Hemiplegia in the primary school classroom

A child with hemiplegia should be able to participate fully in most classroom activities, although he or she will need some help with certain things. Parents and therapists will have been working with the child to make him or her as two-sided as possible and it is important that this is reinforced at school.

Left to themselves, children with hemiplegia often tend to ignore their weak side, out of frustration with its uselessness. This might lead to serious physical problems later, as well as preventing the child from making maximum use of the affected side.

Seating

The child should:

• face the teacher
• face the board or demonstration area
• be away from the main aisle or door, to minimise distraction
• sit squarely at the desk or table, with the affected arm on the table, to keep spine straight
• have their table and chair at the right height, i.e. he or she should sit with feet flat on the floor and knees at 90 degrees.
• have adequate space for the affected arm
• have unrestricted movement of the dominant arm

Posture is equally important when standing, at an easel for example. The child should be facing forwards, not sideways, and both feet should be firmly on the floor.

However, if the child has a visual impairment, these suggestions may not be appropriate. In this case, seek advice from the child's therapists.

The child should be encouraged to make use of his or her affected hand as much as possible, although constant nagging can of course be counterproductive. If the arm is not being used it should rest on the table, or the child may prefer to grip the edge of the table (a non-slip mat will help stabilise the arm, as well as books and paper). Placing a friend on the weak side may encourage awareness of that side.

Written work

Problems

• stabilising of paper
• drawing of graphs, diagrams etc.
• setting out of work
• poor co-ordination affecting handwriting
• slowness at completing tasks

Suggestions:

• a non-slip mat can help stabilise paper
• a magnetic board, used with rulers and geometry instruments also backed with magnetic strips, can help with drawing graphs, diagrams etc. Blobs of 'Blu-Tack' can help anchor paper
• loose sheets of paper are easier to manage than exercise books
• pre-prepared diagrams and graphs may help
• extra time may be needed to complete tasks
• tasks may be broken down into more manageable units

Practical work

The child may feel more conscious of his or her hemiplegia during activities requiring particular dexterity, and may need encouragement to participate fully.

Problems:

• cutting and pasting
• modelmaking
• experiments
• sewing and knitting
• cookery
• safety factors (the affected limb may have reduced sensitivity

Suggestions:

• pairing with another child
• modified equipment (e.g. left-handed or mounted scissors, clamps, adapted cookery equipment etc.)
• extra time to complete tasks