Funding Issues

Sample Justification Letter for the KidWalk Mobility System

___________ was seen at _________ along with ___ mother and therapist _____________. _________ has a type of Cerebral Palsy manifested predominantly as spastic movements in all four limbs. With CP each child may experience symptoms differently. The child may have muscle weakness, poor motor control, or have shaking, also called spasticity, of the arms or legs. Muscle stiffness in the form of stiff legs or clenched fists may also be seen.

A mobility system that would position ________ in an upright position with ___ arms and hands free to interact with the environment would be greatly beneficial to ___.   We are requesting funding authorization for a KidWalk Mobility System which ___ was tested in and ___ performed quite well with it. _______ diagnosis is Cerebral Palsy thus ____ lacks muscle tone control and balance to stand or walk without adequate support. Without the highly supportive KidWalk Mobility System that offers both support and safety, _______ will not have the opportunity to be in an upright position that promotes good health and also allows ___ to be independent in ___ environment.

It is important to get children with motor involvements such as ______, up and moving to their greatest functioning potentials. This has impacted children both therapeutically and medically. Prolonged positioning in a wheelchair or stroller causes flexion contractures at hips and knees that result in corrective surgeries and increased therapy interventions. These are costly and cyclical problems that can be improved and often avoided with early intervention in providing the proper equipment that supports being upright and gives opportunities for independent mobility.

It has been shown that even the most significantly involved child can learn new skills but there must be many opportunities to practice movements. The KidWalk Mobility System offers the most comprehensive system of support to provide ______ with these opportunities.

The KidWalk Mobility System will support even the most significantly involved child in an upright and mobile position. The therapeutic benefits to standing are overwhelming with benefits in improving digestive function, bowel/bladder function, increase to muscle activity, decreasing likelihood of muscular spasms and contractures. It also promotes increased bone density through weight-bearing. Activate and invigorate a healthy circulatory system, develop and improve postural trunk control and necessary body movements needed for respiratory efficiency. Enhance social interaction, improve self-assurance, and promotes a more positive overall mental health.

The motivation to walk is very strong within the human spirit and when children are at eye level with their peers, their social, emotional, and psychological development is enhanced, all necessary for the growth of a well-rounded and healthy child. This inclusion is a profound motivator for movement and with a hands-free posture also allows upper body development. Because of the weight-shifting and positioning components on the KidWalk Mobility System, ______ will have many opportunities to develop more naturally. As _______ progresses, supports can be lowered or taken away, further improving overall muscle strength and control.

The KidWalk Mobility System is very adjustable for growth and comes apart for easy transport.   The KidWalk Mobility System promotes an upright posture to improve internal organ functioning, strengthen arms and legs with ability to move, improve social/emotional growth and increase overall strength and endurance giving opportunities to progress to independent mobility.

The KidWalk Mobility System allows for hands free mobility enabling unrestricted use of hands and arms. The lateral weight shift unit allows a more natural gait during ambulation than other devices.  Large wheels assist in maneuvering over carpet for the indoor environment where children spend 80% of their time.  The mid-wheel design encourages the rotation of the upper body over the pelvis while turning and makes for a small turning radius. It has tool-free adjustability. For therapy, the weight shift mechanism allows work on balance and motor development and the auto centering pelvic guides align the trunk, pelvis and legs. Placement into the KidWalk can be achieved easily by one-person. All positioning components, height and tilt are easily adjusted during use.

The KidWalk Mobility System can save on costly medical and surgical interventions that become inevitable when one is in a wheelchair for a long term and having muscles contracting. Upright movement promotes health and decreases costs of hospitalizations of the high needs clients. Most importantly, the KidWalk Mobility System will allow ______ to work toward becoming more independent rather than being totally dependent on caregivers for the rest of ___ life.

The KidWalk Mobility System also has the potential of saving future medical costs of caregivers injuring their backs with lifting and during transfers. Considering the above, the KidWalk Mobility System will not only meet the needs of ______, ___ family, and caregiver, but also be most cost effective to the insurer.

Thank you for your consideration,

Funding for a Powered Mobility Device

A letter to a funding agency to encourage the decision maker to authorize a powered mobility device for a 20-month old child with a muscle disease. 

TO:  Dr. B Re:  The denial for Jenny C’s  power wheelchair 

Thank you for a stimulating and challenging phone conversation regarding the denial of our request for a powered wheelchair for Jenny due to her age and your belief that a powered mobility device is not appropriate for a child under 3 years of age. There have been many assumptions over the years that young children are not capable of using a powered mobility device. However, several studies have demonstrated that children as young as 20 months can learn to safely drive a powered mobility device. (see references)  As an occupational therapist for the past 25 years, I have evaluated hundreds of clients for mobility, including powered mobility for children as young as 20 months. If the only successful method a child has to achieve mobility, due to limited physical ability, is powered mobility, then the child’s skills required for maneuvering in the environment are assessed. This assessment must also include the child’s positional needs and access method, which may greatly influence the child’s ability to accurately maneuver the mobility device. The assessment may be videotaped and a report is written for the physician who may or may not provide a prescription for the durable medical equipment.  The recommendations are based on a physical or occupational therapist’s recommendations, following an evaluation. If the child does not readily demonstrate the ability to maneuver a powered mobility device during the evaluation, loaning or renting the equipment is recommended so the child can have an opportunity to learn the skills necessary for utilizing powered mobility.  Physical age is not a consideration in recommending powered mobility devices, other than the child’s ability to listen and follow a command. Limited vision, uncontrolled seizures, inability to follow a command or difficulty in determining a consistent means to access the joystick or switches on the powered device are considerations that may negatively impact a child’s ability to functionally use a powered mobility device. Of all the children over the years I have evaluated, only a handful could not successfully utilize powered mobility, which was due to our inability to successfully determine an access method or commonly due to vision problems. Jenny, on the other hand, has clearly demonstrated her ability to use a powered mobility device as demonstrated in the enclosed videotape.  A powered mobility device is the only means Jenny will have for independent mobility, due to her muscular dystrophy. Denying her powered mobility, because she is 20 months old, when she is capable of utilizing it, will further handicap her development, independence and self-esteem. If you need any more information to assist you in meeting your client’s needs in regards to providing assistive technology to augment her disability, we would be pleased to provide you with more information 

Christine Wright-Ott, MPA, OTR