CMC Pediatric Mobility Solutions 2 — Questions and Answers
Question 1: When evaluating a child for a power wheelchair, which factor is most critical to assess first?
- Cognitive and developmental ability to operate controls safely (Correct answer)
- Family's preference for joystick vs. alternative drive controls
- School transportation accessibility
- Insurance coverage limits
Correct answer: Cognitive and developmental ability to operate controls safely
Cognitive and developmental readiness determines whether a child can safely and effectively operate powered mobility before any other considerations.
Question 2: Which seating component is most important for preventing windswept hip deformity in a pediatric wheelchair user?
- Elevated leg rests
- Lateral hip guides and pelvic positioning belt at 45 degrees (Correct answer)
- Tilt-in-space function only
- A firm seat cushion without lateral supports
Correct answer: Lateral hip guides and pelvic positioning belt at 45 degrees
Lateral hip guides combined with an angled pelvic belt help maintain neutral pelvic alignment and prevent the asymmetrical posture that leads to windswept deformity.
Question 3: A 4-year-old with spastic diplegia is being assessed for mobility. Which option is MOST evidence-supported for early independent mobility?
- Manual wheelchair propelled by caregiver only
- Power mobility introduction as early as 12–18 months adjusted for readiness (Correct answer)
- Gait training exclusively until age 6
- Stander frame only until school age
Correct answer: Power mobility introduction as early as 12–18 months adjusted for readiness
Research supports introducing power mobility as early as 12–18 months for children with motor impairments, promoting cognitive and social development.
Question 4: What is the primary purpose of a tilt-in-space feature in a pediatric wheelchair?
- To increase wheelchair speed on slopes
- To redistribute pressure and manage tone without changing hip angle (Correct answer)
- To allow the child to reach lower surfaces
- To facilitate transfers to the floor
Correct answer: To redistribute pressure and manage tone without changing hip angle
Tilt-in-space rotates the entire seating system around the hip joint, redistributing pressure and managing extensor tone while maintaining the hip angle.
Question 5: For a child with scoliosis using a wheelchair, which seating intervention is typically tried first before considering a custom-molded system?
- Solid seat and back with lateral trunk supports and contoured cushion (Correct answer)
- Sling seat with no modifications
- Thoracic extension orthosis alone
- High-back recliner with no lateral supports
Correct answer: Solid seat and back with lateral trunk supports and contoured cushion
A solid seat and back with appropriately placed lateral trunk supports and a contoured cushion provides structured support and is the first-line intervention before more complex custom systems.
Question 6: Under Medicaid funding rules, how frequently can a child typically receive a new medically complex pediatric wheelchair?
- Every 12 months regardless of diagnosis
- Every 3–5 years unless medical necessity for replacement is documented (Correct answer)
- Whenever the therapist recommends it
- Only once before age 18
Correct answer: Every 3–5 years unless medical necessity for replacement is documented
Medicaid generally follows a 3–5 year replacement cycle for complex rehab technology, though earlier replacement may be approved with documented medical necessity.
Question 7: Which growth accommodation feature is MOST commonly specified for pediatric manual wheelchairs?
- Removable anti-tip wheels
- Adjustable seat depth and width via spacers or sliding seat frames (Correct answer)
- Carbon fiber footrests
- Foldable backrest canes
Correct answer: Adjustable seat depth and width via spacers or sliding seat frames
Adjustable seat depth and width allows the frame to be modified as the child grows, extending the useful life of the equipment and avoiding premature replacement.
CMC Pediatric Mobility Solutions 2
When evaluating a child for a power wheelchair, which factor is most critical to assess first?