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Positioning for play: how do we best achieve this?

Throughout the day, every child, with or without a physical disability, will spend time sitting comfortably with good stability so they can focus, play and learn; as well as making sure they get plenty of time to stretch and move.

This is just the same for a child with more complex cerebral palsy who needs assistance with sitting, standing and movement throughout the day. How do we achieve this?

A child with more complex cerebral palsy will be in a variety of positions throughout their day whether it is in lying, sitting in a chair, sitting on the floor, or standing. Learning to be set up well in all these positions will really benefit a growing child, protect their muscles and joints and help to build strength and skills. When a child has overactive muscles, extra movements or even a floppy body, the effects of gravity are greater and if left asymmetrical and unsupported, it can be detrimental to their body in the long term. This will then impact on their ability to participate actively in everyday life. Your child’s therapy team will collaborate with you to identify the supports your child needs to be positioned in alignment, safely and enable their participation.

Positioning does not have to be an extra task in your day, it can be built into things you are already doing every day. Here are some activities to do in each position:

Long sitting with leg wraps on, one arm wrap on for stability, if needed;

- Reading books and chatting

- Doll play or animals and cars

- Playing with balls

- Playing with bubbles

- Playing with switch toys.

Sitting at a supportive chair with feet flat, may use ankle weights for extra stability and feedback, if needed, using a table or tray for activities;

- Pretend play e.g. cooking, animals, dolls

- Drawing, cutting and pasting, art and craft

- Messy play e.g. sand, mud, shaving cream

- Blocks

- Accessing communication device or computer

- Eating.

Standing in a standing frame, AFO’s, leg wraps and or one arm wrap on if needed and arm wrap on for extra stability to upper body;

- Water play or sand play

- Helping with cooking in the kitchen

- Brushing teeth

- Music and dance

- Painting at an easel.

24 hour positioning also includes sitting in stroller/wheelchair, relaxation on the couch, sitting in a car seat, shower/commode chair and also sleeping at night.

Please talk to your child’s physiotherapist and occupational therapist to work out how to best support your child to have comfortable, quality positioning throughout the day and overnight as needed. Alternatively, you can call us on (03) 9560 0700 to speak to our team.

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