Spinal Cord Injury T1-T9
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 and 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 the circulatory system
- Bowel and bladder care
- Groom myself (brush teeth, comb hair) with only a little help
- Dress myself with some help
Wheelchair and special equipment
- Sit in my wheelchair
- 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.
Positioning and exercise
- Do my lower body range of motion stretchs with help from my family
- Do my upper body exercises with a little help from my family
- My family understands shoulder preservation strategies
- Stay seated on the mat with someone just in the room
- Change my hand positions while seated on the mat with a little help
- Sit at the edge of the bed or mat with just a little help
- Roll in bed using the bed rails with some help
Recreation and leisure
- Learn how to do activities that are important to me in my free time
- Apply for an accessible parking permit
Self-care
- Do pressure releases with just a little help. My family knows how to help.
- Learn about my medicines
- Learn more about skin care and how to put on my splints
- Complete skin checks with a lot of help from my nurse
- Bathe myself with special equipment and some help
- Groom myself while sitting in my wheelchair
- Dress myself with some help
- Learn how to manage my fluids and cath myself
- Complete my bowel program seated on the toilet with help
Wheelchair and special equipment
- Sit in a wheelchair for up to 8 to 10 hours a day
- Do wheelchair endurance program with some help
- With help from my therapist, my family knows what they need to do to prepare my home for my wheelchair
Other
- Learn about medical conditions related to spinal cord injury
Step 3
Many skills have been introduced by step 3. You will spend the next steps building strength and learning to do tasks more independently.
Positioning and exercise
- Stay seated on the mat table by myself using my arms to support myself
- Change my hand position while seated on the mat by myself
- 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
- Roll in bed without using the bed rails and just a little help from my legs
- Sit up from lying on my bed or mat table with some help
- Transfer onto the mat table using a sliding board with some help
- Complete arm exercises with my therapist or family just watching
- Discuss shoulder preservation strategies
Recreation and leisure
- Learn about safe transportation options
- Participate in a community outing
- Plan and complete family day pass
- Learn about ADA (Americans with Disabilities Act)
Self-care
- Do pressure releases, bed turns, and skin checks daily with the help of my family
- Groom myself when my supplies are set up for me
- Dress my lower body with some help
- Dress my upper body with just a little help
- Cath myself with the help of my family
- Drink the right amounts and keep score with the help of my family
- Do my bowel care with the help of my family
- Transfer on and off the toilet, bath or shower with some help
- Bathe myself with just a little help and special equipment
- Take my medicines with the help of my family
Wheelchair and special equipment
- 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
- Access items in my backpack behind or under my chair with some help
- My family understands changes are recommended for my home to be ready for me and my wheelchair
Other
- Understand and discuss medical conditions and medicines related to spinal cord injury
- My family and I will continue training in possible medical issues like: autonomic dysreflexia (AD), deep vein thrombosis (DVT) and hypotension prevention. We have been given a backpack by our nurse and know what it should have in it.
- Learn how to communicate my wants and needs with the help of my family
Step 4
Positioning and exercise
- Roll in bed with someone just watching
- Sit up from lying on my bed or mat table with just a little help
- Complete a level transfer using a sliding board with just a little help
- Do arm exercises with my therapist or family just watching
- Discuss should preservation strategies
Recreation and leisure
- Participate in adaptive sports demonstration
- Help plan and attend a community outing with help from my family
- Continue to participate in family day pass
- Explain ADA and my rights and responsibilities
Self-care
- Do all my 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 some help
- Do my bladder and bowel management on my own or with the help of my family
- Keep score of how much I drink by myself
- Bathe myself with just a little help and special equipment
- Groom myself when my supplies are set up for me
- Dress my lower body with some help
- Dress my upper body by myself
- Put on any needed braces or splints on my own
- Take medicines on my own or with the help of my family
- Able to reach for items at different levels, open doors and cupboards with a little help
- Prepare age-appropriate snack with some help
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 a lot of help
- Access items in my backpack behind or under my chair with a little help
Other
- My family and I will start to understand issues around aging and spinal cord injury
Step 5
I will be ready for an overnight pass at the end of step 5.
Positioning and exercise
- Sit up from lying on my bed or mat to table by myself
- Complete a level transfer using a sliding board by myself
- Complete a level transfer without a sliding board with a little help
- Transfer across an uneven surface with a little help
- Transfer in and out of a car with some help
- Tolerate a standing frame for 5 minutes
- Complete arm exercises with my therapist or family just watching
- Discuss shoulder preservation strategies
Recreation and leisure
- Complete family weekend overnight pass
Self-care
- Transfer on and off tub or shower bench and toilet with just a little help
- Use long-handled equipment and bathe myself with someone close by
- Get and set up my clothing myself
- Dress my lower body with just a little help with the bed flat and without using bed rails
- Dress my upper body by myself
- Open doors, go in and out of public bathroom stall without help
- Reach for items at different levels, open doors and cupboards
- Prepare age-appropriate snack with a little help
- Take my medicines without any help
- Manage my bladder needs myself
- Manage my bowel needs by myself
- Drink the right amount on my own
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
- Do a wheelie and a pop-up in my wheelchair with just a little help
- Go from the floor into my wheelchair with some help
- Access items in my backpack behind or under my chair
- Confirm my home is ready for me and my wheelchair
Other
- Review the "Yes You Can" book with my nurse
- Review with my nurse all training needed before an overnight pass home
Step 6
I will be ready to discharge 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 just 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 within my community
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
- Open and close doors, retrieve items from different heights or behind/under my wheelchair
- Prepare age-appropriate snack by myself
- Finalize my home skin care program and supplies
- Finalize my home bladder program
- Finalize my home bowel program and learn what to do if things change
- Learn my medicine
Wheelchair and special equipment
- Go from floor to wheelchair with some help
- Go up and down a curb with a little help
- Do a wheelie and pop-up over small obstacles or thresholds by myself
- I have the supplies and equipment that I need from home
Other
- 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 Services
206-987-1500 - Occupational/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.
