Positioning and Mobility By Andrea Bilello, M.Ed.

What are seating, positioning, and mobility devices?  They are products that support or improve mobility and the equipment used to customize mobility alternatives. Mobility devices aid movement in space as well as movement over distance.  Seating and positioning devices improve body stability, provide trunk and head support, and reduce pressure on skin.

Physical Disabilities  Refers to a group of students who have different characteristics, such as severe orthopedic impairment, that adversely impact their education performance and impact their ability to access the general education curriculum.  Students with physical disabilities that participate in their regular education classroom often require related service to access their physical environment, the curriculum, and participate in extracurricular activities.

Questions to Consider Regarding Positioning  How will the student be positioned throughout the day?  How will proper positioning help the student participate in the general ed. curriculum?  What is the most useful AT device that will enhance the student’s participation?  What are the best positions for muscle development and alignment?  Will the position support his/her circulatory, digestive, and respiratory functions?  Where will devices be used? Johnston et al. ( 2007) pg. 83

Positioning/Seating Aids  Beanbags  Bolsters  Mobile Standers  Prone Standers  Wedges  Cushions  Chair  Trays and Worktables

Stander

Tumble Form Feeder System-adaptive positioning seats

Resources for AT Devices for Positioning and Seating Disabilitiy Products AT for daily living Varilite Seating and Positioning devices Invacare Comfort-Mate Extra Cushion Cushion for seating PleezeElite Gel Foam Cushion Pressure relieving gel and memory foam cushion SimpIX FT Foam Cushion Another cushion (Johnston et. al, 2007, pg 85)

Positioning  Adjust heights of tables and desks to allow active participation in the general education classroom.  The use of standers which enhance a student’s muscle length and development can allow student to participate in group learning activities.  When positioning students in AT equipment, it is important that their head, neck, and trunk are properly aligned to assist the student in maintaining their posture and muscle tone.

Mobility  Mobility devices should enable students to move as effectively and independently as possible.  Two types of mobility devices are manual and powered devices.  Determine the students PLEP to help determine what is the most appropriate mobility devices needed to access the general ed. curriculum.

Mobility Considerations  Are students who are dependent on positioning/mobility devices changing positions frequently to prevent skin from breakdown?  Does the student have the cognitive and sensory skills to operate the AT device, follow directions, and understand potential environmental dangers?  Is the AT device as unobtrusive as possible to allow the student to interact with their peers?  Is a PT and/or OT part of the IEP team when making decisions about AT for positioning/mobility?  Are IEP teams working collaboratively to support the student use of AT to access their general education curriculum?  Where and how are the AT devices going to be used? (Johnston et al. 2007)

Mobility Devices  Manual wheelchairs and power wheelchairs  Scooters  Canes  Crutches  Walkers  Gate Trainers Gate Trainer

The Busy Bee Pediatric Postural Walker is an adjustable walker designed for children to encourage active postural control during standing and walking. It is a lightweight walker which can be folded up for easy story and transportation. Locks on the back wheels prevent unintented backward movement.

Types of Wheelchairs  Manual wheelchairs  Power wheelchairs  Sports Wheelchairs  Junior Wheelchairs  Racing Wheelchairs

Manual Wheelchair They are made of light weight material. Manual wheelchairs require the student to use both hands to push the wheels to make it move.

Power Wheelchair

Basic Design Considerations for Wheelchairs  Seat  Seatback  Armrests  Controls  Front riggings  Wheels and rear tires  Casters  Handrims  Seatbelts  Parking Locks  Anti-tripping devices  Trays

Other Important Considerations Importance of early intervention services that focus on motor development which includes proper positioning across all environments. Consider how the position/mobility devices can impact peer social interactions. Positioning and mobility devices should promote independence and access to the regular education setting/curriculum.