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Cerebral palsy is a disorder in which the brain cannot properly control and coordinate the body’s movement. CP is usually caused by damage to the brain during childbirth. Cerebral palsy is the most common childhood motor disability in the U.S.
Not every child with CP needs a wheelchair. In fact, almost 60% of all children with cerebral palsy can walk independently without any equipment. Many of these children were once in a wheelchair but could later ambulate with the chair. Some children with cerebral palsy who cannot walk independently use handheld mobility equipment, and others require wheelchairs.
Different Types of Wheelchairs
The good news is that in 2024, there are many different types of wheelchairs available specifically designed to accommodate the unique mobility needs of children with all types of cerebral palsy.
Manual Wheelchairs
Traditional, manual-powered wheelchairs are inexpensive and easy to transport. They typically feature two small caster wheels in the front and two large wheels in the back with rims for pushing. Manual wheelchairs can be rigid or foldable, and they offer a variety of customizable features. The upside of a manual wheelchair is that the user gets exercise navigating and powering the chair.
Some children with cerebral palsy have limited arm strength or control. So they may not be able to move by themselves in these types of chairs. This makes traditional wheelchairs less effective mobility devices for kids with CP.
Electric Wheelchairs
Powered electric wheelchairs have the most to offer for children with cerebral palsy. Electric wheelchairs offer various control options that can give almost any child with cerebral palsy the ability to move around independently.
Most electric wheelchairs for CP feature a joystick type of control that enables the user to move the chair in any direction simply by moving the control stick. More advanced operating systems are available for users who cannot use a joystick control, including touchpad controls and even eye gaze controls.
Electric-powered wheelchairs can be equipped with additional features and operative enhancements to benefit children with cerebral palsy. Many of these features are discussed below.
Tilt-in-Space
One of the most common wheelchair enhancement features for cerebral palsy users is power tilt or tilt-in-space. Tilt-in-space chairs have special seats that can pivot 30-60 degrees upward with the push of a button (or manually) while keeping the hips and knees at 90-degree angles.
In other words, the user remains in the fixed seated position with their knees bent while the entire chair pivots backward.
Tilting offers several general benefits. It shifts body weight to relieve pressure from specific areas of the body, such as the lower back, which is very important for users who spend all day in their wheelchairs. It also helps improve circulation.
Tilt-in-space chairs provide mobility benefits particularly useful for children with cerebral palsy. With a tilt chair, a child with CP can be moved into a postural position, making them more functional in performing specific tasks.
Children with CP often cannot control spastic muscle responses, frequently triggered by moving the legs out of a seated position. The tilt-in-space avoids this by pivoting the user with the legs in the fixed seating position. Various studies have shown that tilt-in-space chairs benefit children with cerebral palsy.
The main drawbacks of tilt-in-space chairs are that they are large and cumbersome, making them difficult to transport and maneuver. They also seat the user much higher than other chairs, making it harder to fit under tables.
Reclining Chairs
Reclining wheelchairs enable users to open the seat-to-back angle and elevate the legs. The movement is that of a typical reclining easy chair. The reclining feature offers many of the same benefits as tilt-in-space, including relief of pressure, comfort, and improved circulation.
They can also move the user to more functional positions, but not as effectively as a tilt-in-space chair.
One significant problem with reclining chairs, however, is sheering and sliding. When the user reclines back, gravity causes the body to slide downward. This can be very problematic for kids with CP who have problems with spastic muscle control.
Standing Wheelchairs
Some children with CP might be able to use standing wheelchairs. These types of electric-powered chairs look a lot like a Segway or scooter. They support the user in an upright position with back and head stability. Movement is usually controlled with a joystick on the armrest.
Customized Seating Wheelchairs
These wheelchairs have customized seating and positioning options for maximum comfort and support. They often include features like specialized cushions, backrests, and headrests tailored to the user’s unique needs.
Transport Wheelchairs
Lightweight and compact, transport wheelchairs are designed for easy transportation and storage. A caregiver typically pushes them and is suitable for short trips or medical appointments.
Rehabilitation Wheelchairs
These wheelchairs are used during rehabilitation to improve mobility, muscle strength, and posture. They may have adjustable features to accommodate changing needs as the individual progresses.
Sports and Recreation Wheelchairs
These wheelchairs are specially designed for adaptive sports and recreational activities. They are lightweight, agile, and equipped with features that enable users to participate in various sports and games.
Kids born with cerebral palsy generally have a host of special educational needs and requirements that should be when it comes to basic things such as school and child care. Fortunately, in the United States we have a high quality special education system for children with cerebral palsy and other disabilities. This page will review the basic educational services and other benefits available under this system and other supplemental assistance programs.
Assistive Technology for Children with Cerebral Palsy
In addition to the variety of wheelchairs available, assistive technology plays a critical role in helping children with cerebral palsy enhance their mobility and independence. Communication devices, such as augmentative and alternative communication (AAC) systems, can help children with CP who have difficulty speaking by allowing them to communicate using symbols, pictures, or text-to-speech tools. These devices can be customized to meet each child’s specific needs, making communication more accessible.
Additionally, adaptive switches can be used in conjunction with powered wheelchairs to control various features, such as adjusting seat positions or using entertainment devices like computers and tablets. These switches can be activated by different parts of the body, such as a slight head movement or a foot press, making them especially useful for children with limited motor control. Smart wheelchairs with integrated technology are also becoming more common, offering features like GPS, obstacle detection, and automatic braking to increase safety and independence for children with cerebral palsy.
The integration of assistive technology alongside traditional wheelchairs and other mobility aids can significantly enhance a child’s quality of life, allowing them to engage more fully in education, social activities, and daily living tasks.
Education Programs for Cerebral Palsy
Early Intervention Services
The term “early intervention” refers to certain public educational support services that are available for infants and toddlers with certain developmental delays and disabilities such as cerebral palsy. The early intervention (EI) program is actually part of the federal education assistance system mandated by the Individuals with Disabilities Education Act (IDEA) of 1975. IDEA requires state public school systems to identify children with special needs and provide them with certain support services for which the states receive large amounts of federal funding. One of the support service programs required by IDEA is the EI program.
The EI program offers free developmental services to certain qualified children 0-3 years old. Infants and toddlers can become qualified for the EI program in one of 2 ways:
- Parents with concerns can request that their child be evaluated for developmental delays. If the testing and evaluation determines that the child is developmental delayed they will be approved for the program. Pediatricians will often refer children for EI evaluation but any concerned parent can have their child tested and assessed on request.
- Children who are diagnosed by doctors with certain birth injuries or disorders that are known to cause developmental delays or cognitive impairment will be automatically qualified from EI services based on solely on that diagnosis.
A diagnosis of cerebral palsy will automatically qualify a child for the EI program without testing or evaluation. The following link provides information on state specific eligibility requirements: State EI Programs.
Early intervention programs are administered by the state and services are typically provided through the local school system or in some states they are contracted out to private companies. Individual EI services are provided in various settings (e.g., at home, daycare, clinics, etc.) depending on the child’s needs and situation. The preliminary assessment testing and evaluation are entirely free and most EI services are also provide entirely free of charge. However, some states do assess small fees for families who have household income over a certain level.
A very broad range of distinct services are offer under the EI program. The specific services provided through the EI program will vary depending on the unique needs and requirements of each child. Once a child is admitted into the EI program parents have an initial meeting with program providers at which time a customized support plan and developed based on the evaluated needs of the child and what services they might benefit from. The customized service plan is called an Individualized Family Service Plan (IFSP). The primary categories of support services offer through early intervention programs include:
- Physical Therapy
- Occupational Therapy
- Medical / Nursing Assistance
- Speech Development
- Education Assistance
- Social Services
- Nursing Care
- Counseling for Parents
- Nutritional Counseling
- Mobility Devices
- Assistive Technology
- Transportation
Children who are evaluated and assessed with limited, specific developmental needs may only receive 1 of these services. For example toddlers with speech delays will typically just receive speech development therapy. Children with any type of cerebral palsy, however, will typically be provided the full range of EI services. The physical and occupational therapy services available through EI can be very beneficial at helping children with CP.
Educational Services for Children Over 3
For the first 3 years children with cerebral palsy can receive support services through the EI program. Children older than 3 years fall under different IDEA programs which are usually described as Individualized Education Programs (IEP) and Special Education. Special education programs provide children with one-on-one teaching and other special educational resources (e.g., speech therapy).
Special education is provided to children within their public school but new program rules prevent them from being isolated in a special class so they remain in a regular classroom setting most of the time. Most children with cerebral palsy will meet the qualification criteria for special education services. The IEP is a customized support service plan similar to the IFSP but for children over 3 years old.
Daycare and Preschool Programs
Kids with cerebral palsy often need to be in daycare and/or preschool just like other toddlers and young children. The problem is that many young children with cerebral palsy have significant special needs that cannot always be accommodated at standard daycares. Most states have programs that provide special funding to childcare centers that are certified to provide care and services to children with disabilities and special needs. Moreover, children with IEPs are automatically entitled to free enrollment in state sponsored preschool programs. These preschools are usually provided through the local public school.
- More thoughts on measuring and picking the best possible wheelchair for a child with cerebral palsy
- What is ataxic cerebral palsy?
- Children with CP sometimes have torticollis or hypertonia or are frequently arching their back.
- Does my child have CP? Signs and symptoms of cerebral palsy (symptoms specific to toddlers)