Hélène Larin

Sleep Issues in Children with Physical Disabilities and Their Families

Sleep has a significant impact on the daily functioning of children and their parents. The purpose of this study was to describe the sleep patterns, issues, and strategies used to facilitate sleep in children with and without physical disabilities and their families. Data were collected from questionnaires completed by caregivers and siblings. Caregivers of children with physical disabilities reported significantly greater concerns regarding general sleep problems, safety, and discomfort at night, night wakening, daytime irritability, interference with daytime activities and sleep-related health concerns in children with physical disabilities than in their counterparts. Caregivers, but not siblings, in families of children with physical disabilities experienced an increased prevalence of sleep issues. The most frequently cited strategies to alleviate problems were the establishment of consistent routines and provision of calming, supportive sleep environments. Pediatric therapists need to assess and address sleep issues to promote the well-being of children and their families.

Ethically-based clinical decision-making in physical therapy: process and issues

The identification and consideration of relevant ethical issues in clinical decision-making, and the education of health care professionals (HCPs) in these skills are key factors in providing quality health care. This qualitative study explores the way in which physical therapists (PTs) integrate ethical issues into clinical practice decisions and identifies ethical themes used by PTs. A purposive sample of eight PTs was asked to describe a recent ethically-based clinical decision. Transcribed interviews were coded and themes identified related to the following categories: 1) the integration of ethical issues in the clinical decision-making process, 2) patient welfare, 3) professional ethos of the PT, and 4) health care economics and business practices. Participants readily described clinical situations involving ethical issues but rarely identified specific conflicting ethical issues in their description. Ethical dilemmas were more frequently resolved when there were fewer emotional sequelae associated with the dilemma, and the PT had a clear understanding of professional ethos, valued patient autonomy, and explored a variety of alternative actions before implementing one. HCP students need to develop a clear professional ethos and an increased understanding of the economic factors that will present ethical issues in practice.

WeeBot: A novel method for infant control of a robotic mobility device

A novel method for controlling a robotic mobility platform, the WeeBot, is presented. The WeeBot permits an infant seated on the robot to control its motion by leaning in the direction of desired movement. The WeeBot hardware and software are discussed and the results of a pilot feasibility study are presented. This study shows that after five training sessions typically developing infants ages six to nine months were able to demonstrate directed movement of the WeeBot.

A comparison of the efficacy of weight-shift vs. joystick control of a robotic mobility device by infants ages 5 to 10 months

ABSTRACT The onset of crawling in infants contributes to cognitive, perceptual, social, and emotional development. Conversely, infants with motor impairment that delays or prevents autonomous mobility often have associated developmental delays. Evidence suggests that providing mobility may have positive developmental outcomes, however powered wheelchairs may not be recommended for very young children, due to safety concerns and the child’s level of cognitive maturity. The WeeBot is a mobility device controlled by infant weight shifting while seated; infants as young as 5 months have learned to use it. This study compares the efficacy of using the WeeBot vs. using the traditional manual joystick to control a robotic mobility device. Participants were 20 typically developing infants between 5 and 10 months who had not yet achieved independent mobility. A quasi-experimental two-group design was used: The first 10 participants recruited used the WeeBot (weight-shift); the next 10 used the joystick. Results showed that infants learned to use weight-shift control more easily and more skilfully than did infants using the joystick. The ability of infants to use the WeeBot suggests that an intuitive alternative control might allow very early powered mobility for children with disabilities, which might have implications for various aspects of their development.