Seating and Mobility Equipment

Custom seating and mobility equipment can help kids who have disabilities with improved function, comfort, mobility and health.

Examples of seating and mobility equipment can include:

• Manual wheelchairs with custom seating.
• Power wheelchairs with custom seating and controls (including “sip and puff” breath-controlled technology).
• Walkers.
• Standers.
• Lifts.
• Feeding chairs.
• Other equipment and mobility products.

If your child has trouble walking on their own or staying comfortably upright, they might benefit from seating and mobility equipment. At Gillette Children’s, certified seating practitioners work in teams with therapists and other experts to assess your child’s needs, recommend equipment and create custom solutions.

Kids who benefit from mobility seating and equipment often have the following conditions:

• Cerebral palsy.
• Brain injury and related neurotrauma.
• Muscular dystrophy, spinal muscular atrophy and other neuromuscular conditions.
• Spinal cord injury and related neurotrauma .
• Other disabilities that affect muscle tone, sensation and walking ability.

Proper mobility equipment helps children explore and learn. It’s a good idea to have a seating and mobility evaluation if your child:

• Is 18 months old and can’t crawl or walk (even if they will eventually be able to walk).
• Can walk, but they get tired easily, or have a condition that puts excessive wear and tear on their joints.

Before your child starts using wheelchairs and seating equipment, they’ll receive a full seating and mobility evaluation. In these tests, we gather information about your child’s abilities, select appropriate equipment and technology, and design adjustments to meet their needs.

During a seating and mobility equipment evaluation:

• An occupational or physical therapist measures your child’s ability to operate mobility equipment.
• A durable medical equipment vendor demonstrates options for mobility equipment. (You will select the vendor based on your insurance coverage.)
• A certified seating practitioner helps with equipment-related decisions, such as recommendations for modifications, new custom seating and other wheelchair adaptations and controls.

We encourage you to be present for the evaluation. Community and school therapists, teachers, and group home staff members can also provide useful information and insights.

Here’s what you can expect from an evaluation and fitting for seating and mobility equipment:

Assessing Abilities and Environment

During a seating and mobility test, a therapist measures functional abilities and examines positioning needs. For example, we look at your child’s:

• Ability to balance when seated.
• Range of motion.
• Level of activity.
• Level of muscle tightness and stiffness (also known as spasticity).
• Body measurements.
• Ability, with training, to operate manual and power wheelchairs, including various types of switches and controls.
• Environments at home, school and in the community.

Learning About Options

A durable medical equipment vendor will help you understand your options by demonstrating equipment and discussing:

• Manual and power wheelchair options.
• Frame size options and wheelchair positioning.
• Foot and arm rest options.
• Options for transporting the wheelchair.
• Insurance coverage.

Determining Equipment Needs

One of our certified seating practitioners will help determine the best option for your child’s seating and mobility needs. We take into account:

• Concerns about and history of pressure sores.
• Expected growth and function.
• Need for body and head support.
• Needs related to mobility (to determine if a manual or power system is the best choice).
• Additional equipment, such as an existing augmentative and alternative communication (AAC) device, ventilator tray or lap tray.

Receiving Recommendations

Working closely with you and your child, our team will make seating and mobility equipment recommendations. After an evaluation, we might suggest that your child:

• Use a manual or power wheelchair for the first time.
• Replace an existing manual or power wheelchair.
• Adjust or replace seating or equipment on a new or existing wheelchair.
• Develop additional skills before considering new mobility equipment (especially in the case of power wheelchairs).

We will continue to revisit these recommendations as your child grows, as their skills change, and as technology advances.

Undergoing Fittings and Receiving Training

Once your child receives our seating and mobility equipment recommendations—and after an insurance provider approves ordering the equipment—we schedule equipment fittings.

Fitting sessions involve receiving the equipment, modifying it to fit your child’s needs, and learning how to use it. Depending on the type and complexity of the equipment, appointments (such as for a wheelchair evaluation) can take anywhere from one to three days.

Before a seating and mobility test at Gillette, your child will need an order from a health care provider—whether that provider works at Gillette or is a provider in the community.

You are responsible for inviting a durable medical equipment vendor to the evaluation, based on insurance coverage and service locations (consider the most convenient location for maintenance). If your insurance company doesn’t offer specific recommendations, you can view our Vendor Resource List (PDF).

You and/or your child will meet the vendor, your community provider and a Gillette seating specialist at one of the following locations for an evaluation:

• Baxter
• Duluth
• Mankato
• St. Paul
• St. Paul – Phalen 
• Willmar

Once we have an order and you have chosen a vendor, we ask you to complete a questionnaire. Your responses help structure the evaluation in a way that best meets your child’s needs.

What to Bring With You

If you have any of the following items, please bring them to your child’s appointment:

• Back-up wheelchair or equipment.
• Current mobility system (manual or power wheelchair, stander, walker, etc.).
• Communication devices and mounts.
• Information about your home or environment that might affect equipment choices. For example, if any areas in your home create special mobility challenges, consider measuring these areas or taking photographs.
• Lap trays.
• Medical records and medical history.
• Braces (also known as orthoses).
• Respiratory and feeding equipment.

We encourage staff from your child’s school to attend the evaluation and share input on equipment decisions, if possible. You might also want to get statements ahead of time from caregivers who aren’t able attend the evaluation.

Insurance and Prescriptions for Equipment

Insurance companies and third-party payers usually expect prior authorization before they will pay for durable medical equipment, including manual and power wheelchairs. Sometimes insurance companies require that you test equipment in your home and community to make sure you’ve made the best choice for your child’s needs.

Once you choose the equipment, Gillette submits the authorization for custom seating. Meanwhile, your durable medical equipment vendor will submit prior authorization for your mobility base (wheelchair or stroller). This process can take several weeks. If your insurer denies the prior authorization or asks for more information, a Gillette therapist responds on your behalf.

Once coverage for Gillette custom seating is approved, we set up your fitting session and coordinate the appointment with your durable medical equipment vendor if needed. If your insurance coverage is limited, we can connect you with a social worker to help you find other resources.

Choosing the right seating and mobility equipment involves collaboration between your family and experts in various specialties. As part of their evaluation and treatment, your child might receive care from specialists in the following areas:

• Orthotics, Prosthetics and Seating.
• Occupational therapy.
• Physical therapy.

Through Gillette Adult Clinic, we also offer ongoing care for kids whose needs continue into adulthood.