Power mobility in children with motor impairments: adaptations in electric toy cars to improve handling in natural environments - a case series.

AIM: To assess the effectiveness of adaptations in electric-ride-on toy cars for improving mobility in children with Spinal Muscular Atrophy (SMA) with two copies of SMN2, emphasizing their use in natural environments.

METHOD: A case series study, including children (aged 10 months to 5 years) with severe motor disabilities, was conducted. Each child received a customized adaptation of an electric toy car, modified to meet their specific postural and motor needs. The "Assessment of Learning Powered Mobility" 2.0 (ALP 2.0) tool was employed to track learning progress during weekly training sessions conducted in the children's natural environments with family involvement.

RESULTS

Nine children successfully completed the study protocol. By week 8, all participants had reached at least level 6 on the ALP 2.0 tool, demonstrating significant improvement in driving ability. Adaptations were refined for two children during the study due to improvements in handling skills.

INTERPRETATION: Personalized adaptations and training in familiar environments enhance independent mobility and participation in children with SMA with two copies of SMN2. The findings suggest that neither initial motor skills nor the type of adaptation required limits progress. This study underscores the importance of early powered mobility interventions and highlights the need for further research to optimize training and adaptation strategies for young children with motor impairments.