Paediatric Seating and the Benefits of 24 Hour Postural Support

What is ‘good sitting’ for a Child?

By approximately 8-10 months old, a developing infant demonstrates good sitting posture;

• The Pelvis and Spine are aligned
• The Head is balanced and aligned above the hips
• Weight is taken evenly through both hips (ischial tuberosities)
• The Hands are free to interact with their environment
  
  

When a child has developed this posture they are able to reach for toys which are outside their mid line, retrieve the toy to midline without falling over. When the pelvis and trunk are supported this allows the child to freely use their hands. Stability is essential for function and in encouraging development and play.

What is Incorrect Posture in Children?

Incorrect Posture refers to an abnormal body state in which the body cannot maintain a stable state and the normal function of tissues in an upright state.1

Children with neurological impairment, altered muscle tone or orthopaedic conditions may have reduced ability to hold an upright position against gravity without assistance. This affects their functional ability and can lead to a deterioration in their posture.

How can Specialised Seating Help?

Specialised Seating and adaptive equipment help to improve the quality of life by stabilising the pelvis and trunk.2

Tilt in Space can prevent sliding out of the chair, improve functional ability and assist in the ability to relax. Tilt in Space can also improve trunk and head control when the child is tired.3

24-Hour Postural Care

Provision of 24-hour postural care reduces health risks and improves quality of life for individuals. It can also benefit those caring for the person.4 Children may require access to a range of equipment and positioning techniques, including adaptive seating and equipment to support lying positions.

Sleep Systems

Products that support posture while children are in lying positions and during sleeping can benefit them, through lying straighter, sleeping better and showing less pain.

Wheelchairs

In many cases, children and their families use their wheelchair to primarily enable their mobility and encourage independence. Often wheelchairs are used to transport to school or the day centre and for getting around outdoors. Sometimes postural support is provided in the form of moulded seating.

Functional / Working Chairs

Working chairs aim to establish an ideal sitting position for functional activities for example when at school. Postural support in functional and working chairs is important to help the child or young person achieve their goals.

Comfort Seating

When it's time to relax, comfort seating provides postural support and pressure management to complement the use of the wheelchair and functional chairs. This comfort seating should be designed to give the child an alternative to their wheelchair without compromising the therapeutic goals of seating. We have observed when children want to get a break from their wheelchair, without a comfort chair they may sit or lie on a sofa, on the floor or on a beanbag. These rarely provide the appropriate support and negatively affect the posture which has been carefully managed throughout the rest of the day.

Seating Matters Kids Chairs™ Comfort Seating

Seating Matters Kids Chairs™ make sitting comfortable for children while helping manage postural and pressure management needs and can assist in encouraging development and play. Children’s Occupation Therapists have told us that with children’s seating you don't ever get a final solution due to the child's growth and condition development. “As our feet grow, we get new shoes to fit... Paediatric chairs should allow us to do the same for our children's comfort.”

Just like Seating Matters Adult Chairs, Seating Matters Kids Chairs™ offer a range of features and accessories that offer multiple benefits.

Adjustability is an integral feature to accommodate growing kids, allowing them to adapt and retain the same chair. Adjustable back angle recline in seating allows for accommodating children with limited hip flexion and when used in combination with tilt in space it can prevent sliding from the chair.

Tilt in Space is a significant feature which can be used to improve children’s posture, head control and redistribute pressure. This can also be converted to include forward tilt for self-transferring situations.

Optional lateral supports and supportive pillows can help to maintain or improve midline posture and facilitate function and engagement in activities of daily living such as eating and communicating and playing. The correct use of these features and accessories can also reduce common problems such as falling to the side when seated.

Kidz to Adultz Exhibition Scotland

Martina Tierney, Occupational Therapist and Clinical Director will present Paediatric Therapeutic Seating & its Benefits at the Kidz to Adultz Scotland exhibition in Edinburgh on Thursday 8th September 2022. Seating Matters will exhibit the Kids Phoenix at Stand E22.

For further information visit: https://www.kidzexhibitions.co.uk/kidz-scotland/

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Seating Matters offers a complimentary, no obligation Seating Assessment. The needs of the child will be identified to help inform the type of chair they may require to meet their needs both now and in the future.

For more information email contact@seatingmatters.com or call 020 3982 2900.

References:

1. Dolphens, M., Cagnie, B., Coorevits, P., Vanderstraeten, G., Cardon, G., Dʼhooge, R., and Danneels, L. (2012). Sagittal standing posture and its association with spinal pain: a school-based epidemiological study of 1196 Flemish adolescents before age at peak height velocity. Spine 37, 1657.

2. Strobl, W.M. (2013). Seating. Journal of Children’s Orthopaedics, 7(5), 395-399.

3. Angelo. J. (1993) Using Single-Subject Design in Clinical Decision Making. The Effects of Tilt-in-Space on Head Control for a Child with Cerebral Palsy. Assistive Technology, 5(1) 46-49.

4. Postural care and people with learning disabilities: guidance. (2018). https://www.gov.uk/government/...;