Aims This qualitative grounded theory research study was designed and carried out as a PhD thesis to explore the question ‘How does a child learn to use powered mobility to explore their environment?’. Methods The research took place in four interconnected stages. Initially 11 typically developing children were observed and video-taped learning to use a powered wheelchair. Comparison and coding of the video data to develop the emerging themes led to three further data sets: consulting with seven experienced power mobility users in focus groups; observing 11 children with disabilities using powered wheelchairs; and focus groups with 22 peer professionals. Findings The findings identified three stages of developmental learning and the themes of ‘partnerships and models’, ‘listening to disabled children’ and ‘engaging with children through play’. Analysis of these themes led to the emergence of the core category ‘responsive partner’. Conclusions A constructivist methodology of exploration enabled child-centred research to take place. Components of learning were identified and stages of progression for powered mobility discovered. Findings revealed that services should focus on the clinician being a responsive partner who does not command but is able to elicit new learning, and future research should explore this framework further.

Abstract-Collaboration by two grounded theory researchers, who each had developed a learning continuum instrument, led to the emergence of a new tool for assessment of learning powered mobility use. We undertook a rigorous process of comparative reanalysis that included merging, modifying, and expanding our previous research findings. A new instrument together with its facilitating strategies emerged in the course of revisits to our existing rich account of data taken from real environment powered mobility practice over an extensive time period. Instrument descriptors, categories, phases, and stages allow a facilitator to assess actual phase and plot actual occupational performance and provide a learner with the just right challenge through the learning process. Facilitating strategies are described for each of the phases and provide directions for involvement during learner performance. The learning approach is led by a belief system that the intervention is user-led, working in partnership and empowering the learner. The new assessment tool is inclusive of every potential powered mobility user because it focuses on the whole continuum of the learning process of powered mobility use from novice to expert. The new tool was appraised by clinicians and has been used successfully in clinical practice in the United Kingdom and Sweden.

The scientific knowledge base on tool use learning and the new theory conveys the information necessary for practitioner's cognizing how to apply the learning approach of the ALP tool in order to enable tool use learning through powered mobility practice as a therapeutic intervention in its own right. This opens up the possibility for more children and adults to have access to learning through powered mobility practice. Implications for rehabilitation Tool use learning through powered mobility practice is a therapeutic intervention in its own right. Powered mobility practice can be used as a rehabilitation tool with individuals who may not need to become powered wheelchair users. Motivation, confidence, permissiveness, attentiveness and co-construction are key properties for enabling the application of the learning approach of the ALP tool. Labelling and the use of language, together with honing observational skills through viewing video footage, are key to developing successful learning partnerships.

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