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Background and Purpose: Physical therapists and occupational therapists frequently use adaptive seating devices to improve stability in sitting for children with neuromotor impairments. The purpose of this study was to examine the effects of a contoured foam seat (CFS) on postural alignment and on the ability of infants with neuromotor impairments to engage with toys. Parental perceptions regarding the use and effects of the CFS also were assessed via semistructured interviews., Subjects: Subjects were 4 infants, ages 9 to 18 months, who were unable to sit independently., Method: A time-series, alternating-treatments design was used, with data collected under 3 conditions: (1) a regular highchair, (2) a regular highchair with a thin foam liner, and (3) a CFS used as an insert in a regular highchair. The primary dependent measures were postural alignment and engagement with toys. Engagement with toys was defined as percentage of intervals with 2 hands on a toy and percentage of intervals with no hands on a highchair tray and 1 or 2 hands on a toy., Results: Results showed a sustained effect of the CFS on improving postural alignment for all subjects. Effects of the CFS on increasing the number of intervals of bimanual play were not demonstrated for any subjects, although some improvement in the infant's ability to free the arms from support was observed for 2 subjects. Mothers reported acceptability of the CFS for everyday use and described benefits for themselves and their infants., Discussion and Conclusion: The results support the use of a CFS for improving postural alignment. Future research on adaptive seating should focus on interventions and outcomes that help children participate in functional activities relevant to them and their families.

Background and Purpose: Most clinical evaluations of postural control in children are relatively subjective and have not been tested for reliability of scoring. The purpose of this study was to investigate the test-retest reliability of measurements obtained with two tiltboard tests., Subjects: Subjects were 18 children, aged 53 to 81 months (mean = 64.4, SD = 8.3), who were typically developing (TD group) and 18 children, aged 50 to 79 months (mean = 63.3, SD = 8.4), with developmental delays (DD group)., Methods: Each child was tested using the two tilt-board tests and was then retested using the same tests approximately 1 week later. The maximum angle of tiltboard tilt prior to any postural adjustment by the child was recorded., Results: Intraclass correlation coefficients for test-retest reliability (two-way, random-effects, repeated-measures model) ranged from .49 to .54 for the TD group and from .52 to .82 for the DD group. Angles were higher for both groups for the second test., Conclusion and Discussion: The results suggest that these tiltboard tests do not give stable and reliable measurements across test sessions. Before these tests can be used to document change in postural control abilities across time, further research is warranted.

The purpose of this study was to examine the interrater and test-retest reliability of a one-leg balance test and a tiltboard balance test. Twenty-four normally developing children aged 4 through 9 years participated in the study. Time and quality of balance on one leg and degrees of tilt on a tiltboard prior to postural adjustment were measured. Both tests were completed with eyes open and with eyes closed. Interrater reliability was examined using two raters. Test-retest reliability, with a one-week interval between test and retest, was examined for a subgroup consisting of 12 children. Spearman rank-order correlation coefficients were used as indexes of both interrater and test-retest reliability for time and degrees of tilt. To supplement the correlation coefficients, the magnitudes of difference between raters' scores and between test and retest scores were calculated. Spearman coefficients were moderate to high for one-leg balance when scores for both feet were combined for both eyes-open and eyes-closed conditions. The magnitude of difference between scores was low, indicating good agreement between raters and across time. Interrater and test-retest reliabilities of quality of one-leg standing balance were examined by calculating percentages of agreement and Cohen's Kappa statistics. Results of these analyses revealed the need for further study. The Spearman coefficients for the interrater tiltboard test were high; however, the test-retest coefficients were low. The magnitudes of difference between scores were small for the two raters, but large for test and retest. These results are important to consider when using these tests for initial evaluation or for monitoring patient progress.