Early Intervention Seating in Pediatric Rehab Strollers
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1 Early Intervention Seating in Pediatric Rehab Strollers Eli Anselmi Product and Education Specialist Convaid University, May 15, 2014 NuMotion Clinical Education
2 Objectives Attendee will be able to describe 3 primary clinical objectives in Early Intervention Attendee will be able to describe 3 primary objectives in Early Intervention seating goals Attendee will be able to describe seating alternatives in the pediatric market Attendee will be able to describe 3 challenges in early intervention seating
3 Early Intervention Definition: Early Intervention is defined by Stephens & Tauber (2001) in two parts, early refers to the most critical period of a child s development between birth and three years of age. Intervention refers to the program implementation designed to maintain or enhance the child s development in natural environments and as a member of a family.
4 What are the goals of Therapeutic Seating To enable the atypical child with minimal to profound physical development to parallel as closely as possible normal developmental patterns and milestones, with early intervention and the right equipment.
5 When should we be thinking about seating & positioning? Child should be allowed to meet recognized milestones, even if modified Should be encouraged to develop stable sitting at an appropriate age Children normally achieve momentary, unstable sitting between 3 and 7 months We should provide our children with effective support in sitting at equivalent age
6 Developmental Milestones Can hold head up at 2 months At 4 months, Pushes down on legs when feet are on a hard surface. Can hold a toy and shake it and swing at dangling toys At 6 months, looks around environment, near objects. Rolls over in both directions Children normally achieve momentary, unstable sitting when placed in position between 3 and 7 months
7 Developmental Milestones At 9 months, sits without support Pulls to stand and crawls Uses fingers to point at things Makes a lot of sounds Understands No Average child walks between ages 8 15 months
8 Developmental Milestones At 12 months, explores things by shaking, banging, throwing Lets go of things without help Looks at right things when named Gets to standing without help At 18 months, knows ordinary things Points to body parts Scribbles Pulls toys while walking
9 Why Seating and Positioning? We should provide our children with effective support in sitting and mobility at equivalent age Stable platform allows exploration of their environment, leading to the development of visual and sensory perception Allows physical and mental development of the child with needs as closely as possible to an able child
10 Clinical Objectives for Early Intervention Prevent development of secondary problems and further developmental delay which may otherwise result in difficulties in feeding or breathing Prevent inappropriate movements patterns that interfere with normal development Prevent development of deformities Assist in development and/or increase of fine motor skills
11 Clinical Objectives for Early Intervention Facilitate proper development of sensory and visual motor control Facilitate development of upper body and head control Facilitate development of self help, learning and behavior skills Increased interaction between parents and siblings
12 Wheelchair vs. Stroller Perceptions Frame Growth: Generally speaking, wheelchairs provide more growth than rehab strollers Frame Adjustment: Generally speaking, wheelchairs provide more adjustment, ie recline, tilt Fixed tilt: Many strollers have a fixed tilt in space, providing significant fixed posterior tilt.
13 Wheelchair vs. Stroller Perceptions Seating: Generally speaking, wheelchairs provide more aggressive seating. Strollers less aggressive and promote Kyphotic posture Age appropriateness: Parent s acceptance in early intervention vs. older child. Independent Propulsion: Wheelchair provide options when appropriate.
14 Strollers and E.I. Perception: Poor Sitting Poor pelvic positioning contributes to upper body unbalance Contractures of lower extremities - causing pain and displacement Contractures of upper extremities impacting range of motion and limiting function Poor head control impacting field of vision, respiratory, feeding
15 Poor stroller posture Stroller
16 Adaptive Strollers and E.I. By age 5-7 months, child should benefit from augmentative mobility Support of the Pelvis, Trunk and Head Use position to develop head control and tracking If you wait past 8 months, lost opportunity to develop tracking and eyes working together Proper therapeutic seating helps maximize cognitive and language development
17 Stroller A kid in a stroller is just another kid! A kid in a wheelchair is disabled
18 Strollers and E.I. Foundation in seating: Proximal stability equals distal function In our case: Pelvic stability equals optimal use of extremities Convaid s proprietary Self-Tensioning Seating System provides therapeutic pelvic positioning in a lightweight umbrella-style folding wheelchair
19 Strollers and E.I. Parents: Acceptance. Personal and Peers Convenience. Use Age appropriateness Transport Therapist: Minimize effect of abnormal tone Increase functional skills Assist in development of motor, cognitive and visual control
20 Strollers and E.I. Vendors: Meet clinical goals Low maintenance, high quality Growth. 4-5 years built in growth Flexibility Dependability
21 Therapeutic Seating EZ Rider Cruiser
22 Stroller Strollers and wheelchairs are blending together: Many options now available on strollers: Recline, Tilt, Seating, Positioning Options Many tilt in space wheelchairs have adopted stroller features such as 12 rear wheels and stroller handles Wide range of frame configurations and sizes Simple in design, complex in features - customizable Can be used as primary chair Growth build in! Easier to fold and blend with family s needs Strollers are available that are very durable and have a high quality
23 Adaptive Strollers - The Advantages Modern Adaptive Strollers are able to meet the clinical and therapeutic needs of patients with complex needs Benefits of a conventional wheelchair without the added weight or complexity Lightweight (under 40 lbs) Easy to transport Facilitate MRADL without hindrance
24 Adaptive Strollers - The Advantages Modern Adaptive Strollers offer the ability to accommodate Life Support equipment options. Offer the adaptability of conventional wheelchairs in a lighter, smaller package
25 Strollers and E.I. Proper use of application or a rehabilitation stroller as early as possible, will reduce complication and difficulties down the road Is child able to self propel? If not, stroller is appropriate choice Provide the least restrictive proximal physical support that facilitates function and communication
26 Strollers and E.I. Consistent therapeutic seating can normalize tone Increased socialization through optimal posture Enhanced respiratory/ pulmonary function Increases visual awareness and contact with parents and family
27 Strollers and E.I. Meet the clinical objectives Meet the Parent/caregiver needs Meet Provider s needs
28 CONTACT INFORMATION For more information please visit our website at: Speaker Contact: Eli Anselmi Convaid Numotion Clinical Education Course transcripts and additional copies of certificates of completion are available upon written request: 5501 Wilshire Blvd NE Ste C ABQ, NM
29 888-Convaid Convaidwheelchairs Convaid 2830 California Street, Torrance, CA USA
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