A LO O K A H E A D
WHAT PEDIATRIC POWER MOBILITY NEEDS IN THE FUTURE Written by: SAM LOGAN, PH.D.
PEDIATRIC POWER MOBILITY (PPM) IS STILL IN ITS PUNK PHASE, AND THAT’S NOT A GOOD THING. For the past decade, I’ve been involved with the Go Baby Go (GBG) program. GBG modifies commercially available, off-the-shelf and low-cost (~$200) ride-on toy cars for children with disabilities to use for mobility (see Figure 1). Punk and GBG are grounded in do-ityourself culture and activism. Punk bands are known for starting in garages with little to no music experience, trying out new sounds and speaking out against injustice. GBG relies heavily on the do-it-yourself spirit of families, clinicians, teachers, researchers and community members to modify ride-on cars, often with very little technical expertise. GBG embraces mobility as a human right, in alignment with the United Nations and advocates on behalf of children with disabilities. Like the early punk scene, GBG is enthusiastically embraced by like-minded individuals, but PPM is still on the fringe of rehabilitation culture. My vision is PPM gains widespread acceptance in rehabilitation culture and broader society.
FIGURE 1
MY VISION IS PPM GAINS WIDESPREAD ACCEPTANCE IN REHABILITATION CULTURE AND BROADER SOCIETY. PRODUCTS: Permobil’s release of the Explorer Mini (EM) for children aged 12-36 months is a major step forward for the industry because of the lack of other commercially available power mobility options for young children in the United States. The EM also represents a significant upgrade in functionality compared to modified ride-on cars. The EM requires a doctor’s prescription for trial or purchase and costs $2,803, which is low for Complex Rehabilitation Technology, but high for families to pay out-of-pocket. The EM prescription requirement and cost establishes a massive class divide and creates systemic inequity in access. White and middleto-upper class families over represent PPM access, at least partly
Modified ride-on car with a large, easy-to-press activation switch and customized seating support. Photo credit: Alan Calvert, College of Public Health and Human Sciences, Oregon State University.
due to the resources needed for home, vehicle and lifestyle adaptations required for standard motorized wheelchairs. Equitable PPM device access could be addressed through realignment of funding priorities.
FUNDING: One lesson of COVID-19 is funding priorities and health care decisions can change overnight, especially when able-bodied people become at risk for a debilitating infectious disease. Imagine a world where a global pandemic permanently caused young children to be unable to walk. Oh, right — polio and the resulting federally-funded vaccine program eradicated its existence in the United States (see "Polio: An American Story" by David M. Oshinsky for further reading). I am NOT suggesting mobility disabilities should be cured with medical treatment, but rather the response to polio is an example of how societal priorities can impact children’s lives. People with disabilities are not valued in our society, and children with disabilities are oppressed and relegated
