Commentary on “Ride-On Car Training for Behavioral Changes in Mobility and Socialization Among Young Children With Disabilities”

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“How should I apply this information?”
The importance of early intervention to promote development of sitting, reaching, hand use, and independent mobility has been stressed.1 Therapists working with infants and toddlers are encouraged to incorporate high-dosage, child-active interventions into practice.2 An adapted ride-on toy car intervention may represent just such an intervention. Case studies suggest beneficial effects on mobility and socialization as well as potential to impact overall development. Therapists should consider mobility training using a ride-on car either at a hospital, therapy, or other community setting if the home or child-care indoor environment or weather is not conducive.
“What should I be mindful about when applying this information?”
This study included children with good sitting abilities, who were able to use the switch independently 50% of the time from the first session. They did not have significant physical access limitations and already had established concepts of cause-effect. Children functioning at Gross Motor Function Classification System levels IV and V would likely require more adaptive seating and some may be more successful using switches with the head. Children with more complex disabilities may require more complex seating and switch mounting solutions that may be challenging for clinicians to implement. This remains a barrier to implementation of ride-on toy car modifications for clinicians working in community settings without rehabilitation engineering consultation or other technical support.
This article makes a good case for implementing mobility training for infants and children with mobility impairments in a clinical setting. A 30- to 60-minute session may more typically be tolerated depending on the age of the child. There is a need for similar studies including larger numbers, more complex populations and either more rigorous single-subject or randomized controlled group designs.
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