Wheelchair Positioning: The Head

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Some wheelchair seating systems do not include any support for the head and many systems only include a simple posterior head support. Some clients require additional support secondary to impaired head control or asymmetrical head postures. The position of the head must optimize vision, breathing, and swallow, as well as function. This course is applicable to occupational and physical therapists who work with clients using wheelchairs and applies to multiple practice settings.

Learning Objectives

Implement assessment strategies for a client with a suboptimal head position
Correlate specific client parameters to posterior head support product features
Determine when lateral head support is required
Determine when anterior head support or a collar is indicated
Implement appropriate wheelchair seating interventions to improve mobility to enhance participation in desired daily occupations and reduce risk for complications such as skin breakdown or contractures

Meet your instructor

Michelle L. Lange

Michelle Lange is an occupational therapist with over 38 years of experience and has been in private practice, Access to Independence, for over 19 years. She is a well-respected lecturer, both nationally and internationally, and has authored numerous texts, chapters, and articles. She is the co-editor of Seating and Wheeled…

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Chapters & learning objectives

1. Positioning the Head: assessment considerations

Positioning the head involves strong knowledge of where to provide support to achieve postural alignment of the neck and head while respecting vision, breathing, swallows, and functional needs.

2. Positioning the Head: Posterior Head Supports

Head support is typically provided posterior to the head. Some head pads only contact the occiput, while others provide support at the suboccipital area, typically in combination with the occipital pad. Each product offers specific features to match individual client need.

3. Positioning the Head: Lateral Supports

Lateral head support is added to a posterior head support to address lateral neck flexion and/or rotation. Matching specific product features to individual need and understanding optimal lateral pad placement is critical.

4. Positioning the Head: anterior supports and collars

For clients with minimal head control, anterior support at the forehead or a collar under the jaw may be required to maintain an upright head position. Clinical advantages and disadvantages to these options are important to understand and convey to the seating team.

More courses in this series

Wheelchair Positioning: The Extremities

Michelle L. Lange