• Manual Dexterity
• Mobility
• Transportation

Hand and arm weakness are typical challenges faced by children with neuromuscular disorders. Schoolwork often becomes difficult because of pain, fatigue, and problems with motor co-ordination. As a result of this fatigue and limited mobility, in-class assignments, homework assignments, and exams present special challenges for these individuals. Further obstacles in school include the fatigue associated with taking notes for a long period of time, slowness or inability to get ready for class because of the fatigue associated with lifting a book and opening it to the correct page as well as in getting out a pencil and piece of paper, the need for assistance with toileting, and the inability to rise from a seated position on the floor or in a chair to a standing position.

It is important that teachers are aware of these difficulties, that they provide the appropriate extra attention, and that they are flexible regarding work pace. Teachers may incorporate strategies into their classroom instruction to ensure these difficulties are accounted for. For instance, special desk tops or desks that may be adjusted to wheelchairs may allow for more functional movements to take place, a container may be placed on the student’s desk so supplies are within easy reach, and built up pencil grips may be used to allow for better hand positioning and function. In addition, a smaller volume of work may be provided to these individuals in comparison to that of their classmates, or assignments may be shortened so long as they cover the appropriate content matter. What is important is that these children do just enough work to demonstrate an understanding of the material.

For many students with a neuromuscular disorder, having a one-on-one aide in the classroom proves to be the best solution to combat many of these obstacles. Other options include having note-taking assistants in class, having the teacher provide a written copy of notes, using a tape recorder, or copying another student’s notes. Finally, as children dislike being left to work alone, having teachers arrange for them to be accompanied by a friend is usually greatly appreciated.

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Mobility within the school environment is a common barrier for children with neuromuscular disorders. It is important to ensure that these children receive the appropriate mobility aids and devices so that they may partake in school and classroom activities. Children with neuromuscular disorders will typically use mobility aids to accommodate for the weakness and fatigue experienced as a result of the neuromuscular disorder. For instance, braces, orthoses, and standing frames help to prolong walking and standing. Other mobility and positioning aids include transfer boards, mechanical lifts, scooters, and wheelchairs.

Some suggestions that teachers may oversee include encouraging the child to use a scooter or wheelchair within the school even though the child is ambulatory. This will serve to keep fatigue at a minimum and thereby conserve energy for other scholastic activities. In addition, children often have difficulty getting from class to class due to mobility problems or in trying to avoid being knocked over. Teachers can ensure that moving around the building is made easier by allowing students to leave class early and make the trip with friends and support assistants who carry their bags. Furthermore, to ease mobility, one set of textbooks may be left in the appropriate classroom and another set at home so there is no need to carry heavy books around.

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Appropriate transportation services need to be arranged for children with neuromuscular disorders so they may attend all field trip and out of school activities. Teachers should be aware of how to book such services or how to accommodate children on the regular school bus or in regular vehicles.

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