Establishing best practice in seating assessment for children with physical disabilities using qualitative methodologies.

Purpose: To identify best practice in children's seating assessment in the UK and Ireland.

Method: The researchers observed six children's seating assessments performed by four therapists at three regional centres, to capture routine seating assessment practice. Observed assessment components were recorded on an 83-item checklist derived from existing published literature, and supported by video-recording. A Delphi technique obtained opinions on best practice seating assessment from seven expert therapists using three rounds of questionnaires. Themes were rated by respondents on 'importance', 'desirability' and 'feasibility'. Consensus of 70% was sought on all rated sub-themes.

Observation: two assessment items (problem identification and prescription) were observed on every occasion. All other items occurred zero to five times. Standardised assessment methods were not observed. Delphi: themes identified were 'assessment process', 'assessment approach' and 'broader issues'. Consensus was reached on importance and desirability of 'assessment process' and 'assessment approach' sub-themes.

Conclusions: Variation in seating assessment practice occurred between regions, yet there was agreement on theoretical best practice components. This may reflect the complexity of seating assessment in reality. The need for, and benefits of, a consistent approach was clearly identified. Future research should be directed toward developing a best practice assessment tool, which links assessment findings to appropriate seating solutions.