Wheelchair for 2 Year Old??

[shawntain]

Hi Ladies!

So, my little guy, 27 months, has mild/moderate CP -- fluctuating tone mostly that makes it hard for him to get his balance and calibrate his movement.  At first glance you wouldn't notice it if he was sitting or playing on the floor.  He walks in a gait trainer/walker and the physiatrist has predicted that he will walk independently, even play soccer someday! 

Our PT on the other hand is a glass-half-empty person by nature and today she suggested it was time to look at getting a wheelchair for him.  She is more skeptical and gloomy about his chances of walking, whereas I have always felt intuitively that he would.  She says it will be easier for him to get around and function at school in a chair.  She doesn't know we are already attending homeschool co-op and probably won't enroll him in school. 

Is the wheelchair going to reduce his motivation to walk?  I'm having a tough time with this decision.  As it is, we work a lot with him using Conductive Education principles (Hungarian system) and putting him in a wheelchair at this age seems really inconsistent with encouraging maximum independence.  Also, I still really want him to master crawling, which we are working hard on.

Thoughts appreciated!  I want to be sure I'm considering all sides.

Warm wishes,

Shawntain

[beachcomber]

I don't have personal experience, but it seems to me that 2 is young for a wheelchair for him given the positive prognosis his physiatrist is making. It's certainly something where you have time on your side. If you're planning to homeschool, you have even more time before you have to decide about this.

[askew]

Sounds too early to me, and I have a not yet walking about to turn 2 year old. Our Feldenkrais practitioner is pretty against most adaptive equipment until it is clear the child will never....whatever it is. I would certainly wait. At 2 you can still use a stroller, right? 

[mrs.basil]

Although 2 yo isn't too young to introduce adaptive devices for kids who _need_ them to explore their environment, it doesn't sound like your little guy needs this at all.  If he is able to explore his environment, then that pretty much meets his needs now.

Prognostically, if a child sits by age two, then they will generally walk.  I'm surprised that your PT seems so pessimistic.  If he's already almost crawling, I would be _stunned_ if he didn't walk later in life.

I'd say to go with your instincts on this one :)

[shawntain]

Thanks so much ladies, you are echoing my own thoughts....  I try to consider all opinions but I just don't see the sense in the PTs suggestion at all.  He's doing great getting around on his own and in his walker when we're out in the community and is super motivated to walk.  Her thinking persuades me even more that school may not be the most supportive environment for him to reach his physical goals -- taking a little longer to walk on his own vs. whizzing in a chair to keep up with everyone else, etc.  Thanks again for your input!

[beachcomber]

Maybe it's time to find a more positive PT? It must be hard working against that kind of negativity in your little guy's circle of care.

[bandgeek]

I would probably just use a regular stroller until his needs become more apparent.  We got DD's wheelchair when she was 1, but her CP is very severe, and she has heavy equipment that weighs down a regular stroller.  She's 3 1/2 now and still has not gained head control so for us that was the right decision.  But since he can sit up and get around a bit...ehhh...I'd wait it out.  Here, the process of getting a chair takes about 6 months.  You should check into the time frame for your DMEs, insurance, ect so you know how far in advance you should get the process started if you decide he'll need something.

On the other hand, if you get something now or in the near future, it doesn't mean you HAVE to continue using it (or even start using it).  If he doesn't need it, you can pass it on, donate it or something.  Assuming you don't have to pay a bunch OOP or anything, it wouldn't hurt anything to go ahead and get it.

[KatWrangler]

As long as a stroller gives your child proper support, I would stick with that at this point.

Gabrielle is 5 and we are considering a wheelchair for her.  But it would only be used for long outings where she tires easily.

[mekat]

I am going to be honest and say I am stunned you think a wheelchair is going to impede development.  You are the parent if you know your child can use a walker or gait trainer for an outing vs a wheelchair then you leave the wheelchair at home and have the child use the other.  Managing what equipment is used and when is parenting decision made with the input of a therapist.   I really don't want the theme "wheelchair equals dependence"  floating out there for other special needs parents facing a similar decision.  A wheelchair is a tool just like a gait trainer or walker or anything else.  It is all in how it is used.   

You can't blame a therapist for making a wrong equipment recommendation when you are not being honest with them.  If a child isn't expected to walk by the age of three when they start attending Head Start/public preschool then it is their job to make sure your child has an adequate way of getting from room to room and school to home by the most appropriate equipment at that time. 

I would realistically look at a typical outing for your child including mundane shopping trips and ask yourself if realistically your child will be capable of doing them a 100% in a gait trainer/walker within an 18 month time period.  If your answer is no then it would be a good idea to either look into a wheelchair or a special needs stroller.  A child with muscle abnormalities needs proper positioning when seated especially after being about all day and getting tired.   A good rule of thumb ds's old physical therapist gave me is under 30 minutes is okay without proper seating support. 

[oaktreemama]

My son has hemiplegic CP. He never really crawled (he scooted) but walked unassisted finally at 20 months-at three yrs of age he runs and jumps.

What bothers me about your post is how unhopeful your PT is. Our experience was the exact opposite. Our nuerologist feared our son may never walk or if he did, he would drag his right leg behind him. He also feared he would be extremely clumsy. Our PT was CONVINCED he would be walking and running because he was so determined.

And she was right. And more importantly her faith gave us faith and her encouragement and belief in our son helped us all so much.

I can't help with the wheelchair decision but I would consider finding a PT with a more positive outlook at what your son can accomplish.

[anj_rn]

My 2 yr old DD has a wheelchair, but she can not walk or crawl.  We do not use it at home, but we use it when we go out (like you use a stroller).  The wheelchair provides her with better positioning than a stroller would, and holds all her equipment.  It can take 6 months to get a wheelchair (fittings, insurance approvals, etc), so your PT might just be planning for the future thinking your child will be in school). 

I would advise you to discuss your concerns with the PT, it might help understand her thought process, and you can let her know what your plans are.  Our therapists are all aware that we will not be sending our daughter to school at this point, they have been very supportive and have helped us plan accordingly.

[hannahgrace]

Our PT pushed for a wheelchair until I put my foot down. I have twins who dont walk at 2.5. A double stroller fits our needs. Not a wheelchair. How on earth would a wheelchair work for twins?? I finally pulled out the stroller and showed them sitting in it and she was amazed at how well they sat. They are well supported like a typical 12 mo old baby.

I would forgo a wheelchair and just get a nice Mclaren stroller.The cost of a wheelchair infuriates me when a decent stroller provides good support for my guys. If/when they enter school, we will use a chicco or mclaren stroller for transport to the classroom. I dont want my kids confined in a wheelchair all day at aschool when they can sit great and can roll about. just my opinion.

[mekat]

Originally Posted by hannahgrace 

Our PT pushed for a wheelchair until I put my foot down. I have twins who dont walk at 2.5. A double stroller fits our needs. Not a wheelchair. How on earth would a wheelchair work for twins?? I finally pulled out the stroller and showed them sitting in it and she was amazed at how well they sat. They are well supported like a typical 12 mo old baby.

I would forgo a wheelchair and just get a nice Mclaren stroller.The cost of a wheelchair infuriates me when a decent stroller provides good support for my guys. If/when they enter school, we will use a chicco or mclaren stroller for transport to the classroom. I dont want my kids confined in a wheelchair all day at aschool when they can sit great and can roll about. just my opinion.

If you really don't trust the school system to not "confine" a child to a wheelchair what makes you think a stroller is going to be any different?  Why would they care if it was a wheelchair or stroller if you really think they would just park your kid in a corner and forget them?  The thought doesn't seem logical to me at all.   The reason for good positioning is because children with abnormal muscle tone are at higher risk for orthopedic problems.  Other children may need positioning support only when they are tired and walk the rest of the time.   Offering good positioning can free their upper body for more academic pursuits if they need good support to maintain a seated position for long periods of time in a classroom setting.   If you can get good positioning in a mundane stroller that is great but most can't and mainstream strollers are just not going to be good option once a child starts to grow out of them even if positioning is adequate for the time being. 

On a side not they make wheelchairs low enough to the ground for preschoolers so they can independently get themselves in and out of their chair and be at eye level with fellow preschoolers.  If you were to put a preschooler in a wheelchair she/he would be a wheelchair user not "confined" to a wheelchair or "bound" to a wheelchair.  Anybody that would use such a term obviously has never had to chase a "wheelchair bound" child through a store at a full run like I have to do at least once a week.  He's a sneaky little bugger.  

[hannahgrace]

Each kid is an individual. The OP and I both dont think our kids will benefit from wheelchairs. There is nothing wrong with that. We know our children best.

How do I know that the school wont park them in the stroller - well they aren't going to have the stroller in the classroom. I will stroll them in and leave with the stroller, if I do not stay for the day.. I will be an active part of the classroom IF I chose that school is the right choice for them.

Wheelchairs are not evil. They just aren't the best choice for every child. End of story.

[mekat]

If you feel strongly about this you may want to become familiar with your school district's policies.  Some require each special ed student (yes even special ed students in preschool) to have adaptive seating in the classroom if they can not sit properly in a regular chair (the school provided the adaptive chairs).   It is hit or miss if your district will require adaptive seating our old district did but our new district doesn't.  Our old district went a step further with this policy and required separate adaptive seating even if the student has a wheelchair or special needs stroller to use.  My son adored both schools so the presence and absence of the different adaptive seating routines didn't bother him one iota and he crawls, rolls and walks in a gait trainer so his wheelchair isn't his only way around.   He attended preschool in both districts but only went to elementary in our new district.