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.

Purpose/Objective: Health care providers’ attitudes of marginalized groups can be key factors that contribute to health care access and outcome disparities because of their influence on patient encounters as well as clinical decision-making. Despite a growing body of knowledge linking disparate health outcomes to providers’ clinical decision making, less research has focused on providers’ attitudes about disability. The aim of this study was to examine providers’ explicit and implicit disability attitudes, interactions between their attitudes, and correlates of explicit and implicit bias. Research Method/Design: We analyzed secondary data from 25,006 health care providers about their disability attitudes. In addition to analyzing people’s explicit and implicit attitudes (Disability Attitudes Implicit Association Test), we used Son Hing, Chung-Yan, Hamilton, & Zanna’s (2008) model of two-dimensional prejudice to compare provider’s explicit and implicit attitudes. Finally, we used linear regression models to examine correlates of providers’ explicit and implicit attitudes. Results: While on average, provider’s explicit attitudes (M = 4.41) indicated little prejudice, their implicit attitudes (M = 0.54) revealed they moderately preferred nondisabled people—they were aversive ableists. Correlates of providers’ explicit and implicit attitudes also included age, gender, political orientation, and having relationships with disability (friends, family, and being a person with disability). Conclusions/Implications: This study revealed that despite a majority of providers self-reporting not being biased against people with disabilities, implicitly, the overwhelming majority were biased. This study’s findings can be used to better understand how provider disability bias can contribute to inequitable health care access and health outcomes for people with disabilities.

Four themes emerged: (1) Dys/Function of Mobility Technology; (2) Daily Life, Play and Participation; (3) Emerging Self/Advocacy and (4) Complex Family/Industry Interplay.  Conclusions: These themes and experiences may inform further innovation in powered mobility practices, generate new hypotheses about the role of technology in shaping disability identity and demonstrate the feasibility and impact of using participatory methods more broadly in rehabilitation research. Implications for Rehabilitation Participatory methods may be a useful and underutilized research tool in describing the impact of powered mobility provision processes on child and family experiences of technology and disability. Empowering children and families as co-researchers is important to move the field of powered mobility technology forward in creating innovative, accessible and socially welcoming devices and processes. It is important to capture the similarities and differences in child and family perceptions and experiences within different models of powered mobility provision, such as traditional powered wheelchair prescription and crowdsourced ride-on toy car modification. Powered mobility provision processes and the perceptions and experiences of children and families move beyond business or medical transactions and may help shape disability identity and pride. A disability studies framework may be useful in analyzing the complexities of technology provision and the nuanced interplay between bodies and technology.

Objective: To examine the perceived value, benefits, drawbacks, and ideas for technology development and implementation of surface electromyography (sEMG) recordings in neurologic rehabilitation practice from clinical stakeholder perspectives. Design: A qualitative, phenomenological study was conducted. In-depth, semi-structured interviews and focus groups were completed. Sessions included questions about clinician perspectives and demonstrations of four sEMG systems to garner perceptions of specific system features. Setting: The study was conducted at four hospital systems in a large metropolitan area. Participants: 22 adult and pediatric physical therapists, occupational therapists, and physiatrists from inpatient, outpatient, and research settings took part in the study. Interventions: Not Applicable Main Outcome Measures: Interviews and focus groups were audio-recorded, transcribed verbatim, then coded for analysis into themes.

Background/Purpose: Providing powered mobility technology to people with disabilities is a common rehabilitation practice. However, the relationship between powered mobility introduction and identity development, when considered in the context of lived experiences of children with disabilities and their families, is not well understood. Investigating this relationship is timely given the emergence of alternative, community-based early mobility opportunities using adapted mobility toys whose impact may contrast experiences using powered wheelchairs typically provided in rehabilitation settings. Method: Using a qualitative, ethnographic case study approach, in-depth interview and field observation data were collected with 2 children and families, 1 who received a traditional powered wheelchair and the other who received an adapted mobility toy. A grounded theory approach guided the data analysis, and emerging themes were discussed until consensus was reached between Heather Feldner and families. Results: Findings revealed four themes: (1) dys/function of mobility technology; (2) daily Life, play, and participation; (3) emerging self/advocacy; and (4) complex family/industry interplay. Conclusion: Similarities and differences were present within the situated experiences of each family. Experiences were foregrounded by instances of emerging identity development throughout provision processes that were influenced by caregiver perceptions of disability (positive vs. negative), aesthetics and function (medical vs. adventure), and perceived intent of the devices (an opportunity for freedom vs. prolonging need for undesired mobility equipment). These findings highlight the varied dynamics and spheres of influence this transaction may have on the developing identity of children with disabilities, which may ultimately help inform future models of provision and rehabilitation practices. Impact and ImplicationsThis research highlights novel perspectives and experiences of very young children with disabilities and their families participating in early powered mobility provision, which offers a methodological framework for future work capturing young children's voices along with caregiver perceptions by proxy. This study applies a grounded theory framework and qualitative methodology to a rehabilitative process that has been skewed toward quantitative investigation of functional performance assessment and outcomes. By foregrounding the situated knowledge of disability, mobility, and technology experienced by children and families as a central discourse during powered mobility provision processes, this study contributes to advocacy for children who use mobility technology, by questioning how current and future design and provision can improve to positively impact their developing identities. This study helps to challenge traditional and often subconscious mobility hierarchies and advocate for the need for further education for rehabilitation professionals in areas of mobility technology provision and alternative models of disabi...

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Modified ROC use is a feasible and enjoyable powered mobility device for children with complex medical needs.

Purpose: Modified ride-on cars have emerged as an early powered mobility option for young children with disabilities. The purpose of this study was to identify, extract, and synthesize perceived barriers of modified ride-on car use reported in previous studies. Methods: This study was descriptive using a qualitative content analysis of previously published studies identified from a systematic literature search. Results: Categories of perceived barriers were identified: device, environmental, child-related perceived barriers regarding health, tolerance, and abilities, and caregiver-related perceived barriers regarding physical requirements, time, and motivation. Device and environmental perceived barriers were the most reported. Conclusions: Pediatric physical therapists play a critical role in working with families to promote their self-efficacy for using the modified ride-on car and their capacity for overcoming the inherent difficulties associated with use. Most of the reported perceived barriers are modifiable, at least to some degree, with likely effects on modified ride-on car use.