Mobility equipment for children can either be used as a permanent means of getting around, or can be used in the process of establishing a particular skill, as a precursor to developing other mobility skills. For example, during normal development a child will learn to lift their upper body off the floor before they learn to crawl and they will learn to stand before they can walk. In a similar way, although disabled children may do things at a different time, the same basic muscles or skills need to be developed.

Walking equipment is regarded as mobility equipment, and is therefore provided by physiotherapists.

Physiotherapists are usually employed by the health service; the district health authorities in England and Wales, the health boards in Scotland, and health and social services boards in Northern Ireland. They are usually based in hospitals, health centres and sometimes GP practices.

A pushchair or wheelchair should provide the child with a stable and comfortable seated position for being out and about.

Depending on the child's abilities and the type chosen, it may also be able to provide them with some independent mobility.

Remember that one wheelchair may not suit all situations. Some children will require two different types of wheelchair, each for a different range of activities - e.g. one self-propelled wheelchair for everyday use and another for sports purposes; or a self-propelled wheelchair for use indoors for short distances, and a powered wheelchair for long distance outdoor use.

It is important that the child's occupational and physiotherapist are involved in the choice of pushchair or wheelchair so that they can advise on the most appropriate position for the child which will encourage the development of head control and sitting balance and minimise the effects of an asymmetrical sitting posture on the child's hips and spine if they have abnormal muscle tone.

Wheelchairs and related equipment are provided through a number of different channels depending upon its primary purpose - especially whether it is for permanent loan or temporary use.

• most statutory provision of pushchairs and wheelchairs is carried out by, or through, the wheelchair service. This is part of the health authority or hospital trust and is organised on a district-wide basis. Often based at the local district hospital, it is able to provide a wide range of wheelchairs and cushions



• referral to the wheelchair service can be made by a range of professionals including therapists, nurses and doctors. The prescription, however, needs to be undertaken by expert prescribers, i.e. they are accredited or recognised therapists or sometimes specialised nurses, hospital consultants or GPs
• powered indoor/outdoor wheelchairs are provided to severely disabled people who meet the local eligibility criteria. This usually includes the user being unable to propel a manual wheelchair, benefiting from an improved quality of life, and being able to control the chair safely. Powered attendant-propelled chairs can also be provided if it is hard for the carer to push the user out of doors



• the NHS (www.nhs.uk) holds special seating and buggy clinics and will vary in the models it may provide to children with mobility and postural needs, depending on local budgets
• standard cushions, special cushions and special seating are also available. These require varying levels of assessment and authorisation
• children with delayed mobility only are unlikely to be given a buggy until over the age of three years, the age which children can usually walk reasonable distances independently
• children with a postural need and delayed mobility should be able to be provided with a supportive buggy through the NHS, as soon as the need is recognised before the age of three. This may vary depending on the priority criteria of the local service
• the NHS do not provide accessories such as rain hoods and covers, shopping baskets and leg muffs for the buggies they issue.

• equipment that can be funded through the education service should be needed primarily for education and includes wheelchairs for mobility at school.

• children over five years with mobility problems may be eligible for the Mobility Component of the Disabled Living Allowance
• this can be used under the Motability (www.motability.co.uk) Scheme towards the cost of a powered vehicle or an adapted car/van to enable the child to be transported in their powered vehicle, but will not cover the costs of both
• Whizz-Kidz (www.whizz-kidz.org.uk) is a charity which raises funds to buy powered outdoor wheelchairs for children, but they require an occupational or physiotherapist to recommend a suitable model for the child's needs. Remember to take the additional costs of repairs, replacement tyres and batteries into account when fund-raising initially.

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