In-Home Mobility Training With a Portable Body Weight Support System of an Infant With Down Syndrome.

PURPOSE: To report on the feasibility of an open-area, portable body weight support system (PBWSS) for in-home use and overground mobility training in an infant with Down syndrome. SUMMARY OF KEY POINTS: The family used the PBWSS on average 4 days/week and for a mean duration of 27.9 minutes/day. Within sessions, the infant's mobility in the open area was greater with PBWSS assistance. The infant's mobility increased whereas variable trends were noted in the infant's motor, language, and cognitive development. CONCLUSIONS: The long-term and frequent use of the PBWSS by this family provided opportunities to practice on emerging motor skills and exploratory actions that may have had a positive effect on her mobility and overall development. RECOMMENDATION FOR CLINICAL PRACTICE: High-dose, body weight-supported training on emerging motor skills is feasible in the infants' natural environments. Future studies using a large sample will quantify the effects.

Use of an In-Home Body Weight Support System by a Child With Spina Bifida.

PURPOSE: To examine the feasibility of a new open-area body weight support system (BWSS) to act as both an "assistive" and a "rehabilitative" device within the home. INTERVENTION: A 5-year-old boy with spina bifida used the BWSS during self-selected activities for 10 weeks. Feasibility, behavioral, and clinical assessments provided a quantification of his activity in and out of the BWSS. OUTCOMES: On average, the child used the device on 2.7 days/week and for 67 minutes/day during intervention. When in the BWSS (assistive role), the child's locomotor activity and engagement in adapted sports activities increased. When not in the BWSS (rehabilitative role), the child's functional mobility and ambulatory ability increased. WHAT THIS CASE ADDS: The use of the open-area in-home BWSS was feasible for regular home use and associated with an increase in functional mobility for a child with spina bifida.

Power-Up: Exploration and Play in a Novel Modified Ride-On Car for Standing.

PURPOSE: The purpose of this study was to compare the physical activity and play behaviors of preschoolers without disabilities and 1 preschooler with physical disability. METHODS: Participants were 42 preschoolers without disabilities and 1 preschooler with physical disability (Child A). Child A used either crutches or a modified ride-on car while in the gymnasium and playground. RESULTS: In the gymnasium, Child A engaged in less solitary play and more parallel play while using the modified ride-on car compared with crutches. On the playground, Child A engaged in more sitting and less running while using crutches compared with preschoolers without disabilities. On the playground, Child A engaged in more peer interaction and less teacher interaction when using the modified ride-on car compared with crutches. CONCLUSIONS: For children with disabilities who may use assistive devices, clinicians, families, and teachers are encouraged to embrace a "right device, right time, right place" approach.

Modified toy cars for mobility and socialization: case report of a child with cerebral palsy.

PURPOSE: Children with cerebral palsy have limited opportunities to explore their physical and social environment. The purpose of this study was to determine the feasibility of using a "ride-on toy car" as a readily available, low-cost, fun, and functional option for children with special needs. METHODS: Brenden, a 21-month-old child, was provided a modified ride-on toy car for a 15-week study period divided up into a 1-week baseline, 12-week intervention, and 2-week postintervention. We coded mobility and socialization measures from video recordings. RESULTS: Brenden was more mobile and had more vocalizations during the 12-week intervention. CONCLUSIONS: Modified toy cars have serious potential to be a fun and functional power mobility option for children with special needs. The opportunity now exists to quantify several effects, including peer socialization, cognitive measures, and body structure/function goals involving neural, muscular, and skeletal physiology. Group study is required to formally test these findings.

Participation-based therapy for children with physical disabilities.

PURPOSE: Optimizing home and community participation of children with physical disabilities is an important outcome of rehabilitation. METHOD: A review of literature identified research and theory on participation of children with physical disabilities. The authors' incorporated current knowledge to conceptualize the experience of optimal participation, formulate principles of participation-based physical and occupational therapy, and develop a five-step process for intervention. A case report was completed to illustrate application to practice. RESULTS: Optimal participation involves the dynamic interaction of determinants (attributes of the child, family, and environment) and dimensions (physical, social, and self engagement) of participation. Real-life experiences enable children to learn new activities and develop skills that optimize their participation and self-determination. Interventions are: goal-oriented, family-centered, collaborative, strengths-based, ecological, and self-determined. A distinguishing feature of intervention is that the therapist's primary role is to support the child and family to identify challenges to participation and solutions to challenges. The therapist is a consultant, collaborating with the child, family, and community providers to share information, educate, and instruct in ways that build child, family, and community capacity. CONCLUSION: The model may have utility for collaboration with families and community providers, determining goals for participation, and providing evidence-informed interventions.