Date Presented 03/28/20
The Explorer Mini is a new power mobility device designed to enhance childhood development and provide access to early mobility for infants and young children. Children with delayed motor skills risk additional cognitive, sensory, and motor delays from limited physical ability to explore through traditional locomotion of crawling or walking. This proposal describes how infants and young children responded to the first opportunity to explore their environment with the Explorer Mini.
Primary Author and Speaker: Eleni Halkiotis
Contributing Authors: Teresa Plummer
PURPOSE: The purpose of this presentation is to describe the 1) driving experiences and 2) emotional responses of young children with mobility limitations during initial Explorer Mini (EM) use. The EM is a powered mobility device for children with mobility limitations 6 to 36 months old. It is operated with a proportional midline joystick (JS) in a supported device that also allows for graded standing and mobility in both sitting and standing. Seven percent of American children have developmental disabilities (Zablotsky et al., 2017) limiting self-initiated mobility and subsequently cognitive, visual, emotional, and social development. This addresses an important opportunity to describe the critical role of OT in the area of mobility for promoting overall child development.
DESIGN: Researchers, Teresa Plummer, PhD, OTR/L, ATP, CEAS, CAPS, Claire Morress, PhD, OTR, ATP, and Sam Logan, PhD studied 33 children (17 females, mean age 17 months). Inclusion Criteria: 6-36 months old; <35lbs; <39” long; unable to mobilize independently; adequate trunk, head control to stay upright in EM. Exclusion Criteria: outside age range; >35lbs; >39” long; able to mobilize independently; unable to regain head control if lost; no awareness/response to toys, objects, sounds, people. IRB approval and written informed consent obtained, subjects received $450, and manufacturer educated researchers to EM operation. Sessions were in child’s home or clinic. Criteria set to measure child’s EM interactions, demonstrate JS use as needed, and offer rest breaks.
METHOD: Observation Form with yes/no questions and notes area assessed 1) Driving Experiences: Does child: reach for JS with or without prompting? visually notice JS to explore with other sensory systems (eyes, mouth)? recognize EM moving?, move EM?; 2) Emotional Responses: Does child show vocal or verbal response? Qualitative data from Observation Form, memos, and notes categorized into 1) “I can move” and 2) “I think I Like it- don’t I?”. Quantitative data from Observation Form calculated behavior frequency and percentage.
RESULTS: For the purpose of this proposal only the children’s results are presented.
“I can move”: Quantitative- 94% visually noticed/explored JS; 88% reached for JS if prompted- 79% independently; 94% moved EM (82% front, 70% back, 61% circles, 61% right, 48% left); 88% recognized EM moving, showed cause and effect by grasping/releasing JS. Qualitative- “ …surprised by this obstacle but not ready to give it up. She maneuvered away from the obstacle and found fun elsewhere”; “As the therapist I usually have my hands on the child’s hips trying to facilitate control. Instead the device provided pelvic control …”.
“I think I like it- don’t I?”: Quantitative- 94% emotional, 64% vocal response. Qualitative- Faces, giggles, gleeful wiggles in operating EM,. “ … nonverbal child …signed with his hands more, more, more”; “ …as the session progressed she spoke … “go, go now” … caregiver commented … her child’s language increased in one session”.
Experiences and responses to EM suggest it promotes exploratory behaviors, emotional expression, and self-initiated movement in young children with mobility limitations.
CONCLUSION: The findings demonstrate that opportunities for early mobility enhance communication, exploration, cause and effect and problem solving. Exploratory pre-driving behavior can now be recognized as first steps toward learning JS directed movement. The EM offers self-initiated mobility as a therapeutic tool to support development and learning.
IMPACT STATEMENT: This study may increase awareness of the availability of a new mobility device and prompt more researchers and occupational therapists to consider early power mobility for infants 6-36 months with mobility limitations.
References
Anderson, D., Campos, J., Witherington, D., Dahl, A., Rivera, M., He, M., Barbu-Roth, M. (2013). The role of locomotion in psychological development. Frontiers in Psychology, 4, 440. doi:10.3389/fpsyg.2013.00440
Bornstein, M., Hahn, C., & Sulwalsky, J. (2013). Physically developed and exploratory young infants contribute to their own long-term academic achievement. Psychological Science, 24(10), 1906-1917. doi:10.1177/0956797613479974
Lynch, A., Ryu, J., Agrawal, S., & Galloway, J. (2009). Power mobility training for a 7-month-old infant with spina bifida. Pediatric Physical Therapy, 21(4), 362-8. doi: 10.1097/PEP.0b013e3181bfae4c
Zablosky B, Black LI, Blumberg SJ. Estimated prevalence with diagnosed developmental disabilities in the United States, 2014-2016. NCHS Data Brief, no. 291. Hyattsville, MD. National Center for Health Statistics. 2017. Retrieved from https://www.cdc.gov/nchs/data/databriefs/db291.pdf
