The Importance of Mobility
We often take the ability to move in our home and community for granted, but for our family member with a disability even the smallest step can prevent them from accessing all parts of his or her life. Being mobile enhances a person’s ability to learn, interact with others, earn a living and participate in the community. For children with mobility impairments, a variety of mobility aids and devices are available to provide support, motion and access, as well as to enable them to lead active and fulfilling lives.
Assistive Technology and Mobility
Because there are so many different types of mobility devices for children with special needs an assessment is needed. Assessments determine your child’s physical ability, functional ability, environmental, age consideration.
Physical ability assessments are done by medical personnel, including physical and occupational therapists, exercise physiologists, orthotists, prosthetists and physicians. They evaluate: muscle strength, posture, sensation, vision/perception, the skeletal system, the central/peripheral nervous system, ambulation capabilities, stamina and energy levels.
Assessment of functional abilities and desired activities incorporates:
- determining the activities in which the child currently participates
- identifying where these activities take place
- identifying places where the child would like to go but cannot currently go without assistance
- taking time to observe and get to know the person; finding out their likes and dislikes; finding out their current abilities and limitations
All aspects of the child’s various physical environments must be assessed (home, educational, social). For each environment, information must be gathered on the following:
- entrances and exits (slope and length)
- steps (number, height and depth)
- floor coverings
- hallways and doorways (width)
- location of bathrooms
- methods of gaining access to other floors
- climate and expected weather patterns
Finally, the child’s age must be considered from a number of perspectives. For children, will they outgrow the devices? For children and adults, what is the stability of the individual’s condition? In addition, what is the impact of age on future needs? All of these questions can be discussed with the medical professional.
Once an assessment is completed different types of devices and aids can be discussed to best suit your child’s specific needs. These include: ambulation, wheeled mobility, manual wheelchairs, and power wheelchairs.
Ambulation devices include canes, walking poles, crutches and walkers.
- Canes – used when a child experiences weaknesses in the lower extremities. They can be wooden or metal, as well as single, triple or quad-footed.
- Crutches – consist of three types. Auxiliary crutches are wooden or metal and require good arm strength. Platform crutches provide forearm support and are used by individuals who cannot put pressure on their hands or wrists. Forearm crutches and Lofstrand crutches involve a cuff that encircles the arm and are commonly used by individuals with polio.
- Walkers – provide a stable and wide base of support by ensuring four points of contact with the floor. They can be two-handed or one-handed.
A variety of battery-powered and manually-pushed devices provide wheeled mobility for individuals who cannot power themselves. Such devices include scooter boards, knuckle boards, upper-extremity powered bicycles, reclining bikes, tandem bikes, and strollers.
The basic manual wheelchair has been around for decades and includes the base components of a seat, back, and leg/footrest on four wheels. The standard manual wheelchair is heavy and offers minimal adjustments for comfort. It is a basic mobility device and the least expensive wheelchair. Lightweight high-strength wheelchairs can be adjusted to create a tilt in the wheelchair for improving posture. Adjustable ultra-light wheelchairs increase the ease of propulsion and lower the center of gravity. They are the most expensive manual wheelchairs.
Powered wheelchairs run on batteries and cost from a low of $3,500 to more than $12,000. The standard power wheelchair is used by an individual who can operate a joystick with good control and does not have weakness, tremors, or spasticity in the upper extremities. The battery is located under the seat and the settings are preset at the factory (and therefore not adjustable). Higher- technology (and therefore more expensive) wheelchairs have better controls built in. The user can control acceleration/deceleration rates. Tremor adjustments can block extraneous upper extremity movement. Short throw adjustments allow persons with weakness to have decreased exertion requirements. Power wheelchairs can be operated by various control devices, including a joystick mounted on an armrest, a chin control, and noncontact switches that respond proportionately to changes in the user’s head position. Tilt and recline features allow the user to obtain pressure relief or rest.