Table 2.

Extraction and Coding of Perceived Barriers from Previously Published Research Studies of Modified Ride-On Cars.

Reference	Perceived Barriers	Assigned Code of Perceived Barrier
Chiulli (1988)	• Initial ‘lurch’ with activation	• Device
Deitz (2002)	• Family vacation • Child’s health • Loud • Disruptive when used indoors • Difficulty driving on rough surfaces • Large turning radius • Experienced frequent but solvable break downs • Impracticality of use in small classrooms/crowded spaces	• Caregiver: Time • Child: Health • Device • Device • Device • Device • Device • Environmental
Huang, Ragonesi, Stoner, Peffley, & Galloway (2014)	• Weather • Child’s tolerance • Inability to install joystick to teach child to steer • Child’s health	• Environmental • Child: Tolerance • Device • Child: Health
Logan, Huang, Stahlin, & Galloway (2014)	• Weather • Child’s tolerance • Child’s health (sickness, tired from multiple medical appointments, recovering from surgery)	• Environmental • Child: Tolerance • Child: Health
Logan, Feldner, Galloway, & Huang (2016)	• Physical effort of clinical staff involved in transition children in and out of ride-on car • Physical exertion required for arm’s length supervision for safety • Physical demand required to assist with driving and positioning since car is low to the ground • Increased personnel demand to supervise car play sessions when researcher not present • Child’s health • Possible that cognitive delay contributed to requiring assistance to learn to drive independently • Difficulty in transferring children into appropriate modified ride-on cars to accommodate size, weight, and operational needs of the child’s ventilator	• Caregiver: Physical • Caregiver: Physical • Caregiver: Physical • Caregiver: Physical • Child: Health • Child: Abilities • Device
Ross et al. (2017)	• Steering was difficult • Refusal of child • Adult supervision required for steering, transferring child in and out of device, avoiding obstacles • Disinterest, fatigue, and request to get out of device	• Child: Ability • Child: Tolerance • Caregiver: Physical • Child: Tolerance
Feldner, 2018	• Lack of space in classroom • Noisy/disruptive in classroom • Expensive as out-of-pocket item • Large size • Family/therapist priority for child to walk as primary mode of mobility • Process of choosing a ride-on car • Community-based, decentralized process of modified ride-on car provision was frustrating at times	• Environmental • Device • Device • Device • Caregiver: Motivation • Caregiver: Motivation • Caregiver: Motivation
Feldner, Logan, Galloway (2018)	• Difficult to use on playground woodchips	• Environmental
Huang, Chen, Huang, Shih, Hsieh, & Chen (2018)	• Child’s health (sickness) • Family vacation	• Child: Health • Caregiver: Time
Logan, Hospodar, Feldner, Huang, & Galloway (2018)	• Lack of space • Lack of time	• Environmental • Caregiver: Time
Logan, Catena, Sabet, Hospodar, Yohn, Govindan, & Galloway, 2019	• Weather • Lack of space • Lack of time • Decreased motivation for their child to drive once competence in switch activation was demonstrated	• Environmental • Environmental • Caregiver: Time • Caregiver: Motivation