Learning to ride a bike is challenging for some children with cerebral palsy. It can depend on how cerebral palsy affects them.
Adaptations can often be made to standard bicycles to help suit your child’s needs.
There are many steps and considerations when your child is learning how to ride a bike.
Start with a helmet
All children must wear a helmet when cycling.
If your child dislikes the feeling of a helmet, help them get used to the sensation first.
You could gently massage their head or let them wear the helmet for short periods during play.
Some children like to put their helmet on in front of a mirror, so that they can see what they are doing.
Show your child how to fasten the dial on the back of the helmet, so the helmet does not move on their head.
Make sure the helmet straps are snug but comfortable under their chin - neither too tight nor too loose.
Some bike helmets have a magnetic fastener instead of a buckle. This can make it easier for some children to put it on independently, especially if one hand is weaker than the other.
Getting on the bike
It can be useful for your child to explore ways to get on the bike.
There are many ways to try this, including from an upright position.
Some children find it useful to start with the bike on the ground and stepping over it.
If your child is stronger on one side of their body, it can affect which side they prefer to mount the bike from.
For example, if a child's strong side is the left, they may prefer to stand on the right side of the bike. But it does not mean it is easier to mount the bike from that side.
Let your child experiment to find the side that feels easiest and safest for them.
Walking a bike
It can be useful for your child to walk with their bike so they can feel how to control its movement.
If one side is stronger than the other, explore which side is easier to walk on.
For example, some children who are stronger on their left side may prefer to walk on the right side of the bike. But they may veer to the left when walking as they naturally lean to this side.
For these children, walking on the left side of the bike places their affected side closer to the bike. Some can use the bike almost like a walking aid as they push it. This can help them shift more weight onto their affected side, giving extra support and balance.
This might make it easier for them to walk in a straight line.
After some practice, your child may be able to walk their bike in a figure of 8. This helps check which side is easier to turn to.
Balance bike method
To prepare a standard bike for use as a balance bike, start by removing the pedals.
Place the seat at a height that gives your child a mid-range knee bend (bent about half way) when sitting on the seat.
Balance bikes work by taking most weight through the seat, and not the feet. Many children perch rather than sit, to start.
Some children may benefit from spending time just sitting on the bike as though it were a wobbly stool.
This can help them get a feeling for the bike and practise putting their weight through the seat.
When learning to cycle, it is best that no one holds your child or their bike. They can learn how to control the bike better by themselves.
To roll the bike forward
Teach your child how to roll or scoot the bike forward with their legs on either side of the bike.
Remind your child to keep their weight through the seat, not their feet. This is important because they need their feet to propel them.
When they are confident with this, they can increase their speed. Chasing games help make them faster. Speed will help them glide.
Encourage gliding
Gliding means your child rolls the bike forward with their feet off the ground.
Sometimes it can be useful to draw a 'pond' with chalk on the ground. Encourage your child to lift their feet over the pond.
Check if your child can do this by striding. This means using 1 foot, then the other. But if your child struggles to coordinate this, they can try pushing with both feet at the same time.
If your child is anxious about doing this, they could try going down a very gentle slope to gain more momentum for gliding.
Introducing pedals
When your child can glide for about 5 seconds, they are ready for a pedal.
If your child is stronger on their left side, replace the right pedal first. And if they're stronger on their right side, replace the left pedal.
Place the pedal at its lowest position and encourage your child to stay stationary on the bike with one foot on the pedal.
Hold this position for 10 seconds without losing balance.
Watch the 'introducing pedals' chapter on the bike skills video.
Bike skills for children with cerebral palsy (video)
Gliding with pedals and pedalling to cycle
Teach your child to keep their foot on the 1 pedal and use the other foot to scoot along the ground. As they become more confident, they will be able to glide while keeping their foot on the pedal.
Attach the second pedal.
Repeat the one-footed scooting. When they have enough speed going, encourage them to put their foot onto the second pedal.
From here, your child can start practising pedalling the bike. Having learned to balance the bike and using the pedals to propel it, they will start to cycle.
After practising this newly learned skill of independent cycling, it is likely you will need to raise the seat.
Remember, your child's knees should not come higher than their hips.
Working on advanced skills
When your child is cycling independently, they can start to work on more advanced skills.
It is likely that children who are stronger on their left side will find it easier to turn to their left side.
But some children with reduced arm reach might pull one side of the handlebars more than the other. This can make the bike veer to that side.
With advanced skills, your child will be able to turn either way.
Advanced bike skills can include drawing a figure of 8 on the ground or using cones to encourage turning either side. This is sometimes called 'slalom cycling'.
Teach your child hand signals. This is an advanced skill that is needed for cycling on the road.
After lots of practice, your child can learn to ride off a footpath or to cycle while standing up.
If their bike has gears, it is important that they learn how to use them.
Adaptations for standard bikes
When choosing a bike, consider the symmetry and style of the bike.
Where possible, move the handlebars to within easy reach if your child has a weaker side.
You may also need to adjust the position of the brake lever or even start with the brake lever closer to the handlebars.
Help with the brakes
Sometimes switching the brakes around will let your child use their stronger hand to operate the rear-wheel brake. Sharply pulling the rear brake can sometimes cause the bike to skid. Encourage your child to use both brakes if they can.
You can buy dual brake levers. This lets them brake with both front and rear wheels. A bike shop may be able to fit cable splitters to get the same effect on a smaller bike.
Some bikes have coaster brakes. These are brakes that work by pedalling backward, which slows or stops the bike.
Coaster brakes can work well for some children who find hand brakes difficult to use. Others may find them tricky to operate.
Hand position
Your child may find it hard to keep their weaker hand on the handlebars. They could wear a glove with velcro on the palm. This could attach to a small piece of velcro on the handlebar, helping their hand to remain on the handlebar.
Do not use too much velcro or attach the hand too firmly to the handlebar. This can make it difficult for them to pull their hand away from the handlebar when they fall.
Using splints or ankle-foot orthoses (AFOs)
Your child may use their splints or ankle-foot orthoses (AFOs) when cycling. But it depends on what they are comfortable with.
Sometimes cycling with AFOs on can cause pinching on your child’s calf and thigh muscles, especially if the seat is low.
But sometimes cycling with AFOs on can assist your child to keep their foot level on the pedal rather than their foot sliding off the front of it.
They could also use toe clips, with or without side straps.
These can help them keep their foot on the pedal. It’s best not to firmly attach your child's foot to the pedal. It would not be easy for them to remove their foot when stepping off to stop or if they fall.
This could be an option if the child is using a bike with stabilisers and is less likely to fall.
Feet in position
You can buy self-levelling pedals, if foot sliding is an issue.
Some pedals are wider than others. This can help if your child has in-toeing or out-toeing.
If your child walks with their knees very close together, their knees may hit off the top crossbar when cycling.
Think about using a bike with a low crossbar. It can be hard to change this pattern of movement.
Stabilisers and other considerations
Some children with cerebral palsy are safer when cycling with stabilisers. Regular stabilisers may not give enough stability on larger bikes. You can buy oversized stabilisers.
You may think your child needs a tricycle. But sometimes adapting a standard bike has more advantages. For example, the bike might be easier to transport on a car rack or inside the car.
Backrests can be fitted onto standard seats to provide extra support.
T-bars can make seats more adjustable. This can be helpful if your child's hamstring muscles are not the same length.
Other types of accessories
Other types of accessories can make cycling safer. For example, remote indicators. If one of your child's hands is stronger than the other, you can place the remote onto their stronger side.
This lets them signal to others if they are turning. They do not have to take their hands off the handlebars.
Mirrors can also be useful if your child loses balance when trying to look over their shoulder.
Supporting a child with cerebral palsy to ride a bike
Bike skills for children with ambulant cerebral palsy, part 2 (video)
This content was adapted from a 2-part video series by Enable Ireland.