Ride-On Cars With Different Postures and Motivation in Children With Disabilities: A Randomized Controlled Trial

Abstract

Importance: A child’s independent mobility, environments, and mastery motivation are critical factors during early development. Objective: To examine the effectiveness of ride-on car (ROC) training with a standing (ROC–Stand) or a sitting posture (ROC–Sit) in enhancing children’s mastery motivation and decreasing parenting stress levels. Design: Randomized controlled trial (RCT) with a multiple pretest–posttest design. Setting: Hospital-based environment in northern Taiwan. Participants: Thirty-nine children with disabilities ages 1 to 3 yr were randomly assigned to ROC–Stand (n = 16), ROC–Sit (n = 12), or conventional therapy (control; n = 11). All groups received 2-hr training sessions two times a week for 12 wk and then a 12-wk follow-up period that involved only regular therapy. Measures: Assessments included the Revised Dimensions of Mastery Questionnaire–Chinese version and the Parenting Stress Index. Results: All groups showed significant changes in social persistence with adults, mastery pleasure, and general competence after the intervention. The two ROC training groups showed a significantly greater decrease in parenting stress than the control group. In addition, increased general competence of the ROC–Stand group also strongly correlated with decreased parent–child dysfunctional interaction. Conclusions and Relevance: This RCT verifies the effectiveness of ROC training and offers a novel approach to increase children’s mastery motivation and decrease parenting stress. What This Article Adds: Providing a large amount of active, exploratory experiences with goal-directed, moderately challenging tasks and cooperation with caregivers may result in the greatest benefits to young children with motor disabilities.

Caregivers' Perceptions of Ride-On Cars and Behavioral Changes for Young Children With Motor Delays

“…The study was part of a larger randomized controlled trial (RCT) that investigated the effectiveness of ROC training in young children with motor delays, either in standing or sitting postures. 7,15 Study approval (103-7368A8) was obtained from the Chang Gung Medical Foundation Institutional Review Board, and caregivers provided written informed consent prior to data collection. Participants were enrolled in November 2015, and the study was completed in October 2019.…”

“…Current evidence: There is a growing recognition among parents and clinicians of the potential benefits of early power mobility training for children who have motor delays. 6,7 Previous studies have indicated that caregivers commonly perceive device-and environmental-related barriers as the most significant obstacles to successfully using a ride-on car (ROC) in home environments. 10,11 The researchers have suggested that appropriate adjustments and sufficient support from therapists through practical strategies could address most barriers.…”

“…This program introduces the use of an ROC in a community-based hospital environment and integrates a coaching model, drawing inspiration from the principles of family-centered service. 7,[13][14][15] In EI, the active participation of parents is acknowledged as a cornerstone of family-centered care. By employing a coaching approach, the relationship between caregivers and therapists can be strengthened, ensuring responsiveness to the caregiver' s needs and emotions, and thus enhancing their engagement.…”

“…Detailed descriptions of the 2 training programs can be found in a previous publication. 7,15 The aim of the ROC training group was to enhance children' s exploratory experience and psychosocial function through a context-focused program that emphasized cooperation between the therapist and caregivers at each session. Specific training guidelines focused on developing causal-effect concepts, goaloriented driving, using upper limb actions in functional tasks, and interacting with the surroundings through ROC use.…”

“…1,5,6 These effects include improvements in mobility, social-emotional skills, and mastery motivation. 1,5,7 However, only a few studies have examined caregivers' perceptions of their children' s use of ROCs in different environments. 8,9 Logan et al 8 synthesized previous studies and identified 2 commonly reported perceived barriers to the use of ROCs: device-related and environmental factors.…”