Nursery World - Children with physical disabilities: Bring the world closer

Carers in integrated early years settings can enable children with disabilities to share vital physical experiences, writes Jane Muir

How often is that phrase 'she's into everything...' used to describe a toddler's first explorations of her world? Small children explore everything in their world all of the time, from the moment they open their eyes in the morning until they collapse into bed at night, and however insignificant these explorations may seem at the time, they are crucial to a child's early development. But what of a child with physical disabilities who is unable to crawl or walk, or perhaps has difficulty holding or manipulating objects?

'Even severe motor difficulties do not automatically mean learning difficulties,' says Judi Williams, co-ordinator for Support Services for Children with Physical Disabilities in Oxfordshire. 'But often specific learning difficulties later on may arise as a result of the lack of adequate physical experience of the world in the early years.

'Practical and sensory experiences are very important as the child builds up an internal spatial map of the relationship between herself and the world around her. The child establishes a bank of concepts (such as in, off, on, under, out of, together, away from). This learning experience is accompanied by language, initially provided by adults and then by the child. At the same time, the child is developing a growing sense of herself as a social being with the power to control and manipulate the environment around her.'

If a child cannot reach out to the world, it is important for his carers to bring the world to him. We need to ensure we genuinely include physically disabled children in their local playgroup or nursery. Inclusion is not just a case of the child 'being there' - we have to make sure that they are really taking part in social and learning activities, and that the child always has something within reach that will interest and inspire them.
Creative solutions

Early years staff need to think creatively about ensuring access for children with physical disabilities to a variety of activities - on the floor, at a table, at an easel, sand pit or water trough - or when they are playing with other children outside in the garden. Lunchtime might be a time when you could let the child who cannot feed himself experiment a little. It might be helpful to contact a physiotherapist to suggest positions for a particular child, or the occupational therapist for advice on supportive seating.

An edged tray can stop things rolling away. Dycem mats, available in all colours, shapes and sizes, are invaluable to help stop things slipping and sliding. Extra-strong sticky-backed Velcro will stick down things that need to stay put. A cover-all long-sleeved plastic apron, like a painting apron, is also useful to protect clothes.

Early years workers should bear in mind that messy play, sand or water play, cooking and painting, are activities that a busy parent may not feel able to give a child at home, where, with a disabled child even more than with the average toddler, they may end up with paint spattered on walls, sand on the floor, flour in hair and earth in carpets.

Judi Williams is enthusiastic about trying to bring everyday experiences to the children. She says, 'Do ensure that the child can roll in the snow, paddle in the mud with bare feet, get wet in the rain and feel how it feels to be on top of a whole heap of other children, under a blanket or in a tent. Feeling what it is like to fall and hurt yourself is an important experience from which we might over-protect a disabled child. Let the child practise whole body games and activities on the floor, pretending to be a slithery snake, a cat, or a jumping frog.'

If you are doing cookery sessions, make sure a child with physical disabilities gets to participate fully - stirring, kneading, smelling and tasting, even if more of it lands on the floor than in the oven. As with painting, the mess is worth it. These early years may be a child's only chance to delve into the experience without being self-conscious about the end results.

All together now

Nicola Cherry, senior nursery nurse at Blackbird Leys College day nursery, emphasises the importance of making sure that all the children are having a go at the same thing at the same time, even if it means everyone gets covered in more flour, paint or water than they would do otherwise. Nicola acquired a standing frame for a child in her group who had cerebral palsy. 'All the children wanted to stand in it for painting,' she recalls. 'It was really funny - we let them each have a go, and they loved it!'

Interactive play outdoors may be a challenge. When the other children are running around, in and out of the playhouse, enjoying fast games, climbing on equipment, don't leave a child with disabilities to merely sit and watch passively. A supportive swing or roundabout or slide for them could be shared by all the children. There are also some well-designed mobility toys such as trikes, which might give a child who learns to walk late the opportunity to move around independently in the garden.

Nicola said, 'We've managed somehow to adapt trikes ourselves, with string and Velcro to keep feet on pedals and hands on handlebars. Sometimes you can get long-term loans of special toys and equipment through the occupational therapist, or the local special needs toy library,' says Nicola. 'It's amazing what's out there if you can find it.'

Sounds great

Music is something nearly all children can enjoy. It need not be limited to shakers, bells or drums; don't forget the rustle of dried autumn leaves, the rattle of seeds in a pod or the clunking of conkers in a bucket. Don't just leave a child with a music tape playing. Brightly coloured 'jelly bean' switches will enable a child who cannot access small buttons to turn a cassette player on and off with only the slightest effort, and will also transfer easily to any other battery-operated toys such as cars or robots, giving a child some measure of control.

Let a child with physical disabilities experiment with all the everyday objects that would be within reach of other children - not just toys but toothpaste tubes and washing-up bottles they can squeeze, wool, string, tape to tangle, chocolate wrappers to scrunch, ice cubes, shells, pebbles, bark, mud, sand, earth and water to explore, feel and make a mess with. How do different pebbles compare in weight, texture, colour? What happens if we squeeze a foil chocolate wrapper and then let go of it? What noise does it make? How does it change shape? Does it still smell of chocolate?

When reading a story to a mixed group of children, remember that the experiences in the story may well not be experiences a child with physical disabilities has ever had. Try to bring the story alive by accompanying it with real objects, wherever possible. For 'The Three Little Pigs', could you get hold of some straw, bricks and sticks for the children to handle? Pictures may not be enough; children need to be able to smell the straw, feel the bricks and break the sticks.

Mail order companies such as 'Toys for the Handicapped', 'Rompa' and 'Spacekraft' (contact numbers below) are full of good ideas. Their specially developed toys and 'fun' equipment are designed to give the greatest reward with the least effort, and include all sorts of musical instruments, jigsaws with extra large pieces, scented crystal bell balls, wiggly giggly balls, slow motion balls, squeezies and squashers, which offer sensory feedback and appeal to all children.

Also, as Nicola points out, 'If you are strapped for cash, a lot of things you can just make yourself. Some of the things shown in the catalogues can be made by anyone. Once you've got the idea it's down to the DIY store or the art shop for paint and glue and you're away!'

Toy and equipment suppliers: