Seeing the “bigger picture” among many seating system details
can be even more challenging when working with young
clients.

“Growth is going to be a factor there,” says Jay Doherty, OTR,
ATP/SMS, Quantum Rehab’s clinical education manager. “When a
child does grow, they may not have the same protection around
the bony areas, because they’ve stretched out more. You do have
to look at things like skin protection, especially as they’re getting
heavier. You have to look at the way they’ve grown, and does that
seat cushion still meet their needs?”

But ATPs should keep in mind, as they’re building a system that
meets the funding source’s demands for growability, there are
other concerns that should be considered.

Says Lois Brown, MPT, ATP, rehab clinical education specialist,
Invacare Corp.: “We try to provide chairs that, due to funding, kids
can grow into. But often, the kids are positioned too high above
a large wheel and cannot reach for propulsion. This creates poor
postural tendencies as they lean forward to reach for the wheel,
and creates stretch weakness of the trunk muscles and subsequent
injury.”