Active assisted range of motion exercises are apt to be more effective than passive sensory stimulation or massages in reducing the urges to stand or sit up.

ACL 2.0

The person is able to sit up for longer periods and have a moderate / low risk of developing pressure sores. Caregivers will need to monitor and observe for pressure sores and use appropriate pressure relieving devices.

Common pressure relieving devices are:

ACL 2.0

As the person has better trunk control and is able to move oneself, unsupported seating may be used.

ACL 2.2

Footplates may be removed to allow "walking" in chair for brief periods.

Use a wheelchair with an anti-tip bar / wheel to prevent the chair from tipping backwards.

ACL 2.0 - 2.2

The person has some postural control but not enough to transfer independently. Two people and a safety belt will probably be needed.

A stand lift / stand up lifter may be preferred.

Experiencing falls, near misses, and being yelled at rarely prevents falls. The most effective prevention of falls is a regular daily schedule for sitting, standing and stepping forward for the sole purpose of preserving muscle strength and balance. Due to an inability to regain their balance when it is lost, falls must be prevented by the assistance of two people and equipment. Specifically designed standing tables or stepping forward supports with their weight on forearm rests are usually required.

Hair & Nail Care

Prevent ingrown or broken nails by cutting and smoothing nails.

Prevent hair matting by a short hair cut or by brushing and braiding hair.

Oral Hygiene

Use oral swabs or a child's toothbrush training set for stimulating or desensitizing oral tissues, oral motor facilitation and cleaning their mouth. Use child toothpaste that can be swallowed, and place mouthwash on a cloth.

ACL 2.0

They can go beyond a soft diet but foods must be cut up into small pieces. Hard to chew and stringy foods should be avoided. Provide opportunities to make food choices (up to three choices) and honor their preferences. Continue to encourage self-feeding with finger foods.

Mobility is the least restricted when the person uses incontinence pads that have soft elastic waists because they are not as bulky as other pads. The elastic waist encourages their use of the toilet because they are easier to adjust than zippers or buttons.

ACL 2.0 - 2.2

They can sit in a mobile shower commode chair or a shower chair and toilet seat with arms. Many people are able to sit long enough to void.

They can lean forward on the count of three to cooperate with personal hygiene; physical assistance to sustain leaning forward may be necessary.

ACL 2.0 - 2.2

Dressing can be done for them while sitting with back support. The improved trunk control will allow sitting up for 20 to 30 minutes without sliding out.

While sitting, they can lift a foot to help with dressing. They can standup and hold on while their pants are pulled up, but their hands will probably have to be placed on a rail for them.

Assistance with dressing includes placing the garments beside them and cueing to the openings for their hands and feet. They will need assistance with using buttons, zipper, Velcro or magnetic fastenings.