Dynamic, Real World Learning, Innovative Mobility, and Versatile Exploration (DRIVE): Evaluating a dose-matched developmental powered mobility intervention for young children with Cerebral Palsy

About This Grant

Project Summary Power mobility intervention for non-mobile toddlers with cerebral palsy (CP) will directly address a primary cause of developmental delays. Children with CP encounter the central problem of impaired self-initiated mobility before age 2, which disrupts typical developmental cascades and leads to detrimental downstream effects in cognition, communication, and motor development. Less than 30% of toddlers in Gross Motor Function Classification Levels II-IV have access to independent, self-initiated mobility by 4 years old, a significant developmental and experiential mobility gap. Outcomes of traditional motor-focused therapies for children with CP are variable and fail to adequately address overall development. While the promise of power mobility as a solution has existed for decades, it is not standard of care and rarely considered as an option, let alone provided, during early intervention in the United States. Do-it-yourself solutions such as ride-on cars have significant access and functionality limitations, families and clinicians may be reluctant to pursue wheeled mobility solutions, even if temporary, and fidelity monitoring in previous power mobility research is nonexistent. Developmental power mobility intervention (DPM) is an innovative, process-based approach that leverages the FDA cleared Explorer Mini to address the above gaps and engage children in tool use, exploratory perceptual motor experiences that trigger developmental cascades, and goal-directed mobility regardless of a child’s walking potential. We will conduct a 2-arm, dose-matched, randomized clinical superiority trial with an active control group and pre-post-follow up study design that will test our central hypothesis that DPM will produce greater improvements in short-term (12 weeks) and medium-term (6 months) global development and activity performance outcomes compared to usual care physical therapy focused on movement, orientation, repetition, and exercise (MORE-PT) in young children with CP, and will not impede gross motor function. We will recruit children 12-30 months expected to have both delayed onset of walking and use of hand-held or wheeled (manual or powered) devices. Both groups will receive intervention twice weekly for 12 weeks, either (A) DPM (treatment) or (B) MORE-PT (usual care active control). Our specific aims are to: (1) Quantify and compare global development outcomes; (2) Quantify and compare change in gross motor function; and (3) Quantify and compare change in activity performance. Our long-term goal is to advance scientific understanding of DPM use to support enhanced development and functional mobility for young children with CP. This work will strengthen evidence and translational support for clinicians and families navigating complex mobility-related clinical decision-making.