The International Classification of Functioning, Disability and Health provides a Model for Adaptive Seating Interventions for Children with Cerebral Palsy

Abstract

Children with severe types of cerebral palsy use adaptive seating systems to encourage function and assist in delaying the development of deformity. These systems are often assessed for and provided by occupational therapists. However, there has been no unifying policy or theoretical basis on which these systems are provided and research evidence is lacking, with studies tending to be small and non-controlled. The International Classification of Functioning, Disability and Health (World Health Organisation 2001a,b) aims to establish a common language for clinical practice as well as research, while bringing together the opposing social and medical models of health care delivery. This paper suggests that the ICF model is an ideal theoretical basis for adaptive seating system assessment and provision, given that these systems often conflict between the medical model of reducing or delaying impairment of body functions and structures and the social model of children and families accessing life and environmental situations through mobility and seating equipment. The paper considers all the domains of the ICF with regard to the current literature. It concludes that using the model in the context of providing adaptive seating gives occupational therapists both a powerful tool for communicating with children and families as well as managers and a basis for evaluating practice.

Postural Control Influence on Upper Extremity Function among Children with Cerebral Palsy: A Literature Review

“…Postural control has an important influence on sitting (Costigan, & Light 2010;Rodby-bousquet & Hägglund 2010) as described in three previous studies (Harbourne et al 2010;Kyvelidou 2011;McDonald et al 2004). Firstly, it promotes a functional sitting posture (McDonald et al 2004) to accomplish functional tasks (Grant 1999;Harbourne et al 2010;Ju et al 2012;Kyvelidou 2011).…”

“…Inadequate force production (Bigongiari et al 2011) and individual demands and environmental context (Ju et al 2010) to maintain postural control may lead to abnormal posture (Batra et al 2011;Chung et al 2008), cause functional difficulties in eye-hand coordination (Batra et al 2011;Kyvelidou 2011;McDonald et al 2004), as well as motor development deficits (Batra et al 2011;Brogren et al 2001). …”

“…Firstly, it promotes a functional sitting posture (McDonald et al 2004) to accomplish functional tasks (Grant 1999;Harbourne et al 2010;Ju et al 2012;Kyvelidou 2011). …”

“…Parents also need to be taught and supported to position their child appropriately (Pountney & Green 2004). Adaptive seating (Grant 1999;McDonald et al 2004;Rahman et al 2012) and seat surface inclination (Arakaki et al 2012) are the example of support for CWCP proper positioning.…”

Assistive devices for children with functional impairments: impact on child and caregiver function

“…[1][2][3] Unless the development of independence is well supported, children with functional impairments may be at risk of developing learned helplessness. 1,4 Clinicians attempt to overcome these limitations through interventions that focus on remediation, adaptation, and/or compensation. Remediation techniques target the problem at the level of 'impairments', in an effort to promote 'normal' functioning.…”