I always have the feeling I’m being rushed by others, by my parents. But it’s all a matter of perspective, isn’t it. One could also say my family is living too fast.


Stefan – a 17 year old - was born with spina bifida (SB), a developmental birth defect that can contribute to disability (see Case Study 13 for more on this condition). In addition to living with this condition, at the age of 15 –Stefan was unfortunate enough to also suffer a traumatic cervical spinal cord injury that would further complicate his disability.

Stefan has spent much of his life undergoing medical procedures and rehabilitative interventions to treat a number of secondary conditions (luxation of hip joints, pressure ulcers, and development of scoliosis) related to his SB. These began with surgeries at the age of nine, and later on with rehabilitation interventions for his traumatic spinal cord injury. Underlying many of the later efforts, increasing his independence was an important objective.

Stefan is living with his family and attends a regular school. He enjoys solitude and maintained a few close friendships. He’s a passionate reader, a musician (he is a gifted pan-pipe player) and is skilled and knowledgeable in working with computers. Now, at the age of 17, Stefan was to graduate shortly and intended to take part in a one-year, vocational preparatory course. He hoped to gain a degree of independence through the rehabilitative interventions, and planned to travel home each weekend.

These weekly trips home would require a significant level of independence, including the ability to travel by train. In preparation for his new life phase, Stefan’s health insurance agreed to have him attend a three-week, in-patient rehabilitation program that aimed to increase independence in adolescents living with spinal cord injuries or disease.

Increasing his independence was an important objective.

Within the program, structured rehabilitation management would provide Stefan with an assessment, set appropriate goals for independence based upon his specific impairments and level of functioning, and also undertake the appropriate interventions to meet those goals.