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PE1250 Spinal Cord Injury L3 and Below

A Guide for Families

You are an important member of your child’s recovery team. Use this checklist to monitor your child’s progress.

Our goal is to help your child and family adapt to changes after injury or illness. Over the course of your stay you and your child will be working with a team of professionals including doctors, nurses, occupational (OT) and physical (PT) therapists and other rehabilitation team members. Together, we will perform a complete evaluation of your child’s needs and abilities and develop a treatment plan that considers your family’s circumstances.

You and your child’s team will meet weekly to develop goals and check in on your child’s progress. Help us by bringing your care notebook, this checklist, and your questions to these meetings.

Step 1

I will start to learn how to do the following:

Positioning and exercise

  • Upper and lower body range of motion stretches with help
  • Upper body strengthening program
  • Shoulder protection strategies with help
  • How to stay seated without back support on the bed or mat, with help

Recreation and leisure

  • Learn what recreation and play opportunities are available in the hospital

Self-care

  • Pressure releases
  • Skin care routine
  • Ways to support my circulatory system
  • Bowel and bladder care
  • Bathe myself with special equipment and some help
  • Groom myself (brush teeth, comb hair) when my supplies are set up
  • Dress my lower body with some help
  • Dress my upper body with just a little help
  • Drink the right amount and keep score with the help of my family
  • Cath myself with the help of family
  • Learn about my medicines

Wheelchair and special equipment

  • Sit in my wheelchair for up to 4 to 6 hours a day
  • Propel my wheelchair
  • How my home can be modified for a wheelchair
  • Use a special chair to bathe and go to the toilet

Step 2

Each step will build on the one before. I will be ready for a day pass at the end of step 2.

Positioning and exercise

  • Do my lower body range of motion stretches with help from my family
  • Do my upper body exercises with a little help from my family
  • My family understand shoulder preservation strategies
  • Stay seated on the mat with someone just in the room
  • Change my hand positions while seated on the mat by myself
  • Sit at the edge of the bed or mat by myself
  • Roll in bed using the bed rails with a little help
  • Sit up from lying on my bed or mat table with a little help
  • Transfer onto the mat table using a sliding board with a little help
  • Stand in parallel bars with some help and bracing as needed
  • Move in parallel bars with lots of help and bracing

Recreation and leisure

  • Learn how to do activities that are important to me in my free time
  • Plan and complete a family day pass
  • Apply for accessible parking permit

Self-care

  • Do pressure releases with just a little help. My family knows how to help
  • Learn more about skin care and how to put on my splints
  • Do pressure releases, bed turns, and skin checks daily with the help of my family
  • Transfer on and off the toilet, bath or shower chair with a little help
  • Complete my bowel program seated on the toilet
  • Bathe myself with just a little help and special equipment
  • Groom myself while sitting in my wheelchair with supplies set up
  • Dress my lower body with some help
  • Dress my upper body with just a little help
  • Take my medicines with the help of my family
  • Complete training on Sub Q injections

Wheelchair and special equipment

  • Sit in a wheelchair for up to 8 to 10 hours a day
  • Learn how to best access desks and tables with some help
  • Begin to reach for items at different levels, open doors and cupboards with some help
  • My family understands what changes are recommended for my home to be ready for me and my wheelchair

Other

  • Learn about medical conditions related to spinal cord injury
  • Learn about ADA (Americans with Disabilities Act)
  • Learn about transportation options

Step 3

I will be ready for an overnight pass at the end of step 3.

Positioning and exercise

  • Sit at the edge of the mat by myself using my arms to support myself
  • Sit at the edge of the mat and touch the floor with both hands by myself
  • Complete a level transfer without a sliding board with a little help
  • Roll in bed without using bed rails
  • Transfer onto the mat table using a sliding board by myself
  • Sit up from lying on my bed or mat table by myself
  • Complete arm exercises with my therapist or family just watching
  • Stand in parallel bars with supervision and bracing as needed
  • Move outside parallel bars with some help and bracing as needed

Recreation and leisure

  • Plan and complete family overnight pass

Self-care

  • Do all pressure releases, bed turns, and skin checks daily with the help of my family
  • Get and set up my clothing by myself
  • Groom myself
  • Dress my lower body with a little help
  • Dress my upper body by myself
  • Do my bowel care with the help of my family
  • Transfer on and off the toilet bath or shower chair with a little help
  • Bathe myself with just a little help and special equipment
  • Take my medicines with help from my family
  • Give Sub Q injection on my own or with help from my family

Wheelchair and special equipment

  • Push my wheelchair up and down a ramp with just a little help
  • Do a wheelie and a pop-up in my wheelchair with a lot of help
  • Go from the floor into my wheelchair with some help
  • Access items in my backpack behind or under my chair with some help

Other

  • Understand and discuss medical conditions and medicines related to spinal cord injury
  • My family and I will continue training in deep vein thrombosis (DVT) and hypotension prevention
  • Learn how to communicate my wants and needs with the help of my family
  • Learn about community support available
  • Review the Yes You Can book with my nurse
  • Confirm my home is ready for me and my wheelchair
  • Review with my nurse all training needed before an overnight pass home

Step 4

I will be ready to discharge home at the end of this step.

Positioning and exercise

  • Manage the sliding board by myself. Transfer using a sliding board across uneven surfaces with someone just watching
  • Transfer without a sliding board with someone just watching
  • Transfer in and out of a car with a little help
  • Do arm exercises by myself
  • Discuss shoulder preservation strategies without help
  • Transfer on and off a toilet with supervision
  • Transfer on and off a shower or tub bench with someone standing by

Recreation and leisure

  • Know how to locate and use leisure resources

Self-care

  • Complete pressure releases and skin checks by myself
  • Bathe myself with someone just standing by
  • Get my clothes, get dressed and complete grooming activities by myself
  • Finalize my home skin care program and supplies
  • Finalize my home bladder program
  • Finalize my home bowel program and learn with a to do if things change
  • Prepare age-appropriate snack by myself

Wheelchair and special equipment

  • Push my wheelchair in the community over level surfaces by myself
  • Push my wheelchair up and down a ramp by myself
  • Go from floor to wheelchair with a little help
  • Go up and down a curb with a little help
  • Do a wheelie and pop-up over small obstacles or threshold by myself
  • Able to reach for items at different levels, open doors and cupboards with a little help
  • I have the supplies and equipment that I need for home

Other

  • Explain ADA and my rights and responsibilities
  • Review with my nurse all training needed before going home
  • Meet my outpatient nurse at my discharge team meeting
  • Meet with a rehab psychologist to discuss my feelings about going home
  • Hospital staff will coordinate with my school for a timely and safe return
  • Learn how my care needs will be met at school

To Learn More

  • Rehabilitation Medicine
    206-987-1500
  • Occupational and Physical Therapy 
    206-987-2133
  • Ask your child's healthcare provider
  • seattlechildrens.org/patient-education 

Free Interpreter Services

  • In the hospital, ask your nurse.
  • From outside the hospital, call the toll-free Family Interpreting Line, 1-866-583-1527. Tell the interpreter the name or extension you need.
Seattle Children's Hospital

Seattle Children’s offers free interpreter services for patients, family members and legal representatives who are deaf or hard of hearing or speak a language other than English. Seattle Children’s will make this information available in alternate formats upon request. Call the Family Resource Center at 206-987-2201. This handout has been reviewed by clinical staff at Seattle Children’s. However, your needs are unique. Before you act or rely upon this information, please talk with your healthcare provider.

© 2026 Seattle Children’s, Seattle, Washington. All rights reserved.

03/01/2025
PE1250
Patient and Family Education | Rehabilitation Medicine

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