Powered Mobility for the 2-to-5-Year-Old Disabled Child

E. SNELL, CET, M. MILNER, PHD, E. ENG, CCE, G. VERBURG, MAM. PILKINGTON, BSc, OT AND W. N. LOTTO, MD*Toronto, Ontario>


The physically disabled child unable to ambulate or propel a passive mobility aid depends heavily on others to provide environmental stimulation.

Such stimulation may not be of the same nature or degree as experienced by physically normal children. Altered stimulation coupled with a restricted ability to initiate stimulation sets the stage for potential developmental delays.

A research project in progress for over a year was initiated to study the impact on the family and the 2-to-5-year-old disabled child, consequent on the provision of powered mobility via the miniature powered vehicle (MPV) 5. Ten children with disabilities such as cerebral palsy, spina bifida, spinal muscular atrophy and congenital limb deficiency have received MPVs.

Psychological Assessments

The impact of powered mobility on the disabled child is being monitored by the application of standard measures which include a semiannual assessment of physical development appropriate to the child's age level, administration of the Vineland Social Maturity instrument 3 semiannually and the administration of the Developmental Profile 11 instrument', both at the commencement and at the end of the project.

Initial testing yielded the following results:

a) Chronological age range: 1 year 11 months to 4 years 9 months

b) Physical Development age range: 5 months to 1 year

c) Vineland Social Maturity Scale: 1 year 3 months to 3 years 8 months

d) Developmental Profile age range: 1 year 4 months to 3 years 4 months.

Both the Vineland Social Maturity Scale and the Developmental Profile 11 are based on physically normal development and do not have provisions to account for disabled individuals using a technical aid such as the MPV. As a result the following comparisons are to be performed:

a) The developmental level the child exhibits without the use of the technical aid (MPV)

b) The developmental level the child could attain if credit were given for items failed due to the child's handicap4

c) The developmental level the child exhibits with the use of the technical aid (MPV).

Logbook and Family Interviews

A further objective of the research is to evaluate the performance and suitability of the MPV in meeting the needs of the disabled child. Data in this regard are being recorded on a daily basis in the MPV logbook by the family and include frequency of operation, duration of operation, use indoors and outdoors and the MPV's odometer reading. Further data are being accumulated on a quarterly basis through family interviews and measures of the child's driving performance through an obstacle course. A statistical-analysis package is being assembled to determine trends in, and correlations between, the accumulated data.

Technical Aspects

A miniaturized universal interface mobility control system6 is under development that will have direct applications to the interfacing needs of children and adults in conventionally powered wheelchairs. The control system will allow the use of a wide range of interfaces such as capacitive touch-plates7 or a scanning interface2, depending on the level of the child's physical involvement.

Features of the control system include:

a) Operating voltage: 10-30VDC

b) Independent acceleration and deceleration control

c) Closed-loop feedback speed control

d) Thermal limiting and automatic reset

e) Low power consumption and high efficiency operation.

Acknowledgment

This work is supported by a grant from the National Health Research Developmental Program of Health and Welfare, Canada.

*Rehabilitation Engineering Department, Ontario Crippled Children's Centre, 350 Rumse Road, Toronto, Ontario M4G 1R8, Canada

References:

  1. Alpern, G., T. J. Boll and M. S. Shearer: Developmental Profile II Manual. Aspen: Psychological Development Publications, 1980.
  2. Antczak, J., and E. Snell: A Scanning Interface for Powered Mobility and Communication, Proceedings of the 6th Annual Conference on Rehabilitation Engineering. San Diego: 229-232, 1983.
  3. Doll, E. A.: Vineland Social Maturity Scale: Condensed Manual of Directions. Minnesota: American Guidance Services, Inc., 1965.
  4. Gouin Decarie, T.: A Study of the Mental and Emotional Development of the Thalidomide Child. In B. M. Foss (ed.) Determinants of Infant Behaviour IV. London: Methuen and Co., 1969.
  5. Naumann, S., S. Walder, E. Snell and M. Milner: A Powered Mobility Aid for the Two to Five Year Olds with Neuromuscular Disorders, Proceedings of the 5th Annual Conference on Rehabilitation Engineering: 74, 1982.
  6. Snell, E. and M. Milner: A Miniaturized Universal Interface Mobility Control System, Proceedings of the 6th Annual Conference on Rehabilitation Engineering. San Diego: 226-228, 1983.
  7. Snell, E.: Capacitive Touch Plate Controller for Powered Mobility in Severe Motor Disability, Proceedings of the 4th Annual Conference on Rehabilitation Engineering. Washington, DC: 69-71, 1981.