Page 78 - Handbook of Electronic Assistive Technology

Chapter 3 • Functional Posture 65

In infants and young children, the development of postural control is closely intertwined
with the development of movement and consequent motor skill acquisition. It is therefore
important to have an understanding of how postural control develops when assessing and
determining the optimum postural management equipment. In the past, motor develop-
ment was regarded as an innate, maturational process; a child would learn to sit when they
were ready (Peiper, 1963). However, nowadays it is accepted that experience plays an impor-
tant role although it is debated as to what extent. Theoretical frameworks for motor develop-
ment such as dynamic systems theory (Thelen, 1995) and neuronal group selection theory
(Hadders-Algra, 2000) propose more complex systems and influences on motor develop-
ment than genetics alone. Postural management solutions therefore need to be relevant to
the child’s developmental stage and carefully consider not only how they will impact and
improve the child’s posture, but their present function and future development of function.

Assessment of Postural Ability for Functional

Positioning Solutions

This section will focus on the assessment of a child’s or adult’s postural ability with the
aim of providing functional seating equipment (Fig. 3-9). While seating is a functional pos-
ture for many activities during the day, other positions such as standing or lying may also
require assessment to promote maximum function. For some individuals, they may use
alternative equipment such as a standing frame for certain activities. For example, a child
may need to use their augmentative assistive communication equipment effectively when
in a standing position. The assessment process for other functional positions should be
largely similar and follow this systematic, holistic approach to equipment provision.
When a young person or adult is referred for Electronic Assistive Technologies (EAT),
what do you need to consider regarding their posture in sitting, standing or lying? It will be
helpful to refer back to the ICF framework to ensure that you consider this piece of equip-
ment in terms of how it might benefit or impact on all components of the ICF; their body
structure and function, their activity and participation. Consider the environmental or per-
sonal factors that may affect the use of this equipment. You will already have asked the ‘big-
ger picture’ questions around how this equipment will fit into their life, what the purpose
of this equipment will be and importantly what the person’s priorities are. For a person to
be able to use any equipment effectively, they will need to be positioned optimally for both

Gathering your Iden fica on of Recommenda ons for
informa on problems and needs prescrip on

Constraints

FIGURE 3-9 Assessment process diagram�