Therapists always try hard to be optimistic when discussing their pediatric client’s future. Why not? Kids have amazing potential, and we aren’t fortune tellers; there are so many things that can go right.
As therapists, we also should share the reality of how bad choices create unfortunate consequences. Among them are the long-term results of falls, especially head injuries. Kids fall, kids trip, kids walk into things. All kids, and for much of early childhood. The hypermobile child will have more episodes of injury, often has greater injury occurring in each episode, and frequently experiences a slower or less complete recovery from injury. This isn’t a criticism of parents, kids, or even acute medical care. It is the reality of living with a condition, often a syndrome, that has effects beyond just loose joints.
This can include connective tissue disorders that create weak skin, ligaments, and tendons, decreased pain registration, delayed protective reactions when falling, and cognitive or behavioral complications that make learning and controlling actions more difficult. Hypermobile kids often spend more years in an unstable state in which they need assistance and supervision. And more years when they are vulnerable to serious injury. A head injury or a spine injury isn’t an “unfortunate” event. It is frequently a life-changing event. The course of education and employment can be forever altered. For the worse.
In a clinic or school setting, your therapist is bound to guidelines that indemnify them and the facility. While they cannot control what happens at home, you should know what to do to make your home safer for a child with hypermobility. It begins with your environment, then you change your responses, then your build your child’s ability to incorporate safety awareness into their day.
- Create a safe but accessible home. This expands on “baby proofing” to include railings set at a height that allow your child to push up rather than hang on them. Removal of loose rugs and adding padded floor surfaces in common areas, especially areas where they are climbing or running. Bathrooms are the location for many injuries once children become independent in toileting or bathing. Instead of supervising them forever, create a safe place with hidden grab bars (there are toilet paper holders and towel racks that are actually grab bars) and non-slip flooring. Place needed items within easy reach without climbing.
- Teach safe movement from the start. Children that learn how to move versus children that are passively moved will have more safety awareness. For children that still need a lot of help, narrate your moves and weave in safety messages. It will sink in. Finally, don’t allow unsafe moves, even if they didn’t hurt themselves. Tell them to try it again the safe way. Read Joint Protection And Hypermobility: Investing in Your Child’s Future to learn what to teach them. Children are unable to anticipate the results of their actions. This is why we don’t let 12 year-olds drive or let 5 year-olds cross the street alone. Sometimes the reason they do things our way is because we said so. Until they are old enough to understand the “why”.
- Share your thought processes with children as soon as they can wrap their heads around things. Even kids in preschool can follow along with the idea that too many “boo-boos” will stop them from being able to play. Older kids can learn that the right chair helps them stave off fatigue until they finish a game. Children don’t pick up on subtle cues, so don’t be subtle. Be direct.
- Ask your therapists for specific safety advice, and then carefully think through their answers. The truth is that some therapists are more safety-aware than others. I have been told that I am one of the most vocal therapists on a team when regarding safety issues. Perhaps it is because I spent 10 years working in adult rehab, treating patients for problems that started decades before I met them. I have seen what overuse and poor design has cost people. By then it is often too late to do much more than compensation and adaptation. I am committed to prevention with my pediatric clients. The cost is too high not to say something and say it loud.
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