As I reflect over the past 10 years, as it pertains to pediatric mobility, I am extremely excited… not only about the advances in technology, but also at the changing perceptions associated with power mobility for young children.
With rising awareness of current (as well as older) research that supports power mobility as a means of independent mobility for children, we are seeing clinicians promoting devices that provide young children the opportunities to explore their environments independently. This involves thinking outside the box and realizing that just because something is “the way it has always been done” doesn’t make it right. In turn, as medical professionals begin to promote power mobility devices for young children, parents’ eyes are being opened to the possibilities that these devices offer — enhanced learning, development, socialization, and self-confidence!
In the past, there has also been a focus on exercise over function. Clinicians particularly wanted to require children to use a walker or manual wheelchair, even if these devices did not provide true functional independence. In recent years, therapists have become more focused on prescribing therapeutic exercise programs in addition to a functional mobility device instead of requiring the child to use the mobility device for exercise at the expense of functional independence and efficiency. The emphasis is beginning to transition toward functional performance.
As we think about function, we must remember that a child’s job is to play and explore their world in order to develop skills that other children do every day. We shouldn’t restrict a child to the home environment when their peers are out and about seeking experiences in the world! Our goal as a therapy team should be to integrate the child as much as possible into their world — allowing them to function with their peers independently.
Though these concepts still have not caught on throughout the country, there is definitely a movement in the right direction. It is my hope that in the next 10 years we see mobility devices that provide independence (whether power, manual or otherwise) as great opportunities for promoting ability instead of carrying the negative stigma of being “disabled.” Additionally, with this new acceptance and realization of the positive effects of providing children with a means for independent exploration, funding options will also be enhanced, and parents’ negative perceptions of wheelchairs will be transformed. As more and more people request appropriate devices for children and challenge equipment denials, we will see coverage policies expanding and recognizing the benefit of providing independent exploration to children with disabilities as their typically developing peers experience.
We still have a long way to go, but I am optimistic that in the next decade, we can change the outcome for many children with disabilities by intervening earlier with independent mobility devices… using powered mobility devices as therapeutic tools for infants and children to promote cognitive, visual, and social development despite the child’s lack of motor control. Here’s to the next 10 years… the future starts now!
Amy Morgan, an MM editorial advisory board member, is the pediatric & standing specialist at Permobil.