Not so long ago, “early-intervention”
power mobility meant giving
5- and 6-year-olds access to power
wheelchairs.
Now that power mobility access is
being offered, at least in some settings,
to children 12 months old and younger,
what is early intervention’s next
horizon?
A possible answer: using power
mobility as a potentially temporary,
therapeutic intervention for children
who will likely learn to ambulate later
in life, but whose independent mobility
— and therefore, many other aspects
of development — will be significantly
delayed.
Referring to power mobility as therapeutic
intervention, Permobil’s Amy
Morgan, PT, ATP, says, “Kids with
Down’s (syndrome), I think, could
utilize power mobility on a more transient
basis, supplementing their lack of
mobility until they get that skill. Any
child that has a mobility impairment,
no matter what their diagnosis is, and
is unable to functionally move on a
developmental sequence or very close
to the developmental sequence should
have some type of supplemental mobility
and intervention in their life so they can
continue to develop.”
For such children, Morgan says,
power chair usage would be shorter
term, “until their motor skills get to the
point where they’re functionally able
to move themselves around without
the chair. You continue the therapeutic
intervention on the motor skills, but
get them a means of development and
interaction and appropriate peer activities
while they’re working on those
skills.”
Morgan acknowledges that parents
can find it very difficult to opt for power
mobility for a child who may eventually
learn to walk: “They want to focus all
efforts and require them to use walking
and crawling, even if it totally wears (the
child) out and it’s not functional.” Even
therapists, she says, can believe that
introducing power mobility may hamper
efforts to teach a child to walk.
“That’s the mentality that I try to
challenge out there,” she says. “We’re
not holding them back by putting them
in a power chair. They need to have
this access for their cognitive development,
their social development. And
if they gain some mobility skills and
start gaining some ambulation, that’s
wonderful. Let’s supplement that.”
Morgan also knows the “current
funding environment and our current
therapeutic environment haven’t quite
embraced that concept yet,” in part
because of the relatively high cost of
power chairs. Still, she says of using
power chairs as therapeutic intervention,
“I believe it’s on the verge of
happening. It’s a progressive thought,
a correct thought in my opinion. In
a perfect world, that would happen
with every child with any mobility
limitation.”
