The purpose of this study was to determine the usefulness of custom-contoured cushions (CCCs) in providing a safe sitting surface. The efficacy of CCCs was investigated using ten spinal cord injured persons who evaluated contoured foam as their primary wheelchair cushion. External pressures at the seat interface were measured on a subject's regular cushion and on a CCC to compare the respective load distributions. Pressure distributions measured on a CCC were statistically lower than those measured on the subject's usual cushion (p less than .05). Eight clinical variables were used to judge each cushion's effect on the functional abilities of wheelchair users. Sitting on a CCC seemed to improve posture and balance when compared to the subject's regular cushion. Based on these results, it is suggested that contouring technology be developed as a clinical tool for managing wheelchair users' seating problems.