Mobility and Students with Physical Limitations

Students with physical limitations vary widely in mobility. Some are totally dependent and will require full physical assistance. Many students with a physical disability have equipment that enhances their participation in daily life activities, i.e., wheelchairs, crutches, orthoses (an appliance that provides support to a limb or joint).

Depending on the student’s ability, type of activity, level of physical and cognitive involvement, and need for adaptations, the educational program will vary greatly. The following should be considered when designing and carrying out an educational program:

• medical diagnosis, including restrictions on certain activities or susceptibility to fractures.
• equipment currently being used/needed for mobility and positioning.
• any recent medical procedures that may affect functioning level or handling techniques.
• general mobility level.
• overall skills: gross motor, intellectual, fine motor, and visual perception.

The occupational therapist and/or physical therapist can assist in teaching the safety precautions and adaptations necessary in order for the student to participate in appropriate activities.

Many severely disabled students are unable to move volitionally, change positions, or express their need to change positions. Alignment and safe and comfortable positioning are essential services. As with any student, rest and frequent changes of bodily positions are necessary throughout the day (minimally once every two hours).

Proper handling and positioning facilitates the development of gross motor skills, improves range of motion, increases comfort, and addresses postural problems. For example:

• A child with severe and multiple disabilities, such as a child with cerebral palsy, may have limited voluntary movements, and may also have limited or exaggerated reactions and responses to being moved.
• If the child has spasticity, he/she will become stiffer if not handled properly when moved. This is due to the damage to the brain and the areas that coordinate movement.
• The child with athetosis, characterized by involuntary movements and constantly changing tone of muscles can easily lose his/her balance and fall.
• The child with hypotonia (low tone) is “floppy” and will need to be well supported and provided with additional hip, trunk, head, and neck support in order to be kept upright.

Due to these factors, a child with significant disabilities should be handled gently and moved slowly to allow the child to adjust to the movement. The child should be in a supportive environment which allows him/her the time to achieve his/her potential.