Wheelchair Provision for Children with Disabilities in Rural Thailand: The Roles of Family Support and Environmental Barriers in Daily Participation

Wheelchair provision remains an essential component of rehabilitation and participation support for children with disabilities, yet there is limited evidence on how wheelchairs are incorporated into daily activities and schooling decisions in rural low-resource contexts where environmental, social, and service constraints are substantial. This study employed a strictly exploratory multiple case study design involving two children with disabilities. Two home visits were conducted for each case, and a qualitative, descriptive cross-case analysis was conducted by integrating semi-structured interview data with WeeFIM scores and ICF Environmental Factors ratings. Wheelchair provision supported short-distance mobility and engagement in household and community activities and reduced some caregiving demands. Positive experiences during outdoor mobility and community interactions contributed to enjoyment and confidence. However, inaccessible housing, limited transportation, and family concerns about safety and readiness continued to inhibit broader independence and school enrollment. Both children remained outside formal schooling, while activities offered by Special Education Centers provided meaningful but limited opportunities for social interaction and development. The findings highlight not only practical implications but also the conceptual importance of environmental constraints and the ambivalent role of family support in shaping participation in rural settings.