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SSIG- SATCo & Segmental positioning in schools - Shared screen with speaker view
Lorrie Sylvester
28:20
everyone needs to mute
Wendy Harrell
30:48
Usually yes we share powerpoint with certificates following the webinar to today’s attendees. We will check with her and let you know for sure. Thanks
Karen Konish
31:54
may we record
Laurie Ray
32:26
This is being recorded and will be posted on the School SIG webpage
Melanie Natalie
32:39
Thanks !
Deb Davison
35:16
Do you want support for the feet?
Wendy Harrell
38:10
Deb you don’t have to support the feet
Deb Davison
39:19
Thanks
Deb Davison
39:50
Just wondering if that impacts results
Ginny Paleg
42:41
Novak and Rosenbaum and other recent publications challenge us to give up facilitation and handeling (and brisk nudges) as well as no longer focusing on quality. We are encouraged to embrace activity and participation with our hands off. How does SATCO fit with these new evidence based findings?
Melanie Natalie
43:05
we used this ….this year and got better with practice
Laura Kredit
45:11
Are there any recommendations of strategies to encourage keeping hands off of thighs or other surface during testing if they are older/larger students with lower cognition?
June Cunningham
45:12
Ginny - this is an assessment for trunk control. How does your question relate to this?
Lorrie Sylvester
45:14
Interesting Ginny! I think these help formalize 'assessment', and it is a familiar process. So this may be more assessment/not participatory intervention. I see your point though.
Ginny Paleg
48:07
Segmental control is a Bobath concept. It's not part of HABIT or CIMT or newer EBM. We know that children with CP don't develop "trunk control" in this way, so I'm struggling to understand how this assessment relates to activity and participation. I keep hearing folks I respect - like Danni- who love this, so I'm trying to figure it out. I'll be patient, but I'm hearing a lot of Bobath and even Vojta terminology.
Nicole Schiffmacher
51:39
I think that especially in a school based setting, this helps us with assessing children for adaptive seating that provides enough support for them to attend to academic/social activity. this gives us a baseline, and re-assessment can give us information about improvements (or not) in control.
Deb Davison
53:02
Is there a measure for endurance...how long the child can sustain the static, active or reactive before collapsing? Impacts school participation as well...
JOCELYN NEWELL
54:36
I agree Nicole, SATCo has been very helpful for us to determine optimal positioning in adaptive equipment so students can participate in classroom lessons/activities without working so hard to keep themselves up.
Karen Gartner
57:16
Ginny this isn’t treatment. This is assessment of trunk control so that the child is able to be positioned and stabilized appropriately in equipment so that they can then function independently. That goes along with what you are looking for, hands off for the child to function without handling. This is important for school but also for home based services. The little girl who melts into her plate clearly needs to have her home seating assessed and changed if necessary so that she can do what she can do.
Joanne Welles
58:40
Were you shifting the child for the reactive?
Benita Hodges
59:03
Where does one purchase the SATCO protocol/ instruction manual?
Benita Hodges
59:21
Where does one find the strapping system used in the test?
Karen Stone
59:31
Are there specific straps that are used or is there a type of strap/measurements for the straps that are used?
Danielle Bellows
59:33
@Ginny this is not Bobath or NDT. It is entirely a biomechanical and degrees of freedom assessment and the related approach to segmental positioning also relies on that scientific foundation.
Ginny Paleg
59:34
Leceky seels the bench!
Michael Gallano
59:38
Is there a specific strap for SATco that I can buy?
Ginny Paleg
01:01:22
Leckey (Ki in USA) sells a bench for SATCO
Denise Swensen
01:01:53
Yes they do.
Danielle Bellows
01:01:58
@Ginny it provides the appropriate support for function. Totally focused on what is needed for function in the school setting. Not looking for typical development but appropriate upright function against gravity
Melanie Natalie
01:01:59
Plus the constant nagging breaks down relationships
Denise Swensen
01:02:52
You can also put the strapping system on benches yourself according to the directions.
Nicole Schiffmacher
01:03:13
Kaye products also makes a bench. You can provide a strap yourself.
Danielle Bellows
01:04:20
Leckey not yet available in US but hopefully soon
June Cunningham
01:04:48
The Rifton Pelvic straps have been awesome to support this! The pelvic straps can also be added to wheelchairs.
Wendy Harrell
01:05:00
Sandy will send SATCo strap info to anyone who is interested
Michael Gallano
01:05:10
Thank you
Denise Swensen
01:05:24
We have also adapted regular classroom chairs with the strapping system
Rebecca Renfro
01:05:36
That would be great…can she send it out with a group email?
Nicole Schiffmacher
01:05:45
Rifton has a video on segmental positioning using their activity chair, with a case study
Cheryl Baker
01:06:34
How do we get more training
Wendy Harrell
01:07:19
SATCo protocol downloadable for free from PubMed
Danielle Bellows
01:07:58
Here is a link to the strapping system. https://www.dropbox.com/s/ni7teebnr6wlh34/BenchStrapSystem_2015.doc?dl=0
Wendy Harrell
01:08:14
Regional reps will email out links to SSIG members
Alexandra Talbott-Welch
01:08:28
Are there more videos available to watch someone testing?
Laurie Ray
01:08:39
We can ask Sandra to send any resources she can share to our SSIG regional representatives. You can contact them directly.
Laura Kredit
01:09:27
Any suggestions for keeping hands off thighs or bench for older students with long arms and low cognition who may not follow directions to keep hands up? Namely for assessing static control.
Danielle Bellows
01:09:44
SATCo form and instructions for strap system for older children https://www.dropbox.com/s/as0qbh5pe9b5kab/SATCo-Form-and-instructions.pdf?dl=0
Danielle Bellows
01:13:19
Nationwide Children's has also developed a strapping system in-house on a board that can be added and removed to benches just for testing
Michele Wiley
01:15:21
Testing protocol is available on Pediatric PT journal October 2010. Article is free.
Danielle Bellows
01:17:25
Refinement, Reliability, and Validity of the Segmental Assessment of Trunk Control https://journals.lww.com/pedpt/Fulltext/2010/22030/Refinement,_Reliability,_and_Validity_of_the.2.aspx
Marycaarol Baker
01:19:56
Will the chat links be available after the webinar
Laurie Ray
01:20:29
The chat is archived with the recording. Will be archived on the School SIG webpage.
Karen Gartner
01:26:10
Triwall cardboard, pegs and glue gun
Jan Meehl
01:28:05
Yes, Karen! So many things I built out of triwall at one point in time. :)
Lorrie Sylvester
01:28:07
I remember using this really hard corrugated cardboard over 30 years ago for special seating for kiddos!! These are the principals of adaptive seating we've used in RESNA...our hands tell us where we might put the support in the seating system. Still the basis of what we do today!
Cynthia Fisher
01:28:28
Me too!
Karen Gartner
01:30:49
A few of us are showing our age. There used to be books of plans for all sorts of pieces of equipment and in the 70s and 80s before equipment became marketed commercially this was all many of us had.
Cynthia Fisher
01:32:23
Oh NO! I remember those as well
Lorrie Sylvester
01:32:38
Absolutely! but these basic principles are still what I discuss with DME and wheelchair providers!
Nicole Schiffmacher
01:32:45
"Sooner or later, what was old is new again." Stephen King
June Cunningham
01:33:08
Sandy - please comment on the importance of working with your OTs in the schools. Because many times there is a collaboration regarding how we want the student positioned for SATCo principles and what OTs want for fine motor function.
Nicole Schiffmacher
01:33:23
I remember 20 years ago in school making a stander out of triwall
Wendy Harrell
01:33:52
Great point June
Nicole Schiffmacher
01:34:07
and collaboration with speech/language pathology as well - accessing communication devices and alignment for speech production.
Karen Gartner
01:34:37
Yes! We used to regularly use very high trays, and that went out of favor. Hopefully this will bring that back, as well as keeping the kids upright or tipped slightly forward for improved visual attention and less stimulation of tone (TLS)
Lorrie Sylvester
01:34:49
Yes...right on ... critical for accessing AAC devices/speaking/BREATHING!
Tammy Kimmelman
01:35:31
Our department in Austin, TX has had a workshop with an “Adaptive Equipment Specialist” for about 40 years, and this year our new Sped administration decided that there was too much liability for us to adapt equipment ourselves. But, they balk when we request commercial equipment. We still have lots of triwall, pvc piping, foam, and vinyl that we’re not supposed to use. It’s so frustrating.
JOCELYN NEWELL
01:36:57
Lorrie, I had a student whose speech production/volume improved with proper segmental support so the SLP always wanted her positioned in her stander
Lorrie Sylvester
01:38:49
Hmmm...looks something like a TLSO. It also appears you all decreased the seat-to-back angle....closer to 90. Something we can do with most wheelchairs anyway!
Danielle Bellows
01:40:11
Lorrie generally I find kids are not as firmly supported in vertical with just the wc back. The firm support is key
Karen Gartner
01:41:55
When I was regularly working on w/c prescriptions I rarely opened the seat to back angle. I preferred to order TIS and set them at 90/90 to allow for them to have an upright trunk for function.
Lorrie Sylvester
01:42:39
That firm trunk support is like our hands supporting him...but gets him higher and more visually engaged.
Danielle Bellows
01:42:50
@Karen I agree but I have also seen this approach work for kids with hip flexion contracture who can't tolerate 90 degrees hip flexion
Jan Meehl
01:44:42
@Karen Wht is "TIS" ?
Lorrie Sylvester
01:45:51
TIS is Tilt in Space.
Jan Meehl
01:46:03
thanks
Karen Gartner
01:46:23
Do any of you have teams that go around and do some of these difficult positioning assessments for classroom function, AAC etc.? We do in VT. we have and EI team and also a K-12 team that schools can request.
Jan Meehl
01:46:38
No! I wish...
Jan Meehl
01:46:46
I'm in Nebraska
Karen Zylstra
01:47:19
Not in my area of Virginia—would love that.
Lorrie Sylvester
01:47:35
We used to have AT teams and folks to consult with schools here in OK...no longer...some of us still go to the schools but not as formally.
Denise Swensen
01:48:08
Yes, we have a community of practice group that goes around to the early childhood centers in the county to test children with challenging positioning issues.
Allison Swisher
01:48:49
Do you need two people to perform the SATCo? I am the only PT in our district, so trying to determine how to perform this accurately.
JOCELYN NEWELL
01:49:01
We actually have SATCo clinic days where a group of therapists administer the SATCo assessment for a few students (3-4 usually) and then work on positioning in adaptive equipment with proper segmental support..
Wendy Harrell
01:49:04
Karen that’s so helpful. We have a SATCo Community of practice who want to learn and gradually feel more comfortable with assessment and positioning. People can request members of the team come out to help them assess, but also we spend about a day a month at different schools to assess and help others
Jan Meehl
01:49:25
@Allison me too. I won't be able to use SATCo if it takes two TRAINED people. :(
Wendy Harrell
01:49:40
Allison you need 2-3 people but they don’t have to be PTs.
Cheryl Baker
01:49:43
What material are you using to cover the boxes with?
Allison Swisher
01:50:02
Any one from Ohio or nearby that we could work together?
JOCELYN NEWELL
01:50:03
It does take 2 people but think about using an OT, teacher or even a paraprofessional
Laura Kredit
01:50:11
@Allison I've recruited an OT who overlaps one day with me to assist! It was a great experience and further opportunity to collaborate for our students.
Kerry Clemens
01:50:11
We don’t have those teams either here in AZ where I am but it sounds nice.
Wendy Harrell
01:50:15
In IT we often have PT holding from behind and the parent in front moving an object
Laurie Ray
01:51:00
and so many of us after a day online!!
Karen Gartner
01:51:40
The ones in VT are through UVM and the CIDL I was hoping there would be one of our PTs on this webinar but they aren’t. VT is so small that it is doable.
Wendy Harrell
01:53:45
This side view is where the 3rd person is helpful to let the person behind know if the child leans forward to backward or uses compensatory strategies with his hands
Allison Swisher
01:55:01
Anyone have plans for how to build a sit to stand box?
Nicole Schiffmacher
01:55:21
what materials did the students use to construct the sit<>stand box?
Benita Hodges
01:55:38
I am also interested for plans in how to build the sit to stand box as well as the tray height adaptors.
Danielle Bellows
01:56:25
My students are working on the plans for the Sit to Stand box and hope to be able to distribute these by fall.
Danielle Bellows
01:56:41
The one shown here is made out of the same cardboard shown earlier
Rebecca Renfro
01:57:03
How did they stabilize the bolster?
Allison Swisher
01:57:08
Would they be interested in sending one to Ohio?
Jan Meehl
01:57:22
And to Nebraska? :)
Karen Gartner
01:57:29
This is similar to a cube chair with higher sides and a tray attached in front. It should be fairly easy to figure out what dimensions the child would need.
Rebecca Renfro
01:57:51
That sounds great Danielle…how can we be on the distribution list?
Karen Zylstra
01:58:44
Thank-you Sandra, this was excellent.
Karen Gartner
01:58:59
This has been a wonderful presentation! Thank you
Marycaarol Baker
01:59:00
Thank you
Nancy Canto
01:59:07
thank you!
Jeanne McCoy
01:59:29
Thanks so much for these really informative presentations!
Stacy Zousmer
01:59:31
Thank you! This was excellent!
Melanie Natalie
01:59:37
thank you so much this was great!
Nicole Schiffmacher
01:59:41
Thank you very much, this was a great presentation!
Lorrie Sylvester
02:00:01
Fun and make me want to get more creative again! Yes, very useful for speaking and eating....great!
Karen Konish
02:00:03
Very interesting. Despite a long day of remote school meetings and classroom Zooms, so glad I tuned in this evening. Thank you.
Michael Gallano
02:00:04
Great presentation on SATCo assessment and application on classroom participation! Thanks!
Lauren Beeler
02:00:21
Many thanks to Sandra and peds SIG!
Michele Wiley
02:00:39
thank you-excellent!
Rebecca Renfro
02:00:46
Thank you for giving a nice presentation on SATCo and especially the implementation of information to guide intervention strategies…
Denise Swensen
02:00:50
Excellent presentation, Sandy! Thanks so much for your expertise and time. Thanks too to the SSIG.
Danielle Bellows
02:00:56
If you are interested in the plans for the STS box we will be sending out a version and looking for feedback from therapists and/or families sometime in the next 3-4 months. You can email me at bellows@hartford.edu to be on the list
Kerry Clemens
02:01:01
Great presentation. Thanks!
Karen Gartner
02:01:56
A parent handout will be wonderful to help parents understand that a child may need more or less support depending on time of day, fatigue level etc. ie the little girl who would fall into her food, who needs more support at night.
Deb Davison
02:02:41
Maybe a Fact Sheet....
Danielle Bellows
02:02:42
Thanks Karen. We agree! Also to be able to advocate with physicians and other providers unfamiliar with the approach
Lorrie Sylvester
02:02:48
Thanks to the School-Based Sig for sponsoring!
Cheryl Baker
02:03:03
Who do we send email to?
Robin Jorlett, PT
02:03:08
Awesome presentation with so many great ideas!! Loved the videos. Enhanced understanding of severe kids who are challenged with head control.
Cynthia Fisher
02:03:18
Thank you great Presentation!
Karen Gartner
02:03:22
yes, like Medicaid and other insurers when you need to order some additional straps etc for use different times of the day!
Laurie Ray
02:03:28
bellows@hartford.edu
Denise Swensen
02:03:30
so hard now not being able to get into families homes or the classroom. But all this will pass too
Karen Konish
02:03:45
If we are not members of the pediatrics, group will we still have access to the video?
Julie Wickham
02:03:51
Thank you for this helpful presentation!
Robin Jorlett, PT
02:04:13
Can we get a copy of the presentation?
Danielle Bellows
02:04:40
Also know the policies of your organization. This is a challenge in all the hospital settings and some schools
shannon
02:04:47
thank you for a wonderful presentation!
Anitha Sanisetty
02:04:49
It was interesting and modifying seating systems for classroom for more functional participation. Thank you for the excellent presentation.!!
Alexandra Talbott-Welch
02:05:59
which wheelchair manufacturers use that type of cardboard?
Rebecca Renfro
02:05:59
Does anyone know how to get DESMO foam?
Karen Gartner
02:06:04
For those doing telehealth during covid, this might be something you ask families to do with you. Look at the equipment in the house for feeding and see if there are suggestions that can be made
Benita Hodges
02:06:08
Does the new cardboard cut with a box knife?
Sandra Larson
02:06:22
So helpful, thank you!
Dana Tuomi
02:06:26
Do you know of any workshops that provide opportunities to learn more about modifying adaptive equipment?
Edith Searles
02:06:32
Thank you!
Benita Hodges
02:06:41
A serrated edge knife, like a bread knife?
Karen Gartner
02:06:41
electric knife
Cheryl Baker
02:06:43
Is the sit to stand consdidered a restraint at all
June Cunningham
02:06:46
Thank you! Miss seeing you!
Anne Stoltzfus
02:06:48
thank you, this was a wonderful presentation
Alexandra Talbott-Welch
02:07:26
Which wheelchair manufacturers use the cardboard?
Kathy Moody
02:07:51
We got the cardboard when we ordered changing tables for our schools.
Robin Jorlett, PT
02:08:16
Thanks you SSIG for allowing EI folks to join this webinar with you!!
Alexandra Talbott-Welch
02:08:36
What brand of changing table?
Karen Gartner
02:08:39
The energy expenditure for kiddos is so much less when they are well supported in upright. They can really use what they have so much more easily
Nancy Canto
02:09:15
thank you ssig for this training.
Nicole Schiffmacher
02:09:18
And they can LEARN so much easier!
Kathy Moody
02:09:20
Can’t remember the changing table brand. It was a hi-lo table with safety rails. New brand for our district and a co-worker did the ordering.
Alexandra Talbott-Welch
02:09:36
Thanks Kathy!
Karen Gartner
02:09:53
If there are mechanical equipment companies near you, they may be a resource for the cardboard as well.
Cheryl Baker
02:10:00
Is the sit to stand box considered a restraint?
Nancy Canto
02:10:19
please consider training on Schoolbased PT teletherapy specifically.
Terri Sadecki
02:10:20
Thanks so much for bringing to school-based SIG members
Terri Sadecki
02:12:34
yes please consider training on school based PT teletherapy
Denise Swensen
02:13:35
Consider starting the assessment in EI so children are ready for school at transition with their SATCo level and adaptive equipment in p;ace
Denise Swensen
02:13:40
Place
Rebecca Renfro
02:13:46
I would be glad to help anyone on some of the Telehealth…relore7@gmail.com
Nancy Canto
02:14:16
thank you,Laurie. great to hear from you.
Jan Meehl
02:14:26
@Denise, yes - I think it would help make some decisions on equipment needed for preschool!
Deb Davison
02:15:08
Thank you all so much...this was great!!
Cheryl Baker
02:15:14
Any chance a pdf available for presentation?
Rebecca Renfro
02:15:18
Definitely, worth it>>
Benita Hodges
02:15:19
Yes, worth it! Thank you for presenting!
Lynn Condon
02:15:21
Thank you for all the ideas, research and presentation!
Benita Hodges
02:15:56
Yes
Karen Tartick
02:15:58
Thanks -this was a great session!!!
Rebecca Renfro
02:15:58
yes
Karen Gartner
02:15:59
YES!!!!
Nicole Schiffmacher
02:15:59
sure
Julie Wickham
02:16:04
yes
Anitha Sanisetty
02:16:04
yes
Nancy Canto
02:16:07
yes
Danielle Bellows
02:17:14
This child is GMFCS Level IV
Cheryl Baker
02:18:13
Amazing! Getting goose bumps!!!
Nicole Schiffmacher
02:18:27
Great
Tammy Kimmelman
02:18:32
Thank you!
Nancy Canto
02:18:44
thanks.
Anna Fornaro
02:18:48
Thank you!
Wendy Harrell
02:18:51
Next webinar 6/9/20 6:30 pm EST on Dosing/Frequency of service by Susan Cecere Register in advance for this meeting:https://us02web.zoom.us/meeting/register/tZIoc-qprDsuGdK9o36GfJ3h-BsCjNbptJPgAfter registering, you will receive a confirmation email with meeting details
Karen Gartner
02:18:55
In the olden days we used bolster chairs regularly. For those of you wondering what you can do, you can get the rolls from carpet companies and then use vinyl and padding to upholster.
Lynn Louison
02:18:56
Awesome! Thanks for sharing.
Cheryl Baker
02:18:59
Do you paint the boxes? Just wondering
Priscilla Killette
02:19:00
Thank you
Jan Meehl
02:19:20
Yes, I would like the foot strap handout
Karen Stone
02:19:21
@Wendy - will these be shared also via email to SIG members?
Benita Hodges
02:19:27
Yes, would like to know how to make the foot supports.
Karen Gartner
02:19:35
The cardboard can be painted, but also if you use contac paper, you have a surface that is wipeable for kids who drool
Cheryl Baker
02:19:37
Great idea, Karen!
Cheryl Baker
02:20:02
YES PLEASE!!
Terri Sadecki
02:20:02
YES that would be great!!
Stacy Zousmer
02:20:07
yes! Thank you!
Wendy Campbell
02:20:09
YES PLEASE!
Benita Hodges
02:20:09
You are very generous!
Denise Swensen
02:20:11
I have used the Kaye bench with the side and back supports and a pommel for sit to stand and it worked well too
Anna Fornaro
02:20:11
That would be great. Thank you!
Kerry Clemens
02:20:20
Thank you so much!
Danielle Bellows
02:20:48
Foam rollers can be a good enough bolster for smaller kiddos
Deb Davison
02:21:08
Unfortunately, many districts are concerned about liability and won't allow for handmade equipment to use directly with students
Allison Swisher
02:22:01
Where would you find information about the straps for pedals?
Kathy Moody
02:22:28
We use neoprene ankle supports with trike pedals. They work great.
Cheryl Baker
02:22:47
Can this information be shared with other colleagues?
Jan Meehl
02:23:46
@Kathy Moody what do those ankle supports look like?
Deb Davison
02:24:23
Join! It's well worth it!!!
Cheryl Baker
02:24:27
So glad to be a member! Thank you all so much! Great
Karen Gartner
02:24:37
we will have an email about that webinar?
Stephanie Dillon
02:24:48
Thank you for your information!
Joanne Welles
02:24:48
Yes, glad to be a member. Thank you!
Laurie Ray
02:25:12
pediatricschoolsig@gmail.com
Kristie Hawley
02:25:14
Thank-you for everyone's hard work to make this happen!
JOCELYN NEWELL
02:25:21
Great job Sandy! I love how excited everyone is!!
Laurie Ray
02:25:39
send your ideas for topics pediatricschoolsig@gmail.com