Development and Effectiveness of the Participatory Adapted 3D Sedentation System (SSAP3D).

Change in the score on the Pediatric Evaluation of Disability Inventory-Computer Adaptive Test (PEDI-CAT). The PEDI-CAT is a computerized and adaptive questionnaire completed by the family that measures the child's functional performance in the areas of activities of daily life, mobility, social/cognitive function and responsibility in complex daily tasks. In addition, in children with Neuromotor Dysfunction, the PEDI-CAT has been shown to be a valid instrument to measure functional ability.

30-70: Considered the expected range for age, indicating normal functional capacity.

< 30: Suggests lower than expected functional capacity for age.

Changes in the score of Postural control measure (SPCM): a 34-item scale designed to measure changes in postural alignment and functional movement produced by an intervention focused on adapted seating systems. It has shown good psychometric properties for children with Neuromotor Dysfunction.

• Postural Alignment Section (SPCM-A): 22 items, scored on a 4-point ordinal scale. From 1: Neutral alignment (typical posture), to 4: Severe deviation
• Functional Movement Section (SPCM-F): 12 items, scored on a 4-point ordinal scale. From 1: Unable to initiate the task, to 4: Successful completion of the task

Change in the score on the Box and Block Test (BBT). The BBT measures the functionality of the upper extremity in children with Neuromotor Dysfunction, specifically gross motor dexterity in a unimanual way in terms of speed and accuracy.

Change in the score on the Canadian Occupational Performance Measure (COPM). The COPM is designed to identify occupational performance problems through a semi-structured, clinically useful and responsive interview that allows for person-centered practice. The COPM will be used to establish three occupational performance problems in each child, which will be identified by the family and used as functional treatment goals.

• Importance Score: The client rates the importance of each activity identified for their life, using an ordinal scale from 1 to 10.

1: Not important at all. 10: Extremely important.

• Performance: How well do you currently perform the activity?

1: Unable to perform at all (or with great difficulty). 10: Able to perform extremely well (or without difficulty).

• Satisfaction: How satisfied are you with your current level of performance in this activity? 1: Not at all satisfied. 10: Extremely satisfied.

Change in the score on the Young Children's Participation and Environment Measure (YC-PEM). Measurement instrument filled out by the parents or primary caregiver, which analyzes the different activities of the child between 0-5.9 years of age, assessing their level of participation and the qualities of the environment in which they develop.

• Frequency of Participation 8 points, from 0 (never) to 7 (one or more times a day). A higher score indicates greater frequency of participation in these activities.
• Level of Involvement 5 points, from 1 (not very envolved) to 5 (Very involved.).A higher score indicates a greater level of interaction and active participation in activities.
• Percentage of Desired Change Percentage (0% to 100%). A lower percentage suggests greater satisfaction with the child's current participation.

A higher percentage indicates that the caregiver desires change.

• Environmental Support (Facilitators and Barriers) Percentage (0% to 100%)

Change in the score on the Pediatric Quality of Life Inventory (PedsQL): a tool for measuring health-related quality of life in children and adolescents aged 2 to 18, assessing physical, emotional, social, and school functioning. In the versions for younger children, a report completed by parents is used. Widely adapted and validated in Spanish.

• Ages 5-7 (Parent-report): 3-point scale.
• Ages 2-4 (Parent report): 3-point scale.

To calculate the final scores, the items are reversed and linearly transformed to a scale of 0 to 100, where:

• 0 (frequent problem) becomes 0 (low HRQoL).
• 4 (never a problem) becomes 100 (high HRQoL) High Scores (close to 100): Indicate excellent quality of life and few health problems.

Low Scores (close to 0): Indicate poor quality of life and significant health problems.

Change in the score on the Family Impact of Assistive Technology for Adapting Sitting (FIAT-AS). It is a questionnaire completed by parents that measures the functional status and change in habits of the child with Neuromotor Dysfunction and the family as influenced by interventions focused on adapted seating systems.

Parents respond to 64 items (originally 89) using a 7-point Likert scale, ranging from:

1: Strongly Disagree 7: Strongly Agree. High Scores (close to 7): Indicate a positive impact and better functioning of the child and family in that specific dimension. For example, a high score on "Autonomy" means that the child is perceived as very autonomous.

Low scores (close to 1): Indicate a negative impact, poorer functioning, or the presence of significant barriers. For example, a low score on "Caregiver Relief" means that the caregiver experiences little relief from their tasks.

Changes in the score of Segmental assessment of trunk control (SATCo): validated and reliable scale for children with Neuromotor Dysfunction and for neuromotor disorders, which measures the degree of trunk control its different segments while seated.

The score is based on a "pass/fail" (present/absent) system for control in each segment, under three specific conditions at each level:

Static Control Active (Anticipatory) Control Reactive Control

For data analysis and clinical follow-up, an ordinal numerical value is assigned to each level of control achieved:

• Functional control of the head only (the trunk is unstable and requires maximum support).
• Control of the head and upper cervical segments.
• Control of the head and upper chest.
• Control of the head and most of the thorax.
• Control of the head, thorax, and upper abdomen.
• Control of the entire spine except the pelvis
• Complete trunk control, no manual support required