Assistive Devices for Cerebral Palsy
Introduction
Many children with Cerebral Palsy can be more independent with the help of (simple) equipment.
These devices aim to help the individual improve their quality of life and lead a more independent
lifestyle.
There is vast array of assistive devices that can prove useful for a child with CP. The selection of devices
depends upon the needs of child. While choosing an assistive device, it is important to note that[1]:
There is no one size which fits all
Each child is different. Be creative and find different ideas.
Discuss with the child and the family first: do not give people equipment because you think it is
needed. Make sure the family wants to use it.
Children grow, so the equipment should grow with them.
Advantages of Assistive Devices in CP
There are a variety of pros of using Assistive devices in CP. The use of such devices can:
1. Inspire confidence, improve quality of life.
2. Make the child more self-sufficient and independent.
3. Give improved Educational Outcomes – provide tools needed to keep up with school curricula.
4. Increase Understanding – Comprehension, reading ability, and vocabulary improve, reducing the
learning curve for children facing CP.
5. Facilitate Communication– Aid in expressing feelings, as well as help in understanding those of
others.
6. Prove to be a support for Caregivers – reinforce understanding between patients and caregivers,
ensuring parents recognize and accurately interpret feedback from the child.
7. Lead to occupational gains in the long term.
Types of Assistive Devices
The Assistive devices can cover a range of areas[2]:
1. For better mobility
2. For better communication
3. For help in ADLs
4. For better participation in society
Comprehensive rehabilitation and assistive devices are an integral part of life for patients with CP
throughout their lifespan[3].
Below are some photos of assistive devices that are not necessarily correct for the child:
Wheelchair is far too big for The chair does not support him Does not look as if she needs
him, but the grandmother, who enough: not helping to keep his this much support;
is taking care of him is very head up, the knees are “falling” This girl could sit
happy with it, because she does side-wards, the arms are turned independently; just needed a
not need to carry him inwards. chair so she could put her feet
This is a very floppy boy; and on the floor; no need for a
reflects the reality. This picture was special chair.
taken when trying to find a better
chair and sitting position for him
Orthoses
These are external devices[4] that are often required to keep joints working properly in the upper and
lower limbs. They can help improve walking, decrease contracture and increase endurance. They also
help to reduce trips or falls. They are made from a variety of materials with some very fashionable
patterns now. They are generally slid or strapped on with Velcro. Orthoses help the child become more
independent.
Case Study
Roelie Wolting, our Cerebral Palsy expert, has reported on a Doctors Review of Assistive Chairs for
children with Cerebral Palsy:
A doctor was doing research on the causes of disability in children. He was meeting a lot of children
with Cerebral Palsy and their families. The children were usually lying on a mattress and did not have
any assistive devices. The doctors wrote a project proposal for an Embassy in order to be able to
provide all these children with special chairs specifically designed for Cerebral Palsy. He was granted
the money and had the chairs made by a local carpenter. He then gave the chairs to the families and
asked them to have the child sit in the chair because that is much better for the development of the
child. After three years the doctor wanted to know what had been the impact of these chairs on the
development of the children and their families so he visited all families again. He found that 95% of the
chairs were not being used.
Here are some of the reasons why they were not used:
The children could not sit comfortably in the chairs because they were not ‘custom-made'. If a
chair is not comfortable, nobody wants to sit on such a chair for hours.
The chairs were often too big for the small family rooms.
The doctor thought this would help the family but he did not discuss with the family their needs
and their priorities.
Here is a picture of assistive chairs being distributed, a 'one size fits all.' This is still done in many
countries today.[1]
Assistive Devices for Children with Cerebral Palsy
You can find many ideas for assistive devices for children with cerebral palsy. One of the books to get
ideas from is: Disabled Village Children. Some of the chapters are listed below in additional resources.
The most important things to remember when looking at providing an assistive device for a child with
cerebral palsy are:
That it fits the needs of the child and the family and,
It is made to measure for the child / it fits the child
Here are some ideas of different assistive devices from eating to walking.
Cups with cutouts
can allow for Cups with handles and lids make it
Deep bowls can
easier drinking as Adaptive cutlery makes easier to handle and avoid
make it easier to get
the child does not it easier to hold and use. spillages if there is difficulty with
food onto a spoon
have to extend motor control.
their neck as much.
Spoon with hand
Non-slip mats under the
strap can help if Some form of
plate can prevent the
there is difficulty rubber around the Wedges under a child may help
plate from moving
with fine motor handle of the promote cervical extension and
around if there is
control and the child spoon can assist use their arms for play
difficulty with motor
cannot grip with grip.
control.
efficiently
Walkers
There are two types of walkers[5] for pediatric use: anterior walker and posterior or reverse walker.
The posterior walker in the majority of children with CP is the most appropriate as it provides the best
gait pattern and is less energy-consuming. Standard anterior walkers lead to increased weight bearing
on the walker and increased hip flexion during gait. Choose them only in cases where extensor
spasticity predominates. Children with spastic diplegia have problems with posterior balance and tend
to fall backward. In this case, prescribe a walker. The child who walks very slowly in a high guard
position and falls backward after a few steps will benefit from a posterior walker as an aid to improve
his balance.
Posterior Walker Anterior Walker
Conclusion
There have been many developments in assistive devices for individuals with cerebral palsy. It is
important to understand the impairments, needs and abilities of each individual before prescribing an
assistive device.
References
1. Moen, R. D. and Østensjø, S. ‘Understanding the use and benefits of assistive devices among young
children with cerebral palsy and their families in Norway: a cross-sectional population-based
registry study’, Disability and Rehabilitation: Assistive Technology, 2023; 19(4), pp. 1454–1462.
2. Bolton M, Donohoe M. Ambulatory assistive devices for children and youth with cerebral palsy.
Cerebral Palsy. 2020:2963-75.
3. Zeńczak-Praga K, Zgorzalewicz-Stachowiak M, Cesar K. Analysis of using assistive devices by
patients suffering from cerebral palsy-preliminary report. Polski Merkuriusz Lekarski: Organ
Polskiego Towarzystwa Lekarskiego. 2015 Nov 1;39(233):311-5.
4. Melanda AG, Pauleto AC, Iucksch DD, Cunha RF, SMAILI S. Results of orthoses used on ambulatory
patients with bilateral cerebral palsy. Acta Ortopédica Brasileira. 2020 May 22;28:137-41.
5. Tao R, Feng L, Xiao Z, Zhang BH. Posterior versus anterior walkers for children with cerebral
palsy-biomechanical analysis and energy consumption: a systematic review. Journal of
Developmental and Physical Disabilities. 2020 Dec;32:877-92.
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