Factors influencing postural management for children with cerebral palsy in the special school setting

Abstract

Purpose. Postural management is used to help address the musculoskeletal and participation issues associated with cerebral palsy (CP). This study aimed to identify the factors influencing postural management in special schools.

Method. A purpose-designed, cross-sectional, descriptive survey was sent to teachers, physiotherapists, occupational therapists and speech pathologists working with children with moderate-to-severe CP, aged 5–12 years, in special schools within South Australia. The instrument included four main areas: demographics, perceived benefits of postural management, factors facilitating or hindering the implementation of postural management programmes and suggestions for improvement. Results were analysed descriptively.

Results. Forty-three therapists and 18 teachers completed the survey (response rate 81%). The most common factors hindering postural management were positioning equipment being unavailable or difficult to use, lack of time and school staff's knowledge and skills to carry out postural management. Facilitating factors included therapy staff providing a written postural management programme, open and regular communication between therapy and school staff and timetabling of postural management into the daily routine.

Conclusions. Numerous factors impact on postural management for students in special schools. Practical solutions highlighted were increased training for school staff, timetabling of postural management into students' routines and provision of written postural management programmes.

Keywords:

• Cerebral palsy
• education
• school
• posture

Acknowledgements

We thank Pammi Raghavendra, Sue Gibson and Sue Gilson, for contributing to the design of this study. We also thank Helen Dabbs, Mark Richardson and Chris Harrison, for advice which informed the development of the survey tool.