Retrospective Analysis of Predictors of Proficient Power Mobility in Young Children With Severe Motor Impairments



      To determine if child characteristics, maternal education, intervention parameters, type of wheelchair control mechanism, or a combination of these variables were associated with proficient power mobility skills in children with severe motor impairments aged 14 to 30 months; and to determine if performance on the Wheelchair Skills Checklist (WSC) was associated with performance on the Powered Mobility Program (PMP).


      Secondary data analyses on data collected from 2 previously completed randomized controlled trials (RCTs).


      Intervention and outcomes measurements took place in natural environments.


      Participants included children who were assigned to the intervention groups in 2 RCTs (N=31).


      Children practiced maneuvering individually customized power wheelchairs for 12 months in natural environments.

      Main Outcome Measures

      Proficiency was assessed using the WSC and the PMP. The Battelle Developmental Inventory and Merrill-Palmer-Revised were used to assess baseline cognition and motor skills. Baseline mobility was assessed using the Pediatric Evaluation of Disability Inventory.


      Cognition, fine motor skills, and wheelchair control mechanism were associated with proficiency. Cognition, type of wheelchair control, and diagnosis all predicted proficiency while controlling for other covariates using multiple regression analysis. Agreement between the WSC and PMP was 94.7%.


      Cognition, type of wheelchair control, and diagnosis might predict power mobility proficiency in young children with severe motor impairments. These factors however should not be used to determine whether a child has the opportunity to participate in a training program. Agreement between the WSC and PMP could help researchers and clinicians compare results across studies that use only one of these outcome measures.


      List of abbreviations:

      BDI (Battelle Developmental Inventory), PMP (Powered Mobility Program), RCT (randomized controlled trial), WSC (Wheelchair Skills Checklist)
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Archives of Physical Medicine and Rehabilitation
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Guerette P.
        • Furumasu J.
        • Tefft D.
        The positive effects of early powered mobility on children's psychosocial and play skills.
        Assist Technol. 2013; 25: 39-48
        • Jones M.A.
        • McEwen I.R.
        • Hansen L.
        Use of power mobility for a young child with spinal muscular atrophy.
        Phys Ther. 2003; 83: 253-262
        • Butler C.
        Effects of powered mobility on self-initiated behaviors of very young children with locomotor disabilities.
        Dev Med Child Neurol. 1986; 28: 325-332
        • Jones M.A.
        • McEwen I.R.
        • Neas B.R.
        Effects of power wheelchairs on the development and function of young children with severe motor impairments.
        Pediatr Phys Ther. 2012; 24: 131-140
        • Lynch A.
        • Ryu J.C.
        • Agrawal S.
        • Galloway J.C.
        Power mobility training for a 7-month-old infant with spina bifida.
        Pediatr Phys Ther. 2009; 21: 362-368
        • Ragonesi C.B.
        • Chen X.
        • Agrawal S.
        • Galloway J.C.
        Power mobility and socialization in preschool: a case study of a child with cerebral palsy.
        Pediatr Phys Ther. 2010; 22: 322-329
        • Wiart L.
        • Darrah J.
        • Hollis V.
        • Cook A.
        • May L.
        Mothers' perceptions of their children's use of powered mobility.
        Phys Occup Ther Pediatr. 2004; 24: 3-21
        • Butler C.
        • Okamoto G.A.
        • McKay T.M.
        Powered mobility for very young disabled children.
        Dev Med Child Neurol. 1983; 25: 472-474
        • Furumasu J.
        • Guerette P.
        • Tefft D.
        The development of a powered wheelchair mobility program for young children.
        Technol Disabil. 1996; 5: 41-48
        • Bottos M.
        • Bolcati C.
        • Sciuto L.
        • Ruggeri C.
        • Feliciangeli A.
        Powered wheelchairs and independence in young children with tetraplegia.
        Dev Med Child Neurol. 2001; 43: 769-777
        • Furumasu J.
        • Guerette P.
        • Tefft D.
        Relevance of the Pediatric Powered Wheelchair Screening Test for children with cerebral palsy.
        Dev Med Child Neurol. 2004; 46: 468-474
        • Nilsson L.
        Training characteristics important for growing consciousness of joystick-use in people with profound cognitive disabilities.
        Int J Ther Rehabil. 2010; 17: 588-594
        • Butler C.
        • Okamoto G.A.
        • McKay T.M.
        Motorized wheelchair driving by disabled children.
        Arch Phys Med Rehabil. 1984; 65: 95-97
        • World Health Organization
        International Classification of Functioning, Disability and Health.
        World Health Organization, Geneva2001
        • Livingstone R.
        A critical review of powered mobility assessment and training for children.
        Disabil Rehabil Assist Technol. 2010; 5: 392-400
        • Steiner E.
        Methodology of theory building.
        Educology Research Associates, Sydney1988
        • Newborg J.
        • Stock J.R.
        • Wnek L.
        • Guidibaldi J.E.
        • Svinicki J.
        Battelle Developmental Inventory Screening Test.
        DLM-Teaching Resources, Allen1984
        • Berls A.T.
        • McEwen I.R.
        Battelle Developmental Inventory.
        Phys Ther. 1999; 79: 776-783
        • Roid G.H.
        • Sampers J.L.
        Merrill-Palmer-Revised Scales of Development.
        Stoelting, Wood Dale2004
        • Haley S.M.
        • Coster W.J.
        • Ludlow L.H.
        • Haltiwanger J.T.
        • Andrellos P.J.
        Pediatric Evaluation of Disability Inventory: development, standardization, and administration manual.
        New England Medical Center Publications, Boston1992
        • Haley S.M.
        • Coster W.J.
        • Faas R.M.
        A content validity study of the Pediatric Evaluation of Disability Inventory.
        Pediatr Phys Ther. 1991; 3: 177-184
        • Feldman A.B.
        • Haley S.M.
        • Coryell J.
        Concurrent and construct validity of the Pediatric Evaluation of Disability Inventory.
        Phys Ther. 1990; 70: 602-610
        • Nichols D.S.
        • Case-Smith J.
        Reliability and validity of the Pediatric Evaluation of Disability Inventory.
        Pediatr Phys Ther. 1996; 8: 15-24
        • Upshur R.E.
        The ethics of alpha: reflections on statistics, evidence and values in medicine.
        Theor Med Bioeth. 2001; 22: 565-576
        • Mutch L.
        • Alberman E.
        • Hagberg B.
        • Kodama K.
        • Perat M.V.
        Cerebral palsy epidemiology: where are we now and where are we going?.
        Dev Med Child Neurol. 1992; 34: 547-551
        • Tefft D.
        • Guerette P.
        • Furumasu J.
        Cognitive predictors of young children's readiness for powered mobility.
        Dev Med Child Neurol. 1999; 41: 665-670
        • Agrawal S.K.
        • Xi C.
        • Ragonesi C.
        • Galloway J.C.
        Training toddlers seated on mobile robots to steer using force-feedback joystick.
        IEEE Trans Haptics. 2012; 5: 376-383
        • Chen X.
        • Ragonesi C.
        • Galloway J.C.
        • Agrawal S.K.
        Training toddlers seated on mobile robots to drive indoors amidst obstacles.
        IEEE Trans Neural Syst Rehabil Eng. 2011; 19: 271-279
        • Kenyon L.K.
        • Farris J.P.
        • Gallagher C.
        • Hammond L.
        • Webster L.M.
        • Aldrich N.J.
        Power mobility training for young children with multiple, severe impairments: a case series.
        Phys Occup Ther Pediatr. 2017; 37: 19-34
        • Nilsson L.
        • Nyberg P.
        Driving to learn: a new concept for training children with profound cognitive disabilities in a powered wheelchair.
        Am J Occup Ther. 2003; 57: 229-233
        • Wright-Ott C.
        The transitional powered mobility aid: a new concept and tool for early mobility.
        in: Furumasu J. Pediatric powered mobility: developmental perspectives, technical issues, clinical approaches. Rehabilitation Engineeting and Assistive Technology Society of North America, Arlington, VA1997: 58-69