Adaptive Equipment

Achieving Independence with Adaptive Equipment

Cerebral palsy can cause a wide range of disabilities and physical impairments that make it difficult to speak, walk, and eat. The severity of the disabilities varies in scope, and some can significantly reduce mobility and quality of life. They can also adversely impact physical and mental health.

Adaptive equipment can help individuals with cerebral palsy achieve a greater level of independence and autonomy. Equipment such as braces, wheelchairs, and walkers can significantly improve mobility and increase self-confidence.

Sometimes these tools are used in conjunction with physical therapy. A physical therapist will often teach children with cerebral palsy how to properly use their adaptive equipment. This can lead to improved socialization and the ability to participate in recreational activities and sports.

Types of Adaptive Equipment

There are many different tools, equipment, and methods that can allow children with cerebral palsy to live more independent lives. Adaptive equipment can help with everything from changing clothes to driving a motor vehicle.

Below are examples of specific types of adaptive equipment and how they can benefit children with cerebral palsy.

Wheelchairs

A wheelchair is an essential piece of equipment for many people with cerebral palsy. A wheelchair can come in many sizes and control modes.

For example, one wheelchair might have a “joystick” control while another might be controlled with a mechanism that sits behind the operator’s head. This allows kids with very little coordination to move about with more freedom.

New advancements in adaptive equipment for cerebral palsy are being made every day. This is certainly true in the case of the wheelchair. For children who have been severely disabled by cerebral palsy, there is even a wheelchair that can be controlled with voice recognition or other alternative methods of control.

If your child uses a wheelchair, check often for pressure sores and other skin problems. It is important to rotate positions throughout the day in wheelchairs so that there is not increased pressure on certain areas, especially bony areas where pressure sores are more often to occur.

If your child uses a wheelchair, check often for pressure sores and other skin problems. An occupational therapist can help teach you and your child on how to prevent pressure sores.

Strollers

Sometimes, a child with cerebral palsy will have weak trunk muscles and need assistance to sit upright. Cerebral palsy strollers with chest straps can help.

Shopping for Strollers

When shopping for a stroller, there are some features to look out for that will help make a child with cerebral palsy comfortable.

These features include:

• Sturdy frames that can hold up under the strain of frequent use
• A gentle chest harness and lap belt
• Growth adjustable components
• Adjustable footplates and straps
• Indoor swivel wheels
• Spring shock absorbers

Walkers

Walkers are important pieces of adaptive equipment for kids with cerebral palsy. They are useful if your child can walk but needs help with balance.

Some kids with cerebral palsy make great strides in their mobility and muscle coordination with the help of a walker.

Walkers are usually made out of a light metal. They usually have four legs with adjustable height to grow alongside your child. Sometimes a walker will have wheels or a basket or pouch to store the child’s belongings.

Like other adaptive equipment for individuals facing the challenges of living with cerebral palsy, walkers have come a long way in recent years.

The Adapt-A-Walker device is a popular standing walker that provides children with greater mobility. The device has a front restraining gate that secures the child and confirms closing with a clicking sound.

This is beneficial because it helps a child to move around while seated or standing as tolerated. If sudden and quick movements occur, it helps them move without the fear of falling and creating more health issues.

The walker is made from healthcare-grade PVC and is secured and reinforced at its stress points.

Braces

Braces help children improve their mobility and muscle tone. Also known as an orthosis, a cerebral palsy brace helps by stretching muscles that can get over-tight, as well as helping with stability.

Braces are available for arms, wrists, hands, hips, legs, ankles, knees, and other limbs affected by cerebral palsy. Braces can be made from leather, metal, plastic, or a combination of any of these.

Your child’s doctor and an orthotic specialist will help fit your child with their brace(s) and give you instructions for maintaining it.

Rapidly growing children often outgrow their braces quickly, and a poor fit can lead to rashes, redness, and blistering.

The frequent need to replace outgrown braces can create a financial burden on families. As a result, some may extend the use of a brace beyond its ideal fit, which, unfortunately, can lead to issues like rashes and blistering, particularly if families are unable to afford timely replacements.

Orthotic Boots

Because cerebral palsy affects movement and muscle control, children with cerebral palsy often have difficulty walking. Orthotic boots for children with cerebral palsy are footwear that helps stabilize the feet and legs for improved mobility.

When children with cerebral palsy are not able to use certain muscles, those muscles can weaken over time. Orthotic boots for cerebral palsy can help to correct underdeveloped muscles. This makes orthotic boots especially effective in children with severe cases of cerebral palsy.

Orthotic boots go beyond the more common shoe inserts. They may have supportive parts that are plastic, metal, carbon fiber, and/or leather. They are often custom-built.

Benefits of Orthotic Boots for Cerebral Palsy

Orthotic boots for cerebral palsy have the main benefit of helping children walk.

Additional benefits include:

• Safeguarding the feet and ankles from types of injuries caused by spastic limbs, stumbling, and related incidents
• Enhancing the function of joints, pelvis, and spine
• Relieving pain
• Correcting abnormal foot alignment and structure

Ankle-Foot Orthoses (Orthotic Devices)

AFO is the abbreviation for ankle-foot orthoses. An AFO is worn on the lower leg, foot or both. They are often made of plastic and must be fitted correctly to be effective.

If your child has cerebral palsy, consult a doctor or physical therapist about whether an AFO might help your child to move more independently.

An AFO has the following functions:

• Provides support for a weak leg
• Holds a leg with rigid muscles in a straight and comfortable position
• Sometimes restores function
• Can treat specific problems such as foot drop

There are several different styles of AFOs that range from pliable to sturdy based on the required level of support. Traditional AFOs are made of sturdy materials like metal or hard plastic. They typically have a plate that slides into the shoes to help keep the foot level.

AFOs should be custom-fitted by a physical therapist or doctor for the best results.

Brachiation Kits

Brachiation kits can help to improve mobility in children with cerebral palsy. The word “brachiation” sounds technical, but the kits are designed in a fun way to get your child up and moving around the house.

Brachiation bars can be found in most playgrounds for children. You might know them as “jungle gyms” or “monkey bars.” Brachiation bars focus on moving unaffected limbs like the arms.

Acquiring a brachiation kit for cerebral palsy children might be the next step in advancing their mobility beyond that of a wheelchair.

There are many benefits of brachiation kits for cerebral palsy children:

• As the child moves left to right, each side of the brain is independently exercised.
• Brachiation kits for cerebral palsy can be built indoors, outdoors, or both.
• The kits promote health in the chest, arms, and sections of the body that can weaken when not used.

Consider installing a brachiation kit for cerebral palsy inside or outside of your home. With the use of a brachiation kit, children with cerebral palsy can exercise mobility without the use of a wheelchair or stroller.

Toilet Chairs

Toilet training is an important milestone in a child’s life. It means a step towards independence and freedom. The process of toilet training can be stressful for children and frustrating for parents, especially if the child has cerebral palsy.

Usually, children will begin potty training at approximately 2 to 3 years of age. This time frame might be delayed for children with cerebral palsy. Fortunately, toilet chairs are designed to control mobility and give added support, making the potty training experience less stressful.

Toilet chairs for children with cerebral palsy:

• Have a harness and straps to help children sit upright
• Provide neck and head supports
• Can adjust to the changing height of your growing child
• Are portable and can wheel away from the toilet when not in use
• Are often easy to clean and store

If you have a child with cerebral palsy, you know that adapting to life with a disability requires help. Equipment like toilet chairs may be needed throughout life to provide adequate care.

Bath Chairs

Children with cerebral palsy may have trouble sitting upright in the bath or standing in the shower. The symptoms of cerebral palsy may also make it difficult for a child to sit in chairs that do not have neck, back and arm supports.

Specially designed bath chairs for people with cerebral palsy are an effective solution to this challenge.

Types of Bath Chairs for Cerebral Palsy

Most infants, toddlers, and children with cerebral palsy find it difficult to lay with their legs straight out or to sit upright in an unsupportive chair. This is why there are so many bath chairs for children with cerebral palsy.

Some varieties include:

• Bath Overlays: Bath overlays are removable trays that sit across the rim of a standard-sized tub. The overlay is placed under the faucet, and the water drains into the tub below.
• Bath Lifts and Hoists: These consist of a small range of manual lifts that offer children support in a reclined or semi-reclined position.
• Adjustable Height Baths: Adjustable height baths are bath seats with either mechanical or electric adjustments to heighten or lower the bath.
• Bath Boards and Seats: Spanning the rim of the bath with a platform, this bath seat provides grab rails as secure handholds for transferring children in and out of the tub.

Cerebral Palsy Vehicle Modification

Cerebral palsy can affect a person’s ability to ride or drive safely in a car. When a child with cerebral palsy is old enough to drive, he or she may be able to do so with vehicle modification for cerebral palsy.

Because cerebral palsy affects movement and muscle control, cars need customized modifications to adapt them for use by a person living with cerebral palsy.

Long before a child with cerebral palsy is able to drive, he or she will still need to get in and out of a vehicle frequently. Sometimes, vehicle modifications for cerebral palsy include adding equipment to accommodate safe passenger traveling.

Types of Vehicle Modifications for Cerebral Palsy

According to the National Highway Traffic Safety Administration (NHTSA), a driver may have to seek special training and licensing to operate a vehicle with modifications for cerebral palsy. If the modifications do not affect the driver, just the usability, you may still be required to seek training on the proper use of installed equipment.

Some vehicle modifications for cerebral palsy include:

• Car seat harnesses
• Modified or custom-built seats
• Push-button gear selectors
• Hand-operated gas and brake pedals
• Gas and brake pedal extensions
• Spinning knobs on the steering wheel
• Automatic door and window openers
• Column extensions
• Motorized or manual lifts and ramps
• Wheelchair carriers

Driving for People With Cerebral Palsy

The Association for Driver Rehabilitation Specialists (ADRS) states that a driver rehabilitation evaluation should take place for every child with cerebral palsy who reaches legal driving age. This evaluation tests a person’s strengths and weaknesses with common driving tasks.

The goal is to determine what vehicle modifications for cerebral palsy will make the driving experience the safest. No vehicle modifications for cerebral palsy should be made until a thorough evaluation is completed.

Car Seats

Because cerebral palsy affects motion control in babies and children, special car seats are important to keep your child safe.

Your child will need to travel in a car whenever they have an appointment with a specialist such as a dentist, nutritionist, or another medical professional. A special car seat can help keep your child safer when riding in a car.

AmTryke Cycles

The AmTryke Cycle is the brand name of a specialized tricycle. It was designed for people with disabilities such as cerebral palsy and can be made in a variety of models.

Physical therapists use the AmTryke Cycle to help children with cerebral palsy increase their mobility. The AmTryke Cycle can also be used as a substitute for a wheelchair or a bicycle.

Both children and adults can use AmTryke Cycles. They are customized to fit the person’s size and specific needs. The tricycle manufacturer will need measurements of the arms and legs.

Similar products that perform the same functions include:

• Rifton Adaptive Tricycles
• Triaid Terrier Special Needs Tricycles
• TMX Pediatric Adaptive Tricycles

These cycles are all specifically designed for children with cerebral palsy or other disabilities. The hands, feet or both power the tricycle. They can help kids with cerebral palsy have more independence.

They can also help build self-esteem, strengthen muscles, and improve motor coordination and range of motion while making exercise fun.

Therapeutic Crawling Device

A child’s first steps are one of the most memorable moments in a parent’s life. This developmental milestone in children with cerebral palsy may be delayed. Children with severe cerebral palsy may never be able to walk.

A therapeutic crawling device, such as a creepster crawler, is a mobility aid for kids and toddlers with physical limitations caused by cerebral palsy.

A therapeutic crawling device could be the tool needed to get your child ready to successfully crawl for the first time. A therapeutic crawling device is a metal frame on wheels with padded straps that suspend children by the hips, stomach, and shoulders. This leaves the arms, knees, and feet free to move.

This type of device:

• Assists children in applying pressure evenly to their hands and knees while learning to shift forward
• Strengthens a child’s neck, back, shoulder and arm muscles
• Improves visual skills
• Increases tolerance to unfamiliar positions and textures
• Develops coordination in preparation for walking
• Promotes motor development
• Provides a child with means of independent mobility

A therapeutic crawling device is very effective for certain children with cerebral palsy. However, if your child has little or no head control, this device is not a fit. Children with no head control will not be able to move the neck and this may lead to excess saliva flooding the nostrils.

Similarly, a therapeutic crawling device for cerebral palsy is not a good fit if your child cannot use his or her arms.

Gait Trainers

Children with cerebral palsy typically face challenges with walking and moving freely because they cannot control their muscles well. Gait trainers can help children with cerebral palsy to move more freely.

Gait trainers are like wheelchairs in that they provide wheel-assisted mobility. Gait trainers were developed to improve the walking ability of children with spastic limbs.

These devices are well-suited for children who can still move their legs but are not required to apply steady force to their heels.

Gait trainers for cerebral palsy children can help:

• Improve mobility, balance, and independence
• Build muscle strength
• Reduce the amount of assistance required

When used in combination with regular physical therapy and other necessary treatments, gait trainers can provide many benefits. Several studies conducted by the U.S. National Institutes of Health (NIH) prove that the use of gait trainers improves balance, gait speed, and step length in children with cerebral palsy.

Sleep Aids

Children with cerebral palsy often have difficulty falling and staying asleep at night. Cerebral palsy sleep aids are medications and/or alternative methods to treat this symptom.

People often think of cerebral palsy sleep aids as medications, but they can also be natural remedies like adjustable beds and weighted blankets.

Types of Cerebral Palsy Sleep Aids

Medications are the most common sleep aid for people with cerebral palsy. These include both natural dietary supplements as well as prescription medications.

One of the most commonly used medications is melatonin. This is a natural sedative that helps children with cerebral palsy sleep through the night. However, melatonin can interfere with other medications. Check with your child’s doctor before using melatonin as a sleep aid.

Adjustable beds may also help a child with cerebral palsy sleep. People with cerebral palsy can have trouble lying flat on the back or on the side due to tense areas around the spine. Certain positions also can interfere with normal breathing.

With an adjustable bed, you can raise the head of the bed to a reclined position. This can help take the pressure off of tense muscle groups and allow a child with cerebral palsy to sleep comfortably. You can also raise or lower the foot of the bed. Experiment with adjustable beds to find the right position for your child.

Another drug-free cerebral palsy sleep aid is a weighted blanket. These can be soothing for a child as they can help calm some of the spastic movements associated with their condition. Weighted blankets can be custom-made for your child’s specific needs.

Lightwriters

Cerebral palsy can sometimes affect the muscles that control speech, causing communication challenges in kids with the condition.

One approach to helping a child overcome these challenges is the use of a communication device such as a Lightwriter. Lightwriters are specifically designed for children with cerebral palsy or other disabilities that make speech challenging.

A Lightwriter is an easy-to-use portable communication device. It uses a text-to-speech mechanism that allows its user to simply type in what they want to say. A child can use this device to synthesize speech when they are unable to speak easily.

The parent or listener can either read what is being communicated on the screen or listen to a synthetic voice from the machine.

Outside of the speech benefit, Lightwriters are waterproof and spill-resistant, making them more durable than a computer. They are also portable and easy to use anywhere.

Lightwriters help kids with cerebral palsy have more independence. They can also help to build self-esteem and strengthen cognitive capabilities.

Additionally, children with CP often face challenges in communicating their discomfort, which can result in delayed detection of ailments. For example, in the early stages of a pressure ulcer, a child might experience increased tenderness or pain in a specific body area. If they can effectively communicate this, caregivers can promptly ease pressure on that area, helping to prevent further complications.

The Makaton Language Program

The Makaton Language Program is a simply structured language that uses gestures, facial expressions, eye contact, body language, signs, and symbols to help children communicate. It is based on a list of everyday words.

The Makaton Language Program will benefit your child by:

• Increasing vocalizations
• Reducing frustrated behaviors, such as biting and hitting
• Promoting positive social skills by increasing patience and attention span
• Helping them listen, communicate, and interact with others

Children who learn to communicate using the Makaton Language Program gain the ability to express their needs. However, keep in mind that teaching a child a new language takes time and patience.

Sometimes, weekly or even daily lessons by trained professionals are required to teach a child this new language. Depending on the child, learning the Makaton Language Program can take years. This can become quite costly over time, but it will help improve your child’s ability to communicate.

Communication Boards

Children with cerebral palsy can sometimes have difficulty communicating verbally.

A communication board for children with cerebral palsy is a non-verbal communication aid. It is a device that uses picture symbols, words, and recorded phrases to communicate. Communication boards are useful when vocal cords are affected by cerebral palsy.

Depending on the area and severity of the brain injury, different muscle groups can be affected. According to the National Institute of Neurological Disorders and Stroke (NINDS), about 20% of children with cerebral palsy are unable to produce understandable speech.

These children also have difficulties in other areas of communication, like hand gestures and facial expressions. Not being able to communicate well can be frustrating and increase feelings of isolation and loneliness if they feel like they aren’t understood.

Communication challenges will last throughout their lives. Communication boards for cerebral palsy can help them carry on a conversation.

Speech and Language Therapy

In addition to using communication boards, speech therapy is an option. Speech therapists work with kids with cerebral palsy to help them overcome communication difficulties.

Exercises might include saying letters and words. Speech therapy also helps children practice social skills such as keeping their heads up, maintaining eye contact, and clarifying when misunderstandings happen. Some speech therapy exercises may also use communication boards.

Oral Motor Therapy

Symptoms of cerebral palsy can include speech challenges. Oral motor therapy is one option to treat this symptom.

Cerebral palsy affects a child’s muscle control. This includes muscles of the mouth that control speaking, swallowing, and eating. These muscles are called articulators. Children with cerebral palsy are at high risk for having weak articulators.

Oral motor therapy for children with cerebral palsy can strengthen muscles in the face and mouth that help with speech. This allows some children to gain some or total control over how they eat and speak.

Benefits of Oral Motor Therapy for Cerebral Palsy

Oral motor therapy for cerebral palsy involves exercising the muscles of the mouth. Oral muscles do not typically need exercise in the way that our larger muscle groups do.

For most people, regular speech and eating habits keep oral muscles in great shape. For people with cerebral palsy, the part of the brain that controls these muscles is damaged. For this reason, people with cerebral palsy might require help to gain more control over their mouth muscles.

Oral motor therapy can help improve:

• Articulation (clarity of speech)
• Language development
• Social and emotional development
• Cognitive development
• Feeding and eating
• Sensory integration

Using Adaptive Equipment for Cerebral Palsy Management

There are many different types of adaptive equipment for individuals with cerebral palsy. The type of equipment used varies based on each individual’s specific symptoms and unique needs. A medical professional can help your child determine the proper adaptive equipment for their condition.

Adaptive equipment is often fairly expensive and can be required for a lifetime. If your child’s case of cerebral palsy may have been caused by medical negligence, you may be able to receive a financial settlement that will pay for your child’s care and adaptive equipment.