Powered mobility acquisition by an adolescent with severe visual and physical disabilities: a naturalistic...

Purpose: Children and youth with both severe visual impairment and physical disabilities are often excluded from powered mobility training due to safety risks, leading to learned helplessness and limited participation.

Materials and methods: This naturalistic, longitudinal single-case study examined the process, feasibility, and outcomes of acquiring powered mobility skills for a legally blind adolescent with motor impairments. A 13-year-old adolescent diagnosed with Arts syndrome who uses a joystick and a cane underwent a 3-year program of powered mobility training at school, home, and community settings. Data included standardized assessment outcomes (Pediatric Progression of Powered Mobility [3PM] and Assessment of Learning Powered Mobility [ALP]) from video recordings at four time points. The adolescent's mother was also interviewed.

Results: The adolescent progressed from exploratory behaviors while driving a powered wheelchair to consistent, accurate performance across diverse environments. The 3PM scores indicated a steady development in operational and functional skills, while ALP scores reflected a shift from "sophisticated beginner" to "proficient driver." The interview revealed the adolescent's progression from initial resistance to motivated, self-initiated use of the device, highlighting the importance of environmental adaptation, family support, and therapist collaboration.

Conclusion: This case highlights that, with training and individual support, powered mobility is achievable for children and youth who are blind and have physical disabilities. This result challenges policy restrictions that disqualify users solely because of severe vision loss and demonstrates the value of low-cost, non-robotic solutions. The findings support the integration of powered mobility lending programs, early intervention, and inclusive assessment approaches.