Info for doctors and therapists
A growing body of research is showing the cognitive, perceptual, language and social benefits of early powered mobility in toddlers and infants. It has been shown that babies as young as seven months old have the capacity to learn to drive a powered mobility device with a joystick. Much like the growing research that signing for babies facilitates speech, independent mobility exposes toddlers to new possibilities before learned helplessness sets in, and the inborn drive to move is lost.
Here is a link to a great Powerpoint presentation on the subject (www.seatingandmobility.ca/Libraries/powerpoint_presentations/Beginning_Power_Mobility_
Therapist_presentation.sflb.ashx)
Current thinking is that children need to move in order to learn about movement. It was once thought that spatial relations, problem-solving skills and concepts of cause and effect develop through independent mobility and should not be thought of as a pre-requisite for introducing powered mobility. Significant cognitive deficits should also not necessarily preclude children from having opportunities to learn independent powered mobility skills. Although some children with complex disabilities or visual impairment may continue to need one-to-one supervision, studies have shown improvements in many aspects of social, communication, perceptual and cognitive skills when these children are given opportunities for independent movement through powered mobility.
Typically, developing toddlers spend at least 80 per cent of their wake time moving. The learning opportunities are significant in these early developmental years, and depend on independent, goal-directed movement. Powered wheelchairs do not always address this need. They are typically bulky, heavy and powerful machines and are not always appropriate for toddlers. They are also not appropriate for a child with a temporary movement difficulty, or sometimes for parents and whanau that are not yet ready for wheelchairs.
The Go Baby Go concept addresses these issues in a fun and appealing toy.
- Firstly and most importantly the cars are enjoyable and likeable to the child, their friends, parents and whanau. Other children are drawn to the toddler using the car, creating opportunities for many more social interactions than might otherwise be possible.
- The cars are not powerful enough to be a danger if the toddler has not quite mastered the stop-start-turn functions… or just loses concentration on the way to get somewhere.
- They are at the right height for a child-friendly environment – allowing eye-level face-to face contact with peers.
- They provide opportunities for an unstructured play environment for the toddlers to experiment with, leading to better skill retention in the longer term.
- Working closely with the Gobabygo NZ team, the cars can be used to enhance therapeutic goals at the same time the child is having fun driving around and interacting with friends and siblings. Toggle switches and adaptations to the car can provide or encourage trunk control, lower limb stretches or weight bearing. Upper limb dissociation, sit-to-stand function or any number of activities can be built into the car’s core function. The opportunities for therapeutic benefits are only limited by the therapist’s imagination.
Further reading:
Butler C, Okamoto GA, McKay TM. (1983) Powered mobility for very young disabled children. Dev Med Child Neurol, 25(4):472-474.
Zazula JL, Foulds RA. (1983) Mobility device for a child with phocomelia. Arch Phys Med Rehabil. 64(3):137-139.
Butler C, Okamoto GA, McKay TM. (1984) Motorized wheelchair driving by disabled children. Arch Phys Med Rehabil, 65(2): 95-97.
Butler C. (1986) Effects of powered mobility on self-initiated behaviors of very young children with locomotor disability. Dev Med Child Neurol. 28(3):325-332.
Howes C, Rubin KH, Ross HS, French DC. (1988) Peer interaction of young children. Monogr Soc Res Child Dev. 53, i, iii, v, 1–92.
Jones MA, McEwen IR, Hansen L. (2003) Use of power mobility for a young child with spinal muscular atrophy. Physical Therapy, 83(3): 253.
Hay DF, Payne A, Chadwick A. Peer relations in childhood. (2004) J Child Psychol Psychiatry 45(1):84-108.
JC Galloway, J. R. (2008). Babies driving robots: self-generated mobility in very young infants. Intel Serv Robotics , 1, 123-134.
A Lynch, J. R. (2009). Power Mobility Training for a 7 month old infant with spina bifida. Pediatric Physical Therapy , 21 (4), 362-368.
CB Ragonesi, X. C. (2010). Power mobility and socialization in preschool: A case study of a child with cerebral palsy. Pediatric Physical Therapy , 22 (3), 322-329.