Thanks for your replies

The only contact that doesn't trigger extensor spasms is when his mother strokes his cheeks.

I have taught her how to do passive exercises for the whole body and to talk to him throughout doing the exercises and to try and include him as much as possible. She is also going to do sensory stimulation/massage with him.

After a week of treatment we managed to get him to accept a prone position for 30 seconds using several pillows (when we started prone actually increased the spasm and he didn't relax at all into flexion) but it is still a work in progress...

I have also advised her on how to start standing when she can get sufficient DF in the feet (currently in PF++ (probable shortening of gastroc) with toe flexion esp. big toe).

As for some of the other questions:
- spasticity is present awake & asleep
- positioning is sitting/supine with hip and knee flexion
- he has no active movements as such

They live over 3 hours away so I won't be seeing him again until later in July. I'll keep you updated as to how he goes.

Thanks again.