From Head Control To Trunk Control

John is now able to maintain good head control from left to right. He does however still have difficulty with full extension (bringing his ears directly over his shoulders). When he attempts full extension, his head suddenly drops backward so we watch for this and try to protect this from happening.

With that being said and since he is showing good control even if his head doesn't have full extension, we have started working with him on his trunk control. We do this by working with him on our lap with him in the sitting position. Its that same position as you would put someone in to play patty-cake with. We will gently bounce him. We start with our hands up under his arms as to provide full support of his trunk and we gradually move them down toward his hips. Even though he doesn't have enough trunk control for us to be able to move our hands to his hips, that is the goal.

Another technique that we use is to lay down with our hips and knees bent so as to make him a recliner to sit in. As he sits on our stomach, we hold his hands and allow him to sit up with us just holding his hands.

Trunk control is also addressed when he plays on the floor. We put him on his stomach and place his elbows on the floor under his shoulders. This not only promotes good head control against gravity but also assists in good upper trunk control.

These exercises have given us good results but the ability of controlling the head needs to be taken into account before progressing through these techniques. We don't limit practicing trunk control to "therapy times" but also in how we carry him. Carrying him upright on our shoulder vs. letting him lay in a car seat promotes more of an upright posture. When carrying him in on our shoulder, we place one hand on his lumbar spine which prevents the spine from bulging outward.

We also work on Johns pre-verbal skills by talking to him and singing to him. He coos to us and we coo back. We talk to him in the mirror which helps him to see his different facial expressions. I realize that I am probably intense about his therapy and that he will probably learn to do this eventually but it is just not my personality to just let it happen in its own time. I want to help him perform as well as he is able and he has shown me that he is capable of what is given to him.