Positioning: Treat in the wheelchair or transfer carefully; support head, trunk and limbs; never force limbs
Bite and startle reflexes: Mouth props and finger guards for the bite reflex; slow, forewarned movements to limit startle
Airway protection: Choose a position compatible with swallowing, breathing, and contractures. Use effective suction and rubber dam when tolerated and feasible; no device eliminates aspiration risk
Sedation risk: impaired swallow, aspiration, seizures and contractures; coordinate the safest setting and airway plan with anesthesia