A welcome break

A Liverpool-based team of physios gained local council support to provide summer holiday activities for children. Ian A McMillan reports

'The kids absolutely love it here,’ said Sue McGuckin as she basked in a welcome burst of summer sunshine with her grandson at north Liverpool’s Ellergreen leisure centre.

Ms McGuckin was at one of the ‘Summer Sports Taster Days’ that were held twice weekly during July and August at Ellergreen and another council-run centre, Park Road in south Liverpool.

The scheme, developed by a physiotherapy team, gave young people aged from eight to 18 opportunities to participate in games and other activities during the school holidays.

They had a range of conditions, including muscular dystrophy, cardiopulmonary problems and Down syndrome.

Some are confined to wheelchairs during most of the day, and a number also have profound learning disabilities. Like Ms McGuckin’s grandson, David Malloy, many require round-the-clock support, and traditionally miss out on the local authority-run sessions that tend to target the ‘able-bodied’.

‘David is quadriplegic. I couldn’t take him to a normal swimming pool, but he does have hydrotherapy at Alder Hey Children’s Hospital and at school.

'They did say he wouldn’t live past the age of two but he’s had numerous operations and just keeps bouncing back. He’s such a fighter.’

Able-bodied brothers and sisters were invited along to the scheme, giving the whole family a break from everyday routine, a chance to let off steam and perhaps sample a new sport.

The scheme was also important to adults such as Ms McGuckin. Their children and grandchildren may all be regular patients of Alder Hey’s community paediatric physiotherapy team, but the adults rarely meet up simply to chat and swap stories.

‘This project gives us the chance to talk to other parents in an informal atmosphere,’ she explains. ‘It also gives me a chance to sit back and relax. I only wish it was available more often.’

As soon as a letter outlining the scheme had dropped through the letter box at the purpose-built bungalow where she lives with her grandson and his able-bodied sister, Ms McGuckin says she was on the phone booking David in for four sessions.

Stuart Clark, a band 7 senior physiotherapist with the Alder Hey-based team, was a prime mover behind the scheme, which, he explains, was fine-tuned following a pilot version in 2011 and extensive consultation with the children and their families.

Working with the local leisure club

It’s a 35-person team, including managers, that works in schools that are specialist, mainstream or ‘enhanced’. This last type has above average numbers of pupils with physical disabilities and receives extra support.

‘In setting the summer scheme up we also worked quite closely with the council’s sports and leisure team,’ Mr Clark noted. ‘Linking up with the city’s leisure facilities was important because if the families want to get more involved in sports and activities, then it’s most likely this will happen at a local sports centre.

‘Eleven of the 16 we invited came to today’s session, with a few siblings as well, which is probably about what we would expect.’

At other sessions, the more able youngsters are introduced to sports such as basketball, handball, gymnastics and boxing. ‘If they find something they like, then they can go on and develop their interests with local sports clubs.  

A project like this aims to break down barriers and stigma. The feedback from families says it’s been really useful.

‘Obesity is a concern nationally at the moment – regardless of having a learning impairment or physical disability. We are working with the public health department at Alder Hey to look at ways of promoting physical activities with this group of individuals.’

He adds: ‘It’s as if I’m being paid to play all day. There’s a lot of job satisfaction in seeing their smiling faces.’  

In the sports hall where the activities were in full flow, the physios’ enthusiasm was palpable. Kirsty Adams, who has fulfilled a lifelong ambition by working with children with disabilities, said: ‘I really enjoy the feedback you get from these kids. There’s not a lot out there for them and they need access to the opportunities that other children have.’

Ms Adams, who completed an accelerated masters programme at Glasgow Caledonian University in 2006, explained that many of the activities on offer are highly labour intensive.

At a ‘rebound’ session, children took turns lying on a large trampoline surrounded by a four-person team – two of whom stood either side of the child, making bouncing movements. Parents acted as  ‘spotters’, charged with ensuring there were no safety issues.

‘We use rhythms to help relax the child’s muscles and give them a sense of freedom. I see it as a “funfair ride” –  a build up of anticipation, followed by a free fall effect,’ Ms Adams says. Other activities included races between children in wheelchairs and their able-bodied siblings.


Imaginative ideas

During school terms, Ms Adams works with pupils aged from five to 11. She already knew many of those attending the scheme from the swimming and hydrotherapy sessions she runs in local special schools. Sometimes, parents go into the pool too.

‘It gives them a chance to see how the physio handles their child in the water and we can pass on important information while we chat,’ Ms Adams notes.

‘I’m a very creative person and I like thinking outside the box,’ she says. ‘You have to come up with imaginative ways of getting the kids to do their physiotherapy exercises without them realising it. You might get them to kick a ball standing on one leg, for example.

‘It’s not traditional physiotherapy: you might, for example, use a scarf and pass it over the child’s skin to create a certain sensation over the skin. Some of them are reliant on their carer and your knowledge of how they interact with them and respond is crucial.

‘I might adapt something they want to do by getting them to kneel and then half-kneel, then they will still see the exercise as really good fun.’

A number of the youngsters want to be cosseted but others are ‘very active’ and need steering towards exercising in a safe way, she says. ‘Some are even members of Liverpool football club’s disability team.’

Ms Adams is due to join the physio team linked to secondary schools in the new term, and admits to having mixed feelings . ‘You do get emotionally attached to the children. You also get to know the families and the siblings. It’s great to have rapport with the parents. It will be hard to move on but that’s part of our role.’

Having four teenagers, aged 13, 15, 17 and 19, at home doesn’t seem to faze Angela Billington. ‘It’s a happy house,’ she says.

The youngest pair, Laura and Joseph Burns, both of whom have severe learning difficulties, had a ‘fantastic time’ at the centre, which was just a short drive from the family home, said Ms Billington.

‘As soon as we draw up in the car, Laura will be happy. It’s a break from the norm. We are so lucky to be with the Alder Hey physio team – they are so enthusiastic.

‘There’s not a lot on  locally  in the summer holidays,’ says Ms Billington, who had just returned from a family holiday at Center Parcs .

Ms Billington said she had also appreciated an opportunity to meet the community physio who will take over Joseph’s care in the new term.

Most parents celebrate when their children reach the age of 18 and take their first steps into adult life. But when your son or  daughter has a learning disability, the ‘transition’ stage means losing support from a dedicated children’s service. Being moved on to an adult service can trigger feelings of dread.

Ms McGuckin, in her early sixties, notes. ‘David will be going through transition soon – the thought is scary. I feel such a rapport with the team at the moment. Getting to know a new team will be difficult, especially because David has such complex needs.’ fl

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Ian A McMillan

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