Activities which lets the person use their mental capacity to build a positive sense of who they are affirmative. These affirmative activities keep the person happily occupied and reduces problematic behaviours. As their attention span is short, the activities also need to be short.

Within ACL 2.0, the person likes to stand up. Within ACL 2.2, the person likes to stand and take a few steps. Within ACL 2.4, the person likes to walk unsupported.

Sensory activities are calming and relaxing and also keeps the person happily occupied.

The person has an innate need to stand. Providing opportunities to stand will help prevent problematic behaviours.

Most of them do not rest as long as they should because they do not have a sense of time.

Note cards are better than books or calendars for looking at pictures because they are a smaller size and easier to hold. Another advantage is that they can be handed to the person, even while walking, which may help capture and sustain their attention. These pictures are a good example of a single subject foreground and a minimal background that help the person focus their attention on the information that they are able to process.

Active assisted range of motion exercises are apt to be more effective than passive sensory stimulation or massages in reducing the urges to stand or sit up.

ACL 2.0

The person is able to sit up for longer periods and have a moderate / low risk of developing pressure sores. Carers will need to monitor and observe for pressure sores and use appropriate pressure relieving devices.

Common pressure relieving devices are:

ACL 2.0

As the person has better trunk control and is able to move oneself, unsupported seating may be used.

ACL 2.2

Footplates may be removed to allow "walking" in chair for brief periods.

Use a wheelchair with an anti-tip bar / wheel to prevent the chair from tipping backwards.

ACL 2.0 - 2.2

The person has some postural control but not enough to transfer independently. Two people and a safety belt will probably be needed.

A stand lift / stand up lifter may be preferred.

Experiencing falls, near misses, and being yelled at rarely prevents falls. The most effective prevention of falls is a regular daily schedule for sitting, standing and stepping forward for the sole purpose of preserving muscle strength and balance. Due to an inability to regain their balance when it is lost, falls must be prevented by the assistance of two people and equipment. Specifically designed standing tables or stepping forward supports with their weight on forearm rests are usually required.

Hair & Nail Care

Prevent ingrown or broken nails by cutting and smoothing nails.

Prevent hair matting by a short hair cut or by brushing and braiding hair.

Oral Hygiene

Use oral swabs or a child's toothbrush training set for stimulating or desensitising oral tissues, oral motor facilitation and cleaning their mouth. Use child toothpaste that can be swallowed, and place mouthwash on a cloth.

ACL 2.0

They can go beyond a soft diet but foods must be cut up into small pieces. Hard to chew and stringy foods should be avoided. Provide opportunities to make food choices (up to three choices) and honour their preferences. Continue to encourage self-feeding with finger foods.