Exploring the functional impact of adaptive seating on the lives of individual children and their families: a collective case study.
This study examined parent-reported change in the functional performance of four school-aged children with wheeled mobility needs who had used a new adaptive seating system for 6 weeks.



The collective case study involved four mothers whose children, ages 6-9 years, received a new adaptive seating system for a manual wheelchair or stroller. Mothers completed the Family Impact of Assistive Technology Scale for Adaptive Seating (FIATS-AS) at the time their child received a new seating system, and then after 6 weeks of daily use. Other questionnaires, health records, and semi-structured interviews provided additional data about the seating interventions and their functional effects on individual children and their families.



The FIATS-AS detected overall functional gain in one family, and both gains and losses in 2-7 dimensions for all families. Functional status and change scores showed consistency with measures of seating intervention satisfaction, global functional change, and home participation. Interview themes also suggested consistency with change scores, but provided a deeper understanding of important factors that influenced adaptive seating outcomes.



This study supports the need to explore further the complexity, temporality and meaningfulness of adaptive seating outcomes in individual children and their families. Implications for Rehabilitation Assistive technology practitioners need to adopt practical measurement strategies that consider the complexity, temporality, and meaningfulness of outcomes to make evidence-informed decisions about how to improve adaptive seating services and interventions. Health measurement scales that measure adaptive seating outcomes for service applications must have adequate levels of reliability and validity, as well as demonstrate responsive to important change over time for individual children and their families. Needs-specific measurement scales provide a promising avenue for understanding functional outcomes for individual children and youth who use adaptive seating systems.
a Department of Occupational Science and Occupational Therapy , University of Toronto , Toronto , Ontario , Canada.
Carly D
CD
Stier
a Department of Occupational Science and Occupational Therapy , University of Toronto , Toronto , Ontario , Canada.
Ivan B
IB
Chieu
b Holland Bloorview Kids Rehabilitation Hospital , Toronto , Ontario , Canada.
Lori
L
Howell
a Department of Occupational Science and Occupational Therapy , University of Toronto , Toronto , Ontario , Canada.|b Holland Bloorview Kids Rehabilitation Hospital , Toronto , Ontario , Canada.|c Bloorview Research Institute , Toronto , Ontario , Canada.
Stephen E
SE
Ryan
D002547:Cerebral Palsy / Q000534:rehabilitation*; D002648:Child; D004185:Disability Evaluation; D019988:Children with Disabilities / Q000534:rehabilitation*; D004867:Equipment Design; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D007407:Interviews as Topic; D008297:Male; D009035:Mothers / Q000523:psychology*; D011187:Posture; D015203:Reproducibility of Results; D014910:Wheelchairs
Assistive technology; outcomes; postural support; technology assessment