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Reading, writing and studying

Managing the effects of EDS and HSD on these key skills

The impact of EDS and HSD on reading, writing and studying

EDS and HSD can affect the wrist and finger joints, making joints unstable and painful and difficult to grip.  Pain, fatigue and autonomic nervous system effects can also make concentration difficult. Pupils with EDS or HSD often have problems with handwriting and may struggle to hold large or heavy books,  for prolonged periods, making reading difficult.


Grips to put around pens and pencils can reduce the impact of writing on unstable and painful joints. Pupils with fine motor difficulties sometimes find it easier to write with a pen than a pencil so consider this option too. Where writing is extremely difficult, a basic keyboard and screen, such as an AlphaSmart, could be considered or other dragon software.  Pupils with EDS and HSD may have been given hand exercises to do by their physiotherapist. These could be discreetly encouraged in class if hands become painful or tired. Some of these preventative exercises could be using theraputty to help warm fingers and prepare for writing.

Tips for writing:-

Resources tips  see link.

Scenario 1
Pupil, a 17 year old high school student

During class a teacher gets frustrated with a pupil who so far she has only seen in the mornings. After timetable changes she sees this pupil at the end of the day. The pupil, an exam candidate, doesn’t want to write in class and if she is writing she holds her pen in a fist which results is unreadable handwriting. The pupil does not express why she is doing is and is affecting her grades.

Potential responses:

Sophie Year 11 pupil numerous musculoskeletal issues, shoulders hips. Quiet and passive anxious. Has been marked low attendance in the past due to illness and appointments. Not reaching potential. Doesn’t have many friends, often accused of daydreaming but can ‘make a mountain out of a molehill’.

An occupational therapist's perspective

Copy to go here


Tips for sitting :- Sitting and writing for long periods,

Pupils should be encouraged to sit with a support if needed.  W sitting is not encouraged as it exacerbates the hip/pelvis.  Do not Sometimes sitting on a chair is easier but bear in mind the social environment.  Often pupils do not want to be seen as different.

Tips for studying/exams :- such as in exams, can be very challenging for some pupils with EDS or HSD. Where a young person with EDS or HSD has a history of needing reasonable adjustments in the classroom, consideration should be given to applying for exam access arrangements for the pupil when they sit exams. These can include providing extra time to complete the exam, supervised rest breaks or a scribe.

The following will be helpful for some pupils with EDS and HSD, depending on how their condition affects them:

  • Allowing the child to bring nutrients into the exam (if needed regularly, for example to manage PoTS). This might include a sugary drink, salts or a snack (parents can advise).
  • Allowing them to bring in additional water
  • Allowing them supervised toilet breaks, as frequently as they need (as EDS and HSD is often associated with bladder and bowel problems)
  • Allowing the child to sit in the place that is most appropriate for them (e.g. near to or away from a window)
  • Providing a foot rest, writing slope or writing aids, where needed

It is important to make sure the invigilator knows that there is a pupil with EDS or HSD sitting the exam and what adjustments to usual procedure have been agreed.

For pupils severely affected by their condition, alternative ways of demonstrating competence might need to be considered, for example using oral responses instead of written ones.

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