With pediatric occupational therapy going on at home using parents as surrogate therapists, it isn’t helpful to ask a parent to do too much repositioning of children with low tone.  First of all, kids don’t like it.  Second, kids really don’t like it.

I have never met a child that enjoys therapeutic handling, no matter how skilled I am, and I don’t think I ever will.  They don’t know why we are placing their hands or legs somewhere, and they tend not to like to be told what to do and how to do it.  The best you can hope for at times is that they tolerate it and learn that therapists are going to be helping them do what they want to do For Kids With Sensory Issues and Low Tone, Add Resistance Instead of Hand-Over-Hand Assistance.

Leaving a child in an awkward and unstable position isn’t the right choice either.  They are going to struggle more and fail more when out of alignment and unsteady.  If you know this is going to happen, you can’t let them stay that way because you also know that this will blow back in your face in the form of frustration, short attention span, and children developing a sense that whatever they are doing or whomever they are doing it with is a drag.  A real drag.

So how can you improve the posture of a child with low tone without forcing them physically into a better position?

• Use good seating and other equipment that facilitates postural control.  A chair that is too small, a slippery floor and footie pajamas….try not to make stabilization too hard unless you are a licensed therapist and you know how to juggle all the variables.  If you are a parent, ask your child’s therapist what kind of seating, tables, ride-on toys, etc are the right ones.  Don’t think your therapist knows what you need?  My e-books can help you and your therapist because they have guidelines and checklists to learn about selecting all of these things.  They are part of The JointSmart Child series! Read more here The JointSmart Child Series: Parents of Young Hypermobile Children Can Feel More Empowered and Confident Today!   and here: Parents and Therapists of Hypermobile School-Age Kids Finally Have a Practical Guidebook!
• Respect fatigue.  A mom told me today that her daughter’s telehealth PT sessions end in tears at least half the time due to exhaustion.  That is simply unacceptable.  Great therapists don’t leave kids that upset for parents to deal with after the session.  They taper the session demands, and end on a good note.  There are always other positions to play in or other things to do when a child has fatigued postural muscles.  You know they are fried because if you present them with a fun activity and they simply cannot manage it, you aren’t being played.  They are tired.
• Create routines that incorporate postural control.  My little clients over 2 know that their non-dominant hand had a job to do and what it is.  They know that we place feet in a certain way, and that specific games call for specific positions.  Read  A Fun Way to Help Kids With Low Tone Stand Up Straight: Stomp-Stomp!  for a fun idea to improve foot placement with younger kids.  When good posture is a habit, there fights are fewer going forward.  They know what to do and what I expect, and I know that they will be successful if they follow our routines.  Read How To Correctly Reposition Your Child’s Legs When They “W-Sit” and Is Your Hypermobile Child Frequently In An Awkward Position? No, She Really DOESN’T Feel Any Pain From Sitting That Way for more information on this subject.