Use BRAVE (Break, Review, Adapt, Voice, Empathy) as a guide for supporting children and young people with symptomatic hypermobility. Written by Jane Green MBE FCCT.



Breaks for movement: Keeping still stiffens joints and increases pain. Provide regular opportunities for movement and allow agreed fidget items. Sitting still on carpets or stools can be difficult – provide supportive seating. Lift passes are helpful and chairs for queuing might be needed. If carrying heavy items, taking multiple trips might be advisable.



Review the condition as it fluctuates. Do not assume that the Child/Young Person’s (CYP’s) condition is stable, so keep the situation under review. Invisible illness flares and, with symptomatic hypermobility, a CYP can feel differently from morning to afternoon, from day to day and week to week. Ensure you have knowledge and understanding of the symptoms.



Adapt and adjust to the CYP’s needs. This might include providing adaptive equipment, such as writing slopes, laptops, cutlery, sensory materials and more. Check whether reasonable adjustments, including extra time, can be put in place for national tests and examinations.



Listen to their voice at every opportunity. Ask for their account, their experiences and what can help them. Be aware of differences in the way they understand their senses, both interoceptively (signals from internal organs, e.g. needing to go to the toilet) and proprioceptively (sense of location, position and movement of parts of the body). They may mask pain, so check in with them often.



Look for expressions of pain or anxiety. Know that headaches and stomach pain can have a physical cause as well as being indicative of social, emotional and wellbeing needs. Appreciate the difficulties that can arise due to attendance and attainment; know that parents/carers may be experiencing this too. Nurture the areas they are strongest in, for example, some parts of PE can be challenging, but they may be very creative or particularly strong in certain academic subjects.


  • Jane Green MBE

    Jane is a former assistant headteacher, autism lead, LA advisory teacher and now the founder and chair of SEDSConnective, a charity for neurodiversity and symptomatic hypermobility. She is a non-executive director and co-author of the peer-reviewed paper ‘Co-Occurring Physical Health Challenges in Neurodivergent Children and Young People’.
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