Magazine article The Exceptional Parent

Proper Seating and Positioning

Magazine article The Exceptional Parent

Proper Seating and Positioning

Article excerpt

To participate in the everyday activities of life while using their maximum abilities, children with disabilities must be seated in a comfortable position. Proper seating and positioning allows children to use their bodies and minds to the best of their abilities without worrying about balancing and personal safety.

"A seating system is the center of all other activities," says Elaine Trefler, M.Ed., OTR, an assistant professor in the School of Health and Rehabilitation Sciences at the University of Pittsburgh and expert on seating and positioning. "If a child is well seated and comfortable, the child will be able to participate at his or her optimum."

When to start

Although premature babies have been fitted for positioning equipment, parents are likely to begin the process when their child is about six months old because of the increased need for and use of car seats, highchairs and strollers. This is also about the time when a diagnosis is clear and the child may start to fall behind on motor skill development.

The most important step for ensuring a child is fitted with a proper seating and positioning system is a thorough evaluation and prescription by a qualified team. The team should include physical or occupational therapists, a physician specializing in rehabilitation medicine or orthopedics, a rehabilitation technology supplier and parents.

Other members of the team may include school therapists and classroom teachers if the child is in school, and a rehabilitation engineer if the child has severe disabilities and needs a custom-designed system.

Finding the right team

Not every therapist or health care provider is properly trained to evaluate and prescribe the proper components for seating and positioning.

There is no formal training or testing to accredit health care providers who specialize in seating and positioning. RESNA, an organization of rehabilitation professionals, is developing guidelines that may be used to certify specialists in this area.

Parents need to ask about their team's experience - what seating and positioning equipment have they worked with, how many years have they worked in the seating and positioning field, and what type of conferences and training programs do they attend?

Although some professionals may be offended when asked about their expertise, these questions are important. "Why do we feel comfortable asking the qualifications of the TV repair man but not the people looking after our health?" asks Trefler, adding, "If the professional is not willing to share - or if they become offended - the parent might need to go elsewhere."

A qualified team will make sure the parents are involved with the evaluation and the choice of seating and positioning equipment. Trefler advises parents to ask themselves, "Are they (the parents) just going to a clinic and being told what's right or are they truly being included as one of the team members?"

A qualified evaluation team should: * Ask parents about the child's lifestyle, his or her environment at home and school and overall community involvement. Ideally, the team would be able to observe the child in these different environments. * Use techniques to simulate different positioning options. This can be done with a seating simulator, a device that simulates different systems by changing seat and back angles and positions. Simulators help determine the correct size of the system and its different accessories. …

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