Michelle L. Lange, OTR/L, ABDA, ATP/SMS Background: Hannah is a 14 year old young woman with the diagnosis of cerebral palsy. She was born prematurely. Other diagnoses include cortical visual impairment (CVI), chronic lung disease, adrenal insufficiency, and type II diabetes. She has had her salivary glands removed and is now on Robinol which is reducing her secretions and subsequent aspiration. She is on oxygen and uses BPAP at night. She has a low core temperature and heart rate. Circulation is reportedly poor, particularly in her legs. She takes cortisol for the adrenal insufficiency. She has not yet begun puberty and is small for her age. Hannah was seen to…

Michelle L. Lange, OTR/L, ABDA, ATP/SMS Background: Max is a 33 year old man with the diagnosis of cerebral palsy. He lives at home with his parents and volunteers at an animal shelter. He is a long-term user of assistive technology, including a communication device and power wheelchair. Max uses both a manual tilt in space wheelchair, as well as a midwheel drive power wheelchair with a compact joystick. He is seated in a molded seating system that fits him well. But there was a problem – Max can’t look straight ahead. Current Positioning: Max sat with his neck hyperextended and rotated to his right side, influenced by an Asymmetrical…

Michelle L. Lange, OTR/L, ABDA, ATP/SMS One of the most challenging areas of wheelchair seating is achieving and maintaining the head in a neutral and upright position. Many times, we assess, provide optimal seating, and still the client continues to stare at their lap. Before going to the closet to pick out a solution, we need to know what is causing the issue. So, what does it take to hold our head upright? Adequate muscle strength. Our head weighs about 10 pounds (approximately the weight of a bowling ball) and a certain degree of strength is required to hold that up. For clients who tend to hold their head forward,…