Hesperian Health Guides

Chapter 51: Adapting the Home and Community

HealthWiki > Disabled Village Children > Chapter 51: Adapting the Home and Community


The kind of adaptations needed in the home will partly depend on the kind of disability a child has, the severity of the disability and the age and size of the child. Adaptations for a child who is blind are very different than those for a child who is paralyzed and uses a wheelchair. A child who is completely dependent will need aids and adaptations to help the family care for him and move him—especially as he gets older and heavier. However, the disabled child who can do a lot for herself may be helped by adaptations that make self-care and work in the house easier.

The kinds of adaptations needed will also depend on the local living situation, style of house, and customs. For example:

a child in wheelchair going into her house using a ramp
A simple ramp may work well for a wheelchair entrance to a house near ground level.
Ramp can be made of wood or of dirt or rocks, perhaps covered with a thin layer of cement. See "Adapting the Community"
girl in wheelchair using pulley to get into the house on stilts
A system of ropes and pulleys may be the best way for a person with strong arms to lift herself without help to a ‘house on stilts’.
block and tackle (system of pulleys)
canvas sling

The ‘lift’ can be made with a platform so that the whole wheelchair can be lifted. But if the house is small and people cook and eat at floor level, it may be best to leave the wheelchair outside.

Adaptations for the child who is learning to walk and balance


These can be fixed to the walls and furniture. If necessary, pathways with rails can be put up so that the child can walk with support almost anywhere in the house, and also outside to the latrine (toilet) or garden (see "Adaptations for farm work and gardening").

Before attaching hand rails firmly, test the child with a temporary rail at different heights to find out what works best As the child grows, you may need to place the rails higher. Or you may want to remove rails little by little to help the child improve her balance and walk more independently.

inside of a house with poles and rails around for child's support
Hand rails of different height form a ‘ladder’ on which the child can pull to standing.
pole to help child stand up at table
chair with crossbars for child to climb up on
high stool with climb-up poles for kitchen work
Where floors are of dirt, hand rails can be mounted on upright poles.


For the child who only rolls or crawls, some kind of straw mat or rug will help protect her knees and skin, and will help her stay cleaner (if floors are of dirt).

door handle
Easy-to-turn door handle for child with poor hand control.
A child in a room crawling with things within her reach
low light switch
Door handle at low height for crawling child (or high if you do not want her to go out alone.
Water jug and cup near floor for older child who can only crawl.
The ‘model home’ in PROJIMO is a guesthouse. It has features that make it easier to care for a disabled person, or for a disabled person to care for herself and do housework. Visiting families can find out what is useful for their child and can adapt their own home. Here PROJIMO workers split wild cane to make screens to keep out the animals.
workers working on a house

Home adaptations for wheelchair riders


a child using a wheelboard wheeling through a bumpy road and a child on a wheelboard wheelong through a smooth road

For almost any disabled person—but especially those who use wheelboards or scooters with small wheels, the floor should be as smooth and firm as possible (but not slick or slippery). Packed, smoothed clayand- cow-dung surfaces (as used in India) work well. Cement is even better for long-lasting use of a trolley or wheelchair. Although expensive, a smooth cement floor makes getting around a lot easier.


child in wheelchair going through a door
Put latches and door handles low enough for easy reach.
door sill
small ramp

Make all doorways extra wide. Remember, your child will grow and may need a bigger, wider wheelchair.

In a house that already has very narrow doorways, be sure the wheelchair you buy or make is narrow enough to fit through easily. Most commercial chairs are much wider than necessary, especially for a child.

Try to avoid any rise or bump at the doorway. If it already has a raised sill and you cannot remove it, build a small ramp to go over it. (This will be of special help for children with weak arms and hands).


A bathroom plan with homemade furniture
Be sure the room is big enough for a wheelchair to turn around in easily.
A wheelchair without armrests or with a removable armrest is best for transferring to the toilet.
hand rail on far side from wheelchair
toilet seat the same height as seat of wheelchair
bathing stool same height as wheelchair, with metal frame and woven plastic or rubber strips of car inner tube
towel on
low rack
washstand at height just above knees of wheelchair rider
For a wheelchair rider, a curtain is often easier to open and close than a door.


person in wheelchair cooking
mud stove on mud covered pole frame
low, easy to reach shelves

The stove, work areas, and tables should be as low as possible, but high enough so that the legs of the wheelchair rider can fit under them.

DVC Ch50 Page 488-3.jpg
The cooking and eating area in the model home at PROJIMO has a lot of adaptations.


The bed or cot should be the same height as the wheelchair for easier transfer.

Child in wheelchair transferring into low cot on his own.
One or more hanging bars or other supports may help the child to transfer or to sit up in bed.
Cot height can be adjusted by drilling new holes and changing the position of the bolt.

WASHING AREA (outdoor)

Child in wheelchair washing clothes.
cement wash stand with ridged bottom
DVC Ch50 Page 488-6.jpg
Outdoor washing area at PROJIMO— designed for work from a wheelchair.

IMPORTANT! Before building fixed-height stoves, tables, and wash areas, set up something temporary to figure out what works best. Remember that the child is growing, so try not to make things too fixed or permanent.

This page was updated:27 May 2020