Adaptive seating systems for children with complex disabilities: a reflection on the evidence and description of current research

Children who have severe disabilities (equivalent to children with cerebral palsy levels 4 and 5 of the Gross Motor Function Classification System) use adaptive or special seating systems in order to enhance their function in a seated position, as well as to help prevent positional deformity from developing. There continues to be very little research evidence to support the use of such adaptive seating. This presentation will review the levels of evidence for different seating interventions for this group of children, report two recent research projects investigating the effectiveness of the adaptive seating devices on health, activity and participation of the participants, and suggest strategies for further investigations into assessment, provision and review of these systems using the International Classification of Functioning, Disability & Health (ICF, WHO 2001). Controversy continues to exist about the most effective seating position for children with complex needs. Furthermore, the purpose of the seating position remains undefined - Comfort? Function? Postural management? Ease of care? Or a combination of these and other factors. We remain at a loss to effectively measure outcomes on how successful adaptive seating is. However, successfully documenting outcomes depends on having appropriate measurement instruments and methodologies available. This presentation will present some proposed novel outcome measures, recently piloted, and found to show consistent results. The interpretation and synthesis of the results will also be presented