Changing philosophical perspectives on the management of children with physical disabilities--their effect on the use of powered mobility

Abstract

The clinical implications of this philosophical shift for the use of powered mobility with children with physical disabilities are explored. A collaborative approach to working with families throughout the process of selecting mobility options for their children is discussed.

Toy-Based Technologies for Children with Disabilities Simultaneously Supporting Self-Directed Mobility, Participation, and Function: A Tech Report

“…Emerging research indicates that this sentiment is the consequence, in part, of a lack of positive disability narratives that challenge walking as the only means of "normalcy, " which, left unmitigated, often results in children with disabilities' internalization of stigma and low self-worth (Gibson et al, 2011;Gibson and Teachman, 2012). Several studies cite the role of rehabilitation professionals as key in either maintaining or challenging these established normative views on disability and walking (Wiart and Darrah, 2002;Bottos and Gericke, 2003;Wiart et al, 2004;Gibson et al, 2011;Gibson and Teachman, 2012).…”

“…Perhaps the social model of disability needs even further influence in rehabilitative practices surrounding self-directed mobility. Although commonly cited as at odds with rehabilitation frameworks, the ICF incorporates psychological and social (environmental) factors of the social model, and provides a framework to engage these models in a complimentary way as demonstrated in the current technical report (Wiart and Darrah, 2002;Gibson et al, 2009;Gibson and Teachman, 2012;McKeever et al, 2013).…”

“…The ICF includes three health domains: (1) body structure (anatomical parts of the body) and function (physiological functions of body systems); (2) activity (execution of a task or action by an individual); and (3) participation (involvement in life situations). The ICF also considers environmental factors that make up the physical, social, The ICF was generated out of concern that previous classifications of the various domains of health and functioning neglected to recognize the social and environmental barriers to function that exist external to an individual, thus situating disability as solely an individual problem (Wiart and Darrah, 2002;Ostensjø et al, 2005;Gibson and Teachman, 2012). The ICF model, as a response to these concerns, contains body function and structure domains as well as activity and participation domains, all of which can influence or be influenced by personal factors and environmental contexts, but which are not meant to be linear or to imply causal relationships (Law et al, 2007;Gibson et al, 2009;Gibson and Teachman, 2012).…”

Critical Reflections on the Physiotherapy Profession in Canada

“…For example, changing philosophical perspectives on the PT management of children with physical disabilities has resulted in a practice shift toward offering early powered mobility. 18 In another example, Nicholls and Gibson have recently written about a theory of embodiment that integrates the self, body, and society beyond the ''body as machine'' model that is prevalent in PT, in order to offer new ways for physiotherapists to understand and to respond holistically to their patients' experiences of illness. 20 In a third example, Nixon is using a critical public-health ethics lens to evaluate the intersections of 98 Barbara E. Gibson, PhD, PT: Department of Physical Therapy, University of Toronto, Toronto, Ontario; Bloorview Research Institute, Bloorview Kids Rehab, Toronto, Ontario.…”

“…[6][7][8][9][10][11][12] Others have written about the lack of an established theoretical framework in PT. [13][14][15][16][17][18] Although our practice is underpinned by theoretical knowledge, we have largely borrowed our conceptual groundings from elsewhere in the biomedical, physical, and social sciences 13 or concentrated on ''middle range theories'' that are specific to different areas of practice. 19(p.25) These contributions are important, but what is missing is the work of addressing, unpacking, and (re)imagining larger ideas about the practice of physiotherapy.…”