May 1, 2013
A Dynamic Core for Kids question
I’ve had a query from one of the participants of last week’s Dynamic Core for Kids course in Ottawa. I thought it was a great question so I’ve posted my answer here.
“Is it common to see mobile kids who don’t like supine lying if their alignment is poor?” In my experience there could be a couple of things going on. First, we need to be very careful about head/rib cage position. If the head is not on an appropriate pillow and the rib cage isn’t supported in alignment, they feel as if they are falling backwards and the Moro kicks in at some level. If they have any level of anxiety day-to-day it cues me to the fact that they almost always have the remnant of a Moro and poor anti-gravity flexion. Supine can feel like a vulnerable position for them. If you can set them up in alignment in sitting, it might be faster to go from there. Secondly, remember that breathing is actually harder work for the diaphragm in supine as there is decreased input from the vestibular system with respect to gravity. So again, I will work in sitting or semi-supine on a wedge or therapy table with the head tilted up. Lastly, it seems to work better in supine if the child is on my therapy table i.e. off the ground. I really don’t thoroughly understand this. This doesn’t work well for kids with spasticity or significant gravitational insecurity but it works really well for children who are mildly involved with lower tone. I’m not sure if it has something to do with vision.
If any of you have thoughts or comments, please post them so we can all learn together!