Driving to Learn. The process of growing consciousness of tool use - a grounded theory of de-plateauing

University dissertation from Lund University, Faculty of Medicine, Department of Health Sciences, Division of Occupational Therapy and Gerontology

Abstract: The Driving to Learn project explored possible achievements of training people with cognitive disabilities in a joystick-operated powered wheelchair utilizing the grounded theory approach. Theoretical sampling led the concomitant collection and analysis of data. During a period of 12 years, 45 participants with profound cognitive disabilities, aged 12 months to 52 years, were engaged in the project. Typically developed infants and participants with less degree of cognitive disabilities formed two reference groups. Data sources were video-recordings, field notes, interviews and information from medical records. Constant comparative analyses led the emergence of an eight-phase process of growing consciousness of tool-use, training strategies, a tool for assessment of joystick-use and identification of factors influencing the outcome of the training. The tool was tested for inter-rater reliability and used to evaluate the outcome of the 45 participants. Growing consciousness was by amplification conceptualised to a grounded theory of de-plateauing. Attainment of de-plateauing was reliant on the interdependent properties motivation, endurance, responsiveness, adaptability and access to resources with high predictability and usability. De-plateauing was defined as a positional change exceeding preconceived expectations. I argue that the grounded theory of de-plateauing might be useful in many more fields, where the phenomenon of plateauing attitudes is present either explicitly or implicitly.

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