Introducing powered mobility to children can be quite daunting and is usually a nervous time for both clinicians and families. Clinicians want any introduction to be successful to maximise a child’s independence, and families usually have some concerns regarding whether powered mobility can be implemented safely. Overall, it is usually a period of excitement, and one that our assistive technology consultants love to be a small part of.
Over the years of scripting and setting up powered mobility for children, GTK consultants have become aware of things that are important to consider and can help the process be smoother and more successful. We hope that by sharing them here in this blog post it can help others when beginning the exciting journey of introducing powered mobility to children.
When first considering powered mobility:
The only prerequisite for powered mobility is the need for powered mobility.
Powered mobility is never ‘an only’. It doesn’t preclude other mobility forms. For some children, a power wheelchair might be perfect for longer distances and outdoor use, but a walking frame or manual wheelchair might be suitable for indoor mobility. It’s important to recognise that using a power wheelchair does not mean that this is the only form of mobility a child can have.
When conceptualising power mobility, it’s important to remember that we’re teaching mobility, not ‘driving’. The skill and task of driving assumes mobility experience and matching knowledge, as we don’t generally put people in the driver’s seat of a car without assuming they understand the concepts of direction and speed amongst others. Powered mobility assumes no knowledge or experience, we can place a child into a carefully set up wheelchair and give them the freedom to simply explore.
Mobility for children is a lot like buying them new shoes or a bicycle. We start with identifying the right product, then we fit it correctly, and then we start to learn how to use it.
When setting up the powered wheelchair for children:
Consider what type of wheelchair controls would be most suitable. Often we go straight for a joystick, but a joystick can be unpredictable for a child. Using switches can be easier to learn as they are more predictable (e.g. this switch makes wheelchair go forwards, this switch makes it go backwards).
Consider how you will program the wheelchair. Sometimes we might only offer one directional command at first before introducing others in the future. For example, we might set up the wheelchair to only have the left directional command so the child can practice pressing the switch or joystick to get a response, and then learn that when they release the switch or joystick the movement ceases.
When introducing powered mobility, don’t provide the child with on/off capability for the wheelchair. We want the adult to set up the wheelchair ready to use, and let the child focus solely on mobility, not on powering the wheelchair on/off. An example of this is when a child is learning to ride a tricycle. Usually the adult will be the one to get the tricycle out of the garage and set it up on the driveway, and we wouldn’t expect the child to do this.
When setting up the environment that will be used to introduce powered mobility:
A somewhat familiar environment is vital when teaching power wheelchair skills. We want the child to be able to concentrate on exploring mobility, and not completely distracted by a new environment they haven’t been in. Although we might automatically assume the home is the best environment as this is the most familiar, we still want the environment to be of interest to them so that the need to explore is present. For many children, home might not be that environment as it might not be interesting at all, or the desire to play with a certain toy might be too distracting. It can be tricky to find an environment that is familiar but not boring to the child, but it can be an important factor in making early power mobility use a success.
To develop proficiency in any skill, we are looking to develop new neural pathways. Developing neural pathways happens more easily with repetition and in familiar environments, where we can focus on the skill itself, and the environment can almost fade into the background.
As always, when introducing any new skill or equipment, adult supervision is key. Like any child learning a new skill, they are unlikely to be 100% safe all of the time. Having good supervision is the key to ensuring safety. Often this can be the part most families are nervous about, but in many ways powered mobility is just like any mobility task a child learns. When a child is first learning to walk or use stairs, parents don’t leave them to their own devices in new environments and hope nothing goes wrong, children are usually closely supervised. Introducing powered mobility is very similar to any new mobility task and requires close supervision.
As the child’s skills in powered mobility improve, the environment should change predictably to offer new challenges and new environments should be introduced as skills progress.
When teaching powered mobility:
You can consider a remote stop system on the wheelchair. This is a remote that the clinician or parent can hold, and it simply turns the wheelchair off from a distance if the child requires assistance or gets into a dangerous situation.
Consider the time the child spends in the wheelchair when beginning to introduce powered mobility. When first starting, it is usually best to start with short periods or ten minutes to ensure the child doesn’t fatigue too quickly.
It can be tempting to use bubbles, toys or music to attract the child into moving in a certain direction in the power wheelchair. While these techniques can have their place, it’s important to simply let the child explore. Mobility in its most basic form is the ability to explore, approach and then leave, and independent mobility or exploration is what we want to facilitate.
When teaching how to turn the wheelchair, remember that turning for children has nothing to do with ‘turning’. It is simply them wanting to look around.
If a child is turning around and around in a circle, which is quite common, consider leaving them for a little longer than what you initially think. It’s hard for adults to watch 25 seconds of turning as it irritates our vestibular system, so generally adults want to stop before 25 seconds. Consider leaving them a little longer, if safe, to see if they independently stop.
Remember that a lot of repetition and practice is needed to develop new skills and kinaesthetic awareness.
Helping a child develop power wheelchair skills can be one of the most rewarding aspects of being a clinician in the assistive technology field. It takes considerable planning and numerous teaching sessions, but the reward of seeing a child have access to independent mobility is so worth it. We hope some of these tips in this post help make the process of introducing powered mobility to children less intimidating. As always, our GTK consultants are always available to assist. Our consultants have many years’ experience scripting and introducing power mobility to children. Contact us today to see how we can help.