As we entered the technology age, wheelchairs suddenly became sophisticated and expensive. Children who previously had no hope of self movement because of severe physical problems could now be taught to drive. Therapists became high technology specialists. They learned how to assemble and repair the complex systems (and when to send them back to the factory), and; they learned ways to teach children how to use the sophisticated systems. Because high technology evolves very rapidly, therapists must sign on to continual re-education. Sophisticated wheelchair technologies have made the therapy team indispensible; no one else has the expertise to handle this complex job.
Physically impaired children (starting as young as three years old) learn to drive wheelchairs just as 16 year olds learn to drive cars. They learn how to pass pedestrians, how to move down narrow aisles without knocking bottles of perfume on the floor, how to back onto a lift bus, which side of the hall or mall to drive on, how to be safe on ramps, and how to adjust speed for different conditions. Therapists teach drivers training to wheelchair users.
The old rule "If something can go wrong, it will," applies to wheelchair travel. Wheelchairs are always breaking down, usually ten miles from the nearest allen wrench. Therapists are the resident wheelchair mechanics.
Wheelchairs are custom built for individual students. Therapists decide which seat molds, braces and pads to use for the specific physical problems of impaired children. When traveling, the therapist is constantly monitoring a student's posture and repositioning the child as necessary. A student's comfort level and physical well being depend upon the skill of the therapist.
Mealtimes are especially busy. Therapists teach the use of adaptive utensils, as well as basic techniques for eating and drinking. Therapists also know what foods can and cannot be eaten by specific students. They are trained to respond quickly to choking.
Most trips into the community involve shopping for personal items or food. These activities require reaching, grasping, and bending. Students need to reach toward store shelves, grasp the object they need and place it on their wheelchair. They need to pick up dropped objects. They need to get out their money, hand it to the cashier, and retrieve change. They need to push the buttons to make the elevator work. These are monumental tasks for most physically impaired children. Therapists have a bag of tricks and a satchel full of tools for solving these problems.
Toileting is another huge problem. Students need to move in and out of tight public bathrooms with people constantly coming and going. They need to remove adaptive clothing and put it back on. They need to transfer from chair to toilet and back. They need to wash and dry their hands. Many children must learn how to cath themselves, and to do so at times in public bathrooms. A therapist is needed to teach every one of these skills.