NEWS
Major review recommends powered mobility for under-fives with mobility limitations
A major evidence review is recommending that powered mobility interventions provided for under-fives can help with participation and development regardless of whether or not children will need them for mobility later in life .
The Early Mobility and Powered Wheelchair Evidence Review ( EMPoWER ) looked at whether providing powered mobility for children under five years old with mobility limitations provided more benefits than waiting until children are older .
The study found that powered mobility interventions are likely to have multiple benefits for children under five years , although it did find a lack of robust evidence to demonstrate this .
In particular it can have a positive effect on children ’ s movement , and it can boost children ’ s social interactions with other people , as well as their independence . Children using powered mobility were able to go to their friends by themselves , move around a play space as they wanted and take part in physical activities and games .
The authors conclude that the provision of independent mobility options , including powered mobility , should ‘ start as early as is feasible , and interventions should be tailored to each child ’ s current and future developmental and cognitive abilities ’.
Fit with the child ’ s environment was found to be particularly important , and if there was not good fit , children experienced lots of problems and often used a manual wheelchair instead . The authors also recommend that fit between a child and powered mobility should be explicitly optimised as part of any powered mobility intervention .
Dr Jennifer McAnuff , one of the authors from Newcastle University , says the report builds on work by others including the US ’ s Professor Cole Galloway and Dr Sam Logan on providing powered equipment for young children to be mobile regardless of whether they would need a powered wheelchair later in life . The issue was also in the top 10 childhood disability research priorities identified by the British Academy of Childhood Disability and the James Lind Alliance .
‘ The findings of this study mean that as an occupational therapy community we need to rethink and get on the same page about what early powered mobility is for ,’ says Dr McAnuff . ‘ We usually think powered mobility is about getting from A to B , but it ’ s important that mobility is also about movement for movement ’ s sake – developing , exploring , initiating , being with others , getting into mischief , regardless of what happens to your mobility in future .
‘ We also have to think about who it ’ s for . Early powered mobility is applicable and beneficial for a much wider population , and we need to think more broadly than just children who are going to be powered wheelchair users .
‘ And we also need to think about when it ’ s for . We already get on with early powered mobility much later than we need to , often around age three or four years old . If we ’ re thinking about movement for movement ’ s sake then we need to get in earlier .’
Dr McAnuff suggests that while local wheelchair services have a role to play , partnerships with third sector organisations such as Designability , which has strong track records in working with very young children , could provide the best way forward . Local charities and child development centres could also play a role .
‘ It ’ s about being more strategic about commissioning , and formalising some of the partnership working which is already in action in some places ,’ she says .
Dr McAnuff is urging members to read the report and discuss it in teams , and think about what practical steps they can take to work with local and national organisations to open up referrals and make the most of their existing resources .
She also recommends RCOT ’ s report on embracing risk and enabling choice as useful to think through some of the broader issues .
Quote of the month As an occupational therapy community we need to rethink and get on the same page about what early powered mobility is for ...
The team was from Newcastle University and Bangor University , and the project was funded by the National Institute for Health Research . The results were published in October ’ s Health Technology Assessment .
Read the full research report at : www . journalslibrary . nihr . ac . uk / hta / hta24500 . To help communicate the findings , the project teamed up with AniMates , a group of young people who make art work about research . See the videos at : www . bit . do / EMPoWERvideos . Read RCOT ’ s report on embracing risk at : www . bit . do / RCOT-embracing-risk .
Dr Jennifer McAnuff
12 OTnews January 2021