Introduction / Background Progressive neurological conditions like Huntington's Disease (HD) present extreme assistive technology (AT) challenges due to uncontrollable choreic movements and cognitive decline. Standard equipment often fails to mitigate injury risk and leads to severe occupational deprivation in critical areas like sleep, rest, and seated activity. This presentation details a best-practice, occupational therapy-driven model for complex AT prescription in high-risk neurological populations.

Method / Implementation A structured, three-pillar assessment framework was implemented: Safety/Injury Prevention, Posture/Positioning (using the Mechanical Assessment Tool - MAT), and Caregiver Occupational Safety (using Manual Handling Assessment). This framework was applied to a real-world case series of clients with mid-to-late stage HD to justify the staged scripting of specialised protective bed and chair systems.

Discussion / Outcomes The framework successfully translated objective findings (e.g., MAT-identified postural deformities and high-risk manual handling scores) directly into specific equipment features (e.g., Vertical Lifting Mechanisms, anti-entrapment design). The resulting equipment enabled safe transfers and prolonged therapeutic posture, thereby facilitating sustained engagement in daily occupations and significantly reducing high-risk scenarios.

Conclusion Occupational therapists are uniquely positioned to manage complex AT for clients with severe involuntary movement. The systematic application of this MAT-informed, three-pillar framework provides a confident, evidence-based rationale for prescribing protective seating and beds, moving practice beyond containment towards the maximisation of safe occupational performance.