The 411 on Adaptive Strollers

The 411 on Adaptive Strollers

Adaptive strollers are a wonderful invention and have matured in their design and development from their early days. Now the value of a stroller has been recognized as a viable and important means for mobility. Strollers come in a variety of styles and serve just as many functions from pure recreational enjoyment to acting as the primary positioning and mobility device for a child with special needs. Throughout this article, we will identify the styles of strollers available and some of the features that are unique to each design. We will also discuss how to choose a stroller, the pros and cons of the most popular designs and explore the options for funding.
  As we mentioned there are many options to consider prior to purchasing a stroller. In effort to narrow the choices to a reasonable amount, one first needs to determine the primary goal of the stroller. Is it for park use and exploration on rural or rugged terrain for the family on the go? Is going to be the primary mobility device for the child to get to medical appointments or places in the community and to and from school? Does it need to be able to be used on a bus or adaptive van (i.e. capability for wheelchair tie-downs)? These 3 questions can help narrow the field immensely. Secondly, the field of potential strollers can be further narrowed down by amount of positioning support available, the opportunity for tilt or recline, how it folds for transport, how it will be transported, weight of the stroller and also by the size of the child. Lastly, the stroller can be narrowed down by color options and orientation of the stroller. For example, does the child face forward or backward?    
Now let’s explore the basic styles of strollers. These include jogging, positioning strollers and “on the go” – folding strollers. First, let’s explore the jogging strollers. The special needs community has designed the jogging stroller to meet the active needs of a family. They are modeled after the commercially available jogging stroller in principle and performance. A few of the more popular models of the jogging stroller available are the Otto Bock Kimba Cross, the Axiom Lassen, the Special Tomato Jogger, and the Ormesa New Bug with the 3 wheel jogging base.  Within the jogging stroller family, there is spectrum of positioning support offered by the stroller and overall size of the stroller.  The Kimba Cross and the Ormesa offer the most support for positioning. The Kimba Cross can actually use custom seating designed for a wheelchair that interfaces with the base. This is a great option if you need both the wheelchair and desire the jogging frame as well. The stroller base can be purchased through alternative funding while the wheelchair and seating is purchased through insurance. The Ormesa is also very versatile with its positioning system. The Special Tomato can have additional support added with the Special Tomato inserts allowing for minimal to moderate positioning support. The Axiom offers minimal positioning support. The pros of a jogging stroller are: generally very economical, easy to push outdoors, often have additional accessories like a bug netting available, can hold up to 100+ pounds, and typically fold for transport. The cons are: the footprint is longer, so it can make for difficult turns in tight areas (i.e. stores and congested areas), frequently have pneumatic or air filled tires which require maintenance, may not offer much growth in seat depth, can be heavy and awkward to lift and place into a car, most are not crash tested or approved for transportation, and most likely will only fit in larger vehicles for transportation.  
    Positioning strollers are strollers that offer a variety of positioning and postural supports. The options for positioning can include fixed angle, tilt/recline and early intervention/infant-toddler strollers. The fixed angle strollers typically come in some degree of tilt and or recline. Examples of these include the Lightening stroller by Stealth, a variety of products from Convaid including the Cruiser, Lite Rider, E-Z Rider and Convertible models, and the Special Tomato MPS with stroller base and EIO strollers. Within this group there is also a large discrepancy between the amount of postural support available, price, and overall features. This group includes an umbrella stroller as light as 16 pounds and some that are over double that weight. Within this group there is also a large quantity of strollers that have been crash tested and are approved for transportation. The Special Tomato MPS is the only stroller in this category that can be used for other purposes (i.e. on different bases for seating in the home or in the car).
The tilt/recline strollers offer the opportunity for postural rest breaks to increase comfort and sitting tolerance. Recline is a very useful feature for feeding and toileting management. Tilt is beneficial for reducing the effects of gravity while offering a rest break. This category includes the Safari and Rodeo by Convaid, the Ormesa, the Kimba, and the Easy S strollers. The Easy S stroller will actually recline beyond flat which is beneficial to children with significant respiratory needs.  
Finally, the last style within the tilt/recline category includes the early intervention/infant-toddler strollers. These strollers have been designed to meet the needs of the smallest of children. The push in recent years has been to be very proactive with positioning with the goal to facilitate good postural habits versus trying to correct postural abnormalities after the fact. These strollers often have very family friendly features. For example on the Stingray by Snug Seat, the child can be positioned so that the child and parent face each other. This is important for the parent’s piece of mind, the child’s safety and it also allows for early social interaction. These strollers also have the ability to be removed from the stroller base and placed onto other styles of bases so that the stroller also becomes seating in the house.  Strollers within this category include: the Ormesa Bug, the Convaid Cuddle Bug, the Kimba with Leckey Squiggles seat and the Stingray by Snug Seat.  
The pros of the positioning stroller: very easy to use, some options are fairly lightweight, small footprint making navigation and turns easier, a variety of tire options to meet more rugged outdoor needs, often a tray is available as an accessory for arm support, meals or fun activities, large variation in price, many are crash tested and a few of the seats on the strollers interface with other bases. The cons include the variation in price, the models with greater positioning support can be heavier to lift into a car, all of these strollers are coded the same as a wheelchair for insurance funding which means alternative funding may be required.
The final category of strollers are the ‘On the go” folding strollers. These strollers are the closest to an umbrella stroller for special needs children. They fold in essentially the same way as a commercially available umbrella stroller and are very light. The stroller only offers minimal postural support and may or may not come with tie-downs. This stroller works best for children that do not need a lot of support but become too fatigued with walking or are unsafe. Examples of this stroller are the EZ Rider and Lite Rider by Convaid and the Stealth Lightening. The pros of this stroller are the weight, economical value, easy to use, easy to transport, and may be crash tested. The cons are mainly centered on the lack of postural support available.
Now that the styles of stroller and their ability to meet a variety of needs has been addressed. Let’s move on to the funding portion. Unfortunately, jogging strollers are not funded by insurance. They can be funded through waiver programs or alternative funding. For the remaining categories of strollers, these are all classified as wheelchairs according to insurance. This means only one every 5 years. That being said, waiver programs and supplemental state programs often fund strollers if a wheelchair has been provided. If the stroller is the only “wheelchair” it is typically not a funding problem; but remember this stroller has to meet the child’s needs for 5 years. For this reason, many people prefer to use alternative funding or the waiver programs to secure a stroller. There are many options to secure the additional funding to offset the cost of the desired stroller. Many times the United Way can direct a family to organizations to help, local Kiwanis, Knights of Columbus and Lions Clubs also tend to donate money. There are available grants from United Health Care of up to $5000 for adaptive equipment (you don't even have to have UHC insurance to qualify), the Pepsi Refresh Project, and organizations that assist with funding special needs equipment (i.e. Children's Charity Fund).
If at any time, it becomes too confusing or difficult to navigate through the world of strollers or any other piece of equipment, please do not hesitate to contact us here at Tadpole Adaptive. We are always willing to provide unbiased and informed guidance.