The Effect of a Wheelchair skills training programme for children

Title: The Effect of a Wheelchair skills training programme for children: A Pilot Study. Background and context: In 2008, the Department of Health and Social Services and Public Safety, Northern Ireland launched the “Proposals for the reform of the Northern Ireland Wheelchair Service” (2008). Recommendations for service improvements were made following a 2-year review completed from partnership working between healthcare staff and wheelchair service users. Wheelchair service users identified manual wheelchair skills training for children as a priority issue to be addressed. The review highlighted that throughout the region, there was an inequitable provision of wheelchair skills training opportunities for children. This study was framed around promotion of independence in young wheelchair users. Wheelchair users conduct all activities while in their wheelchair therefore it is critical for them to learn to use their chair to the best of their ability.Aim and objectives: This project was to identifying a skills teaching programme that could be used to standardise manual wheelchair skills training for children across Northern Ireland. The project implemented a wheelchair skills programme and tested skill level pre and post the skills training in children.Outline main content: Ethical approval was obtained from the University Research Governance Filter Committee, Office of Research Ethics, NI (ORECNI) and governance through the Northern Health and Social Care Trust (NHSCT). Following ethical approval and informed consent 11 participants were recruited, mean age of 10.5years. The wheelchair skills programme took place over an eight-month period consisting of two testing days (pre/post) and six monthly training sessions. Evaluations and outcomes: Participants were tested on the basic and intermediate levels of the Wheelchair Skills Test. The Activity Scale for Kids (ASK) (Young et al., 2011), a demographic questionnaire and an impact questionnaire were also administered. Of the 11 participants recruited, 8 completed the full programme. All participants showed an increase in the Wheelchair skills test, basic skills increased by 9%; intermediate skills by 31%, although not significant; (p = 0.041); (p= 0.12). The Activity Scale for Kids’ (ASK) questionnaire showed little to no increase in performance, post skills training (1%). Participant’s feedback was generally positive via the impact questionnaire, reporting improved confidence and independence. Conclusions and implications: Overall, the monthly wheelchair skills training showed an improvement at the basic and intermediate skills level in all participants. However, these levels did not reach significance. This may be due to the duration of the study; perhaps it should be extended over a longer period of time to see the full effect.While skills levels has the potential to improve skill acquisition in children aged 5-15, this pilot study has its limitations, small numbers of children, different patents completing the questionnaires, which resulted in them voicing a different view of their child’s skills level/years. Although feedback was positive, parents voiced their concerns over the lack of activities available to their children specific to their needs, something as occupational therapists we need to address.