Lisbeth NilssonLund University | LU · Department of Health Sciences
Lisbeth Nilsson
PhD, Occupational therapist
Implementation of Driving to Learn in a powered wheelchair and the Assessment of Learning Process (ALP)
About
107
Publications
19,127
Reads
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463
Citations
Introduction
Lisbeth Nilsson developed the Driving to Learn intervention. Her present research focus the universal process of tool use learning in children and adults. The original studies engaged participants with cognitive disabilities in powered mobility use. Later work has involved other assistive technologies and types of tool-use learning.
More information at:
Home page: http://www.lisbethnilsson.se/en/
YouTube: https://www.youtube.com/channel/UCUBwG9MOiJgzBUTvxp-sWGA
Additional affiliations
September 2011 - present
Lund University, Health Science Centre
Position
- PhD, lecturer (hours)
January 1993 - present
Lund University, Health Science Centre
Position
- Chair
Description
- Using practice in a special powered wheelchair to enhance attention, cognition and executive functions Assessing and facilitating tool use learning
Education
October 1996 - March 2007
September 1992 - October 1996
Field of study
- Public health and community medicine, with focus on occupational therapy
September 1971 - June 1974
Health Care School, Gothenburg
Field of study
- Occupational therapy
Publications
Publications (107)
The Driving to Learn project explored ways to help people with profound cognitive disabilities practice operating a joystick-operated powered wheelchair. The project used a grounded theory approach with constant comparative analysis and was carried out over 12 yr. The participants were 45 children and adults with profound cognitive disabilities. Re...
Collaboration by two grounded theory researchers, who each had developed a learning continuum instrument, led to the emergence of a new tool for assessment of learning powered mobility use. We undertook a rigorous process of comparative reanalysis that included merging, modifying, and expanding our previous research findings. A new instrument toget...
The Driving to Learn project was an exploration of how those with significant cognitive disabilities could benefit from training in a joystick-operated powered wheelchair. This study focuses on a particular part of the wider Driving to Learn project, mainly looking at the relationship between characteristics connected to powered wheelchair-use and...
Purpose: To explore the knowledge necessary for adoption and implementation of the Assessment of Learning Powered mobility use (ALP) tool in different practice settings for both adults and children. To consult with a diverse population of professionals working with adults and children, in different countries and various settings; who were learning...
Young infants, children, and persons of any age who have cognitive limitations can be thought of as tyro learners, who are beginners in learning. For tyro learners, the self-produced mobility afforded by a powered mobility device offers opportunities, to explore tool-use learning and interact with the surrounding environment, thereby potentially en...
Background
Including people with severe/profound intellectual disabilities as research participants challenges researchers due to their diverse abilities to participate and express themselves. Ensuring the rigour of the research and the credibility of the findings presents a challenge.
Methods
We use examples from our research to demonstrate that...
Lisbeth Nilsson
Summary presentation Kids Loco
I am most thankful to meeting with sensai Junichi Takashio in England 2012 and getting the opportunity to visit Biwako Gakuen in 2014, and returning to Japan in 2017 and 2018. Thanks to these meetings Driving to Learn and the Assessment of Learning Powered mobility use (ALP) became known in Japan.
Th...
According to the World Health Organization Wheelchair Provision Guidelines (2023) wheelchair training is a critical component of the wheelchair provision process. In fact, the guidelines ‘strongly recommend’ that training for power and manual wheelchairs needs to be provided to enable maximum use and prevent abandonment and secondary injuries. More...
Background: Infants and toddlers with disabilities follows the same developmental paths as typically developing children, but build individual patterns of achievements in their own pace.
Aim: To illustrate development in infants who got opportunities to experience locomotion before the age when they developed the physical abilities to move by roll...
Introduction
Process-based assessment is quite a new phenomenon in evaluation of outcomes of intervention. The process-based ALP-tool focus on analysis of individual performance of an activity in a situation matching actual abilities and preferences. Assessed phase of learning guides choice of strategies used to support advancement of performance....
Objective:
Powered mobility offers young children the opportunity to explore their world, develop awareness of their environment, and actively participate in play and daily activities. It enables children with severe disabilities to experience equity and equality by increasing their mobility. Powered mobility devices not only provide means for mov...
C O M M E N T by Lisbeth Nilsson
Baby Science Target Paper
by Dr. Hitomi Fujita
Dr Lisbeth Nilsson, PhD, Reg
Occupational Therapist, Associated to Department of Health Sciences, Lund University, Sweden
Thank you for the opportunity to comment on Dr Fujita’s important case study of an infant/young child with Fukuyama congenital muscular dystrophy,...
Background
Few studies synthesising knowledge about meaningful occupation are available. Meta-ethnography allows the synthesising of a variety of empirical findings and translational knowledge may be developed.
Aim
Investigate how individuals from diverse cultures and contexts experience meaningful occupation as described in qualitative research, a...
Informed on Assessment of Learning Process and facilitation of using motorized devices Video-clips with children who participated in the AME-project were used to illustrate the two parts in the ALP-tool - the ALP-instrument for assessment of learning and the ALP-facilitating strategies for advancing tool-use understanding.
The aim of the study was to explore inter-rater reliability and rater experiences of applying the universal instrument Assessment of Learning Process (ALP) with persons with profound intellectual and multiple disabilities. The study used a mixed-methods design. Inter-rater reliability was tested by eight clinical raters who assessed 23 video clips...
The graphical abstract illustrates how to use the two parts of the ALP-tool for advancement of learning and understanding of tool-use. Assessment with the ALP-instrument is guiding the choice of ALP-facilitating strategies in a continuous circular process.
OBJECTIVES
The symposium will provide the know-how about powered mobility use in children with Spinal Muscular Atrophy Type I. Define what are the barriers of their mobility and how powered mobility can facilitate participation and social interaction. Disseminate the importance of family involvement in early powered mobility through the use of adap...
Introduction:
Clinicians and educators use assessments to identify an individual’s abilities and goals to tailor a powered mobility intervention session. There are two approaches to what performance characteristics or qualities to evaluate. Task-based approaches evaluate an individual’s performance of specific, standardized tasks. Process-based ap...
Engaging tyro learners in exploring powered mobility use to support their tool-use learning and understanding of their relationships to the surrounding world
Every Child Has the Right to Move: Providing Self-generated Mobility Experiences in Early Childhood
Using powered mobility as a therapeutic intervention to support development and learning across the lifespan
Four decades have passed since powered mobility studies first documented the developmental and functional benefits of self-generated mobility for children with disabilities. But why are power mobility interventions still so rarely used with...
Exploring power mobility use – a learning approach for children and adults with cognitive impairment
If children and adults with multiple and complex disabilities involving cognitive impairment, are given opportunities to explore power mobility experiences, their consciousness of tool use can grow. Power mobility devices are powerful mediators of...
Assessment of Learning Powered mobility use - approach and application
The learning approach Assessment of Learning Power mobility use (ALP) was developed for power mobility intervention with children and adults with multiple and complex disabilities involving mild to profound cognitive impairment. The ALP tool includes the ALP-instrument for asse...
1,500-1,800 words (characters including spaces). The project Driving to Learn resulted in the identification of the process of learning tool-use. Awareness of the process was developed in interaction with children and adults with cognitive disabilities and infants with typical development who were engaged in joystick-operated powered wheelchair pra...
1,500-1,800 words (characters including spaces). Powered mobility intervention for infants and toddlers is an emerging field. Actual research has suggested the new concept ON Time mobility, emphasising the importance of becoming mobile at the time when crawling and walking occur in very young children. A guideline on introducing powered mobility to...
Introduction: For children who have multiple, complex disabilities, learning to use a powered mobility device provides more than just locomotion. Our work suggests that the experience of self-produced movement in a powered mobility device enhances development in these children by providing opportunities to explore tool-use learning and interact wit...
Introduction
The Assessment of Learning Powered mobility use (ALP) tool including the ALP instrument and facilitating strategies, was developed for Driving to Learn. This therapeutic intervention aims to provide children and adults who have profound cognitive disabilities with opportunities to learn tool use through powered mobility practise. To al...
We employed a study with a time series design to evaluate the effectiveness of powered mobility training in two children with cerebral palsy using following assessments: mobility in meters/session, the Assessment of Learning Powered Mobility Use (ALP), Assessment of Motor and Process Skills (AMPS), Paediatric Evaluation of Disability Inventory (PED...
Disclosure B. I (Tim Adlam) have an ongoing association with Designability Charity (UK reg. charity no. 256335), manufacturers of the Wizzybug powered wheelchair. I was employed by Designability full time from 1996 to December 2018, and part time (1 day / week) since then. I hold the post of Principal Engineer. B. I (Lisbeth Nilsson) have and have...
Disclosure B. I (Lisbeth Nilsson) have and have had associations with equipment manufacturer in the fields of Alternative and Augmented Communication (Saltillo-Prentche Romich Company, today) and Powered mobility (Permobil Sweden/Europe, ended in 2017). In both fields the involvement only concern research collaboration, agreements on ownership of i...
Despite growing evidence focused on early power mobility, questions regarding application in practice persist and may influence a young child’s access to power mobility. This full day workshop explores advantages and barriers for clinical and community implementation of power mobility programs for infants and toddlers with mobility limitations. Evi...
Invited editorial for the British Journal of Occupational Therapy.
The editorial presents Nilsson's research trajectory from 1993 and on, covering the development of the Driving to Learn intervention; the properties of the theory of de-plateauing; the collaboration with Durkin leading to the development of the ALP tool and the discovery of the theo...
Åhörarkopian är en färsk översättning av den aktuella amerikanska versionen av bedömningsinstrumentet ALP for AAC, som utvecklats tillsammans med logopederna Sarah Wilds och Chip Clarke i USA. ALP for AAC har fått ett mycket positivt mottagande av kliniker i USA.
Instrumentet är en adaptation av ALP verktyget (Avgöra fas i LärandeProcessen) som ut...
Det finns många hjälpmedel för kommunikation, men vi behöver lära oss hur de fungerar för att använda dem på bästa sätt i vardagen. Om vi har förståelse för den individuella lärandeprocessen kan vi lättare anpassa inlärningen och välja de strategier som passar bäst för att utveckla individens förståelse av hur deras nya verktyg och hjälpmedel kan a...
The Assessment of Learning Process (ALP) for AAC (2017) is a framework for assessing how individuals learn to use AAC devices. This presentation will use case studies and videos to illustrate the stages/ phases of the ALP, highlight facilitating strategies, discuss communication & language development, and identify influencing factors in an individ...
Handout of ALP for AAC provided to participants at various conference presentations in 2018 and also at the ATIA conference in Orlando in Jan 2019.
Smart wheelchairs are powered wheelchairs equipped with technologies that can collect information on powered wheelchair use, the driver, and interaction with the environment, and can use this information to modify wheelchair and/or driver behavior. These technologies could potentially be used to create tools to optimize design of training sessions,...
60 word abstract:
The Assessment of Learning Process (ALP) for AAC (2017) is a framework for assessing how individuals learn to use AAC devices. This presentation will use case studies and videos to illustrate the stages/ phases of the ALP, highlight facilitating strategies, discuss communication & language development, and identify influencing fac...
The ALP-tool (instrument and facilitating strategies) translated to Japanese
Presentation of the Driving to Learn intervention in a powered wheelchair and the application of the ALP tool for assessment of the learning process and stimulation of further learning.
The aim of this on stage conversation is to inspire delegates so that they might see for themselves the potential of Driving to Learn with this cohort of people and to trigger their own curiosity and response, and consider taking the research and exploration further.
Initially Lisbeth will illustrate the intervention with a short video and then Gr...
This session examines tool use learning as it applies first to powered mobility (Assessment of Learning Powered mobility use – ALP), second as it applies to augmentative and alternative communication (ALP for AAC), and third as it applies to other areas within assistive technology. Through interprofessional collaboration, the authors will demonstra...
Introduction
Occupational therapists experience difficulties in finding effective interventions for rehabilitation of patients with stroke and neglect syndrome. Recovery after stroke is negatively affected by persistent neglect and cognitive limitations. Driving to Learn in a powered wheelchair is an intervention developed for children and adults w...
Augmentative and Alternative communication (AAC) is a growing field for many occupational therapists working in pediatric and adult settings. Specifically, OTs are a primary part of an AAC assessment and implementation team when the client requires an alternative form of access – eye gaze, switch scanning, head pointing, joystick, etc. Unfortunatel...
1 hour Educational Breakout Session on Augmentative and Alternative Communication (AAC).
Abstract: Alternative access of AAC devices (e.g. eye gaze, head pointing, switch use) can be difficult to assess and teach. There is a lack of research-based assessments / frameworks available to help guide clinicians in assessing a client's understanding of a...
Smart wheelchairs are powered wheelchairs equipped with technologies that can collect information on powered wheelchair use, the driver, and interaction with the environment, and can use this information to modify wheelchair and/or driver behavior. These technologies could potentially be used to create tools to optimize design of training sessions,...
Alternative access of AAC devices (e.g., eye gaze, head pointing, switches) can be difficult to assess and teach. There is a lack of research-based assessments/frameworks available to help guide the SLP in assessing a client's understanding of an alternative access method, and to help increase proficiency with the chosen access method. This present...
Bakgrund: Eldrivna förflyttningshjälpmedel ger användarna ökade möjligheter till aktivitet och delaktighet. Hur de använder hjälpmedlet påverkas av hur väl bedömningen och träningen de fick under förskrivningsprocessen stämmer överens med deras förmåga, behov och livsmiljö.
Syfte: Att göra en övergripande genomgång av instrument och metoder för bed...
Bakgrund: Metoden Köra för att Lära i elrullstol utvecklades för personer med kognitiva funktionsnedsättningar men är användbar för att stimulera utveckling och lärande över hela åldersspannet oavsett funktionsnedsättning. Verktyget Avgöra fas i LärandeProcessen (ALP) används för att bedöma framsteg i lärandet och ger ideer om hur förståelse av ver...
Background: The growing elderly population, increasing number of individuals returning from conflict situations, availability of better medical care for children and adults with complex disabilities, and provision of powered mobility interventions at younger ages has led to the increase in number of powered mobility device (PMD) users. With escalat...
Scenario: Early positive engagement with powered mobility can offer physical, developmental and cognitive benefits to young children from the age of 18 months. There is general agreement that service and provision improvements can be made across stakeholder networks which will assist first access to, and support for, young children effectively util...
Att få uppleva rörelse är en stark drivkraft för att främja lärande och öka barns
delaktighet i vardagen. Eldrivna hjälpmedel används för att ge barn möjlighet
till självständig förflyttning men också för att förbättra deras psykosociala
utveckling. Metoden Köra för att Lära utvecklades för barn och vuxna med stora
kognitiva svårigheter och den är...
ALP-instrument version 2.0 translated to Hebrew, December 2015
Translators: Vardit Kindler, Naomi Gefen and Lori Rosenberg, Jerusalem, Israel
Tema: OTHER – Abstraktet presenterar ett innovativt Nka-projekt med fokus på att stödja anhöriga i deras ansträngningar att ge sina barn och unga med flerfunktionsnedsättning möjligheter att vara aktiva och delaktiga i olika sammanhang. Abstraktet avser en oral presentation på 15-20 minuter Lisbeth Nilsson Barn och unga med flerfunktionsnedsättning...
Theme: OTHER-This abstract presents an innovative Nka-project with focus on providing carers with a review of relevant knowledge about resources that can assist their efforts to provide their child or youth with multiple and complex disabilities with opportunities to activity and participation. This is an abstract for an oral presentation of 15-20...
ALP-verktyget med ALP-instrument och ALP-främjande strategier version 2, på svenska
Den engelska versionen av orginalet finns i Appendix 1 och 2 i JRRD artikeln om Assessment of learning powered mobility use
Original ALP-instrument and ALP-facilitating strategies, version 2.0
Both can be accessed as Appendixes in the article about assessment of learning powered mobility use.
Link to the article at Journal of Rehabilitation Research and Development home page:
https://www.rehab.research.va.gov/JOUR/2014/516/jrrd-2013-11-0237.html
Appendix 1, ALP Instru...
”Köra för att Lära” - en övning som stimulerar Barn och vuxna med kognitiva funktionsnedsättningar kan utvecklas och återhämta funktioner genom övning i elrullstol. Övningselrullstolen Tiro är utvecklad för metoden och har en sittenhet som kan användas av både barn och vuxna. Senaste nytt om övningens effekter och pågående forskning med små barn. L...
It is a challenge to select suitable and developing activities for children with limited physical and cognitive abilities. Their restricted ability to perform, express themselves and participate in a multiplicity of activities may hide potential to learn and develop.
The empirically based research project Driving to Learn focused on what people wi...
Background:
The research project Driving to Learn (1994-2007) found that practice in a joystick-operated powered wheelchair could facilitate cognitive development in children and adults with cognitive disabilities of different origins, severity, and time passed after onset of impairment/injury.
Method:
The project used grounded theory methodology...
Background:
During the research project Driving to Learn (1994-2007) evidence was found that children and adults with profound cognitive disabilities could achieve unexpected cognitive achievements from practice in a joystick-operated powered wheelchair.
Method:
Participatory action research during implementation of the new intervention Driving t...
Forskningsprojektet som ledde till utvecklingen av metoden Köra för att Lära™ startade 1993. Effekterna av övning i elrullstol med styrspak undersöktes med 126 barn, unga och vuxna: 45 med djupa kognitiva funktionsnedsättningar; 64 med andra grader av kognitiva svårigheter; och 17 spädbarn med normal utveckling. Resultaten presenterades i en avhand...
The Driving to Learn research project, initiated in 1993, had the aim to explore what could be achieved if children and adults with profound cognitive disabilities were provided with access to practice in a joystick-operated powered wheelchair. The findings encompass: TIRO – the learning tool, a special joystick-operated powered wheelchair for prac...
This paper describes a pilot study aimed at exploring the effects of using the Driving to Learn method in the sub-acute phase after stroke with spatial neglect. Five participants, aged 40-82 years, 10 days to 10 months post stroke with right hemisphere lesions and spatial neglect, did one test trial in a TIRO, a special powered wheelchair for peopl...
Introduction: The Driving to Learn project studied possible benefits from practice in a joystick-operated powered wheelchair in people with cognitive disabilities. It showed that also people with profound cognitive disabilities could develop some tool use ability
Aim: To explore the effects from using Driving to Learn with old people with cognitiv...
Introduction: The method Driving to Learn in a joystick-operated powered wheelchair was developed and tested with children and adults with cognitive disabilities at pediatric clinics, special schools, day centers for adults with intellectual disabilities and primary health day care. The most important effects from using the method were increased al...
Introduction: Durkin and Nilsson each developed a tool for assessment of powered mobility use when they carried out studies for their dissertations. Durkin studied children and youth and Nilsson studied children, youth, adults and old people.
Aim: To merge the two assessment tools into a new modified and expanded version.
Methods: Using classic gro...
Practice in a powered wheelchair may have effects other than independent mobility. These effects may be essential for people with cognitive disabilities, a population frequently excluded from access to powered mobility.
The research project Driving to Learn focused on what could be achieved if children and adults with profound cognitive disabilit...
The chapter in the book provides perspectives on the use of video-recordings in grounded theory research, using the experience from studying people with profound cognitive disabilities practicing in powered wheelchair as an example.
About the book:
"This anthology provides a unique collection of articles on classic grounded theory, as developed by...
People with profound cognitive disabilities are not expected to learn powered mobility use. The Driving to Learn project focussed on what this population could achieve from practising in a joystick-operated powered wheelchair. By means of using grounded theory methodology an eight-phase process 'growing consciousness of joystick-use' was identified...
Powered Mobility for People with Cognitive Disabilities
Learning Objectives:
Introduction
Cognitive disabilities – causes and definitions
Powered mobility – safety, technology, learning tool use
The research project Driving to Learn
Short about method, participants, practice, outcomes, findings
Infants with typical development making tests in a jo...
The Driving to Learn project explored what people with profound cognitive disabilities could achieve from practice in a joystick-operated powered wheelchair and what facilitated their eventual achievements.
Grounded theory methodology was applied for a project involving 45 children and adults with profound cognitive disabilities, 64 with milder de...
Describes the development of TIRO-the learning tool a powered wheelchair for enhancement of tool use and cognitive abilities.
Presentation of the method Driving to Learn
Aim: The Driving to Learn project focused on people with profound cognitive disabilities and their possible achievements from practicing joystick-use in a powered wheelchair. The aim of this study within the project was to statistically analyse the participants' outcomes, and to explore factors, in terms of participant and training characteristics,...
Driving to Learn™ an intervention for people with profound cognitive disabilities.
Introduction
People with profound cognitive disabilities seldom get the opportunity to learn powered mobility. The obvious reason is low expectations of their ability to learn safe and secure driving. Rehabilitation engineers have created technology enabling this po...
(In English and Swedish)
The research project with training in an powered wheelchair was started in 1993 by
the occupational therapist Lisbeth Nilsson at the children's rehabilitation center in Gällivare (Nilsson, 1996 and 2000). The project was continuously developed and expanded and in the early 2000s the training method was given the name of
Dri...
The Driving to Learn project explored possible achievements of training people with cognitive disabilities in a joystick-operated powered wheelchair utilizing the grounded theory approach. Theoretical sampling led the concomitant collection and analysis of data. During a period of 12 years, 45 participants with profound cognitive disabilities, aged...
Paper II in the thesis from 2007 includes more information than the article based on this paper, published in AJOT 2011
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 inf...
Studies of training walking individuals with brain dysfunction in powered wheelchair has shown positive effects on cognitive functions. The participants trained in a powered wheelchair designed for unskilled drivers. The training took place in different spaces, from open simple to narrow complicated spaces. Navigation was performed with increasing...
Methodbook
The Methodbook describes how the powered wheelchair, in an unconventional manner can be used as a tool for treatment and training. The method is suitable for children, adolescents and adults who from different causes have profound or mild cognitive disabilities. The method Driving to Learn can be practiced as early as at the age of 6 mo...
Metodboken
Boken beskriver hur man på ett okonventionellt sätt kan använda elrullstol som ett verktyg för att ge träning och behandling. Metoden är lämpad för barn, ungdomar och vuxna som av olika anledningar har svårare eller lättare kognitiva funktionsnedsättningar. Metoden kan användas så tidigt som vid 6 månaders ålder och därefter i alla åldra...
Questions
Question (1)
Dear collegues,
I have referenced your work and appreciate it. Hope you will put more energy into the project as it seamingly always is actual. It is astonishing that it is more than 30 years since Butler presented her findings and still it is difficult for young children to be provided with powered mobility equipment, not to talk of people with cognitive limitations.
Best wishes
Lisbeth Nilsson
