Author: Darlene Sekerak, PT, PhD
Carmen is a four-year-old at Happy Days Pre-school. She loves adventure, speed and movement. Because she has cerebral palsy and is unable to walk more than short distances without great effort, she uses a motorized wheelchair at the preschool. Her chair helps her to play with her friends on the playground and to get around the building on her own. Her wheelchair also makes it possible for Carmen to go on field trips with her friends and on family outings. She continues to work on walking skills with her physical therapist and walks in the classroom and at home.
Carmen rides a private van to preschool. The van has an automated lift and wheelchair tie downs that keep her chair still while the van is moving. When Carmen first received her chair, her physical therapist spent many sessions with Carmen teaching her basic motoring skills and safety rules. Before she would recommend that Carmen be allowed to operate her chair by herself, she had Carmen complete a "driving test" around the preschool that included going up and down ramps, through doorways, over the grassy playground, along straight and crowded walkways and through obstacle courses. Carmen passed with ease. She was a "natural". The physical therapist invited Carmen's mom to the last "driving school" lesson where she reviewed the safety rules she had taught Carmen and went over some wheelchair care and maintenance suggestions.
Carmen scratched a few walls over the first month and got stuck in the mud once but nothing serious. She loved her chair and was a very careful and skillful "driver". But about six months later Carmen had her first accident. She was driving down the sidewalk to the van. Looking sideways to say something to a friend, she misjudged the distance to the curb. Her right wheel went over the edge, tipping the wheelchair on its side. Carmen fell into the parking lot in front of the parked van. The van driver and one of the teachers were standing within arms reach of Carmen but were helpless to do anything to stop the fall.
Carmen was a little stunned and then began to cry. There were cuts on her head and her elbow where she hit the pavement. She was complaining that her arm hurt. The teacher called her mom and she came to school and took her to the emergency room where they determined that she had a concussion from hitting her head but her arm was not broken. Carmen returned to school the next Monday.
The teacher and the school director were naturally concerned about Carmen. They were also concerned about being sued for negligence. Mom assured them that she did not hold them responsible. She knew that they provided careful supervision, that Carmen had been carefully instructed in the safe use of the motorized chair and the teachers enforced all safety rules. Her comment to them was "some kids fall off bicycles or out of trees. My child fell off a curb. Those are just the normal risks of growing up. I would much rather risk an accident than have her unable to do all the things that this wheelchair allows her to do on her own. I know that she has learned an important lesson. I also suspect this won't be her last accident. Lets hope there aren't too many more. "
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