Two Seating Systems' Effects on an Adolescent With Cerebral Palsy and Severe Scoliosis

Background and Purpose: To compare physiological functioning, communication switch activation, and response accuracy in a 19-year-old young man with quadriplegic cerebral palsy and neurological scoliosis using 2 seating systems within the school setting. Methods: Prospective single-subject alternating treatment design with 2 conditions: baseline phase with standard planar inserts (A1), custom-molded back with original seat (B), and return to baseline (A2). Measures included oxygen saturation (SaO(2)), heart rate (HR), respiration rate (RR), body temperature (BT), processing time to activate switches, and response accuracy. Results: SaO(2) levels increased from distressed to normal; variability decreased. HR, RR, and BT fluctuations decreased with the custom-molded back. Processing time decreased with increased variability, affected by subject's motivation; accuracy improved slightly. Reported social approachability and student-initiated communication increased. Conclusions: SaO(2) increased and HR, RR, and BT fluctuations decreased with a custom-molded back. Graphing data may help determine seating effect with complex clients.