Assistive devices for children with CP
Specialized technology devices provide individuals with cerebral palsy the opportunity to enjoy life independently. Devices are available in various shapes and sizes to ensure that every child with CP is able to receive the assistance they need as they transition into adulthood.
Benefits to using assistive devices include:
- Improved educational performance and staying on track with school program
- Ability to clearly express feelings, thoughts and emotions
- Increased vocabulary, comprehension and reading level
- Devices can be mounted on mobility aids to meet child’s needs throughout maturity
- Parents no longer have to guess their child’s wants or needs
- Communication skills will enable employment and independent living
Similar to mobility aids, the overall advantage to using assistive devices is that they allow for an improved quality of life for a child with cerebral palsy. With the help of these tools and devices, children with CP are given the opportunity to be self-sufficient and participate in everyday life with confidence.
Children with various types of cerebral palsy often struggle with the essential ability to communicate. This is due to symptoms of CP such as muscle spasms in the throat, mouth and tongue. These physical limitations make it difficult to form words or sentences, which can make daily life a challenge for children and parents alike.
Assistive communication devices empower a child with CP to meaningfully contribute to conversations and form friendships and relationships. With the help of these devices, children with CP are able to ask questions, express emotions and actively engage in the world around them.
Electronic communication boards
An electronic communication board is a tool that allows children to choose letters, words and phrases on a screen to verbally express their thoughts and emotions. These boards are similar to electronic tablets and contain letters, images, photos and symbols that a child can point to with their finger or a pointer tool. Then, the selected words or symbols are generated into sentences that are read out loud for others.
Images and phrases are organized into categories such as food, people, sports and objects so that children can easily search and select the words or phrases they want. Generally, communication boards can produce 8-12 words per minute.
The level of training needed to operate a communication board depends on the child’s existing level of literacy, as they may need to be taught the meaning of symbols and images before using the device. This can be done in speech therapy where a Speech Language Pathologist (SLP) will teach the child how to use the assistive device to communicate.
Communication boards come in two basic types:
- High-tech boards — includes speech generation and eye-tracking technology to assist children with limited mobility in arms, hands or fingers
- Low-tech boards — a basic sheet of paper that allows children to point to letters or words to display what they want to communicate
Oftentimes, individuals with cerebral palsy have difficulty moving their arms, wrists, hands or fingers. This can make selecting images or symbols on a communication board difficult. Fortunately, there is eye-tracking technology available that eliminates the need to actually push a button or use a pointer.
Many high-tech communication boards feature eye-tracking technology that functions like a mouse on a computer, allowing users to make eye contact with a symbol or letter for a short period of time to make a selection. Once a symbol has been “selected,” it is received by the device in the same way it would have been with a physical point or click.
Eye-tracking devices are incredibly helpful for children with a more severe level of CP that limits their upper mobility. This type of technology is often utilized during speech therapy and treatment to improve the ability to express thoughts and ideas. Parents of children who have limited movement in their arms, hands or fingers should seek out communication devices that operate using eye-tracking technology. This will assure that a child’s development or communication isn’t being restricted by physical capabilities.
Assistive hearing devices
An estimated 20% of children with cerebral palsy also have a hearing impairment.
Hearing loss of any severity will affect the way a child with CP matures and is able to communicate with their peers, teachers and family. Deafness on its own is a challenging condition, but for children with CP, it can further complicate physical and cognitive abilities. If a child with CP has limited mobility in their hands and fingers, it may be difficult to communicate through sign language or braille letters. This severely limits the linguistic options for those who are hearing impaired.
While deafness is a permanent condition that cannot medically be reversed, there are various assistive hearing devices that can help individuals with mild to severe deafness lead an independent life.
Cochlear implants are mostly designed for the hard of hearing and those who are moderately to fully deaf. This type of implant is especially recommended for children with CP that have a coexisting condition, such as blindness or muteness.
While cochlear implants are not technically a hearing aid due to the way in which they are inserted, they do provide individuals with the ability to hear loud noises and understand spoken words. This can dramatically improve the quality of a child’s life who is living with CP and hearing loss.
How does a cochlear implant work?
Cochlear implants are made up of two parts, a small implant that is surgically placed under the skin of the ear, and an external device that sits behind the ear. The implant bypasses the damaged areas of the ear that can’t receive sound and stimulates the auditory nerve, where it then interprets the signal as sound.
Cochlear implants are installed while an individual is under general anesthetic and the surgical process usually takes around 2 hours to complete. Patients are generally released from the hospital the day after implantation.
After surgery, patients will not be able to hear immediately. Approximately 3-6 weeks after the surgical wound has healed, individuals will be fitted for the external devices, which will be programmed specifically for the child. They should then be able to hear with the help of their cochlear implants.
In order to determine if a child with CP is a good candidate for cochlear implants, there are a few factors to consider:
- Current linguistic skills
- Level of hearing loss or severity of deafness
- Child’s overall health
- Ability of child or family to commit to post-implantation therapy
When considering if cochlear implants are a viable option for a child with CP, it is important to take into consideration the potential risks associated with a surgery like this. While there are many benefits, there are also dangers that come with cochlear implants that parents should be aware of before making the decision to have the surgery done.
Disadvantages to cochlear implants include:
- Not recommended for the mildly deaf
- High financial cost ($40,000-$120,000) typically not entirely covered by insurance
- Surgery is performed under general anesthesia, which carries a small risk
- Possible development of necrosis near the implant site
- Facial nerves can sometimes be damaged during surgery
- Increased risk of meningitis, dizziness, vertigo, blood and fluid collection at surgery site
While it’s always a good idea to be aware of the potentially adverse effects of a procedure such as cochlear implants, the risks associated with this surgery are rare. Implantation is generally considered to be a safe, beneficial procedure.
Adaptive writing and typing aids
Children with CP often have reduced hand or finger movement, as well as decreased grasping power and strength. This can affect their ability to write or type, as they may have difficulty using a traditional writing utensil or keyboard.
Adaptive tools that help children with disabilities gain control over their movements and perform tasks such as writing and typing are instrumental to ensuring that they stay on track with their educational program.
There are various aids that can help individuals with CP learn the valuable skill of writing without having to worry about being in pain or straining different parts of the body.
Writing aids come in the form of:
- Pencil or pen grips — available in various shapes and colors to help children comfortably hold onto their writing utensil while activating the proper hand muscles for better handwriting
- Weighted pen or pencil — the weight can be transferred to any writing utensil and is used to provide children with extra leverage and guidance as they learn the mechanics behind writing
- Slanted writing board — provides a flat, customizable surface for children with disabilities to write on. The angle of the board will help keep muscles relaxed and properly aligned as they improve fine motor skills needed to write
For children with limited mobility in their hands and arms, a typing aid can be extremely beneficial to provide the additional support needed to press small buttons or keys on devices such as communication boards.
Typing aids are fastened around the hand with a velcro or elastic brace and come with a metal or steel “pointer” that extends out of the brace. Individuals can use the “pointer” of the typing aid to press down on the keys on a keyboard or to steadily push smaller buttons, such as on a telephone or calculator. This can allow children to use technology that was previously difficult for them, as it is transferrable to any device.
Assistive devices to help with daily tasks
Children with cerebral palsy often have a harder time completing fundamental daily activities, such as getting dressed in the morning or brushing their teeth.
The use of assistive devices to help with everyday tasks in the home can dramatically improve the way that children with CP view themselves once out in the world. By equipping them with assistive devices that help to perform daily responsibilities, this will give a child with CP the confidence to begin to live an independent life.
Assistive devices to help with everyday activities include:
- Adaptive dressing aids
- Long handle bath sponges and brushes
- Adaptive bath benches
- Raised or lowered toilet seats
- Safety grab bars in rooms
- Weighted silverware, cups, bowls and plates
- Adapted scissors
- Reaching aids
- Manual house key turners
- Non-slip mats
- Pull-out tables next to bed, couch, chairs
- Bed positioning aids and pillows
Getting assistive devices for a child with CP
Once a child with CP has been evaluated by a physical therapist, occupational therapist or an orthopedic surgeon to determine which physical limitations require additional assistance, these professionals will be able to steer you in the right direction to locate the appropriate assistive devices.
There are countless assistive devices available that can provide a child with CP the support needed to connect with their loved ones and live self-sufficiently. With devices that assist with speaking, hearing, writing and completing daily tasks, this offers children with cerebral palsy the chance to lead a life that is no different than their peers.
If you have any more questions about cerebral palsy or assistive devices, try downloading our free Cerebral Palsy Guide.