Kids in walkers

On my Paeds placement, I have come across a few different experiences with walkers for children. One child we assessed at school in a walker, in order to approve him for funding to have his own at home. I had seen him previously in his wheelchair, and although he seemed content, he didn’t seem happy or enthusiastic about much. However seeing him in a walker, he was like a different child. He stood up tall through his legs (with a seat support and trunk supports) and took steps independently, mostly toe walking but occasionally achieving heel strike and good step lengths. As he zoomed around the corridors, he looked so excited at the prospect of seeing people from the same position he was in (standing!) and took in everything he could at his new eye level. It was the most wonderful thing to see a child gain some independence and feel like ‘one of the others’.

Another child we assessed in a walker at an external clinic who provide walkers for children. His mum, myself, my supervisor and two Physio’s from the clinic were all present. This child’s mother had been pushing for a long time for her child to be put in a walker, against the recommendations of my supervisor and the Physio’s at the clinic (who believed there would be very little benefit from a walker as he had severe spastic quadriplegia CP). When the child was placed into the walker, he hung on the seat and trunk and arm supports, with his head flopping from flexion to extension (as he had very poor head control). He occasionally achieved some movement by using mass extensor tone through his head and trunk although had no real desire to walk or attempt to stand. His mother burst into tears, realizing that her child was not suitable to use a walker. It was quite a traumatic event for her, having pushed so hard for him to try, that her child could not walk or even maintain standing with the help of a walker.

It made me realize that although parents are often extremely keen for their children to “just be able to walk”, they often need thorough education as to reasons why it would not be suitable or realistic for their child- rather than just that they are ‘not suitable’. I think this approach prior to having a trial (which may be the only way to show the parents what their children are capable of) may have made it a little less traumatic should the trial not be as successful as they had hoped.