Move to learn: considerations for providing upright, hands-free, self-initiated mobility to children with severe physical and communication disabilities

Development in children is sometimes described as a series of isolated milestones, e.g., first smile, first word, sitting, crawling, first step, and so on, even though that is not actually how human development unfolds. Rather, many of the skills that emerge during childhood are better understood using neuroplasticity, dynamic systems theory, and embodied cognition. Based on these findings and theories, we explore the potential impact that upright, hands-free, self-initiated mobility can have on children with severe physical and communication disabilities who use augmentative and alternative communication, specifically focusing on their growth in communicative competence. We discuss research that demonstrates the benefits to children with different physical abilities when they engage in upright, hands-free, self-initiated mobility. This article reflects the World Health Organization's International Classification of Functioning, Disability and Health for Children and Youth by considering the importance of identifying functional communication needs and goals, taking into account participation barriers, communication limitations, and personal and environmental factors. We advocate for adopting family-centered, interprofessional collaborative service delivery models that more directly align with current theories of human development. Finally, we call for the adoption of implementation science to help bridge the existing gaps between theory and evidence-based practices.