Page 7 - Mobility Management, August 2019

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All in This Together: The CRT Assessment
Complex rehab tech- nology (CRT) is, well, complex. That’s partly
because the equipment itself
is highly sophisticated; CRT
includes wheelchairs made of
aerospace-grade materials,
and electronics can multi-task
to an amazing degree. But it’s
also because CRT users have
significant disabilities often
accompanied by comorbidities.
A client who cannot functionally
ambulate due to cerebral palsy
might also have trouble speaking and therefore use a speech-generating device, for example.
One of the critical early steps in choosing, configuring and fitting a wheelchair and its seating system is the assessment. And as with any meeting, the assessment’s success depends on getting perspectives from all the right people, right from the start.
The Players in a Seating & Mobility Assessment
So who should attend the assessment? The first three participants are the most common: 1, 2
• The clinician, usually an occupational or physical therapist and preferably one who specializes in seating and wheeled mobility.
• The CRT provider, the equipment expert. Many funding sources require a provider with the Assistive Technology Professional (ATP) credential to be closely involved in this process.
• The client, who should be the central focus of the assessment and equipment goals.
But some seating and mobility assessments can benefit from the participation of additional members:
• Family members or caregivers who live with or support the CRT user. They might be the ones who help with transfers in and out of the chair. They might load the chair into their vehicles for transportation, or might be the ones to remove the cover from a cushion to wash it.
• Speech language pathologist (SLP): These professionals assess, diagnose and treat speech and language disorders.3 They also work with adults and children who have swallowing disorders. An SLP can share information on a client’s augmentative and alter- native communications device(s), which could impact
Team
the choice of wheelchair, seating and accessories. • Recreational thera-
pist (RT): The American Therapeutic Recreation Association says recre- ational therapy is “designed to restore, remediate and rehabilitate a person’s level
of functioning and indepen- dence in life activities, to promote health and wellness, as well as reduce or eliminate the activity limitations and
restrictions to participation in life situations caused by an illness or disabling condition.” Since mobility is a big part of those goals, recreational therapists could weigh in on what they and their clients are working to achieve, and what sort of mobility would benefit those goals.
• Mobility dealer: Particularly if the team is consid- ering a power chair that will need to be transported,
a mobility dealer’s opinions can be helpful.4 Mobility dealers work with wheelchair-accessible vehicles, so they can share insights on how the wheelchair will be secured within the vehicle, the interior space available for the power chair to maneuver or for the client to transfer, and other logistics, such as if the power chair user wants to drive or be a passenger.
Anybody Else?
That sounds like a full assessment room, but it’s possible that additional participants — from personal aides to teachers to Registered Nurses — could also contribute information based on their knowledge about the client’s everyday environments and activities.
Checking with the client and with other members of the team as part of the scheduling process can ensure that the best people are in the room when it’s time for that mobility evaluation. m
Sources & Resources: 1 United Spinal, https://tinyurl.com/ y4qppvgq; 2Numotion, https://www.numotion.com/blog/ june-2017/nu-digest-purpose-process-of-a-clinical-seating; 3American Speech-Language-Hearing Association, https:// www.asha.org/Students/Speech-Language-Pathology/; 4National Mobility Equipment Dealers Association, https:// nmeda.com/what-to-buy/
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