Presented by: Tamara Kittelson-Aldred, MS, OTR/L, ATP/SMS
The bodies of children with chronic motor impairments often distort as they grow, developing joint contractures and dislocations, scoliosis and kyphosis. The problems start early – often related to habitual postures assumed both day and night – and can worsen quickly during growth spurts. Human beings spend their lives in three orientations – lying, sitting and standing – and for children with limited movement this can become complicated! Too often, the foundational orientation of lying is overlooked, as we work toward upright orientation goals. 24-hour posture care management (24-7 PCM) analyzes and addresses postures that can become destructive over time. Non-invasive strategies are used to protect growing bodies from distorting, in some cases restoring them to better alignment without surgery.
24-7 PCM promotes the support of healthy posture in all orientations as crucial for children with a limited movement repertoire, who cannot change their positions easily, often and with variety. In North America this approach is novel but becoming recognized for its potential to protect and improve body alignment, support restful sleep, safeguard respiratory and digestive functions and reduce pain. 24-7 PCM builds a foundation of body symmetry and stable posture that will support therapeutic goals in all areas of development. Lying postures with poor body alignment may be noted, but are often not routinely addressed in treatment planning – to the detriment of growing kids.
This course provides an evidence based overview of theory and practice with visual examples, longitudinal case studies and demonstrations to illustrate concepts underpinning 24-7 PCM. Early assessment and therapeutic positioning intervention is important! Learning to predict likely distortions early on and how to effectively create and implement 24-7 PCM plans with a focus on time outside the wheelchair is emphasized.
LEARNING OBJECTIVES: Upon completion of this course, participants will be able to:
1. Compare and contrast characteristics of beneficial and destructive daily postures (sitting, lying, and standing.)
2. Identify health conditions associated with body shape distortions.
3. Describe how body position, soft tissue adaptation, gravity and time affect the ribcage, spine, pelvis and hips.
4. Predict the likely direction of chest, pelvic and hip distortion.
5. Describe sleep patterns, thermal regulation and behavior change influences on effective night therapeutic positioning.
6. List safety risks, mitigation strategies and care team roles.
7. Using case study information and assessment tools, analyze habitual postures and develop a 24 hour therapeutic positioning plan for an individual.
FORMAT: This is an online 7-hour lecture/discussion course
Who should attend? Occupational Therapists, Occupational Therapy Assistants, Physical Therapists and Physical Therapy Assistants
Group Discount: Register for 3 (or more) attendees at once and receive 20% off. Discount automatically applied at check-out – must register for all attendees in one transaction.
8:00 – 8:15 Introduction
8:15 – 8:30 How it can work – Montana Postural Care Project results
8:30 – 9:00 Analyzing daily postures in sitting, lying, standing
9:00 – 9:30 Health conditions associated with complex body shapes
9:30 -10:00 Body position, gravity, time and the ribcage, spine and hips
10:00 – 10:15 BREAK
10:15 – 11:00 Body position, gravity, time and the ribcage, spine and hips
11:00 – 11:30 The Crystal Ball – predicting likely body shape distortions
11:30 – 12:00 – Questions and discussion
12:00 – 12:30 LUNCH
1:00 – 2:00 Influence of sleep patterns, thermal regulation and behavior
2:00 – 2:15 BREAK
2:15 – 3:00 Safety – risk vs benefit, mitigation strategies, care team roles.
3:00-3:30 Assessment tools and intervention strategies
3:30 – 4:30 Develop a 24 hour therapeutic positioning plan proposal for an individual.
4:30- 5:00 – Share case studies, discussion and questions
PRESENTER: Tamara Kittelson-Aldred is an occupational therapist, RESNA Assistive Technology Professional/Seating and Mobility Specialist, and holds advanced postural care certificates through the Open
College Network West Midlands in England. She directed the Montana Postural Care Project, funded by the Montana Council on Developmental Disabilities, and leads Eleanore’s Project, promoting posture care management and responsible wheelchair provision in low resource settings. Tamara has written and presented on these topics in the United States, Canada, Peru and Colombia. She is the Founding Chair of a new RESNA 24-7 PCM Special Interest Group. Tamara has served individuals with complex neurodisabilities in Montana since 1983; she credits her daughter Eleanore, born with cerebral palsy and profound deafness, as her best teacher.