Why Early Access to Mobility Can Matter for Development

For most children, learning to move independently is a natural part of growing up. Crawling, walking and moving towards a toy or a parent open up a world of exploration and interaction.

But what happens when a child has a significant mobility limitation and cannot move independently?

For these children, access to mobility is about much more than getting from A to B. Being able to move independently can create opportunities to explore, play, interact with others and make choices. This is one of the reasons why early access to powered mobility is increasingly being considered as part of paediatric rehabilitation.

Movement is part of how children learn

Children do not learn about the world by simply watching it. They learn by interacting with it.

A child who can crawl towards a toy can decide what to explore. They can move closer to another child, reach a different part of the room or follow a parent. These experiences provide opportunities for physical, cognitive and social learning. For children with significant mobility limitations, these opportunities may be reduced.

The EMPoWER evidence synthesis, which reviewed 89 studies on powered mobility interventions for young children, found strong support for a positive impact on movement and mobility. It also found moderate support for benefits related to participation, play and social interaction.

This does not mean that powered mobility automatically improves a child’s development. The available evidence has important limitations, and the researchers concluded that more high-quality research is needed.

However, the findings highlight an important principle:

Independent movement can create opportunities for development.

Mobility is more than getting from A to B

For adults, powered mobility is often viewed primarily as a way to get somewhere independently. For a young child, the purpose can be quite different. Moving around can be part of play itself.

A child may use mobility to:

Explore a new room
Move towards a toy
Follow another child
Choose where to play
Approach a parent or teacher
Explore objects and their surroundings
Participate in games and activities

The EMPoWER review describes these two aspects as different but connected: movement for its own sake and destination-focused mobility. Both are important, but movement for exploration and play can be particularly relevant during early development.

This changes the way we can think about powered mobility in young children. It does not necessarily have to be something a child receives only when they are expected to use a wheelchair for everyday transportation. It can also be a tool for learning through movement.

Early mobility can support exploration

Exploration is one of the most obvious benefits of being able to move independently.

Imagine a young child sitting on the floor while other children move around them. Without independent mobility, the child may have to wait for someone else to move them closer to a toy, another child or an interesting object.

With an appropriate powered mobility device, the child may be able to make that decision themselves. That opportunity to choose where to go can change the child’s role from being moved to moving.

The evidence synthesis found examples of children using powered mobility to move towards friends, explore play spaces and participate more actively in physical activities and games. These may seem like small everyday experiences, but they can be meaningful opportunities for learning and participation.

Independence starts with small choices

Independent mobility can also give children opportunities to make their own choices:

Where do I want to go?
What do I want to play with?
Who do I want to move towards?
When should I move?

These choices may seem simple, but having control over them can contribute to a child’s sense of autonomy.

The available evidence suggests that powered mobility can support concepts such as independence, autonomy, choice and control, although the evidence for these outcomes is more limited than for movement and mobility itself.

This is why the goal should not simply be to teach a child how to operate a powered wheelchair. The bigger goal can be to give the child opportunities to act on their environment independently.

Social interaction matters too

Mobility can influence how children interact with the people around them. Being able to move towards another child can make it easier to join a game. Moving independently around a classroom or play area can create more opportunities to interact with peers.

The EMPoWER review found moderate support for positive effects of powered mobility on participation, play and social interaction.

This is particularly relevant because participation is not only about being physically present. A child can be in the same room as everyone else without being able to independently approach, explore or join an activity. Independent mobility can help reduce that gap.

Why wait until a child is older?

Traditionally, powered mobility has often been associated with older children who are expected to use a powered wheelchair for everyday mobility. But this raises an important question:

Does a child have to be old enough to need a conventional wheelchair before they can benefit from powered mobility?

Current evidence does not support using age alone as the deciding factor.

The EMPoWER review specifically concluded that age should not be the key criterion for deciding whether a child should have access to powered mobility. Instead, the focus should be on whether the intervention is developmentally appropriate and whether there is a good fit between the child, the equipment and their environment.

This does not mean that every young child with a mobility limitation should receive a powered wheelchair. It means that age alone should not automatically rule it out.

Learning to drive takes time

Another reason early access can be relevant is that learning to control powered mobility is itself a process. Children need opportunities to practise, experiment and understand the relationship between their actions and the movement of the device.

The evidence suggests that children can develop powered mobility skills through experience and play, rather than relying exclusively on formal driving training. This can be particularly important for children with complex motor impairments.

Instead of expecting a child to immediately demonstrate perfect control before providing access, the process can work in the other direction: give the child an appropriate opportunity to move, then allow skills to develop through experience.

Of course, the equipment, control system and environment need to be appropriately matched to the individual child.

The right fit is essential

Early access does not simply mean providing a powered wheelchair as quickly as possible. The solution needs to fit the child. That includes considering:

The child’s physical abilities
Cognitive and communication abilities
Available voluntary movements
Seating and positioning
The child’s environment
Their opportunities for practice
The type of activities they want to participate in
The control method they can use

The environment matters too. A child may have access to a suitable mobility device but still have limited opportunities for independent movement if the environment is inaccessible or adults consistently move the child instead of allowing them to explore independently.

The EMPoWER review identified the fit between the child, equipment and environment as an important factor influencing outcomes.

Early mobility is not about replacing other therapy

Powered mobility should not be viewed as a replacement for physiotherapy, occupational therapy or other forms of developmental support. Instead, it can be another way of creating opportunities for movement and participation.

A child may still work on standing, walking, transfers or other motor skills where appropriate. At the same time, powered mobility can provide access to movement and exploration that the child cannot achieve independently through walking.

This is an important distinction. A child does not have to choose between developing physical skills and having access to independent mobility. Both can have a place.

What could early access look like?

There is no single model for introducing powered mobility. For one child, it may involve a powered mobility device used during play. For another, it may involve practising movement around the classroom or therapy environment.

The objective can also change as the child grows. At a younger age, the focus may be on:

Exploring movement
Cause and effect
Playing
Making choices
Interacting with the environment

As the child becomes older, mobility may increasingly support:

Getting around school
Joining activities with peers
Moving independently in the community
Increasing autonomy in daily life

The important thing is that mobility develops alongside the child.

Independent mobility is an opportunity

The evidence around early powered mobility is promising, but it is important not to overstate what we know. The EMPoWER review found encouraging evidence across several outcomes, while also highlighting that the overall evidence base is limited and that more robust research is needed.

What is clear is that movement gives children opportunities:

Opportunities to explore.
Opportunities to play.
Opportunities to interact.
Opportunities to make choices.

And, perhaps most importantly, opportunities to experience that their own actions can change what happens around them.

For children who cannot achieve this independently through walking or other forms of self-directed movement, appropriately introduced powered mobility may help open that door.

At CoMoveIT, independent mobility is particularly relevant for people with complex movement disorders. The company’s work originated from research and clinical expertise in neurorehabilitation, including work with children with cerebral palsy and other complex movement disorders.

The broader principle goes beyond any particular device:

Mobility is not only about where a child can go. It is also about what they can discover, choose, experience and participate in along the way.