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Wheels in motion: Improving mobility technologies for children

February 28, 2024

Being able to easily get from the house to the playground affects how long and how often children use an adapted ride-on car, according to a study, Off to the park: a geospatial investigation of adapted ride-on car usage, published by CREATE Ph.D. student Mia Hoffman with CREATE associate directors Heather A. Feldner (lead researcher on the project), Katherine M. Steele, and Jon Froehlich. Their research demonstrates the importance of accessibility in the built environment and that advocating for environmental accessibility should include both the indoors and outdoors.

Two children ride in small toy cars, one of which has an adapted steering wheel to make it accessible for the child to use.

For a recent study, adapted ride-on cars were provided to 14 families with young children in locations across Western Washington. Photo courtesy of Heather Feldner.

Ride-on cars are miniature toy cars for children with steering wheels and a battery-powered pedal. Adapted ride-on cars are an easy-to-use temporary solution for children with mobility issues. Although wheelchairs have more finite control, insurance typically covers new wheelchairs every five years. Children under age 5 can use adapted ride-on cars to explore their surroundings if they outgrow their wheelchair, or if they aren’t able to be in a wheelchair yet.

Exploration is critical to language, social and physical development. There are big benefits when a child starts moving.

Mia Hoffman, CREATE Ph.D. student

“Adapted ride-on cars allow children to explore by themselves,” says Mia Hoffman, the Ph.D. candidate in mechanical engineering who co-authored the paper published in fall 2023. “Exploration is critical to language, social and physical development. There are big benefits when a child starts moving.”

The researchers adapted the ride-on cars to make them more accessible. Instead of a foot pedal, children might start the car with a different option that’s accessible to them, such as a large button or a sip-and-puff, which is a pneumatic device that would respond to air being blown into it. Researchers added additional structural supports to the device, such as a backrest made out of kickboards or PVC side-supports.

Adapted ride-on cars were provided to 14 families with young children in locations across Western Washington. Heather Feldner, an assistant professor in the Department of Rehabilitation Medicine and adjunct assistant professor in ME, trained families on how to use the cars. The families then spent a year playing with the cars. Each car had an integrated data logger that tracked how often the child pressed the switch to move the car, and GPS data indicated how far they traveled.

The study found that most play sessions occurred indoors, underscoring the importance of indoor accessibility for children’s mobility technology. However, children used the car longer outdoors, and identifying an accessible route increased the frequency and duration of outside play sessions. Study participants drove outdoors more often in pedestrian-friendly neighborhoods, measured by researchers with the Walk Score, and when close to accessible paths, measured by Project Sidewalk’s AccessScore.

“Families can sometimes be uncertain about introducing powered mobility for their children in these early stages of development,” says Feldner. “But ride-on cars and other small devices designed for kids open up so many opportunities — from experiencing the joy of mobility, learning more about the world around them, enjoying social time with family and friends in new environments, and working on developmental skills. We want to work with kids and families to show them what is possible with these devices, listen to their needs and ideas, and continue working to ensure that both our technology designs and our community environments are accessible and available for all.”

Exploring different mobility devices

Heather Feldner and Mia Hoffman stand next to their poster board about adapted ride-on cars research at a conference.

As a graduate student, Hoffman conducts research on children ages 3 and under who might crawl, roll, sit up, or cruise in a power mobility device. Besides processing sensor data and other data analysis, Hoffman’s work also involves getting to know families, “playing with a lot of toys, singing, and entertaining kids,” she jokes.

Research involving pediatrics and accessibility like the adapted ride-on cars study is why Hoffman joined the Steele Lab. She became interested in biomechanics in sixth grade, when she learned that working on engineering and medical design was possible. As an undergraduate at the University of Notre Dame, Hoffman studied brain biomechanics, computational design and assistive technology. She worked on projects such as analyzing the morphology of monkey brains and creating 3D-printed prosthetic hands for children.

After connecting with Feldner and Kat Steele, Albert Kobayashi Professor in Mechanical Engineering and CREATE associate director, Hoffman realized that the Steele Lab, which often collaborates with UW Medicine, was the perfect fit.

Hoffman is currently working on research with Feldner and Steele that compares children’s usage of a commercial pediatric powered mobility device to their usage of adapted ride-on cars in the community environment. Next, Hoffman will conduct one of the first comparative studies about how using supported mobility in the form of a partial body weight support system or using a powered wheelchair affects children’s exploration patterns. The study involves children with Down Syndrome, who often have delayed motor development and who are underrepresented in mobility research.

There can be stigma associated with using a wheelchair instead of a walker or another mobility device that may help with motor development, but Hoffman says the study could demonstrate that both are important.

“The goal is to show that children can simultaneously work on motor gains while using powered wheelchairs or other mobility devices to explore their environment,” she says.

“Our hope is for kids to just be kids,” says Hoffman. “We want them to be mobile and experience life at the same time as their peers. It’s about meeting a kid where they’re at and supporting them so that they can move around and play with their friends and family.”


This article was excerpted from an article written by Lyra Fontaine for Mechanical Engineering.

Off to the Park: A Geospatial Investigation of Adapted Ride-on Car Usage

November 7, 2023

Adapted ride-on cars (ROC) are an affordable, power mobility training tool for young children with disabilities. But weather and adequate drive space create barriers to families’ adoption of their ROC. 

CREATE Ph.D. student Mia E. Hoffman is the lead author on a paper that investigates the relationship between the built environment and ROC usage.

Mia Hoffman smiling into the sun. She has long, blonde hair. Behind her is part of the UW campus with trees and brick buildings.

With her co-advisors Kat Steele and Heather A. Feldner, Jon E. Froehlich (all three CREATE associate directors), and Kyle N. Winfree as co-authors, Hoffman found that play sessions took place more often within the participants’ homes. But when the ROC was used outside, children engaged in longer play sessions, actively drove for a larger portion of the session, and covered greater distances.

Accessibility scores for the sidewalks near a participant’s home on the left and the drive path of the participant on the right. Participant generally avoided streets that were not accessible.

Most notably, they found that children drove more in pedestrian-friendly neighborhoods and when in proximity to accessible paths, demonstrating that providing an accessible place for a child to move, play, and explore is critical in helping a child and family adopt the mobility device into their daily life.

Heather Feldner ‘wrote the book’ on  power mobility device for babies

CREATE Associate Director Heather Feldner has ​authored two guidebooks, instructing caregivers, researchers and ​clinicians how to introduce Permobil’s ​Explorer Mini to young children between the ages of 12 and 36 months. Permobil’s Explorer Mini is a new, lightweight, joystick-operated powered mobility device ​that provides opportunities for mobility, exploration, and play for children with disabilities at ages and stages that are more equitable compared to their peers without disabilities.

Headshot of Heather Feldner, smiling brightly. She is a white woman with short brown and grey hair, and wears dark rimmed glasses, a gray shirt and black sweater.

Feldner ​and her co-authors have synthesized their own work  and ​work from pioneers in the field, describing the benefits and impact of on-time access to mobility, as well as evidence-based strategies for introducing powered mobility to young children based on developmental and experiential learning stages. ​This multidisciplinary guideline was authored by Feldner, a pediatric physical therapist, Teresa Plummer, an occupational therapist, and Alyson Hendry, a speech-language pathologist, with key input from 40 stakeholders across the world, including caregivers of young children who use powered mobility devices.

The guideline is available open-source and consists of a full, peer-reviewed research document as well as a caregiver guidebook version introducing the Explorer Mini and the various learning stages for infants and toddlers with disabilities. The guideline covers a wide variety of topics including collaborative partnership with caregivers and children, safety, a description of developmental domains that powered mobility introduction affects (such as cognition, communication, socio-emotional development, and participation), as well as practical tips and strategies for facilitating success in mobility and exploration at every learning stage. 

Feldner’s research ​at UW centers on the design and implementation of mobility technology and its effects upon activity and participation within a variety of personal and environmental contexts, including how perceptions of disability and identity emerge and evolve through technology use. ​She is also engaged in research and advocacy work centered on disability as an integral part of Diversity, Equity, and Inclusion initiatives and anti-ableism in healthcare education and beyond. 

Feldner and Steele’s ‘Reimagining Mobility’ series featured in The Daily

Collaboration and diverse perspectives and approaches are at the heart of CREATE’s mission to make technology accessible and make the world accessible though technology.

One program developed by CREATE faculty looks at mobility solutions and ways to eliminate barriers. Hosted by CREATE associate directors Kat Steele and Heather Feldner, the Reimagining Mobility Conversation Hub brings in speakers from a variety of backgrounds and industries to inspire conversations about the future of mobility.

The UW student newspaper, The Daily, featured the program in Reimagining Mobility: Professors Amplify Disabled Voices in the November 15 2021 issue.

Headshot of Kat Steele, smiling warmly. She is a white woman with long brown hair.

Working at a children’s hospital made me want to grow my knowledge as an engineer. There was just this disconnect of how we thought about technology, how we thought about what was possible, and what was actually available.

Dr. Kat Steele, CREATE Associate Director and Albert S. Kobayashi Endowed Professor of Mechanical Engineering.

Headshot of Heather Feldner, smiling brightly. She is a white woman with short brown and grey hair, and wears dark rimmed glasses, a gray shirt and black sweater.

How we move around really impacts our social relationships. It impacts our ability to participate in school, in jobs, in social events — it’s really one of our major connections to the world. The end goal of mobility is to engage in our lives and participate meaningfully.

Dr. Heather Feldner, CREATE Associate Director and
Assistant Professor, Rehabilitation Medicine: Physical Therapy

Go Baby Go Car Adaptation Workshop

UW Go Baby Go, co-directed by CREATE Associate Director Heather Feldner, is excited to announce its fall workshop where we will build ten Go Baby Go cars for local children with disabilities and their families!

Composite of 4 images from Go Baby Go workshops: participants modifying ride-upon toys and excited toddlers sitting in a variety of toys.

UW and CREATE students, postdocs, and faculty (especially from engineering, computer science, and rehab programs), local clinicians, and parents/caregivers are all encouraged to attend.

Saturday, November 6, 2021

* Workshop: 8:30 a.m.-2 p.m.
* Family car fittings and pickup: 2-4 p.m.

UW Rehab Medicine, BB tower 916 and 918
Outdoor car pickup location TBD

Each car will be custom-adapted for safety and accessibility so children can engage in self-initiated mobility, exploration, and socialization at ages equitable to their non-disabled peers. Through sponsorship and fundraising, cars are provided at no cost to families. 

Volunteers needed!

To volunteer, please fill out the volunteer form and we will be in touch with all the rest of the logistics and details!

Please note that per Washington State and UW policy, all volunteers will be required to mask up throughout the build and show proof of full COVID vaccination to participate.

We will have a separate refreshment space for breaks and snacks/drinks throughout the build. 

Questions

Email us at gobabygo@uw.edu.


CREATE is proud to sponsor this event.

$1M NIDILRR award for leadership training program

A team of CREATE faculty has received a five-year, $1M grant from the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) for the project, “ARRT: Postdoctoral Training in Physical Computing and Fabrication to Support Innovations for Community Living and Participation.” Congratulations on the funding to the team members:

  • Co-PI Jennifer Mankoff, Ph.D and Professor Paul G. Allen School of Computer Science and Engineering
  • Co-PI Anat Caspi, Ph.D. and Principal, Paul G. Allen School of Computer Science & Engineering
  • Heather Feldner, PT, Ph.D., PCS and Assistant Professor, School of Medicine, Department of Rehabilitation Medicine
  • Kat Steele, Ph.D. and Associate Professor, Mechanical Engineering 

The award funds a program that will train four postdoctoral fellows to become leaders in rehabilitation research who can harness advances in physical computing and fabrication to enhance community living and participation with people with disabilities. Each fellow will complete a 24-month training program to build their expertise in physical computing, fabrication, rehabilitation, and disability studies. Training will address a shortage of people qualified to harness, deliver, and advance physical computing for rehabilitation research. The four postdoctoral fellows will participate in research, coursework, and mentoring that expands expertise in using primary and complex adaptation tools, 3D-modeling software, and fabrication machines (e.g., laser cutters, 3D printers) for rehabilitation applications. Their innovative research, publications, presentations, and community resources will amplify the impacts of this training program.

Feldner team receives grant to study pediatric mobility technology

Heather Feldner, Rehabilitation Technology and Disability Studies

CREATE Associate Director Heather Feldner and her research team have been awarded a pilot research grant from the newly founded NIH Pediatric Rehabilitation Resource Center (C-PROGRESS) to study early mobility technology.

The team, one of only three selected across the country, includes Sam Logan, an associate professor at Oregon State University, and Lisa Kenyon, a professor at Grand Valley State University.

Study Details: The use of powered mobility devices for young children with cerebral palsy (CP) has been gaining traction.  Evidence shows that the use of powered mobility at young ages complements (rather than detracts from) other interventions focused on more traditionally viewed mobility skills such as crawling and walking, as well as broadens accessible participation and experiences for children and families.  

Collage of four young children riding on commercial and DIY powered mobility technologies, including the Permobil® Explorer Mini and modified Go Baby Go  ride-on toy cars

Heather will lead the multi-site team of investigators in collecting preliminary data to investigate device use patterns, caregiver perceptions, and developmental outcomes of children with CP after introduction of two forms of early powered mobility technologies: commercial (the Permobil® Explorer Mini) and DIY (a Go Baby Go modified ride-on toy car). As FDA clearance for the Explorer Mini was just received in March of 2020, this is the first opportunity to provide key data on the integration and use of the device in the home and community, and it represents the first opportunity to compare the novel device with a modified ride-on car, which has also been customized to support early self-initiated mobility in a socially inviting way.

Why it matters: Research comparing these devices in natural environments can add critical data to the evidence supporting early powered mobility for children with CP as a part of a multimodal mobility approach to care across the lifespan. It also presents a unique opportunity to further engage in critical discussion of facilitators and barriers to mobility and access for disabled children and families.

Learn more:

New CREATE Conversation Hub: Reimagining Mobility

Mobility is a central part of accessibility and this new Conversation Hub, hosted by CREATE Associate Directors Kat Steele and Heather Feldner, provides a way to connect and learn from guests who are engaged in critical mobility work — ranging from researchers to small business owners to self-advocates.

We will dive deeply into conversations about mobility as a multifaceted concept, and explore how it intersects with other dimensions of access across contexts of research, education, and public policy.

Learn more & Sign-up

Read more about Reimagining Mobility and see future and past events.

Upcoming conversations

UW Disability Studies, D Center win UW Medicine CLIME Grant

UW faculty and staff affiliated with CREATEUW Disability Studies and the UW D Center have received a grant from the Center for Leadership and Innovation in Medical Education (CLIME) to explore what it means to be an ally to people with disabilities. “This is an integral issue informing professional education in the medical fields as well as in design and engineering, says PI Heather Feldner. “I am most excited that this project has the potential to further the conversation about how an inclusive mindset can shape contemporary health professions education and practice. Accessibility and technology will be a big part of these conversations and the subsequent training material development. To be able to approach this project with the multidisciplinary perspectives of the CREATE team as a resource is a huge asset.”