Children In Wheelchairs Research Articles

Bone mineral density and body composition in Polish girls with Myelomeningocele: effects of adapted physical activity and past fractures.

The aim of this cross-sectional study was to evaluate the relationship between the condition of bone mineral density and body composition and the adapted physical activity, the number of past fractures and selected somatic characteristics of girls with myelomeningocele (MMC). The study examined 37 girls with myelomeningocele (MMC) at the age of 11.9 ± 1.8 years. Bone mineral content (BMC) and bone mineral density (BMD) of the forearm were measured by dual-energy X-ray absorptiometry (DXA). Anthropometric measurements were also made and selected anthropological indices were calculated. A percentage of body fat, fat mass (FM in kg) and fat-free body mass (FFM in kg) were calculated, whereas the incidence of fractures of lower and upper limbs was evaluated during interviews. Underestimated BMD characteristic for osteopenia occurred only in physically inactive girls. Low % age-matched was observed in all physically inactive girls, whereas it was less pronounced in physically active girls. Statistically significant positive correlations were found between BMD and: body height, sitting height, body weight, BMI, fat mass and fat-free mass. Regardless of physical activity, significantly higher Z-score values (F = 12.9; p ≤ 0.001) were observed in girls who had not suffered from fractures compared to their peers who reported one or more past fractures in different skeletal locations. Active participation in physical activity of children with MMC may be a factor determining good bone tissue condition. The prevention of fractures in children in wheelchairs can be an important part of maintaining healthy bone tissue and a better quality of life.

Larisa Rudenko

Born in 1943 during World War 2, Larisa Rudenko grew up in Zaporozh'ye, in southeast Ukraine. Having lost her father during the war, she was raised by her mother, a paediatrician, and spent many early days queuing for food rations. Later, things improved and they were able to take family holidays to Crimea. “I saw many unhappy children in wheelchairs there, and mother told me they had polio and there was no treatment”, she tells The Lancet Infectious Diseases. “I wanted to help those children. My mother said that American and Russian scientists were working together on a vaccine to help prevent this horrible disease.”

Intentions of children without disabilities to form friendship with peers with physical disability: a small scale study

ABSTRACT This small-scale study, conducted in Cyprus, considers issues of friendship by exploring the views of children (aged 6–8 years) without disabilities towards peers with physical disabilities. Participants were interviewed with the use of images depicting children with physical disabilities and were asked to justify their friendship, express their feelings and estimate the feelings of unfamiliar children in wheelchairs. It was found that friendships between typically developing children and peers with disabilities are regularly formed on the basis of children’s understandings, attitudes and feelings towards peers with disabilities that appear to mirror the societal stereotypes to disability and arise from the social environment in which children are growing up. In order to encourage children’s sensitivity and understanding towards social inclusion for their peers with disabilities, there is a need for children to have better and more insightful understandings of diversity, social inclusion and acceptance through first hand experiences.

School Bus Transportation of Children With Special Health Care Needs.

School systems are responsible for ensuring that children with special needs are safely transported on all forms of federally approved transportation provided by the school system. A plan to provide the most current and proper support to children with special transportation needs should be developed by the Individualized Education Program team, including the parent, school transportation director, and school nurse, in conjunction with physician orders and recommendations. With this statement, we provide current guidance for the protection of child passengers with specific health care needs. Guidance that applies to general school transportation should be followed, inclusive of staff training, provision of nurses or aides if needed, and establishment of a written emergency evacuation plan as well as a comprehensive infection control program. Researchers provide the basis for recommendations concerning occupant securement for children in wheelchairs and children with other special needs who are transported on a school bus. Pediatricians can help their patients by being aware of guidance for restraint systems for children with special needs and by remaining informed of new resources. Pediatricians can also play an important role at the state and local level in the development of school bus specifications.

How Young Children Evaluate People With and Without Disabilities.

How do preschool-age children evaluate people with disabilities, and does social contact make children more positive toward those who are different from them? To answer these questions, typically developing 3- to 5-year-old children completed tasks designed to measure their social preferences for, and judgments about the actions of, unfamiliar individuals with and without disabilities. Participants preferred pictures of typically developing children over children in wheelchairs, but did not prefer children who were described with disabilities over those who were described with mildly negative facts. In a third task, participants evaluated actions that violated norms more negatively than those that did not, regardless of whether the actors had a disability. Children's participation in inclusion programs did not appear to affect their responses. We consider possible explanations for children's responses - including the absence of social contact effects - in the discussion.

Transporting Children in Wheelchairs in Passenger Vehicles: A Comparison of Best Practice to Observed and Reported Practice in a Pilot Sample

We compared observed and reported practice among children with special health care needs transported in wheelchairs with the recommendations from the American National Standards Institute/Rehabilitation Engineering and Assistive Technology Society of North America Committee on Wheelchairs and Transportation voluntary standards for best practice for using wheelchairs in vehicles. A convenience sample of vehicles exiting the garage of a children's hospital was observed. Certified child passenger safety technicians gathered driver demographics and the child's reported medical condition, weight, age, clinic visited, and relation to the driver. Technicians observed how the wheelchair and occupant were secured. A sample of 20 vehicles showed that 90% used four-point tie-down systems to secure the wheelchairs. A total of 88% of drivers tied the wheelchairs down correctly; only 20% used a separate lap-shoulder belts to secure the occupants. Twenty-five percent used lap trays, which are not recommended. Fifteen participants traveled with medical equipment secured inappropriately. Many deviations from best practice were observed and highlight areas for increased awareness, education, and resources for caregivers.

Correction versus bedding: Wheelchair pressure distribution measurements in children with cerebral palsy

Most children with cerebral palsy classification Levels IV and V in the Gross Motor Function Classification System (GMFCS) are unable to walk and, therefore, spend almost all day in a sitting position in their wheelchairs. As a result of the spastic muscle contraction, malpositions of joints or a scoliosis develop, which require a decision to be made on whether to correct the posture or simply find the best soft bedding position. The distribution of pressure on the seat while sitting in a wheelchair was measured with a pressure distribution measuring mat. The different distribution patterns were analyzed. Pressure distribution measurement allows to find a compromise between posture correction and soft bedding. Additionally, pressure-reducing seats were examined on their effectiveness. We also focused our measurements and data analyses on recognizing the causes for pain. Sometimes, the origin of the problems and pain of children in wheelchairs is not clear. Using the above-mentioned measuring equipment, the causes of these problems can be detected much more easily than just by clinical examination. The pressure measuring mat can help to optimize the seating position for the spastically handicapped children and adapt technical aids. Examples demonstrate the most frequently occurring problems of these children in their wheelchairs which are typical for neuro-orthopedic diseases.

School Bus Transportation of Children With Special Health Care Needs

School systems are responsible for ensuring that children with special needs are safely transported on all forms of federally approved transportation provided by the school system, and a plan should be developed to provide the most current and proper support to children with special transportation requirements. This statement provides current guidelines for the protection of child passengers with specific health care needs, including those with a tracheostomy, those requiring use of car seats, or those transported in wheelchairs. Guidelines that apply to general school transportation should be followed, including the training of staff, provision of nurses or aides if needed, establishment of a written emergency evacuation plan, and a comprehensive infection control program. Research provides the basis for recommendations concerning occupant securement for children in wheelchairs and children with other special needs who are transported on a school bus. Pediatricians can help their patients by being aware of guidelines for restraint systems for children with special needs and by remaining informed of new resources. Pediatricians can also play an important role at the state and local level in the development of school bus specifications.

A comparative study of children's attitudes towards deaf children, children in wheelchairs and blind children in Greece and in the UK

This comparative study explores the attitudes of children towards deaf children, children in wheelchairs and blind children in Greece and in the UK. A total of 463 children participated in this study, with 229 children from Greece and 234 children from the UK, in the fifth and sixth grades in primary schools. The views of the children were elicited with the use of an attitude scale. The roles of prior contact and current contact were examined. Results indicated that all children were positive towards the three categories of children and that girls were more positive than boys. Comparative findings showed that children's attitudes in the two countries differed in several ways. Children in Greece were more positive than children in the UK. However, children attending schools with special education units in Greece held more negative attitudes than children attending schools with special education units in the UK. Also, children in Greece who had prior contact with deaf children were less favourable towards deaf children compared with children in the UK. Furthermore, the results indicated that children held positive attitudes at a superficial level, expressing mostly social and emotional concern, and not a willingness to interact with these children. The findings stimulate a discussion regarding the impact of sociocultural characteristics upon children's attitudes towards children with special educational needs.

Children’s Attitudes Toward Peers with Severe Disabilities: Revisiting Contact Theory

The purpose was to compare the effects of three physical education settings (structured contact, nonstructured contact, and no contact) on attitudes of children toward peers with severe mental retardation who used wheelchairs. Contact theory (Allport, 1954) guided the study. Participants were 131 Grade 4 students (62 females, 69 males) in three intact classes that were randomly assigned to treatments. During the experimental period (4 weeks, 20 sessions, each 25 min), two children in wheelchairs were integrated into each contact class, and a special helper model was implemented. The experimental design was pretest-posttest randomized groups. Attitudes were assessed by an adjective checklist and an intention survey. A three-way ANOVA (Gender X Group X Time) revealed that females had significantly better attitudes than males. Subsequent analysis revealed that males in the structured contact group improved significantly on the adjective checklist, whereas males in the nonstructured contact group improved significantly on the intention survey.

A Survey of Transport for Children in Wheelchairs

This article is the result of an investigation carried out during 1988/1989 into the way in which local education authorities transport children in wheelchairs to and from school. It covers areas such as the number of children with special needs transported on a daily basis, the ownership of the vehicles used to transport them, the use of tail gate lift vehicles and the details of any accidents that had happened during the previous 5 years. There did seem to be a wide variation across the country in the suitability of transport provided for the children. In general, Northern Ireland and the metropolitan areas of England provided more appropriate transport.

Guidelines for Safe Transportation of Children in Wheelchairs

Advocacy efforts by health care professionals have prompted state legislative changes mandating the use of car seats and seat belts by children. These initiatives have greatly improved the level of safety in transportation of nonhandicapped children. Despite these positive changes, the transportation needs of nonambulatory children have not been addressed. In addition, implementation of Public Law 99-457 will result in larger numbers of young children with motor impairments requiring transportation to preschool early intervention programs. This study sought to describe how safely children in wheelchairs are transported. Observations of subjects were made as they were transported by their families or agencies at a residential summer camp, a preschool program for children with developmental disabilities, and a school for children with cerebral palsy. A safety score system was developed based on laboratory studies conducted on wheelchair restraint systems. This observation tool described the position of the wheelchair in the vehicle, the occupant restraint system, and the wheelchair restraint system. These structured observations revealed inadequate safety measures. Comparisons of safety scores of subjects transported by families with those transported by agencies were not found to have statistically significant differences. The findings of this study demonstrate a gap between minimal safety standards in wheelchair transportation and actual observed practices. In an effort to promote safe transportation practices of children regardless of their developmental differences, we present guidelines for health care providers for monitoring safe wheelchair practices in family, school, and community settings.

Social Acknowledgments for Children with Disabilities: Effects of Service Dogs

While service dogs are known to perform important tasks for people using wheelchairs, such as retrieving dropped items or pulling a wheelchair, they may also serve as an antidote for social ostracism. Adults in wheelchairs have been found to receive many more social acknowledgements when a service dog is present than when not. This study examined whether disabled children in wheelchairs with service dogs receive more frequent social acknowledgment than when no dog is present. Behaviors of passersby in response to children in wheelchairs were recorded in shopping malls and on school playgrounds. In both settings, social acknowledegments (e.g., friendly glances, smiles, and conversations) were substantially more frequent when a service dog was present. Social effects of the dog were more pronounced in shopping malls, typical of unfamiliar settings where the child would be likely to experience being ignored or overlooked. Service dogs may assist in normalizing the social interactions for children with disabilities producing social isolation.

Children in wheelchairs

Children in wheelchairs

Children in wheelchairs

Children in wheelchairs

Children in wheelchairs.

Three hundred and seventy-five families replied to a questionnaire about the use of their disabled children's wheelchairs. Many problems were found, such as difficulty in folding the chair and placing it in the car boot and difficulty in using pulbic transport. These families need adequate guidance to anticipate and deal with the problems. Provision of a wheelchair does not solve the mobility problems. The parents are faced with the task of transporting both the disabled child and the wheelchair whenever they want to use their own car or public transport. Ease of folding and lightness are important criteria for wheelchairs carried by cars. Parents need careful guidance about selecting suitable cars and also need to be shown how to lift the chairs without endangering their backs. Such advice should be provided by every wheelchair clinic and assessment and rehabilitation certre.