Travelling with a child with cerebral palsy: an accessibility and care continuity guide

Children with cerebral palsy travel well when the trip is built around three things: getting the mobility equipment and the child safely from door to door, finding accommodation that supports the child's positioning and transfer needs, and continuing medication, posture and pressure care while away from the regular therapy team. This guide brings together the practical steps that make each of those easier.

Mobility and equipment

• Notify the airline at booking — at least 48 hours before departure for most carriers, longer for transatlantic and long-haul. They need wheelchair dimensions, battery type (lithium-ion above certain Wh values needs declaration), and whether the chair is manual, powered or both
• Take a photo of the wheelchair from each side before check-in. Damage during travel is the single commonest equipment problem; photos make the airline insurance claim straightforward
• Detach loose parts (cushions, joysticks, headrests) and carry them in the cabin. Wrap fragile elements in clothing
• Bring a basic repair kit: pump for tyres, hex/Allen keys, spare castor nuts, gaffer tape, zip ties — fixes most of the wheelchair problems that arise on a trip
• Bring two spare casters and a battery charger with the correct international plug — power-chair batteries usually last 24 hours; chargers do not always fit foreign sockets
• Most airports have airport-supplied wheelchairs through Special Assistance — these are fine for getting through the terminal but should not replace the child's own postural seating for the actual flight

On the plane

• Most airlines have a small dedicated on-board wheelchair (aisle chair) for moving the child between the seat and the toilet — ask at boarding which crew member will help
• Children with severe positioning needs may benefit from a CRELLING or other CARES harness — this is a Federal Aviation Administration- and EASA-approved harness that allows safe seating in a standard plane seat. Bring the harness and the documentation
• Bulkhead row seats give more leg room and easier transfers; book them when offered
• Take a small inflatable wedge cushion to support posture in a standard seat if the child's own postural chair is not flight-approved
• Pressure: change position every hour on long-haul flights — even slight lifting from the seat for 30 seconds reduces the risk of pressure-area skin redness. Set a phone alarm
• Hydration: low cabin humidity is hard on children who already have a higher pressure-injury risk; bring a refillable water bottle through security and offer a small drink every 30 minutes

Accessible accommodation

• Hotels claiming 'accessible' vary enormously — ask for specifics in writing: shower size (1.5 × 1.5 m roll-in shower is ideal), grab rails, bed height (45–55 cm allows hoist transfers), space around the bed (at least one side with 90 cm clearance), and lift width (80 cm minimum)
• Apartments and villas through Airbnb-style platforms often work better than hotels for children with extensive equipment because of the dedicated space and full bathroom
• Mobile hoists, shower chairs, paediatric beds and bath lifts can be hired at most major European destinations through specialist companies for the duration of the trip — book at least 4 weeks ahead
• Confirm power supply for medical equipment: nebulisers, suction machines, feed pumps, BiPAP — and bring a plug adaptor for the destination

Medication continuity

• Antiseizure medicines, baclofen (oral or intrathecal pump), botulinum toxin schedules, melatonin, laxatives and reflux medication should be continued exactly as at home
• For children with an intrathecal baclofen pump — bring the pump card, identify the nearest specialist centre at the destination, and note the next refill date. Some long trips need to be timed around the refill calendar
• Carry the medication doctor's letter (see the epilepsy travel article — same template works) in English and ideally the destination language
• Refill timing: bring enough medication for the trip + one extra week, split between cabin and hold luggage

Posture, pressure and skin

• Reposition every 30–60 minutes during car or plane journeys — even a small shift offloads pressure points
• Check skin at the end of every day, particularly heels, sacrum, ischial tuberosities and any contact point with splints or the chair
• Hot climates increase sweating — extra showers and barrier cream protect skin in pressure-prone areas
• Sun protection: a wide-brimmed hat, UV-protective clothing and SPF 50+ for all exposed skin, reapplied every 2 hours and after swimming
• Many splints stretch in hot water — rinse them in cold water after the pool

Therapy on holiday

• A two-week break from formal therapy is usually fine and even helpful — children come back motivated
• Bring stretch routines, oral-motor exercises and AAC devices that work without the therapist
• Pools, beaches and warm-water environments are excellent therapeutic settings — hydrotherapy effects without the clinic. Many resorts have warm pools that are quieter in the early evening
• Discourage families from booking an intensive 'therapy holiday' (e.g. some commercial residential programmes) without first checking the evidence base with the child's own team — many advertised programmes are not supported by current Cochrane reviews

Hot climates and dehydration

• Children with cerebral palsy regulate temperature less well, particularly if they take antiseizure medication or anticholinergics
• In countries over 30°C, increase fluids by at least 30%, and offer oral rehydration sachets after activity, in the car or pool
• Plan outdoor activity for before 10am and after 5pm — keep the middle of the day cool and indoors
• Air-conditioning is not a luxury — booking a room with AC is a clinical decision, not a comfort one

Emergency planning

• Identify the nearest paediatric A&E and an out-of-hours pharmacy on day 1
• Carry a one-page medical summary: diagnoses, medications, allergies, baseline mobility, equipment needs, emergency contact
• Travel insurance must explicitly cover the diagnosis and any equipment — the cheapest policies often exclude both
• If your child has had a seizure: see the separate epilepsy travel article for medication and emergency steps