Assistive Technology and Adaptive Equipment for Children with Cerebral Palsy
This article has been fact checked by a Board Certified Pediatrician. Sources of information for the article are listed at the bottom.
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Assistive technology is a broad term that includes any device or piece of equipment that can be used to help a person perform some type of activity or improve their ability to function. An adaptive device is any tool or other device that has been altered in a specific way that makes it easier for a person with a disability to use.
For a child with cerebral palsy, there are many different types of devices that can be used to allow for participation in more activities, enhance learning, improve communication, hearing, and mobility, and to make life easier. Assistive technology is crucial in helping a child succeed and transition into independent adulthood.
How Children Can Benefit from Technology
Cerebral palsy causes a number of different types of disabilities, from issues with walking to hearing difficulties, and the ability to communicate or even hold a pencil. The severity of these disabilities ranges from mild to severe and can impair quality of life, independence, and all aspects of health from physical to emotional and social. The use of assistive technology devices can provide a child with a great number of benefits, including:
- Better academic performance
- More inclusion in activities and recreation
- A more engaged social life
- Improved communication with others and a better response to a child’s needs as a result
- Increased ability to express emotions
- Enhanced self-confidence
- Greater independence and self-sufficiency
- More opportunities
While the symptoms and complications of cerebral palsy can vary widely from one individual to the next, most children with this condition have some degree of mobility limitation. Many children are unable to walk, while others can walk with assistance, and some without any support at all. Aids used to enhance mobility can be quite low-tech, including the use of walkers and non-electric wheelchairs.
There are also aids that use more technology, such as electric wheelchairs. These help children who struggle to use their arms and hands get around with just the touch of a button or joystick. Lifts can be used to help a child move between floors in the home, into and out of vehicles, and from sitting to standing positions. A power scooter is another option for mobility.
An exciting technology that holds great promise for helping disabled individuals gain more mobility is called functional electrical stimulation. A small device is used to deliver electrical impulses to stimulate specific muscles. It works by activating the nerves and causing the muscles to move, training the muscles to function better over time. Studies using this device have proven that children with spastic cerebral palsy can benefit by being able to walk more easily and with less pain. This is not a device that will work for every child, but many who walk with difficulty may benefit.
Technology for Communication
For many children with cerebral palsy, communication is an issue. A child may have muscles in the throat and mouth that are affected by the condition, creating difficulty forming words. This makes it challenging to express emotions and needs, to learn in school, and to be social with others. Children can work with speech/language therapists to improve communication skills, and these professionals often use assistive technology:
- Electronic communication boards. These devices are much like a tablet or may even be a tablet using a special app or program. A communication board presents the child with a choice of letters, words, numbers, and pictures. The child can then select them to communicate with others. Depending on a child’s ability, they may need instruction from a speech/language therapist to use a communication board successfully.
- Low-tech communication boards. The low-technology version of this is simply using a pencil and paper to express oneself. This is only useful for a child who can grip a writing implement and use it to clearly write words or draw pictures. There are also boards containing photographs of objects that a child can point to, such as a glass of water, or a toilet. This way, a child who is too young or is unable to deal with the complexity of a tablet may indicate their needs.
- Speech-generating devices. There is a more advanced version of an electronic communication board that actually functions to generate speech. The child types or taps words and sentences, and the device formulates it into speech that others can understand clearly.
- Eye-tracking devices. This type of device is best used with children who are unable to use their arms, hands, or fingers to tap at images on a communication board. These individuals can benefit from an eye-tracking device, which follows where the eyes are moving and looking. When the child looks at a specific word or image on the communication board, it is selected without the need to actively tap on the surface.
Typing and Writing Devices
Many children with cerebral palsy struggle with the fine motor skills needed to hold a pen or pencil and to hit individual keys on a keyboard. Written communication is important for children who cannot speak easily or at all, and it is also necessary for academic work. There are several devices available that can facilitate a child to write.
Simple, low-technology grips or specially-designed pencils are adaptive devices that can enable a child to hold a writing implement and manipulate it. A weighted pen or pencil, for instance, can help a child get more leverage and more easily manage the tool while learning how to write. A steadying device can be attached to a pen or pencil to help a child with shaky movements. Having a desk with a surface that can be adjusted for height and angle can also help a child get the right alignment and most comfortable position for writing.
A child who struggles to use traditional writing implements may benefit from the opportunity to type, but some children also have a hard time using keyboards. A simple adaptive device is a pointer that is attached by Velcro to the hand or wrist, allowing a child to press small buttons on keyboards, tablets, or phones. Other typing technologies that can help children communicate more effectively include word prediction software and spell- and grammar-check.
Hearing loss is an issue that many children with cerebral palsy struggle with, but the technology has come a long way in providing devices to improve the ability to hear. Hearing aids, for instance, can facilitate hearing for those who are not deaf but have some level of hearing loss. For children with more severe hearing deficits, a cochlear implant may be a good option.
Cochlear implants have a small device that is inserted beneath the skin inside the ear and an outer piece that sits behind the ear. It works by stimulating the auditory nerve and bypassing damaged parts in the ear that prevent hearing. Getting this device requires surgery, and it can take several weeks before it is ready to use and for the child to be able to hear.
Getting a cochlear implant is not recommended for all children with hearing difficulties. It is expensive, requires surgery, and comes with some rare but serious health risks. It is particularly recommended for those children who have multiple special needs and complications from cerebral palsy. Being able to improve hearing can be a significant benefit for a child struggling with several disabilities.
Other devices that can help children who are hard of hearing include assistive listening systems. These are devices that capture sound, amplify it, and deliver it to the ear. A good device can help a child hear their teacher speaking in the classroom, for instance, even with a lot of background noise.
Technology to Help with Daily Activities
In addition to the assistive technology devices that help children with specific issues, like hearing, writing, or communicating, there are a number of adaptive tools that help with the activities of daily living. These are devices that can make life easier, make a child more self-sufficient, and help them achieve greater independence. Some of these specially-adapted devices are:
- Specialized toilet seats, safety bars, and bathing benches in the bathroom
- Sponges and brushes with longer handles
- Eating utensils with grips or that are weighted
- Plates and bowls with non-slip bottoms
- Non-skid rugs
- Dressing aids
- Tables that can be moved up and down
- Adaptive scissors and art supplies
- Key turners
- Aids for positioning in bed or on couches and chairs
A child with cerebral palsy can benefit in major ways from using assistive technology and adaptive devices. Parents can advocate for what their children need by working with the public schools. With an evaluation, a child can get an individualized education program (IEP) through the special education department. This may include assistive devices that the school will then provide. Parents or adults with cerebral palsy can contact government organizations, advocacy groups, and community groups to seek assistance with paying for and getting these much-needed devices.