1. Seating and Positioning for Low Incidence Populations in the School Setting June 30, 2009

2. Objectives Review optimal and functional seating positions Identify factors that influence posture and positioning Review types of mobility, positioning, and seating equipment

3. Objectives Explore purposes of positioning/seating equipment Review case study of child using seating/positioning equipment

4. Optimal Seating Position Head/Neck Trunk Lower Extremities –Knees 90-105 –Ankles 90 Upper Extremities –Shoulder flex 30 –Elbow flex 60

5. Factors That Influence Posture Abnormal muscle tone Joint deformity Persistence of primitive reflexes Range of motion limitations

6. Mobility Equipment and Seating Systems Mobility Manual wheelchair Electric wheelchair Scooter Cane Crutches Walker Seating Systems Cushions Custom fitted systems Tilt or recline features Accessories like lateral supports, foot supports, trays

7. Example of Seating System

8. Example of Positioning System for Standing

9. How to Achieve Functional Position for Task Performance Provide a stable surface with adequate trunk support to allow upper extremity function Reduce extraneous movement Decrease influence of reflex patterns Decrease tonal influences Increase comfort Maintain alignment to prevent deformity

10. Case Study - Gianni 3 years old Normal Cognitive Development Congenital Muscular Dystrophy Decreased Muscle Tone Decreased Active Range of Motion Against Gravity Respiratory and Feeding Issues

11. Components of Seating System to Maximize Function High Back Lateral Trunk Supports Hip Guides Foot Plate Tray

12. Additional Support Needed for Stability

13. Improved Upper Extremity Function for Completion of Daily Living Tasks

14. In Conclusion Mobility aids can contribute to improved quality of life by enabling a student to move with greater independence and safety in the school environment. Seating and positioning equipment provide a student with stability, and allow a student to function at the highest level possible by facilitating improved control of head, arms, and hands.