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Common Concerns with Mobility Training in Schools

Michelle Lange, OTR, ABDA, ATP/SMS

July 7, 2015

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Question

What are some common concerns when it comes to mobility training and a new power chair at school?  

Answer

There are some common concerns that I find when it comes to mobility training and this new power chair showing up school.  The most common concerns tend to be safety of the other students and behavioral issues on the part of the driver.  Now training in context, as part of the school day, means that students will bump into the wall.  They may even bump into other students.  Here are some suggestions.  We do not want to start that in-context training as part of the school day with other students around right away.  We want to start in those quiet areas, help the child build some skills, and then start moving more into context.  

You can also reduce one or two settings on the chair to help the power chair have less force.  One is called power and the other is called torque.  Torque is like driving in low gear.  These chairs have so much power in them that you can literally move furniture across the room with a power wheelchair.  They can be turned down so that if a new driver bumps into a wall, they will simply bump the wall rather than put a hole through the drywall with their footplate.  It is important with the new driver to have this chair turned down, not just in power and torque, but also speed and acceleration.  That gives a new driver time to respond to movement of their chair.  If the chair is too responsive, then the driver will be less successful.  As they build in their skills, the programming can be changed.  Also power chairs tend to have more than one drive; sometimes that is called a profile.  It could be that drive 1 is set really slow.  Drive 2 may be a little faster and drive 3 might be for outdoors, when the client wants to really book it.  It could be that this new driver is regulated to drive 1 for a while.  If you are not familiar with wheelchair programming this is something that the supplier can help you out with.

In general, I recommend that if the student is acting up that the people around them try to address this the same way they would a typical student whenever possible.  For example, if a child is running down the hallway, the child is required to return to their starting point, back to the beginning and they have to then walk down the hallway.  If a student is driving their wheelchair too fast, then that student can be required to come back to the teacher, for example, put that chair at a slower drive and go down the hallway at an appropriate speed.  As much as possible, we want to address it the same way as their typical peers.  I get many calls from people saying we need to take this chair away because the client is driving too fast, has bumped into something, etc.  Instead of removing the wheelchair, we need to intervene on these behaviors. 


michelle lange

Michelle Lange, OTR, ABDA, ATP/SMS

Michelle is an occupational therapist with 25 years of experience and former Clinical Director of The Assistive Technology Clinics of The Children’s Hospital of Denver. She is a well-respected lecturer, both nationally and internationally and has authored 7 book chapters and over 175 articles. She is the editor of Fundamentals in Assistive Technology, 4th ed. Michelle is on the teaching faculty of RESNA and the University of Pittsburgh. She is on the RERC on Wheeled Mobility Advisory Board. Michelle is a credentialed ATP, credentialed SMS and is a Senior Disability Analyst of the ABDA.


Related Courses

Wheelchair Seating: Considerations for the Hands-Free Sitter
Presented by Michelle Lange, OTR, ABDA, ATP/SMS
Recorded Webinar

Presenter

Michelle Lange, OTR, ABDA, ATP/SMS
Course: #3585Level: Advanced1 Hour
  'It was very well organized'   Read Reviews
Wheelchair seating is designed to provide postural support and alignment, stability for function and mitigate pressure issues. This course will address assessment and intervention when working with a client who can sit without the support of their hands, referred to as the ‘hands-free’ sitter.

The Seating and Mobility Specialist (SMS) Certification: An Overview
Presented by Michelle Lange, OTR, ABDA, ATP/SMS
Recorded Webinar

Presenter

Michelle Lange, OTR, ABDA, ATP/SMS
Course: #3586Level: Advanced1 Hour
  'Instructors pace and knowledge of content'   Read Reviews
The Seating and Mobility Specialist (SMS) certification recognizes competence in assessment and intervention. This course will cover what this certification is, who the SMS is designed for, why it was developed, why the SMS may be beneficial to a clinician and how to acquire this certification.

Wheelchair Seating: The Mat Assessment
Presented by Michelle Lange, OTR, ABDA, ATP/SMS
Recorded Webinar

Presenter

Michelle Lange, OTR, ABDA, ATP/SMS
Course: #3590Level: Advanced1 Hour
  'details of mat assessment were very helpful; good case studies'   Read Reviews
A key component of wheelchair seating evaluation is the mat assessment. This course will present the mat assessment, including supine and sitting, and will include case studies and videos.

Wheelchair Positioning: Pressure
Presented by Michelle Lange, OTR, ABDA, ATP/SMS
Recorded Webinar

Presenter

Michelle Lange, OTR, ABDA, ATP/SMS
Course: #3595Level: Advanced1 Hour
  'Clear presentation; easy to follow slides'   Read Reviews
A main goal of wheelchair seating is pressure management, specifically to prevent development of pressure injuries. This course will present pressure injury definitions, staging, etiology and specific seating interventions.

Wheelchair Positioning: Postural Care
Presented by Michelle Lange, OTR, ABDA, ATP/SMS
Recorded Webinar

Presenter

Michelle Lange, OTR, ABDA, ATP/SMS
Course: #3596Level: Advanced1 Hour
  'I love all her courses!'   Read Reviews
The goals of wheelchair seating include managing posture and pressure as well as providing stability for function. Postural care addresses positioning outside of the wheelchair, particularly during sleep, and can be used to improve the quality and duration of sleep, promote health and maintain safety during sleep, as well as to minimize, prevent and even reverse orthopedic changes.

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