Consumer safety is the primary concern of all Orientation and Mobility Instructors. Initially, instructors monitor the student very closely. This decreases over time as skill and consistency develops. While it is impossible to eliminate all risk, the instructor should help the student understand the risks involved with travel.

It is critical that the instructor has the ability to stop a student’s movement. Yelling “stop” will not always work. When working with wheelchair users, the instructor’s position is different in relation to the student than when working with ambulatory consumers. This is especially true during assessment. His position is also markedly different depending on the type of wheelchair or scooter. The instructor may have to vary his strategy based on his own size and strength, the size of the student, and the level of skill the student has achieved in her instruction. Until the student demonstrates the ability to detect and navigate drop-offs and obstacles consistently, the instructor should monitor the student from a position close enough that he can react to potential dangers. Always inform the student when the instructor has backed away to a position where he can no longer intervene.

Verbal commands are helpful but should not be the only method of warning a student of a hazard. Use the student’s name and provide a short prompt to help the student react quickly and appropriately. Give the prompt, the name, and repeat the prompt. Then a more detailed prompt can be given. “Stop, Jane, stop; curb in front,” tells Jane that she needs to stop and why. “Left, John, left; curb on right,” tells John to turn to the left to miss a drop-off on his right.

Anti-tippers (or wheelie bars) are a very important component of safe chair operation. Many people remove the bars because they get in the way when climbing/descending level changes. Anti-tippers are designed to keep the chair from tipping over backward. They are also important in the techniques described below for instructor-controlled emergency stops.

Drop-offs, as small as 2 inches, have the potential to tip over a chair. Read the owner’s manual to determine what is safe for the chair. Speed, angle of approach, consumer strength, and degree of physical impairment all affect how the wheelchair user can navigate safely.

Instructor-Controlled Emergency Stops

Before leaving a safe indoor environment, the instructor should determine how he will be able to stop the wheelchair in an emergency. Emergency stops should be practiced in a safe environment. The instructor must determine the best technique to stop the chair and how far it will travel once he initiates an emergency stop. If the instructor determines the chair will travel 12 inches before it can be stopped, he should be careful to have the student stop and slow down before the wheelchair is within 12 inches of any drop-off.

Electric or Manual Wheelchairs With Handles on the Back

If the wheelchair has handles on the back, safety can be effectively monitored from behind the wheelchair. This technique works best with rear-wheel drive chairs. For front- or mid-wheel drive chairs, the instructor may need to use the technique for chairs without handles.

  1. As the student approaches a hazard, step up directly behind the chair and lightly place both hands on the handles. The student may react to the instructor moving closer; if so, the instructor may need to walk within reach of the back of the chair.
  2. If the student fails to detect or stop for the obstacle, grab both handles and pull back. The chair should pop a wheelie. If the instructor’s body falls back into a seated position, his body weight will help lift the front of the chair.

Watch video MCS7a: Monitoring Consumer Safety: Instructor-controlled emergency stops in a safe environment: Electric or manual wheelchairs with handles on the back.

  1. Keep pulling back until the chair stops moving forward. The chair should rock back putting weight on its anti-tippers. Once on the anti-tippers, the drive wheels should spin, but not continue the forward momentum.
  2. If the momentum continues, pull the handles farther back and down. This should lift the consumer’s feet farther up, putting less weight on the drive wheels.
  3. DO NOT LET GO!
  4. When all forward motion has stopped, pull the chair back from the hazard.
  5. Do not lower the front wheels until they are back over safe ground. Ask the student to back up, if necessary. If the student is using the chair controls to back up, the instructor must also move backward keeping pace with the chair, so that the front wheels do not drop until over safe ground.

Watch video MCS7b: Monitoring Consumer Safety: Instructor-controlled emergency stops outside: Electric or manual wheelchairs with handles on the back.

This is a formidable process. The hardest part is backing up and keeping the front wheels up at the same time. Some instructors may not be able to perform the technique if the student or wheelchair outweighs them by too large a margin. Practice the technique in safe surroundings before assessing skills in other environments. Both the student and the instructor should be prepared in case an emergency stop is required.

Electric Wheelchairs Without Handgrips on the Back

To practice instructor-controlled emergency stops with electric wheelchairs without handgrips on the back, follow these steps.

  1. Monitor from the side, and stay on the side with the joystick.
  2. When a stop is needed, take the student’s wrist and lift straight up, removing her hand from the joystick.
  3. Be prepared for the chair to continue moving a short distance. Brace to catch the chair should it tip.

Watch video MCS7c: Monitoring Consumer Safety: Instructor-controlled emergency stops from the side: Electric wheelchairs without handgrips on the back.

When the instructor cannot reach the student’s hand, he can stop the chair by pulling back on the shoulders of the seatback and dropping into a seated position. This should shift the weight of the chair to the rear wheels. The instructor should keep pulling back, and if necessary, ask the student to drive backward until the drive wheels are back on solid ground.

Watch video MCS7d: Monitoring Consumer Safety: Instructor-controlled emergency stops from the back: Electric wheelchairs without handgrips on the back.

If absolutely necessary to keep the student and chair out of danger, lower the student’s wrist into her lap and briefly drive the chair. Otherwise, point out why it was necessary to stop the chair and ask the student what she needs to do to avoid the problem area.

An alternative method is for the instructor to grasp the student’s hand while still on the joystick and move the joystick to the reverse position. See the section below on instructor-controlled change of direction.

Scooters

Scooters cannot be stopped from the back. Movement is usually controlled by a two-sided lever that toggles forward or backward; this allows the driver to go forward or backward from the same side of the lever. Most people drive by applying light pressure on the throttle to the side that allows the scooter to drive forward, usually the right side. Squeeze on the opposite side to initiate backward movement.

To practice instructor-controlled emergency stops with scooters, follow these steps.

  1. The instructor should stand on the side of the scooter with the throttle control that initiates backward travel. (This is not the same for every scooter, but most often is the left side.)
  2. If the student fails to detect a hazard ahead, reach in and squeeze the throttle control to initiate backward movement.
  3. Squeeze just long enough to stop the forward movement. Make sure that the student does not reapply pressure to the opposite side.
  4. Do not squeeze too long; the chair may go out of control backward.

Watch video MCS7e: Monitoring Consumer Safety: Instructor-controlled emergency stops from the left side: Scooters.

This technique may seem formidable at first, but continue to practice in a safe environment before the student’s skill level is assessed in other environments. Both the student and the instructor need to be prepared in case the technique is needed.

If the instructor is on the opposite side of the scooter from the backward throttle control, he should take the student by the wrist and lift her hand off the control, as described above for wheelchairs without handles.

Watch video MCS7f: Monitoring Consumer Safety: Instructor-controlled emergency stops from the right side: Scooters.

Instructor-Controlled Change of Direction

Wheelchairs With Handgrips on the Back

To initiate instructor-controlled change of direction with wheelchairs that have handgrips on the back, follow these steps.

  1. Follow the chair closely. If the student approaches a hazard on the side, step up behind the chair and lightly grasp both handles.
  2. If the student does not detect or react to the hazard in time, tightly grab the handle in the direction of the desired turn (side opposite of the hazard), stop walking, lean back, and pull hard on the handle. The chair should turn in that direction. If it does not turn in that direction, perform the instructor-controlled emergency stop described above.
  3. The process may need to be repeated more than once.
  4. In case the chair is overcorrected, the instructor should be prepared to pull in the opposite direction.
  5. With manual chairs, a quick pull or push on the armrests can change the chair’s direction.

Watch video MCS7g: Monitoring Consumer Safety: Instructor-controlled change of direction: Wheelchairs with handgrips on the back.

Practice this technique in a safe environment before assessing skills in other environments.

As an alternative, the instructor can walk beside the student on the same side as the joystick and, when necessary, reach out and take control of the joystick.

Electric Wheelchairs Without Handgrips on the Back

To initiate instructor-controlled change of direction for electric wheelchairs without handgrips on the back, follow these steps.

  1. Walk on the side of the chair with the joystick.
  2. When the student veers too close to something or appears to be about to drive into or off something, lean in and guide the student's hand on the joystick to help steer the chair.
  3. Maneuver the joystick in the needed direction. If a stop is required, pull back or lift the student’s hand off the joystick. Pull the joystick to the reverse position to minimize the distance that the chair travels forward.
  4. Continue to drive the chair for several seconds until the student understands what needs to be done.
  5. Release the student’s hand, but be ready to repeat the steps again because the student may overcorrect in the opposite direction in response.

Watch video MCS7h: Monitoring Consumer Safety: Instructor-controlled change of direction from the side: Electric wheelchairs without handgrips on the back.

If the instructor is behind the wheelchair, he may be able to adjust the direction of travel by grabbing the top corners of the seatback or the headrest. Pull the left corner of the seatback to turn the chair to the left. Likewise, pull the right corner of the seatback to turn the chair to the right. The headrest must be pulled across you to the right to redirect the chair to the left and pulled across you to the left to adjust the chair to the right. This technique takes strength and may not be effective. Practice this technique in a safe environment before assessing the student’s skill level in other environments. Both the student and the instructor need to be prepared in case the technique is needed.

Watch video MCS7i: Monitoring Consumer Safety: Instructor-controlled change of direction from the back: Electric wheelchairs without handgrips on the back.

Scooters

Direction changes for scooters can be initiated by physical manipulation of the handlebars. The instructor can walk on either side of the scooter. If the instructor walks on the side of the hazard, it will often prompt the student to move away from the hazard without realizing it. It is easier to change the scooter’s direction of travel from the side opposite of the hazard. To initiate instructor-controlled change of direction with scooters, follow these steps.

  1. Reach up and push or pull the handlebar to initiate the change of direction.
  2. Be prepared to repeat the process or make the opposite adjustment in case of overcorrection.
  3. Some students become frightened or flustered when the handlebars are grabbed. Be ready for the student to react; she may let go, jerk the handlebars back, or squeeze the throttle control lever tighter.
  4. Be cautious of large turns or adjustments. Some scooters, especially three-wheeled chairs, can tip over during sharp turns.

Watch video MCS7j: Monitoring Consumer Safety: Instructor-controlled change of direction: Scooters.

Secondary Controls

Some electric wheelchairs may use a remote joystick to maneuver the chair. Many chairs have the capability of including a second control box. The instructor can carry the secondary control or attach it to the back of the wheelchair. Thus, the instructor is able to operate the chair from behind or the side, overriding information given from the student’s joystick.

OOPS

If the student drives off a drop-off, the instructor should attempt to stabilize the chair and keep it from turning over. The instructor will likely not be able to lift the chair or hold it up; however, it takes a lot less strength to keep the chair upright. If in front, the instructor should grab the sides of the seat or possibly the armrests (if the instructor is strong enough and the armrests do not flip up freely). For scooters, the instructor can grab both sides of the handlebars. Avoid grabbing the student’s knees. If the chair goes over the drop-off, holding the student’s knees could further injure her. The front corners of the seat provide the strongest place to grab from the front.

If the instructor is behind the chair and it has handles, they are the best place to grab. In the absence of handles, the top corners of the seatback can provide a significant amount of leverage. This also works well for scooters. As a last resort, the instructor can grab the headrest.

Watch video MCS7K: Monitoring Consumer Safety: Oops: Scooters

To stabilize a chair from the side, the correction method depends on which direction the chair seems to be tipping. However, the instructor may want to grab on before it is determined which way the chair will tip. Put one arm around the chair back and hug it to your body. This may help keep the chair upright. If the chair hits the drop-off at an angle, the chair will tip in the direction of the first wheel to go over the edge. An instructor situated behind the chair may be able to alter the direction of the chair enough so that it goes straight off, which will reduce the chance of tipping.

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