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SEND advice and guidance

Positioning

Positioning and Readiness to Learn

Correct positioning is crucial to allow children and young people to optimise their ability to access the curriculum.

For instance, if a child or young person with limited sitting balance has to think about keeping themselves upright, this will impact their ability to complete tasks.  Without a secure base it is hard to concentrate, think and write as mind and muscles are focussing on maintaining stability.

Of course it is important to consider the child or young person’s comfort too, for some, the most stable position (below) may not be comfortable and would therefore affect their learning.

In the long term, poor positioning can have a serious impact on back health.

Stability

Stability is a key issue alongside the ergonomic set up of a work station.

The majority of children and young people will be most stable as pictured below:

Line drawing of a person sitting at a desk

Non seated positioning

Most learning within the classroom may be done whilst seated at a table but standing frames, floor seats, wedges, and other positioning aids can also help children and young people get into good positions for learning, socialising, playing and eating.

For many children and young people with limited mobility these changes of position also help them to develop strong bones and muscles, aid circulation and avoid issues like pressure sores.

Therapist advice about positioning

It is important to discuss positioning with the child or young person’s therapist, this will usually be an Occupational Therapist for their seating and a Physiotherapist for standing and lying. Make sure their recommendations, such as symmetry, using both hands, not twisting / leaning are implemented.

You can contact a therapist to:

  • discuss concerns about a child or young person’s position
  • check specialist equipment if incorrectly setup or sized
  • to book an annual seating review (If a child or young person has previously had seating provided)

Contact the Occupational Therapy team using the following link: https://childrenandfamilyhealthdevon.nhs.uk/occupational-therapy/

For Physiotherapy support you can contact the team at Vranch House using the following link: Contact – Vranch House

Writing and positioning

For good positioning, the key thing to observe is that the hand can move to write, with the wrist steady, rather than having to adjust position for every letter.

Parts of the forearm, wrist and heel of the hand should rest on the work surface giving stability. The non-writing hand could be used to steady the work. A sloping surface – e.g. a writing slope can help with posture and hand position, it also may encourage extension of the wrist and lessen stress on the forearm.

The paper should be placed to the same side of the body as the writing hand and lined up with the forearm of the writing hand. A tripod grip (thumb and fingers 1 & 2) should be encouraged.

Remember that before children are ready for writing, they need to develop hand skills and develop strength and control in their arms and shoulders so that they can steady themselves.

There are many pre-writing activities to develop hand, arm and shoulder control as well as hand eye coordination, see the Occupational Therapy section of Children Family Health Devon website School Age Therapies Toolkit – Children and Family Health (childrenandfamilyhealthdevon.nhs.uk)


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