As John is at risk of hip subluxation, ideally the seating system would facilitate wide abduction of the hips and influence the development of this joint, by ensuring a close approximation of the femoral head and acetabulum.
Although John could get into sitting, he could not get out of this position, belly crawl or scoot.
His head control was poor and he maintained his head in a “forward head posture” with cervical and thoracic kyphosis.
John’s seating system needed to stabilize his pelvis and lower spine, whilst still require him to actively extend his trunk and spine to achieve/maintain upright posture against gravity. It also had to promote John’s ability to engage in midline play with a toy or book.
The primary aim of the new seating system was;
To strengthen his trunkal musculature by initially offering high trunk support then gradually lowering the supports until only his pelvis is supported.
To stabilise his pelvis and lower abdomen whilst encouraging John to reach and hold his upper trunk upright, facilitating a lumbar curve. This will also reduce his thoracic and cervical curves.
The height and angle of the easy chassis could be adjusted manually providing anterior tilt so that gravity would encourage John to actively extend and align his spine.
The aim was also to reduce the lower trunkal support over time so that skills gained could be transferred to a classroom chair and the floor.
Over a period of 11 months John achieved independent floor sitting with one hand stabilising on the floor. The seating support had been reduced to the stage where only pelvic support was needed as John has improved his trunkal strength and head control. The Squiggles Saddle Seat also enabled John to sit in a beneficial position of wide leg abduction, and engage in various activities during circle time comfortably.