Moving ahead

Successfully including children with cerebral palsy in an early years setting doesn't depend on having lots of specialist equipment or staff - it just requires broader thinking, as Catherine Gaunt discovers

When Tom Bradford started attending Liverpool Early Years Centre (LEYC) at 18 months old, he could not walk and had never crawled.

His traumatic birth involved resuscitation and a broken clavicle. At ten months he was diagnosed with left-side hemiplegia - cerebral palsy affecting one side of his body. Now three years old, Tom walks unaided, thanks to a combination of weekly sessions of physiotherapy and occupational therapy and the dedication of LEYC staff.

His father, Garry Bradford, says, 'I don't think he'd be as far along as he is, without that support. They've taught him how to make the best use of what he's got.'

LEYC is an integrated nursery run by Scope, a disability organisation focusing on cerebral palsy, in partnership with Liverpool social services and partly funded by Liverpool city council. It has 60 children, their numbers split between children with disabilities and those without, who are referred by social services because they are classed as children in need.

Tom's social worker referred him to the centre and he was visited by nursery manager Lynda Maxwell to assess his needs. She stresses the importance of home visits and dialogue with parents and carers to find out as much about the child as possible, including whether they use specialised equipment, and their likes and dislikes. This encourages a close partnership between parents and carers.

Tom now attends the centre for three sessions a week. When he started the physiotherapist taught Tom's keyworker the best way to lift and position him. These details were written down and the keyworker made other staff aware of them. Now he has sessions with a physiotherapist and occupational therapist every week and his keyworker also follows an individual programme set by them.

The staff encourage the development of Tom's motor skills through play. He is right-handed but is encouraged to use his weaker left side as much as possible during activities, such as playing with a ball.

Tom no longer needs the support of a special chair, but staff ensure he maintains a good posture with both feet on the floor and both hands on a table in front of him. Although Tom can now walk, staff continue to help strengthen his left leg with activities including riding a bike and kicking a ball.

Lynda Maxwell says that LEYC is fortunate to have specialist equipment, but this should not discourage mainstream nurseries - much can be done by simply adapting the good practice policies at the heart of any setting (see box).

'People tend to think that if they're going to have disabled children they need all this equipment and extra staff, but they don't. They just need to think through what they're already doing and do it a little bit differently,' says Lynda. 'Just as non-disabled children in a mainstream nursery are at different developmental stages and ages, so are disabled children. You just have to think more broadly, and know your children, gauge what level they are at and then accommodate them within the setting.'

Lynda thinks Tom will go on to attend mainstream school. He may require additional support, depending on what is identified in his statement, but she expects this will become less as he gets older.

FURTHER INFORMATION

* Cerebral palsy helpline call free 0808 800 3333. * www.scope.org.uk/earlyyears