When starting in the Handimachal unit 3 months ago I was really interested to look at the different varieties of seating available for the children, most have been designed by previous volunteers and Shruti, and are either a corner type chair or a made to measure structured chair with a variable tilt and head support. These chairs were fantastic for use at home with the children and I gained feedback that the parents found them very useful.
The problem I found with these seats was their inflexibility to place the children in numerous different positions, and the inability to use one chair for different children with multiple conditions, making them difficult to use day to day in the Unit. With the wise advice of the Pediatric team back in my Hospital in London I started looking at the option of the ‘Squiggles play mat’ which enabled a child to be positioned in various ways enabling optimum positioning for rest, feeding and play. After discussion with Shruti, we decided to have a go at making out own version, ‘The Stori positioning Mat’!
So we scoured Kullu for foam, wire and lots of Velcro and set about creating Stori! It was relatively easy to make, taking a few days in between therapy sessions to make the base and rolls, and with Auntie's invaluable stitching skills it was ready! Another benefit of this mat is that it was relatively cheap to make, costing approx 1200 rupees. We hope that because of this, parents might be interested in commissioning us to make one for them to use with their children at home.
With the mat we are able to place children in the following positions, which are focused on the activities required for purposeful play.
1. Back lying (supine) - good position for sensory stimulation and to increase range of movement in upper limbs while playing
2. Tummy lying (prone) - good position to build head control and to practice weight bearing through arms.
3. Side lying – this is an optimum position for play as the child’s arms do not have to move against gravity.
4. Floor sitting - to improve sitting balance and an optimum position for feeding
5. Hands and knees (for point kneeling) - to practice weight bearing through limbs to prepare for crawling.
Our first opportunity to trial this mat was with 11 month old Tenzin who has been attending the Unit since August 2013. Tenzin has a diagnoses of Epilepsy and Erbs Palsy, meaning he now has weakness in his right upper limb, he also has no active sitting balance.
His parents currently have to hold him all the time as struggle to position him well. Tenzin’s parents will leave the local area for a few months for work, and are worried about positioning him at home when he will not be receiving any regular therapy input. We trialed Tenzin in the Stori Positioning Mat, at first he was a little resistant due to not being used to being away from his mother but we were able to position him in a good sitting and laying position for play and feeding. And laying him prone over a roll wedge to aim to increase independent head control.
New opportunities for Tenzin and his parents!
Tenzin’s parents were really happy with the outcome and have taken the mat with them, with instructions for different positions. So we will gain feedback when they return! In the mean time we need to set about making another mat for use with children in the unit - foam and scissors at ready!
Tori North, OT volunteer
9 October 2013