Physical Disabilities in Children

Children that have physical disabilities often have difficulties participating in everyday activities such as walking, playing, dressing themselves, and going to school. A physical disability can be any condition that impacts on a person’s normal body movement and control.

What are common types of physical disabilities?

Common physical disabilities include cerebral palsy, spina bifida, muscular dystrophy and spinal or acquired brain injuries.

Cerebral palsy is a condition that affects movementand posture. It is a permanent life-long condition,but generally does not worsen over time. It is due to damage to the developing brain either during pregnancy or shortly after birth. There are different types of cerebral palsy including:

spastic quadriplegia – affects movement in both arms and both legs
diplegia – affects movement in both legs
hemiplegia – affects movement on one side of
the body
ataxia – affects balance and coordination

Spina bifida occurs during pregnancy when the spinal cord does not fully close. Children with spina bifida may have paralysis or weakness and/or sensory loss. They also can have difficulties with bowel and bladder control.

Muscular dystrophy occurs when muscles that control movement start to weaken. There are different types of muscular dystrophy however the most common is Duchenne Muscular Dystrophy, which occurs mainly in boys. Muscular dystrophy is a progressive condition which means it gets worse over time, and there is no cure. Most children who have Duchenne Muscular Dystrophy are in wheelchairs by the time they reach adolescence.

People with spinal or acquired brain injuries can have difficulties with moving certain body parts depending on the location of the injury.

Children with physical disabilities may present with other conditions including hydrocephalus (fluid on the brain), scoliosis (curvatures of spine) and bone and joint deformities (due to differences in growth).

How do Physical Disabilities Occur?

Physical disabilities can be caused by a number fo different of different factors including:

Inherited or genetic conditions such as muscular dystrophy
Congenital (present from birth) such as spina bifida or some types of cerebral palsy
Serious illness or injury that affects the brain including meningitis, spinal cord injury or acquired brain injury (stroke, near drowning, trauma to head).

The role of Allied Health Professionals:

To assist children with physical disabilities in achieving independence and developing functional skills.In addition to medical professionals, allied health professionals form part of the healthcare team.

Occupational therapists assist children with physical disabilities to participate in everyday activities such as feeding, dressing, toileting, playing and school activities such as drawing and writing. Occupational therapists use a variety of play-based activities to practice these skills and provide recommendations on changing the activity to make it easier, or provide equipment to make the activity achievable. For example, occupational therapists will trial equipment for seating, feeding and hygiene activities that assist the child to be supported, safe and able to participate in the activity if possible. Occupational therapists will work on the child’s ability to engage in age appropriate play including early object play (banging, casting and posting toys) to construction play (building blocks and Lego) and even imaginative play.

Physiotherapy is a vital profession in helping children with physical disabilities achieve gross motor skills and movement. Physiotherapists engage a wide range of interventions to improve a child’s strength, balanceand movement including walking, being able to transfer (lie to sit, sit to stand) and of course running, jumping, hopping and skipping. Physiotherapists work with the child and their family to incorporate exercises to strengthen muscles and train correct movements in the developing child to prevent deformity and improve function. Physiotherapists also train the caregiversin how to safely lift and position the child to prevent caregiver injuries.

Speech pathologists work with children who have physical disabilities to help them communicateand address feeding and drinking difficulties. Communication is such an important skill in everyday life and is at times affected by physical disabilities. Speech pathologists also assess and prescribe the use of alternative and augmentative communication (AAC) systems when a child has complex communication needs (for example, a speech generating device, or a communication app for a tablet device).

Other health professionals that work with children with physical impairments include;

Orthotists who fabricate foot orthoses to help with walking and prevent deformities of the feet.
Psychologists who assist with supporting a child’s emotional health, addressing complex behavioural problems and supporting thinking and learning.
Audiologists who assess hearing difficulties.
Ophthalmologist who assess vision difficulties.

Equipment that Children with Physical Disabilities May Need:

Depending on the child’s age and level of disability there are various pieces of equipment that may assist the child to participate in daily activities. These include standing frames to promote muscle strength and postural control, walkers to develop gait and support mobility, and wheelchairs to provide mobility for those who are unable to walk. Seating systems are often required to maintain good posture for attending to everyday activities such as eating, doing schoolwork or playing and also assist with preventing deformities due to muscle weakness. Showering and toileting equipment is required at times to keep the child and caregiver safe during these daily tasks, in addition to promoting the child’s independence within these personal activities.

Other equipment such as modified play equipment and communication devices are also available to enhance a child’s ability to engage in everyday life.

Going to school with a physical disability

Going to school can host a number of challenges for children with physical disabilities. Legislation such as the Disability Discrimination Act (1992) and Disability Standards for Education (2005) provide schools with guidelines on how to support students with disabilities in attending and achieving at school. Schools in Australia have specialist support from teachers and allied health professionals to assist with meeting the educational needs of the individual. There are often specialist teachers and facilities available to assist children. Examples of what support schools are required to provide include adjustments to curriculum, assessment modifications, assistive technology such as software to support learning (e.g. voice to text, predictive text) and accessible buildings and facilities.

Children with physical disabilities have difficulties with moving or controlling their body. However, with the support, assistance and acceptance from the wider community these children are able to engage in everyday activities to learn, develop and achieve!