Developing the Foundation for Pediatric Wheelchair Skills

Transitioning from a stroller to a self-propelling wheelchair is a significant milestone in a child's journey towards independence. As therapists, we play a crucial role in facilitating this transition, ensuring that children not only adapt to using a wheelchair but thrive in doing so. Developing wheelchair skills early is paramount, as it sets the foundation for mobility, independence, and confidence. By introducing essential skills and exercises when the child is developmentally ready, we can make this transition smoother and more empowering for our young clients.

Why Pediatric Wheelchair Skills Matter

Physical development

Learning wheelchair skills promotes physical strength, coordination, and endurance. It encourages the use of muscles that are vital for pushing and maneuvering the wheelchair, contributing to overall physical health and fitness.

Independence and confidence

Mastering wheelchair skills early helps children feel more in control of their environment. It fosters a sense of independence, allowing them to navigate their surroundings confidently, reducing the reliance on caregivers.

Cognitive and motor skills

Engaging in wheelchair skills training aids in developing cognitive and motor skills. Children learn spatial awareness, problem-solving, and hand-eye coordination, which are essential for everyday activities.

Social integration

Proficient wheelchair skills enable children to participate more fully in social activities, play with peers, and engage in school settings. This can improve their social skills, self-esteem, and overall quality of life.

Tips for Learning Wheelchair Skills

To effectively prepare children for using a self-propelling wheelchair, therapists can incorporate specific exercises that enhance bilateral coordination, strength, and control. Here are some practical tips and exercises to consider:

Symmetrical bilateral coordination exercises

These exercises involve using both hands simultaneously to perform the same action. They are foundational for developing the strength and coordination needed to push a wheelchair forward or backward.

• Drumming. Use hand drums or even a table surface to encourage rhythmic drumming with both hands. Start with simple beats and gradually increase complexity as the child learns to copy and follow.

• Clapping games. Engage in clapping games that require the child to clap their hands together in response to a rhythm. This can be both fun and effective in promoting coordination.

• Pushing a rolling pin. Have the child practice pushing a rolling pin or a similar object back and forth using both hands. This mimics the forward and backward motion required to propel a wheelchair, building the necessary strength and muscle memory.

Asymmetrical bilateral coordination skills

These activities require both hands to work on the same task but move in different directions, which is critical for maneuvering and steering the wheelchair.

• Dancing and marching. Encourage dancing or marching activities that involve arm movements. For example, raising one arm while lowering the other or swinging arms in opposite directions. This helps children learn to control movements independently and simultaneously.

• Propelling ride-on mobility device. Introduce a ride-on mobility device, like the Firefly Scooot or Bella's Bumbas, that requires steering with both hands. This activity simulates the forward/backward movement needed to propel a wheelchair and can help children learn to turn left and right smoothly.

• Playing with steering wheels. If available, use a toy steering wheel to practice turning motions. Although a slightly different action, this can help develop useful wrist and arm movements.

Building Up to Complex Skills

As a mom as well as a technician, I know that using resistance bands or weights to increase complexity may not be interesting for kids, so keep their engagement with any song or game that captivates their attention and pull in family or friends to help motivate.

• Progressive resistance. Start with simpler exercises that focus on basic coordination and gradually introduce more complex tasks that require increased strength.

• Obstacle courses. Set up small obstacle courses where children can practice navigating around objects. This can be done with a ride-on toy, being helped to get started, and later in their wheelchair to simulate real-world environments.

• Consistent practice. Help parents to incorporate regular, short practice sessions into daily routines rather than use their energy on infrequent, longer ones.

• Keep it positive. When challenges by activities, it can be frustrating for a child, so it's important to end with success. This can be done by scaling back to a preferred or previous successful activity.

Conclusion

Development of pediatric wheelchair skills is a vital step towards ensuring children's independence, confidence, and overall well-being.

A great way to learn pediatric wheelchair skills in a safe, inclusive environment is with the Scooot, a 4-in-1 mobility rider designed to help children with special needs play, explore, and participate in ways that suit their own abilities. Scooot enables children to be down on the floor with their peers, learning invaluable skills through play. 

By prioritizing these techniques in your therapeutic approach, you will not only be enhancing their physical abilities but also empowering children with the confidence and independence they need to navigate their world on their own terms.