A Good Foundation

1. A Good Foundation Adaptive Positioning and Equipment Prekindergarten Program for Children with Disabilities Miami-Dade County Public Schools

2. Adaptive Positioning and Equipment • Used to enhance function • Allows positions child is unable to sustain independently • Should match environment and activity • Should ALWAYS be considered in collaboration with and prescribed by a registered physical and/or occupational therapist

3. Adaptive Positioning and Equipment • Evaluate child and prescribe positions and equipment • Adjust equipment for growth over time • Train school team on body mechanics and proper use of equipment Role of Therapist Role of teacher • Implement use of adaptive equipment and positioning throughout ACTIVE learning • Monitor child’s function and status • Monitor for growth • Consult with therapist(s) regularly

4. What is “Good” Positioning? • Child can see activity/people • Child is supported but can move freely • Hips at approx. 90˚ angle (sitting) or slightly less (forward) • Feet supported flat on a surface (sitting and standing) • Tray or work surface at elbow height or slightly higher • For more info…consult with a therapist

5. Sitting

6. Adapted chair FUNCTION: FEATURES: • Back and side support • Footplate with optional sandals • Optional wheel base • Tray • Activity surface at table level • Cafeteria • Supported sitting for children with adequate trunk/head control

7. Seating Systems FEATURES: FUNCTION: • Variety of sizes • Many support options • Wheel base/tray • Tilt in space • Raise and lower in space • Recline while keeping hip flexion angle • Activity chair for children who need maximum support • Inclusion in table activities

8. Bolster Chair • Bolster to separate legs for children with increased tone and poor trunk control • Tray, wheels

9. Adjustable Corner Chair FUNCTION: FEATURES: • Promotes symmetrical posture and midline control of head and arms • Reduces retraction (pulling back) of arms/shoulders for children with poor trunk control and stabilization against gravity • 3-way angled backrest • Adjustable height and seat depth • Tray/wheels

10. Educube Chair FUNCTION: FEATURES: • Side support • Sense of boundary or personal space • For individual or group activities • Shallow or deep seat • Tray

11. Adapted Educube Chair FEATURES: • Tray with bumpers • Abductor • Support straps • Crayon holder

12. Adapted Educube Chair FEATURES: • PVC Tray Stand • Bicycle seat

13. TumbleForms Feeder Seat FUNCTION: FEATURES: • Comfortable chair for children with poor head control • Floor level activities • Precautions for insufficient back/hip support • Adjustable recline • Soft, contoured surface • Separate tray ($$)

14. Homemade Feeder Seat Tray

15. Floor sitter FUNCTION: FEATURES: • Floor level activities • Precautions for children with less than 90˚ hip flexion • Hip/chest support • Tray

16. Bench FUNCTION: FEATURES: • Sitting level activities • Develops trunk control • Adult can sit with child • Can be used as “tray” for floor sitting • Adjustable height and angle

17. Standing

18. Supine Stander/Easy Stander FUNCTION: FEATURES: • Weight bearing • Upright positioning for children with difficulty with head control • Activity surface in standing • Chest, hip, knee, foot straps • Hip guides and other supports • Adjustable angle of incline • Goes from sit to stand easily

19. Prone Stander FUNCTION: FEATURES: • Weight bearing • Upright positioning for children with some head control • Activity surface in standing • Back, hip, and foot straps • Hip/trunk guides and other supports • Adjustable angle of incline

20. Tot Stander FUNCTION: FEATURES: • Weight bearing • Upright positioning for children with good head control and some trunk control • Get closer to activity • Torso, hip, and foot straps • Knee guides

21. Mobility

22. Dynamic Stander FUNCTION: FEATURES: • Mobility for children who can wheel themselves • Activity surface for dynamic activities • Classroom traffic patterns must be considered • Torso, hip, and foot straps • Knee guides • Large wheels with grab bar • Tray

23. Adapted Dynamic Stander

24. Gait Trainer FUNCTION: FEATURES: • Mobility for children who can take steps • Classroom traffic patterns must be considered • Various models offer different degrees of support

25. Walker FUNCTION: FEATURES: • Mobility for children who can support upper body and take steps • Classroom traffic patterns must be considered • Can be used anterior or posterior • Wheeled option

26. Floor Positioning

27. Prone Wedge FUNCTION: FEATURES: • Floor level play • Develops head control and weight bearing on arms • Precaution to avoid frustration – make it functional • Available in different heights (elbow to shoulder) • Strap option for help with hip extension Hint: For smaller children, a rolled up towel can serve the same function!

28. Sidelying BENEFITS: • Floor level play • Incline option • Promotes midline orientation for children with poor control against gravity • Relaxed position benefits breathing and digestion

29. Tadpole Positioning System FUNCTION: FEATURES: • Floor level play in variety of positions: prone, supine, sitting and sidelying • “Grasshopper” is available for older, larger children • Soft vinyl modular pieces that can be put together (velcro) in different configurations

30. Recreation/Daily Living

31. Adapted Tricycles FUNCTION: FEATURES: • Supportive back • Lap/chest belts • Footplates, straps • Adapted handle bars • Adapted pedals • Mobility on playground • Different models for different strengths and needs

32. Adapted Ride-On Toys

33. Adapted Potty Seats FUNCTION: FEATURES: • Sitting support on toilet • Different models offer different levels of support