Adaptive equipment may be anything that helps a child with their positioning, mobility, and activities of daily living. Physical therapists can assist with recommending positioning equipment including wedges, bolsters, floor sitters, sidelyers, and standers (which can be prone, supine, or sit to stand) as well as mobility devices including wheelchairs, gait-trainers, and walkers.
Occupational and Speech therapists are typically more involved with devices that would assist with feeding, posture, fine motor skills, and communication devices (Assistive communication devices). Physical therapists may also recommend orthotics for the lower extremities which could be KAFOs (longer leg braces), AFOs (ankle-foot orthoses), SMOs (shorter than AFO’s to just above the ankles), arch supports for shoe inserts, and recommendations for appropriate shoe wear for children and toddlers.
Why Is Adaptive Equipment Important?
Adaptive equipment and orthotics can provide optimum positioning to help children interact more efficiently and age appropriately in their environment. They provide support when children have neurological impairments affecting their muscle strength and tone which may not allow them to sit, stand, or walk independently.
For example, a child nearing 1 year of age that is still not able to sit, crawl, or pull to standing without considerable or maximum assist from a therapist or caregiver would benefit from a stander to allow them to be upright to play, see, and interact with their family members and environment in a position that is more appropriate for their age. The child’s head control is a factor in deciding whether it should be a prone or supine stander or one that moves from sitting up to standing. Some of the other potential health benefits of being in a stander daily are:
Improves muscle strength in the legs
Improves endurance and overall cardiovascular health
Prevents or improves contractures in the legs by providing a gentle stretch.
Reduces spasticity in the legs
Improves bone mineral density and strengthens bones.
Prevents fractures
Walkers, gait-trainers, and wheelchairs can help a child learn to move more independently in their environment. In addition to physical therapy, they can help strengthen and lengthen muscles, prevent contractures, improve bone mineral density, build endurance, and promote confidence and self-esteem. Positioning equipment can also help prevent contractures, strengthen and lengthen muscles, and allow a child to access toys using their hands with optimum support for their trunk and head. Orthotics can provide lower extremity support for weak muscles, prevent contractures, and provide a stable base of support needed to help a child progress with their skills for standing and walking.
How Does Pediatric Physical Therapy Help With Adaptive Equipment?
Pediatric physical therapists work very closely with DME companies (Durable medical equipment) and Orthotists to help parents schedule consultations, assist with recommendations for appropriate equipment or orthotics, and to be available for deliveries and fittings to ensure the therapeutic goals and needs of the child and family are being taken care of. A lot of these companies will schedule consultations and fittings with the physical therapist at their clinic or in the child’s home which makes the process comfortable and easy for the parents and children.
The physical therapist can be involved in requesting orders and writing letters of medical necessity that may be needed for the DME or orthotist to start the process of obtaining authorization from the child’s insurance company. After being fitted with their equipment or orthotics, the therapist will then monitor the child’s positioning and progress during sessions and help the parent with communication that may be needed with the providers to make adjustments as needed.
