Occupational Therapy News: Hypermobility

You might have heard the word Hypermobility before or terms like low muscle tone, or double jointed and still not really know what it means. The term hypermobility refers to increased range of motion in the joints and can occur throughout many joints in the body.  It commonly occurs with low muscle tone (hypotonia) and the ligaments are longer and hence the joints more mobile.  Generally, hypermobility can be ranked on a scale up to 9 (Beighton hypermobility scale), anything over 5 is considered hypermobile.

Hypermobility is quite common in society with about 20% of the population having hypermobility. It can prove to be a physical advantage for many people such as dancers, gymnasts and athletes, as long as the increased range of motion in their joints coincides with good strong muscles.

To support hypermobility, it is important to build up strength and maintain physical activity. Lots of core strength exercises and daily physical activity (60 mins a day for children aged 5-12 years) is essential for all children but really important for kids with hypermobility. The more we can support them to build up muscle strength around the joints and core of the body, the more they can compensate for their joint mobility. Unfortunately it may cause fatigue, but this is more reason to make the muscles keep building strength.

The thing to be mindful of is pain. If a child complains of sore legs, muscles or often stumbles then it may be worthwhile seeking advice from your GP or physiotherapist as they may refer onto a specialist to check that the hypermobility is benign. Curtin University offer a free paediatric physiotherapy clinic at Cockburn Central for child aged 5 and under or you could seek a referral to the Child Development Services or seek advice from a private physiotherapist.

Things to help

Hypermobility will be with you through life, so if you find that your child is “bendy” you will most likely also find someone else in your family is also hypermobile. To support them, physical activity throughout life is important and keeping all your muscles at a good strength and length. Sometimes, children will sit in different postures when they are hypermobile and this may lead to muscle tightness later on, so it is really important that we also encourage good posture.

Some strategies that we use around the school include daily fitness, as well as different seating options. Air filled cushions on the mat or other individualised seating aids can provide good postural support as well as consistent feedback to the body.  Wearing compression clothing can also be beneficial as it can provide body and muscles with feedback consistently throughout the day and this is really valuable for a child with hypermobility.

Activities such as swimming, dancing, gymnastics, yoga and martial arts are all great for people with hypermobility and keeping an active lifestyle and being mindful of fatigue and pain is a great habit to start from an early age.

For more information

Visit https://arthritisaustralia.com.au/types-of-arthritis/hypermobility-syndromes/

Berry Johnston
Occupational Therapist

Occupational Therapy News: The Alert Program

The Alert Program®

At the Fremantle LDC the Alert Program is used to support student and teacher self-regulation. The language of this program, visual supports and sensory tools are used in all classrooms to help your child feel switched on and in a “just right” arousal zone.

This week as part of your child’s health or physical education lesson, we have been learning about the Alert Concepts.

What is the Alert Program®

Our bodies are like engines of a car, sometimes they run high, sometimes they run low and sometimes they run just right. If your engine is running on high speed you might be overexcited, out of control and not want to sit still. If your engine is running on low speed you might feel tired and zone out, not wanting to learn. If your engine is just right it is easier to learn, play and get along with others.

In order for children to focus their attention, manage their emotions and control their behavior, their engines need to be at their just right speed, more of the time. Everyone’s just right is different!

Engine Changers

Activities can change our engine speeds throughout the day. These “engine changers” come from a range of sensations including movement, touch, looking, listening and smell and taste.


Being able to manage the pace of your engine and knowing how to change it is called self-regulation. Self-regulation is vital for all people to use and can be developed over time. You can help your child to self regulate by:

  • Talking about the pace at which their body is running (e.g. “How is your engine running?”)
  • Talking about how they can change their engine speed. Parents giving examples of what they do to change their own engines can be an excellent model for children.
  • Participating in regular physical activity throughout the day ie walk breaks, heavy load activities, ride a scooter, walk the dog, trampolining, dancing etc.

Your child may indicate a preference for certain engine changers to help them feel just right, such as sitting on a wobble cushion, going for a run before they do homework, listening to music as they read. It is helpful for children to learn self-regulation when family and teachers support them in finding what makes them feel just right.

The classroom has access to several items for students to use, however if your child wishes to use something in particular from home, talk to the teacher about how this may be incorporated into the class.

Other great resources to support self-regulation include:

  • Smiling mind app, which helps us to be mindful
  • Cosmic Yoga for mindfulness and being physically active

You can find links to these on https://www.lil-peeps.com.au/wellbeing or visit Lil Peeps OT for Kids YouTube channel for a parent friendly “Self Regulation” https://www.youtube.com/watch?v=sFNtewS_Cqk

Lil’ Peeps has integrated concepts from the AlertProgram® into its therapeutic approaches. The Alert Program® concepts and specific vocabulary, including the use of the “engine analogy” are intellectual property of TherapyWorks, Inc. For further information about the program, free YouTube videos, and other resources, please visit: AlertProgram.com.

To open a printable PDF of this document, please click here

Occupational Therapy News: Occupational Therapy at the Fremantle LDC

Starting school can be an exciting time, where children learn new skills, build new relationships and often leave their family and carers for the first time. As children start on their schooling journey, there are lots of new experiences but also challenges they will face, and sometimes these take us by surprise.

Evidence indicates that children with language impairment often experience difficulties with motor coordination and self-regulation. The difficulties may be apparent when the child is young, however it may be more noticeable when the child has to engage in new tasks that really challenge their skills, such as learning a new skill in school.  Many families will already be on their journey supporting their child’s language skills but may not have noticed challenges with their child’s motor skills or self-regulation.

Occupational Therapy (OT) can support these areas and that is why the Fremantle Language Development Centre (LDC) utilises the services of a consultant OT to support teachers to assist student participation and enhance student engagement in classroom programs. This can include teacher training, provision of resources, assessment and referral of children and whole school programming. You can learn more about this service by watching this video: https://screencast-o-matic.com/watch/cYXniZsKn4

If we feel that your child may need more targeted support to master some of the skills required for school, we may also refer your child for Occupational Therapy through a private provider or the Child Development Services.

The OT support at the Fremantle LDC does not replace an OT service. Families are encouraged to maintain contact with their OT if they are accessing services or have been recommended to seek the support of an external Occupational Therapist.

For more information about OT support, visit:

I look forward to supporting the Fremantle LDC in 2021!


Berry Johnston
(Consultant OT)
0417 961 276