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.
