Clinically Speaking

"Look Who's Driving Now!" Activity Ideas for Power Mobility Evals

Recommending the best power mobility system for a specific client’s needs typically involves navigating through countless equipment options. A proper evaluation is crucial because obtaining funding for new devices often takes a substantial amount of time. An improper “yes” or “no” recommendation for specific devices during a one- or two-hour evaluation can lead to lasting consequences. Further difficulties arise in the evaluation process due to financial and space constraints. It is virtually impossible to have all of the options at one’s fingertips during an evaluation, and technology is ever-changing. Moreover, like everyone, clients have good and bad days, so if caught on a bad day, the client may not exhibit all of their potential during the evaluation.

Out of the desire to best serve the clients I worked with and see better outcomes from power mobility evaluations and recommendations, I established a powered mobility driver’s education program. This program includes not only an evaluation, but also protocols for what to do when a client exhibits potential for learning specific powered mobility options.

Training sessions provide the best framework for determining the potential for powered mobility. These sessions provide clients the opportunity to trial more equipment and develop skills, while a treatment team is able to dial in the ideal power mobility system.

I have led training sessions that have resulted in a virtual standoff with clients who refuse to activate the input device to move the chair because refusing was the only bit of control they had. And I have worked with clients who refuse to stop or follow directions once they get the wheelchair moving. Situations such as those can be frustrating for clinicians and caregivers because we know that the client has the potential to become independent in mobility if he would simply follow instructions and fully engage in training.

Through significant time and trial, I developed a set of strategies to increase the rate of success for clients who demonstrate the potential for powered mobility.

What Makes Your Client Tick?

The client and/or caregiver interview portion of the evaluation process is the perfect time to gather essential information, such as what motivates the client and, more importantly, what the client does not like. Knowing what the client does not like can help you establish purposeful movements and skills. For example, if you put three of the client’s favorite toys or activities directly in front of him and ask him to drive to the activity he wants, no matter where he goes, it is a win. But if you establish contrast in the options using only one option that he likes and others he does not like, then there is a motivating force to see if the client will drive toward a desired option.

Rolling with Tunes

Music can be a tremendous motivator and one that is relatively easy to implement in a time when music is digital and portable. The concept of this strategy is simple. When the client is moving in the wheelchair, play the music; but the moment the chair stops, turn the music off . Eventually the client will learn that if he keeps driving, he will get to enjoy his favorite tunes.

Go Get It

Take the client’s favorite toy or item, and place it a few feet in front of the client in his line of vision. Inform the client that if he drives over to where the item is, he can play with it for an established amount of time. As time goes on, your goal will be to increase the distance that the client must drive to get the item and decrease the length of time he is allotted to play/engage in the activity.

Red Light/Green Light

Some clients find it difficult to stop once they get moving, while others have difficulty moving once they have stopped. The classic game “Red Light/Green Light” is a fantastic activity to teach stop and go. Involve the client’s friends or siblings if it is appropriate.

Scavenger Hunts

Through the use of clues and prizes, you can create a fun activity that requires the client to drive to specific locations and include a variety of skills in the adventure.

Obstacle Course

As the client advances with his skills, create an obstacle course through which the client has to complete fun activities while timing the event. Push the client to see if he can improve his time each training session.

Create a Game Tape

If the client and caregiver agree, video tape portions of the very first session, a few in between and the final session. Just as a professional football team would do, review the tapes with the client and caregivers to identify strengths and areas that need to be improved.

Because of the objective limitations that arise during a power mobility evaluation, it is critically important to tailor device suggestions based on a client’s potential abilities instead of present abilities. Use of the above strategies in making your professional recommendations can be the key to seeing your client drive on to success in their power mobility device.

This article originally appeared in the August 2013 issue of Mobility Management.

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