I met Diana in 2008 at a visit to a school for special needs. We evaluated several children and tried to position them with materials at hand such as washcloths, pillows, or pieces of wood. These adaptations were clearly inadequate. Diana spent most of her time lying in a crib, since her scoliosis made sitting uncomfortable in her standard wheelchair.

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Diana’s evaluation, 2012

This visit was what stimulated me to search for creative solutions to positioning problems and led me to ADA. I saw Diana a few years later, and with her parents, her school personnel, and our orthotists, we devised a combination seat with a custom molded thermoplastic back, a wood seat heavily padded with custom cutouts formed to her shape, cardboard supports for her feet and trunk, dacron seat belt, cardboard tray, and customization of her commercial metal and plastic molded headrest. Although this sounds complicated, only the thermoplastic back required specialized tools and techniques.

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Casting Diana for the thermoplastic seat insert

 

When Diana was lying in a crib she appeared infantilized, but Diana sitting in her wheelchair is a teenager in the midst of whatever is happening.