SSIG- SATCo & Segmental positioning in schools - Shared screen with speaker view
everyone needs to mute
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
may we record
This is being recorded and will be posted on the School SIG webpage
Do you want support for the feet?
Deb you don’t have to support the feet
Just wondering if that impacts results
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?
we used this ….this year and got better with practice
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?
Ginny - this is an assessment for trunk control. How does your question relate to this?
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.
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.
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.
Is there a measure for endurance...how long the child can sustain the static, active or reactive before collapsing? Impacts school participation as well...
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.
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.
Were you shifting the child for the reactive?
Where does one purchase the SATCO protocol/ instruction manual?
Where does one find the strapping system used in the test?
Are there specific straps that are used or is there a type of strap/measurements for the straps that are used?
@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.
Leceky seels the bench!
Is there a specific strap for SATco that I can buy?
Leckey (Ki in USA) sells a bench for SATCO
Yes they do.
@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
Plus the constant nagging breaks down relationships
You can also put the strapping system on benches yourself according to the directions.
Kaye products also makes a bench. You can provide a strap yourself.
Leckey not yet available in US but hopefully soon
The Rifton Pelvic straps have been awesome to support this! The pelvic straps can also be added to wheelchairs.
Sandy will send SATCo strap info to anyone who is interested
We have also adapted regular classroom chairs with the strapping system
That would be great…can she send it out with a group email?
Rifton has a video on segmental positioning using their activity chair, with a case study
How do we get more training
SATCo protocol downloadable for free from PubMed
Here is a link to the strapping system. https://www.dropbox.com/s/ni7teebnr6wlh34/BenchStrapSystem_2015.doc?dl=0
Regional reps will email out links to SSIG members
Are there more videos available to watch someone testing?
We can ask Sandra to send any resources she can share to our SSIG regional representatives. You can contact them directly.
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.
SATCo form and instructions for strap system for older children https://www.dropbox.com/s/as0qbh5pe9b5kab/SATCo-Form-and-instructions.pdf?dl=0
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
Testing protocol is available on Pediatric PT journal October 2010. Article is free.
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
Will the chat links be available after the webinar
The chat is archived with the recording. Will be archived on the School SIG webpage.
Triwall cardboard, pegs and glue gun
Yes, Karen! So many things I built out of triwall at one point in time. :)
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!
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.
Oh NO! I remember those as well
Absolutely! but these basic principles are still what I discuss with DME and wheelchair providers!
"Sooner or later, what was old is new again." Stephen King
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.
I remember 20 years ago in school making a stander out of triwall
Great point June
and collaboration with speech/language pathology as well - accessing communication devices and alignment for speech production.
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)
Yes...right on ... critical for accessing AAC devices/speaking/BREATHING!
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.
Lorrie, I had a student whose speech production/volume improved with proper segmental support so the SLP always wanted her positioned in her stander
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!
Lorrie generally I find kids are not as firmly supported in vertical with just the wc back. The firm support is key
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.
That firm trunk support is like our hands supporting him...but gets him higher and more visually engaged.
@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
@Karen Wht is "TIS" ?
TIS is Tilt in Space.
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.
No! I wish...
I'm in Nebraska
Not in my area of Virginia—would love that.
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.
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.
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.
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..
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
@Allison me too. I won't be able to use SATCo if it takes two TRAINED people. :(
Allison you need 2-3 people but they don’t have to be PTs.
What material are you using to cover the boxes with?
Any one from Ohio or nearby that we could work together?
It does take 2 people but think about using an OT, teacher or even a paraprofessional
@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.
We don’t have those teams either here in AZ where I am but it sounds nice.
In IT we often have PT holding from behind and the parent in front moving an object
and so many of us after a day online!!
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.
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
Anyone have plans for how to build a sit to stand box?
what materials did the students use to construct the sit<>stand box?
I am also interested for plans in how to build the sit to stand box as well as the tray height adaptors.
My students are working on the plans for the Sit to Stand box and hope to be able to distribute these by fall.
The one shown here is made out of the same cardboard shown earlier
How did they stabilize the bolster?
Would they be interested in sending one to Ohio?
And to Nebraska? :)
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.
That sounds great Danielle…how can we be on the distribution list?
Thank-you Sandra, this was excellent.
This has been a wonderful presentation! Thank you
Thanks so much for these really informative presentations!
Thank you! This was excellent!
thank you so much this was great!
Thank you very much, this was a great presentation!
Fun and make me want to get more creative again! Yes, very useful for speaking and eating....great!
Very interesting. Despite a long day of remote school meetings and classroom Zooms, so glad I tuned in this evening. Thank you.
Great presentation on SATCo assessment and application on classroom participation! Thanks!
Many thanks to Sandra and peds SIG!
Thank you for giving a nice presentation on SATCo and especially the implementation of information to guide intervention strategies…
Excellent presentation, Sandy! Thanks so much for your expertise and time. Thanks too to the SSIG.
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 email@example.com to be on the list
Great presentation. Thanks!
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.
Maybe a Fact Sheet....
Thanks Karen. We agree! Also to be able to advocate with physicians and other providers unfamiliar with the approach
Thanks to the School-Based Sig for sponsoring!
Who do we send email to?
Robin Jorlett, PT
Awesome presentation with so many great ideas!! Loved the videos. Enhanced understanding of severe kids who are challenged with head control.
Thank you great Presentation!
yes, like Medicaid and other insurers when you need to order some additional straps etc for use different times of the day!
so hard now not being able to get into families homes or the classroom. But all this will pass too
If we are not members of the pediatrics, group will we still have access to the video?
Thank you for this helpful presentation!
Robin Jorlett, PT
Can we get a copy of the presentation?
Also know the policies of your organization. This is a challenge in all the hospital settings and some schools
thank you for a wonderful presentation!
It was interesting and modifying seating systems for classroom for more functional participation. Thank you for the excellent presentation.!!
which wheelchair manufacturers use that type of cardboard?
Does anyone know how to get DESMO foam?
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
Does the new cardboard cut with a box knife?
So helpful, thank you!
Do you know of any workshops that provide opportunities to learn more about modifying adaptive equipment?
A serrated edge knife, like a bread knife?
Is the sit to stand consdidered a restraint at all
Thank you! Miss seeing you!
thank you, this was a wonderful presentation
Which wheelchair manufacturers use the cardboard?
We got the cardboard when we ordered changing tables for our schools.
Robin Jorlett, PT
Thanks you SSIG for allowing EI folks to join this webinar with you!!
What brand of changing table?
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
thank you ssig for this training.
And they can LEARN so much easier!
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.
If there are mechanical equipment companies near you, they may be a resource for the cardboard as well.
Is the sit to stand box considered a restraint?
please consider training on Schoolbased PT teletherapy specifically.
Thanks so much for bringing to school-based SIG members
yes please consider training on school based PT teletherapy
Consider starting the assessment in EI so children are ready for school at transition with their SATCo level and adaptive equipment in p;ace
I would be glad to help anyone on some of the Telehealth…firstname.lastname@example.org
thank you,Laurie. great to hear from you.
@Denise, yes - I think it would help make some decisions on equipment needed for preschool!
Thank you all so much...this was great!!
Any chance a pdf available for presentation?
Definitely, worth it>>
Yes, worth it! Thank you for presenting!
Thank you for all the ideas, research and presentation!
Thanks -this was a great session!!!
This child is GMFCS Level IV
Amazing! Getting goose bumps!!!
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
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.
Awesome! Thanks for sharing.
Do you paint the boxes? Just wondering
Yes, I would like the foot strap handout
@Wendy - will these be shared also via email to SIG members?
Yes, would like to know how to make the foot supports.
The cardboard can be painted, but also if you use contac paper, you have a surface that is wipeable for kids who drool
Great idea, Karen!
YES that would be great!!
yes! Thank you!
You are very generous!
I have used the Kaye bench with the side and back supports and a pommel for sit to stand and it worked well too
That would be great. Thank you!
Thank you so much!
Foam rollers can be a good enough bolster for smaller kiddos
Unfortunately, many districts are concerned about liability and won't allow for handmade equipment to use directly with students
Where would you find information about the straps for pedals?
We use neoprene ankle supports with trike pedals. They work great.
Can this information be shared with other colleagues?
@Kathy Moody what do those ankle supports look like?
Join! It's well worth it!!!
So glad to be a member! Thank you all so much! Great
we will have an email about that webinar?
Thank you for your information!
Yes, glad to be a member. Thank you!
Thank-you for everyone's hard work to make this happen!
Great job Sandy! I love how excited everyone is!!
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