Learning how to perform various wheelchair skills safely and properly, such as navigating various environments, terrains, and obstacles is something that is infrequently taught to manual wheelchair users (MWCU). Many research studies indicate that this is due to a lack of training for occupational (and other) therapists at both the graduate and professional levels. As a result of this lack of education, MWCU are missing key components necessary to maximize independence safely and effectively in their daily lives.
Skills on Wheels is an evidence-based training program designed to help kids maneuver life situations in their wheelchairs. The program includes children between 6 and 17 years old who are manual wheelchair users, regardless of their diagnosis. Trained occupational therapists from Riley Hospital for Children in Indianapolis, Indiana partner with occupational and physical therapy students from Indiana University-Indianapolis to implement this program.
Background
The program began in 2020 with a pilot study of four participants. The program was loosely structured utilizing Dalhousie University's Wheelchair Skills Program and is the first pediatric wheelchair training program in the United States. Over the last four years, the program has expanded to roughly 20-25 participants in each iteration. Skills on Wheels was designed to also include various research components such as skill improvement (utilizing the Wheelchair Skills Test), as well as various measures of confidence and satisfaction for both the child and the caregivers.
Program Structure
Skills on Wheels has expanded and evolved over the course of the last four years, changing as necessary to ensure optimal outcomes. The program consists of five sessions and is individually tailored to each participant. The child completes the Wheelchair Skills Test in the first session to set a baseline, and then again in the fifth session to track progress at the end of the program. Weeks 2-4 are then tailored for each child to work on the specific skills identified during week one. Occupational and physical therapy students, along with other volunteers (therapists, vendors, or other healthcare volunteers) are assigned to a participant to work on activities to improve their ability to perform various skills, such as popping wheelies, navigating obstacles, or going up inclines. During the fourth week, the participants, volunteers, and family members take the skills outside and complete a community day, practicing their skills in a real world application.
While the participants collaborate with their trainers, there are activities for caregivers and siblings, too. The caregivers often participate in educational sessions, learning about topics such as wheelchair maintenance, available features, and Medicaid waivers, or they simply converse with one another and share similar experiences. Meanwhile, the siblings get to have fun in Sib Crib, a fun and interactive environment for siblings to play while also having the potential to grow and learn as a child with a sibling who has a disability.
Every aspect of the Skills on Wheels program is completely free to participants and their families. The program is funded solely by grants and donations.
Successes & Expansion
Since Skills on Wheels launched in 2020, there have been four iterations of the training program, with the fifth one coming in Spring 2025. Throughout the year, there are multiple community events, where families come together with the Skills on Wheels team for fun activities such as baseball games, picnics, and holiday parties. Additionally, a dance program is now offered in which participants learn a dance routine over the course of four sessions, utilizing various wheelchair skills. This is a partnership with a local dance program (Kids Dance Outreach) with a performance at the conclusion of the sessions. There has also been one adult training program (in partnership with NeuroHope Rehabilitation), with a second iteration coming in early 2025. Lastly, a pilot study will be launched in Spring 2025 for wheelchair training for power wheelchair users as well.
Skills on Wheels has now published two papers in Disability and Rehabilitation: Assistive Technology Journal. NRTTS also offers an On Demand CEU about the program. Skills on Wheels has been featured on NPR and many other publications and news stories, as well as participants in posters and presentations at ISS.
Want to know more or start your own Skills on Wheels program?
Ideally, Skills on Wheels will become a nationwide program. The hope and goal of the Indianapolis program is to empower and help other therapists start and run their own Skills on Wheels program. To find out more about the program, please visit the Skills on Wheels website.
To inquire about beginning your own program or if you have questions related to this blog or Skills on Wheels, please email us at wcskills@iu.edu.
Tiffany Stead is an occupational therapist at Riley Hospital for Children. She is also the clinical director of the IU Skills on Wheels program. Tiffany earned he master's degree in occupational therapy from the University of Southern Indiana in 2010. Since graduating, she has worked at Riley Hospital for Children in various roles, from outpatient to inpatient pediatric therapy, and is currently one of the primary therapists in the outpatient Adaptive Equipment department. As clinical director for the Skills on Wheels program, she oversees the trainings and education of the volunteers, and assists in coordinating safe and proper learning and techniques of the skills. Tiffany is also an adjunct faculty member with the IU Indianapolis (IUI) occupational therapy doctorate program. She is pursuing her post-professional doctorate with IUI, with completion of this degree set for August 2025. Tiffany is a registered and licensed occupational therapist, and additionally has credentialing/certifications as an Assistive Technology Professional (ATP) and a Certified Passenger Safety Technician (CPST).