Vol. 6, No. 5 Fall 1998	Previous Issues Subscribe to AT Messenger Download PDF Viewer
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Powered Mobility for Children:
Is My Child Too Young?

by Nancy Chipman Ranalli, ATRC Assistant Coordinator

Previous issues of The AT Messenger have discussed both manual and power wheelchairs. This issue addresses powered mobility for young children. Please note that I prefer to use the term "power wheelchair" rather than "electric chair" because of the image conjured up by the latter term. Powered mobility is a good option for many people, both children and adults, but this article will address children specifically.

When is it too early to look at powered mobility for a child? There is no hard and fast rule for this. Children have started with pre-power wheelchair activities, such as using a motorized car (the Cooper Car, for example), or using a joystick to maneuver a remote controlled car, as early as two years of age. The criterion most often used is that if a child (or adult for that matter) understands cause and effect, he or she may begin to understand how to use a power wheelchair for mobility. There are certainly many other skills one needs to acquire before independent mobility with a power wheelchair is achieved, including directionality and stopping/starting, but if the child can begin to understand that by moving a joystick a certain way s/he can make the car or wheelchair move, it is a major step in the right direction.

As an example, John Doe is a two year old child with spastic cerebral palsy affecting all four limbs. At this point in time he requires others to assist him with all movement, as he is unable to roll, crawl or walk. He has demonstrated the ability to understand cause and effect through various therapy activities. When placed in a powered mobility device, he is able to use the joystick to cause the device to go in circles. Imagine the look on his face when he does this independently. It is likely to be the first time he has had some control over his environment, and the smiles are endless!

Parents often are reluctant to have their young child use a wheelchair, much less a power wheelchair. There still seems to be a "stigma" attached to using a wheelchair, and they want to keep their child out of it as long as possible. In addition, they often feel that using a wheelchair means that the therapist will stop addressing walking. On the contrary! Using a power wheelchair often assists children with walking because they now feel that they are able to move independently and want to try it by various methods. Often, once a parent sees a child move independently in a wheelchair, the parent realizes that the wheelchair, too, can be used to help in the child's therapy.

As with most devices, physical limitations do not negate use of a power wheelchair. There are many methods of access for power wheelchairs, including (but not limited to) joysticks, single switches, chin controls or head controls. With a variety of controls come just as many placement options for each control. For instance, if a child is accurate with his left elbow and right knee, it may be possible to place single switches at each one of those sites to allow the child to control the wheelchair in that way. Additionally, if the child's head control is the most accurate method of accessing the power wheelchair, that method could also be used. Combinations of access devices may also be used if necessary.

Other factors should be considered when assessing a child's use of a power wheelchair. The accessibility of the home is a major consideration. Will the child be able to use the wheelchair in his/her home? How about the school situation and access to community activities? Are the school, local park, and favorite recreation spot accessible to the power wheelchair? If not, they should be! In addition, how will the wheelchair be transported? There are power wheelchairs that can be disassembled to be placed in the trunk of a car, but this is often a lengthy and weighty task. Will the family be able to transport the wheelchair in a minivan or sport utility vehicle? With some creativity and resourcefulness, many of these barriers can be overcome to allow the child to use a power wheelchair.

Finally, as has been stated in other articles, it is very important that the child receive a thorough and appropriate evaluation of his/her skills using a power wheelchair and the accompanying seating components. The child should be assessed by therapists who are skilled in addressing seating needs and familiar with a variety of controls and access options to assure that all avenues are explored. If not, an expensive purchase may be made, and it may not suit the needs of the child for whom it was purchased.

In conclusion, this article was meant to open the doors to the possibility of powered mobility for young children. If you have questions or concerns about your child's ability to use a power wheelchair, please discuss it with your child's physical or occupational therapist, or school teacher, or call one of the Assistive Technology Resource Centers for more information.