AgDARE - Agricultural Disability Awareness and Risk Education

  • Kidd, Pamela;
  • Reed, Deborah

Spinal Cord Injury - Narrative Simulation

Answer Key


Compare your answers to the questions in the story to the answers and ideas listed in this key. Discuss the answers and any differences of opinions with your friends and the instructor. Your ideas are important and can help to improve this exercise. Therefore, please don't mark additional answers or change the answers you marked on your answer sheet.

Question A

T   1. A ROPS on Bob's tractor and his seatbelt fastened would have kept him in the ROPS frame of safety on the tractor.
  2. All tractors manufactured after 1986 come with a ROPS and a seatbelt. A newer tractor will not prevent an overturn. But a newer tractor should have a ROPS unless it has been removed. A ROPS would prevent Bob from being crushed, but not from being thrown.
  3. Size and horsepower are no substitutes for safety. Every tractor should have a ROPS. Even capable drivers overturn tractors, but with a ROPS and a fastened seatbelt, Bob wouldn't have been thrown from the tractor.
  4. Henry is inexperienced. He doesn't know the lay of the land or the capability of the tractor. Plus, he could damage the tractor. The most experienced worker should operate dangerous equipment.
T   5. Paying attention to the task, and working safely are the best ways to prevent serious injury. However, when using a tractor, an overturn is always possible.

Question B

T   6. Because Bob's spinal cord was crushed, his brain can't send messages to his legs and he can't move them. For the rest of his life Bob will need assistive devices (like a walker, braces, or a wheelchair) to get around.
  7. Bob will probably need help going to the bathroom and may have to use a catheter or wear diapers because he no longer is able to fully control his bladder and bowels.
  8. Bob may be able to have sex some day, but he will have difficulty achieving and maintaining an erection. He may require special devices in order to have sexual intercourse.
T   9. Because Bob will be unable to move his legs, pressure from sitting can cause deep life-threatening ulcers and sores on his buttocks and legs.
  10. Paralysis will not spread but Bob will have to increase the strength in his arms and upper body. He'll have to use his arms and upper body in place of his legs.

Question C

T   11. Bob's family members are likely to feel sadness as well as fear and anxiety about how Bob's life has changed and what this change means for the family. People may stare or avoid talking with Bob because they are unsure of what to say.
  12. The costs of caring for a spinal cord injury patient are more than $100,000 per year and depend upon the level of spinal cord injury. Bob will need urine collection devices and walking adaptive devices (wheelchair, braces, special shoes) just to name a few. He will also need physical therapy. These costs will make it hard for the family to make house payments, and buy food and gas. There will be little time or money for vacation and travel.
  13. Anger is a normal emotion in this situation. Bob and his family may feel they don't have adequate control over their circumstances. Feelings of anger and resentment must be dealt with.
T   14. Family responsibilities and roles will have to change in order to care for Bob. Eventually, Bob will be able to get around using the adaptive devices. But in the beginning, he'll need help getting out of bed, going to the bathroom, dressing, and bathing himself.
T   15. The time and energy needed to care for Bob will be added to the family's regular duties. Physical exhaustion is a strong possibility for Bob and members of his family.
T   16. Most farm families do not have adequate health insurance. Even in cases when they do, the insurance does not cover many costs associated with the injury. For example, decreased quality of the harvest because of less time and fewer workers available to work the crop, and money and time for traveling to medical appointments and rehabilitation. A serious injury like Bob's can cause the family to lose the farm.

Question D

T   17. Bob has many symptoms of depression. Change in appetite, lack of enjoyment of favorite activities, and general sadness, all indicate he is depressed. If the depression goes untreated, it could become so severe that he begins to think about suicide.
  18. Bob is having difficulty being so dependent on other people. He must be partially cared for by his family, and can no longer interact with his friends in some of the ways he used to. It will take some time for him to adjust to his situation, and how it affects his relationships.
  19. Bob's self-respect is likely to be affected by his disability. He may feel hopeless and helpless for some time. Bob needs to relearn to feel useful and in control of most aspects of his life once again.
  20. Although Bob's injuries were severe, the doctors determined his head was not injured. A head injury does not develop this late after the initial injury.

Question E

T   21. Bob can learn to drive a car or van using hand controls. However, the cost of converting a car for these controls is expensive, $4400 on average.
  22. Swimming is a possibility after Bob builds up his upper body muscles through physical therapy.
  23. With the help of artificial insemination, or in some cases, adaptive penile devices, Bob could possibly father a child. Yet, the sperm count in a paralyzed male is usually not as high or sperm as mobile, so his chances of fathering a child are less.
T   24. Participation may be limited to Special Olympic events or other events that have wheelchair divisions. But, if Bob works hard to stay fit and healthy, he can still be an outstanding athlete in these sports.

So what happened to Bob? He's gone on to live a productive life, but it's very different than the one he had imagined. He has become a strong young man by following a rigorous workout schedule. He plays basketball for the Wheelcats. He has a specially equipped car to get around. Bob graduated from high school at age 19. Repeated infections and occasional hospitalizations slow his progress. Even though he works hard to stay in shape, his spinal injury remains a serious health threat throughout his life. On the average, injuries like this decrease life expectancy.

Finding Your Score

Compare your answers to those on the answer key. Count the number you got correct.

If you got _____, you are:

24  Expert
19-23  Pretty good
14-18  Trying
0-13  In big trouble

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This curriculum guide was supported by Grant Number 1 R01/CCR414307 from NIOSH. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of NIOSH. Special thanks to Dr. Ted Scharf.

Disclaimer and Reproduction Information: Information in NASD does not represent NIOSH policy. Information included in NASD appears by permission of the author and/or copyright holder. More