A time of transition

and hip flexibility can directly impact posture and mandate changes in wheelchair configuration. In addition to the seating itself, the orientation of the system through both tilt and recline can help functionally compensate for muscle length and tone changes. For example, if extensor muscle recruitment creates anterior progression on the seat surface, a combination of tilt and recline may allow for the individual to independently reposition themselves, decreasing reliance on a caregiver. Unique combinations of lateral tilt, anterior tilt and pre-cline to the typical posterior orientation changes should also be considered to increase variety in positions for task performance as well as to compensate for a loss of flexibility in cervical musculature which may limit visual field through poor head orientation. In many instances, creative opportunities for supplemental positioning including nighttime positioners and stretching through weight bearing in supported standing can assist with overall joint maintenance. Growing pains in adolescence encompass the entire spectrum. Physical changes often capture the spotlight but are closely intertwined with character development. This is a time when boundaries are questioned, pushed and often broken and moments can begin to define individuals. More often than not, these defining times emerge out of engagement in family, social and academic life. Physical barriers to participation are often a hallmark component of disability. Technology, equipment and education when well implemented can often minimize these participation barriers. When this technology and equipment is not well prescribed or when education is lacking, barriers can be magnified rather than eliminated. Pathways to independence are rarely downhill and coordinating a team approach to equipment provision that facilitates the emergence of a successful individual somewhere along the way has its ability to challenge the strongest leadership.