John Farris

Power Mobility Training for Young Children with Multiple, Severe Impairments: A Case Series

ABSTRACT Aims: Young children with neurodevelopmental conditions are often limited in their ability to explore and learn from their environment. The purposes of this case series were to (1) describe the outcomes of using an alternative power mobility device with young children who had multiple, severe impairments; (2) develop power mobility training methods for use with these children; and (3) determine the feasibility of using various outcome measures. Methods: Three children with cerebral palsy (Gross Motor Function Classification System Levels IV, V, and V) ages 17 months to 3.5 years participated in the case series. Examination included the Pediatric Evaluation of Disability Inventory—Computer Adaptive Test (PEDI-CAT) and the Dimensions of Mastery Questionnaire (DMQ). An individualized, engaging power mobility training environment was created for each participant. Intervention was provided for 60 minutes per week over 12 weeks. Results: All participants exhibited improvements in power mobility skills. Post-intervention PEDI-CAT scores increased in various domains for all participants. Post-intervention DMQ scores improved in Participants 1 and 2. Discussion: The participants appeared to make improvements in their beginning power mobility skills. Additional research is planned to further explore the impact of power mobility training in this unique population.

Promoting self-exploration and function through an individualized power mobility training program.

Purpose: This case report describes the development and implementation of an intervention program that used a Power Wheelchair Trainer (Trainer) to enable an individual with severe impairments to participate in power mobility training. Case Description: The participant was an 18 year-old female with spastic quadriplegic cerebral palsy, Gross Motor Function Classification Level V. The examination included the Power Mobility Screen and the Caregiver Priorities & Child Health Index of Life with Disabilities (CPCHILD). Switches on the participants headrest provided control of the Trainer. Intervention consisted of power mobility training in an engaging environment that was set-up to focus on specific power mobility skills. Results: Scores on the Power Mobility Screen and the CPCHILD were higher after intervention. Discussion: The outcomes of this case report appear to support the use of the Trainer, which allowed the participant to practice power mobility skills and participate in self-exploration of her environment.

Integration of design and manufacturing processes in first-year engineering curriculums

Current industry expectations of engineering graduates are becoming increasingly more demanding in the areas of design and manufacturing. Their concerns are focused on the fact that graduates are not capable of producing realizable results based on their conceptual designs. One reason for this is their inexperience in understanding interrelationships between the design and manufacturing processes required to fabricate engineering designs. Engineering curriculums tend to overlook design and manufacturing relationships until the senior capstone course sequence. The Padnos School of Engineering offers programs in Computer, Electrical, Manufacturing, and Mechanical Engineering. All students in the programs participate in a mandatory co-op engineering program. Response from the co-op employers has consistently focused on the students abilities in realizing conceptual designs, the processes required to produce a given design, and the ability to function in interdisciplinary design teams. For all of our students, the first course in the program is Engineering Principles I, a traditional engineering graphics course using CAD. To address the concerns of industry, we have adopted a new methodology for teaching students the design process and the subsequent manufacturing of products. This has been accomplished using 3D solid modeling techniques for design and hands-on CNC milling exercises for producing their designs. Four design and build exercises used in the course, two of these are performed individually and two are completed in teams. Results of the pilot program have been received positively by both the students and the faculty. This paper examines the effectiveness of offering a non-traditional approach to the engineering graphics course, and discusses the types of projects implemented.

Development and content validation of the power mobility training tool

Abstract Purpose: This paper outlines the development and content validation of the power mobility training tool (PMTT), an observational tool designed to assist therapists in developing power mobility training programs for children who have multiple, severe impairments. Methods: Initial items on the PMTT were developed based on a literature review and in consultation with therapists experienced in the use of power mobility. Items were trialled in clinical settings, reviewed, and refined. Items were then operationalized and an administration manual detailing scoring for each item was created. Qualitative and quantitative methods were used to establish content validity via a 15 member, international expert panel. The content validity ratio (CVR) was determined for each possible item. Results: Of the 19 original items, 10 achieved minimum required CVR values and were included in the final version of the PMTT. Items related to manoeuvring a power mobility device were merged and an item related to the number of switches used concurrently to operate a power mobility device were added to the PMTT. Conclusions: The PMTT may assist therapists in developing training programs that facilitate the acquisition of beginning power mobility skills in children who have multiple, severe impairments. Implications for Rehabilitation The Power Mobility Training Tool (PMTT) was developed to help guide the development of power mobility intervention programs for children who have multiple, severe impairments. The PMTT can be used with children who access a power mobility device using either a joystick or a switch. Therapists who have limited experience with power mobility may find the PMTT to be helpful in setting up and conducting power mobility training interventions as a feasible aspect of a plan of care for children who have multiple, severe impairments.

Does power mobility training impact a child’s mastery motivation and spectrum of EEG activity? An exploratory project

Abstract Purpose: The purposes of this exploratory project were: (1) to evaluate the impact of power mobility training with a child who has multiple, severe impairments and (2) to determine if the child’s spectrum of electroencephalography (EEG) activity changed during power mobility training. Study design: A single-subject A–B–A–B research design was conducted with a four-week duration for each phase. Two target behaviours were explored: (1) mastery motivation assessed via the dimensions of mastery questionnaire (DMQ) and (2) EEG data collected under various conditions. Power mobility skills were also assessed. Methods: The participant was a three-year, two-month-old girl with spastic quadriplegic cerebral palsy, gross motor function classification system level V. Each target behaviour was measured weekly. During intervention phases, power mobility training was provided. Results: Improvements were noted in subscale scores of the DMQ. Short-term and long-term EEG changes were also noted. Improvements were noted in power mobility skills. Conclusions: The participant in this exploratory project demonstrated improvements in power mobility skill and function. EEG data collection procedures and variability in an individual’s EEG activity make it difficult to determine if the participant’s spectrum of EEG activity actually changed in response to power mobility training. Additional studies are needed to investigate the impact of power mobility training on the spectrum of EEG activity in children who have multiple, severe impairments. Implications for Rehabilitation Power mobility training appeared to be beneficial for a child with multiple, severe impairments though the child may never become an independent, community-based power wheelchair user. Electroencephalography may be a valuable addition to the study of power mobility use in children with multiple, severe impairments. Power mobility training appeared to impact mastery motivation (the internal drive to solve complex problems and master new skills) in a child who has multiple, severe impairments.

Design and Evaluation of the Kinect-Wheelchair Interface Controlled (KWIC) Smart Wheelchair for Pediatric Powered Mobility Training

Background: Children with severe disabilities are sometimes unable to access powered mobility training. Thus, we developed the Kinect-Wheelchair Interface Controlled (KWIC) smart wheelchair trainer that converts a manual wheelchair into a powered wheelchair. The KWIC Trainer uses computer vision to create a virtual tether with adaptive shared-control between the wheelchair and a therapist during training. It also includes a mixed-reality video game system. Methods: We performed a year-long usability study of the KWIC Trainer at a local clinic, soliciting qualitative and quantitative feedback on the device after extended use. Results: Eight therapists used the KWIC Trainer for over 50 hours with 8 different children. Two of the children obtained their own powered wheelchair as a result of the training. The therapists indicated the device allowed them to provide mobility training for more children than would have been possible with a demo wheelchair, and they found use of the device to be as safe as or safer than conventional training. They viewed the shared control algorithm as counter-productive because it made it difficult for the child to discern when he or she was controlling the chair. They were enthusiastic about the video game integration for increasing motivation and engagement during training. They emphasized the need for additional access methods for controlling the device. Conclusion: The therapists confirmed that the KWIC Trainer is a useful tool for increasing access to powered mobility training and for engaging children during training sessions. However, some improvements would enhance its applicability for routine clinical use.

Innovative teaching to engage and challenge twenty-first century entrepreneurship students: an interdisciplinary approach

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Minimum Cost 100% Inspection Systems with Inspection Error

A field failure in certain products has the potential to cause human suffering and/or loss of life. To the manufacturer, these failures will result in a significant external failure cost. In this paper, cost minimization models are developed to determine an optimal inspection system for multiple 100% attribute inspections with inspection error. An example involving the visual inspection of a braze joint in a cardiac biopsy device is presented to illustrate the use of the models. A key result is that a system requiring an item to pass every inspection in order to be shipped to a customer is not always the best alternative. Examples illustrating the sensitivity of the model results to key cost and operational parameters are shown.

Power Mobility Training Methods for Children: A Systematic Review

Purpose: To summarize and critically appraise the existing evidence related to power mobility training methods used in research studies conducted with children 21 years or younger. Methods: A systematic review was conducted using 16 electronic databases to identify primary source quantitative studies published in peer-reviewed journals. Data extraction, determination of level of evidence, evaluation of methodological rigor, and assessment of the risk of bias were completed. The Evidence Alert Traffic Light Grading System (EATLS) was used. Results: Twenty-seven studies were included in the review. Levels of evidence were II to V; scientific rigor scores were 2 to 7. Conclusions: An overall Yellow EATLS level of evidence was found indicating that therapists should use caution when providing power mobility training interventions and measure outcomes related to established goals in areas such as development, functional skills, or use of a power mobility device.

Changes in EEG spectrum and mutual information during power mobility training

EEG PSD is often used as a measure of cognitive function and emotional state while MI is a reflection of functional connectivity in the brain. Analysis of both quantities in a child with severe disabilities suggests that PMT may be associated with an increase in cognitive performance, as well as connectivity between the frontal and parietal lobes.