Kids on Wheels, Volume 1: A Young Person's Guide to Wheelchair Lifestyle.

Kids on Wheels, Volume 1: A Young Person's Guide to Wheelchair Lifestyle

Kids on Wheels, Volume 2: A Guide to Wheelchair Lifestyle for Parents, Teachers and Professionals

Dobbs J, ed. Horsham, PA 19044, No Limits Communications Inc, 2004, spiral-bound, 155 pp (vol 1), 305 pp (vol 2), illus, ISBN: 0-9712842-3-7, $24.95.

This 2-volume set consists of a "kids' volume" and an adult volume. The purpose of the set is to "plant the seeds of independent living" in children with disabilities and to encourage them to envision a life full of possibilities. It also encourages parents and professionals to do the same. The writers are adults with a disability, parents of a child with a disability, and others who have background in a variety of issues affecting people with disabilities.

The kids' volume was written for grade-school children. The text speaks directly to them; however, the authors use sophisticated vocabulary that places the reading level at the seventh to ninth grade level. Younger children would need an adult to help them or to read the text to them.

Eleven chapters cover a variety of topics that are of interest to children. They are written from the point of view that the most important goals children with a disability can have are independence and eventual control of their own life. The author emphasizes that "kids on wheels" can live lives full of sports, art, learning, and success, and that they have choices. Positive, upbeat profiles of children with physical disabilities make up most of the content. The profiles match the chapter topics and highlight the way each child actively participates in his or her own area of interest.

In chapter 2, "Sports and Recreation," there are brief descriptions of 19 separate sports and recreation activities. The reader is given suggestions on how to find adaptive sports programs in their own communities. In a chapter titled "Fun and Games," the reader can find resources for dolls and action figures with disabilities or adaptive equipment, and adaptive controllers for video games.

Service animals and hippotherapy are covered in chapter 4. There is even a section in this chapter called "Pets on Wheels," which pictures and profiles animals who use wheelchair-like devices.

Chapters 6 and 7 discuss the presentation of people with disabilities in the media and in books. Chapter 6 reviews specific television shows and movies that feature children and adults with disabilities. Chapter 7 contains reviews of 29 books that feature children with disabilities. The reviews are divided into 3 categories: picture books for 4- to 8-year-olds, chapter books for 8- to 12-year-olds, and chapter books for ages 10 and up. The chapter author reviews each book and tells "what we at Kids on Wheels think about it." Some books receive negative reviews because of poor-quality or dated pictures or poor story lines. I found it interesting that these books were included because the reader is being encouraged to read books that depict children with disabilities in positive or interesting ways.

Chapters 8 and 9 talk to children about how to deal with school and about making friends. For example, there are sections on how to explain a disability to someone and how to deal with teasing. Chapter 10, titled "Family," includes some simple but honest discussions about family life. The author talks to children with disabilities about the care-giving efforts of parents, understanding the frustrations of their brothers and sisters, and hiring their first personal care assistant.

Chapter 11, "Famous Wheelers," profiles Ed Roberts, referred to in the text as the "father of the independent living movement." Several small sidebars about other well-known or well-accomplished adults with disabilities, such as Christopher Reeve and Franklin Roosevelt, are also included. The book closes with a chapter on rights and a simple explanation of the Americans With Disabilities Act.

Like the kids' volume, the adult volume also has 11 chapters covering a wide array of topics. In the first chapter, "Empowering Kids," the author helps parents examine attitudes that foster their child's dependence and prevent parents from empowering their children from an early age. The chapter briefly covers topics such as "tough love," not giving in to tantrums, fostering independence, and letting go. Chapter 2, "Parenting Resources," emphasizes the need for parent-to-parent support as well as support from community-based centers and programs.

Chapters 3 and 4 cover specific health-related issues. Chapter 3, "Health and Medicine," summarizes the types, causes, symptoms, and treatment for the most common physical disabilities in children: cerebral palsy, spina bifida, muscular dystrophy, and spinal cord injury. A section called "The Cutting Edge" briefly reviews active areas of research in treatment or symptom management for each of these diagnoses. Under the cerebral palsy heading, the author includes information on interventions that are becoming increasingly popular in the United States, such as suit therapy, constraint-induced movement therapy, hyperbaric oxygen, and "dolphin" swimming. Fortunately, the author indicates whether there is research supporting the efficacy of these interventions. There is, however, little or no mention in this volume of more mainstream interventions that have a stronger evidence base, such as electrical stimulation, strengthening, or participation in sports or fitness activities. Participation in sports, however, is emphasized in the kids' volume. The sections end with a short list of resources specific to each diagnosis.

Other less common conditions in children are briefly discussed in this chapter as well, including brain injury, multiple sclerosis, spinal muscular atrophy, stroke, and transverse myelitis. Surprisingly, osteogenesis imperfecta is not included. There also is a section on secondary conditions, including autonomic dysreflexia, bowel and bladder issues, breathing problems, pain, scoliosis, and skin breakdown. The benefits of standing are presented in this chapter, as well as short sections on mental health and avoiding abuse. Current options for spasticity management are reviewed, but the author makes some questionable statements such as "physical therapy can reduce the severity of spasticity"; that "muscle can be stretched to stimulate normal growth" after botulinum toxin injections; or that "passive standing may help muscles from being too spastic." The research that supports the accuracy of these statements is not as clear or as well defined as the author might lead readers to believe. Electrical stimulation is mentioned here as being used "with the idea that a more balanced muscular system will be less spastic." It is not clear whether the author is referring to neuromuscular electrical stimulation (NMES) or a different technique called threshold electrical stimulation.

Chapter 4 addresses health insurance issues. Parents are familiarized with the variety of private and public health coverage options. Tips on dealing with denials and appeals are covered, including hiring advocates when needed. Chapters 5 through 8 cover managing personal assistants, education, legal and financial issues, and transportation. Chapter 9, "Accessible Travel," focuses on things to consider when traveling with a child with a disability. A nice section in this chapter gives examples of accessible kid-friendly destinations such as theme parks, campgrounds, interactive museums, and zoos.

Chapter 10, "Technology and Products," focuses on wheelchair selection and use. The author emphasizes the need for parents to utilize health care professionals familiar with assistive technology in the evaluation process. Funding options and ways to deal with funding denials are presented. In a section called "Tilt and Positioning," the author presents information on specific wheelchairs rather than on the reasons for choosing and using a tilt-in-space chair. Unfortunately, he omits some excellent choices for tilt-in-space wheelchairs. In addition, the information on specific chairs could soon be outdated because the technology, names, and features of wheelchairs change so rapidly. A discussion of the use of computer-assisted technology or augmentative communication devices is not included, although there are a few resources included in the list at the end of the chapter.

Finally, chapter 11 contains a list of resources available in each state and territory. Resources listed previously in individual chapters are not repeated here. Many of the resources are specific to local areas. However, it would have been helpful for organizations that have a large regional or national focus to have been listed together in a separate section.

The adult volume contains many stories from parents about their own experiences. Unfortunately, many of these stories relay their most negative experiences in dealing with professionals in health care and educational fields. I was also surprised by an ad for a personal injury lawyer, because it seemed to be in direct contrast to the otherwise positive approach.

The mostly positive nature of these 2 volumes, with their emphasis on independence and wheelchair lifestyle, is refreshing. The layout is excellent. Both volumes are well organized and easy to read. They provide concise and easy-to-understand overviews of a wide range of topics without being wordy or overly technical. Separate sidebars that add additional information to the text are scattered throughout each chapter. Pictures are used generously throughout. Parents and children alike would enjoy reading the profiles of children who share their same interests. They may also spark some interest in trying new activities. Some of the subjects covered in each of the volumes, particularly in the kids' volume, could open up some nice discussions between parents and their children. "Kids on Wheels" is not a must-have for pediatric physical therapists, but these 2 volumes would be a very nice addition to parent and family libraries in pediatric settings.

Gretchen E. Meyer, PT

Easter Seals

Peoria, Ill

Ms Meyer is the Senior Physical Therapist and Area Supervisor at Easter Seals and an Adjunct Clinical Instructor at the Bradley University Physical Therapy Program. She specializes in the examination and management of children and adults with developmental disabilities.