Riley: driving with her foot and conquering the world!

Background:
Riley is a 10 year old girl with the diagnoses of cerebral palsy and autism. When I first met her, she already had quite a bit of seating and mobility equipment including a Rifton activity chair, an adaptive stroller, a gait trainer, and a power wheelchair. Riley was also using a communication device. The supplier working with Riley, Lindsey Rea, ATP of Numotion, referred her for evaluation of her driving method. Although Riley had a head array on her current power wheelchair, she demonstrated very good control of her right foot and Lindsey was hopeful this could be used for driving. Her speech language pathologists, Jill Tullman and Christie Bowers, were also interested in evaluation of Riley’s access to her communication device. While the device was set-up for eye gaze control, Riley continually attempted to access this with her right foot.

Positioning:
Riley could sit independently on the floor; however, she required a stable contoured cushion to support how she accessed her assistive technology devices with her right foot. In conjunction with a contoured back, she would have adequate postural support for her functional activities.

Mobility:
Riley could use a gait trainer though used the power wheelchair for longer distances and to provide more efficient mobility. Riley had had a power wheelchair for nearly 5 years at the time of the initial evaluation.
During the evaluation, the attendant joystick was moved from the rear of the power wheelchair and placed at her right foot where she was able to grasp and move this with her shoe and sock removed. I determined that Riley did have more control driving with her right foot than with her head. We next needed to determine how to implement this recommendation. The joystick needed to be embedded into the right footplate itself. Specifically, I recommended the Stealth Products Mushroom joystick, as this works well for foot drivers, being quite durable for this placement. The body of the joystick would be mounted under the footplate while the handle needed to protrude above the level of the footplate toward the distal end.

Recommendations:
A new power wheelchair, the Quantum Rehab Stretto, was recommended with the Mushroom joystick, as well as mounting for the communication device. The power wheelchair was shipped from Quantum Rehab to Stealth Products for the Mushroom joystick to be installed. Although Riley could use the dome shaped handle, the family ultimately used a custom 3D printed goalpost style handle which worked better for driving. She can even drive this with her shoe on! Tracking technology further optimizes her driving. The new power wheelchair also includes a seat elevator which helps Riley with transfers, as well as extends her functional reach with her right foot. A power tilt allows her to shift her weight.

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