Impacts of early powered mobility provision on disability identity: A case study.
Heather Feldner
PMID 30570332WHAT IT FOUND
Children with cerebral palsy experienced early powered mobility differently.
Sam's wheelchair was tied to choice and play; Jamie's ride-on car was tied to school play, while his mother saw it as delaying a wheelchair.
Key findings
01Sam and Jamie showed emerging agency around mobility: Sam began operating his wheelchair controls without waiting, and Jamie said he wanted to drive by himself.
02Caregiver beliefs shaped device meaning: Sam's mother valued the wheelchair for control, while Jamie's mother valued the ride-on car partly because it prolonged the need for a wheelchair.
03Provision systems were part of family experience: Sam's wheelchair approval caused a nearly three-month delay and an over $4000 out-of-pocket seat elevator, while Jamie's ride-on car was not reimbursable.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
Only two children and families were studied, so these are experiences, not evidence that powered mobility improves identity, play, or independence. Follow-up captured only very early use, three months after Sam's delivery and two months after Jamie's build. Most time with Sam and all time with Jamie was with mothers, so fathers' perspectives were limited. The sample was relatively homogeneous and excluded children with cognitive impairment or families unable to communicate in English. The researcher was a pediatric physical therapist with experience in both models, which could introduce insider status or bias. The study reports perceptions and observations, not measured outcomes or comparisons large enough to test effects.
The easy way to misread this
Do not conclude that powered wheelchairs or ride-on cars improve disability identity or participation. The study describes families' early experiences and perceptions, and it cannot separate device effects from caregiver beliefs, environment, or individual differences.