Role Updated 6 132018 Rehabilitation Therapist Role Includes physical and occupational therapists Assess a childs physical capabilities and determine ways to improve a childs interaction with their environment ID: 776694
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Rehabilitation Therapist Role
Updated 6/13/2018
Slide2Rehabilitation Therapist Role
Includes physical and occupational therapistsAssess a child’s physical capabilities and determine ways to improve a child’s interaction with their environment Essential members of a child’s medical team Often work with children who have involved positioning needs
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Slide3Rehabilitation Therapist Role
Can offer individualized positioning guidelines if questions arise regarding how to position a child in a child safety seat Most are not CPSTs but important to involve them when working with children with complex positioning needs
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Slide4Rehabilitation Therapist Role
Primary goal of CPST rehab therapist is to provide family centered care to enhance participation in every day activities by providing safe transportation optionsCan be achieved through the use of conventional or specialized restraints
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Slide5Client and family interviewPositioning assessment and interventionRecommendationsOrder equipmentDeliver equipment
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Rehabilitation Therapist Role
Slide6Client / Family Interview
Occupational therapist interviewing family
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Slide7Client/Family Interview
The interview documents: Diagnosis Weight, height and age Positioning assessment Number and position of passengers in vehicle Current child restraint system Type and year of vehicle Installation information Equipment recommended
Interview form developed
by occupational therapists at Riley Hospital for Children
6/13/2018
Slide8Positioning Assessment
High muscle toneMuscles are contracting more than normal and muscles are very tightLow muscle toneMuscles are contracting less than normal and may feel very loose
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Slide9Positioning Assessment: Head Control
Decreased head controlHead can fall forward, to the side, or back
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Slide10Intervention: Decreased Head Control
Head padsSoft cervical collar or towel rollsChoose a seat that offers head support system
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Slide11Positioning Assessment:Trunk Control
Decreased trunk controlRounded backFalls side to side
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Slide12Intervention:Decreased Trunk Control
Towel rolls on both sides or one side of trunkConsider adaptive car seat with positioning pads
Source: Automotive Safety Program
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Slide13PositioningAssessment / Intervention
Muscle tone in lower extremitiesLegs can scissor, or crossFoam abductor or towel roll between legs
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Slide14PositioningAssessment / Intervention
Muscle tone in lower extremitiesLegs can abduct (far apart)Towel rolls on side of hips
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Slide15PositioningAssessment/Intervention
ScoliosisHarness may be looser on one sideMay be an empty space behind childMore padding on one side compared to the other for optimal supportChoose a seat that offers options e.g. Roosevelt scoliosis harness
Adjusts at hips to accommodate for asymmetry
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Slide16Positioning Assessment/Intervention
Anterior/posterior pelvic tilt Towel rolls under knees to help keep pelvis positioned back in seat Place child in seat in an already flexed position to inhibit tone
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Slide17Trial various medical seatsMeets child’s needsMeets family’s needs
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Recommendations
Slide18Recommendations
Take measurementsHead circumferenceChest circumferenceSeated waist circumferenceShoulder to hip height (seated torso height)Leg length (seat depth)Shoulder width
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Slide19Ordering Equipment
Determine is child restraint will fit in car with other passengers Order equipmentObtain prescription form (prior to appointment)Write letter of medical necessityAgree upon vendor/supplier with family inputVendor receives funding approval and orders child restraint system
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Slide20Fit and deliver restraint systemInstall child restraint in family vehicleMay need to arrange for heavy duty tether installationFamily return demonstrate installation
6/13/2018
Delivering Equipment
Mobility specialists installing heavy duty tether anchors