therapy is a great benefit to the success of the kids who take home toys and switches.”
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