Underappreciated challenges to pediatric powered mobility - Ways to address them as illustrated by a case report

Rehabilitation Engineering and Assistive Technology Society of North America (RESNA) has published a position paper strongly advocating powered mobility (PM) for children with severe physical limitations (Rosen et al., 2009). Many studies have established that there are gains in social skills and functional mobility. While PM can aid independence, there has been more emphasis on the improvements in socialization rather than the positive changes PM can make in a child's daily living. For example, Bottos and colleagues stated the quality of life did not change for the children in their study (2001). This could be an explanation for why insurance companies deny coverage for PM. However, without coverage for PM, these children face major barriers to mobility and accessibility, even if they are able to use PM at physical therapy. If they obtain PM at home through other funding, transportation still remains an issue. These barriers have not been addressed or only briefly mentioned. We present a case of a 2 years 10 months old boy with rachischisis (cervical level spina bifida) who had impressive gains in both functional communication and social skills through achieving PM.