‘Posture for Learning’: meeting the postural care needs of children with physical disabilities in mainstream primary schools in England – a research into practice exploratory study

Abstract

Purpose. To explore teachers and teaching assistants' (TAs) views of how to manage the postural care needs of children with physical disabilities (PD) in mainstream primary schools, with the aim of developing strategies to support teachers and assistants in this role.Method. Qualitative data were gathered from a purposive sample of four primary schools in one county in the UK. Individual and focus group interviews with 36 teachers and TAs were carried out and used to generate an explanatory framework around their experiences of managing the postural care needs of children with PD.Findings. Teachers and TAs in schools were found to have limited understanding of postural management. Very few had personal experience of the benefits of postural care – instead, most appeared to think in terms of ‘doing’ rather than ‘knowing’ about postural care. When implementing therapy programmes, teaching staff followed therapists' instructions carefully, but did not understand the purpose of their actions. Participants described the emotional impact of caring for a child with PD and expressed anxieties about causing discomfort when using equipment such as specialist seating and standing frames. Equipment was viewed as bulky, uncomfortable and restrictive and not suited to the school environment. When asked which kinds of support would be valuable, participants identified practical solutions such as additional space or resources. Based on these findings, therapists, specialist teachers and parents developed an ‘A–Z of postural care’. This information resource aimed to address the gaps in knowledge and understanding highlighted by teachers and TAs in the interviews and to acknowledge their anxieties when teaching and caring for children with PD. Stakeholder involvement in all aspects of the project from setting the research question to the development of the A–Z resource has assisted in the dissemination of the resource and its integration into the mainstream school system within the county.