Impact of Use of a Ride-On Toy Car by Children With Mobility Impairment

BACKGROUND AND PURPOSE: Independent mobility is essential to early childhood development, and motor delays contribute to deficits in other developmental domains (Henderson et al., 2007; Huang & Galloway, 2012; Logan et al., 2016; Ragonesi et al., 2011). A study by Jones and collaborators (2012) investigated the effects of power wheelchairs on the development and function of young children with severe motor impairments. The results of that study supported the use of a power wheelchair by children as young as age 14 mo. Power wheelchairs, however, can be expensive and difficult to fit to young children, and children require significant time to develop proficiency. Therefore, there is a need to investigate the efficacy of a more sustainable and accessible solution for young children with mobility impairment.

Battery-powered ride-on toy cars (RTCs) have been shown to be an attractive alternative that is fun, easy to use, and more socially acceptable than power wheelchairs. They are readily available and relatively inexpensive in the United States, and individualized adaptation is feasible for children with disabilities (Huang & Galloway, 2012; Logan et al., 2016; Ragonesi et al., 2011). However, evidence is lacking on efficacy related to participation in occupations, specifically play and social interactions. Therefore, we hypothesized that the RTCs would facilitate the development of personal-social, communication, motor (gross and fine), and cognitive skills in children with mobility impairment after 4 mo of using an RTC.

METHOD: This pilot study was conducted with children with mobility impairment using an RTC that was modified to accommodate each child’s postural and functional needs. For the purpose of this study, mobility impairment was defined as no prognosis of independent walking at the moment of enrollment. The inclusion criteria were age 12–60 mo; resident in San Antonio, Texas; impaired mobility; and undergoing one or more therapy sessions (occupational therapy, physical therapy, speech therapy). Exclusion criteria were severe vision impairment and need for more postural supports than could be provided with use of the RTC.

RTCs were modified to accommodate each child’s postural and functional needs, and the caregivers were trained on their use. The RTC was sent home with the families, and the children were able to explore their familiar environments and keep the car after the study was done. Parents were encouraged to take the children out in the community while using the RTC.

Data were collected using the Battelle Developmental Inventory (2nd ed.; BDI–2) and the Peabody Developmental Motor Scales (2nd ed.; PDMS–2) 1 mo before the intervention and 1 mo and 3 mo after the children received the cars. Normalized scores allowed comparison of the developmental trajectory and progress of children of different ages and with different developmental delays. Paired t tests were used to examine significant changes in BDI–2 and PDMS–2 scores.

RESULTS: More than half (56%) of enrolled children completed pre and post assessments. Most were boys (56%) and Hispanic (47%), and mean age was 34 mo (SD = 18). Cerebral palsy was the most common diagnosis (50%). From baseline to 3 mo, significant improvements emerged on the PDMS–2 motor domain and on the BDI–2 adaptive, personal-social, communication, and motivation domains. No differences emerged from baseline to 1 mo or as a function of child gender, age, or ethnicity.

CONCLUSION: Use of an RTC had a positive impact on the children’s motor and social development.

References

Henderson, S., Skelton, H., & Rosenbaum, P. (2008). Assistive devices for children with functional impairments: Impact on child and caregiver function. Developmental Medicine and Child Neurology, 50, 89–98. https://doi.org/10.1111/j.1469-8749.2007.02021.x

Huang, H. H., & Galloway, J. C. (2012). Modified ride-on toy cars for early power mobility: A technical report. Pediatric Physical Therapy, 24, 149–154. https://doi.org/10.1097/PEP.0b013e31824d73f9

Jones, M. A., McEwen, I. R., & Neas, B. R. (2012). Effects of power wheelchairs on the development and function of young children with severe motor impairments. Pediatric Physical Therapy, 24, 131–140. https://doi.org/10.1097/PEP.0b013e31824c5fdc.

Logan, S. W., Feldner, H. A, Galloway, J. C., & Huang, H. H. (2016). Modified ride-on car use by children with complex medical needs. Pediatric Physical Therapy, 28, 100–107. https://doi.org/10.1097/PEP.0000000000000210

Ragonesi, C. B., Chen, X., Agrawal, S., & Galloway, J. C. (2011). Power mobility and socialization in preschool: Follow-up case study of a child with cerebral palsy. Pediatric Physical Therapy, 23, 399–406. https://doi.org/10.1097/PEP.0b013e318235266a