Shriners Children’s Therapists Refine Innovative Infant Mobility Toy

This article is part of an ongoing series spotlighting the innovative research of providers throughout the Shriners Children's system. Read another here.

What good is an invention if you can't get it to consumers? Just ask Henry Ford. He created the assembly line and other manufacturing firsts to make his Ford Model T available and affordable for millions of middle-class Americans.

Physical therapists Scott Jerome and Matt Lowell of Shriners Children's Salt Lake City faced a similar dilemma with their pediatric mobility device, although on a much smaller scale. Smaller in the sense that the Baby Bug Learning Toy (BBLT) was created with a select population in mind, infants with mobility impairments, and in the sense that the members of that population are, in fact, babies.

But the impact of the two-motor mobility chair has already proven huge for its users and their families, and it's about to get bigger thanks to a new collaboration between Shriners Children's and Utah State University. Together, they've simplified the design of the BBLT to allow for easier and faster production, putting it in more (tiny) hands of those who need it than ever before.

Starting Strong

A product of the hospital's wheelchair, seating and mobility department, the BBLT was first designed by Ken Kozole, BSME, OTR/L, in 2020 before retiring from Shriners Children's Salt Lake City. The BBLT was further developed by Lowell, Jerome and other members of the team to provide infants who can't move independently - and who are too small to use a wheelchair - the ability to participate in On Time Mobility, which is crucial in early childhood development.

"The goal of creating the BBLT was to investigate an infant's ability to learn how to participate in self-initiated mobility, now commonly referred to as On Time Mobility," Jerome said. "We have learned the importance of this as it corresponds to an infant's overall development in many areas, including understanding the benefits of mobility as it relates to being an active participant in learning about their environment, socialization with others, speech and language development and becoming an autonomous person." He also noted that the negative effects of immobility include "learned helplessness, decreased autonomy and slower development in many domains."

Jerome called the BBLT's design "simple yet incredibly functional." Meant to be used under the direction of a licensed physical therapist or occupational therapist, the adapted baby seat on wheels features a joystick positioned midline on the body that allows the child 360 degrees of movement. The device itself is easily transported and, "most importantly," Jerome said, was designed for the environments in which infants develop, close to the floor and in the home.

"These points listed are critical in an infant's development, and were not available in any other product that we researched to be able to meet an infant's needs to allow them the opportunity to participate in On Time Mobility, and therefore was the driving force of its development," Jerome said.

The BBLT's evolving design hasn't been without its challenges, however, as Lowell and Jerome struggled at times with the seating component, safety features and finding cooperative partners to obtain the electronics and motors. However, Shriners Children's has supported the project every step of the way by giving the team the proper time and funding to fine-tune and test the BBLT, they said.

While their ongoing research has yielded positive results, some of the best evidence of the device's success are the happy children and families who have used the BBLT either at Shriners Children's or at home. One great example is Claira, a toddler from Ogden, Utah, with arthrogryposis who "has not missed a beat in her development from a mobility standpoint," Lowell said, since beginning to use the device when 10 months old. She used it until 22 months old, when she was transitioned to the team's custom-modified Go Chair. (Once a child outgrows the BBLT or reaches 18 months old, they use the Go Chair to continue to participate in On Time Mobility.)

Moving Forward

In August 2023, Jerome, Lowell and their team at Shriners Children's Salt Lake City partnered with the Utah Assistive Technology Program (UATP) at Utah State University to move the project forward by allowing free access to the BBLT design for others to reproduce as well. "They have been critical in allowing for training and access to our Early Intervention community," Jerome said about UATP.

Dan O'Crowley, the lead engineer in the lab, and his team developed an Instructable - a set of illustrated digital instructions and downloadable plans for 3D-printed parts and hardware - ensuring standardized sizing and quality control for any member of the public who endeavors to produce it.

UATP also helped refine and troubleshoot the BBLT along the way, Jerome said. The result? "They built 10 BBLTs that were able to be sold at cost ($400) to interested Early Intervention programs throughout the state of Utah who were interested in On Time Mobility and use in their treatment plans."

The partnership with UATP has also helped with statewide education about On Time Mobility. Tressa Johnston, D.P.T., an Early Intervention program director with UATP, has connected the Shriners Children's team with Baby Watch Early Intervention administrators throughout Utah "to allow us to educate them on the benefits of On Time Mobility, of how to incorporate into their treatment programs the use of power mobility and objective measurement tools to allow them to measure progress/outcomes with power mobility use," Jerome said. "It has led to Utah's community being more aware and committed to providing On Time Mobility to our infant population with mobility impairments."

Currently, the Shriners Children's team plans to continue refining the Instructable and will soon add a training section on how to use the BBLT for treatment, including measurement tools to establish progress.

Jerome couldn't be happier with how this collaborative process has helped elevate their original product in so many ways. "This has cemented in me that, with the right partnerships, ideas like this can flourish," he said. "We need people with different areas of expertise to be successful in providing appropriate care to the patients and families we serve."