Synopsis
Prescribe and review mobility, positioning and pressure-care equipment around the child's goals, prevent device-related injury, maintain safe transfers and preserve participation through reliable provision across home, school and community settings.
- Begin with the child's goals for movement, comfort, communication and participation before choosing a device or postural system.
- Assess body dimensions, joint range, tone, skin risk, vision, cognition, transport, home layout and caregiver handling together.
- Mobility includes self-propulsion, powered movement, assisted walking and supported transfers; the most independent safe method may vary by setting.
- Pressure risk comes from load, shear, moisture, friction, immobility, malnutrition, reduced sensation and poorly fitted devices.
- Inspect skin at every high-risk contact point, especially after new equipment, growth, weight change or increased time in one position.
- Specify training, maintenance, charging, cleaning, transport restraint and a breakdown route when equipment is issued.
- A device that remains at school or cannot enter the home does not meet whole-life mobility need.
- Review effectiveness through comfort, skin integrity, transfers and actual participation rather than technical fit alone.
Key red flags
Non-blanching erythema, blister, purple discoloration, broken skin or rapidly increasing pain over a pressure area requires prompt assessment and offloading.
A new swollen painful limb after equipment use may represent fracture, dislocation, vascular compromise or an excessively tight support.
Seating that compromises breathing, swallowing or head control must be reviewed urgently rather than tolerated for postural appearance.
A failed hoist, wheelchair or communication mount without a safe alternative can prevent essential care and should trigger an urgent equipment response.
Repeated unplanned manual lifts place both child and carers at injury risk and indicate that handling assessment or provision is inadequate.
Unexplained patterned pressure injury or poor equipment hygiene may signal neglect, training failure or unsuitable provision and requires safeguarding consideration.
Investigation priorities
Define active control, fixed limitation, comfort and task-specific support requirements.
Management branches
Mobility, posture, care or participation cannot be achieved safely with current support.
- Agree the child's functional goals and identify every intended environment.
- Assess posture, skin, transfers, communication, transport and caregiver capability.
- Trial suitable options during meaningful activities and record trade-offs.
- Issue the item with settings, training, maintenance and review responsibilities.