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Difference Between Pediatric and Adult Seating

Michelle Lange, OTR/L, ABDA, ATP/SMS

September 1, 2023

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Question

What is the difference between pediatric and adult seating? 

Answer

There are several factors to consider when choosing a seating system for children with mobility challenges. In the past, most seating systems and mobility bases were scaled-down versions of adult systems, but now there are options designed specifically for children.

The choice of seating is closely related to the mobility base being used. For very young children, adaptive strollers are commonly used, and the seating available for them may differ from what's available in manual and power wheelchairs. Therefore, the seating options might be limited by the mobility base being used.

Size is an important consideration, as children range from very small (neonatal intensive care unit graduates) to teenagers as tall and heavy as adults. Seating systems need to accommodate this wide range of sizes, from newborns requiring medical equipment support to teenagers who are larger than many adults.

Another crucial factor is the available growth in the seating system before it needs replacement. Some off-the-shelf cushions might not offer any growth options, but working with a complex rehab supplier can help incorporate growth options for the client. Depending on the child's growth rate, a seating system should ideally accommodate growth for about one to three years.

Contrary to a common misconception, there is no fixed time frame for replacing equipment. If a child outgrows the available growth in the seating system or if the system no longer provides adequate postural support, it should be replaced. The mobility base usually outlasts the seating system, and a child may go through one or two seating replacements while continuing to use the same base.

Flexibility is essential to accommodate changes in the child's medical condition. Progressive conditions like spinal muscular atrophy or metabolic conditions may require adjustments in seating support and shape over time. Orthopedic surgeries, sudden weight gain, and tone management interventions can also impact seating requirements. Seating systems must address orthopedic changes, including spinal curvature development due to growth spurts, muscle imbalance, and muscle weakness. The shape of the trunk can be affected, and the seating system should address these changes.

Furthermore, the environment in which the child will use the seating system should be considered. As they grow, their mobility needs may change, ranging from home-based use to daycare, preschool, elementary school, and community trips. The seating system should be adaptable to various environments and support the child's function and comfort during extended periods of sitting.

The type of mobility base, whether dependent or independent, also influences the choice of seating. Dependent mobility bases include adaptive strollers and manual wheelchairs, while independent mobility bases include manual and power wheelchairs. Depending on funding sources and the child's needs, they may have more than one type of base for different purposes.

In summary, what do we need to keep in mind? We need to keep the seating system flexible to accommodate physical growth, developmental and medical changes and respect the need of individuals in their various environments. Pediatric seating is also dependent upon the mobility base.


michelle lange

Michelle Lange, OTR/L, ABDA, ATP/SMS

Michelle Lange is an occupational therapist with over 35 years of experience and has been in private practice, Access to Independence, for over 15 years. She is a well-respected lecturer, both nationally and internationally, and has authored numerous texts, chapters, and articles. She is the co-editor of Seating and Wheeled Mobility: a clinical resource guide. She is the former NRRTS Continuing Education Curriculum Coordinator and Clinical Editor of NRRTS Directions magazine. Michelle is a RESNA Fellow and member of the Clinician Task Force. Michelle is a RESNA certified ATP and SMS.


Related Courses

Supporting Respiratory Equipment on Wheelchair Bases
Presented by Michelle Lange, OTR/L, ABDA, ATP/SMS
Recorded Webinar

Presenter

Michelle Lange, OTR/L, ABDA, ATP/SMS
Course: #4894Level: Introductory1 Hour
Many people who require respiratory equipment, such as oxygen and ventilators, use a wheeled mobility base. This course will address how to support respiratory equipment on an adaptive stroller, manual wheelchair, or power wheelchair safely and as a part of a team.

Wheelchair Seating For The Pediatric Population
Presented by Michelle Lange, OTR/L, ABDA, ATP/SMS
Recorded Webinar

Presenter

Michelle Lange, OTR/L, ABDA, ATP/SMS
Course: #4669Level: Advanced2 Hours
  'Material explained well and thoroughly, pictures of seating equipment and clients were very helpful'   Read Reviews
Pediatric seating and mobility equipment are not simply smaller than equipment designed for adults. This course will present the importance of pediatric positioning, clinical considerations, how to determine if a child is positioned adequately, as well as alternative positioning. A detailed case study will pull all the information together in a practical way.

Pediatric Power Wheelchair Assessment And Training
Presented by Michelle Lange, OTR/L, ABDA, ATP/SMS
Recorded Webinar

Presenter

Michelle Lange, OTR/L, ABDA, ATP/SMS
Course: #4967Level: Advanced3 Hours
  'I learned a lot'   Read Reviews
Pediatric power wheelchair assessment, including determining and developing cognitive and motor readiness, team evaluation, and mobility training as a part of the school day, will be comprehensively addressed in this course. Assessment, skill development, and skill training are critical to achieve functional and independent use of power mobility.

Secondary Supports: It’s All In The Angles!
Presented by Michelle Lange, OTR/L, ABDA, ATP/SMS
Recorded Webinar

Presenter

Michelle Lange, OTR/L, ABDA, ATP/SMS
Course: #4808Level: Intermediate1 Hour
  'I enjoyed the pace and overall breakdown of the main objects (i'   Read Reviews
Wheelchair seating systems often include secondary supports including pelvic belts, anterior trunk supports, and ankle straps. This course will explore secondary supports and appropriate clinical applications, as well as what to do when secondary supports are required, and team members have restraint concerns. Case studies will be included.

Matching Products to Seating Needs
Presented by Michelle Lange, OTR/L, ABDA, ATP/SMS
Recorded Webinar

Presenter

Michelle Lange, OTR/L, ABDA, ATP/SMS
Course: #4099Level: Introductory1 Hour
  'excellent slides'   Read Reviews
Once the wheelchair seating assessment has been completed and seating interventions considered, it is time to match specific client needs to product interventions. This course presents various categories of seating systems. Seating systems, whether linear, contoured, or molded, are comprised of primary support surfaces, secondary support components, and materials. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT/PTA.

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