Implementing Powered Mobility in Early Childhood Settings for Children With Cerebral Palsy

NCT ID: NCT07220590

Last Updated: 2026-01-02

Basic Information

• Recruitment Status: NOT_YET_RECRUITING
• Clinical Phase: NA
• Total Enrollment: 24 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2026-01-01
• Study Completion Date: 2028-09-30

Brief Summary

The goal of this clinical trial is to learn if a therapist training program can help providers in Part C Early Childhood Settings use powered mobility (PM) with young children who have cerebral palsy (Gross Motor Function Classification System Levels IV-V). The study will also look at whether this training is practical and useful for therapists, families, and children.

The main questions it aims to answer are:

1. Can therapists successfully use the training to provide powered mobility interventions in home and early childhood settings?

2. Do families and children find the intervention acceptable and helpful?

3. What benefits do children show in mobility, participation, and engagement after using powered mobility?

In this study, therapists and families will:

1. Take part in a training program about how to use powered mobility with young children

2. Use powered mobility devices (Permobil Explorer Mini) with children during everyday routines

3. Complete surveys, interviews, and observations about their experiences

Detailed Description

Cerebral palsy (CP) is the most common cause of physical disability in childhood. Children classified at Gross Motor Function Classification System (GMFCS) Levels IV-V experience significant limitations in mobility and typically require assistive technology to move independently. These early months, between 12-36 months, are a critical period for brain development and learning. Without access to independent mobility, children with CP have fewer opportunities to explore, communicate, and engage socially, which can contribute to secondary developmental delays.

Power mobility (PM) devices, such as the Permobil Explorer Mini, provide opportunities for self-initiated exploration of a child's environment. Research has shown that access to PM in early childhood can promote cognitive, social, and motor development, while also supporting participation in family and community life. Despite this growing evidence base, PM use in Part C Early Childhood Settings is infrequent and inconsistent. Many families never receive the option of PM during their child's first years. Barriers include a lack of provider training, limited availability of devices, uncertainty about service delivery models, and the perception that PM should be delayed until school age.

This study directly addresses these gaps by developing and testing a training program for Early Childhood Setting providers to deliver PM interventions with young children with CP (GMFCS IV-V). The project uses a community-engaged, implementation science approach to ensure that the intervention is not only clinically meaningful but also feasible and sustainable within real-world Part C Early Childhood Setting systems.

The research is guided by three aims:

1. Identify provider needs and barriers through surveys and focus groups with providers.

2. Co-design a training program with input from a Community Advisory Board that includes clinicians, families, administrators and researchers. This process ensures that the training reflects real-world challenges and priorities.

3. Conduct a feasibility trial to test the training program with providers and families of young children with CP.

The feasibility trial will combine implementation and child-level outcomes in an effectiveness-implementation hybrid design. Implementation outcomes will include acceptability, appropriateness, feasibility, and fidelity, using validated measures such as the Acceptability of Intervention Measure (AIM), Feasibility of Intervention Measure (FIM), and Implementation Appropriateness Measure (IAM). Fidelity will be examined through session recordings and coding of adherence to intervention strategies.

The intervention itself consists of therapist training in PM use, assessment, and caregiver coaching. Providers will be introduced to the Explorer Mini and will learn strategies to embed mobility into family routines. Therapists will then coach families to use PM with their children during everyday activities, both in the home and community. The emphasis is on real-world use, giving children opportunities to explore, make choices, and participate in their environments.

Child outcomes will include mobility, engagement, and participation, measured through caregiver report, standardized assessments, and observational coding of video-recorded sessions. Family experiences will be assessed through surveys and semi-structured interviews, to better understand acceptability and perceived benefits of PM.

This study is expected to generate critical pilot data on how PM interventions can be implemented in Part C Early Childhood settings, a setting where they are currently underutilized. By focusing on both therapist training and family engagement, this project bridges the gap between evidence and practice. Findings will inform larger-scale trials and lay the groundwork for integrating PM into standard Early Childhood setting services, ensuring that children with CP and significant motor impairments have earlier opportunities to move, explore, and participate fully in daily life.

Conditions

Cerebral Palsy Children; Motor Disabilities; Developmental Disability; Rehabilitation; Early Intervention; Assistive Technology

Study Design

• Allocation Method: NA
• Intervention Model: SINGLE_GROUP
• Primary Study Purpose: HEALTH_SERVICES_RESEARCH
• Blinding Strategy: NONE

Study Groups

Powered Mobility Intervention

This mixed-methods feasibility trial includes one experimental arm in which all participants receive the powered mobility intervention following a structured therapist training. Trained physical and occupational therapists participate in one to two days of in-person training to learn how to implement the intervention with children with cerebral palsy (GMFCS IV-V) and their caregivers in early childhood settings. Following training, therapists identify eligible child-caregiver dyads from their caseloads and conduct twelve biweekly home-based intervention sessions over six months. Each session focuses on mobility opportunities, caregiver coaching, and integration of powered mobility into daily routines using the Permobil Explorer Mini device. All sessions are video recorded for fidelity monitoring and qualitative analysis.

Group Type: EXPERIMENTAL

Therapist Training on Powered Mobility Implementation

Intervention Type: BEHAVIORAL

Therapists participate in a structured, evidence-based training on implementing powered mobility interventions for children with cerebral palsy (GMFCS IV-V) in early childhood settings. Training consists of one to two days of in-person sessions focused on knowledge transfer, therapist confidence, self-efficacy, and use of caregiver coaching and routines-based strategies. The training is co-designed with a community advisory board of administrators, therapists, and caregivers to ensure contextual relevance and feasibility.

Powered Mobility Intervention for Child-Caregiver Dyads

Intervention Type: BEHAVIORAL

Following therapist training, participating therapists deliver a six-month powered mobility intervention to children with cerebral palsy (GMFCS IV-V) and their caregivers. Therapists conduct twelve biweekly home-based sessions focused on providing mobility opportunities, caregiver coaching, and integration of powered mobility into daily routines. The intervention uses the Permobil Explorer Mini device to facilitate self-initiated mobility. All sessions are audio-video recorded for fidelity monitoring and qualitative analysis.

Interventions

Therapist Training on Powered Mobility Implementation

Therapists participate in a structured, evidence-based training on implementing powered mobility interventions for children with cerebral palsy (GMFCS IV-V) in early childhood settings. Training consists of one to two days of in-person sessions focused on knowledge transfer, therapist confidence, self-efficacy, and use of caregiver coaching and routines-based strategies. The training is co-designed with a community advisory board of administrators, therapists, and caregivers to ensure contextual relevance and feasibility.

Intervention Type: BEHAVIORAL

Powered Mobility Intervention for Child-Caregiver Dyads

Following therapist training, participating therapists deliver a six-month powered mobility intervention to children with cerebral palsy (GMFCS IV-V) and their caregivers. Therapists conduct twelve biweekly home-based sessions focused on providing mobility opportunities, caregiver coaching, and integration of powered mobility into daily routines. The intervention uses the Permobil Explorer Mini device to facilitate self-initiated mobility. All sessions are audio-video recorded for fidelity monitoring and qualitative analysis.

Intervention Type: BEHAVIORAL

Eligibility Criteria

Inclusion Criteria

Children:

1. Diagnosis of cerebral palsy or similar motor impairment

2. Gross Motor Function Classification System (GMFCS) Levels IV-V

3. Age 12 to 32 months at enrollment

4. Enrolled in early intervention services

Caregivers:

1. Parent or legal guardian of an enrolled child participant

2. Age 18 years or older

3. English- or Spanish-speaking

4. Able and willing to participate in home-based data collection, including caregiver coaching sessions, completion of surveys, and video-recorded sessions

5. Able to provide informed consent

Therapists:

1. Licensed physical therapist or occupational therapist

2. Employed at participating early intervention or early childhood special education settings

3. Provide services to children with cerebral palsy or motor delays

4. No prior powered mobility intervention training required

5. Willing to complete powered mobility implementation training and participate in study assessments

Exclusion Criteria

1. Inability or unwillingness to provide informed consent

2. Inability to complete required study procedures

• Minimum Eligible Age: 1 Year
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Oregon Health and Science University

OTHER

Sponsor Role: lead

Responsible Party

Bethany Sloane

Associate Professor

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Bethany M Sloane, PT, DPT, PhD

Role: PRINCIPAL_INVESTIGATOR

Oregon Health and Science University

Locations

Northwest Regional Education Service District

Hillsboro, Oregon, United States

Multnomah Early Childhood Program

Portland, Oregon, United States

Oregon Health & Science University

Portland, Oregon, United States

Countries

United States

Central Contacts

Bethany M Sloane, PT, DPT, PhD

Role: CONTACT

sloaneb@ohsu.edu

503-494-3232

Facility Contacts

Rikkie Schley, M.S. CCC-SLP

Role: primary

rschley@nwresd.k12.or.us

971-393-3333

Ashleigh Walters

Role: primary

ashleigh_walters@ddsd40.org

503-256-6500 ext. 4656

Bethany M Sloane, PT, DPT, PhD

Role: primary

sloaneb@ohsu.edu

503-494-3232

References

Sabet A, Feldner H, Tucker J, Logan SW, Galloway JC. ON Time Mobility: Advocating for Mobility Equity. Pediatr Phys Ther. 2022 Oct 1;34(4):546-550. doi: 10.1097/PEP.0000000000000939. Epub 2022 Aug 4.

Reference Type: BACKGROUND

PMID: 35943383 (View on PubMed)

Sloane BM, Kenyon LK, Logan SW, Feldner HA. Caregiver perspectives on powered mobility devices and participation for children with cerebral palsy in Gross Motor Function Classification System level V. Dev Med Child Neurol. 2024 Mar;66(3):333-343. doi: 10.1111/dmcn.15718. Epub 2023 Jul 28.

Reference Type: BACKGROUND

PMID: 37515376 (View on PubMed)

Feldner HA, Logan SW, Otieno S, Fragomeni A, Kono C, Riordan K, Sloane B, Kenyon LK. Short-Term Powered Mobility Intervention Is Associated With Improvements in Development and Participation for Young Children With Cerebral Palsy: A Randomized Clinical Trial. Phys Ther. 2025 Jan 8;105(1):pzae152. doi: 10.1093/ptj/pzae152.

Reference Type: BACKGROUND

PMID: 39450982 (View on PubMed)

Kenyon LK, Jones M, Livingstone R, Breaux B, Tsotsoros J, Williams KM. Power mobility for children: a survey study of American and Canadian therapists' perspectives and practices. Dev Med Child Neurol. 2018 Oct;60(10):1018-1025. doi: 10.1111/dmcn.13960. Epub 2018 Jun 28.

Reference Type: BACKGROUND

PMID: 29956320 (View on PubMed)

Kenyon LK, Hostnik L, McElroy R, Peterson C, Farris JP. Power Mobility Training Methods for Children: A Systematic Review. Pediatr Phys Ther. 2018 Jan;30(1):2-8. doi: 10.1097/PEP.0000000000000458.

Reference Type: BACKGROUND

PMID: 29252826 (View on PubMed)

Other Identifiers

1K23HD119273-01

Identifier Type: NIH

Identifier Source: org_study_id

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