child at table‌Hemiplegic cerebral palsy affects around 12000 children in the UK. Children with hemiplegia need lots of encouragement and practice to keep using the affected hand and arm. From here on, we will refer to the affected hand as the helper hand because it is our aim that this hand can help as much as possible in bimanual tasks. Sometimes it’s hard to get enough therapy for the helper arm and hand, yet most activities we do every day are much easier to do if the two hands are used together. Encouraging the use of both hands from an early age could help with independence later in life, and we know from research evidence, including our own, that repeated practice improves children's ability to use both arms and hands. We also know that this practice needs to be done often, preferably by spending some time on this each day. Play and leisure time provides a good opportunity for this.

We wanted to find lots of toys and games suitable for children age 3-10 years with hemiplegia, to encourage use of the helper hand and arm. Many of the activities require use of the two hands together. Often we have had to adapt the "rules" to get the most out of the games for children with hemiplegia. Each game was chosen to work on specific aspects of movement. We also wanted to have lots of variety so that you could find a range of games to suit your child’s interests and abilities as well as therapy needs.

The games and toys are aimed at supplementing other therapy your child may receive. They can be incorporated into your child’s playtime at home with you and are aimed to be fun! There are stepwise photos to guide you through the instructions.

Where did these instructions come from?

The instructions were developed by Emma Kirkpatrick whilst undertaking a PhD at the Institute of Neuroscience, Newcastle University, supervised by Dr Anna Basu and with advice from senior paediatric occupational therapist Janice Pearse. Our research group is interested in therapies which can help children with hemiplegia to improve their hand function.

The project was funded by WellChild and by a Henry Miller studentship from Newcastle University. The instructions were made as part of a trial comparing two forms of play-based therapy to improve upper limb function in children with hemiplegia age 3-10 years. Can play-based therapy improve hand function in hemiplegia?

Kirkpatrick EV, Pearse JE, James P, Basu AP. Effect of parent-delivered action observation therapy on upper limb function in unilateral cerebral palsy: a randomised controlled trial. 2016 - full text version available.

The trial was sponsored by the Newcastle upon Tyne Hospitals NHS Foundation Trust. 

We would like to thank Ellie Meardon, Ceri Gillet, Blythe Wright and Ceit Jesmont for their input to this project.