Why the time is right for a radical paradigm shift in early powered mobility: the role of powered mobility technology devices, policy and stakeholders

Abstract

This article explores the changing landscape of early pediatric powered mobility. We specifically focus on key indicators that suggest pediatric powered mobility technology (PMT) practice for very young children is poised for a radical paradigm shift. This shift will challenge the current purview of PMT design and function, how it is obtained, and its introduction to children and their families. We propose that this positive, yet radical shift is essential in achieving a standard of practice in which PMT provides for early exploration and participation for children with disabilities at an age concomitant with their non-disabled peers, and within socially inclusive environments. To sustain this new standard, we must acknowledge the significant disconnect that currently exists between clinical research supporting the use of PMT with very young children, and barriers to widespread device access, effective user-driven design and positive social perception of PMT. In this article, we discuss three areas that are particularly important for both shift and sustained change: the history and current availability of novel and conventional PMT devices, pediatric PMT policies and the role of children and families as primary stakeholders in PMT practices. Within each area, we suggest barriers, facilitators and future directions.

Implications for Rehabilitation

• The time is right for reframing how powered mobility technology for very young children is conceived, designed, and implemented.

• In order for multiple innovative devices to survive in the powered mobility industry, it is important to continue to show the benefits of early powered mobility use for both traditional and non-traditional users, and also enact and enforce policy that promotes sustainable access and financial support for powered mobility technology.

• The experiences of children and families and the realities of everyday use of powered mobility technology must be brought to the forefront of a movement toward user-centered design.

• Advocacy efforts undertaken in partnership with families, clinicians, researchers, and disability communities are essential in recognizing mobility, and access to early powered mobility technology, as a human right.

Keywords:

• Assistive technology
• children with disabilities
• participation
• pediatrics
• user-centered design

Acknowledgements

The authors wish to thank RJ Cooper, Carole Dennis, Scott Inghram, Hélène Larin, Michele Lobo, Permobil Inc., and Catherine Wright-Ott for their contributions to the development of this manuscript and their gracious permission to use photographs of their devices.

Declaration of interest

The authors have no conflicts of interest to report.

Notes

¹ Although this is the first example we have found in the literature, it is important to note that since starting our Go Baby Go program, families and clinicians across the US have contacted us about the modified toys and other devices that they successfully fabricated and used prior to 1988.

² Phrase coined by Michele Lobo, PhD, PT 2014.