Adaptive Equipment: When Is The Right Time To Start?

Adaptive equipment can make a world of difference for a child with gross motor impairments, such as Cerebral Palsy. Adaptive equipment includes custom devices designed to support posture, enhance mobility, and foster independence and participation. When the right equipment is matched to a child's needs, it can open doors to learning, play, and meaningful participation at home, school, and in the community. At Coastal KIDS, we have therapists who specialize in adaptive equipment and can help support you and your child in finding the most appropriate devices to help them thrive! 

What is adaptive equipment:

Examples of adaptive equipment include (but not limited to) wheelchairs, standers, gait trainers, walkers, and bath chairs. These devices are custom configured for each child’s specific needs and they are not one size fits all. They are designed to support a child in an optimal posture and allow for maximal independence of positioning or movement. For example, a wheelchair can allow a child to sit with good trunk support, while mobilizing around a room on their own or with some help. Equipment has important physiological benefits, too. For example, a stander allows for important weight bearing for bone mineral density and healthy hip development.

When should adaptive equipment be introduced:

At Coastal KIDS, we like to follow the evidence based approach of the On Time Mobility framework. This approach supports providing children with beneficial opportunities for upright positioning and movement as early as possible, as research has shown that the first few years of life is an important time for neuroplasticity and motor development. The concept behind On Time Mobility is to offer equipment for standing and mobility around the same time that their peers would be developing these skills, which is typically in the first year of life. For example, this could mean introducing a stander at around 9 months old, and a gait trainer and/or wheelchair at 12 months old. This allows the child engage in the same, important learning and social experiences that are achieved through standing and mobility. To learn more about On Time mobility, check out this article from Rifton: https://www.rifton.com/education-center/articles/on-time-mobility-framework 

How do I order adaptive equipment:

To order equipment, a physical therapist will evaluate your child and determine which equipment is appropriate and what specific parts are needed on the device to best support them. We work with an assistive technology professional (ATP) to select and order the equipment. Careful consideration is made to determine what your child needs now and what they may need in the future. Insurance only covers new equipment about every 3-5 years based on growth or medical changes, therefore its very important that the correct equipment and parts are ordered from the start. 

If you have questions about adaptive equipment or are interested in an evaluation for your child, reach out! We have a team of skilled and compassionate physical therapists to help you along this journey. 

~ Emily Messerschmidt, DPT
Adaptive Equipment Specialist @ Coastal KIDS

Citations:

Morgan C, Fetters L, Adde L et al. Early intervention for children aged 0 to 2 years with or at high risk of cerebral palsy, International clinical practice guideline based on systematic reviews. JAMA Pediatr. 2021;175(8):846-58. DOI: 1001/jamapediatrics.2021.0878

Paleg GS, Williams SA, Livingstone RW. Supported Standing and Supported Stepping Devices for Children with Non-Ambulant Cerebral Palsy: An Interdependence and F-Words Focus. Int J Environ Res Public Health. 2024 May 23;21(6):669. doi: 10.3390/ijerph21060669. PMID: 38928915; PMCID: PMC11203597.

Sabet A, Feldner H, Tucker J, Logan S, Galloway JC. ON Time Mobility: Advocating for mobility equity. Pediatr Phys Ther. 2022;34:546-50. DOI: 10.1097/PEP.00000000000009392