Mobility & Seating Clinic

Overview

The Mobility and Seating Clinic at Cleveland Clinic Children’s Hospital for Rehabilitation focuses on mobility solutions for infants, children, adolescents and young adults. Together, we explore a variety of options to help those with mobility challenges get moving to explore, learn and participate!

Our unique team approach involves the patient and their family, our specialized physical and occupational therapists, rehab physicians, durable medical equipment suppliers and anyone on the patient's therapy, medical and caregiving team. Mobility gives us the freedom to participate, make choices and make friends. 

Who benefits from a mobility evaluation?

• Infants and toddlers
  • Anyone who is at least 6 months old and has a diagnosis which may delay or prevent the onset of crawling, standing, and walking (even if they will eventually learn to walk).
  • Anyone who is at least 12 months old and has motor delays that include: limited or no crawling or limited or no standing. 
  Toddlers and preschoolers
  • Children who have motor delays that prevent them from moving independently at home, outdoor or in activities (even if they are working on walking or will eventually learn to walk).
  • Children who can walk but their endurance or medical condition limits their ability to participate at the same level as other children their age.
  School aged: kindergarten through high school
  • Children who have motor delays that prevent them from moving independently in all environments (even if they are working on walking or will eventually learn to walk)
  • Children who can walk but their endurance or medical condition limits their ability to participate at the same level as other children their age.
  • Any child who can walk or wheel but cannot keep up with kids their own age.
  • Children whose diagnosis will lead to an eventual loss of mobility.
• Post high school
  • Any young adult who can walk part time but has difficulty keeping up with friends, maintaining balance in crowds, or tires out limiting their participation.
  • Any young adult who has motor limitations that prevent them from moving independently in all environments.
  • Any young adult whose motor limitations limit their participation in work or college.
• Anyone with a mobility system that needs modifications because of:
  • Growth
  • A change in medical status
  • A need for increased independence for school, home or work
  • A change in school or work environment such as a transition to a larger school campus that affects independence
  • Body changes that need different supports for posture
  • Is experiencing redness or open areas from using their current mobility system
• Anyone that needs consideration for a secondary system as a backup to a primary chair.
• Anyone who would like to consider other equipment such as bath equipment, adaptive car seats or standers..

Don't watch life from the sidelines! Get moving!

Our Program

At Cleveland Clinic Children's Seating and Mobility Clinic, we believe the best results happen when we work together. While you'll have a primary seating and mobility therapist dedicated to your child, our entire staff works behind the scenes to share ideas and problem-solve. This means your child benefits from our whole team’s combined experience and creative thinking.

You're the expert on your child. We always welcome your perspective and encourage you to invite your child’s current therapists, caregivers or doctors to be part of the process.

Why families trust us

We are passionate about staying at the forefront of mobility so your child has every advantage:

• Proven methods: We stay up to date on the latest research to ensure our recommendations are safe and effective.
• Pediatric experts: We partner with equipment suppliers who specialize in kids, ensuring your child’s gear is built specifically for their needs.
• Constant improvement: Our team is always learning. We regularly attend workshops to find the newest and best products available.
• Leading the way: We aren't just following the latest trends; we help teach other professionals by presenting at conferences near and far.
• Coordinated support: If your child uses a communication device, we work closely with their speech team. We make sure their equipment is set up so they can move and communicate comfortably at the same time.

Team members include (but are not limited to):

• You, your child and/or your family
• A Mobility Clinic physician (pediatrician or physiatrist)
• Lainie Holman, MD
• Erin Murdock, MD
• Mary Wong, MD
• Noel Pristas, MD
• A Mobility Clinic therapist (occupational therapist or physical therapist)
• Andrina Sabet, PT
• Meghan Price, OTR/L
• Ann Donnelly, OTR/L
• Dan Schaefer, PT
• Scheduling and Support
• Stefanie Plevrakis
• A durable medical equipment supplier (this is chosen by you or your insurance)

Choosing a durable medical equipment (DME) provider

Getting the right equipment for your child is a team effort, and your medical equipment supplier plays an important role. They join us for evaluations, handle all the insurance paperwork and provide the hands-on service and repairs your child’s equipment might need down the road.

Because pediatric equipment is such a specialized field, we work closely with these trusted suppliers:

• National Seating and Mobility
• Millers Rental and Sales 

Before we get started, we recommend checking with your insurance provider (including private insurance or Medicaid HMOs). Some plans require you to use a specific "preferred provider," and knowing this ahead of time will help ensure the process goes as smoothly as possible.

Our focus

New and replacement equipment

Choosing the right equipment is a big decision, and it’s completely normal to have questions or feel a bit overwhelmed by the process. Between navigating insurance and figuring out what works for your daily life, there's a lot to consider. We know that the chair that works great in your living room might not be the best fit for the playground or a busy school hallway.

Our goal is to help you explore all the possibilities. We look at everything from equipment your child can move on their own to options designed for you to help them get around. We love finding ways that the right gear can help your child stay active, reach new milestones, and truly join in on the fun.

Whenever we can, we make sure you can see or try the equipment in person—because a picture in a catalog just isn't the same as seeing it in action. Our team is here to provide the resources, training, and "test drives" needed to find exactly what will make the biggest difference for your child and your family.

Equipment modification

Many insurance plans expect a mobility base to last for five years. However, we know that children grow and needs change well before that milestone. Whether your child has a growth spurt or simply needs a few tweaks to stay comfortable and active, we're here to help.

Together, we can look at ways to adjust or modify your current equipment to make sure it continues to be a perfect fit and keeps your child moving!

Mobility training

Whether your child uses a manual or a power chair, we’re here to help. We can take a close look at how the chair is set up and how your child moves to make sure everything is working as well as it possibly can.

In one-on-one therapy sessions, we’ll focus on the goals that matter most to your family.

 

How to Get Started

Questions

If you have any questions about the Mobility and Seating Clinic, please call 216.448.6127 or email TSSSpecialtySch@ccf.org.

Ready to schedule an appointment?

Note: ALL Mobility Clinic patients require a prescription. 

• If you need new equipment or modifications to existing equipment:

• Physician prescription needs to include: Your child’s diagnosis, Mobility Equipment Evaluation, and Occupational and Physical Therapy (OT/PT)

• If you need mobility training:

• Physician prescription needs to include: Your child’s diagnosis, Mobility Training, and Occupational and Physical Therapy (OT/PT)

If you have a Cleveland Clinic physician, your referral will automatically be available to our team. If your physician is a non-Cleveland Clinic provider, please fax your prescription to 216.448,6013.

Once you have a prescription, call the intake line at 216.448.6127. You'll be asked to complete a brief intake questionnaire.

Additional Scheduling Information

Physical Therapy and Occupational Therapy Visits

All appointments through the Mobility and Seating Clinic involve either an occupational or physical therapist. If you have a limited number of therapy visits on your insurance policy, please be sure to discuss this with the scheduler when you register.

Choosing a Durable Medical Equipment Provider

Ordering equipment is a team effort and a durable medical equipment supply company is a valuable part of our team. They participate in the assessment, process all paperwork to the insurance company and provide service to the equipment down the road. Pediatric equipment is a unique specialty. We have a working relationship with the suppliers listed below. If your child is covered under private insurance or under a Medicaid HMO, please contact your insurance company to determine if there is a preferred provider.

Our clinic works primarily with two local companies:

• National Seating and Mobility
• Cleveland Branch (6430 Eastland Rd., Suite 1, Brookpark)
• Dawn Havrilla, ATP, and Jeromy Havrilla, ATP
• Parma Branch (5230 Hauserman Rd., Suite A, Parma)
• Lisa Nemec, ATP
• Millers Rental and Sales (5410 Warner Rd., Cleveland)
• Don Shiplett, ATP

Understanding Your Private Insurance Policy & Durable Medical Equipment

It is important to understand any financial obligations that you may have. You can contact your insurance company prior to your appointment for the below information. 

• What is your DME (durable medical equipment) policy?
• When many families ask this question, the insurance company may ask you for a code for a chair or piece of equipment so that they can tell you if it is covered. At this stage we are looking for more general information regarding your policy. Here are some direct questions that might help.
• At what percentage is equipment covered?
• If it less than 100%, does your policy have a set deductible to meet and then a change in coverage percentage?
• If so, has your deductible been met for the year?
• Are there any equipment exclusions unique to your policy?
• Some policies have specific items that they do not cover, for example: Bathroom equipment.
• Does my policy require the use of a preferred durable medical equipment supplier? If so are either Health Aid of Ohio, National Seating and Mobility, or Millers Rental and Sales in network?

New Equipment

What to Expect: Evaluations for New Equipment

  What to Bring

• A copy of your most recent insurance card
• A current height and weight for you or your child
• A list of what you like about you or your child's current equipment or mobility solution
• A list of any problems or challenges with you or your child’s current equipment or mobility solution
• You or your child’s orthotics: any braces worn during the day for the back, neck, hands, or feet
• You or your child’s current mobility equipment including wheelchair or stroller with all parts (headrest, lap tray, etc.)

Location: Cleveland Clinic Children's Hospital for Rehabilitation
2801 Martin Luther King Jr. Dr.
Cleveland, OH 44104

Parking is available in the lower lot. Upon entering the facility, please check in at the registration desk and then take the elevator to the first floor lobby. The therapist will meet you there.

Our Approach

We have a multi step evaluation system, created in response to family feedback. Equipment decisions involve multiple considerations which can be overwhelming for many families. Your insurance expects this equipment to last for 5 years so it is important to take the time to make a thoughtful decision. These appointments allows time for questions to be answered and families to learn about all of their options. It also allows us more time to get to know you and your child so we can make better recommendations. While we strive to have demos of multiple types of equipment, we frequently have to make arrangements for trial equipment. This approach allows us the time to do so.

Step 1: Evaluation Part 1 will last approximately 60-90 minutes.

1. This session will involve:
• Our mobility clinic therapist and one of our physicians.
•  You are welcome to bring any therapists or caregivers to any appointment.
• If you are under 18, at least one parent must attend this session. 
• If your child is shy around new people, please feel welcome to bring a video or photos of your child doing things she enjoys.
2. This session will focus on
• Your or your child’s history
• Activities, hobbies, and interests
• Places or activities where participation is challenging due to mobility limitations
• An assessment of you or your child’s posture and flexibility
• An assessment of movement, balance and strength
• A discussion of the pros and cons of different types of mobility and equipment
• A decision of what equipment types need to be explored

Step 2: Mobility Trials: 4-6 sessions with a mobility therapist lasting 60 minutes each.

1. These sessions will focus on exploring a variety of independent mobility options.
2. If you or your child are not pursuing independent mobility or a change in independent mobility type, you will go directly to step 3
3. Some time will be spent adjusting the equipment for use by you or your child.
4. Multiple opportunities are necessary to learn new ways to move and try different approaches.
5. This concludes with a trial of the equipment in your home and community
6. Parents are encouraged to attend these sessions but this may involve a combination of caregivers if you are under 18

Step 3: Evaluation Part 2 will last 60-90 minutes.

1. This session will involve:
• The mobility clinic therapist and the durable medical equipment supplier.
• You are welcome to bring any therapists or caregivers to any appointment.
• If you are under 18, a parent must be present for this session.
2. This session will focus on
• Measurements of you or your or child for sizing purposes
• Any additional equipment trials or demonstrations
• Determine all specifics of the equipment prescription

Step 4: Submitting to Insurance

After all equipment decisions are finalized, documentation is generated to be sent to your insurance company. This is a combined effort of the therapist, the physician and the DME provider.

Your insurance will make a decision regarding each item that was submitted. If denials occur, we will work with your family to appeal the denials or consider alternatives. This time frame is unique to each individual.

Step 5: Receiving your equipment

1. Custom Seat and Backs: Some have a custom seat or back as part of their equipment. Once insurance has approved the custom seat and/or back, you will be contacted to schedule a molding appointment.
   • 60 minutes for a seat
   • 60 minutes for a back
   • 90 minutes for a seat and back
• This appointment determines the shape of the cushion and/or backrest.
• Appointment lengths vary but last approximately:
• You or your child should wear light, comfortable clothing
• Avoid clothes with stripes or patterns as this can cause confusion in the molding process
• This is often a good time to review what was decided and is on order. Please allow extra time if you would like to review the order.
2. Equipment Delivery
• This appointment is scheduled at the Mobility and Seating Clinic to ensure that the chair is well fitted to you or your child, to educate you on the new equipment and address all questions.
• These appointments vary in length, most deliveries will take around 2 hours to complete adjustments. Check with your primary therapist to get an estimate that reflects your appointment specifics.

Step 6: Using your equipment:

Training sessions can be scheduled with your mobility therapist so you or your child can master moving in the new ride. Please let your mobility therapist know if you are interested in scheduling these sessions.

Equipment Modifications

What to expect: evaluations for equipment modifications

What to bring:

• A copy of your most recent insurance card.
• A current height and weight for you or your child.
• A list of what you like about you or your child's current equipment or mobility solution.
• A list of any problems or challenges with you or your child’s current equipment or mobility solution.
• You or your child’s orthotics: any braces worn during the day for the back, neck, hands, or feet.
• You or your child’s current mobility equipment including wheelchair or stroller with all parts (headrest, lap tray, etc.).

Location: Cleveland Clinic Children's Hospital for Rehabilitation
2801 Martin Luther King Jr. Dr.
Cleveland, OH 44104

Parking is available in the lower lot. Upon entering the facility, please check in at the registration desk and then take the elevator to the first floor lobby. The therapist will meet you there.

Our approach

We have a multi step evaluation system, created in response to family feedback. Equipment decisions involve multiple considerations which can be overwhelming for many families. Your insurance expects this equipment to last for 5 years so it is important to take the time to make a thoughtful decision. These appointments allows time for questions to be answered and families to learn about all of their options. It also allows us more time to get to know you and your child so we can make better recommendations. While we strive to have demos of multiple types of equipment, we frequently have to make arrangements for trial equipment. This approach allows us the time to do so.

Step 1: Evaluation appointment

1. Evaluations for modifications to current equipment: Insurance companies expect your frame to last 5 years.  During this time, modifications are often necessary for growth or changing needs.
2. This is one appointment which will last approximately 90 minutes
   • You will meet with the mobility clinic therapist, the physician, and the durable medical equipment supplier. You are welcome to bring any therapists or caregivers to any appointment. If you are under 18, at least one parent needs to be present at this appointment.
   • This session will focus on
   • A discussion of goals and challenges with your current equipment
   • Aan assessment of you or your child’s posture, flexibility, balance, strength and movement.
   • An opportunity to learn/discuss types of modifications possible on your equipment
   • Measurements to look at sizing of equipment that is being discussed
   • Determine if additional equipment trials would be helpful: Some modifications can be big changes and it can be helpful to determine if the changes are going to have a good chance of success.
   • Determine all components of the equipment
3. This session will focus on
   • Your or your child’s history
   • Activities, hobbies, and interests
   • Places or activities where participation is challenging due to mobility limitations
   • An assessment of you or your child’s posture and flexibility
   • An assessment of movement, balance and strength
   • A discussion of the pros and cons of different types of mobility and equipment
   • A decision of what equipment types need to be explored

Step 2: Submitting to insurance

After all equipment decisions are finalized, documentation is generated to be sent to your insurance company.  This is a combined effort of the therapist, the physician and the DME provider.

Your insurance will make a decision regarding each item that was submitted. If denials occur, we will work with your family to appeal the denials or consider alternatives.  This time frame is unique to each individual. 

Step 3: Receiving your equipment

1. Custom Seat and Backs: Some have a custom seat or back as part of their equipment. Once insurance has approved the custom seat and/or back, you will be contacted to schedule a molding appointment.
   • This appointment determines the shape of the cushion and/or backrest.
   • Appointment lengths vary but last approximately:
     • 60 minutes for a seat
     • 60 minutes for a back
     • 90 minutes for a seat and back
   • You or your child should wear light, comfortable clothing
   • Avoid clothes with stripes or patterns as this can cause confusion in the molding process
   • This is often a good time to review what was decided and is on order. Please allow extra time if you would like to review the order.
2. Equipment Delivery
   • This appointment is scheduled at the Mobility and Seating Clinic to ensure that the chair is well fitted to you or your child, to educate you on the new equipment and address all questions.
   • In an effort to reduce the time of this appointment, the supplier may need to pick up your current chair the day before to complete some of the changes at their shop.
   • Check with your primary therapist to get an estimate that reflects your appointment specifics.

Step 4: Using your equipment

Training sessions can be scheduled with your mobility therapist if you or your child need help to improve mobility skills.

Mobility Training

What to expect during mobility training

Mobility needs change as kids get older. Schools get bigger and interests change. One way to help your participation in activities is to make sure that your chair is helping you be as independent as possible. In a manual chair, you may need to learn some new skills like how to get up and down a curb safely or better techniques for managing ramps and hills. Maybe the set up of your chair could be altered to keep your speeds high and minimize stress on your shoulders.

Power chairs may need changes too! Many power chairs have highly sophisticated electronics that can be adjusted to your unique needs for independence. Sometimes the way to control your chair needs to change or maybe you are just ready to do more with your chair.

No matter how you roll, if you are relying on caregivers more than you used to or just want to be more independent, mobility training may help. It is easy to think moving a chair will come with just practice. While practice is critical, techniques and chair set up can make a definite difference. Your initial session will include an evaluation of how you move in your chair as well as an assessment of your strengths and posture on the mat. We have therapy options of varying intensity to best match your schedule, goals and insurance funding.

What to bring:

• Your chair and all components: headrests, lap tray, etc.
• Your goals
• Contact information for your therapists and your equipment supplier
• If you are under 18, a parent or caregiver must attend these sessions.

Resources

Wheelchair Transportation Safety

• Wheelchair and School Bus Transportation Safety
• American Academy of Pediatrics Statement 2018

Funding Challenges

• Disability Rights Ohio

Why Mobility Matters

• Upworthy Video- How a system of ropes and pulleys may change the lives of babies with Down Syndrome

Contact Us

Scheduling/General Information

Please call 216.448.6127.

Cancellations

Need to cancel? Please let us know as soon as possible by calling 216.448.6127. Because your visit is a team effort that often involves a physician, supplier, and therapist, we ask for at least 24 hours' notice for cancellations. This ensures we can provide the best care for you and others.

Location

Cleveland Clinic Children’s Hospital for Rehabilitation
2801 Martin Luther King Jr. Dr.
Cleveland, OH 44104

Problems with your chair?

For service related issues or emergencies related to the safe use of your equipment, please contact the supplier who provided your equipment. Here are the service numbers for suppliers that regularly participate in our clinic:

National Seating and Mobility Cleveland branch on Brookpark Rd.
440.471.7973, dial 6 for service

National Seating and Mobility Parma branch on Hausserman Rd.
440.421.2189

Millers Rental and Sales, Cleveland Office on Warner Rd.
330.572.2607

For any other non-urgent problems or concerns, please contact your Mobility Clinic therapist

• Ann Donnelly, OTR/L 
• Meghan Price, OTR/L
• Andrina Sabet, PT, ATP
• Dan Schaefer, PT