Some children with spastic cerebral palsy may require a hand brace or hand rest to prevent hand joint deformities or to improve hand movement patterns, such as assisting in holding objects with wrist up. Some children with spastic cerebral palsy need to change their posture frequently to prevent joint deformation. 1. Correct abnormal shoulder posture (1) Sit the child in a seated position with the therapist behind the child, hold the child’s head with one hand, and slowly flex the shoulder joint up to 180 degrees with the other hand, and hold it for 30 seconds. (2) Repeat the action of (1), when the shoulder joint of the affected upper limb is flexed up to 180 degrees, bend the child’s elbow joint to 90 degrees and place it behind the head, keep the forearm rotated back, pay attention to the action should be gentle, do not force too hard, hold time 30 seconds, do 10-20 times. (3) The child still takes a sitting position, let the affected side of the upper limb behind the body, and the other hand to hold each other, the palm of the hand outward to do the “back hand” action. Initially, let the child’s double located in the position of the tailbone, gradually lift to the L1, hold time 30 seconds, do 10-20 times. (4) The child is placed in a lateral position, with the affected side on top, the therapist sits behind the child, puts the right lower limb across the hip joint of the child and fixes it, then fixes the armpit of the child with one hand, fixes the five fingers on the supraspinatus muscle of the ipsilateral shoulder, presses rhythmically, the direction of force can be divided into forward, downward and backward, the verse and frequency of each direction is: 30 seconds each time, do 20 times. 2.Promote the development of visually guided hand grasp function Children with cerebral palsy have limited ability to establish visually guided reaching and grasping as well as the ability to discover various parts of their bodies. Therefore, the position should be selected according to the type and degree of the child’s impairment, and the child’s shoulders and upper limbs should be trained to reach forward to complete grasping while maintaining the child’s stable, symmetrical posture. The therapist supports the child’s armpits with both hands, and the child supports his or her weight with one hand, while the other hand can reach forward to touch the therapist’s face. With the child’s back on the therapist’s lower extremities and feet flat on the floor, the therapist guides the child to touch his or her face with his or her hands, telling the child about the eyes, nose, ears, mouth, hair, etc. while allowing the child to touch the appropriate parts. The degree of support provided by the therapist’s lower extremities is determined by the child’s ability to maintain a forward sitting position of the trunk. Children with spastic hemiplegia have strong gross motor skills, so their fine motor skills of the hands may be given more attention, especially the coordination of the hands. Training focuses on the upper extremity of the affected side, especially hand function, and bilateral coordination for functional independence. Functional improvement of both hands in sitting position: tactile and proprioceptive stimulation input of the affected child; enhancement of weight transfer in sitting position and weight-bearing ability of the affected side; improvement of play function of both upper limbs. The most effective training method is to use the child’s upper extremities, hands, and trunk to teach the child to complete activities independently, such as writing, drawing, cutting, dressing, eating, and managing his or her belongings. Assistive devices such as sitting chairs, splints, special scissors and cutlery are used to help improve the child’s skills, prevent the occurrence of hand deformities on the affected side and make some work activities easier. In addition to improving motor function, the occupational therapist also supports the child’s social and psychological education. Improving the child’s self-esteem and self-confidence ability is the focus of occupational therapy, as well as making the child happy, adapting to society and coordinating the function of both hands outside, which can be helped environmentally, such as using loose-leaf to fix the paper. Quadriplegia Since tetraplegic children have more severe upper limb dysfunctional training, grasping and releasing is the attention training program for these children, and these training must be aimed at improving their daily living skills.