On Thursday, November 8th, our group visited the Susan Gray School at Vanderbilt to learn more about the patients our mobility devices would be deployed to and understand their needs. Heather Winters, an occupational therapist at the school, was able to take some time to walk us through the school and talk to use about the patient needs. We began by looking at the devices that were already in use, and an old GoBabyGo car to understand why it wasn’t being used.

Major issues with the current GoBabyGo car included that the charger was missing, the user had a difficult time putting a child into the car and that it was bulky and heavy. It was used for a child who exhibited self-injurious behaviour and was only used once in a therapy session.

Next, we went to observe the specific children that our cars would be used by and asked about their particularly limitations and what they would require. We were able to observe two students directly with the following limitations.

• Student 1: 3 year old with fluctuating athetoid cerebral palsy. Specific mobility restrictions includes little muscle tone in arms, and lack of fine motor control, limited communication and lack of fluid movement. Currently uses a Riftch Activity Chair, a weight bearing stander and a gait trainer. Need to address problems with communication, social interactions and muscle control.
• Student 2: 3 year old with spina bifida. Strong upper arm movement and head control with no control below the waist. Limited vision. Currently uses a wheelchair and a stander.

Heather noted that there are two other students that would potentially be able to use our devices but they were not available for us to observe at that time.

On the tour we were also able to see the specific areas that the cars would be used in. Primarily the cars would be used by children on either of two playgrounds at the school. Some important considerations for the playgrounds is that they do include water play areas, have stairs and metal equipment and are not completely covered. The cars would primarily be used on the playground floor and not near the stairs or the metal structure.

Further, some use would be in the gym which included tile floors and blue raised mats. In this area the students would interact with other students and be encouraged to socialize and design considerations should be made for this type of social environment.

Finally, Heather talked to us about some final design aspects that she would want to ideally see. Her suggestions included the following:

• A component of the car that allowed the children to make simple choices to help with communication
• A door that opened
• Secure harnesses
• Increases in resistance as the muscle develops
• Multiple speed levels
• Removable floor for children with some use of their legs
• Removable handle for a parent
• Velcro on pedals if applicable
• A design that is lightweight

During our research, we found a few sources particularly helpful. Our design is largely based on work done previously by the Go Baby Go foundation operated out of the University of Delaware, and there are specific projects on the mobility devices as they relate to Cerebral Palsy, as found below.

• https://sites.udel.edu/gobabygo/
• http://yourcpf.org/cpproduct/go-baby-go-the-ultimate-toy-hack/

Further, on Thursday we were able to visit the Susan Gray school and directly observe the patients that our devices would be helping. Understanding the purpose of the Susan Gray School and its efforts was vital in our research.

• https://peabody.vanderbilt.edu/admin-offices/sgs/index.php
• https://news.vanderbilt.edu/2014/07/10/susan-gray-school/

Finally, understanding the clinical relevance of our project was important to address the cognitive developmental impairments in children. We referenced the literature to characterize these problems and aid in our design development.

• https://www.tandfonline.com/doi/full/10.1080/10400435.2017.1415575
• https://journals.sagepub.com/doi/abs/10.1177/0956797613479974
• https://www.frontiersin.org/articles/10.3389/frobt.2017.00007/full

This week for our design project, we spoke on the phone with one of the pediatric occupational therapists at the Susan Gray School, Heather Winters. On this call, we spoke about some of the current equipment available at the school. Heather went into depth about which pieces of equipment seemed especially useful for the children, as well as what pieces of equipment they felt could potentially be improved. As for the toy cars, there were many design aspects Heather mentioned that she felt would be useful for both the development of individual children and the range of children for each individual car could be used. Talking to an occupational therapist was extremely helpful, since some of Heather’s design insights were ideas that one without her specific knowledge likely wouldn’t come up with. Some of these examples include a 5-point harness and the ability to tilt the car seat at various angles.

In addition to this, we talked to Dr. Teresa Plummer from the Belmont School of Occupational Therapy about next steps moving forward with the Susan Gray School. She solidified the ideas that we came up with after speaking with Heather and mentioned that moving forward in the Susan Gray school may require some extensive protocols for approval. Luckily, Dr. Plummer has a new graduate student starting at the Susan Gray School in January of next year and if we are able to get a prototype working before then we would be able to work alongside her graduate student in studying the development of children with mobility issues. The paperwork would be accounted for and we would be able to test our design in a controlled environment.

Moving forward, we have established a timeline for some key stage gates moving forward. First we will be visiting the Susan Gray School this upcoming Thursday in order to talk to Heather Winters about the needs of the children as well as seem what kinds of design aspects we feel are most important. Working with the children and observing them in the setting which they would use the mobility devices will help us understand all of the needs of the design. We are then meeting as a group at the Wond’ry to be trained and learn about the manufacturing equipment that we have at our disposal. With the manufacturing capabilities in mind, our designs will be more streamlined and cost effective. Next, we will gather all the information from our conference calls, and visit to the Susan Gray school to develop an extremely well defined set of design requirements. We have set a meeting with our advisor to discuss our progress of these milestones, and set out a productive path moving forward.