Over the last 3 years, we have come to realize that the old belief that children under the age of 2 years are not capable of using power mobility devices is simply not true. This new understanding has led to a clinical paradigm shift that promotes early exposure of children with mobility limitations to power wheelchairs. We have come to understand what is possible through a series of case reports that describe the training of an infant1 and child2,3 to use power mobility. Credit for this innovative approach must go to Cole Galloway's group at the Infant Behavior Laboratory at the University of Delaware that has worked quickly to share their advances with their clinical colleagues. As this editor has often stated, “Case reports lead to research questions,” and those questions lead to evidence that supports our clinical practice.
Through the hard work of 2 research groups and the magic of serendipity, we have what evolved into a “mini special issue” that highlights power mobility. The lead article by Jones, McEwen, and Neas4 presents a pilot randomized clinical trial examining the effects of power mobility for young children. Their results are most promising as receptive communication, mobility skills, and mobility and self-care caregiver assistance scores improved significantly over a control group. But it doesn't stop there. Ragonesi and Galloway5 provide another case report, this one focused on an 11 month old child, who was later diagnosed with cerebral palsy, learning to drive a power chair. They show that it is possible to quantify the progress of this infant's acquisition of the skills needed to run the power chair. Sensitive to our mandate to document outcomes, this case report will be an excellent clinical resource.
And finally, Huang and Galloway6 have provided a technical report that addresses the issue of a need for less expensive and lighter weight power mobility options for the young children we treat. They describe modifications to the readily available toy cars that children love (and adults covet), which can be employed to increase the use of power mobility for a variety of therapeutic goals. The equipment and supplies and directions needed to adapt these toy cars for specific children and goals are included as a resource, with an illustrative case report. And within the technical report is a recommendation that should not be overlooked by those who design and manufacture power wheelchairs. Power mobility devices need to be designed with children and families in mind. Toy cars are lighter and much more appealing than traditional power wheelchairs.
So the clinical bottom line is progress, progress, progress! Children—start your motors!
Ann F. Van Sant, PT, PhD, FAPTA
1. Lynch A, Ryu JC, Agrawal S, Galloway JC. Power mobility training for a 7-month-old infant with spina bifida. Pediatr Phys Ther. 2009;21(4):362–368.
2. Ragonesi CB, Chen X, Agrawal S, Galloway JC. Power mobility and socialization in preschool: a case study of a child with cerebral palsy. Pediatr Phys Ther. 2010;22(3):322–329.
3. Ragonesi CB, Chen X, Agrawal S, Galloway JC. Power mobility and socialization in preschool: follow-up case study of a child with cerebral palsy. Pediatr Phys Ther. 2011;23(4):399–406.
4. Jones MA, McEwen IR, Neas BR. Effects of power wheelchairs on the development and function of young children with severe motor impairments. Pediatr Phys Ther. 2012;24(2):131–140.
5. Ragonesi CB, Galloway JC. Short-term, early intensive power mobility training: case report of an infant at risk for cerebral palsy. Pediatr Phys Ther. 2012;24(2):141–148.
6. Huang H-H, Galloway JC. Modified ride-on toy cars for early power mobility: a technical report. Pediatr Phys Ther. 2012;24(2):149–154.