Positioning involves providing the child with external supports to help him/her compensate for lack of stability (Campbell 1982). Many children with severe and multiple disabilities require good positioning to facilitate motor function, promote normal muscle tone, stabilize body parts, and maintain alignment of the body. For example, supportive seating adapted to allow for head movement and provide trunk support might give a child the chance to practice head control during story time. However during meal time, working on head control and finger feeding might be too demanding on the child, so the additional head support may be needed. Positioning and adaptive equipment can be used to further musculature problems. Also a variety of positions should be used for increasing function and independence. The staff working with the child should be trained in positioning and handling techniques. Suggestions for inservice training, safety, and skill development regarding positioning are as follows:

• Ask therapist to demonstrate ways to handle the child based on principles of good body mechanics and prevention of staff injuries.
• Develop a procedure and a schedule for checking the child's position through out the day to ensure correct and timely changes in position.
• Take videotapes and/or photographs of the child in positioning equipment, carrying positions, and transferring positions so that reviews can be done, new staff trained and visual reminders of procedures provided.
• Involve occupational and physical therapists in developing strategies for positioning within the classroom environment.
• Provide all staff with opportunities to handle and position the child in order to become comfortable in working with a child with disabilities.
• Ask parents or caregivers for their suggestions on positioning strategies based on their experiences, previous school or therapy received or the home environment.
• Determine how positioning can be achieved through the use of an adult or peer's body, specially designed furniture or equipment, or supportive material such as towel rolls, pillows or wedges, depending on the available resources and the child's needs.

It should be emphasized that the position of a child should be as natural as possible and similar to the way in which other children in the classroom might be positioned. The position that is selected should enable the child to participate with the class. Keep the child at the same level as the other children as much as possible. When an activity is conducted on the floor, position the child on the floor with the appropriate supports such as an adapted chair or adult body. Select the best time of the day for certain equipment to be used. For example, a child might be able to participate well when placed in a stander at the water table, however, the child would not be able to interact as well in the stander during a circle activity when the other children are on the floor. When carrying the child, try to hold the child in a manner that allows him or her to visually inspect the environment and socialize with others while helping to build strength. Also consider the childõs choice and preferences when implementing positioning and handling strategies. Allow the child to select positions and areas to which the child would like to move and play. Remember to give the child the opportunity to perform as much of the movement as possible, even if this slows down the process.