Ross Care

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Provision of buggies and wheelchairs

The Wheelchair Service can provide buggies and wheelchairs for children who have significant physical difficulties preventing them from moving around.

If a child requires a buggy or wheelchair to support their mobility due to a physical condition, the Wheelchair Service recommends that the buggy or wheelchair should be age appropriate. This means that children over 4 years old would, in most instances, be provided with a wheelchair.

When a child has no physical need, but the family have difficulty managing the child’s behaviour when outside, a buggy or wheelchair is sometimes requested because a child:

• Runs off
• Sits and refuses to walk
• Has no sense of danger

There are various diagnosed and undiagnosed conditions that can result in children not understanding instructions, experiencing sensory difficulties that result in ‘sensory overload’ and, sometimes, can result in an increased need for movement such as running. Alternatively, the child may refuse to walk.

It is not recommended to use a buggy or wheelchair to manage a child’s behaviour. It is advisable to seek a referral to an appropriate team to access specific advice about how to manage the child’s behaviour outdoors, without equipment.

Where children are able to walk, the best advice is to encourage walking, and to consider what is in the best interests of the child, as well as what is the least restrictive option. Families may sometimes choose to purchase a buggy for occasional use.

The Wheelchair Service is, however, not commissioned to, and therefore does not, provide a buggy or wheelchair for a child who does not have significant physical difficulties and is independently mobile.

Typical child development

It is not unusual for children under the age of 5 to:

• Get tired and sit down after prolonged periods of walking
• Lie down and have a tantrum if they can’t do what they want to
• Try to run off
• Have limited awareness of danger
• Need a parent to keep them safe

These are not reasons for children to be provided with a specialist buggy or wheelchair.

Potential complications of using a buggy or wheelchair:

Using a specialist buggy or wheelchair when there are no physical difficulties can result in:

• Future behaviour difficulties. Children will learn that they don’t need to walk and will quickly expect not to walk, resulting in more difficulties with behaviour as they get older.
• Fewer movement opportunities, limiting sensory experiences throughout the day.
• Reduced muscle strength and stamina, resulting from less opportunity to be active and to explore their environment.
• Less opportunity to develop their motor skills. This can have a knock-on effect on how children learn to move themselves and use toys and objects in the environment.

Benefits of walking:

• Movement opportunities provide daily sensory experiences.
• Increased muscle strength and stamina.
• Learning to stay safe through parent’s prompts.
• Exercise releases ‘happy hormones’ so helps children feel better.
• Forms good habits for staying safe around roads and listening to adults.
• Increased opportunities to develop motor skills with more positive behaviours and independence.

Top tips

• Try a backpack with reins. Add in some weight to help give your child more sensory input. This should be around 5% of a child’s body weight. Dried rice weighed and put into a zip lock bag can be useful to try in a backpack.
• Be consistent. Rules such as holding a hand or always wearing backpack with reins should be enforced all the time when out. Visual cue cards to reinforce this will help some children.
• If your child has a younger sibling, buggy boards can help children take a quick break from walking without needing their own buggy or wheelchair.
• Scooters and trikes with handles can offer children more engaging ways to get around without needing a specialist wheelchair.
• Plan ahead. Where possible, leave enough time and don’t plan long journeys requiring a lot of walking if your child struggles to walk for an extended period.
• Use distractions. Have favourite toys with you to motivate your child. Sometimes if children become bored, they may start creating their own fun. By having small toys that can be used to distract and keep your child focused, this can help your child stay with you.
• Some children become overwhelmed in busy, noisy places. This can result in children running to find somewhere quiet. Peaked caps, sunglasses, hoods, ear defenders or music players can help children to cope a little better at these times.
• Some children run to get their parent’s attention. It is important to keep track of when your child runs. Sometimes it may be that your child wants your attention and running off is a good way to achieve this. If you think your child may be trying to get your attention, it is important not to chase after your child if safe to do so, or if you have to chase, that a very low level, ‘boring’ response is given. As soon as your child is doing something you want them to, reward this behaviour.
• Use of maps. Some children become worried in new environments and may run to check the perimeter of areas. Through using maps in advance, including ‘Street View’, this can help decrease the need to visually check out areas.

We have created video guidance below on how to support your child to sit comfortably in their wheelchair and when to request a review due to growth.

Watch the video here.