In addition to the three case studies, Nivedita Swaroop Cawand conducted a comparative study between children using an adaptive seating device during therapy sessions, and those who did not. This study focused on the impact of including the newly designed adaptive seating device, known as the D chair, during occupational therapy sessions for children with Down syndrome (Cawand, 2014). The D chair was redesigned to provide comfort and proximal stability at the child’s trunk, allowing the child to focus on developing fine motor skills (Cawand, 2014). Twenty-eight children were evenly split into an experimental group and a control group; the main focus of both groups focused on improving fine motor skills. The fourteen children in the experimental