Lisbeth Nilsson

Assessment of learning powered mobility use-Applying grounded theory to occupational performance.

Collaboration by two grounded theory researchers, who each had developed a learning continuum instrument, led to the emergence of a new tool for assessment of learning powered mobility use. We undertook a rigorous process of comparative reanalysis that included merging, modifying, and expanding our previous research findings. A new instrument together with its facilitating strategies emerged in the course of revisits to our existing rich account of data taken from real environment powered mobility practice over an extensive time period. Instrument descriptors, categories, phases, and stages allow a facilitator to assess actual phase and plot actual occupational performance and provide a learner with the just right challenge through the learning process. Facilitating strategies are described for each of the phases and provide directions for involvement during learner performance. The learning approach is led by a belief system that the intervention is user-led, working in partnership and empowering the learner. The new assessment tool is inclusive of every potential powered mobility user because it focuses on the whole continuum of the learning process of powered mobility use from novice to expert. The new tool was appraised by clinicians and has been used successfully in clinical practice in the United Kingdom and Sweden.

Powered mobility intervention: understanding the position of tool use learning as part of implementing the ALP tool

Abstract Purpose: To explore the knowledge necessary for adoption and implementation of the Assessment of Learning Powered mobility use (ALP) tool in different practice settings for both adults and children. To consult with a diverse population of professionals working with adults and children, in different countries and various settings; who were learning about or using the ALP tool, as part of exploring and implementing research findings. Method: Classical grounded theory with a rigorous comparative analysis of data from informants together with reflections on our own rich experiences of powered mobility practice and comparisons with the literature. Results: A core category learning tool use and a new theory of cognizing tool use, with its interdependent properties: motivation, confidence, permissiveness, attentiveness and co-construction has emerged which explains in greater depth what enables the application of the ALP tool. Conclusions: The scientific knowledge base on tool use learning and the new theory conveys the information necessary for practitioner’s cognizing how to apply the learning approach of the ALP tool in order to enable tool use learning through powered mobility practice as a therapeutic intervention in its own right. This opens up the possibility for more children and adults to have access to learning through powered mobility practice. Implications for rehabilitation Tool use learning through powered mobility practice is a therapeutic intervention in its own right. Powered mobility practice can be used as a rehabilitation tool with individuals who may not need to become powered wheelchair users. Motivation, confidence, permissiveness, attentiveness and co-construction are key properties for enabling the application of the learning approach of the ALP tool. Labelling and the use of language, together with honing observational skills through viewing video footage, are key to developing successful learning partnerships.

Driving to LearnTM in a Powered Wheelchair: Cognitive Outcomes for Children and Adults with Neurological Disorders

The Driving to Learn research project, initiated in 1993, had the aim to explore what could be achieved if children and adults with profound cognitive disabilities were provided with access to practice in a joystick-operated powered wheelchair. The findings encompass: TIRO – the learning tool, a special joystick-operated powered wheelchair for practice; an eight-phase learning process; a tool for assessment of powered mobility use; strategies facilitating the learning process; and awareness of how it is possible that Driving to Learn can give generic transitional effects. Those findings can encourage clinicians to use powered mobility practice to facilitate attention regulation, cognition, executive functions and social interaction in both walking and non-ambulant children and adults with neurological disorders.