Poster #47 - Driving Towards Independence

• In Event: 2-055 - Poster Session 06
  In Poster Session: PS 06 Section - Developmental Disabilities

Integrative Statement

Purpose: Children with Down syndrome (DS) experience motor delays that result in limited opportunities to engage in independent mobility at the same age as their typically developing peers (Pereira et al, 2013). For example, children with DS, on average, start walking at 24-months, a 12-month delay compared to typically developing peers. Modifications to off-the-shelf, battery-operated ride-on toy cars offer a low-cost, portable, and fun opportunity to augment mobility experiences. A recent modified ride-on car design is the sit-to-stand (STS) version; this was developed to incorporate functional standing training with the experience of powered mobility. The STS car can also be used as a power push device, offering further functional training. The aim of this exploratory study was to examine: (1) onset of independent driving, and (2) onset of selected motor milestones in relation to total dosage and daily usage of modified ride-on cars by young children with DS participating in a 7-16 month progressive intervention. Method: Eight young children with DS (8.6 +/- 2.0 months) participated in this home-based intervention (See Table 1). Children used three modes of the modified ride-on car: Seated: activation switch in steering wheel; STS: reverse-activated switch in seat, requiring that the child pull-to-stand and remain standing to power the car; Power-Push: activation switch attached to back of STS car, requiring the child step to keep up with the car (See Figure 1). Video recordings of biweekly 10-minute car-play sessions were coded to determine the onset of independent driving in each mode. Daily usage was recorded by parents. Motor performance was assessed monthly using the gross motor sub-scale of the BSID-III. Results: All eight children were able to independently drive the modified ride-on car in both seated and standing modes. Five of the eight families elected to use the STS car as a power-push device; four of these five families remained in the intervention until the onset of independent walking. These four children were the youngest at study entry and were also four of the earliest walkers, walking at ages ranging from 19.9 to 21.8 months. On average, children required 24 days of use (SD=15 days) to achieve independent driving in the seated mode, with an average dosage of 674 minutes (SD=419 minutes) accrued during this time period. On average, children required an additional 24 days of use (SD=20) to achieve independent driving in the standing mode, with an average dosage of 660 minutes (SD=568 minutes) accrued during this time period. Total dosage across the entire intervention ranged from 2,515 to 11,808 minutes (M=6267, SD=3270). Most motor milestones were earlier in this sample than expected for DS norms; for example, children walked independently at 19.9 to 28.8 months old (M=22.9, SD=3.1), with 6 of the 8 walking earlier than 24 months old (See Table 1). Conclusions: The developmentally progressive nature of the intervention and high dosage may have been instrumental in encouraging the onset of independent driving and motor milestones. Future work is needed to determine the potential developmental benefits of modified ride-on car interventions.

Authors

• Christina Michelle Hospodar, New York University
  Presenting Author

• Andrina Sabet, Cleveland State University
  Non-Presenting Author

• Samuel Logan, Oregon State University
  Non-Presenting Author

• Michele Catena, Oregon State University
  Non-Presenting Author

• Cole Galloway, University of Delaware
  Non-Presenting Author