Will he or she walk?
This is a question of tremendous importance to most families with a disabled child. An important role for the clinician is
to help families refocus the goal to gaining maximal efficiency and independence in mobility. The therapeutic team can then
use this framework to help the child and family determine how best to optimize mobility at each stage of the child''s development.
For example, while a particular child may ambulate in the home and in the classroom, his ambulation may not be efficient enough
to hang out with peers on field trips or to keep up with others on a family outing.
When the family understands this, they can begin problem solving and may be guided to an effective solution (e.g., continued
ambulation at home/school but utilization of a wheelchair when it provides for more optimal societal inclusion).
Mobility goals and the need for adaptive or orthotic equipment are driven by what is age appropriate. Evaluation for equipment
to support independent sitting
might occur at 6-9 months, standing around 12-15 months, and mobility over the second year of life.
For the child who has cerebral palsy or any condition which impacts tone and
gait, regular (e.g. yearly) monitoring of the child's gait pattern and musculoskeletal exam by a physiatrist or orthopedist experienced
in gait analysis is critical to ensure appropriate interventions necessary to optimize gait efficiency.
Interventions may include:
- spasticity management
- orthotics
- physical therapy
- surgical interventions
Resources
Information & Support
The following link is to eparent.com, where registration is required but is free. Once on this site, there is a helpful article
called "What you should know about the first wheelchair" that covers many considerations in choosing a chair, including mode
of propulsion (power vs. manual), style, stability, sizing, handles, leg/arm rests, bus accessibiltiy, etc.
For Professionals
eParent.com
Individuals must register (free) for access to this site. Once in the site, there is an excellent article titled "Effective
Planning for Your Child with Special Needs". This is an online article from Exceptional Parent which provides the basics and
links to other resources.
For Parents and Patients
eParent.com
Individuals must register (free) for access to this site. Once in the site, there is an excellent article titled "Effective
Planning for Your Child with Special Needs". This is an online article from Exceptional Parent which provides the basics and
links to other resources.
Helpful Articles
Gormley ME Jr.
Treatment of neuromuscular and musculoskeletal problems in cerebral palsy.
Pediatr Rehabil.
2001;4(1):5-16.
PubMed abstract
This is a review article for professionals which summarizes common neuromuscular issues and treatment options.
