Background: Julian is a young adult and busy college student. He has places to go and things to do! Julian also has spinal muscular atrophy (SMA), type I, which leads to profound muscle weakness. He started using a ventilator at about 1 year of age and has been driving a power wheelchair since he was 3. Julian’s needs have changed over the years as his muscle weakness progresses. As a result, his seating and access have also changed. Julian requires a custom molded seating system to support his orthopedic asymmetries and provide adequate postural support. Julian has never been able to use any type of joystick, but he has been…

Michelle L. Lange, OTR/L, ABDA, ATP/SMS Quite a variety of head supports are available to meet individual needs. These head supports have unique features designed to match specific requirements. Posterior head supports are by far the most common and may include lateral support. Collars provide support under the jaw and the suboccipital shelf. Forehead supports or straps provide support anterior to the forehead. One product provides support superior to the head, allowing for rotation and some limited flexion and extension while supporting/suspending the head in an upright position. Head supports are commonly referred to as head rests as many clients use this seating component to rest against. A simple posterior…

Michelle L. Lange, OTR/L, ABDA, ATP/SMS Our last Blog addressed some of the causes of poor head position. In this Blog, we will explore general intervention strategies – things to try long before grabbing a specific head support. It is so tempting when we see a client with a sub-optimal head position to immediately try a different head support. However, our solution will be dictated by specific causes. And many of our solutions involve overall client position, not just a head support. General Interventions include: Ensuring the pelvis is in a neutral rotation Increase trunk extension and scapular retraction Change the impact of gravity on head position Refer to neuro-optometrist,…