Silas has reasonable head control, but his head will fall forward when he is tired. He requires support to sit, and is unable to walk. Silas also has a number of sensory needs – he has a cortical visual impairment, is tube-fed due to an inadequate suck/swallow reflex, and verbal communication is limited to a couple of words. Silas is dependent on his parents and caregivers for all activities of daily living, but the spasticity in all four of his limbs makes some activities such as dressing very difficult, even with assistance. Silas attends preschool three days per week and receives occupational therapy, physical therapy and speech and language therapy. He also receives therapy for his visual impairment. Outside of school, Silas’s parents have organised hippotherapy and Masgutova Neurosensorimotor Reflex Integration (MNRI) therapy (http://masgutovamethod.com/).
Silas’s parents bought a Playpak for him so that he could play at ground level without having to be in a supine position
Silas has used the Playpak to support him in a floor sitting posture. He is able to play independently with his toys, while working on head control, and appears to have gained confidence from the new posture. His parents report, “He chuckles like he is so proud of himself as if to say look at me!” Silas’s parents enjoy that Silas is able to see the world like everyone else, and have noted that because he is upright, people pay extra attention and interact more with him. Because they find it so versatile, Silas’s family have used the Playpak at home, friends’ houses, and they also intend to take it on holiday with them.