Access to commercial powered mobility devices is often limited by funding or size. Many families use toy ride-on cars for early mobility, which can be easily adapted for safety and accessibility. The modified ride-on car will be provided for 8-weeks, and families will be provided with suggested use frequencies and provided with support for implementing the device intervention with their child.

Child Engagement in Daily Life (CEDL). The CEDL is a caregiver survey tool that assesses participation in family and recreational activities and uses a 5-point Likert scale to assess frequency of participation and enjoyment of participation. The CEDL also assesses participation in self-care behaviors and uses a 5-point Likert scale to assess the degree to which the child participates in the daily self-care activities of feeding, dressing, bathing, and toileting. Scores are reported for the first section, Frequency of Participation, and the third section, Participation in Self-Care, using scaled scores validated with individuals with CP, which range between 0-100. For the remaining section (Enjoyment of Participation), only raw scores are reported, with ranges of 11-55, respectively. Higher or increased scores indicate better outcomes on all scales.

Child Engagement in Daily Life (CEDL). The CEDL is a caregiver survey tool that assesses participation in family and recreational activities and uses a 5-point Likert scale to assess frequency of participation and enjoyment of participation. The CEDL also assesses participation in self-care behaviors and uses a 5-point Likert scale to assess the degree to which the child participates in the daily self-care activities of feeding, dressing, bathing, and toileting. Scores are reported for the first section, Frequency of Participation, and the third section, Participation in Self-Care, using scaled scores validated with individuals with CP, which range between 0-100. For the remaining section (Enjoyment of Participation), only raw scores are reported, with ranges of 11-55, respectively. Higher or increased scores indicate better outcomes on all scales.

Child Engagement in Daily Life (CEDL). The CEDL is a caregiver survey tool that assesses participation in family and recreational activities and uses a 5-point Likert scale to assess frequency of participation and enjoyment of participation. The CEDL also assesses participation in self-care behaviors and uses a 5-point Likert scale to assess the degree to which the child participates in the daily self-care activities of feeding, dressing, bathing, and toileting. Scores are reported for the first section, Frequency of Participation, and the third section, Participation in Self-Care, using scaled scores validated with individuals with CP, which range between 0-100. For the remaining section (Enjoyment of Participation), only raw scores are reported, with ranges of 11-55, respectively. Higher or increased scores indicate better outcomes on all scales.

Caregivers will complete a 3-measure perceptual implementation outcome survey. All measures are 4-item, 5-point likert-scale surveys. The minimum score is 1 and the maximum score is 5 per measure. The Acceptability of Intervention Measure (AIM) is designed to measure how receptive stakeholders are to adopting an intervention, the Intervention Appropriateness Measure (IAM) is designed to measure suitability of the intervention in a given environment or circumstance, and the Feasibility of Intervention Measure (FIM) is designed to measure how possible and likely stakeholders are to adopt an intervention. Higher ratings indicate better outcomes, in this case greater acceptability, intervention appropriateness, and feasibility of adoption. Mean rankings are reported out of a total maximum of 5 for each section.

Semi-structured interviews with caregivers using an interview guide will be conducted to understand their experiences using the respective powered mobility devices, barriers encountered and solutions discovered, and perceptions of self-efficacy and behavioral capacity.

Young Children's Participation & Environment Measure (YC-PEM).The YC-PEM is a caregiver survey tool that has 3 sections: home, daycare/preschool, and community, with each section assessing participation and the environment. For participation items, parents are asked how often their child has participated in different types of activities, how involved their child is when participating in activities of this type, and if parents would like their child's participation to change. For environment items, parents are asked if specific aspects of the environment facilitate or hinder their child's participation and if specific supports are available and/or adequate to support their child's participation.

Caregivers will complete a driving log that indicates the date, time, and environment of Explorer Mini (A) or modified ride-on car use (B). Caregivers will also make notes about the child's enjoyment level and general activities while using each device. To supplement caregiver reported data, automated device use data such as frequency and duration of activation, average speed, and distance traveled, will be collected either via a custom data logger (mounted on the modified ride-on car) or through integrated device systems (built-in to the Explorer Mini).

Young Children's Participation & Environment Measure (YC-PEM).The YC-PEM is a caregiver survey tool that has 3 sections: home, daycare/preschool, and community, with each section assessing participation and the environment. For participation items, parents are asked how often their child has participated in different types of activities, how involved their child is when participating in activities of this type, and if parents would like their child's participation to change. For environment items, parents are asked if specific aspects of the environment facilitate or hinder their child's participation and if specific supports are available and/or adequate to support their child's participation.

Children randomized into this arm will first trial a modified ride-on car over an 8-week intervention period, then trial a Permobil Explorer Mini powered mobility device over a second 8-week intervention period in their home and community environments.

Permobil Explorer Mini: The use of powered mobility devices for young children with cerebral palsy is increasingly recommended. The Permobil Explorer Mini is a new pediatric powered wheelchair that has been cleared by the FDA. The Explorer Mini will be provided for 8-weeks, and families will be provided with suggested use frequencies and provided with support for implementing the device intervention with their child.

Modified Ride-On Car: Access to commercial powered mobility devices is often limited by funding or size. Many families use toy ride-on cars for early mobility, which can be easily adapted for safety and accessibility. The modified ride-on car will be provided for 8-weeks, and families will be provided with suggested use frequencies and provided with support for implementing the device intervention with their child.

Total of all reporting groups

Children randomized into this arm will first trial a modified ride-on car over an 8-week intervention period, then trial a Permobil Explorer Mini powered mobility device over a second 8-week intervention period in their home and community environments.

Permobil Explorer Mini: The use of powered mobility devices for young children with cerebral palsy is increasingly recommended. The Permobil Explorer Mini is a new pediatric powered wheelchair that has been cleared by the FDA. The Explorer Mini will be provided for 8-weeks, and families will be provided with suggested use frequencies and provided with support for implementing the device intervention with their child.

Modified Ride-On Car: Access to commercial powered mobility devices is often limited by funding or size. Many families use toy ride-on cars for early mobility, which can be easily adapted for safety and accessibility. The modified ride-on car will be provided for 8-weeks, and families will be provided with suggested use frequencies and provided with support for implementing the device intervention with their child.

The Bayley Scales of Infant Development (BSID), 4th Edition is an internationally recognized, norm referenced set of tests designed to assess developmental domains from one month to 42 months of age. This BSID-IV assessment includes Cognitive, Receptive Communication, Expressive Communication, Gross Motor, and Fine Motor subscales. Each subscale has unique score value maximums, but on all subscales, higher scores mean a better outcome. Raw score scales are in increments of 1 and range from: Cognitive (0-81); Receptive Communication (0-42); Expressive Communication (0-37); Gross Motor (0-58); Fine Motor (0-46). Mean changes in Raw Scores are reported for each domain in this summary.

The Bayley Scales of Infant Development (BSID), 4th Edition is an internationally recognized, norm referenced set of tests designed to assess developmental domains from one month to 42 months of age. This BSID-IV assessment includes Cognitive, Receptive Communication, Expressive Communication, Gross Motor, and Fine Motor subscales. Each subscale has unique score value maximums, but on all subscales, higher scores mean a better outcome. Raw score scales are in increments of 1 and range from: Cognitive (0-81); Receptive Communication (0-42); Expressive Communication (0-37); Gross Motor (0-58); Fine Motor (0-46). Mean changes in Raw Scores are reported for each domain in this summary.

Child Engagement in Daily Life (CEDL). The CEDL is a caregiver survey tool that assesses participation in family and recreational activities and uses a 5-point Likert scale to assess frequency of participation and enjoyment of participation. The CEDL also assesses participation in self-care behaviors and uses a 5-point Likert scale to assess the degree to which the child participates in the daily self-care activities of feeding, dressing, bathing, and toileting. Scores are reported for the first section, Frequency of Participation, and the third section, Participation in Self-Care, using scaled scores validated with individuals with CP, which range between 0-100. For the remaining section (Enjoyment of Participation), only raw scores are reported, with ranges of 11-55, respectively. Higher or increased scores indicate better outcomes on all scales.

In this parent reported measure, all 12 participants in each arm fully completed all items in section 1 (Frequency of Participation) and section 3 (Participation in Self Care). However, 3 participants in the AB Arm and 4 participants in the BA arm chose to leave portions of section 2 (Enjoyment of Participation) blank. Therefore, there were many items in this section that had no comparator values. Thus, we included all participants who had fully completed all items for analysis from section 2.

Child Engagement in Daily Life (CEDL). The CEDL is a caregiver survey tool that assesses participation in family and recreational activities and uses a 5-point Likert scale to assess frequency of participation and enjoyment of participation. The CEDL also assesses participation in self-care behaviors and uses a 5-point Likert scale to assess the degree to which the child participates in the daily self-care activities of feeding, dressing, bathing, and toileting. Scores are reported for the first section, Frequency of Participation, and the third section, Participation in Self-Care, using scaled scores validated with individuals with CP, which range between 0-100. For the remaining section (Enjoyment of Participation), only raw scores are reported, with ranges of 11-55, respectively. Higher or increased scores indicate better outcomes on all scales.

In this parent reported measure, all 12 participants in each arm fully completed all items in section 1 (Frequency of Participation) and section 3 (Participation in Self Care). However, 3 participants in the AB Arm and 4 participants in the BA arm chose to leave portions of section 2 (Enjoyment of Participation) blank. Therefore, there were many items in this section that had no comparator values. Thus, we included all participants who had fully completed all items for analysis from section 2.

Child Engagement in Daily Life (CEDL). The CEDL is a caregiver survey tool that assesses participation in family and recreational activities and uses a 5-point Likert scale to assess frequency of participation and enjoyment of participation. The CEDL also assesses participation in self-care behaviors and uses a 5-point Likert scale to assess the degree to which the child participates in the daily self-care activities of feeding, dressing, bathing, and toileting. Scores are reported for the first section, Frequency of Participation, and the third section, Participation in Self-Care, using scaled scores validated with individuals with CP, which range between 0-100. For the remaining section (Enjoyment of Participation), only raw scores are reported, with ranges of 11-55, respectively. Higher or increased scores indicate better outcomes on all scales.

In this parent reported measure, all 12 participants in each arm fully completed all items in section 1 (Frequency of Participation) and section 3 (Participation in Self Care). However, 3 participants in the AB Arm and 4 participants in the BA arm chose to leave portions of section 2 (Enjoyment of Participation) blank. Therefore, there were many items in this section that had no comparator values. Thus, we included all participants who had fully completed all items for analysis from section 2.

Caregivers will complete a 3-measure perceptual implementation outcome survey. All measures are 4-item, 5-point likert-scale surveys. The minimum value is 1 and the maximum value is 5 per measure. The Acceptability of Intervention Measure (AIM) is designed to measure how receptive stakeholders are to adopting an intervention, the Intervention Appropriateness Measure (IAM) is designed to measure suitability of the intervention in a given environment or circumstance, and the Feasibility of Intervention Measure (FIM) is designed to measure how possible and likely stakeholders are to adopt an intervention. Higher ratings indicate better outcomes, in this case greater acceptability, intervention appropriateness, and feasibility of adoption. Mean rankings are reported out of a 5 point scale for each section.

Caregivers will complete a 3-measure perceptual implementation outcome survey. All measures are 4-item, 5-point likert-scale surveys. The minimum score is 1 and the maximum score is 5 per measure. The Acceptability of Intervention Measure (AIM) is designed to measure how receptive stakeholders are to adopting an intervention, the Intervention Appropriateness Measure (IAM) is designed to measure suitability of the intervention in a given environment or circumstance, and the Feasibility of Intervention Measure (FIM) is designed to measure how possible and likely stakeholders are to adopt an intervention. Higher ratings indicate better outcomes, in this case greater acceptability, intervention appropriateness, and feasibility of adoption. Mean rankings are reported out of a total maximum of 5 for each section.

Semi-structured interviews with caregivers using an interview guide will be conducted to understand their experiences using the respective powered mobility devices, barriers encountered and solutions discovered, and perceptions of self-efficacy and behavioral capacity.

Semi-structured interviews with caregivers using an interview guide will be conducted to understand their experiences using the respective powered mobility devices, barriers encountered and solutions discovered, and perceptions of self-efficacy and behavioral capacity.

Young Children's Participation & Environment Measure (YC-PEM).The YC-PEM is a caregiver survey tool that has 3 sections: home, daycare/preschool, and community, with each section assessing participation and the environment. For participation items, parents are asked how often their child has participated in different types of activities, how involved their child is when participating in activities of this type, and if parents would like their child's participation to change. For environment items, parents are asked if specific aspects of the environment facilitate or hinder their child's participation and if specific supports are available and/or adequate to support their child's participation.

Caregivers will complete a driving log that indicates the date, time, and environment of Explorer Mini (A) or modified ride-on car use (B). Caregivers will also make notes about the child's enjoyment level and general activities while using each device. To supplement caregiver reported data, automated device use data such as frequency and duration of activation, average speed, and distance traveled, will be collected either via a custom data logger (mounted on the modified ride-on car) or through integrated device systems (built-in to the Explorer Mini).

Young Children's Participation & Environment Measure (YC-PEM).The YC-PEM is a caregiver survey tool that has 3 sections: home, daycare/preschool, and community, with each section assessing participation and the environment. For participation items, parents are asked how often their child has participated in different types of activities, how involved their child is when participating in activities of this type, and if parents would like their child's participation to change. For environment items, parents are asked if specific aspects of the environment facilitate or hinder their child's participation and if specific supports are available and/or adequate to support their child's participation.

Children randomized into this arm will first trial a Permobil Explorer Mini powered mobility device over an 8-week intervention period, then trial a modified ride-on car over a second 8-week intervention period in their home and community environments.

Modified Ride-On Car: Access to commercial powered mobility devices is often limited by funding or size. Many families use toy ride-on cars for early mobility, which can be easily adapted for safety and accessibility. The modified ride-on car will be provided for 8-weeks, and families will be provided with suggested use frequencies and provided with support for implementing the device intervention with their child.

Children randomized into this arm will first trial a modified ride-on car over an 8-week intervention period, then trial a Permobil Explorer Mini powered mobility device over a second 8-week intervention period in their home and community environments.

Modified Ride-On Car: Access to commercial powered mobility devices is often limited by funding or size. Many families use toy ride-on cars for early mobility, which can be easily adapted for safety and accessibility. The modified ride-on car will be provided for 8-weeks, and families will be provided with suggested use frequencies and provided with support for implementing the device intervention with their child.

Children randomized into this arm will first trial a modified ride-on car over an 8-week intervention period, then trial a Permobil Explorer Mini powered mobility device over a second 8-week intervention period in their home and community environments.

Permobil Explorer Mini: The use of powered mobility devices for young children with cerebral palsy is increasingly recommended. The Permobil Explorer Mini is a new pediatric powered wheelchair that has been cleared by the FDA. The Explorer Mini will be provided for 8-weeks, and families will be provided with suggested use frequencies and provided with support for implementing the device intervention with their child.