Driving to Learn in a Powered Wheelchair: The Process of Learning Joystick Use in People With Profound Cognitive Disabilities

Abstract

The Driving to Learn project explored ways to help people with profound cognitive disabilities practice operating a joystick-operated powered wheelchair. The project used a grounded theory approach with constant comparative analysis and was carried out over 12 yr. The participants were 45 children and adults with profound cognitive disabilities. Reference groups included 17 typically developing infants and 64 participants with lesser degrees of cognitive disability. The data sources included video recordings, field notes, open interviews, and a rich mixture of literature. The findings that emerged yielded strategies for facilitating achievements, an 8-phase learning process, an assessment tool, and a grounded theory of deplateauing explaining the properties necessary for participants to exceed expected limitations and plateaus. Eight participants with profound cognitive disabilities reached goal-directed driving or higher. Participants were empowered by attaining increased control over tool use, improving their autonomy and quality of life.Nilsson, L., Eklund, M., Nyberg, P., & Thulesius, H. (2011). Driving to learn in a powered wheelchair: The process of learning joystick use in people with profound cognitive disabilities.

Assessment of learning powered mobility use—Applying grounded theory to occupational performance

“…Nilsson also carried out GT research [1,[14][15][16][17][18]: her work focused on people with profound cognitive disabilities from several age groups. Nilsson studied what this population could achieve from practice in a powered wheelchair.…”

“…Nilsson studied what this population could achieve from practice in a powered wheelchair. She collected data from 45 participants who had profound cognitive disabilities with age of inclusion between 12 mo and 52 yr, 64 participants who had other degrees of cognitive disabilities aged 16 mo to 86 yr, and 17 typically developing infants aged 3 to 12 mo [17]. The work was carried out from 1993 to 2007.…”

“…Durkin and Nilsson both carried out their research with the learners/users in their real environment and both studies received ethical approval from their respective national organizations [12][13][16][17].…”

Engineering Hope: Enhancing Quality of Life through Design Education

“…As background to the project, the physical therapist explained to the class that young children with these multiple, severe deficits are limited in their ability to use self-initiated movement to explore and learn from the world around them. Such children are often dismissed as either too young or too physically involved to use power mobility [8][9][10][11] . If a trial of power mobility is attempted, simple, readily available power mobility options such as adapted ride-ontoys do not provide these severely involved children with the external support necessary for them to safely and effectively use a joystick or switch to control the mobility device.…”

“…If a trial of power mobility is attempted, simple, readily available power mobility options such as adapted ride-ontoys do not provide these severely involved children with the external support necessary for them to safely and effectively use a joystick or switch to control the mobility device. Given that selfinitiated locomotion is critical to the development of numerous cognitive, perceptual, and social skills, young children who are unable to move and explore their environment may not gain the skills necessary to maximize development in these essential areas of function [8][9][10][11] . Faculty from engineering and physical therapy thus felt that a device was needed to allow these children to safely explore their environment.…”