Driving to learn in a powered wheelchair: the process of learning joystick use in people with profound cognitive disabilities.

The Driving to Learn project explored ways to help people with profound cognitive disabilities practice operating a joystick-operated powered wheelchair. The project used a grounded theory approach with constant comparative analysis and was carried out over 12 yr. The participants were 45 children and adults with profound cognitive disabilities. Reference groups included 17 typically developing infants and 64 participants with lesser degrees of cognitive disability. The data sources included video recordings, field notes, open interviews, and a rich mixture of literature. The findings that emerged yielded strategies for facilitating achievements, an 8-phase learning process, an assessment tool, and a grounded theory of deplateauing explaining the properties necessary for participants to exceed expected limitations and plateaus. Eight participants with profound cognitive disabilities reached goal-directed driving or higher. Participants were empowered by attaining increased control over tool use, improving their autonomy and quality of life.

[1]  JamesW. Lewis Cortical Networks Related to Human Use of Tools , 2006, The Neuroscientist : a review journal bringing neurobiology, neurology and psychiatry.

[2]  A. Ayres,et al.  Sensory Integration and the Child , 1972 .

[3]  A. Strauss,et al.  The discovery of grounded theory: strategies for qualitative research aldine de gruyter , 1968 .

[4]  Barney G. Glaser,et al.  Doing Grounded Theory , 1998 .

[5]  A. Wilcock Reflections on doing, being and becoming* , 2002 .

[6]  Lisbeth Nilsson,et al.  Driving to Learn. The process of growing consciousness of tool use - a grounded theory of de-plateauing. , 2007 .

[7]  Annabelle Blangero,et al.  Got it! Understanding the concept of a tool , 2010, NeuroImage.

[8]  Astrid Gynnild,et al.  Grounded theory : the philosophy, method, and work of Barney Glaser , 2011 .

[9]  M. Eklund,et al.  Training characteristics important for growing consciousness of joystick-use in people with profound cognitive disabilities , 2010 .

[10]  J. Bonica The need of a taxonomy. , 1979, Pain.

[11]  B. Glaser Theoretical Sensitivity: Advances in the Methodology of Grounded Theory , 1978 .

[12]  M. Eklund,et al.  Driving to Learn in a powered wheelchair: inter-rater reliability of a tool for assessment of joystick-use. , 2011, Australian occupational therapy journal.

[13]  Clayton Lewis HCI and cognitive disabilities , 2006, INTR.

[14]  J S Bailey,et al.  Current limits to reinforcer identification for some persons with profound multiple disabilities. , 1996, Research in developmental disabilities.

[15]  Lisbeth Nilsson,et al.  Driving to learn: a new concept for training children with profound cognitive disabilities in a powered wheelchair. , 2003, The American journal of occupational therapy : official publication of the American Occupational Therapy Association.

[16]  E. Yerxa Health and the human spirit for occupation. , 1998, The American journal of occupational therapy : official publication of the American Occupational Therapy Association.

[17]  C. Vlaskamp,et al.  A Need for a Taxonomy for Profound Intellectual and Multiple Disabilities. , 2007 .

[18]  Scott H. Johnson-Frey The neural bases of complex tool use in humans , 2004, Trends in Cognitive Sciences.

[19]  P. Tengland Empowerment: A goal or a means for health promotion? , 2007, Medicine, health care, and philosophy.

[20]  Nirbhay N. Singh,et al.  An overview of research on increasing indices of happiness of people with severe/profound intellectual and multiple disabilities , 2005, Disability and rehabilitation.

[21]  R. Hagedorn Occupational therapy : perspectives and processes , 1995 .

[22]  M. Eklund,et al.  Driving to learn: powered wheelchair training for those with cognitive disabilities , 2006 .