Decisions about Special
Seats and Wheelchairs
64CHAPTER
589
In this chapter we look at the things you will need to consider when buying or
building a special seat or wheelchair, to best meet the needs of a child. Adaptations
of seats and wheelchairs for special positioning needs are discussed in Chapter 65.
Designs for building 6 basic wheelchairs are in Chapter 66.
Meeting the needs of the individual child, family, and community
Most children who need a wheelchair or special seat have severe weakness in parts
of their bodies, or muscles that pull them into awkward or deforming positions. Seating
should, as much as possible, keep these children in healthy and useful positions. It
must provide support, but also allow them enough freedom to move, explore, and
develop greater control of their bodies. For example:
1. A child who
is ‘floppy’ and
slow to develop
ability to sit,
2. may at first
need a seat
with straps
and supports
to hold her
up.
3. As she
develops better
head control
and then body
control, the
supports can be
removed little
by little,
4. until finally—
if possible—
she is able to
sit anywhere,
with little or
no special
supports. Now
low back
support is all
she needs.
CP
CAUTION: If a child needs to be supported as much as the one in the second
picture, do not keep her strapped in her seat for long. She also needs periods
of free movement and exercise to develop more independent head and body
control. Keeping her strapped in for too long, or providing too much support
after she has begun to gain more control, may actually slow down her progress.
Seating needs to be changed and supports reduced as the child develops.
Also, children who do not feel in their butts need frequent position changes and
‘lifting’ (see p. 198), and special cushions (see p. 200).