During my experience with Numotion, I have been able to observe conversations between the Assistive Technology Professional (ATPs), therapists, clients and parents/ caregivers. I feel like the most difficult conversations are sometimes the most rewarding. Bringing up the topic of powered mobility (PM) to parents can no doubt be an uncomfortable conversation, but it is necessary to provide the best outcomes for children who are appropriate for powered mobility.

One of the most impactful learning experiences I had involved this very topic. The ATP I was with gently brought up the topic of PM to the parents of a child with mobility impairments. The ATP and therapist presented all of the benefits of PM in a very optimistic manner, and described how it could directly and positively impact their child’s function. The parents immediately gave pushback on the idea and felt defeated at the thought of a powered wheelchair, saying that they were hopeful that their child would soon learn to walk. It would have been easy to present the evidence that PM does not hinder motor development, and aggressively push the idea on the parents. However, the ATP and the therapist acknowledged the parent’s thoughts, and listened to their concerns. They displayed empathy, understanding, and that acceptance of the idea may take time.
 
It was apparent that the ATP and therapist left their personal judgments out of the conversation, and made an effort to understand the parent’s perception and address it appropriately. They used phrases such as, “this is what I’ve learned from other parents,” to help ease uncertainty.

This support and encouragement eventually resulted in the parents seeing the positive impacts the device could have. They left the session hesitant, but excited for the future for their child.
 
This conversation was an invaluable learning experience for me as a future practitioner, and is a good reminder even for those with years of experience. Understanding the importance of considering the whole family in a child’s care is vital. Without buy-in from the parents/caregivers, the assistive technology, or any therapy intervention, may not be used to its fullest potential - leaving the child with narrowed functional outcomes. This is supported in the literature, where it is clear that parents are an essential factor in recognizing and fulfilling a child’s need for pediatric powered mobility; therefore, supporting the importance of including the family as a whole in the therapeutic process to provide best practice.
 
Shifting the focus from the disability itself to the functional abilities of a child can facilitate a more positive conversation. In doing so, the families can see the value that PM devices add to a child’s life by promoting participation in meaningful activities (Wiart, Darrah, Hollis, Cook, & May, 2004).
 
The widely accepted, yet false, assumption that the use of powered mobility hinders the development of skills necessary for walking, or may decrease a child’s motivation to walk independently, must be combated. As we know, research has found that the use of PM assists in the motivation toward, and acquisition, of all methods of mobility (Butler, Okamoto & McKay, 1983). Having the evidence of the benefits of specific assistive technology including powered mobility on-hand will be useful when communicating with parents and caregivers.
 
One specific study conducted by Guerette, Furumasu, & Tefft (2013) could be helpful to facilitate the conversation of PM. In the study, researchers found that caregivers perceived an increase in positive social skills after their child acquired access to independent mobility. Caregivers believed their children helped and cooperated more with others, interacted better with other children and adults while playing games, and were more independent in their daily lives after PM acquisition. Caregivers also reported more positive social behavior and personality traits, including, enhanced levels of composure, self-confidence, self-esteem, and improvement in the child’s overall quality of life (Guerette et al., 2013).

Considering the thoughts and opinions as well as concerns of families in a child’s care will result in better functional outcomes for the child and higher family member satisfaction. Don’t steer away from the difficult conversations, yet have confidence, empathy, and patience. Having honest conversations and providing full support to families will help paint a clear picture of the potential positive influences of the AT in everyday life.
 
Thanks to Andy Foster, OTR/L, ATP for allowing me to observe the evaluation in the above example.


References

Butler, C., Okamoto, G. A., & McKay, T. M. (1983). Powered mobility for very young disabled children. Developmental Medicine & Child Neurology, 25(4), 472-474.

Guerette, P., Furumasu, J., & Tefft, D. (2013). The positive effects of early powered mobility on children’s psychosocial and play skills. Assistive Technology, 25(1), 39-48.
 
Wiart, L., Darrah, J., Hollis, V., Cook, A., & May, L. (2004). Mothers’ perceptions of their children’s use of powered mobility. Physical & Occupational Therapy in Pediatrics, 24(4), 3-21.