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  Assistive technology and adaptive equipment for children with cerebral palsy include any device or equipment to help perform an activity or improve the ability to function. For a child with cerebral palsy, many different types of devices can be used to allow for participation in more activities, enhance learning, improve communication, hearing, and mobility, and make life easier. Assistive technology is crucial in helping a child succeed and transition into independent adulthood.
  What Is Assistive Tech and Adaptive Devices for Cerebral Palsy?
  Assistive technology and adaptive equipment or devices include anything that helps a disabled child function better. This can include mobility devices like walkers and braces. It can also include communication tools, like computers or tablets.
  These devices and technologies aim to improve access and help children function more independently and with greater confidence.
  How Children Can Benefit from Technology
  Cerebral palsy causes several different types of disabilities, from issues with walking to hearing difficulties and the ability to communicate or even hold a pencil. The severity of these disabilities ranges from mild to severe and can impair quality of life, independence, and all aspects of health, from physical to emotional and social.
  The use of assistive technology devices can provide a child with several benefits, including:
  - Better academic performance
  - More inclusion in activities and recreation
  - A more engaged social life
  - Improved communication with others and a better response to a child’s needs as a result
  - Increased ability to express emotions
  - Enhanced self-confidence
  - Greater independence and self-sufficiency
  - More opportunities
  While the symptoms and complications of cerebral palsy can vary widely from one individual to the next, most children with this condition have some degree of limited mobility.
  Many children cannot walk, while others can walk with assistance and some without support. Aids that enhance mobility can be low-tech, including walkers and non-electric wheelchairs.
  There are also aids that use more technology, such as electric wheelchairs. These help children who struggle to use their arms and hands get around with just the touch of a button or joystick.
  Lifts can help a child move between floors in the home, into and out of vehicles, and from sitting to standing positions. A power scooter is another option for mobility.
  An exciting technology that holds great promise for helping disabled individuals gain more mobility is called functional electrical stimulation. A small device is used to deliver electrical impulses to stimulate specific muscles. It works by activating the nerves, causing the muscles to move, and training them to function better over time.
  Children with spastic cerebral palsy can benefit from being able to walk more easily and with less pain. This device will not work for every child, but many who walk with difficulty may benefit.
  Technology for Communication
  For many children with cerebral palsy, communication is an issue. A child may have muscles in the throat and mouth affected by the condition, creating difficulty forming words. This makes it challenging to express emotions and needs, to learn in school, and to be social with others.
  Children can work with speech and language therapists to improve communication skills, and these professionals often use assistive technology:
  - Electronic communication boards. A communication board presents the child with a choice of letters, words, numbers, and pictures. The child can then select them to communicate with others. Depending on a child’s ability, they may need instruction from a speech/language therapist to use a communication board successfully.
  - Low-tech communication boards. The low-technology version of this is simply using a pencil and paper to express oneself. This is only useful for a child who can grip a writing implement and use it to write words or draw pictures clearly. There are also boards containing photographs of objects a child can point to, such as a glass of water or a toilet. This way, a child who is too young or is unable to deal with the complexity of a tablet may indicate their needs.
  - Speech-generating devices. There is a more advanced version of an electronic communication board that functions to generate speech. The child types or taps words and sentences, and the device formulates them into speech that others can understand clearly.
  - Eye-tracking devices. This type of device is best used with children who cannot use their arms, hands, or fingers to tap at images on a communication board. These individuals can benefit from an eye-tracking device, which follows where the eyes are moving and looking. When the child looks at a specific word or image on the communication board, it is selected without actively tapping on the surface.
  Typing and Writing Devices
  Many children with cerebral palsy struggle with the fine motor skills needed to hold a pen or pencil and to hit individual keys on a keyboard.
  Written communication is essential for children who cannot speak easily or at all and is also necessary for academic work. Several devices are available to facilitate writing.
  Simple, low-technology grips or specially designed pencils are adaptive devices that enable a child to hold a writing implement and manipulate it. For instance, a weighted pen or pencil can help a child get more leverage and more easily manage the tool while learning how to write.
  A steadying device can be attached to a pen or pencil to help a child with shaky movements. Having a desk with a surface that can be adjusted for height and angle can also help a child get the proper alignment and most comfortable position for writing.
  A child who struggles to use traditional writing implements may benefit from the opportunity to type, but some children also have difficulty using keyboards. A simple adaptive device is a pointer that is attached by Velcro to the hand or wrist, allowing a child to press small buttons on keyboards, tablets, or phones.
  Other typing technologies that help children communicate more effectively include word prediction software and spelling and grammar checks.
  Hearing loss is an issue that many children with cerebral palsy struggle with, but technology has come a long way in providing devices to improve the ability to hear.
  Hearing aids, for instance, can facilitate hearing for those who are not deaf but have some hearing loss. A cochlear implant may be a good option for children with more severe hearing deficits.
  Cochlear implants have a small device inserted beneath the skin inside the ear and an outer piece behind the ear. It works by stimulating the auditory nerve and bypassing damaged parts in the ear that prevent hearing. Getting this device requires surgery, and it can take several weeks before it is ready to use and for the child to be able to hear.
  Getting a cochlear implant is not recommended for all children with hearing difficulties. It is expensive, requires surgery, and comes with some rare but serious health risks. It is particularly recommended for those children who have multiple special needs and complications from cerebral palsy. Improving hearing can be a significant benefit for a child struggling with several disabilities.
  Other devices that can help children who are hard of hearing include assistive listening systems. These are devices that capture sound, amplify it, and deliver it to the ear. A good device can help a child hear their teacher speaking in the classroom, for instance, even with a lot of background noise.
  Technology to Help with Daily Activities
  In addition to the assistive technology devices that help children with specific issues, like hearing, writing, or communicating, several adaptive tools help with daily living activities.
  These devices can make life easier, make a child more self-sufficient, and help them achieve greater independence. Some of these specially adapted devices are:
  - Specialized toilet seats, safety bars, and bathing benches in the bathroom
  - Sponges and brushes with longer handles
  - Eating utensils with grips or that are weighted
  - Plates and bowls with non-slip bottoms
  - Non-skid rugs
  - Dressing aids
  - Tables that can be moved up and down
  - Adaptive scissors and art supplies
  - Key turners
  - Aids for positioning in bed or on couches and chairs
  A child with cerebral palsy can benefit significantly from using assistive technology and adaptive devices.
  Parents can advocate for what their children need by working with public schools. With an evaluation, a child can get an individualized education program (IEP) through the special education department.
  This may include assistive devices that the school will then provide. Parents or adults with cerebral palsy can contact government organizations, advocacy groups, and community groups to seek assistance with paying for and getting these much-needed devices.
  - Wu, F.G., Chang, E., Chen, R. and Chen, C.H. (2004). Assistive Drawing Device Design for Cerebral Palsy Children. Technol. Disabil. 15(4), 239-46.
  Retrieved from: https://doi.org/10.3233/tad-2003-15405 - Steven, R.A., Green, K.M.J., Broomfield, S.J., Henderson, L.A>, Ramsden, R.T., and Bruce, I.A. (2011, November). Cochlear Implantation in Children with Cerebral Palsy. Int. J. Otorhinolaryngol. 75(11), 1427-30.
  Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/21893352