Adaptive Equipment

Adaptive Equipment for Cerebral Palsy

If you have a child with cerebral palsy, you know the challenges involved. Adapting to life with a disability requires help. Adaptive equipment is often required for people with CP to perform basic daily activities.

Depending on the severity of the condition, a person with cerebral palsy may not be able to walk without support. He or she may be confined to a wheelchair or bed. The goal for every child with cerebral palsy is to live his or her best life and be as independent as possible.

Achieving Independence with Adaptive Equipment

Adaptive equipment helps a child with CP become more independent. Getting children with CP up and moving is important to their long-term success. When people with CP do not move around enough, muscles can weaken or even break down. Inactivity can also lead to incontinence and pneumonia.

The goal of cerebral palsy treatment is to maximize health and independence. Empowering children to perform tasks themselves allows them to feel greater self-confidence.

Physical Therapy Using Adaptive Equipment

Physical therapy helps children learn how to live with CP. In initial sessions, therapists can measure posture, balance, trunk, arms, legs, hands and feet and order custom-fit equipment like braces. A physical therapist can then teach a child to use the adaptive equipment. Some equipment like braces will fit right on the body.

A therapist may also recommend clothes that are easy to take on and off. There is also adaptive equipment that can help infants and children turn over. Children with CP who receive these therapies and use adaptive equipment have a better chance of being able to eventually reach a shelf or go to another room without help.

Some adaptive equipment helps make homes more accessible. For example, sinks and stoves can be lowered to wheelchair level. There is also adaptive equipment for toilets, sinks and tubs as well as also transfer gear to help people get in and out of beds and chair seats.

Examples of Adaptive Equipment

Here are some additional examples of available adaptive equipment for CP:

  • Crutches, walkers, wheelchair, hospital bed
  • Tub chair, hand held shower, raised toilet seat
  • Custom-made shoes and stockings, tools to put them on
  • Transfer benches or boards, for bed to chair or to commode
  • Exercise equipment
  • Braces for splinting or posture
  • “Reacher” gadget used to grasp items

Wheelchairs for Children with Cerebral Palsy

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 CP are being made every day. This is certainly true in the case of the wheelchair. For children who have been severely disabled by CP, 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. An occupational therapist can help teach you and your child on how to prevent pressure sores.

Walkers for Children with Cerebral Palsy

Walkers are important pieces of adaptive equipment for kids with cerebral palsy . They are useful if your child is able to 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 will usually have four legs that are adjustable in height so it can grow alongside your child. Sometimes a walker will have wheels on it or have a basket or pouch to store the child’s belongings.

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

One new cerebral palsy walker that was developed in 2006 is the TAOS (Therapeutic Ambulatory Orthotic System).

The TAOS is a walker that is a combination of an orthosis (brace) and a mobility base. This combination helps with cerebral palsy rehabilitation by keeping kids’ legs and torso in proper alignment while still letting them explore their world and get much-needed exercise.

Braces for Children with Cerebral Palsy

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 orthotic specialist will help fit your child with their brace or braces 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.

Some of the most common cerebral palsy braces include:

  • Ankle-Foot Orthoses (AFOs): These braces work by stretching the Achilles tendon of children with hemiplegic involvement and are walking on their tiptoes.
  • Back Braces: A back brace can help a child who has difficulty sitting up straighten his or her spine and prevent deformity.
  • Inhibiting Cast: Also known as a tone-reducing brace, this orthosis is used to restrain a specific movement, usually in the leg.

Ankle-Foot Orthoses

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 CP, 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.

Foot Drop

Foot drop is a condition sometimes caused by CP. It happens when the muscles that control the ankle and the movements of the foot are weak. Foot drop affects the ability to walk independently.

An AFO is one piece of adaptive equipment that can help treat this and similar conditions related to CP.

Brachiation Kits for Cerebral Palsy

Brachiation kits can help to improve mobility in children with cerebral palsy. The word “brachiation” sounds technical, but the kits are 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 put the 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 using 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, cerebral palsy children can exercise mobility without the use of a wheelchair or stroller.

Cerebral Palsy 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 for children with cerebral palsy are designed to control mobility and give added support, making the potty training experience less stressful.

Toilet chairs for cerebral palsy children:

  • 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 CP, you know that adapting to life with a disability requires help. Equipment like toilet chairs for cerebral palsy will be needed throughout life to provide adequate care.

Cerebral Palsy Vehicle Modification

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

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

Long before a child with CP 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 don’t 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 CP

The Association for Driver Rehabilitation Specialists (ADRS) states that a driver rehabilitation evaluation should take place for every child with CP 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 safest. No vehicle modifications for cerebral palsy should be made until a thorough evaluation is completed.

Cerebral Palsy Car Seats

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

As often as your child will need to see a specialist such as dentists, nutritionists, and other medical professionals, he or she will need to travel safely in a car. A special car seat can help keep your child safer when riding in a car.

Choosing a Car Seat for a Child with Cerebral Palsy

When looking for a car seat, parents will want one that caters to their child’s growing needs.

An appropriate car seat should have:

  • Firm padding
  • Adjustable restraint recline
  • Both lap and shoulder restraints
  • Additional padding
  • A deeper seat large enough to accommodate children weighing 20 to 100 pounds
  • A comfortable, highly-padded headrest

AmTryke Cycles

The AmTryke Cycle is the brand name of a specialized tricycle. It was designed for people with disabilities such as cerebral palsy.

Physical therapists use the AmTryke Cycle to help children with CP increase their mobility. The AmTryke Cycle also can 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 arms and legs.

Some of the parts that are made to fit include:

  • Seat size and type (bench or bucket)
  • Foot cups, pedal blocks, handlebars with grips, hand wraps
  • Headrests, back support pads, knee separators, hip pads
  • Overall frame design
  • Hand/foot cycles
  • Accessories

AmTryke Cycles are made in a variety of models.

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 CP or other disabilities. The hands, feet or both power the tricycle. They can help kids with CP 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 & Cerebral Palsy

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 like a creepster crawler for cerebral palsy children is a mobility aid for kids and toddlers who have physical limitations caused by CP.

A therapeutic crawling device for cerebral palsy children could be the tool to get your child ready to take those precious first steps. 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 a very effective for certain children with CP. 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.

Oral Motor Therapy & Cerebral Palsy

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

CP affects a child’s ability to control muscles. This includes muscles of the mouth that control speaking, swallowing and eating. These muscles are called articulators. Children with CP 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 don’t typically need exercise in the way that our larger muscle groups do.

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

Oral motor therapy for cerebral palsy can help improve:

  • Articulation
  • Language development
  • Social and emotional development
  • Cognitive development
  • Feeding and eating
  • Sensory integration

Lightwriters & Cerebral Palsy

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 for cerebral palsy children.

A Lightwriter for cerebral palsy is an easy-to-use portable communication device. The Lightwriter for cerebral palsy 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 he or she is 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.

Lightwriters are specifically designed for children with CP or other disabilities that make speech challenging. There are many benefits to using a Lightwriter for cerebral palsy.

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 CP have more independence. They can also help to build self-esteem and strengthen cognitive capabilities.

The Makaton Language Program

Children with CP sometimes have verbal communication challenges. The Makaton Language Program is a communication system designed to help children with CP to communicate without speaking.

How the Makaton Language Program Works

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.

Cerebral Palsy & Sleep Aids

Children with CP 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 CP 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 CP sleep. People with CP 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 CP 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.

Gait Trainers for Cerebral Palsy

Children with CP typically face challenges with walking and moving freely because they cannot control their muscles well. Gait trainers can help children with CP 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 and independence
  • Build muscle strength
  • Reduce the amount of assistance required
  • Improve balance

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

Bath Chairs for Cerebral Palsy

Children with CP may have trouble sitting upright in the bath or standing in the shower. The symptoms of CP 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 CP 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: 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: A small range of manual lifts that offer children support in a reclined or semi-reclined position.
  • Adjustable Height Baths: 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.

Selecting Adaptive Equipment

Adaptive equipment like bath chairs can help kids gain more independence. There are many different kinds of bath chairs for cerebral palsy children.

When shopping for a bath chair, consider:

  • The size of the child, tub or bath basin
  • How much support the child needs, such as head support
  • Whether adjustable straps and belts are necessary for moving limbs

If you have a child with cerebral palsy, you know the challenges involved. Bath chairs for children with cerebral palsy make homes more accessible.

Communication Boards for Cerebral Palsy Children

Children with CP 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 for cerebral palsy children are useful when vocal cords are affected by CP.

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 percent of children with CP are unable to produce understandable speech.

These children also have difficulties in other areas of communication like hand gestures and facial expressions. These challenges will last throughout their lives. Communication boards for cerebral palsy can help them to 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 CP to help them overcome communication difficulties.

Exercises might include saying letters and words and practicing social skills like how to keep their heads up, maintain eye contact and clarify when misunderstandings happen. Some speech therapy exercises might also use communication boards for cerebral palsy.

Orthotic Boots & Cerebral Palsy

Because cerebral palsy affects movement and muscle control, children with CP 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 aren’t 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 and 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 of orthotic boots for cerebral palsy children 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

Strollers for Children with Cerebral Palsy

Sometimes, a child with CP 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 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

Wheelchairs vs Strollers

Cerebral palsy strollers are made to be easily pushed and steered from behind. The child inside the cerebral palsy stroller does not need to propel forward as if in a wheelchair. Cerebral palsy strollers are also lighter and easier to handle than wheelchairs. Especially when children with CP are small, the stroller is the best option.

However, as a child grows into adolescence, independent mobility becomes more important. That might be the best time to switch to a wheelchair.

Author:Birth Injury Justice Center
Birth Injury Justice Center

The Birth Injury Justice Center was founded in 2003 by a team of legal professionals to educate and empower victims and families affected by birth injuries. Our team is devoted to providing you with the best resources and legal information for all types of birth injuries.

Last modified: December 13, 2018

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