Page 23 - Mobility Management, June 2017

“Proportional devices have multiple direc-
tions of control and speed and are more subtle in
responsiveness so they can be more complex for a
child to understand that the change in direction or
speed was a direct result of something they did with the proportional control. The child may not be aware they are
fully in control of the mobility system. The team should keep in mind that the best control over a power wheelchair’s speed and direction comes from proportional controls, so although switches are easier to understand, they don’t offer the exact same or extent of control that a proportional input device offers.”
Advantage: Proportional Controls
So would Doherty prefer to try to start children on proportional controls instead?
“I believe that proportional controls should always be the
first thing you considered utilizing with children,” he said. “A proportional input device allows a child to have great control over modulating speed and direction while driving a power wheelchair. Proportional control is the most efficient way to drive the wheelchair. Therefore, if we can get a child to start with a proportional, that is where we should start.”
But if the mobility team does decide to start a child on a switch
system, is it likely that the child will be “stuck” with that system in the long run?
“A child doesn’t always have to stay with the device they start with,” Doherty said. “Sometimes children will
start with a simple system so they can understand cause and effect and just explore movement with no expectation other than
allowing the child to experience movement. The movement may be spinning, or playing with stop and go to explore movement. In the case of experiencing movement, a single switch may meet the need.
“The team may also choose to allow the child to feel movement in a variety of different directions with a proportional device. If the child has the movement available to potentially use a propor- tional input device, the team may decide to start with a propor- tional input device or graduate to a proportional input device when it is appropriate. A team should never rule an input device out until they know for sure that the child cannot use the device. Often, a device is ruled out because of motoric limitation that a child may present with versus [the fact that the child] just started with switches. The team should always keep in mind that as
the child starts to control the power wheelchair movement and
is moving towards directed movement and finally independent movement, the input method may need to change and be open to exploring other input methods further.”
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