I work in the UK system which I know is very different - the kids I've helped go into school with hypermobility and low muscle tone issues have needed the school to do a risk assessment of all the activities they do where they need extra help, especially PE/Phys Ed, anything involving a lot of walking off site, climbing activities, making sure they wear any footwear that helps (some don't cope too well bare foot) and the staff need to understand they get tired quicker because they have to work harder to do the same movements. Especially with young children, it's easy to think they're opting out or not trying when actually they're tired and need a rest. One child I worked with needed planning to help with writing/fine motor activities because his hands got tired and ached after a few minutes and a balance needed to be struck between activities to develop his hand muscles and writing skills, and activities where the focus was on the learning/thinking and an adult did the writing for him, as we didn't want him to get frustrated, hate writing and add to the problem. Different angle writing surfaces and so on can help too and an occupational therapist is a great resource to advise on that.
Most manage with the arrangements/planning in place unless they have other issues too.
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