Modified toy cars help improve mobility in kids with SMA type 1
Pilot program shows toy cars can help if parents have training and support
Powered, ride-on toy cars to help children with spinal muscular atrophy (SMA) type 1 be more mobile must be adapted for easy access and match a child’s motor abilities, according to parents who took part in a 12-week training program in Spain.
The parents also said it’s important to assess the home environment to identify barriers, to receive education and regular professional support, and to develop family-centered mobility goals.
“Early powered mobility for children with SMA type I should educate, empower, and monitor families to increase the interaction and goal achievement,” the researchers wrote.
The families’ experiences were documented in the study, “Families’ experiences and perspectives on the early use of powered mobility in children with spinal muscular atrophy type I in the natural context,” published in Disability and Rehabilitation: Assistive Technology.
Children with SMA type 1 typically exhibit low muscle tone, a loss of reflexes, and weakness, as well as a failure to reach motor milestones such as rolling over or sitting up. Many of these children remain unable to move around independently throughout their lives, and may give up trying. This “learned helplessness” makes them dependent on others and hinders development, the researchers wrote.
Early exposure to powered devices may spur independence
Emerging evidence suggests that the early implementation of powered mobility devices, including battery-operated, ride-on toy cars, may allow children with developmental disabilities to engage in self-initiated mobility. These cars can be modified by adding seating support or levers for movement and steering control.
The AMEsobreRUEDAS study was designed to train and assess the use of powered mobility in 16 children with SMA type 1 in a home, school, and community environment. Depending on the child’s needs, the cars were modified with a pelvic seat, a single lever in the center, and/or a surface for head support.Â
The 12-week training period consisted of three, half-hour sessions a week in a motorized mobility car, followed by four weeks during which the child could use the device whenever they or their family chose. The nine mothers who completed the program reported that adherence ranged from 86% to 97%.Â
All families said it’s important to use a toy car with easy access to facilitate the child’s autonomy and adapting the device according to the child’s motor ability level. Families stressed the need to train the child and the family to use the device and set goals to achieve objectives to promote adherence, enthusiasm, and motivation.
“My son did not want to use the toy cars because getting into them was horrible, however this car facilitated entry and freedom of movement,” one parent said. Another noted “improvements using levers to facilitate driving” as opposed to a steering wheel.
Mobility devices show benefits for parents as well as children
Families highlighted the need for education to understand “the full intervention,” including objectives and device management. “I could not have carried out the 12-week training without first having had education in its development,” one parent said.
A mother said knowing the objectives helped her “understand that the use of electric cars is not just a game, it is a game that favors the acquisition of goals that help my daughter.”
Parents said the program helped them as well as their children. “Throughout the intervention, I felt useful as a mother, offering all the opportunities to my daughter,” one mother said.
Regular meetings with a professional during the training helped with adherence, parents said. “Having weekly follow-up with a qualified professional, obtaining strategies to be able to use in therapy, has allowed me to feel confident and know that I was doing well with my son,” one parent said.
The weekly follow-ups helped families feel “safe and reinforced,” the researchers wrote. “Feeling that what you say makes sense and being listened to, made me feel satisfied with the training,” a mother said.
Participants also discovered accessibility challenges during the training program. These included uneven terrain, steps, narrow doorways, and a lack of ramps. “Going to the park was a challenge because the terrain was very difficult to access,” one parent said.
“I would have liked to leave my house and go to the shopping center, but it was not feasible because there was no elevator and we could not take the car,” said another.
Other challenges included the size of the car, its maneuverability, and its battery life. The duration of the training sessions and the time it took to record them were also difficult to manage along with medical appointments or other family activities, parents found. “The training took a long time, and it was not easy to balance it with family life,” one mother said.
Families said having a treatment based on play and enjoyment was a positive experience. “Playing during the intervention is essential to have the desire to continue and not abandon the training,” a parent said.
“Early powered mobility aimed at spinal muscular atrophy type I would be satisfactory for families, considering their involvement during the training,” the researchers concluded. “Education, empowerment and monitoring of families by a specialized professional would be necessary to facilitate the understanding of the training and their adherence to the intervention.”
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