Pediatric Evaluation of Disability Inventory (PEDI) 2019
There have been no revisions made to the Pediatric Evaluation of Disability Inventory (PEDI) since the most recent review of the test/measure and the previously reported pricing remains current.
Category: Evaluative
Article Reviewed
Logan SW, Hospodar CM, Feldner HA, Huang HH, Galloway JC. Modified ride-on car use by young children with disabilities. Pediatr Phys Ther. 2018; 30(1):50-56. doi: 10.1097/PEP.0000000000000468.
Purpose: The purpose of this case series study was to evaluate use of a modified ride-on car in the home environment and examine associated child and parental behaviors. Additionally, the authors aimed to determine the impact of modified ride-on car use on functional mobility skills in diverse pediatric populations.
Study Population: Three children were included in the case study. The children ranged in age from 12 to 29 months and had varying medical diagnoses and levels of mobility. All three children exhibited limited mobility skills compared to healthy peers.
Methods: The researchers conducted a prospective 24-week AB case series study. The study consisted of a 12-week baseline period followed by a 12-week intervention period. The baseline period involved choosing and modifying the ride-on car, identifying safe areas for use, and getting the children accustomed to their car, which were only available to them during researcher visits. During the intervention period, the cars were left with the families for use between researcher visits and the focus was on education and training. The following were used to assess change:
Daily Activity Log– The parents were asked to keep a daily activity log of the use of the car and their perception of their child’s enjoyment during use. The log was used to quantify exposure to the car during the intervention period as well as parental adherence to recommendations.
Video Recordings– Videos recorded at baseline and during researcher visits were used to evaluate mobility, visual attention to the car’s operation switch, and contact with the switch. These behaviors were coded for assessment by researchers blinded to the period of the study the video was recorded in.
Standardized Measure– The PEDI is a valid pediatric evaluation measure used to assess performance of basic skills and the amount of assistance required. The mobility section of the PEDI was administered at baseline, pre-intervention, and post-intervention to compare each child’s functional mobility skills.
Results/Discussion: Parents of all three children reported their child enjoyed using the modified ride-on car. Adherence rate to the recommended amount of car use varied measurably from family to family, with only two of out the three achieving greater than 65% adherence rate. Analysis of the video recordings indicated visual attention to the switch varied. Additionally, there appeared to be a correlation between visual attention to the switch and contact with it. Lastly, two out of the three children demonstrated clinically significant improvements in mobility from baseline to post-intervention according to PEDI scores. The authors hypothesize that parental adherence impacted the amount of change seen in the third child’s mobility scores.
Strengths: The children included in this case series study had varying medical diagnoses and baseline mobility skills, however, each demonstrated an improvement in functional mobility. Additionally, these improvement were seen despite mixed exposure to the modified ride-on car. All three children also exhibited an ability to independently drive the modified ride-on car, and enjoyment in doing so, despite not being considered a candidate for a powered mobility device (PMD) according to current qualification measures.
Limitations: Limitations to this study include accuracy of the daily activity logs and parental adherence to recommendations for use of the modified ride-on car. Additionally, this study did not include a control group or period. This study also had a small sample size.
Clinical Application/Overall Conclusion: The results of this case series study indicate children with varying medical diagnoses and functional mobility skills can benefit from modified ride-on cars in the home environment. Also, this study demonstrates the need for detailed parent education and that benefits can be seen even without full parental adherence to recommended use. Lastly, this study demonstrates that current measures used to determine candidates for a PMD may not inclusively identify all children who could potentially benefit from a modified ride-on car.
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