Adaptive Seating

The goals of adaptive seating include:

• Improved function including independent mobility, enhanced feeding ability, upper extremity function, and ability to do activities of daily living;
• Prevent progression of deformity;
• Improved comfort and alleviate pain;
• Facilitate transportation; and
• Enhance quality of life.

In the optimal setting, evaluation for adaptive seating is done by a multidisciplinary team experienced in wheelchair or other evaluations. Roles of the primary clinician might include:

• Referrals to a therapist or seating team for evaluations to determine the optimal type of adaptive seating for any of the following needs:
  • Wheelchairs;
  • Adapted seats for infants to allow independent sitting (6-9 months of age);
  • Adapted stroller (if a standard stroller doesn't provide adequate support);
  • Special car seats (if standard car seats/ seat belt do not provide adequate support);
  • Bathing systems; and
  • Other mobility device (scooters, walkers).
• Monitoring problems with the adaptive equipment (e.g., broken parts, outgrown, poor positioning or support, unable to transport or use in certain environments etc.) and referring back to the team for repairs, growth adjustments, and upgrades.
• In some cases, advocacy by the clinician to help secure funding for adaptive seating.

Some children may require more than one wheelchair (e.g., a power chair and a manual chair). However, getting third party payers or Medicaid to fund a second wheelchair can be difficult. It is very important to get the manual wheelchair first. Once the patient has a power chair, funding for a manual wheelchair will not be available. The Rehabilitation Central website (Select 'Articles,' then select 'Funding.') gives an excellent example of an advocacy letter to request third party funding. They also give a sample letter for requesting funding for a wheelchair tray.