|THE DREAM||The Reality|
- Understand and apply a developmental perspective to pediatric DME
needs, and be able to explain the differences between children and
adults related to growth, development, and systems of service.
- Be able to troubleshoot a problematic seating and mobility system and
recommend appropriate corrections.
- Be able to prescribe and justify an appropriate seating and mobility
system for a variety of adult and pediatric rehabilitation patients.
- Be aware of the existence of various seating components, ADL and
comunications devices, gadgets, and techniques and their appropriate uses.
- Understand the roles and credentials of other professionals invovled
in equipment provision.
Pam Brown's wheelchair PowerPoint and pix, Vikki Stefans' updated version
Barbara Nemeth-King's talk may include information from these sites on DME vendor certification:
More sites on seating and other Assistive Technology:
A Quia quiz on Rehabilitation Equipment and Technology
- The U of Michigan Seating Service site, with more on team members, LMNs, ATS, etc. (WARNING: Dr. Stefans used to work here - be careful what you ask her about it, or you could be overdosed on Historical Perspective yet again.)
- Learning more at ATIA.org - Check out the links to conferences and webinars!
Welcome to Seating Clinic (Troubleshoot This!)
The earliest Developmental, ADL, and Communication slideshow
Slightly newer DevelADLComm
version, though not by much
Updated 2010 developmental
mobility equipment and
Updated 2010 ADL and communication as a separate show
Diagrams and Outline Notes:
From Pam's original lecture:
Overly Complicated Chart from Dr. Stefans' lecture
("LUPUS" should probably be "MS")
Slightly Less Complicated Chart
Just remember the big three questions:
...and that ONLY group 3 and a few group 2 with movement disorder
need custom molded seating
- Postural control
- Deformity - asymetrical vs symmetrical, correctable vs fixed
- Sensation - consider pressure relief cushions
(group 1 is planar, others contoured.)
Degrees of Postural Control
Mechanisms of Symmetrical Slouch and its correction (usually Group 2):
BY THE WAY - What's wrong with this website and how would you fix it?
- Tippability, center of gravity, center of rotation
- Start at the pelvis and work your way up
- Seat and back angle options
- Extra supports
- Proper use of hip guides, abductor, tray, trunk support, headrest
Some items you should look up if you have not heard of:
- One-arm drive kits
- Power assist add-ons
- Offset hinges
- Crutch holders
- Skirt guards
- Bariatric Equipment
Transportation Safety -
regular and adaptive car seats, other options for tie downs
MEDICAL JUSTIFICATION -
- diagnosis, age, functional status
- not able to walk or extremely limited walking
- has pressure sore or need for pressure relief
- limited hand/arm function
- prevent or slow progression of deformity, provide orthopedic support
- do NOT mention caregiver convenience, socialization outside
the home if affected by "Homebound" regulations...sigh...
ADLs - useful gadgets vs human assistance
- basic: eating, grooming, bathing, dressing, toileting, transfers
- instrumental: cooking, cleaning, laundry
- adaptations for:
- fine motor deficit
- one-handedness- easier than commonly thought
UE vs LE prostheticsLE much more often successful because UE
function requires more detailed sensory feedback
crawlers, floor-sitters, corner chairs, standers
driving, working, relationships
Adaptive Driving basics-
- get permit first
- specialized eval unless cerebral function and upper extremities intact
- medical safety issues - seziure control for 6-12 months depending on state, VOLUNTARY reporting preferred, diabetes and heart disease can pose greater risks
- hand controls - sufficient gross leg movements, fast enough and without looking at feet (check proprioception)
- advanced controls
- add-ons - switch a function from one side to the other
ADA issues and accessibility -
...is there really a disability backlash?
If not, why don't the Paralympics get any decent coverage??
classic book, Sexual Options for Paraplegics and Quadriplegics (SCI
- Who needs a device, and for what?
- academics - IDEA, section 504 - handwriting replacers
- what is Section 508?
- deaf vs Deaf
- low vision, blind
- deaf-blind, blind with decreased tactile sensation - greater
Disability Etiquette and Language
why NONE of our patients are "wheelchair bound" or "suffering
Since my M.D. also stands for Messy Desk, please
use my e-mail!
Write me anytime at:firstname.lastname@example.org