The child should:
- sit squarely at the table, with the affected arm on the table, to keep the spine straight
- have the table and chair at the right height to sit with feet flat on the floor and knees at 90 degrees
- have adequate space for the weak arm
- have unrestricted movement of the stronger arm (i.e. don't sit a left-hander next to a right-hander)
- sit square on to the board or face to face with the teacher / support assistant
- stand at the easel or sand tray facing forwards, not sideways, with both feet firmly on the floor
- have computer screens at eye level
- learn to write on a well-stabilised vertical surface, or later on an angled surface
If the child is easily distracted, or may be showing signs of a visual perception problem:
- surfaces need to provide a clear background for drawing, etc.
- white boards are better than black or green. Plain tabletops might be more effective covered in off-white paper
- display boards should be in the child's direct line of vision with the minimum opportunity for distraction, or adjusted for the child's restricted vision / field defects
- in group work the child should be seated in the front or the middle of the group
- for writing instruction and other practical activities the teacher / support assistant should sit alongside to enable them to have the same angle of vision as the child. However, for children who are difficult to keep on task it is helpful to work face to face so that the child can see facial expressions, check eye gaze and eye movements.
Left to themselves, younger children with hemiplegia often tend to ignore their weak side, and need to be reminded from time to time to bring it into their activities. Doing things like dressing or naming parts of the body in front of a mirror can help them to be more aware of both sides of their body.
Sitting on the floor can be more of a problem for some children. Parents / carers and therapists should be able to advise on the best position for the child.