May 8, 2013

Dynamic Core for Kids question #2

This next question is a composite of a couple of queries I have received since our Dynamic Core for Kids course in Ottawa last month.  I am thrilled that so many therapists are integrating the material into their practice so well.

“Where is the best place to start with a child who is low tone, has lots of flexibility, maintains a posterior pelvic tilt in all positions (even with a wedge) and compensates with head and neck extension.  This child  does not like any blow toys, or anything near her mouth.  She also grinds her teeth.”

I would start in a supported sitting position with this child.  Slightly off upright, maintaining alignment so you are using gravity to facilitate descent of the diaphragm.  Once in this position, find an activity the child likes to participate in (hitting a switch, batting a toy) that can be shaped to occur on the exhale.   The teeth grinding could be an attempt to use proprioception to try to recruit some stability at the TMJ for a feeling of increased head stability.  It could also be an up-regulating or a down-regulating strategy.  You will need to sleuth a bit and decide why the child is using this.  Once you decide what the strategy is for, you can provide input in a different way.  Possible options are:   searching for stability – deep pressure through the mandible on an angle towards the TMJ.  Up-regulating –  provide vestibular and proprioceptive input prior to sitting.  Down regulating – try deep pressure prior to and during the activity.

Great observations and questions.  If anyone else has anything to add, please comment!