Goal-Oriented Use of Devices
Our goal is to offer your child the best possible fitting and support in the everyday environment. Medical devices are used at every stage of development and age of the child, therefore our product range is designed so that a product is available and can be used in a goal-oriented manner during every development stage of the child. The devices serve to avoid incorrect positioning of the body and joints and to facilitate the child’s activity level and mobility. In addition, they promote self-awareness and serve as everyday aids which help to assist the child’s caregiver/parent.
In case of a physical disability, one attempts to counteract improper development through physiotherapy and by supporting and training the child in physiological starting positions and movement patterns.
In order to attain the highest possible degree of effectiveness, the child should be able to experience a physiological posture and movement pattern as often as possible outside of therapy. This allows the child to acquire so-called “posture control”, expressed more simply as torso stability, while continuing to develop their motor control abilities.
A device such as an optimally adapted seating system prevents relapse into the accustomed pattern of posture and movement and improves posture control.
In the development of our devices, we work together intensively with all stakeholders so that our products can be purposefully employed, not just by the child but also by the carers and parents. When selecting a device, the everyday environment should always be considered in order to offer the child an adequate fitting with the highest possible degree of independence.
Dysphagia is the term used to describe difficulty swallowing when drinking, eating, or swallowing one’s own saliva. Dysphagia is found not only in older people, but also in newborns, infants, toddlers, and youth with delayed motor development. Depending on the underlying medical condition, dysphagia can present a varied and multi-faceted clinical picture.
Possible reasons for dysphagia include the following:
- Premature birth
- Congenital, faulty swallowing pattern
- Physiologically incorrect head and body posture
- Permanent mouth breathing
- Perception disorders
- Congenital and acquired brain damage
Left untreated, dysphagia can have serious consequences such as:
- Refusing food
- Malnutrition
- Dehydration
- Fever
- Bronchitis
- Pneumonia
- Aspiration (choking, with subsequent problems)
Children with dysphagia need the right support 24 hours a day. Because it’s difficult for caregivers to provide around-the-clock support, it’s important to have optimized posture both while sleeping and throughout the day as soon as a diagnosis is made.
Tonicity describes a muscle’s state of activity. It can be hypotonic (too low), ideally normotonic (normal) or hypertonic (too high). In healthy children, the muscle’s state of tension adjusts automatically as required during relaxation or activity.
In children with a movement disorder, this reaction is impaired and the child is not able to perform or control specific movements due to the impairment.
“Postural control” simply refers to the stability and positioning of the body. Children who have movement disorders or developmental delay are not able to stabilize themselves, making head and upper body control challenging. In such cases, physical therapy and correct fitting with supportive devices is critical. A seating unit that supports good posture is essential, as are positioning harnesses and supports.
Symmetry of the body is important for assuming and maintaining the positions necessary for sitting, standing and walking. What’s known as ‘asymmetry’ can develop if the child is not able to assume such positions due to one-sided activity, reduced muscle tension, or automatic reflexes.
Over the long term, asymmetry can exacerbate postural issues and even lead to orthopedic problems that can cause pain, resulting in such things as continuous muscle contractions. The earlier atypical posture is treated, the sooner it can be counteracted with targeted physical therapy and supportive devices that have been individually adapted for the child. The type of device used depends on the child’s development.
When doing therapy with special needs children, it’s essential to attain the highest possible degree of development at every stage, while limiting any secondary problems.
For toddlers, it’s particularly important to achieve an upright posture. This means that they can support themselves against gravity, whether sitting or standing.
Standing isn’t just important for self-awareness; it’s critical for hip development. If children don’t carry their full weight on their feet by the age of 18 months their femoral heads can’t slide into the hip sockets, preventing the hips from developing correctly. Subsequent orthopedic problems can result, making it difficult for the child to achieve an upright posture and walk in the future. Fortunately, this problem can be limited through physical therapy, and with the help of assistive technology aids.
Medical devices allow the disabled child to develop a sense for a higher starting position, which facilitates independent activity and increases mobility.
Objectives for standing upright:
- Activating body perception
- Heel load for increased stability and contracture prevention
- Development of different foot positions and loads
- Development of the arch of the foot
- Centers the femoral head in the joint socket => joint formation for prevention or therapy, e.g., in case of asymmetries, hip dysplasia or subluxation
- Hip/knee extension and straightening of the pelvis for improved posture
- Balance training through the soles of the feet
- Increased independence and play opportunities
- Awareness
- Improved food intake
- Improved vital functions
- Facilitating growth
- Integration into the social environment
- Transfer
- Easier care
- Use of the hands, one or two-handed
- Preparation for walking
What standing can prevent:
- Contractures/luxations
- Scoliosis/kyphosis
- Decubitus
- Osteoporosis
- Muscular atrophy
- Infections/respiratory diseases
- Social isolation
- Stagnation at a developmental stage
The typical development of a baby Every baby arrives in this world with limited abilities. This is
the reason why the first three years are largely viewed as the most important time in a child’s development. During this time, the nervous system matures and the senses, the muscles and joints develop together with thoughts and actions and learn to work together. In general, these abilities are acquired in a seamless process.
Every skill is a building block for the next, more complex skill. This is called “sensorimotor development”.
Sensorimotor development refers to the dynamic interaction of perceptions through the senses (sight, sound, touch, smell and taste) and reactive movement, which allows the normal infant to develop continuously from birth to an upright stance and gait.
Delayed development
If a child’s development is delayed, they will likely acquire capabilities more slowly or, without help, not at all. An affected child with excessively high muscle tension, for example, is not able to open their hands or bring them in close to the body. They are not able to feel their own touch. Without a sensation of touch, there is no motivation for movement. Without movement, the brain does not receive any information about perceptions and cannot continue to develop. The result is that sensorimotor development is hampered.
This is why perception training plays an especially important role in promoting development and encouraging the interaction of the child with his or her environment.
Early intervention
The earlier this begins, the more receptive the brain is for storing information and implementing what it learns. Professional, timely intervention is called “early intervention”. In addition to the care of doctors and therapists, medical devices can have a positive impact on perception. Seating systems or standing devices, for example, give children a clear boundary in order to classify their own body and to be able to feel themselves, while the Early Activity System (EAS) supports the correct development of the child from the first few months.
Adaptation of Devices
Measuring the child’s body is particularly important for the correct fitting of devices. Errors are frequently the result of inaccurate or insufficient measuring.
Another error is rounding up measurements. An insufficiently accurate fitting or a device which is not anatomically correct has significant consequences, since the child’s posture and independent activity are severely impaired. The result is improper posture and a loss of function.
If all measurements are available ahead of time, it is possible to perform a good advance adjustment of the device. This reduces constant moving of the child in and out of the product.
As a tip from everyday practice, it helps to always take measurements in the same order. This is calming, creates a routine for yourself and avoids forgetting an important measurement. It allows the person fitting the device to achieve a corresponding routine and experience in order to perform professional adaptations of medical devices.
Important measurements in the fitting of seating devices and their order:
1. Seat depth.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . SD
2. Body depth.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . BD
3. Lower arm height (for arm rest).. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . L A H
4. Axillar height.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A H
5. Shoulder height.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . S H
6. Head height (for headrests) .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . HH
7. Lower arm length.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . LAL
(for possible joystick or talker button placement)
8. Body width. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . BW
9. Seat width.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . SW
10. Lower leg length.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . LL
Our specialists will be glad to assist you during the adaptation
of medical devices. Please call us at 800.328.4058 for
technical support.
