Page 15 - Mobility Management, January/February 2020

your hips can shift. We build the chair too wide, so then we put big, heavy hip guides on it to hold your hips. Sometimes, if I’m putting
a 12-month-old in a chair, I can’t get them to [reach] their handrims no matter what I do. They’re going to push on the tire, and that’s fine. But at least they can get to that tire, and they’re in a good position getting to that tire. They’re not significantly abducted.
“I feel like people automatically say, ‘You’re 13" wide right now; we need to go to at least 15" if not 16" because you’re going to grow.’ They grow taller, not necessarily wider. There are growth curves on kids with different disabilities, and the growth curves show that these kids don’t grow in weight and height and size like their age-matched peers.”
3. But Kids Will Need Depth
Witten agreed with the danger of building in too much width: “Especially for someone who’s tiny, if you add width to their frame for growth, then they can barely reach their wheels assuming they’re self propelling,” she said. “With power, you can get away with a little more growth in the system as long as you can still support them, because the wheelbase is generally wider than the seating.”
More seat depth, however, is usually the greater need. Witten
pointed out that a girl at age 14 might have the same hip width
as she did when she was 10... but she’ll be much taller. “They
get longer and taller, quicker than they start changing in their width,” Witten noted. “Frequent depth adjustment is needed, more so than width. They don’t need a whole new seating system, but they do need a longer seat depth.”
Kiger said payors can be more willing to accommodate changing systems that belong to kids: “The frame has to last five years, but especially with pediatrics, you get a bit more grace depending on your funding source and state when it comes to seating. We can make changes to the seat depth on the frame, but we may need to switch out the cushion, which is fine because you can get a cushion and a seating system paid for oftentimes sooner than you can get a brand-new frame.”
4. What Is the Child’s Nutritional Intake Like?
“The majority of the time when you have somebody with a feeding tube, I’m thinking of a child who maybe is an ex-preemie, maybe has cerebral palsy,” Kiger said. “A lot of times, families delay getting the feeding tube because they think the only pleasure the child has is being able to eat. I’ve seen plenty of kiddos not eating appropriately. When they’re eating by mouth, they’re not gaining
Hear Kassandra’s story and discover QUICKIE 2 at... www.SunriseMedical.com/MYQ2
I’m Kassandra
My PASSIONS are baking and Japanese culture. My 3rd QUICKIE® 2 is evergreen and has 80° fixed-frame foot rests with
a 1” frame inset, flip-up foot plates, padded swing-away armrests, a JAY® Ion cushion, 5” casters, Frog Legs suspension forks, 24” light spoke wheels with plastic coated hand rims, airless insert tires, and quick-release axles.
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MOBILITY MANAGEMENT | JANUARY/FEBRUARY 2020 13 12/3/19 11:53 AM