Bridging the Gap: Implementing A Powered Mobility Intervention into Early Childhood Settings for Young Children with Cerebral Palsy (GMFCS IV-V)

/ABSTRACT Powered mobility (PM) interventions offer young children with motor disabilities, such as cerebral palsy, Gross Motor Function Classification System (GMFCS) Levels IV-V, the opportunity to independently explore their environments, which enhances their development and participation. PM experiences in early childhood (12-36 months) are crucial, as this period represents a critical window for development in the areas of cognition, social abilities, motor skills, and daily participation. Despite these proven benefits, PM remains underutilized in early intervention settings due to barriers, such as therapist attitudes, service delivery models, and insufficient training and resources. Further complicating matters, no standardized approaches exist for PM interventions, leaving a critical gap in both research and clinical practice. Early Childhood settings are the ideal setting for implementing PM, as it targets a pivotal developmental stage, allowing for timely access to mobility solutions that can foster independence and participation in daily activities. This project aims to address these barriers by partnering with Early Childhood settings to develop therapist training for PM interventions tailored for children with cerebral palsy, GMFCS Levels IV-V. Using an implementation science and community- engaged research approach, this mixed-methods proposal will focus on three specific aims: Aim 1 involves identifying the needs and barriers faced by early intervention therapists in utilizing PM interventions through surveys and focus groups; Aim 2 aims to co-design a comprehensive therapist training with a Community Advisory Board, which will inform and refine the development of therapist training by reviewing identified needs, evaluating an existing PM intervention’s components, and providing feedback to ensure the training’s relevance; and Aim 3 consists of conducting feasibility trial of the therapist training and PM intervention implementation, assessing the trainings knowledge transfer, confidence, self-efficacy, as well as and the intervention's acceptability, appropriateness, feasibility, fidelity, and pertinent child performance outcomes. My career development goals include enriching my knowledge in pediatric PM intervention design, acquiring skills in implementation science and community-engaged research approaches, enhancing my scientific leadership, and improving my scientific writing skills. My mentors and I have developed a structured 4-year plan encompassing didactics, experiential learning, mentored research, and measurable milestones, aligning with my research aims and maximizing my potential as an independent investigator in pediatric PM intervention research. This proposal is responsive to PA-24-184, which seeks to ‘explore or understand the mechanism of action of an intervention’ and ‘increase the pool of clinical researchers who can conduct patient- oriented studies, capitalizing on the discoveries of biomedical research and translating them to clinical settings.’ My ultimate goal is to bridge the gap between PM evidence and clinical practice, expanding access to essential developmental and motor interventions for children with cerebral palsy. Project Number: 1K23HD119273-01 | Fiscal Year: 2025 | NIH Institute/Center: Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) | Principal Investigator: Bethany Sloane | Institution: OREGON HEALTH & SCIENCE UNIVERSITY, PORTLAND, OR | Award Amount: $168,703 | Activity Code: K23 | Study Section: Function, Integration, and Rehabilitation Sciences Study Section[CHHD-K] View on NIH RePORTER: https://reporter.nih.gov/project-details/1K23HD11927301