1. Open Mitten *

2. Closed Mitten *

3. Offering an Arm

4. Supportive Hug

5. Supportive Hug

6. Supportive Arm

7. Supportive Arm

8. Open Mitten Guide

9. Open Mitten Guide

10. Open Mitten Escort

11. Open Mitten Escort

12. Open Mitten Escort - Paired

13. Elbow Tuck - Rescue Shape
Context
The rescue shape is not designed to be maintained but is used as a familiar shape to return to between transitions

14. Elbow Tuck - Rescue Shape
Elbow tuck shape
Staff arms either side of the child’s arm
Both hands thumb on top
Child shape
Staff shape
All elbow tucks can start from this rescue shape

15. Elbow Tuck - Figure of 4

16. Elbow Tuck - Figure of 4

17. Elbow Tuck - Figure of 4 Context
Elbow tuck figure of 4 is extremely versatile and has high social validity. It is predominantly to control arm movement but can also be used for coaching and damping of movement.

18. Elbow Tuck - Figure of 4 (Operational situation)

19. Elbow Tuck – Lone Worker

20. Elbow Tuck – Lone Worker

21. Elbow Tuck – Lone Worker

22. Elbow Tuck – Lone Worker
Context
Elbow tuck lone worker presents an increased risk to the backs of adults.
Lone worker should be used only where staff have a height and weight advantage and only where the assistance of another adult is not possible.

23. Elbow Tuck - Braced

24. Elbow Tuck - Braced

25. Elbow Tuck - Braced Context
Elbow tuck braced is the most secure of the elbow tucks and as such has lower social validity. It should be used where the mobility and hip movement means that paired elbow tuck would fail to keep the situation safe.

26. Elbow Tuck - Paired

27. Elbow Tuck - Paired

28. Elbow Tuck - Paired Context
Elbow tuck paired is the most socially valid of the elbow tucks but is also the least effective. It is predominantly used proactively to support a child away from an anxiety or stimulus.

29. Hyperflexion (Positional Asphyxia)

30. Hyperflexion (Positional Asphyxia)
Never use a brace when seated

31. Elbow Tuck - Chairs
Body shape (staff removed for clarity)

32. Elbow Tuck - Chairs
Shape
Transition

33. Elbow Tuck - Chairs
Transition
Transition

34. Elbow Tuck - Chairs
Shape

35. Elbow Tuck - Additional Support
Head Shoulders Knees Toes

36. Elbow Tuck - Additional Support
An open mitten can be used to support the head to prevent spitting.
The mitten should pass around the ear.
The hand should be cupped to avoid glasses.

37. Elbow Tuck - Additional Support
A closed mitten can support the shoulder to restrict forward movement or biting.

38. Elbow Tuck - Additional Support
A mitten can be used on the outside of the knee to prevent it lifting.
The mitten should prevent the knee rising rather than push the knee down.

39. Elbow Tuck - Additional Support
A-frame support provides purchase to the outside foot of the staff.
Position should provide additional security at child’s hip and shoulder.

40. Elbow Tuck - Dead Weight
Shape
Transition

41. Elbow Tuck - Dead Weight
Transition

42. Elbow Tuck - Dead Weight
Shape

43. Elbow Tuck – Dead Weight Alternative

44. Shield Escort

45. Shield Escort

46. Shield Escort

47. Shield Turn
Always step forward

48. Protective Stance

49. Protection From Missiles Stance

50. Responses To Wrist Grabs (in and out of the gate)

51. Responses To Wrist Grabs (in and out of the gate)

52. Responses to Wrist Grabs (in and out of the gate)

53. Responses to Wrist Grabs (in and out of the gate)

54. Responses to Wrist Grabs (in and out of the gate)

55. Responses to Wrist Grabs (turning the arm)

56. Responses to Wrist Grabs (turning the arm)

57. Responses to Wrist Grabs (turning the arm)

58. Responses to Wrist Grabs (turning the arm)

59. Responses to Neck Grabs (front)

60. Responses to Neck Grabs (front)

61. Responses to Neck Grabs (front)

62. Responses to Neck Grabs (behind)

63. Responses to Neck Grabs (behind)

64. Responses to Neck Grabs (behind)

65. Responses to Neck Grabs (behind)

66. Responses to Clothing Grabs (in and out of the gate)

67. Responses to Clothing Grabs (in and out of the gate)

68. Responses to Clothing Grabs (in and out of the gate)

69. Responses to Clothing Grabs (sliding)

70. Responses to Clothing Grabs (sliding)

71. Responses to Clothing Grabs (sliding)

72. Responses to Hair Grabs

73. Responses to Hair Grabs (mechanical principle)

74. Responses to Hair Grabs (mechanical principle)

75. Responses to Hair Grabs (thumb and gate)

76. Responses to Hair Grabs (thumb and gate)

77. Responses to Hair Grabs (sliding)

78. Responses to Hair Grabs (sliding)

79. Responses to Bites (in and out of the mouth)

80. Responses to Bites (in and out of the mouth)X

81. Responses to Bites (mechanical principle)1 2 2 1