Watch
Your Toes!
Making Toddlers Safe Behind
the Wheel
by Kathy Wechsler
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Kendle Haught, 4, of Washington, Pa.,
has congenital MD and uses a Quantum Dynamo by Pride Mobility Products. When she first learned to drive her
power wheelchair at age 3, Kendle’s parents would sometimes use the Buddy Button (manufactured by Tash, below)
to stop the wheelchair when it was headed for danger.
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Most infants without disabilities learn to crawl
when they reach 7 to 8 months. A few months later, they can pull
themselves to their feet and toddle around by holding onto furniture. At
age 1, curiosity gets the best of toddlers, and they begin to explore
their environments in ways that offer more independence than ever before —
by learning to walk.
For young children with neuromuscular diseases,
such as spinal muscular atrophy, myotubular myopathy, nemaline myopathy
and congenital muscular dystrophy, crawling and walking aren’t always
possible, even though they’re as ready (cognitively) for exploration and
independence as any other child.
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Owen Norton, 4, of
Braintree, Mass., enjoys the freedom that comes with his Permobil Koala. Owen,
who has spinal muscular atrophy, began using the chair when he was 26 months old.
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Experts say that exploration helps a child’s
mental development. Toddlers using wheelchairs need to be as mobile and
inquisitive as other youngsters.
Power wheelchairs give toddlers the freedom to
explore, learn and grow. The major U.S. wheelchair manufacturers that
offer pediatric power wheelchairs are:
Start Your
Engines!
Ian Kingscote, a rehabilitation technology
specialist (RTS) and rehab equipment consultant with Design-Able in
Bridgewater, Mass., says a child’s cognitive age is more important than
chronological age when it comes to beginning to use a power wheelchair.
He’s worked with children as young as 2 years old.
Whether or not your toddler is ready for a power
wheelchair depends on many factors, including his or her maturity level
and understanding of cause and effect and spatial relations. Readiness is
extremely client-specific, Kingscote says.
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The power assist feature makes the Co-Pilot from Permobil an easy way to push your child’s chair when he or she needs a break.
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To determine whether it’s safe for your toddler to
begin using a power wheelchair, he or she should attend a specialized
clinic for six to 10 weeks. During training, your child’s performance,
endurance and tolerance will be monitored.
“A chair goes where it’s driven, so that’s why the
children really should go to an established pediatric clinic with
experienced therapists and wheelchair vendors,” said Kingscote, who’s been
in the industry for 13 years. “I generally have my clinics at the
Children’s Hospital in Boston ensure that if a power chair is recommended,
it’s because the user has ‘passed his or her test’ and is a safe
driver.”
Medicaid in most states will cover pediatric power
chairs, but the order has to be accompanied by a letter of medical
necessity from a therapist at the clinic. You’ll have to provide
documentation that the youngster has tried specific equipment and knows
how to use it safely.
Who’s in Control?
Experts agree that the number-one rule of power
wheelchair safety with toddlers is supervision. Of course, safety should
come first in any toddler activity.
Most power wheelchairs have controls that can be
programmed. Ask your RTS to adjust the chair’s speed and sensitivity,
especially in the beginning. This way, when your child goes at “top”
speed, the speed is only a fraction of what the chair is capable of. Your
RTS can make adjustments as your child’s ability changes.
Kingscote says that wheelchair electronics
sometimes can be programmed “to cut out if too much resistance is
recognized by the motors — but this isn’t available on all chairs.”
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Permobil also offers the PG Drives Technology attendant control joystick, which can be mounted behind your child’s wheelchair.
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You can also purchase an attendant-control feature
that lets you control the speed, steering, power, or tilt and recline of
your toddler’s wheelchair. With attendant controls, you can help your
beginning driver avoid dangerous situations, or you can take over control
of the chair when your toddler is tired of driving.
Attendant controllers can be mounted behind the
wheelchair’s backrest or attached to a cable that lets you walk beside the
chair. You can even get wireless remote controls.
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The Power Tiger pediatric wheelchair from Invacare offers bright colors and modern styling while providing versatile and responsive electronic controls for pinpoint accuracy. The Orbit seating system can be mounted on both a Power Tiger and a manual Orbit. Invacare has several models of pediatric power chairs, most with the capacity to “grow” with the child.
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These optional features usually can be funded by
Medicaid if they’re medically justified.
Using the emergency stop switch (a.k.a. kill
switch), you can shut down the power, stopping your youngster’s wheelchair
in its tracks. Another option is a second joystick, which allows you to
take over driving the wheelchair when your toddler runs out of energy.
“Generally, when the kid’s very young, all we do
is get them to drive first. Then as they learn the system we can then get
them independent in terms of turning the chair on and off, changing speed
and tilting themselves back,” Kingscote says.
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Manufactured by Adaptive Switch Laboratories, the wireless attendant control allows you to control one or more directions of your youngster’s power wheelchair.
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“We can slowly introduce more features to them as
they get more competent in the chair, so that’s something that’s important
to know: Don’t try and do everything straight away — drip-feed the
information.”
