What Are the Attitudes and Practices of Pediatric Therapists Concerning Power Mobility Use in Children?

PURPOSE AND BACKGROUND: The purpose of this study was to explore the current attitudes and practices of pediatric occupational therapists and physical therapists in Canada and the United States related to power mobility use for children with mobility deficits and limitations. A significant body of research developed over the past 30 years has documented the potential cognitive, developmental, and psychosocial benefits of power mobility for young children with mobility impairments. However, current attitudes and practice trends among occupational and physical therapists in this area of intervention are not known. This study sought to answer the following research questions: What are the current attitudes of pediatric occupational and physical therapists toward the use of power mobility for young children with mobility impairments? What child characteristics are important to therapists when making determinations about whether power mobility use or prescription is appropriate for young children with mobility impairments? How frequently are occupational and physical therapists providing power mobility experiences for young children with mobility impairments?

METHOD: This study used a descriptive, cross-sectional survey design. Of the 1,115 pediatric occupational and physical therapists from Canada and the United States who accessed the survey, 1,009 met the inclusion and exclusion criteria. Licensed therapists who indicated that 50% or more of their caseload consisted of children aged 0–21 yr and who had not completed the survey previously met the inclusion criteria. The web-based survey collected primarily quantitative data and was reviewed and piloted by an expert panel prior to data collection. Questions pertained to therapists’ decisions to trial and use power mobility, agreement or disagreement with various published statements regarding the introduction and use of power mobility, and the frequency of performance of tasks related to power mobility prescription and training.

RESULTS: Therapists from all 50 United States, all 10 Canadian provinces, and one of the three Canadian territories responded to the survey. Sixty-five percent of the respondents practiced in a school system or outpatient clinic. A majority of respondents reported that certain child characteristics (e.g., cognition, safety awareness) were important factors in decisions about power mobility and that other characteristics (e.g., communication abilities, age) were considered less important. Family resources and home accessibility also were not considered as important.

Respondents expressed agreement (range = 66%–96%) with various published statements regarding the introduction and use of power mobility, such as the potential developmental, cognitive, and psychosocial benefits; the age at which children may benefit from power mobility experiences; and the appropriateness of this intervention for children with different types of impairments. Respondents most frequently performed power mobility tasks either 1–2×/yr or never.

CONCLUSION: A majority of respondents appeared to have a positive attitude toward introducing power mobility to young children. However, few therapists appeared to be actively engaged in providing power mobility experiences, and most commonly referred children to specialty clinics. These findings highlight the importance of determining facilitators of and barriers to the implementation of power mobility experiences for young children with mobility impairments. Occupational therapy practitioners working in community settings may benefit from resources to support early introduction of and training in power mobility to increase participation in everyday environments for children.

Reference

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