A qualitative study exploring clinicians’ perspectives on best practice in custom moulded seating provision for children and young people

PURPOSE: In the absence of standards or guidelines for custom moulded seating (CMS) provision for children and young people (CYP), this study explored clinicians' perspectives on best practice in this provision for CYP. METHOBDS: A qualitative exploratory design using a participatory "World Café" workshop approach explored the perspectives of 54 multinational clinicians attending the European Seating Symposium in June 2024. Data collected was analysed using thematic analysis. RESULTS: Five main themes were identified: (1) The child and family's needs are central (2) Varying perspectives on when to recommend CMS (3) The need for efficient and effective CMS processes and pathways (4) Advanced practice knowledge, skills and competencies required (5) Manufacturing of high-quality, adaptable CMS product options. Despite a strong emphasis on early intervention using CMS to protect body shape, some clinicians considered it "a last resort" highlighting clinical tensions. Pain and the achievement of functional goals were key considerations for recommending CMS. Responsive manufacturing of a range of adaptable CMS options was emphasised. Seating clinicians must have advanced practice competencies from assessment to shape capture and CMS provision. CONCLUSION: This research highlighted the inherent complexity within decision making aligned to individualised prescription of CMS. Further examination of when to introduce CMS and its contribution to the prevention and/or management of destructive postures and to participation and quality of life is needed. Service planning and policies must ensure CMS provision is child- and family-centred, with efficient processes that meet users' needs effectively.