RESNA position on the application of power mobility devices for pediatric users

Abstract

This paper serves as an update to the previous RESNA Position on the Application of Power Wheelchairs for Pediatric Users with more current and additional scientific literature. This document contains typical clinical applications and best evidence from the literature supporting the application of power mobility (PM) for young children and to assist practitioners in decision-making and justification. It is RESNA' s position that age, limited vision or cognition, behavioral issues, and the ability to walk or propel a manual wheelchair short distances should not, in and of themselves, be used as discriminatory factors against providing PM for children. RESNA recommends early utilization of PM for children with mobility limitations as medically necessary, to promote integration and psycho-social development, reduce passive dependency, and to enhance participation, function, and independence.

Evaluating a Therapeutic Powered Mobility Camp for Children with Severe Cerebral Palsy

“…It also fits with Nilsson et al's findings that even individuals with severe cognitive limitations can learn powered mobility (Nilsson, 2019;Nilsson & Durkin, 2017). The current study strengthens research concluding that limited vision or cognition, behavioral issues and poor motor abilities should not prevent a child from learning to use a powered wheelchair (Rosen et al, 2018).…”

“…In addition, despite the fact that both exploratory and operational learners started at approximately the same level, one group nevertheless succeeded in advancing to the operational level, showing the difficulty of predicting which subjects will show significant improvement and at what rate of progress. This further reinforces the importance of providing learning opportunities for children at all levels (Livingstone & Paleg, 2014;Rosen et al, 2018).…”

“…Self-generated locomotion has significance beyond movement from one location to another; it allows exploration and promotes development (Anderson et al, 2013). A powered mobility device can provide children with severe CP (GMFCS levels IV and V) opportunities for development, as well as participation (Anderson et al, 2013;Butler, 1986;Rosen et al, 2018); however, operating a power mobility device is a complex activity requiring a variety of physical and mental skills (Smith et al, 2020).…”

“…Children at GMFCS levels IV and V often have lower manual abilities as measured by the manual ability classification scale (MACS) (a five-level scale, in which levels three to five imply a consistent reduction of functional abilities (Eliasson et al, 2006); a study showed that 91% of children at GMFCS levels IV and V were at MACS III-V (Carnahan et al, 2007). Children with CP at GMFCS levels IV and V should be encouraged to learn powered mobility to access opportunities for development, despite the limitation of their manual, cognitive, and/or visual skills (Livingstone & Paleg, 2014;Rosen et al, 2018), but how should this be done if the skills are interdependent?…”

Inter‐rater reliability of the assessment of learning powered mobility use, version 2.0, when applied with children and adults engaged in Driving to Learn in a powered wheelchair

“…The RESNA position on powered mobility for paediatric users (Rosen et al, 2017) supports the value of applying interventions such as the Driving to Learn intervention for children who may never become safe and independent drivers (Nilsson, Eklund, Nyberg, et al., 2011a). In a review of powered mobility intervention measures (Field & Livingstone, 2018), the ALP‐tool is mentioned as a process‐based assessment also covering the early phases in the learning process i.e.…”