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Assessment> Adequate Hand Function
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Adequate Hand Function: Positioning

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For some people, proper positioning can make an huge difference in the ability to use their hands. See “Why positioning is important”.

If a person uses a wheelchair which doesn’t adequately support their body, it’s important that they work with their team members (including a physical therapist or wheelchair vendor) in order to get or modify a wheelchair so that it provides proper support.

Positioning Assessment

(only perform the steps below which seem relevant to the AAC user.)

Position communication BOARD
Ask the person where they want the board (i.e. on a table in front of them, or on their lap.)
Have the individual try pointing to different cells.

If the person has significant weakness, having the board on too high of a surface (like a table top) can make accessing the board harder. (The person is having to expend extra energy just holding their arm in the air.

Try placing the board on a lower surface (one option is to place the board on a pillow lap tray, or directly onto the person’s lap.)

If a person is significantly weak, or has some spasticity, to may make it easier for them to select items if their elbow is supported. A person can support their elbow on the edge of the table, or on the arm of their wheelchair.

Some people may have good hand function, but may have a significant neck weakness. (This may be true for some people with bulbar onset ALS). Even though their hands function well, it can be extremely exhausting to have to look down all the time at a communication board.

If a person has significant neck weakness, it may be much more comfortable to use hand held laser and a large communication board. This allows the person to sit in a comfortable position, with their head supported. Poor positioning can lead to fatigue…

Click here if a person has significant neck weakness.


Visual Assessment