World Cerebral Palsy Day, recognized globally on October 6, celebrates more than 17 million people living with cerebral palsy (CP). But awareness is just the beginning. True inclusion means having the right tools and opportunities to participate, create, communicate, and express yourself.
Discover how Guided Hands® can support children and adults with CP through practical setups, adaptations, and everyday activities.
Understanding Cerebral Palsy
Cerebral palsy is a lifelong condition that affects movement, posture, and coordination. It is the most common motor disability in childhood. In the U.S., about 2.4 in every 1,000 8-year-olds (roughly 1 in 400) have CP, according to 2022 data from the CDC's Autism and Developmental Disabilities Monitoring Network. It can look very different from person to person.
CP is generally classified by the type of movement affected:
Healthcare professionals may also use the Gross Motor Function Classification System (GMFCS) to describe overall mobility and the Manual Ability Classification System (MACS) to describe how a person uses their hands during everyday activities.
However, a classification should never define someone's potential. Individuals may experience spasticity, weakness, tremors, fatigue, limited range of motion, or difficulty with fine motor control while still wanting to participate, communicate, create, and make choices.
That's why assistive technology should be adapted to the individual, not simply their diagnosis or classification level.
How Guided Hands® Supports People with Cerebral Palsy
Guided Hands® is a mechanical assistive device that helps people with limited hand mobility write, draw, paint, access touchscreens, and participate in play-based activities. Used by children and adults with cerebral palsy across 26 countries, Guided Hands® supports participation and independence at school, in therapy, and at home.
How It Works
Guided Hands® supports shoulder-driven movement without relying on fine motor skills, eye-tracking, or hand-under-hand assistance.
The individual's hand and wrist rest on a supportive handpiece, while their chosen tool, such as a pen, paintbrush, or touchscreen stylus, is secured to the connected arm. As the individual moves their shoulder and upper arm, Guided Hands® glides across the surface and moves the tool with them.
Key Benefits
- Supports controlled movementKeeps the hand supported and gliding along the activity surface, helping individuals use the movement they have to perform more controlled, purposeful activities.
- Promotes active participation and independenceEnables individuals to initiate activities using their own movement, reducing reliance on hand-under-hand assistance or eye-gaze technology.
- Supports longer participationReduces the effort required to stabilize the hand and hold a utensil, allowing individuals to focus more of their energy on the activity.
- Unlocks communication and self-expressionProvides a low-tech solution for accessing AAC devices and touchscreens while creating opportunities to communicate thoughts, choices, opinions, creativity, and personality.
- Grows with the individualFrom writing, art, play, and AAC access to therapy, hobbies, work, and everyday activities, Guided Hands® can evolve alongside an individual's goals and needs through different stages of life.
Finding the Right Guided Hands® Setup
Every person with cerebral palsy moves differently, so there is no one-size-fits-all setup.
Start simple and observe how the individual moves. Give them time to initiate movement, focus on participation rather than perfect task completion, and encourage independence before providing physical assistance. Position materials to encourage purposeful movement and adapt the activity or environment before assuming the individual cannot participate.
Choosing a Handpiece
| Handpiece | Supports individuals with | Why it works |
|---|---|---|
| Spherical Handpiece | Low muscle tone, reduced grip strength, or an open-hand resting posture | Its rounded shape provides a larger surface for the hand without requiring a strong grasp |
| Joystick Handpiece | Spasticity, or those who naturally maintain a loose fist or neutral hand position | The fingers can curl around its base while maintaining a comfortable hand position, even when pronation is limited |
| Flat Handpiece | Significant hypertonia, finger flexor spasticity, or a tightly closed fist | The hand can rest on top without requiring a grasp or forced finger extension |
For high tone or spasticity: For individuals with a fisted grip, the flat handpiece is most commonly recommended. The fingers can gently curl around the handpiece or rest on its flat surface.
For low tone or muscle weakness: All three handpieces can work well, so choose the option that is most comfortable. Additional support, such as a strap across the knuckles, can help keep the hand comfortably positioned when needed.
Did you know? You don't need a hand to use Guided Hands®. The handpiece can be removed to support individuals with limb differences or amputations by positioning and securing the arm directly to the device.
Positioning & Environmental Adaptations
Small changes to positioning and the environment can make Guided Hands® more comfortable and easier to use. Start simple and introduce adaptations based on the individual's movement, comfort, and goals. The items mentioned below can all be found in our Guided Hands® Bundle pictured below.
| Adaptation | How it helps | Best for |
|---|---|---|
| Bungee cord resistance | Attach bungee cords to the horizontal and vertical bars of Guided Hands® to add resistance with each movement. This provides proprioceptive input to increase awareness of the hand and arm and may help slow larger or sudden movements for greater control. | High toneInvoluntary movements |
| Wrist weight | Provides additional weight and proprioceptive input that may support stability and body awareness during activities. | High toneLow tone |
| Slant board | Inclines the activity surface to support comfortable positioning and bring the activity into an easier range of movement. | High toneCVI |
| Pool noodle bumpers | Add sections of pool noodle to the sliding system to limit the available range of motion and provide soft cushioning at the end of the movement. | High tone |
| Bring the activity closer | Position Guided Hands® closer to the body or on a lap tray to reduce reaching demands, particularly when shoulder strength is limited. | Low tone |
| Wrist straps | Add a comfortable wrist strap when additional support is needed to help maintain the individual's hand position on the handpiece. | Involuntary movements |
| Suction cups | Secure Guided Hands® to the activity surface using suction cups to help prevent the device from shifting during larger or involuntary movements. | Involuntary movements |
| Slant Board and Light box |
Use a slant board to position the device at a more accessible viewing angle. Place the paper on a light box positioned on the base of the device. Using a red marker on the light box creates high contrast, which may make the activity easier to visually locate and follow. |
CVI |
Note: Every person with cerebral palsy moves differently. When introducing resistance, weights, significant positioning changes, or other physical adaptations, collaborate with the individual's OT or PT when appropriate to ensure the setup is safe, comfortable, and aligned with their goals.
5 Activities to Try with Guided Hands® Across the Lifespan
Guided Hands® can be used for much more than writing and drawing. Explore activities that encourage movement, communication, play, creativity, and participation based on what is meaningful to the individual.
Light-Up Buzzers
Position light-up or recordable buzzers within the individual's movement range and encourage them to move Guided Hands® toward the target.
Great for: Cause-and-effect play, choice-making, purposeful movement, control, and interactive games. Add bungee cord resistance when appropriate for additional proprioceptive input and resistance.
Magnetic Tiles & Play-Based Activities
Use Guided Hands® to push, move, sort, or interact with magnetic tiles, bean bags, pom-poms, and other hands-on materials.
Great for: Play, crossing midline, sensory exploration, crossing midline, visual tracking, spatial awareness, and participating alongside peers or family.
AAC & Touchscreen Access
Insert a touchscreen stylus into Guided Hands® and position a tablet within the individual's comfortable movement range.
Individuals can select AAC messages, interact with educational apps, play games, make choices, and navigate touchscreen activities using their own movement.
Great for: Communication, choice-making, digital access, learning, independence, and self-expression.
Art & Self-Expression
Attach a marker, paintbrush, crayon, or other art tool and let the individual create using movement from their shoulder and upper arm.
Great for: Painting, drawing, colouring, creative expression, and participating in art alongside peers and family.
Life Skills and Independent Living
Guided Hands® can also be adapted for meaningful activities beyond the classroom or therapy session. Remove the handpiece and use the tool holder for activities such as applying makeup or self-feeding!
Great for: Independence, recreation, and self-expression.
Our Family Bundle, Classroom Bundle and Healthcare Bundle each come with an activity kit and guide featuring over 40 different activities.
This World Cerebral Palsy Day, Let's Move Beyond Awareness
Awareness matters, but access creates opportunity.
When we adapt environments, activities, and technology around the individual, we create more opportunities for people with cerebral palsy to participate, communicate, create, make choices, and express who they are.
At ImaginAble Solutions, that's what World Cerebral Palsy Day means to us: focusing not on what someone cannot do, but on what becomes possible when they are given the right tools and opportunities.
Because self-expression is a human right, and everyone deserves the opportunity to leave their mark in the world.
Could Guided Hands® Support You or Someone You Work With?
Every individual moves differently. Our team can help you explore Guided Hands® handpieces, adaptations, activities, and setup options based on the individual's movement and goals.
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