Getting Around
People with cerebral palsy whose physical impairments limit their mobility may need any of a number of devices to help them get around. Adults with cerebral palsy may use them to navigate the workplace. Students with cerebral palsy may use them in their school building and to participate in student activities. Mobility devices include such things as self-propelled walkers, manual or electrically powered wheelchairs, and powered recreational vehicles like bikes and scooters.

The advent of the computer age has made it possible to create sophisticated wheelchairs which can give mobility back to those with poor motor control. If somebody has cerebral palsy and is unable to effectively propel or steer the wheelchair manually, they can still navigate thanks to the technology of switches and controls. Joysticks can be interfaced with the wheelchair's motor and computer in order to direct motion. In addition, switches are available for those who cannot manipulate a joystick. These switches come in a wide variety. Sometimes they are shaped like a button, and the push of a body part against the switch (such as a hand or foot) triggers an action, such as moving forward or turning. Other switches react to the presence of a body part, no touching is required. A wave of the hand or swing of the knee can activate these types of switches. Butt what if one's cerebral palsy makes it difficult to control their hand or knee enough to trigger these switches? They can still be mobile thanks to switches which respond to the position of the neck, head, and chin. Still other switches are manipulated by "sipping" and "puffing" air through a small straw. The sipping action will trigger the switch in one direction, and the puffing in the other. In "sip and puff" switches, often times the lips are used to control which direction to move in. These advances provide those with cerebral palsy or other physical impairments the freedom to get around on their own and become more independent.

Positioning Oneself
In various environments (such as in their job or at their school), individuals with cerebral palsy may need help with their positions for seating so that they can participate effectively. Usually the goal is to try to achieve an upright, forward facing position by using padding, structured chairs, straps or restraints to hold the body in a stable, safe, and comfortable manner. Often, it is necessary to design the positioning systems for a variety of settings so that the person can participate in a number of activities. There might be a position which suits them best when they are in front of the computer, another for meal times, and yet another for relaxing with a good book. Some examples of equipment used for positioning are walkers, crawling assists, floor sitters, side lying frames, chair inserts, wheelchairs, straps, trays, standing aids, bean bag chairs, special pillows, etc.... Thanks to advances in electronics, motorized wheelchairs now exist which can shift and adjust to support it's occupant in various positions. One can even save certain settings so that with the push of a button, the wheelchair can shift them from one position to the next. This can greatly enhance a person's feeling of independence, as they do not require others to shift supports or padding for them.

Environmental Controls

Environmental Control Systems (ECSs) provide alternative access to devices such as lights, audio visual equipment, doors, telephones and much more.

An Environmental Control Unit, or ECU can be installed and switch activated to turn on and off electrical appliances such as a radio, Television, heater, or air conditioner. It can also be used to turn on lights in rooms. Sometimes one will have a remote control with settings for the various electronics in the house (lights, appliances, television, etc...). If the person is unable to manipulate a remote control, independent simple switches can be used to control the environment. Laser beam switches (where the switch is activated by breaking the beam) or pressure sensitive floor switches can be installed in doorways to activate lights as somebody moves around their house. A person can move their wheelchair to a certain spot in the room and activate a floor switch which will turn on the television. Environmental controls offer people with cerebral palsy a large number of ways to have more control over their lives.

Environmental controls can be grouped into low-tech and high-tech systems. Low-tech systems provide somewhat limited control of one or two devices. A low-tech switch can control an electrical device directly. The laser beam switch I mentioned may seem like a high-tech control, but really it isn't since it's just responding to a simple input (whether the beam is broken or not) and performing only one task (turning on the lights). If the switch needs to be activated for the electronic device to run, this is called a "direct control". The floor switch which turns on the television when pressed can be an example of a "direct control" switch. "Timed control" will let the device continue to run for a preset amount of time after a switch is hit once. If a device required one hit of the switch to turn on, and another hit to turn off, it's called a "latch control".

High-tech systems are designed to provide more sophisticated control of a wide variety of devices. Most remote controlled or switch based high-tech systems require reading, though there are now several switch systems that have auditory scanning and speech feedback. See our communication page to learn more about audiotory scanning and speech feedback. This allows a person to speak commands into their device and hear what the resulting action is. Portability is very important for someone who needs control from a wheelchair since they they need to be able to control various parts of their environment from different locations. The development of PDA technology has helped tremendously in making high-tech environmental control systems smaller, more powerful, and more portable than ever.

Another advancement in environmental control is to use a person's AAC to control their environment. An augmentative and alternative communication (AAC) device allows a person to speak by electronic means. By combining environmental controls into the AAC, the number of devices needed to learn to control can be reduced. Another benefit is that the user doesn’t have to read if it is too difficult for them. The AAC can use symbols to operate things (like a picture of a TV, or lamp for example). On top of that, the operator doesn’t even have to see the display, since the AAC can speak the options outloud. Again, advances in computer technology have made it possible for these high-tech systems to be available to those with cerebral palsy.