Lisbeth Nilsson • Tel +46 70-583 85 96 • E-mail: lisbeth.nilsson@kiruna.nu

Research

Research

Occupational Therapist since 1974. Lives in the northern part of Sweden and has clinical association to the Child Habilitation Clinic at the hospital in Gällivare. Has leave for studies and research since 1994-01-01. Started distance studies in Lund in the autumn 1992. Bachelor’s degree 1994 and Master’s degree 1996.

Defended her dissertation in occupational therapy 2007-03-09 at Lund University, Faculty of Medicine, Department of Health Sciences, Section of Occupational Therapy and Gerontology. Developed a research line of her own – studies of powered wheelchair training – which is the main theme through the writings included in the dissertation.

Driving to Learn. A training method for children, adolescents and adults with profound to mild degrees of cognitive disabilities.

The research line was named the Driving to Learn project and focused on how training/activity in a joystick-operated powered wheelchair could be used to stimulate the ability to use tools in people with different degrees of cognitive disabilities.

From the start the target group was very small but over time new groups of participants were added. At the end of the project a total of 109 persons with cognitive disabilities, aged between 12 months and 86 years, had at some time been engaged in powered wheelchair training. The training method was tested and developed during more than 13 years of studies with wide-ranging groups – for example small children with multiple handicaps, adults with profound mental retardation, toddlers with minor cerebral paresis and adults with brain-injury.
To compare the results with typical development and to form a frame of reference for how early the training method could start, a study of typically developed infants aged 3 – 12 months was carried out.

Quite early in the project was co-operation initiated with the powered wheelchair manufacturer Permobil to construct a training powered wheelchair. The manufacturer created three prototypes which one after the other were tested with participants in the project. The testing resulted in the design of the training powered wheelchair Entra Tiro with a “one-for-all” seating-unit. This concept made the training accessible for many with one chair as the seating-unit with a few single manipulations could be changed from child to adult size or vice versa.

The results of the studies early showed that persons with very profound cognitive disabilities as well as persons with minor cognitive impairments and ability to walk could benefit from training in powered wheelchair. Further on in the project the process of growing consciousness of joystick-use was identified. The process has eight distinguishable phases and at each phase specific training strategies are needed to stimulate the person to grow more conscious of how to use the joystick. A special instrument for assessment of a person’s actual phase in the process was developed and its inter-rater reliability was tested with very good result.

The primary goal with the training method Driving to Learn is to stimulate a person’s development of consciousness of his or her ability to cause effects and to use a tool i.e. how to set the powered wheelchair in motion by activating the joystick, how to change direction and how to change speed. Understanding of the person’s actual phase in the process is necessary to be able to select appropriate training strategies stimulating progress. How far a person can develop his or her tool-use ability is not possible to tell on forehand. The training is meaningful even if the person is not able to learn how to navigate the powered wheelchair i.e. if the person grow consciousness of how to cause an effect – that his or her activity on the joystick sets the chair in motion. The person then becomes an agent, someone who can make something happen, someone who do something – without assistance from others. To develop or regain ability to act and to use tools are among the most important activities a human being can do in life.

The aim with further research is:

  • to modify, evaluate and implement the method Driving to Learn in different fields of action in health care and school.
  • to study the process of growing consciousness of tool-use with focus on different degrees of complexity and levels of abstraction i.e. spoon for eating, computer use, working methods.
  • to develop a general instrument for assessment of actual phase in the process and general training/learning strategies.

Lisbeth Nilsson
Lisbeth Nilsson
Conferation of doctors degree 2007-06-01