The “Holy Grail” for most parents of physically disabled kids is their child being able to walk around independently. This includes walking while in school. Most schools are not fully ADA accessible, making walking an easier choice many times. The oldest schools and the poorest districts frequently have the biggest problems and the least access to good OT and PT services. I worked in a building like that. It broke my heart and was a factor in leaving school-based treatment.
But is walking while at school always the best goal? The demands of independent ambulation can actually hold some kids back in some situations. The causes are:
- Fatigue. Many kids get really tired while walking, even after walking for short distances. There are various reasons for this (perhaps another post??). But it happens. And it can happen quickly. Kids can walk to a special like music, and be too tired to safely walk back to their classroom. Tired kids are less available to look for safety hazards, too tired to speak clearly to ask for assistance, and too tired to keep learning. Fatigued kids that struggle like this are more likely to act out. And poorly managed fatigue leads to greater…
- Safety Risks. Constantly having to monitor their movements and the space around them while upright places some kids at risk. If you have ever tried to manage a child while pushing a suitcase along and holding a phone conversation in an airport, you know EXACTLY what this feels like. You don’t have enough hands or eyes to do it all. Something is bound to happen. Even with an aide and a gait belt, it doesn’t take much for accidents to happen to a physically disabled child that has to work so hard to walk. This will lead the aide to take over and create…
- The Appearance of Greater Disability in the Child. Aides will HAVE to jump in and take over some of the tasks, physical, cognitive, AND social, that a child could do if they weren’t so tired, so unstable, or so overwhelmed. Their peers and their teachers will see that this child cannot function without assistance. This risks the child being seen as someone who can walk but who is still impaired. Some peers (and adults) will assume intellectual disability when none exists. Others will assume medical fragility when none exists. Hardly anyone will say what they think out loud. What they do is avoid or infantilize a physically disabled child in ways small and not-so-small.
What should happen instead?
- Independent walking isn’t always the right choice every time, in every situation. When the options are not binary (walking=best, walkers/wheelchairs=bad) then they can be chosen for optimal performance throughout the school day. And the decision can be made without prejudice. In a perfect world, ambulation devices are seen as assistive devices, not signifiers of difference and discrimination. People who use devices are often the smartest people in the room, able to optimize their abilities rather than ashamed of their disabilities.
- Aides and teachers need to get more training from the PT/OT staff. It should be part of the IEP, written into the care plan as a separate session rather than carved out of direct treatment. Expecting staff to add this task onto overburdened schedules indicates that the school administrators don’t see the value of this training. Parents may need to get outside counsel to make this happen. It is an investment in every possible way.
- Parents need to ask leading questions to ascertain that their child is being offered the right level of assistance and the ability to be safely independent. Think of how the lawyers on “Law and Order” grill a witness at first. Sweet and careful, not trying to be mean. They are teasing out information that they witness doesn’t even realize they are sharing. THAT is how a great parent gets things done!
Need more information about how to do this?
