Tools for Tykes

Power wheelchair options and benefits for toddlers

by Barbara and Jim Twardowski, RN on January 5, 2015 - 9:12am

Quest Winter 2015
Gunner Myers

At just 22 months old, Gunner Myers is already learning to drive — a power wheelchair, that is. The toddler received a diagnosis of spinal muscular atrophy (SMA), a condition that weakens muscles and makes crawling and walking difficult, if not impossible. So Gunner’s doctor enrolled him in power chair trials at the MDA Clinic at Nationwide Children’s Hospital in Columbus, Ohio. There, each week, staff members teach him how to safely operate a 300-pound power mobility (PM) device. 

The first time Gunner sat in the chair, he was so excited he spun himself in circles. Highly verbal, young Gunner is being taught how to “stop” and “go” on command and avoid potential mishaps, like running over a sibling’s foot.

Currently, Gunner relies on a 7-pound, Swedish-made manual wheelchair by Panthera to get around. But propelling himself in the manual chair quickly tires Gunner, who becomes frustrated when he can’t keep up with his family.

“Increasing their early movement allows young children to explore their environment and develop,” says Angela Meyer, a licensed and registered occupational therapist and assistive technology specialist at Nationwide Children’s Hospital. “Power mobility can begin as young as 12 months.”  

Meyer sees dozens of patients at the weekly MDA clinic and monthly SMA clinic. 

Kids learn through play. They spot a shiny toy, an empty box or a dog’s wagging tail and their curiosity is piqued. The natural response is to move toward the object to examine it.

Children who are in a stationary position can only watch the activities of others and wait to be given things, which can lead to what researchers call “learned helplessness.” In this way, basic mobility enhances a child’s independence and improves psychosocial development.

Permobil Koala
Invacare Power Tiger

Choosing a chair

Selecting a toddler power wheelchair is a complex process best approached by a team of specialists who can evaluate a given child’s needs and advise the parents accordingly. For example, the Invacare Power Tiger with Orbit Seating has a base that is interchangeable with a power or a manual wheelchair. This type of flexibility is especially handy when families travel. 

The Permobil Koala’s narrower base is scaled to fit a child’s size; the wrong chair dimensions for a smaller body type can inhibit a child’s ability to reach when performing tasks such as brushing teeth or pushing an elevator button. The Permobil K450 seat-to-floor function allows youngsters to get on the ground and participate with peers during circle time, and the chair can be elevated up to 26 inches, which makes sitting at a table or counter more comfortable. The ability to engage eye-to-eye with their peers enhances a child’s social interactions. 

Some chairs also can be configured with a tilting seat so the child can rest on his back and let gravity do its work. While the child can choose the color of the chair, parents will appreciate the optional remote stop system.

“I would like to see a larger variety of products on the market,” says Meyer, who wishes power wheelchairs were more compact and had more power functions to allow the child to control tilting or use augmentative communication.

Jamie Myers, Gunner’s mom, is confident her son will soon be ready for his first power chair, and she is convinced it will be good for him. Inquisitive toddlers, like Gunner, tend to quickly adapt to a power wheelchair and thrive on their new-found independence.   

Resource Corner: More tools to enable and enhance toddler mobility

ZipZac
Kimba Neo
MightyTykes Infant & Child Weights

ZipZac 

Toddlers as young as 9 months and as old as 5 years are zooming in ZipZac chairs, which are available in two sizes depending upon the width of the child’s hips. Propelled by the child pushing on two large latex-free wheels, the ZipZac is flush with the floor. Accessories coming soon: IV poles, push handles and foot extensions. 

How much: Prices vary; inquire for details

Kimba Neo 

This foldable stroller-style pediatric wheelchair with tilt-in-space features is compatible with a variety of seating systems. The four twin-caster wheels aid maneuverability, especially in tight spaces. Optional accessories include a canopy, trays and storage solutions. 

How much: Contact an authorized dealer

MightyTykes Infant & Child Weights 

These tiny ankle and wrist weights were designed by a mom for children ages 6 months and older. The waterproof weights come in three sizes: 1/8 lb., 1/4 lb. and 1/2 lb. Weights are intended for short, supervised sessions. Consult with a physician or therapist before using. 

How much: Ranges from $18.95 to $52.95

Financial Concerns

Power wheelchairs cost thousands of dollars. For children with disabilities like SMA who have Medicaid as their primary insurer, the power chair must be FDA-approved and have a billing code in order for Medicaid to cover the costs of the chair. Plus, families often need to modify their homes and vehicles to accommodate such chairs. 

Unlike a manual wheelchair, power chairs are heavy and cannot be tipped to navigate steps or other architectural barriers. The turning radius of a power chair should be compatible with the child’s home. Can they easily turn in the hallways and is there enough clearance to reach the bathroom sink? Transporting the power chair necessitates an accessible vehicle — most often a van with a ramp. Power chairs cannot be easily folded or broken down. 

Contact your local MDA office (800-572-1717 or mda.org/locate) to learn more about how to locate funding resources in your area.

 

Barbara Twardowski has Charcot-Marie-Tooth (CMT) disease and uses a power wheelchair. Jim, her husband, is a registered nurse. The couple lives in Mandeville, La., and writes about accessible travel, assistive technology and related issues.

 


Note: The products mentioned in this article are not endorsed by MDA. When choosing any assistive technology equipment, be sure to do your research and consult with your MDA clinic team, as well as an assistive technology professional (ATP).

 

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