[The authors] assessed the association between mobility device use and quality of life in a large cohort of children with Friedreich ataxia. Although worsening of the physical domain of quality of life was expected, the impact on psychosocial functioning was found to be significant and is a key concern for patients, their families, and care providers. Mobility device use affected all domains of quality of life, suggesting that affected individuals requiring mobility aids would benefit from increased assessment of their academic, social and emotional needs in school and community settings. Emotional quality of life remained stable during the challenging transition to use of a mobility device, and improved over time, suggesting that psychosocial support in adapting to disease progression is essential. Understanding the trajectory of quality of life currently associated with mobility device use in children with Friedreich ataxia will be useful for counseling and providing anticipatory care for these individuals. Further research is needed to define the unique physical and emotional needs of this population.