The Positive Effects of Early Powered Mobility on Children's Psychosocial and Play Skills

Section: Discussionsupporting

confidence: 81%

‘Power in Mobility’: parent and therapist perspectives of the experiences of children learning to use powered mobility

Kenyon

Mortenson

Miller

2018

“…Conversely, new drivers, or those with complex conditions, may require an adult to facilitate and closely supervise them, or may require additional technologies to keep them safe, as they experience independent mobility and learn to operate their wheelchairs . Although change in affect and engagement have been suggested by quantitative studies, qualitative findings contribute rich descriptions of the changes observed in children's initiation, motivation, responsiveness, confidence, and self‐esteem following power mobility experience.…”

Section: Discussionmentioning

confidence: 99%

The child and family experience of power mobility: a qualitative synthesis

Livingstone

Field

2014

AIM The aim of this study was to critically synthesize qualitative evidence regarding the child and family experience of power mobility, and to examine how this evidence fits with current theoretical concepts.METHOD Electronic database/hand searches were undertaken in September 2012 and updated in February 2014. The searches were restricted to qualitative studies published in English before February 2014 that included at least one child under the age of 19 with a disability and described an outcome related to the use of power mobility. Inclusion criteria were set a priori. Two reviewers independently screened titles, abstracts, and full-text articles and extracted data. McMaster qualitative review forms were used for quality appraisal. RESULTSOf 259 titles, 21 met inclusion criteria. From 143 codes, 15 second-order themes were developed using constant comparison and analysis. Three overarching themes emerged: power mobility experience promotes developmental change and independent mobility; power mobility enhances social relationships and engagement in meaningful life experiences; and power mobility access and use is influenced by factors in the physical, social, and attitudinal environment.INTERPRETATION This qualitative research provides rich and rigorous evidence supporting the benefits of power mobility for children and families. Numerous factors, which warrant careful consideration, influence power mobility access and use.Power mobility devices, such as powered wheelchairs and ride-on toys, provide efficient, autonomous mobility for children with mobility limitations. [1][2][3][4][5] Power mobility may facilitate independent exploration and participation in everyday activities from a young age. 6 These early exploratory behaviors have a positive impact on overall and psychological development, 7,8 and recent research suggests that children can begin using power mobility devices in infancy.9,10 However, power wheelchairs are not commonly prescribed for children below 3 years of age.11-13 Assistive devices, such as power wheelchairs, may be seen as enablers of function or as a stigma.14 For parents, the psychological and social impact is significant, 15,16 with both positive and negative experiences of power mobility reported. [17][18][19][20][21] In keeping with family-centered care, it is essential that clinicians and researchers set meaningful goals collaboratively, in line with child and family priorities. [22][23][24] A recent systematic review of power mobility outcomes for children 5 identified, but did not include, a significant number of qualitative studies relating to the child's and family's perspective, and it was recognized that a separate, more appropriate, analysis was warranted. Three previous systematic reviews on children's use of assistive technologies [25][26][27] included only two qualitative studies on power mobility use. 18,28 Within the wheeled mobility literature, several models attempt to interpret the many factors that influence power mobility use; however, the validity of these mode...

“…The literature review was updated in May 2012 before the formal consensus process. Newly published studies were included and references updated for studies that had previously been included as theses or conference proceedings . The AGREE II checklist was used to reduce bias and ensure quality in the development of the clinical practice considerations.…”

Section: Literature Review and Paper Development Methodsmentioning

confidence: 99%

Practice considerations for the introduction and use of power mobility for children

Livingstone

Paleg²

2013

100

118

Aim The aim of the study was to support clinicians in recommending and justifying power mobility for children of different ages and abilities, and with different needs. The study comprised three distinct parts: a literature review; a Delphi consensus; and clinical practice considerations. Method A scoping review of eight electronic databases and manual searches carried out in February 2011 identified 15 themes or transferable messages among 27 articles meeting initial inclusion criteria and these formed the basis of a draft paper. Informal consensus at two international conference presentations refined and modified the paper to include 10 messages supported by 24 articles. The literature review was updated in May 2012 and a modified Delphi process sought to formalize the consensus process with an international panel of 16 expert clinicians and researchers using a priori criteria of 80% agreement. Results Evidence from studies was classified using the American Academy of Cerebral Palsy and Developmental Medicine guidelines, with evidence from most studies being classified as either level IV or level V, apart from one study each with evidence classified as level II and level III. Expert consensus on the content and wording of nine transferable messages may raise evidence overall to level III. Interpretation This paper suggests that power mobility may reasonably be considered as an effective and appropriate intervention for children lacking efficient, independent mobility from around 12 months of age including children who may never become competent drivers and children lacking independent mobility only in early childhood.