Running head: ASSISTIVE TECHNOLOGY DEVICE 1

Assistive Technology Device

Tiffany Poon
Touro University Nevada









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Client and Diagnosis
The client, Livi, has been diagnosed with cerebral palsy (CP). CP is a term used to
describe motor disorders that are characterized by impaired voluntary movement and muscle
control. CP can result from prenatal, perinatal or postnatal brain injury. There are four types of
CP, characterized by the type of movement disturbances: spastic, athetoid, ataxic and mixed.
There is no single cause of CP and CP cannot be cured. Symptoms of CP can range from
clumsiness to severe spasticity that causes deformities and the need for mobility aids. There are
also common difficulties associated with CP such as cognitive delays, speech difficult, seizure
disorders and others. Secondary conditions are pain, fatigue, arthritis, fractures and osteoporosis.
Those who are diagnosed with CP typically live well into adulthood. Symptoms of CP can be
managed through medical and therapeutic interventions.
Livi has been diagnosed with mild spastic cerebral palsy. She is diplegic, demonstrating
more distribution of spastic tone in her lower extremities and some in her upper extremities. She
shows impaired movement associated with exaggerated reflexes and involuntary movements.
She also attempts to move with quicker movements. She displays mild floppiness in her trunk
and an abnormal sitting posture.
The Gross Motor Function Classification System (GMFCS) is a tool that looks at gross
motor skills in children and young people with CP. Using the GMFCS, children with CP can be
categorized into five different levels. Livi is classified under GMFCS Level IV. She has limited
independent mobility in a manual wheelchair and can participate in standing transfers. However,
Livi is unable to sit independently on the ground, needing some support, when she performs
occupations such as play, feeding and toileting,
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Occupational Profile
Livi is a very spirited 4-year-old girl. She lives at home with her biological parents and
an adopted 2-year-old sister. Her father works full-time at a hardware store and is the only
source of income for the family. Her mother stays at home and has put her career on hold for
their two young daughters. At home, Livi is always eager to play with her baby sister. She also
shows a drive to move without her wheelchair. Livi attends preschool and participates in a
mainstream classroom. At school, Livi loves to interact with her peers and actively participates
in activities such as circle time and snack time. She receives an aid throughout the day in the
classroom to help with most gross motor functions. Livi shows some speech delays but shows
appropriate developmental cognitive ability. With her diagnosis, she is held back from fully
participating in school and social activities.
Livis parents would like to see Livi independently participating in more social activities
such as playing in the sandbox at the park, floor puzzles and board games. Because her mother
spends most of her time at home and alone with her two daughters, Livis mother would like to
see Livi independently sit on her own. If Livi could sit independently while playing and while
feeding, her mother would also be able to support Livis younger sister as necessary. Livis
mother and father also spend a lot of time playing on the ground with their two daughters.
Currently, Livi needs to be held in a sitting position on the ground when playing. The family is
looking for a solution that will help Livi be able to independently sit and play on the ground at
school, home and in the community.


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Assistive Device
The assistive device is a foldable floor corner chair. It is lightweight, transportable and
aesthetically designed for a lively little girl like Livi. Livi would benefit tremendously from this
floor corner chair. This assistive device will provide external support for Livi who has
inadequate postural control of her trunk when sitting on the floor. The corner chair has a V-
shaped back, a padded seat, seatbelt at the pelvis and straps over the shoulders. For Livi, this
corner chair was painted her favorite shade of pink and has a flower designed fabric seat cushion.
The padded cushion is removable and can be replaced if it becomes worn or damaged. The
fabric covering the cushion is waterproof, to prevent spills or urine from leaking through. The
corner chair is conveniently foldable which also allows for easy storage in her classroom, at
home and while traveling in a car.
Purpose
The most important purpose of the floor corner chair for Livi is to provide external
support when she is sitting independently on the floor. The V-shaped back provides support
along the spine and provides Livi with greater freedom of her head and eyes. Having postural
control is essential for visual scanning and attending. It also supports breathing, speaking and
eating. The shoulder straps also help in postural control and this permits Livi to free her arms
and hands to explore, manipulate, and most importantly, play. With this floor corner chair, Livi
is positioned with hips flexed, but knees extended to facilitate long leg sitting. An abductor can
also be positioned in front of the seat, at the distal part of the femurs, if necessary. This will
maintain hip abduction with knee extension. The seat belt is positioned across the hips and aids
in pelvic stability.
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Another purpose of the floor corner chair is its easy transportability. This allows Livis
mother to be able to bring it back and forth from school to home. Her family cannot afford to
purchase a corner chair or floor sitter in the market due to the cost. The floor corner chair is easy
to assemble and fold up. It folds up into a compact size where it can easily fit into small places
such as the car trunk or back seat. It is also cost effective, the wood is durable and parts are
replaceable if broken.
Functional Performance
Functional performance for Livi is very clear when she is seated in the floor corner chair.
When she is seated in the corner chair, her postural control is supported; therefore, she is able to
play independently on the ground at home, school and in the community. At home, her parents
will be able to set her down on the floor in the corner chair and allow her and her sister to play
safely in a confined area. Livi will be able to experience independent play and her parents will
not be restricted to holding her in their lap. This will allow for greater family participation and
socialization. In the floor corner chair, Livis body is supported in an upright position and this
allows her to use her arms to reach, grasp and touch toys and objects within her vicinity. As Livi
is able to explore on her own, development of cognitive ability and awareness will increase.
At school, Livi will be able to participate in more floor play with her peers in preschool.
Many class activities take place on the ground such as circle time and free-play time. Livi
participates in circle time in her wheelchair or in the lap of her aide while the rest of her
classmates are sitting on the ground. This denies Livi of good eye contact with her classmates
and may instill a feeling of isolation. By using the floor corner chair, Livi will be able to sit on
the floor independently with her classmates and fully participate in circle time. In preschool,
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most days consist of free-play. Teachers often put games, puzzles and toys on the floor and
allow the children to explore. Livi will be able to play with her classmates in the corner chair,
not sitting in the lap of the aid or in her wheelchair.
In the community, Livis familys favorite activity is going to the park. Livi and her
younger sister enjoy playing in the sandbox together. Using the corner chair, Livi will be able to
sit independently in the sand and her parents may supervise from afar. This also allows Livi to
interact with peers her own age in the sandbox without the support of an adult. Because the
corner chair is made out of durable wood and the fabric is waterproof, the weather or getting the
chair wet is not a concern.
Literature Review
This first article, The Impact of Adaptive Seating Devices on the Lives of Young
Children with Cerebral Palsy and Their Families, determined the parent-perceived effect of
adaptive seating devices on the lives of young children with cerebral palsy, aged two to seven
years old, and their families. The participants were 30 parents and their children with GMFCS
level three and four CP. The intervention consisted of two special-purpose seating devices: one
for sitting support on the floor and the other for postural control on a toilet. To measure
outcomes, parent reported using the Family Impact of Assistive Technology Scale (FIATS) and
the Impact of Family Scale (IFS) prior and post intervention. The FIATS measured constructs
such as child autonomy, caregiver relief, child contentment, doing activities, parent effort, family
and social interaction, caregiver supervision and safety. The IFS measured parents perceptions
of the psychological and social consequences of having a child with a chronic disability. Lower
IFS scores will indicate lesser parents perceived psychosocial consequences of having a child
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with a disability Results showed significant mean differences in overall FIATS scores between
baseline and intervention, and between intervention and post-intervention phases. However,
there was not a significant change among IFS mean scores (Ryan, Campbell, Rigby, Fishbein,
Hubley, & Chan, 2009).
The results showed that the introduction of assistive devices had a significant positive
effect on the lives of families who have children with GMFCS level three and four CP. During
home activity log interviews, most participants described positive effects on child and family life
with the assistive device. Also, increased quantity and quality of the childrens activities were
reported. Other areas that were positively influenced by an assistive device were the degree of
control the child had over their own activities, how happy the child was, the level of interaction
with others, and the amount of supervision the child needed from the adult (Ryan et al., 2009).
Findings from this study show that special seating devices for young children with CP have a
meaningful, positive impact on important aspects of family life.
The second article, The Effect of Adaptive Seating Devices on the Activity Performance
of Children with Cerebral Palsy, evaluated the short-term impact of two adaptive seating
devices on the activity performance and satisfaction with performance of children with CP, as
observed by their parents. The participants were 30 parents and children, ages two to seven
years old, with GMFCS levels three and four. The intervention of this study is alike the Ryan et
al.s study above. Two special purpose seating devices were used in intervention, one for sitting
support on the floor and the other for postural control on a toilet. The measurements; however,
were different. This study measured the changes in activity performance of the child and the
satisfaction of parents. The activity performance was measured biweekly using a home activity
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log while the satisfaction of parents were rated using the Canadian Occupational Performance
Measure (COPM).
The areas of activity performance that were measured were self-care, play, socialization
and quiet recreation. Examples in the area of play are: sitting on the floor to play, hold/playing
with toys, coloring, writing, playing games and using the computer. There were three themes
that arose from the thematic analysis of this study. The first theme was adaptive seating can
have an enabling influence on child (Rigby, Ryan, Campbell, 2009, p. 1392). Most parents
reported that adaptive seating devices allowed their child to sit better, do more and be more
engaged. Other parents reported that their childs skills improved, their child was happier and
more eager to sit and do activities. The second theme was caregivers and family find adaptive
seating useful (Rigby et al., 2009, p. 1392). During the intervention, parents found the seating
devices convenient, easy to use and reported that the child needed less caregiver help. The third
theme was the adaptive seating devices did not meet every familys needs (Rigby et al., 2009,
p. 1392). Only a few families reported little to no change in how their child completed the
activities identified on the COPM.
Rigby et al.s study concluded that the COPM results indicated that statistically and
clinically significant improvements in activity performance and performance satisfaction were
achieved in children who used assistive seating devices. This study provides preliminary
evidence that adaptive seating interventions can be used successfully to help children with
GMFCS level three or four with CP attain a supportive sitting posture. With a supportive sitting
posture, it enabled the children to perform a variety of childhood activities more successfully
within their daily life at home.
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Conclusion
With evidence-based support, Livi will greatly benefit from a floor corner seat to increase
her activity performance at home. Allowing Livi to be independent in floor play will also
significantly increase family dynamic. Also, introducing an adaptive seating device for floor
play will later contribute to openness of trying other adaptive devices. Because this corner chair
is foldable and easily portable, it can be used in Livis preschool classroom and in the
community. At school, use of the corner chair will permit her to participate in more activities
alongside with her peers and increase inclusion. With the waterproof fabric and durable wood,
the corner chair can be taken outdoors on the playground and into a sandbox. The corner chair
will promote Livi to play independently, but also with the color and designs on the chair, it will
promote eagerness for Livi to use. In conclusion, a supportive seating device for a child with CP
is significant in allowing the child to engage in controlled upper extremity movement; thereby,
engage more actively in meaningful daily activities such as play.







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References
Rigby, P. J., Ryan, S. E., & Campbell, K. A. (2009). Effect of adaptive seating devices on the
activity performance of children with cerebral palsy. Arch Physical Rehabilitation, 90,
1389-1395. doi: 10.1016/j.apmr.2009.02.013.
Ryan, S. E., Campbell, K. A., Rigby, P. J., Fishbein, B. G., Hubley, D., & Chan, B. (2009).
The impact of adaptive seating devices on the lives of young children with cerebral palsy.
Arch Physical Rehabilitation, 90, 27-33. doi: 10.1016/j.ampr.2008.07.011.











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Appendix A
Cost Analysis
Materials Cost Vendor
2 ft. x 4 ft.MDF wood (2) $9.99/each Home Depot
strap hinges (2) $2.47/each Lowes
2-pack narrow hinges (2) $1.49/each Home Depot
seat cushion $3.30 Hobby Lobby
fabric $4.99 Hobby Lobby
2-pack handle $2.79 Home Depot
2- pack straps (2) $5.99/each Home Depot
paint $6.97 Home Depot
Total: $57.93
Note: Cost per item to construct the floor corner chair











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Appendix B
Comparable Assistive Device
Name Price Distributor(s) Picture
Corner Chair $462.78 -
$587.79
Kaye Products
Inc., Tadpole
Adaptive, LLC

Corner Seat $274.95 Achievement
Products, eSpecial
Needs, LLC

Corner Sitter $749.95 Achievement
Products

Rifton Corner
Floor Sitter
$405.00r5t4 -
$477.00
Rifton Equipment,
eSpecial Needs,
LLC, Tadpole
Adaptive, LLC

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Universal Corner
Chair
$499.99 Achievement
Products

Note: Cost comparison of similar items
















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Appendix C
Pictures of Device
Front view (open for sitting)

Top view (open for sitting)

Back view (open for sitting)

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Front view with cushions removed
(open for closing)

Front view with bottom piece folded up
(open for closing)

Side view with two sides folded inwards
(closed)

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Folded chair in storage

Note: Different views of device