Outcomes of Robotic Mobility Experience on Infants With Motor Impairment

SIGNIFICANCE: Research indicates that in typically developing infants, independent mobility heralds the development of a host of skills in domains, including perception, cognition, social/emotional skills, and language. However, infants with motor impairment are deprived of the opportunity for early exploration, which may lead to additional developmental delay. This research reports gains in driving ability, social interaction, environmental exploration, and developmental skills in 2 infants with motor impairment who participated in 12 robot sessions (20 min in length) over the course of 7 wk, thus providing support for early powered mobility for infants with motor impairment.

INNOVATION: This research is innovative in a number of ways. First, infants with motor impairment controlled the robotic mobility device by weight shift, rather than joysticks, which have been used in most other studies. This control device allowed infants to interact freely with objects in the environment, and it used sonar sensors to prevent collisions. In addition, gains in object and social interaction were related to the infants’ ability to control the robot—factors not reported in other studies of early powered mobility. Finally, analysis of data was completed with ELAN annotation software, which permitted exceptionally accurate coding of variables from videotapes.

RESEARCH QUESTION: Will very young children with motor impairments who participate in a robotic training program demonstrate gains in developmental domains, driving success, object and social exploration, as well as positive affect?

BACKGROUND AND RATIONALE: Researchers and clinicians suggest that young children with mobility impairments should be provided with powered mobility as early as is feasible. Research has indicated that children with disabilities as young as 20 mo of age can learn to control movement of a powered mobility device using a joystick but that control of direction of movement with the joystick is poor in very young children. Our research team found that typically developing infants were significantly more successful in learning to control robot direction with weight shifting than by using a joystick. This study examines outcomes of robotic mobility using weight shift in infants with disabilities, and relates outcomes to infant driving success.

METHOD: This case study research reports child outcomes of 12 robotic mobility experiences (20 min in length) that each consisted of an initial 3-min free play period, a 10-min driver training period, and a second 3-min free play period. All components of the study occurred in a laboratory on a college campus. Two children with motor impairment who were unable to creep on hands and knees were recruited from the regional early intervention program. When the study began, Jade was aged 10 mo, with severe undiagnosed hypotonia, and Mikaela was aged 24 mo, with spastic diplegia cerebral palsy (Gross Motor Function Classification System [GMFCS] Level 4).

Pretest–posttest development was measured with the Bayley Scales of Infant Development—Third Edition (Bayley–III). Driving success, object and social interaction, and affect were measured by videotape analysis with ELAN, an annotation software program. Measures of variables in each session were graphed to allow visual inspection. Results of the first six sessions were compared to the last six sessions for each child with Wilcoxon signed-rank tests.

RESULTS: Scaled scores on the Bayley–III increased from pretest to posttest. Significant gains were noted in all variables coded from videotape analysis.

CONCLUSION: Results of the study support the view that self-initiated mobility in children with motor impairments may yield developmental benefits and may support participation in daily life activities. Although encouraging, this case study research does not provide a high level of evidence.