Go Baby Go!

Nadir Mawji, PT Student UofT

ErinoakKidsDecember 19, 2012

Overview

Background/Literature

Types

Modifications

Why is early mobility important?

Majority of brain synapses formed by age 3

Moving towards objects that capture interest

Positive effect on social and cognitive development

Literature Review

Erikson’s theory of psychosocial development

The onset of crawling and walking is a causative factor “for cognitive, emotional, and social development.” (Galloway 2006)

Early evidence of powered mobility on self-initiated behaviours (Butler, 1986)

From Butler 1986 Ages between 23-38 months

Benefits

Positively influence receptive language level, social functional skills and level of caregiver assistance (Jones, 2004)

Increase self-initiated movement, positively impact communication and interaction with toys (Butler, 1986)

Increase interaction and socialization in the preschool environment (Ragonesi, 2010)

How Young is Too Young?

Galloway (2007). Babies driving robots: self-generated mobility in very young infants

Ages 7-15 months

Galloway (2007). Babies driving robots: self-generated mobility in very young infants

What about children who are not

able to sit?

Chen et al. (2010)

From Huang and Galloway. (2012).

From Huang and Galloway. (2012).

From Huang and Galloway. (2012).

Who?

CP (GMFCS IV or V)

Spinal Muscular Atrophy Type I or II

Multiple limb abnormalities

Lumbar level spina bifida

So Why Not?

Safety

Delayed “normal” motor miletones

Traditional clinical beliefs

Cost

So Why Not? Cost

Prices vary from $100-$400 for the ride-on toys

Around $150 for modifications

Investment in a toy with customization

Does not have the same picture of “disability” associated with it

What’s the best way to learn power mobility skills?

Not like learning to drive a car

Use their curiosity to play

Use “come here” or “lets go over to Dad” instead of “turn left” or “go straight”

Length of time practicing and environmental support strongly correlate to success (Bottos, 2001)

From Livingstone (2011).

Where do we go from here?

Can this equipment be bought and loaned out?

Who can make the modifications?

Funding

References1. Bottos M, Bolcati C, Sciuto L, Ruggeri C, Feliciangeli A. Powered wheelchairs and independence in young children with tetraplegia. Developmental Medicine & Child Neurology. 2001;43(11):769-77.2. Butler C. Effects of powered mobility on self‐initiated behaviors of very young children with locomotor disability. Developmental Medicine & Child Neurology. 1986;28(3):325-32.3. Galloway JC, Ryu JC, Agrawal SK. Babies driving robots: self-generated mobility in very young infants. Intelligent Service Robotics. 2008;1(2):123-34.4. Hansen L, Jones MA, McEwen IR. Use of power mobility for a young child with spinal muscular atrophy. (Case Report). Physical Therapy. 2003 2003/03//:253+.5. Huang HH, Galloway JC. Modified ride-on toy cars for early power mobility: a technical report. Pediatric physical therapy. 2012;24(2):149.6. Jones MA. Effects of power mobility on the development of young children with severe motor impairments: University of Oklahoma Health Sciences Center; 2004.7. Kermoian R, Campos JJ. Locomotor experience: A facilitator of spatial cognitive development. Child Development. 1988:908-17.8. Livingstone R. Evidence for Practice. 2011.9. Lynch A, Ryu JC, Agrawal S, Galloway JC. Power mobility training for a 7-month-old infant with spina bifida. Pediatric physical therapy. 2009;21(4):362.10. Ragonesi CB, Chen X, Agrawal S, Galloway JC. Power mobility and socialization in preschool: a case study of a child with cerebral palsy. Pediatric physical therapy. 2010;22(3):322-9.11. Ragonesi CB, Galloway JC, Agrawal SK. Design of a novel mobility interface for infants on a mobile robot by kicking. Journal of Medical Devices. 2010;4:031006-1.