Essential Physical Skills
This assessment tool is not intended to follow a developmental model, but is to help practitioners working with pupils with PMLD to aim towards functional ability in order to open up opportunities within everyday life, therefore meeting need rather than a sequence of development. The pupils in mind when using this tool are those whose physical disability limits their opportunities. By the time a pupil has reached the functional end point we would be expecting them to still require on-going support with positioning e.g. wheelchair, adapted seating, standing frame, etc, but minimal lifting/hoisting would be required, and they would be able to stand with their hands held or using a grab bar and walk with adult support or using a frame for short distances e.g. 25 - 50 metres. The aim is clearly to enable pupils to gain greater levels of autonomy and independence, so enabling access a wider range of opportunities in life, but by developing skills in this way it will result in far less time and energy being used to carry out certain tasks and routines e.g. meeting personal needs, eating a meal, etc.
No time scale can be put on a pupil moving through the steps, but it can be said that the earlier intervention begins the better; the skills are as valuable when a pupil is young as when they are an adult and if they are established as early as possible it will be easier to carry them through into teenage years and adulthood. Pupils will continue to learn as long we teach them.
The motor skills that are being targeted and developed can be worked on while the pupil is engaged in a range of activities, so incorporating the essential learning into everyday structures and routines. Equipment will still be required e.g. standing frames, walkers, adapted seating, etc, but this should be used in such a way that it supports the development of motor skills rather than taking over from the pupil. It is there to provide varying degrees of prompts or support while the pupil is improving their skills. The various pieces of equipment and the levels of support being offered should be considered as temporary or ever-changing, and not remaining static. Support from an adult is great, and in a way better than using equipment, but this is not always available or practical, particularly if the pupil is practising a skill over a length of time - hands and arms get tired! Having said that the preference would always to use human support as when this is possible and practical.
A key thing to mention is the impact this kind of development has on the well-being of individuals. In order to develop bone health and strength in the muscles and joints it is essential that pupils experience weight bearing on their feet. It is thought that a minimum of 45 minutes everyday has a positive impact on the health of bones. By taking part in activities such as lying, sitting and standing and using these skills as part of daily routines, not only are there benefits to bone health, but the functioning of the internal organs also benefits.
Finally, an individual may not reach the functional end point in all the activities listed, but by having this method of assessing pupils it keeps this essential learning high on the agenda, so ensuring that staff are always considering ways of developing a pupil's independence and autonomy, so opening up a lifetime of opportunities. We aim to make a positive difference to the lives of our pupils.