Tech, Equipment, Accommodations, and More for Orthopedic Impairment (OI)

Durable medical equipment refers to medical supports and devices that can withstand repeated uses over time. Common types of DME covered by health insurance (such as Medi-Cal in California) include mobility aids such as wheelchairs and scooters (manual and motorized); ambulation devices such as canes, walkers, and gait trainers; hospital beds and accessories including bedside rails and mattresses; patient lifts and standing systems such as stairway chairlifts and standing frames; portable ramps; and bathroom equipment such as seats, benches, stools, rails, and shower hoses. If you're funding through a Medicaid program, note that Medi-Cal in California excludes some types of DME from coverage, including: orthopedic mattresses and waterbeds, recliners, rockers, seat lift chairs, and other furniture items; as well as exercise equipment such as bikes or tricycles (in most cases).

Here are some devices you can explore:

• Standers, walkers, gait trainers, including the Rifton E-Pacer
• Wheelchairs (manual and power)
• Adaptive seating (e.g., Rifton chair, tomato chair)
• Adaptive tricycles, bikes, and vehicles
• Adaptive bathing equipment
• Specialized writing tools and scissors
• Adaptive toileting options such as the Rifton HTS
• Switches and buttons for access
• Positioning alternatives such as prone wedges for children to explore a variety of positions

Orthotics and bracing

Orthotics, braces, shoe inserts, and support shoes are used as part of PT to improve a child’s mobility, stability, and strength. These devices can be worn on either a temporary or permanent basis, and they are most commonly used by children with cerebral palsy and other neuromuscular conditions. A combination of orthotics and PT can help improve their gait, strength, stability, and balance and reduce the chance of tripping, deformity, spastic movement, and dislocation of joints. Orthotics can also help reduce the need for surgery later on in a child’s life.

Children undergo a physical assessment by a doctor or therapist to determine the best orthotics for their needs. The choice may vary depending on muscle tone, age, and risk of joint misalignment.

Adaptive equipment for kids with cerebral palsy

Kids and adults with CP often need special equipment to help them move around and do everyday things with more independence. This kind of equipment is sometimes called Complex Rehabilitation Technology — but don’t let the big name fool you! It simply means gear that’s specially designed to support mobility and function.

Some examples include power wheelchairs, standers, gait trainers, transport chairs, and even adapted bikes. Other tools like forearm crutches, ankle braces, and shoe orthotics can also make a big difference in how someone moves and feels throughout the day. These familiar items can be part of their therapy sessions to support mobility and build strength in a way that feels comfortable and routine.

• Sometimes, PTs use a device called an electrical stimulator. It sounds fancy, but it simply helps activate or contract a muscle when a child can’t do it on their own. It’s like giving the muscle a gentle nudge to get moving and learn how to work better over time.

• PTs may also use equipment that helps carry some of your child’s body weight during therapy. This could be a lift overhead or a robotic device that supports them while walking on a treadmill. It’s especially helpful for kids who are learning to walk or who need to take more steps but can’t fully support themselves just yet.

• Another helpful tool is a stander. This device allows kids with conditions like CP to stand upright, even if they can’t do so on their own. Standing helps build bone strength and works muscles in the legs and core, which are super important for stability and everyday movement.

• You might also hear about something called a spider system. Despite the name, it’s not scary at all! It’s a support setup that helps kids stay upright and balanced during therapy. It can be used with a treadmill to practice walking or in other ways to help build strength and retrain muscles.

Communication and text access support is important for helping children express themselves and interact with digital content. Speech-to-text (STT) and text-to-speech (TTS) tools enable easy conversion between spoken and written communication, making it simpler for children to express ideas and for them to access written content. Be sure to check out our article on AT for communication to learn more!

• Install adaptive buttons for communication when appropriate.

• Augmentative and alternative communication (AAC) devices further expand communication options, ranging from iPads with dedicated speech apps to specialized communication boards and speech-generating devices like Proloquo2Go.

• Head pointing is a great option for users who need a hands-free device. NuPoint’s Head Tracking for Accent 1400 works by placing a reflective dot on the user’s face, which is tracked by the device and used to control the pointer on screen. Pointer sticks that are worn on the user’s head are also available.

• Eye-gaze technology is also another powerful communication option, allowing children to control their computer or communication device with just their eye movements; notable examples Apple Eye Tracking for iOS 18 (iPad and iPhone), PRC’s Look Eye Tracking systems, the I-Series by Tobii Dynavox, and the MegaBee Eye Pointing Communication Tablet

Navigation extensions for students with fine motor challenges

• CrxMouse Chrome Gestures. This extension customizes mouse gestures to make navigating easy and simple. Users can even program their own custom mouse gestures to open programs and perform other tasks. (FREE)

• Click-free Browsing. For users who have difficulty clicking a mouse, this Google Chrome Extension adds on-screen navigation icons that a user can hover over, prompting the link to be clicked for you. You can also switch between tabs without clicking. (FREE)

• Vimium provides keyboard shortcuts to make navigating on your computer easier.

• AutoClick Extension has a time clicker that replaces a manual click with a mouse.

• Microsoft has built an adaptive mouse with a whole suite of customizable extensions that can be designed, 3D-printed, and programmed to fit a user’s exact needs.

• Caret Browsing provides a movable cursor that allows you to select text with keyboard commands, making navigation easier. (FREE)

• Eye Tracking for Ipad and Iphone is designed to support users with physical disabilities to navigate their iOS device without touch.

• Virtual Trackpad for AssistiveTouch allows users to control their device using a small region of the screen as a resizable trackpad.

• Switch Control allows the user to use the cameras in iPhone and iPad to recognize finger-tap gestures as switches.

• Voice Access allows you to control your android with your voice, completely hands-free.

• Action Blocks allows you shortcuts to certain tasks like “calling home,” or “watching a show” with a click of a button.

• Camera Switches uses facial gestures and recognition to navigate your android.

• Look to Speak allows users to use their eyes to talk to others. Android users just need to set up a custom phrasebook for all the things they’d like to say.

Orthopedic impairments don’t just impact school and therapy — they affect daily life at home. Smart tech and adaptive tools can help!

• Smart lights and outlets (voice or app controlled)

• Grabbers and reachers

• Standing aides for toileting and bathing

• Voice-controlled assistants (e.g., Alexa or Google Home for hands-free help)

• Smart watches to allow for hands free help (there is also a fall detection setting that is available and alerts an emergency contact system)

• Adjustable-height furniture for safe transfers or play

Accommodations for students with orthopedic impairments are supports that remove physical or structural barriers to learning—without changing what’s being taught. These might include things like accessible seating, adapted desks, mobility aids, or extra time to move between classes. Here is a list of some common accommodations

Accommodations for mobility

• Provide wheelchair-accessible desks and aisles.
• Adapt seating and positioning to support posture for classroom engagement.
• Provide grab bars and accessible toileting options.
• Provide staff to help with navigating stairs, cluttered rooms, and other areas where the student may need support.
• Use appropriate workspace height and spacing in the classroom to allow for physical navigation where applicable, especially but not exclusively if the student is using a wheelchair or walker.
• Establish clearly defined times when a student will use a piece of mobility equipment during the day (for example, time in a stander or walker to ensure physical activity, particularly for students who use a wheelchair).
• Provide physical modifications to assignments for increased fine motor control (for example, raised outlines to help a student stay within the lines on writing and coloring projects).
• Allow extra time to get to the bathroom, from class to class, to and from lunch and recess, etc., especially in large buildings.
• Ensure accessible and safe navigation across campus, including door, stair, and elevator access, and restroom accessibility.
• Widen aisles in classrooms to allow for independent movement with mobility devices.
• Ensure the playground is accessible and safe, providing alternative ways to participate socially.
• Preferential seating for ease of movement in and out of workspaces.
• Provide breaks throughout the day for students with endurance/stamina concerns.
• Ensure materials and resources are within reach without requiring assistance.
• Clearly post schedules for all students to ensure accessible classroom environments.
• Attach laminated, accessible schedules for students using wheelchairs for easy reference.
• Coordinate the integration of occupational therapy, vision services, adapted PE, speech therapy, and physical therapy into the student’s daily schedule.
• Conduct home visits before school placement to assess student needs and alleviate parent concerns.
• Use alternative communication methods (e.g., buttons, switches, scanning boards) to support communication needs.
• Train instructional assistants to carry over therapy strategies throughout the school day for consistency.
• Collaborate with parents to build trust and ensure the student’s medical and educational needs are met.
• Promote student independence by gradually reducing hand-over-hand assistance in activities.

• Provide a combination of appropriate seating in the classroom, at school-wide events, and during toileting, such as an adaptive toileting seat, carpet area for balancing practice, and a supportive tomato chair for stability).

Accommodations for socialization

• Introduce students with orthopedic impairments (OI) to their peers and explain their support needs to encourage inclusion.
• Encourage social interactions during recess by facilitating activities like kicking a ball while using a walker.
• Promote participation in all school activities such as field trips, library, garden, music, and dance.

• Include students in morning circle time for optimal participation opportunities.

Accommodations for education

• Give the student tasks one at a time.
• Structure work so that the easiest parts come first.
• Allow the use of sensory tools.
• Provide extended processing time for responding to instructions.
• Modify assignments by shortening tasks to accommodate physical limitations.
• Ensure access to communication switches so nonverbal students can interact with peers.
• Rotate instructional assistants to help students adjust to working with different people and environments.
• Use recording buttons for communication to allow participation in classroom discussions.
• Ensure instructional assistants carry extra writing tools and adaptive materials.
• Install head-controlled buttons for communication when appropriate.
• Encourage full participation through structured routines and clear expectations.
• Check progress frequently and provide positive reinforcement to build motivation and engagement.
• Implement peer support strategies to foster social inclusion.
• Use visual supports and visual aids.
• Ensure assistive technology is available to access the curriculum and communication (e.g., AAC devices).
• Provide health and nursing services for medical needs, including G-tube feeding or suctioning.
• Establish training programs for general and special education teachers on OI-related accommodations.
• Develop clear, specific healthcare plans, including symptom monitoring and emergency protocols.
• Allow parents to observe healthcare-related training to ensure staff competency.
• Ensure access to resources such as the Assistive Technology Professional (ATP) for tailored technology recommendations.

• Check progress and provide feedback often in the first few minutes of each task.

  For more information, head to our article all about orthopedic impairment (OI).