Buggies and wheelchairs for children with autism spectrum disorder

Buggies and wheelchairs as medical devices

The wheelchair service can provide buggies and wheelchairs for children where the child has significant physical difficulties preventing them from moving around. When a child has autism spectrum disorder (ASD) and no physical difficulty, a buggy or wheelchair is sometimes requested because a child:  

  • runs off
  • sits and refuses to walk
  • has no sense of danger.

A buggy or wheelchair is a medical device. It is not recommended to use a buggy or wheelchair to manage children’s behaviour unless the ‘Top Tips’ in this fact sheet have been tried. In some circumstances it may be that children’s behaviour continues to be challenging to the point where a buggy or wheelchair would be less restrictive than not having this, then this can be considered.

In all cases, where children are physically capable to walk, the best advice is to encourage walking, and always think about what is in the best interests of the child, as well as what the least restrictive option is.

ASD and buggies

A diagnosis of ASD does not mean that a child needs a specialist buggy or wheelchair. ASD can result in children not understanding instructions, sensory difficulties that result in ‘sensory overload’ and sometimes, an increased need for movement such as running. This can result in children refusing to move, or running away.

The wheelchair service recommends that if children are to be given a buggy or wheelchair, that this is age appropriate. This means that children over 4 years old would be given a wheelchair. Buggies are not safe for children to independently get themselves into because of the risk of the buggy tipping.

Typical child development

It is not unusual for children under the age of five to:

  • get tired and sit down after prolonged periods of walking
  • lie down and tantrum if they can’t do what they want to
  • try to run off
  • have limited awareness of danger
  • need a parent to keep them safe.

These are not reasons why children should have a specialist buggy or wheelchair.

Potential complications of using a buggy or wheelchair

Using a specialist buggy or wheelchair when there are no physical difficulties can result in future behaviour difficulties. Children will learn that they don’t need to walk and can quickly expect to not walk, resulting in more difficult behaviour when encouraging children to walk later on. Children with ASD are often less flexible with changes, therefore it is really helpful to get into the habit of walking early on. Professionals in wheelchair services have seen adults with ASD who are still using wheelchairs when they have no physical disability due to the use of these when they are younger not being reviewed. It is important to think about the future when getting a buggy and planning how the use of this will be progressed.

It can also result in:

  • less movement opportunities, limiting sensory experiences throughout the day
  • poorer muscle strength and stamina due to less opportunity to be active and explore their environment
  • less opportunity to develop their motor skills. This can have a knock on impact on how children learn to move themselves and use toys and objects in the environment.

Benefits to walking:

  • movement opportunities provide a natural part of daily sensory experiences
  • increased muscle strength and stamina
  • learning to stay safe through parent’s prompts
  • exercise releases ‘happy hormones’ so helps children feel better
  • forms good habits for staying safe around roads and listening to adults
  • increased opportunities to develop motor skills.

Top tips

Attend the Early Birds course offered through National Autistic Society. These run in Bournemouth, Poole and Dorset.

Try a back pack with reigns. Add in some weight to help give your child more sensory input. This should be around 5% of a child’s body weight. Dried rice weighed and put into a zip lock bag can be useful to try in a back pack.
Be consistent – rules such as holding a hand or always wearing back pack with reigns should be enforced all the time when out. Visual cue cards to reinforce this will help some children.
If your child has a younger sibling, buggy boards can help children take a quick break from walking without needing their own buggy or wheelchair.
Scooters and trikes with handles can offer children more engaging ways to get around without needing a specialist wheelchair.
Plan ahead – where possible, leave enough time and don’t plan long journeys requiring a lot of walking if your child struggles to walk for an extended period of time.
Use distractions – have favourite toys on you to motivate your child. Sometimes if children become bored, they may start creating their own fun. By having small toys that can be used to distract and keep your child focussed, this can help your child stay with you.
Some children become overwhelmed in busy, noisy places. This can result in children running to find somewhere quiet. Peaked caps, sunglasses, hoods, ear defenders or music players can help children to cope a little better at these times.
Some children run to get their parent’s attention. It is important to keep track of when your child runs – sometimes it may be that your child wants your attention, and running off is a good way to achieve this. If you think your child may be trying to get your attention, it is important to not chase after your child if safe to do so, or if you have to chase, that a very low level, ‘boring’ response is given. As soon as your child is doing something you want them to, reward this behaviour.

Use of maps. Some children become worried in new environments and may run to check the perimeter of areas. Through using maps in advance, including ‘Street View’, this can help decrease the need to visually check out areas.

Useful documents