Case Studies – Protac Ball Cushion


A 10-year-old boy has been diagnosed with ADHD; he suffers from mental and motor restlessness as well as difficulties concentrating. The boy is very disruptive in class as he is restless on his chair and makes a lot of noise. He now uses the ball cushion, which helps him to sit quietly for longer periods of time than before. He seems more focused and less noisy. The boy uses the ball cushion for all activities that require him to sit quietly and concentrate.

A mother and occupational therapist talks about her eight-year-old son: “He now feels so much cleverer after he has been given the ball cushion to sit on at school.” “Mummy – it used to take me an hour to do four sums, but now I can do six.”

Poor concentration

A four-year-old boy finds it hard to pay attention and concentrate when he has to sit and eat; this is a problem in kindergarten in relation to the other children, but also at home. He tries sitting on a ball cushion on the Trip Trap high chair, and it helps him sit without being so agitated. A ball cushion is also placed under his feet, which has the effect of making him considerably more attentive, calmer and more able to follow what is happening around the table.

A six-year-old girl who goes to speech therapy has low muscle tone in her postural muscles. As a result, she finds it difficult to sit upright on a chair for any length of time, often collapsing and sliding down onto the floor. She tries the ball cushion, and is now able to sit and concentrate for the 30 minutes that the training lasts without feeling tired or collapsing.

A reception class pupil has difficulty concentrating and sitting still on a chair. She sits on her knees on the chair, lies across the table, and turns round and round. Now she sits on a ball cushion, and is immediately much calmer. After a couple of days she was able to concentrate for longer – and is now sitting completely quietly on her chair. She is well aware that the cushion is good for her. When she arrives in the morning, she is usually the first to find her place, and if she wants to play on the computer or sit somewhere else, she pulls her chair with her.

Hypotonia and hypermobile joints

A girl in the preschool class who has hypermobile joints, joint problems as well as moderate Sensory Processing Disorder, has difficulties sitting upright for longer periods of time. She grows tired and inattentive, and slouches in her chair. The girl tries sitting on a ball cushion, and is now better able to sit up during the lessons. The ball cushion also helps the girl’s balance problems.

An eight-year-old boy has low muscle tone in his postural muscles as well as very hypermobile joints. Consequently, he finds it hard to sit still and upright on a chair during classes at school and during mealtimes at home. The boy collapses and looks for support by resting on his desk – and that of his classmate. He is restless and sits in awkward positions. The boy tries sitting on a ball cushion, and a change is immediately observed in his posture and his ability to sit up and quietly. The boy quickly becomes attached to his ball cushion. The school purchases a cushion for the boy. He is also given a cushion to use at home during mealtimes and when he is doing his homework (written by the children’s occupational therapist).

Two boys at the special school where I teach have extreme hypermobility as well as being very restless. The children’s paediatric therapist placed the ball cushion on the seats of the chairs as well as under the boys’ feet, and it had a surprisingly positive effect on the boys’ sitting position, their ability to sit still and their concentration. The school now uses the cushions in class, when the children are eating as well as for activities where the children are expected to sit still and focus on what they are doing.

Motor and mental restlessness

A young boy suffers from extreme akathisia (a condition marked by motor restlessness, ranging from anxiety to inability to lie or sit quietly or to sleep) and the occupational therapist therefore suggests a ball cushion. The preschool class teacher is sceptical, and says: “I thought it would be a problem to get him to sit on the ball cushion. I thought he wouldn’t want to stand out by having a different seat in class. But it is quite the opposite – he loves his ball cushion, and is only prepared to part with it for short periods of time, only lending it to his friends. And the entire class is much calmer now that he is more balanced within himself.”

Balance problems

A 45-year-old woman with multiple sclerosis goes to treatment because of the problems she is facing with her balance and fine motor skills. She also has severe pains in the small of her back. She tries sitting on a ball cushion for the 20 minutes that her hand training lasts. She notices that the pain in her back eases, while the cushion also trains her balance because of the balls’ flexibility.