Clinically Speaking: Pediatric Seating & the S-Word: Part 2

There are some common issues with many infant positioning systems.

  • Why are all the footplates too low? What kind of kids are these engineers measuring? Not my kids! I often have to add 3-6" just to reach the bottom of their shoes (Velcro on wooden blocks is a favorite pastime of mine) with braces (if they are in socks, add even more).
  • Manufacturers, please stop making knobs that need three types of tools. I have metric allen wrenches, and I have English allen wrenches. Please don’t make me use both on one chair. Also, don’t make me go to a hardware store and ask for a square allen wrench. They just laugh at me.Well, maybe they were gonna do that anyway. Please, just make the adjustments tool-less.
  • Another pet peeve is that when I try to use many chairs at their smallest configuration, all the knobs jam up against each other and there is no room, so I can’t even use it at that size. Please make all the adjustment knobs accessible while the child is in the chair so I can adjust it with the child in it.
  • I also wish all manufacturers would code individual parts. When I lose a knob, I want to be able to order just the knob, not the whole headrest. It would be great if the parts were on the Web, so I could call up my local DME provider and say, “I need an E7638, please.”
  • One more request. Please keep some parts stocked in the U.S. When you have to get my knob shipped from another continent, it takes so long that I have lost another part by the time it gets here. Maybe you could cross-hatch the knob so it can’t fall off. Steve Scribner from Snug Seat says I’m the only one who keeps losing the long knobs from the Pony seat. Anyone? Please let him know; a bet has been placed on how many of you will contact him. I have provided a chart of some infant devices that can go down to a 9.5" seat depth or width. It is my intention to help therapists, families and providers find new ideas and solutions. I (and Mobility Management) am not endorsing any particular brand. The weight of the device pertains to its weight as a parent would load it into the trunk of a car. WC19 testing refers to standards; ISO refers to the International Standards Organization.

Some funding sources and some of my colleagues are saying no to infant mobility systems that look like “strollers.” They say they need more growth and more postural control. I say Nancy Reagan was wrong; you can’t always “just say no.” Every child, family and situation is unique. When properly applied, these infant positioning systems are not only appropriate, but medically necessary. For very young and very small (dwarfism, osteogenesis imperfecta, etc.) children, these systems support a child’s unique anatomy and help them learn, see and grow. Choose wisely and make sure you match your mat evaluation to the product parameters. Go out there and make a difference.

View Stroller Comparison Chart (PDF)

This article originally appeared in the September 2009 issue of Mobility Management.

In Support of Upper-Extremity Positioning