Leckey Leckey Early Activity System - OWNER'S MANUAL Owner's Manual

Early Activity
System

User Manual

Supporting
Children

English

p2 Leckey Therapy Bench Manual

The Early Activity System is designed to
offer a range of therapeutic positions and
activity suggestions for early intervention.
This manual shows how you can quickly,
easily and safely make use of all the
functions. The instructions on safety and
maintenance will ensure that you will enjoy
the use of this product for a long time.

Leckey Therapy Bench Manual p3

CONTENTS

01 Intended Use p.04

02 Certication p.04
03 Warnings and Cautions p.04
04 Terms of Warranty p.05
05 Product History Record p.05
06 Product Training Record p.06
07 Safety Information p.06
08 Precautions and Contraindications p.07
09 How to Unpack and Assemble p.08
10 Clinical Setup for Postural Management p.10
11 Cleaning and Care Information p.30
12 Daily Product Inspection p.32
13 Reissuing Leckey Products p.32
14 Product Servicing p.33
15 Technical Information p.34
16 Sizing Information p.35

p4 Leckey Therapy Bench Manual

SECTION 01:
INTENDED USE

Intended use

The Early Activity System is intended
to facilitate early intervention therapy
at home or on the move for children
aged 0-36 months who have mild to
complex postural needs that affect the
ability to maintain a developmental
position without external support.

Indications for us

The Early Activity System has been
designed for special care babies
from birth to 36 months for Early
Intervention use at home or in the care
environment.

SECTION 02:
CERTIFICATION

The Early Activity System is classied as
a Class I Medical Device under EU and
UK regulations. As the manufacturer,
James Leckey Design Limited, declares
that this product conforms to the
Medical Device Regulation (2017/745),
UK Medical Device Regulations 2002,
Medial Device Directive (93/42 EEC)
and EN 12182:2012 Assistive products
for persons with disability, general
requirements and test methods.

Notice to the user and/or patient: Any
serious incident that has occurred
in relation to the device should be

reported to the manufacturer and the
competent authority of the Member
State in which the user and/or patient
is established.

NOTE:
General user advice.
Not following these instructions may
result in physical injury, damage
to the product or damage to the
environment!

SECTION 03:
WARNINGS AND
CAUTIONS

1. WARNING OCCUPANT SECURITY

• Ensure that all components,
supports and straps are securely
applied.

• If the user exhibits any form of
distress, remove from the product
as quickly as is safely possible.

• Users should not be left
unattended at any time whilst
using Leckey equipment.

• Ensure sufcient clearance of any
straps from the user’s neck, during
use of the product and transfers, to
avoid any strangulation risk.

2. WARNING SIDS HAZARD

• Do not let infants sleep in the
equipment due to risk of SIDS.

Leckey Therapy Bench Manual p5

3. CAUTION FINGER PINCH HAZARD

• Take care not to nip ngers when
opening and closing zippers.

4. CAUTION SKIN IRRITATION
HAZARD

• While the user is in the product, the
carer should strive to keep product
adjustments to a minimum.

• Ensure zip slider and chain are
covered before use to avoid the
user getting scratched.

• Ensure hooky Velcro components
face away from user at all times.

5. CAUTION DAILY CHECKS

• The product is to be checked
daily before use to ensure that all
components are securely attached
and safe for use.

6. CAUTION CLEANING

• Clean the product regularly to
prevent the build-up of dirt.
Accumulated dirt can prematurely
wear the fabric components.
Only use non-abrasive household
cleaners and moist cloths, do
not use running water on the
upholstery whilst it is still attached
to the product. See Cleaning & Care
Information of the user manual.

7. CAUTION CLEANING POWER
WASHER/HOSES

• Hoses and power washers are not
to be used to clean the product.
See Cleaning & Care Information of
the user manual.

8. CAUTION DISPOSAL

• When disposing of the product
using a community waste disposal
site, the components should be
disposed of separately where
appropriate.

SECTION 04:
TERMS OF WARRANTY

The warranty applies only when
the product is used according to
the specied conditions and for the
intended purposes, following all
manufacturers’ recommendations
(also see general terms of sale, delivery
and payment). A three year warranty
is provided on all Leckey manufactured
products and components.

SECTION 05:
PRODUCT HISTORY
RECORD

Your Leckey product is classied as
a Class 1 Medical device and as such
should only be prescribed, set up
or reissued for use by a technically
competent person who has been
trained in the use of this product.
Leckey recommend that a written
record is maintained to provide details
of all setups, reissue inspections and
annual inspections of this product.

p6 Leckey Therapy Bench Manual

SECTION 06:
PRODUCT TRAINING
RECORD

Your Leckey product is a prescribed
Class 1 Medical Device and as such
Leckey recommend that parents,
teachers and carers using the
equipment should be made aware of
the following sections.

• 07 Safety Information

• 10 Clinical Setup for Postural

Management

• 11 Cleaning and Care Information

• 12 Daily Product Inspection

Leckey recommend that a written
record is maintained of all those who
have trained in the correct use of this
product.

SECTION 07:
SAFETY INFORMATION

1. Always read instructions fully
before use.

2. Users should not be left
unattended at any time whilst
using Leckey equipment.

3. Only use Leckey approved
components with your product.
Never modify the product in any
way. Failure to follow instructions
may put the user or carer at risk
and will invalidate the warranty
on the product.

4. If in any doubt about the
safe use of your Leckey product or
if any parts should fail, please
cease using the product and
contact our customer services
department or
your local dealer as soon as
possible.

5. Always ensure the user is secure in
the product.

6. Always use the product on a level
surface.

7. Always use the Floor mat as
a base of support and never use
the other components on their
own.

8. Always ensure the hooky Velcro®
components are faced away from
the user at all times.

Leckey Therapy Bench Manual p7

9. Leckey products comply with re
safety regulations in accordance
with EN12182. However, the
product should be kept away from
all direct sources
of heat including naked ames,
cigarettes, electric and gas heaters.

10. Clean the product regularly.
Do not use abrasive cleaners.
Carry out maintenance checks
on a regular basis to ensure
your product is in good working
condition.

11. The product is designed for indoor
use and when not in use should
be stored in a dry place that is
not subjected to extremes of
temperature. The safe operating
temperature range of the product
is +5 to +40 degrees Celsius.

SECTION 8:

• High risk or recent history of bone
fractures

• High risk of pressure related injury
or open sores

• Strong, uncontrolled movement
patterns

• Poorly controlled seizure activity

• Children dependent on the use

of percutaneous endoscopic
gastrostomy

• Medical instability including
compromised respiratory or
cardiovascular function

• Dependant on 3rd party life­sustaining apparatus such as
oxygen tanks

• Signicant learning disabilities and/
or behavioural issues

Contraindications

PRECAUTIONS AND
CONTRAINDICATIONS

• Fixed spinal deformities such as
scoliosis or kyphosis

• Severe muscle contractures

• Severe muscular or skeletal

asymmetry including hip
dislocation

• Progressive and muscle wasting
conditions

There are no contraindications
associated with Early Positioning
Systems.

As the Early Activity System is deemed
as low-level/non assessment product,
all precautions and contraindications
are taken at the discretion of the
parent or prescribing clinician.

p8 Leckey Therapy Bench Manual

SECTION 09:
HOW TO UNPACK AND ASSEMBLE

Check parts

Congratulations on purchasing your
Early Activity System. When opening
the box, take care not to cut through
the box as you may damage some of
the parts contained inside. All of the
parts will be contained in polythene
bags with each one clearly labelled.
Carefully remove them from the box
and check you have all the parts you
have ordered.

Keep polythene bags away
from children

Components

All the components will arrive ready
for use. Simply unfasten the mat and
fold at, remove the rolls and wedges
from the bag and you are ready to start
using the product.

The activity suggestions within the
ve key positions, back lying (supine),
tummy lying (prone), side lying, oor
sitting (long sitting) and hands and
knees (four point kneeling) describe in
detail how to setup and make full use
of the system.

1. The Early Activity System

Designed to have an innite
number of combinations, the
interchangeable positional
supports are listed with some of
their most common uses. All the
postural supports are contained
in a compact carrier bag for easy
storage.

2. Cushioned Floor Mat

Covered with “uffy” Velcro so that
all the supports can be quickly and
easily attached and removed, this
comfy oor mat also has Velcro
on the underside for additional
positioning options.

3. Four Flexible Rolls

The rolls, in two sizes, can be used
on or below the oor mat, and on
their own or with the other support
elements to provide just the right
level of postural support.

4. Positioning Straps

Use these versatile straps in
addition to the rolls for extra
support when needed at the front,
sides or back. Alternatively, use
them on their own for a reduced
level of support when the rolls are
no longer required.

5. Head Support

Contoured to cradle the head,
this support can be used on its
own, or with its removable lateral

Leckey Therapy Bench Manual p9

pieces. While particularly useful
in back lying or side lying, the
lateral supports can also be used
with other components for extra
positioning possibilities.

6. Trunk Wedge

Primarily designed for use in
tummy lying to provide trunk
support, this wedge can also be
used below the head in back lying
to encourage chin tuck, or below
the bottom in oor sitting (along
with the sitting support) to give
a slight forward or rearward tilt,
depending on the
position desired.

7. Sitting Support

This proled cushion is designed to
give your child lower back support,
while allowing the hands to be free

for activity and function. When
used in conjunction with the other
elements additional front, rear or
side support can be increased.

8. Fabric

The fabric used on the positional
supports is a high grade textile
which is almost 100 times more
resistant to wear than standard
vinyls.

The fabric has permanent anti­fungal and anti-bacterial properties
which greatly minimise the risk of
cross infection. Bacteria such as
MRSA cannot grow on the fabric.

The soft touch fabric is easily
cleaned using alcohol wipes so
machine washing is not required.

2

6 5

7

4

3

p10 Leckey Therapy Bench Manual

SECTION 10:
CLINICAL SETUP FOR POSTURAL MANAGEMENT

A typical baby’s development

Every baby comes into the world with
limited abilities. That’s why the rst
three years of a child’s life is widely
regarded as the most important period
of development1. During this time their
nervous system and senses, muscles
and joints, together with thoughts
and actions mature and learn to work
together. Generally, these skills happen
in a seamless progression. Each skill
attained provides a building block for
the next more complex skill. So for
example, a baby will learn to hold his
head up before he will learn to sit. He
will swipe randomly at toys before
learning to open his hand and pick
them up. He will focus on things close
up before he learns to turn his head
and eyes to follow moving objects.

When development is delayed

For some babies, their newborn
limitations are not easily overcome by
time alone. If a child’s development is
delayed for whatever reason, it means
he is likely to acquire skills more slowly,
or the extent to which he masters a
skill may vary. But it is very important
to remember, that regardless of
a child’s abilities, the sequence of
development follows largely the same
pattern. So head control will still come
before independent sitting, swiping
before grasping, focusing close up
before following moving objects.

The brain’s ability to change

At birth, a baby’s brain is not fully
developed. It is growing, changing and
making new connections. It is possible
that new brain cells learn to take on
the functions of damaged cells – to
some extent the brain may learn to
compensate for its damaged areas.
Therapists refer to the ability of the
brain to change as “neural plasticity”2.
However, this capacity to change slows
down as brain growth slows down. This
helps us to understand why the early
years are so important for children.

Early intervention –

benets to children and families

We now appreciate why the rst years
of a child’s life are crucial to their
overall development. However the
brain does not develop these new
connections entirely on its own.
Training and practice are also needed.
When children need extra help to
achieve developmental goals during
their rst three years, this help –
usually occupational therapy and/or
physiotherapy and/or speech therapy –
is referred to as “early intervention”.

Early intervention is supported by
many research studies which identify
its benets. For some children these
can include less irritability
improved physical, sensory and
independence skills

3-5

5,6

For some

, and

Leckey Therapy Bench Manual p11

families these can include improved
bonding and interaction with their
child

3,5,7

decreased anxiety

3,5

and
better information, resources and
support

4,8,9,10

Parents and therapists in partnership

Therapists alone are not able to
provide the level of extra help that
developmentally delayed infants
may need – simply because it is
parents and relatives who provide
24-hour care for their children. But
therapists do play a vital role in
assessing children’s developmental
needs and recommending activities
which will help them reach their next
developmental goals. And research
has shown that early intervention
programmes which combine a parent
and child focus have a greater impact
on the developmental outcomes of
the child11. So parents and families,
working together with therapists
towards agreed developmental goals
for their child, have the potential to
achieve the best results possible.

Playing with a purpose

So far we have talked about children’s
development, early intervention and
therapy. It can all sound very serious so
it’s easy to forget that the
“intervention” and “therapy” we are
talking about is simply play with a
purpose. Children with developmental
delay, just like any other children,
learn through play – in fact children

work harder on therapy goals when
they are having fun through play. So
don’t worry – as a parent, grandparent,
sister or brother, friend…..the list is
endless…..you will be able to help your
little one achieve his potential just by
understanding why you are playing
certain games in certain positions. We
will look at this in more detail later on.

The Early Activity System

At Leckey we have worked with
experienced therapists, used evidence
from published research studies, and
our own experience to develop the
Early Activity System. This modular
oor-based system is designed
to assist your child to improve his
physical, cognitive and sensory
abilities by encouraging play in ve key
therapeutic positions. These are the
main positions in early development
which form the basis for later abilities.

The Early Activity System* is designed
to allow you to “mix and match”
positions and activities for your
child, ensuring the best possible
developmental start. Changing
positions is important, as this is
what allows your child to progress
independently at a later stage. The
aim is to allow your child to develop a
variety of movement skills, as well as
building strength and coordination.

(*Patent Pending)

p12 Leckey Therapy Bench Manual

The Five Positions

The Early Activity System supports
purposeful play in:

1. Back lying (supine)

2. Tummy lying (prone)

3. Side lying

4. Floor sitting (long sitting)

5. Hands and knees (four-point

kneeling)

You may nd your child likes some
positions more than others, or some
positions may not be medically
advisable for your child to use. It
is important for you to take advice
from your therapist(s) about the best
positions to place your child in. This
may depend on whether your child’s
muscles are tight (high tone) or oppy
(low tone), his level of development or
tolerance for certain positions. Some
positions may need to be avoided for
medical reasons, and others will need
to be encouraged, even if your child is
not keen at the start!

weight, then support that weight with
one part of their body while moving
another part of their body. Some
activities will be recommended by your
child’s therapist to work specically on
transitions.

Position versus activity

The position that you place your child
in and the activity that you choose for
your child in that position are equally
important. However your child’s level
of ability in a certain position will
determine how difcult an activity he
can manage. For example, if he nds it
hard to sit up, most of his energies will
be going towards sitting up – so choose
a simple activity for him. But if your
goal involves a more difcult activity,
then you will need to choose an easier
position or provide more support. That
way, your child is not over-loaded and
is more likely to experience success.

Transitions

Transitions are the positions or
movements needed to get from one
position into another. For example,
rolling is the transition needed to
get from tummy lying to back lying
and over again. To be able to change
position independently, your child
needs to learn to shift their body

Leckey Therapy Bench Manual p13

Some points to remember about how
your child learns new skills

Regardless of the position you place
your child in, or the play activity you
are carrying out, there are things you
can bear in mind to help the process2.

Learning is an active process –
encourage your child to do as much
as he can on his own. Even at a very
early stage this active exploring is the
foundation for problem solving.

Motivation is the key – use toys and
activities which you know your child is
interested in, especially if the position
is not a favourite one. Use small
achievable steps to motivate your child.

Practice makes perfect – it seems
obvious, but think about typically
developing children – they repeat tasks
over and over until they have mastered

them. It may not be easy for your child
to achieve a new skill, so be patient
and don’t worry if the skill doesn’t
come quickly. Check with your therapist
about the frequency and length
of your play sessions.

We do not yet understand fully
whether learning transfers from one
activity to another2. Therefore, don’t
be worried if an activity which can be
accomplished in one position needs to
be practised again when a new position
is introduced.

Feedback helps learning – at early
developmental stages this includes
your facial expressions, clapping, etc.
Later on it may include spoken praise,
but be cautious that your enthusiastic
feedback doesn’t distract your child!

p14 Leckey Therapy Bench Manual

BACK LYING (SUPINE)

Clinical reasons for back lying

This is the most fundamental of
developmental positions. When a child
lies on his back, his full body weight
is symmetrically supported by the
surface. This makes it a very secure
position from which to work on the
physical, cognitive and sensory skills
that provide the building blocks to
more complex skills. The following
sections explain a little more about
each skill area.

Physical goals

Baby will benet from strengthened
neck, tummy, shoulder and hip bending
(exor) muscles because he has to lift
his head, arms and legs up against
gravity. It may also help to break up a
pattern of straightening (extension) if
muscles are tight. Foot development
can be encouraged in back lying –
kicking and bringing the feet to the
mouth helps strengthen the foot
muscles which are needed for weight
bearing later on.

Cognitive goals

From this position, baby may be able
to reach and accidentally swipe at toys
dangling from a gym or held above his
face. With practice, this random action
gradually becomes more deliberate,
developing a realisation of “cause
and effect”. Likewise, he may learn
to kick musical toys placed near his
feet. When baby brings his hands and

feet together to explore, he is learning
about his own body parts and their
relationship to each other. This forms
the basis of body awareness and co­ordination.

Sensory goals

When lying on his back it is easiest for
baby to focus his eyes on a dangling
object. First he learns to follow it
through quarter of a circle using just
his eye movements, then through half
a circle moving his head as well as his
eyes. As he becomes aware of his own
hands and feet and takes them to his
mouth, his eye-hand co-ordination
and ne motor skills are developing.
Even the sensations that baby receives
through the back of his body will be
helping him to develop a sense of
front and back. Likewise, the feedback
that baby receives through the joints
and muscles in his limbs (known
as proprioception) gives important
information about his body position in
relation to his environment.

Transitions

Rolling is the skill which enables a child
to move from back lying into tummy
lying. It develops in two stages. Some

children with developmental delay
“log roll” - their whole body moves
as one piece. The aim is to develop
“segmental rolling” - when the head
turns rst, followed by the shoulders,
then trunk, hips, legs and feet. This
rotation of the trunk is an important
building block for the movements
needed for later crawling.

Positioning guidelines

For back lying activities your child
should be placed on his back with
his head supported on a wedge to
encourage chin tuck. Place a roll under
his knees and smaller rolls at either
side of his chest to keep him stable.
Try to ensure that his head starts
and nishes in the midline position.
Remember this is just one positioning
example - your therapist(s) will give
you specic advice.

Leckey Therapy Bench Manual p15

Most activities can incorporate a

sensory component with a little

thought to the toy or the surface

used. Use rattles, squeaky toys,

brightly coloured balls, crackly
paper etc to encourage baby’s

vision, hearing and sensation. If

your baby will tolerate it, let her

carry out her activity sessions in

her vest to allow the maximum

amount of sensory feedback

possible. Your occupational

therapist can advise you best

about your baby’s sensory

tolerance.

Activity Suggestion 1

Hold a brightly coloured object (such
as a scarf or pom-pom) about 12-15”
above baby’s face. Move the object
from left to right through a quarter
circle, then back, going slowly enough
so baby’s eyes can follow it. Make the
task a little more difcult by holding
the object 15-18” from baby’s face
and moving it through a semi-circle to
encourage head movements.

p16 Leckey Therapy Bench Manual

Activity Suggestion 2

Encourage your child to bring his hands
together on his chest. Place your hands
behind his shoulders to encourage his
arms to come forward.

Activity Suggestion 3

Activity Suggestion 4

Hold onto baby’s feet and help him to
kick or “bicycle” his legs. This helps to
strengthen tummy, legs and feet, and
the reciprocal movement is one which
is needed for later weight bearing or
movement.

Activity Suggestion 5

With the same set-up as described in
the positioning guidelines, use the hip
positioning strap to stabilise baby’s
hips. Encourage her to reach across
her body with her left hand to a toy
on the right side, and vice versa. Place
your hand behind her shoulder to
assist if necessary. To make this a bit
more difcult, remove the pelvic strap
and move the toy a little further out of
reach. Your child should need to shift
her weight at her hips to reach the toy.
This is a building block for the transition
of rolling later on.

Bring baby’s hands and feet together.
This midline position is good for
symmetry, and baby is beginning to
learn to use both sides of his body
together. This movement is also a
building block for rolling later on.

Leckey Therapy Bench Manual p17

Activity Suggestion 6

To encourage rolling from back lying to
tummy lying, place baby on his back
and bring his hands and feet together
in midline. Encourage him to roll to one
side into side lying. From this position,
help baby’s hips to turn slightly.
Supporting his hips, use an exciting toy
placed near his head to encourage him
to turn his head and reach for the toy.
Once baby’s head and shoulders turn,
baby will roll onto his tummy. Help him
prop onto his elbows to make sure his
airway is clear.

Activity Suggestion 7

Make rolling a little more difcult by
holding the lower half of the body
steady using your hands or the
positioning strap. Encourage the
child to roll leading with her top half.
Position toys just out of reach of baby.
As her top half turns, allow her lower
half to follow.

p18 Leckey Therapy Bench Manual

TUMMY LYING (PRONE)

Clinical reasons for tummy lying

Research has shown that about one
half of typically developing infants
show some delayed development
by six months of age if they are
never placed on their tummies
when awake12. In addition, the
back muscles (extensors) of children
with developmental delay tend to
be weaker2. This makes it especially
important to have some daily tummy
time. It is a more difcult position for
baby, because to see around her, she
has to lift her head up clear from the
surface. Babies’ heads are bigger in
proportion to the rest of their bodies,
so to lift them up against the force of
gravity is really hard work! Remember
to use simpler activities at rst.

Physical goals

The therapeutic and developmental
benets of lying in this position
have been reported in research
studies as improved upper body
strength, shoulder girdle strength and
improved extension (straightening)
movements13,14,15. Lifting baby’s
head and shoulders up against gravity
helps to strengthen the straightening
(extensor) muscles of the trunk. This
is helpful for children with oppy (low
tone) muscles. It is also an important
foundation for the development of
sitting. Hand development is promoted,
as the weight taken through the bones,
joints and muscles of the hand are

strengthened. Foot development can
also be encouraged in this position,
with carefully placed rolls or toys – see
the activity suggestions later on.

Cognitive goals

In tummy lying, baby needs to have
developed reasonable head control
before she will be able to prop on
her forearms to play with a toy in
midline or reach out with one hand at
a time. Otherwise, tummy lying will
be difcult and tiring. As baby learns
to hold her head up and prop on her
forearms, her shoulders and arms are
giving sensory feedback about their
position in relation to her body and the
environment. As this works together
with her eyes and her environment
when she is reaching for toys, her
spatial awareness is also developing.

Sensory goals

When lying on her tummy, baby can
gain a sense of security. She continues
to develop her visual focusing and
tracking, and her sense of body
awareness. With reasonable head
control, baby will be able to play for
some time in this position, continuing
to strengthen her muscles, while

exploring her environment and looking
around.

Transitions

Rolling is the skill which enables a child
to move from back lying into tummy
lying. It develops in two stages. Some
children with developmental delay
“log roll” - their whole body moves
as one piece. The aim is to develop
“segmental rolling” - when the head
turns rst, followed by the shoulders,
then trunk, hips, legs and feet. This
rotation of the trunk is an important
building block for the movements
needed later for crawling.

Leckey Therapy Bench Manual p19

Most activities can incorporate a

sensory component with a little

thought to the toy or the surface

used. Use rattles, squeaky toys,

brightly coloured balls, crackly

paper etc to encourage baby’s
vision, hearing and sensation. If
your baby will tolerate it, let her

carry out her activity sessions in

her vest to allow the maximum

amount of sensory feedback

possible. Your occupational

therapist can advise you best

about your baby’s sensory

tolerance.

Positioning guidelines

Place a small roll or wedge under your
child’s chest. Support her whole body
so her trunk and legs are stable. Use
the pelvic positioning strap to stabilise
her pelvis if required. Remember this
is just one positioning example - your
therapist(s) will give you specic
advice.

Activity Suggestion 1

Encourage your child to lift his head
up – use a favourite toy to motivate
him. To make this a little more difcult,
try moving the toy slowly from side to
side, so baby has to turn his head to
follow it.

p20 Leckey Therapy Bench Manual

Activity Suggestion 2

Encourage baby to “push-up” on
straightened (extended) arms with
open hands. This will strengthen
her shoulder and upper trunk, and
encourages weight bearing through her
arms – a building block for four-point
kneeling. It is also a very early building
block for ner motor skills which
depend on stability at the shoulder for
the control needed.

Activity Suggestion 4

Activity Suggestion 3

While baby has his head lifted up,
encourage him to reach and grasp with
one hand, then the other. This helps
to develop trunk and lower spine
extension – the start of the lumbar
curve. The weight shift involved when
using one hand at a time uses more
complex muscle control – this helps
later for sitting up and using the arms
against gravity.

Place your child in a curled up position
on her tummy, ensuring her airway is
clear. Make sure her hips, knees and
ankles are bent (exed), and place a
roll rmly behind her feet. Show her
an exciting toy, and she should start

kicking, pushing herself forward. Tickle
baby’s feet, and place them against the
roll to encourage movement. This is a
building block for commando (belly)
crawling and four point crawling.

Activity Suggestion 5

To encourage rolling from back lying to
tummy lying, place baby on his back
and bring his hands and feet together
in midline. Encourage him to roll to one
side into side lying. From this position,
help baby’s hips to turn slightly.
Supporting his hips, use an exciting toy
placed near his head to encourage him
to turn his head and reach for the toy.
Once baby’s head and shoulders turn,
baby will roll onto his tummy. Help him
prop onto his elbows to make sure his
airway is clear.

Leckey Therapy Bench Manual p21

p22 Leckey Therapy Bench Manual

SIDE LYING

Clinical reasons for side lying

Side lying is not, strictly speaking, a
separate developmental stage of its
own. In typical development, children
tend to pass through side lying during
transitions from back lying to tummy
lying and vice versa.

However, for children with
developmental delay, sometimes
back lying or tummy lying present too
many challenges. Where children have
uneven muscle tone (one side of their
body may be different to the other) or
strong reexes which interfere with
their ability to use both sides of their
body together, it can be difcult for
them to bring their hands together in
the midline.

This position particularly allows the
development of ne motor (arm and
hand) skills, cognitive and sensory
skills.

Physical goals

Side lying allows a strong extensor
pattern to be broken (when back lying
can’t achieve this). Gravity helps bring
baby’s arms together in the midline. If
possible, the sides should be alternated
to maintain symmetry. The side
chosen for lying will also depend on
the condition of the child and the aim
of the activity. For example, for some
children with hemiplegia (a form of
cerebral palsy where one side of the
body doesn’t work as well as the other),

lying on the affected side may help
to control unwanted arm movements
and improve two-handed play.
Alternatively, lying on the unaffected
side may encourage the use of the
affected arm. Your therapist will help
you decide which side is best for each
therapeutic goal.

Cognitive goals

Like back and tummy lying, side
lying helps baby to develop cause
and effect play, body awareness
and co-ordination. The stability
that this position gives also allows
concentration to develop because play
is less interrupted by unwanted body
movements.

Sensory goals

Because asymmetrical muscle tone
and/or reexes can affect baby’s
symmetry, side lying reduces the
effects of these, meaning that baby
is able to experience more usual
movement sensations. He can also
use his eyes more efciently to follow
objects when his head position is more
central in relation to the rest of his
body.

Transitions

Rolling is the skill which enables a child
to move from back lying into tummy
lying. It develops in two stages. Some
children with developmental delay
“log roll” – their whole body moves
as one piece. The aim is to develop
“segmental rolling” – when the head
turns rst, followed by the shoulders,
then trunk, hips, legs and feet.

Positioning guidelines

Place baby in a bent (exed) position
on his side. Use a large roll behind
his body and head. Use a small roll
to create a chair shape which keeps
baby’s legs bent and

his bottom supported. Try to alternate
sides if possible. Remember this is just
one positioning example - your
therapist(s) will give you specic
advice.

Leckey Therapy Bench Manual p23

Most activities can incorporate a

sensory component with a little

thought to the toy or the surface

used. Use rattles, squeaky toys,

brightly coloured balls, crackly

paper etc to encourage baby’s
vision, hearing and sensation. If
your baby will tolerate it, let her

carry out her activity sessions in

her vest to allow the maximum

amount of sensory feedback

possible. Your occupational

therapist can advise you best

about your baby’s sensory

tolerance.

Activity Suggestion 1

Place toys within reach of baby’s hands,
encouraging swiping, reaching and
exploration with two hands, passing
toys from hand to hand, or banging
toys together.

p24 Leckey Therapy Bench Manual

Activity Suggestion 2

Hold a brightly coloured object (such
as a scarf or pom-pom) about 12-15”
in front of baby’s face. Move the object
up to a quarter circle, then back, going
slowly enough so baby’s eyes can
follow it. Alternate sides so baby’s head
learns to move in both directions.

Activity Suggestion 3

Activity Suggestion 4

Bring baby’s hands and feet together.
This midline position is good for
symmetry, and baby is beginning to
learn to use both sides of his body
together.

Encourage your child to bring her
hands together on her chest. Place
your hands behind her uppermost
shoulder to encourage her arm to
come forward.

FLOOR SITTING

Clinical reasons for side lying

Sitting is considered a vital part of the
developmental sequence because of
the other skills which are based upon
its foundation. Many research studies
have looked at the importance of
sitting, and some research has shown
lying ability to be related to sitting
ability. Children who can bring their
hands and feet together in midline
(such as in back or side lying) have
shown improved sitting ability16. This
helps to reinforce to us the importance
of the typical developmental sequence.

Physical goals

The main physical purposes of sitting
are to stabilise the trunk and pelvis
allowing the arms and hands to be
free. In turn this allows handling
of objects, exploration, increased
learning opportunities and interaction
with the environment1. Baby can be
encouraged to reach, grasp and release
toys, bang blocks together in midline,
and throw things! When neck muscles
are stronger, baby can now turn his
head through three quarters of a circle.
Long sitting (with legs out in front) also
helps to stretch the muscles at the
back of the legs (hamstrings) which
can often be tight in children with
developmental delay.

Cognitive goals

When a child lies down, he is able to
view the world in a horizontal plane.

Leckey Therapy Bench Manual p25

But when he sits up, he can see the
world from a vertical plane. This helps
him to realise that his environment is
three dimensional – he is starting to
learn the spatial awareness concepts
of depth and distance. Sitting is also a
more social posture – the majority of
us communicate with each other from
an upright posture, whether sitting or
standing. Baby is becoming much more
aware of the others around him and
this leads to an increased interest in
his environment. He will be developing
a sense of object permanence – the
awareness that toys are there even
if he cannot see them – he may even
look for things he has thrown away!

Sensory goals

With head control developing well,
and when securely supported in a
sitting posture, baby’s hands are
free to explore a much greater
range of textures, shapes, and sizes.
Use a variety of these (always with
supervision) to give your child a range
of sensory experiences. Baby will be
learning about rough and smooth, light
and heavy, big and small, up and down.

p26 Leckey Therapy Bench Manual

Transitions

To be able to move in and out of oor
sitting independently, children usually
have to be able to move from a tummy
lying position into hands and knees
position. Please refer to both “tummy
lying” and “hands and knees” sections
for further information.

Activity Suggestion 1

Most activities can incorporate a

sensory component with a little

thought to the toy or the surface

used. Use rattles, squeaky toys,

brightly coloured balls, crackly

paper etc to encourage baby’s
vision, hearing and sensation. If
your baby will tolerate it, let her

carry out her activity sessions in

her vest to allow the maximum

amount of sensory feedback

possible. Your occupational

therapist can advise you best

about your baby’s sensory

tolerance.

Activity Suggestion 2

Encourage your child to reach for toys
while sitting. At rst, place toys within
easy reach and encourage grasping,
moving from hand to hand, banging
together, and throwing (casting).

Encourage your child to reach for toys
while sitting. Make this play more
difcult by placing objects a little way
in front of baby, so he has to reach
further forward to get them.

Leckey Therapy Bench Manual p27

Activity Suggestion 3

While sitting place toys to either side,
encouraging reaching out to the side.
All of these movements help to develop
neck and trunk muscles, eye-hand
co-ordination and weight shift.

Activity Suggestion 4

Hold a brightly coloured object 12
15” in front of your child’s face. Move
slowly in a semi circle. Baby will learn
to turn his head in sitting, using his
hip and pelvic muscles to keep him
steady against gravity, and using trunk
muscles to rotate from one side to
another.

Positioning guidelines

Place your child in supported sitting.
This activity can be done as early as 4
months, as soon as the child can clear
their airway (turn their head to the
side) in tummy lying. You may need
to offer head support in the beginning
and offer some recline to allow for
easy breathing and to ease reux. You
may also need an anterior roll or strap
across the child’s chest to help stabilize
the child who is just learning to tolerate
this position. You can also use a roll to
stop the bottom from sliding forward.

If straightening (extensor pattern) is
a problem, you may need to place the
wedge behind the child to break up the
extension pattern or limit the range
of motion the child has to discourage
them from throwing themselves
backwards.

If the child has oppy muscles (low
tone), use a roll across the front of
their trunk to stop excessive bending
(exion). You may also need to use the
small rolls (usually used for the head)
as lateral supports to keep the child in
midline. You can also use these small
rolls for lumbar supports to help the
formation of the lumbar curve.

Remember these are just positioning
examples - your therapist(s) will give
you specic advice.

p28 Leckey Therapy Bench Manual

HANDS AND KNEES
(FOUR POINT KNEELING)

Clinical reasons for side lying

Hands and knees is a position which
enables children to move into and
out of other positions. They can begin
to move onto hands and knees from
tummy lying, and then in to a sitting
position. Depending on each child’s
capabilities, some will learn to use
hands and knees as a building block for
movement – they may go on to be able
to tall kneel (hands off the oor), or
even begin to crawl.

Physical goals

In the four-point position, baby is
supporting her body weight against
gravity using her extended arms and
bent legs. This strengthens her hips
and shoulders, which will improve her
ability to sit well, and use her hands to
play. It will also be useful if she later
crawls. This position encourages both
sides of the body to work together – in
doing so, the brain is helped to make
connections between the left and right
sides – the wiring is improved, so to
speak. And when baby weight bears
through open hands, her thumbs are
helped into the right position for using
with the forenger for a pincer grasp.

Cognitive goals

Weight bearing against gravity, as we
have seen in all positions, helps baby
to understand where her body is in

relation to her environment, and also
where each of her body parts are in
relation to the other parts. Therefore,
baby’s spatial awareness, body
awareness and coordination continue
to develop. Some research has also
shown that children who experience
hands and knees activities have a
better sense of object permanence –
the understanding that something is
still there, even if it cannot be seen17.

Sensory goals

The palms of the hands are naturally
sensitive, but some children seem to be
over-sensitive and don’t like to touch
things. While it is normal to avoid
touching things that don’t feel nice
to us, children who are over-sensitive
to touch limit their opportunities for
exploring and learning. Weight bearing
through extended arms and open
palms exposes baby to numerous
sensations and can help to improve
tolerance for touch. Therapists call
this “sensory integration” – speak to
your occupational therapist for further
advice if you have worries about your
child’s sensory tolerance.

Leckey Therapy Bench Manual p29

Positioning guidelines

Starting from a tummy lying (prone)
position, help baby to bend her hips
and knees, until she is in a kneeling
position. You can place a roll for
support under her tummy, or against
her feet to prevent her legs sliding
backwards. Remember this is just one
positioning example - your therapist(s)
will give you specic advice.

Most activities can incorporate a

sensory component with a little

thought to the toy or the surface

used. Use rattles, squeaky toys,

brightly coloured balls, crackly

paper etc to encourage baby’s
vision, hearing and sensation. If
your baby will tolerate it, let her
carry out her activity sessions in

her vest to allow the maximum

amount of sensory feedback

possible. Your occupational

therapist can advise you best

about your baby’s sensory

tolerance.

Activity Suggestion 1

This position will be challenging for
baby. The position itself may be enough
to work on initially. Help baby into the
position – it is slightly easier at the start
if baby’s bottom is resting on his heels
in the “bunny” position.

Activity Suggestion 2

Make the position harder by
encouraging baby to lift her bottom off
her heels.

p30 Leckey Therapy Bench Manual

Activity Suggestion 3

Place activities in front of baby to start
with. He will have to use one hand
while balancing on his knees and other
arm.

Activity Suggestion 4

SECTION 11:
CLEANING AND CARE
INFORMATION

How to maintain

When cleaning we recommend that
you use only warm water and a non­abrasive detergent. Never use organic
solvents or dry cleaning uids.

Upholstery and fabrics

Mat

The mat is designed to enable the
positioning components to be attached
via the hook and loop receiving panels.
The mat can be washed at 40 degrees
and tumble dried at low temperature.

Remove the plastic inner before
washing.

To remove the inner, open the zip at
the back, fold the mat in half and slide
the plastic insert out. To insert after
washing reverse the process.

Gradually move activities further away
or to each side – baby will have to
reach out of her base of support. This
improves the strength of her shoulders
and hips, and encourages a rocking
movement. This may be a building
block for movement if your child is
ready for this next stage.

Positional components

The fabric used on the positional
supports is a high grade textile which
is almost 100 times more resistant to
wear than standard vinyls.

The fabric has permanent anti-fungal
and anti-bacterial properties which
greatly minimise the risk of cross
infection. Bacteria such as MRSA

Leckey Therapy Bench Manual p31

cannot grow on the fabric.

The soft touch fabric is easily cleaned
so machine washing is not required.

Cleaning the fabric (manufacturer
guidelines)

The most effective way to clean the
fabric is by using warm water and
a detergent, such as Fairy Liquid
following the simple steps shown
below.

1. Soak a cloth eg a J cloth in warm
water and wring out the excess
liquid. (For body uids eg. blood,
urine, use cold water).

2. Apply a small amount of detergent
onto the cloth.

3. Clean the fabric paying particular
attention to badly stained areas.

4. Apply the cloth to the fabric using
a rm circular motion.

5. A nylon nailbrush can be used on
more stubborn stains. This fabric is
extremely durable and brushing it
will not cause any damage.

7. The fabric can then be either left to
dry naturally or any excess surface
moisture can be mopped up using
paper towels.

8. Once the fabric has dried it is
advisable to lightly brush the
surface using a soft brush.

9. More stubborn stains can be
removed using mineral spirit or
isopropyl alcohol providing the
area being cleaned off is washed
with soap and water immediately
afterwards. A half cup of household
bleach to 5 litres of water can also
be used as a useful disinfectant.

10. Chlorine based cleaning agents
such as CHLOR-CLEAN or HAZ­TABS can be used to disinfect the
product providing they do not
contain more than 10% chlorine by
volume.

11. When using a proprietary product
it is important to follow the
directions on the container.

12. Never use organic solvents such as
dry cleaning uids.

6. Rinse off the surface of the fabric
with warm water ensuring all soap
residue is removed. This fabric is
totally waterproof. Water will not
penetrate the surface of the fabric
and get through to the foam lling.
However, care should be taken
where there are stitch lines as
liquid may seep through.

13. Always ensure the product is dry
before use.

As an alternative to the steps outlined
above, alcohol wipes can be used as
an effective means of cleaning to
prevent cross infection.

Following independent testing

p32 Leckey Therapy Bench Manual

excellent stain removal has been found
for -

Simulated Vomit (Porridge), Simulated
Vomit (Pureed Carrot), Orange Juice,
Gravy, Toast/Butter/Marmite, Tomato
Sauce, Salad Cream/Mayonnaise,
Lipstick, Nail Varnish, Ball Point Pen
Marks, Soy Sauce, Fruit Juice, Animal
Blood, Urine, Iodine, Betadine, Suntan
Lotion, Grease.

Antifungal/Antimicrobial Properties

The upholstery used on the positional
components has an antifungal and
antimicrobial treatment which helps
to prevent and contain cross-infection.
This treatment is permanent and
cannot be washed out. If you clean
your product using the methods
described the risk of cross-infection will
be greatly reduced.

Plastic components

1. Soap and water or antibacterial
spray can be used for daily
cleaning.

SECTION 12:
DAILY PRODUCT
INSPECTION

(THERAPISTS, PARENTS AND CARERS)

We recommend that daily visual
checks of the equipment are carried
out by therapists, carers or parents
to ensure the product is safe for use.
The recommended daily checks are
detailed below.

• Check all upholstery and Velcro®
for signs of wear and tear.

If in any doubt about the safe use of
your Leckey product or if any parts
should fail, please cease using the
product and contact our customer
service department or your local dealer
as soon as possible.

SECTION 13:
REISSUING LECKEY
PRODUCTS

2. For deep cleaning a low pressure
steam cleaner can be used.

3. Do not use solvents eg Cellulose
Thinners to clean plastic or metal
components.

4. Make sure the product is dry before
use.

Most Leckey products are assessed
and ordered to meet the needs of
an individual user. Before reissuing
a product we recommend that the
therapist prescribing the product has
carried out an equipment compatibility

Leckey Therapy Bench Manual p33

check for the new user and has
ensured that the product being
reissued contains no modications or
special attachments.

A detailed technical inspection should
be carried out on the product prior to
reissuing. This should be carried out
by a technically competent person
who has been trained in the use and
inspection of the product. Please refer
to section 12 for the required checks to
be carried out.

Before re-issuing a product, it is
recommended that it is disinfected
using one of the following procedures:

Note: Always clean the product rst to
remove accumulated soiling prior to
disinfecting/sanitising.

1. Where possible, we recommend
the use of an automated “fogger”
disinfection system that is used
to completely cover the product
surfaces with a disinfectant agent.
The manufacturer’s instructions
for the chosen system should
be referred to prior to use and
followed exactly.

2. Where an automated disinfection
system is not available, all product
surfaces should be wiped over
with disinfectant surface wipes or
liquid disinfectant on a soft cloth.
Suitable products are 70% IPA,
70% Alcohol or diluted bleach. The
manufacturer’s instructions for the

chosen product should be followed.
Product upholstery and fabrics
should be cleaned thoroughly in
accordance with section, Cleaning
and Care Information, of this
manual.

Ensure a copy of the Activity
Development Programme is supplied
with the product. Leckey recommend
that a written record is maintained
of all product inspections carried out
during the reissue of the product.

SECTION 14:
PRODUCT SERVICING

Servicing of all Leckey products should
only be carried out by technically
competent persons who have been
trained in the use of the product.

In the UK & ROI please contact the
Leckey Service Centre on UK 0800
318265 or ROI 1800 626020 and our
customer service department will
be delighted to assist you with your
servicing requirements.

All international service enquiries
should be directed to the appropriate
Leckey distributor who will be delighted
to assist you. For further information
on Leckey distributors please visit our
website www.leckey.com

p34 Leckey Therapy Bench Manual

SECTION 15:
TECHNICAL INFORMATION

Product Code: 130-600

Includes; oor mat, sitting support,

trunk wedge, head support, 2
positioning straps, 2 medium rolls, 2
small rolls, Dufe bag and a copy of the
Activity Development Programme.

SECTION 16:
SIZING INFORMATION

Technical Details

Max User Weight 15kg / 33lbs

Age Max 36 months

Stature Max 1000mm / 39.4 inches

System Dimensions

Floor Mat
Width
Length

Sitting Support

Height
Depth

Seat width

Min
Max

Support Roll small

Width
Length

Support Roll medium

Diameter
Length

Trunk Wedge

Width
Length
Angle

Positioning Straps

Width
Length

1760mm / 26.3 inches
950mm / 37.4 inches

190mm / 7.4 inches
300mm / 11.8 inches

200mm / 7.9 inches
250mm / 9.8 inches

60mm / 2.4 inches
600mm / 23.6 inches

80mm / 3.2 inches
700mm / 27.5 inches

270mm / 10.6 inches
208mm / 8.2 inches

7.5 degrees

80mm / 3.14 inches
660mm / 25.9 inches

Leckey Therapy Bench Manual p35

For more information please
visit leckey.com

p36 Leckey Therapy Bench Manual

Symbol Meaning

Medical Device

Read the Instructions for Use

CE mark

Warning

Manufacturer

Serial number

Product code

Max occupancy weight

Date of Manufacture

For indoor use only

Latex free

Unique Device Identication

Machine wash- water temperature 40°C

Tumble dry- low heat

Do not iron

Symbol Meaning

Do not bleach

Handwash

Do not dry-clean

Leckey Therapy Bench Manual p37