Independent mobility plays a crucial role in child development, contributing to motor, cognitive, and social skills. Children with severe disabilities often face limited mobility opportunities, impacting their ability to explore their environment. The ADAPT project, a university-based community and research initiative, aims to promote independent mobility for children and adolescents with disabilities through low-cost assistive mobility solutions. The project follows the principles of Patient and Public Involvement (PPI), ensuring that families are actively engaged throughout the process. This case report highlights the impact of co-designing a motorized mobility device for twins with severe disabilities, emphasizing the role of PPI in assistive technology development.

The primary objective was to analyze the impact of family involvement in the development and implementation of a customized motorized mobility solution for twin brothers with cerebral palsy, visual impairments, and cognitive disabilities (Gross Motor Function Classification System – GMFCS level IV). A secondary objective was to assess the mother’s perception of the intervention’s effectiveness and feasibility through qualitative feedback.

This study employed a case report methodology, using a co-design approach that actively involved the children’s mother throughout the development process. Initial assessments were conducted to understand the children's functional abilities and specific needs. A commercially available ride-on toy was modified to include accessible controls, postural support, and visual enhancements based on continuous feedback from the mother. Data collection was based on qualitative reports from the mother, obtained through semi-structured interviews conducted at different stages of the intervention. Follow-ups were performed to monitor the device’s usability and its integration into the family’s daily routine.

The co-design process resulted in a single adapted ride-on vehicle that could be used by both children at different times, addressing logistical challenges for the family. Key modifications included a centrally positioned activation button with LED lighting for enhanced visibility, an ergonomic seating system to provide adequate postural support, and lightweight motorization to facilitate handling. The mother reported increased participation of the children in daily activities, greater motivation to interact with their surroundings, and improved cognitive engagement. Additionally, she highlighted the ease of integrating the device into their routine and its potential role in preparing the children for future use of powered wheelchairs.

This case report reinforces the importance of PPI in assistive technology development. Family involvement throughout the co-design process ensured that the adapted mobility device was functional, accessible, and aligned with the children’s needs. Future research should explore long-term benefits, including the impact on motor development and the transition to more advanced assistive mobility devices.

This study highlights the significance of integrating PPI principles into rehabilitation and assistive technology development. The findings suggest that co-designed, low-cost assistive mobility solutions can enhance the quality of life and autonomy of children with severe disabilities. Additionally, the approach provides valuable insights for healthcare professionals and policymakers on the role of family engagement in pediatric rehabilitation and accessibility programs.