AEA Staff Help Three-Year-Old Navigate His World

Zach Plueger is just like most three-year-old boys. He likes trucks, tractors, Elmo, cartoons and his dog, Oscar. He has blonde hair, bright brown eyes and a budding personality. He also has Spina Bifida and will likely never be able to walk without assistance.

According to the Spina Bifida Association, Spina Bifida is the most common permanently disabling birth defect in the United States. It occurs when the spine of a baby fails to close during the first months of pregnancy. The effects of Spina Bifida are different in each person and there is no known cause. There are currently around 166,000 people living with the disability in the U.S.

Heartland AEA Physical Therapist, Kristi Allison, works with Zach Plueger on gaining strength in his legs using knee immobilizers.

Heartland AEA Physical Therapist, Kristi Allison, works with Zach Plueger on gaining strength in his legs using knee immobilizers.

Despite having no movement in his legs, Zach is a happy boy who strives to do everything other kids his age can do. “He’s very strong willed,” his mom, Dee Ann, said. “He impresses me daily with the little things he does.”

Assisting Zach in being able to more easily do those little things are Heartland AEA physical therapists and occupational therapists. Zach has been receiving Heartland therapy services since a few months after he was born.

“We called after he was born to inquire about services,” Dee Ann said. “He’s seen an OT (occupational therapist) and a PT (physical therapist), and we have a service coordinator (a social worker). They’ve hooked us up with whatever we’ve needed. They also helped me find the Spinda Bifada support group.”

Zach receives services from a Heartland physical therapist twice a month. Right now he is working on various kneeling positions and standing, both on his own and in a stander, a piece of equipment borrowed from Heartland. Dee Ann notes that Zach has gained a lot of core strength in the last few months leading to him being able to sit up and balance himself.

“They are focused on getting him ready for school,” she said. “I didn’t realize how important that was.”

Dee Ann says that borrowing equipment and having therapists teach her about it have been two of the most important parts of Zach’s therapy.

“The recommendations for equipment—that’s been a key thing,” she said. “We’ve borrowed a lot of equipment. He’s used a bath chair, ball, stander, another chair and will be using a walker soon. We are buying a Rifton stander like the one we borrowed. It’s been really nice to be able to try it out, then we know he likes it.”


The stander Dee Ann is referring to is a mobile, wheeled stander that helps strengthen motor skills so kids like Zach can make progress toward independent standing. It provides a way for children to build the weight-bearing and head and trunk control needed for standing. Dee Ann tries to get Zach to use the stander every day.

As Zach gets older, therapists will continue working with him on increasing his core strength and developing skills that will ultimately help him be as independent as possible. The ability to transfer from a walker or wheelchair to a chair, bed and shower will be very important skills for him as he grows.

Zach also receives private therapy three times a month and Heartland occupational therapy services once every other month to monitor his progress and to work on his fine motor skills.

Zach and his family live in a new home in Ankeny that his parents constructed with his disability in mind. The house has an open layout all on one floor with wide hallways and walking areas.

Amy Tweeten, a Heartland physical therapist, provided guidance to the Pluegers while they were planning their new home and connected them with a consultant who assisted them in laying out a home that would be accessible to Zach for years to come.

Dee Ann says she has also benefited a great deal from the services of Heartland staff. “I really feel like I’ve become a lot more educated,” she said. “They (AEA staff) are so knowledgeable about Spina Bifada and equipment, and I know more little things developmentally to look for. We would have missed out on a lot of help for him (Zach) had we not had (AEA) services. It’s nice to have them (AEA staff) come to our home for services. They are so nice and friendly and helpful. I don’t think Zach would be where he is if we hadn’t gotten services for him.”

Dee Ann shares additional words of praise for Heartland staff members who have helped Zach in his journey thus far. She would say to those staff: “Thank you, you have really helped a lot. Especially with him being our first child, it was overwhelming being a first time parent. They made things make sense. I now consider the staff my friends.”


Some of you may have seen Zach featured in a story in March on KCCI-TV about a wheelchair that his great uncle, a mechanical engineer, designed for him. Click here to view the YouTube video, “Toddler Turns Heads With Wheelchair.”

Caption: Zach Plueger shows off the “bubba chair” his great uncle designed for him to increase his mobility.

The chair is made with a Bumbo infant seat that has been modified to include wheels and a bar in the front that allows Zach to tip forward in the chair. Zach had tried to use a regular pediatric wheelchair, but his parents found it to be too big and difficult for him to maneuver.

Zach has mastered the smaller chair (which his family calls his “bubba

chair”) and zips around the house with ease. He can lean over in the chair to pick up toys or play with his dog, and he can get pretty much wherever he needs to go.

Zach’s uncle is looking at patenting his design to produce more chairs for kids like Zach, so his family is trying to spread the word about the chair and positive impact it has made in Zach’s life.

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