Pediatric Wheelchair Needs
Finding the right mobility source for your child is a very precise challenge. This is an area where you really need to rely on the suggestions of the healthcare provider, usually a Physical Therapist, to assess the needs, safety, and functions of your child.
An Occupational Therapist will offer suggestions as well, especially in the finer coordination of devices to increase function. A physician or physiatrist will offer suggestions as well.
Typically, several companies will work with different organizations which makes a starting place. If something is needed that is not offered by these companies, other resources will be contacted. As a parent, you and your child will be presented with suggested equipment and reasons for use. The therapists will pay particular attention to what your payor will support so your financial burden is less.
Parental suggestions are truly desired but remember, your payor is only going to financially support your child’s needs through the coverage of your individual insurance policy. You will need to finance unique, or not mandatory equipment.
One of the most important factors for the mobility of your child is the ability of the equipment to be adapted to growth spurts. Children’s bodies change quickly. You may need longer leg rests, a taller back, or an adjustment to any part of the equipment. Always check to ensure different parts of the wheelchair can either be lengthened or adjusted for growth as opposed to having to purchase an entirely new device.
Usually, mobility experts start with the frame of a wheelchair. They will look at the seat, back, arms, and legs to see if each part should be adjustable or fixed depending on the individual needs of your child. Typically, your child will have a choice of color for their chair.
Once a decision is made about a manual or power chair. the frame is selected. Positioning and pressure-dispersing equipment selected for the needs of your child are added to the chair. Even though this equipment is there to reduce pressure injury, pressure releases still need to be performed to keep circulation in small capillaries.
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Seating is especially important to avoid falling out of the chair as well as keeping the body in alignment. Children’s growth, especially with neurological issues is not always perfectly symmetrical on both sides of the body. Muscle tone (spasms or flaccidity) can pull bones out of alignment leading to hip dysplasia, scoliosis of the spine, and other boney, nerve, and muscle issues.
Other body supports may include footrests with or without calf support, elevating or fixed, armrests, with or without troughs for support, lateral supports for the torso, and a headrest, all of which should be adjustable to grow with your child. Other positioning items may include a chest strap or vest and a head strap. A seat belt may be needed for safety.
Your healthcare provider, therapist, or nurse may suggest other items that will be helpful to your child. Do not forget your parental needs. Most children’s wheelchairs come with handles so you can push your younger child for safety. The older child will have a larger chair which requires the need to get through doorways.
When your child has adjustments made to their wheelchair, a new wheelchair, or a new adaptation to the chair, be sure to check their skin for changes in pigmentation. This includes those boney pressure points but should also include anywhere skin is against the equipment. Rubbing or jiggling through movement of the chair can lead to pressure injury even on soft tissue so vigilance is needed.
More detailed information can be found on these sites:
Wheelchairs for children under 12 with physical impairments click here.
Evaluation of Pediatric Manual Wheelchair Mobility Using Advanced Biomechanical Methods click here.