Wheelchairs for Children
Orbit Tilt Pediatric Wheelchair
A wheelchair isn't just a wheelchair anymore. As recently as five or six years ago, it would not have been possible to say that. There would have been little or no discussion of finding the proper fit for a wheelchair, either. The word "wheelchair" conjured up the image of a boxy, shiny steel frame and vinyl upholstery. If a child needed a chair, little attention was paid to the fact that he or she was growing; the solution was simply to order a larger chair and let the child "grow into" it. No longer! Now there are almost as many wheelchair styles, colors, and options available as there are children to use them. Many manufacturers offer models specifically designed to meet the changing needs of children, while others offer both child and adult models of chairs in their product line. This fact sheet will explore the special considerations in selecting wheelchairs for children and the many kinds of chairs and alternatives available in meeting those requirements.
The first selecting the appropriate chair is the child's needs as determined by his or her age, disabilities, and abilities. The initial decisions are made by professional wheelchair prescribers such as physical or occupational therapists and/or physicians. They will determine how much support the chair must provide, how it will be propelled, and what special features and adaptations are needed. Decisions such as these will determine whether the child uses a manual or powered chair or a wheelchair alternative, and whether special seating systems or supports are needed.
Children and their parents must also actively participate in the selection process. These individuals are most aware of the environment and circumstances in which the wheelchair will be used. Will it be used primarily indoors or outdoors? Will it be used for play, in the home, in school, or in a combination of settings? Will the chair need to be transported? If so, how will it be transported - in a van, a car, or by some form of public transportation? Are there stairs or other barriers to be considered? The answers to these questions will dictate the best chair for the child.
Finally, the child's personal tastes and interests should also be considered. A wheelchair is not simply something a child needs to use; it is an extension of his or her personality. Being comfortable with a chair is more than how it feels to the body; it must also feel comfortable to the personality. Depending upon age, children should be actively involved in selecting the style, color, and features of their chairs from among the choices available to them.
Wheelchairs are available in two basic types: manual and powered chairs. Both types have some common components. Frames are still available in the traditional stainless steel, but the development of new materials has allowed for lighter weight frames.
Wheelchair frames are now made of chrome, aluminum, aircraft aluminum, titanium, an alloy of chrome and other materials, or other lightweight composite materials. The materials used in the frame determine the wheelchair's strength and capacity. Regardless of the materials used, frames are generally available in folding and rigid styles. Folding frames utilize a crossbrace system that allows the wheelchair to be collapsed for storage or transport. Rigid frame chairs do not fold, but many have quick-release wheels and/or axles to allow the wheels to be removed easily for storage and travel. Many chairs are still available in chrome finishes, but it is increasingly common to find chairs with basic or optional frame colors, including black, white, pastels, brights, and neons.
Upholstery must be rugged enough to withstand daily use and a variety of weather conditions. A number of materials and types are currently available, including nylon, velour and polyester, parapack cloth, vinyl, and leather. Often upholstery is black, but more manufacturers now offer a selection of colors and styles to meet individual preferences.
Wheelchair Seating Systems
Seating systems are frequently selected separately from the wheelchair itself, although some wheelchairs include seating or posture support systems. If the seating system is ordered separately from the chair, it is essential to ensure the frame is compatible with the seating system being considered.
Brakes on manual chairs are usually wheel locks applied manually as "parking brakes." Several styles are available, but most brakes are applied by toggling with a pushing or pulling motion. Brakes can be mounted at different heights depending on the user's needs, and brake lever extensions and other modifications are often available. Powered chairs usually feature electromechanical and/or dynamic brakes. Dynamic brakes engage when the chair is not powered in forward or reverse motion.
Wheelchair Wheels and Tires
Wheels and tires are available in a variety of types and styles. Most wheelchairs use a four-wheel system comprised of two large wheels with tires in the back and two smaller casters in the front. Wheels are generally aluminum or molded composites. The most common rear wheel is 24 inches in diameter, but other wheel sizes are available. Most chairs are equipped with pneumatic tires, but several other types are also available. Tire options include mag tires (oversized width), off-road tires, steel-reinforced radial tires, semi-pneumatic tires (a combination of solid rubber and air-filled tubing), and solid tires (tires without air space or tubes). These tires are extra-cost options on most chairs. The most common caster is 8 inches in diameter with solid tires. Some manufacturers offer smaller casters for specialized use.
Footrests are usually incorporated into the frame of a rigid frame chair. Folding chairs offer a range of options including fixed, detachable, swing-away, or elevating legrests, or legrests featuring a combination of these elements.
Armrests are generally available in full- and desk-length models, and may be detachable, height-adjustable, flip-up, have a combination of features, or be fixed. Some chairs, especially lightweight or sports models, are designed to be used without armrests.
No matter what type of wheeled mobility assistance is chosen, it is always a major investment. Assistance with finances is dependent upon available medical insurance and/or eligibility for medical or social services or income support available from a variety of sources. Some of the common sources for funding of Children's wheelchairs in Ontario:
- Assistive Devices Program (Ministry of Health Ontario),
- Easter Seals,
- Community Service Clubs,
- Private Insurance Plans,
- Children's Aid Societies (For their wards only),
- School Boards (For products needed at school)
- and occasionally, Church Groups.