Orthoses, Equipment, and Assistive Technology

Orthoses

Ankle-foot orthoses (AFOs) are the most commonly used type of orthosis in children with cerebral palsy; by holding the ankle at the desired angle, they aim to provide a more stable base during walking and to reduce energy use. Which type of orthosis is right is decided by taking the walking pattern and the goals into account.

Regularly checking whether an orthosis fits properly is important; in a growing child, an ill-fitting orthosis can cause skin irritation or pressure sores. If you notice any redness or marks from your child's orthosis, I encourage you to tell your orthotist.

Seating and Positioning Systems

Properly supported seating systems both make functional participation easier and help slow the progression of spine and hip deformities. Night positioning systems can also be used to hold the joints in a protective position during sleep.

Mobility Devices

Walkers, crutches, and wheelchairs support independent mobility. Introducing a powered mobility device early does not, contrary to what is assumed, reduce the motivation to walk; on the contrary, it can contribute to cognitive and social development.

I want to emphasize that a wheelchair is not a sign of "giving up" or "failure," but rather a tool that increases independence and participation; although many families feel mixed emotions when they first accept this device, they soon confirm that it was the right decision by observing their children's increased freedom and happiness.

Assistive Technology and Everyday-Life Adaptations

Simple assistive technologies such as adapted spoon-and-fork sets, non-slip mats, pencil grips, and tablet access switches can increase your child's independence in daily life; your occupational therapist can suggest solutions suited to your home environment.

Equipment Maintenance and Tracking Growth

Orthoses, seating systems, and mobility devices need to be reviewed at regular intervals; as your child grows, the size and settings of this equipment also need to be updated. Equipment that is ill-fitting or has become too small can, instead of helping, lead to new deformities; for this reason, I encourage you to make checking the equipment a part of your regular health follow-up.

Insurance and the Equipment Procurement Process

In obtaining orthoses, wheelchairs, and other assistive equipment, a disability health board report and a prescription from the relevant health institution are usually required documents. This process can sometimes be time-consuming; applying early can reduce delays, especially in situations where an equipment change is expected due to growth.

Making the Home More Accessible

Simple changes you can make at home — grab bars in the bathroom and toilet, removing door thresholds, lowering frequently used items to a reachable height — can increase your child's independence within the home. For some of these changes, it may be possible to benefit from support programs offered by local municipalities or certain associations; I encourage you to look into this.

The Child's Motivation in Using Equipment

Accepting a new orthosis, seating system, or mobility device can take time for some children, especially school-age children in whom the equipment may raise a worry about "looking different." Personalizing the equipment (favorite colors, stickers), increasing its use gradually, and associating it with positive experiences (doing a fun activity together with the equipment) can make acceptance easier.

Transporting Equipment While Traveling

When traveling with a wheelchair or other large equipment, looking into the disabled-passenger policies of airlines and public transport authorities in advance reduces the disruptions you might face on the day of travel. It can be helpful to carry the brand/model information of your equipment, and any maintenance requirements, with you in writing.

Using Secondhand Equipment

Some families may consider using secondhand orthoses or equipment for rapidly growing children; although this may be appealing in terms of cost, whether the equipment fully fits your child's individual measurements and needs must always be assessed by a specialist, because ill-fitting equipment can cause harm rather than benefit.