Driving to learn: a new concept for training children with profound cognitive disabilities in a powered wheelchair.

Analysis of the case studies of two preschool children with profound cognitive disabilities indicates that training in a powered wheelchair can increase wakefulness and alertness, stimulate a limited use of the arms and hands, and promote the understanding of very simple cause-and-effect relationships. The enhanced activity level had a positive influence on the children's ability to react to external stimuli and invitations to interact. These effects in turn promoted the development of initiative and exploratory behavior. Because of their profound cognitive disabilities, neither of the children was able to reach the normative training goal-to be able to drive purposefully and safely. In this paper the target group is defined according to criteria for the prescription of powered wheelchairs and the resulting new concept of 'driving to learn' is described and discussed from different aspects.