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The effect of non-powered mobility on the engagement of young children with severe mobility impairment.

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Aims:
To determine the effect of non-powered, self-initiated mobility on the engagement of young children, with severe mobility impairment, in play.
Methods:
A multiple-probe-across-participant design was used. Four participants (aged 2-6 years) with severe motor impairment (GMFCS level V) underwent a minimum of five baseline sessions followed by eight intervention sessions. Engagement was measured during each session using the Individual Child Engagement Record –Revised (ICER-R). The data was presented graphically and analysed using statistical procedures appropriate for single-subject designs.
Results:
All participants demonstrated an improvement in engagement in play with the introduction of the non-powered, self-initiated mobility programme. A reciprocal deterioration in non-engagement was also demonstrated. A decrease in engagement in play at the start of intervention was attributed to the focus of engagement being on mobility skills as the device was introduced but this reverted as the participants spent more time on the mobility device. Functional abilities were identified as having a greater role in engagement than age.
Conclusions:
The introduction of non-powered, self-initiated mobility correlated with the improvement of engagement of young children with severe motor impairment. Non-powered, self-initiated mobility is a viable mechanism for mobility at a young age. Clinically non-powered, self-initiated mobility could be used as an intervention tool to improve engagement of young children with severe motor impairment, even if the motor impairment is temporary.

KeyWords: engagement, non-powered mobility, severe motor impairment, single-subject designs, multiple-probe design.

Author(s):

Kirsty Bastable    
University of Pretoria
United States

Shakila Dada    
Centre for Augmentative and Alternative Communication
South Africa

CJE Uys    
Centre for Augmentative and Alternative Communication
South Africa

 

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