Head Control Starts Day One

Posted by Sharon Galitzer (Physical Therapist) on 11th March 2019 Additional Needs, Advice & Support, Disabilities

This is Sharon, the pediatric physical therapist.

When I treat a baby, I look at the child and think of how their condition may impact their function over their lifespan.

I often take this into consideration when I develop the plan.

While most parents who have children with special needs gain their information from their specialists or may speak with other parents, I have had the privilege of treating hundreds of children with a variety of needs; and I’ve witnessed many benefits and common limitations that can occur over time.

There are some skills that have a great impact on your child’s function.

Head control is number one!!

Head stability is essential for a child to gaze in all directions, for their heads to move on their body, and to ultimately help a child learn about, and participate in, the environment in which they live.

So, how do we work on head control?

TUMMY TIME!! I can’t emphasize enough that any muscles working against gravity will get a better work out.

The benefits of tummy also include scapular stabilization, body proprioception (knowing where your body is in space), and a safe place for your child to explore their environment, and practice rolling or floor mobility.

The first skill associated with head control is for a child to be able to lift and turn their head side to side.

This is not only functional but necessary for safety and clearing their airway to breathe.

Next, good head control is always recommended before a child begins to eat in order to help with the suck, swallow, and breathing coordination.

Although there are high chairs that can recline, have you ever eaten in a reclined position?

Physiologically, it just doesn’t work.

Aside from that, eating then becomes more of a passive, than an active action of food sliding down the chute.

Next, start working on movement higher up against gravity. Stack pillows, use your thigh, build, buy or create a plinth that lifts your child’s trunk off of the floor; this will help them unload part of their body weight off of their arms so they only have to work on lifting their (2-3 kilo) heads up to see what’s going on.

You can use a Swiss ball or a scooter during play. If you are handy, you can also install a harness swing or a platform swing and let them fly like Superman.

If your child is older, proper trunk support is key.

Think of the edifice of a building. A good infrastructure serves as the foundation for the higher floors.

If you are working on head control in upright positions, an erect trunk and a neutral pelvis are ideal but don’t wait for perfect alignment.

If your child is supported down low, things will work better up high. Good trunk support will give your child an opportunity to move their hands away from their body in order to reach, play, feed or explore.

It will also make the scenario the easiest for them to move their head around, visually explore their environment and possibly move within it.

That’s the goal!!

Whether trunk stabilization is achieved by stabilizing the child’s trunk with your hands, legs, an adaptive seat, a stander or a walker: find it, use it, give your child the opportunity to visually scan their environment, to see what’s around them and follow their lead.

Let THEM be active in showing you how and where they’d like to go!

Dr. Sharon Galitzer, PT, DScPT, MS, CIMI