Independence Through Exploration

What are Early Developmental Milestones I need to know for my child?

The illustration below shows milestones for typically developing children. When a child is struggling to meet these milestones there are therapies that children can go through to promote this development (1,2). Achieving each milestone doesn’t happen in a vacuum, they are all tied together, and a key to achieving many of these milestones is self-initiated mobility (1,2). This is a challenge for very young children who may not have the physical capacity to do so, and there is the temptation to think “they just can’t do it.” The Explorer Mini was specifically designed for these very young children to be placed in postures that will promote development and allow for self-initiated mobility.

Key Early Developmental Milestones:

They lie on their tummy, prop up on forearms, hold their head up and start to fix their eyes on objects nearby.

They begin to sit up and they stretch out with their hands to find objects within reach.

When successful at finding and manipulating items in reach they begin noticing items beyond their reach

They reach beyond themselves until they fall on outstretched arms

They begin to crawl to reach objects. This strengthens their arms and legs to prepare for standing and later walking.

But what happens when a young child does not reach for toys in prone or crawls to a desired object due to a development delay or medical condition that limits their ability?

The first two years are crucial for development and there are few devices designed to give a young child with mobility impairments the ability to explore their environment while promoting developmental postures.

What may help provide my child with mobility while supporting development?

Permobil is proud to introduce the Explorer Mini which was designed to provide an opportunity for independent mobility while promoting developmental milestones.

How is the Explorer Mini different than other power mobility devices?

There are limited options for early power mobility devices on the market.

Modified powered toys have been successfully used to provide children with the ability to explore their environment and move from point A to point B, but as non-medical devices they were not designed with the needs of children with mobility impairments in mind. 

Of course there are pediatric power wheelchairs on the market, but the typical age range for these mobility devices is age three and above (4). Waiting for the three year old age range to provide power mobility means potentially missing out on earlier experiences with self-initiated mobility.

The Explorer Mini is a medical device that looks like a toy, but has been designed to promote early exploration and self-initiated mobility for children with mobility impairments. It has been rigorously tested and gone through regulatory approval to be considered a medical device.

The Explorer Mini is not intended to be a child’s full-time device.

It is a tool allowing self-initiated mobility and freedom of movement which can help improve trunk and head control, and functional use of the upper extremities. It is not designed simply to get a very young child from point A to point B but is intended to allow them to explore their environment while in an upright posture that helps support milestone achievement. Each component of the Explorer Mini is intentionally designed to address areas of childhood development and is meant to be utilized as early as 12 months of age.

Developmentally Inspired Seating

The Explorer Mini is an ergonomic device with multiple weight bearing surfaces to help promote safe, stable upright postures. The intuitive design provides just the right amount of support enabling young children with mobility impairments opportunities to develop strength, endurance and postural control. Each element of the Explorer Mini was designed specifically for developmental milestones in early childhood. 

Common misconceptions about early mobility devices

1. Twelve months is too early to begin power mobility

A usability study on the Explorer Mini with young children found the device promoted self-initiated movement in the majority of children tested. The Explorer Mini has been regulatory approved as safe and effective for targeted population. Through a usability study testing, the Explorer Mini was found to promote exploration and self-initiated movement in young children with mobility limitations

2. My child is too young to use a joystick

Of the 33 children under 36 months who participated in human factor validation studies of the Explorer Mini, 94% were able to move the device using the midline joystick control while 88% demonstrated cause and effect learning through grasping and releasing the joystick. The proportional joystick provides multi-modal sensory input and allows movements in all directions. The striking yellow color and position of joystick on the tray encourages eyes and hands coming to midline, grasp & release and bilateral upper extremity integration.

3. Explorer Mini does not provide enough seating or supports

The Explorer Mini provides a safe, supportive position without use of restrictive positioning components that limit freedom of movement necessary to develop postural control, strength and balance. The open design of the Explorer Mini supports development of postural control, strength and balance.

4. The Explorer Mini needs a headrest

As lifting and holding head in prone is usually achieved by 3 months, use of a headrest at this stage may inhibit development. A headrest may contribute to auditory neglect, limit vestibular input or restrict rotation of the head. The Explorer Mini is designed to facilitate activities such as weight bearing on elbows to aid in the development of head control. 

5. The application for the Explorer Mini is limited without alternative drive controls such as switched input devices

The Explorer Mini was designed to support development and self-initiated mobility. Simply pressing a switch may contribute to cause and effect learning but does not provide the same degree of proprioceptive input as a joystick. If the goal was purely movement then a switch might be fine. The purpose of the Explorer Mini is to facilitate development and not just moving from point A to B. 

6. The Explorer Mini doesn't have a soft enough seat cushion

The firm saddle seat provides proprioceptive feedback to facilitate upright posture and is not intended for all day use. The gentle slope of the saddle seat promotes anterior pelvic tilt while positioning the knees in slight abduction to support hip development. Additionally, children in the intended age range are likely to be wearing a diaper while in the Explorer Mini.

7. The Explorer Mini looks like a toy but is priced like a medical device

The Explorer Mini is a Class II prescription only medical device that has been rigorously tested and deemed safe for intended use through human factors validation studies. It is the only power mobility solution for young children ages 12-36 months on the market today that has been regulatory cleared by the FDA. While toy-like in appearance the Explorer Mini is a medical device that was specifically designed to be appealing to young children and their families.

Funding Alternative for the Explorer Mini

As a prescription only medical device, that has been demonstrated safe for intended use via human factors validation studies, the Explorer Mini can be submitted for insurance coverage. In the United States, there isn’t a current HCPCS code available that the Explorer Mini would fall under. A miscellaneous code can be used but coverage will depend upon the funding source. 

While insurance may cover the Explorer Mini, the lengthy process of approving power mobility devices consumes valuable development time.  Currently, the average time it takes for a power mobility device to be approved is 3-6 months, and it can be significantly longer with some funding sources. Given this critical period of development in a very young child's life, it may not make sense to lose that much time trying to get the Explorer Mini covered by insurance. One option may be purchasing the Explorer Mini out of pocket now and submitting a claim to insurance for reimbursement. 

Another consideration for alternative funding for the Explorer Mini is charitable options or state specific grants such as early intervention. For out of pocket alternatives, consider using a Flexible Spending Account or Health Savings Account. Leasing finance options such as Care Credit can be another option. Permobil has compiled a list of alternative funding options that can be explored, find it here: alternative funding resource.

At Permobil, we value the importance of early childhood development and we want the Explorer Mini accessible as possible to families with children who have mobility impairments, so we have priced it significantly below the cost of traditional power mobility devices on the market today.