Background: Modified ride-on toy cars have been recently suggested as readily available, low cost, fun and functional options for the use of training early mobility in toddlers with disabilities. Previous two case studies have demonstrated the benefits of using modified ride-on toy cars in home environment to enhance independent mobility, exploration and socialization in young children with cerebral palsy and Down syndrome. Purpose: The purpose of this preliminary group study is to investigate the effects of using modified ride-on toy cars in the hospital environment on improving mobility and socialization in toddlers with disabilities, compared to those who received regular therapy. Methods: A total of 15 toddlers with disabilities between 1 and 3 years were recruited in the current study from the hospitals in Northern Taiwan. The treatment group (9 participants, mean age: 19.67 months) received 9-week early power mobility training by an independent occupational therapist in the hospital environment (120 minutes/per session, 2 sessions/per week). The control group (6 participants, mean age: 24.67 months) received their regular therapy without any additional intervention. Chinese Version of Pediatric Evaluation of Disability Inventory (PEDI-C) and Parenting Stress Index were administrated before and after 9-week intervention. We used independent t-test and pair t-test to compare demographic data, functional skills and parenting stress scores between and within groups. Results: There was no significant difference between treatment and control groups at pre-test regarding the gender (p = .44), age (p = .21), and the average amount of regular therapy each week (p = .46). After 9-week intervention, a significant difference on self-care (p = .05) and mobility function (p = .05) were found between two groups, but not social function (p = .21). When we compared the scores within each group, the treatment group had significant improvements on self-care (p = .00), mobility (p = .00) and social function (p = .04) after the intervention. The control group only showed significant improvements on self-care (p = .02) and social function (p = .00), but not mobility (p = .11). In addition, the treatment group had significant decreased scores of parenting stress level before and after the intervention (p = .03). The control group had no significant differences on parenting stress within group (p = .31). Conclusion(s): This is the first group study to examine the effects of using modified ride-on toy cars on mobility and socialization in the hospital environment. With increased independent mobility, toddlers with disabilities may have more opportunities to learn through observing behaviors and skills of others. These preliminary results demonstrate that this early power mobility training program is beneficial for improving independent mobility and functional skills in toddlers with disabilities. The increased functional skills may enhance parents' perceptions on their children's capabilities, which may lead to decreased parenting stress level. A future study with large sample size can be conducted to examine the effects of this training program on daily function and family perceptions in toddlers with different severity levels of mobility impairments. Implications: Clinicians can consider using the customized, low cost and fun toy cars as one option of early mobility training in a hospital-based environment. It can enhance independent mobility and socialization in toddlers with disabilities through active exploration and observing behaviors of others.
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