Positioning - Pediatrics

Question 1

Why do we care about positioning?

Answer 1

It is critical to a child’s ability to maintain postural control while participating in daily activities

Question 2

What is a side-lying position useful for?

Answer 2

Useful for weakness thank to a gravity eliminated position

Question 3

What are the prone extension, prone on elbows, and quadruped position useful for?

Answer 3

Preparatory for crawling & proximal stability

Question 4

What is kneeling useful for?

Answer 4

Preparatory to standing

Question 5

What are the long sitting, ring sitting, tailor sitting, and ‘W’ sitting positions useful for?

Answer 5

Sitting while unsupported on the floor

Question 6

Out of the long sitting, ring sitting, tailor sitting, and ‘W’ sitting positions, which one should we not promote after 1 year?

Answer 6

‘W’ sitting

Question 7

What is optimal positioning?

Answer 7

Upright sitting/ sitting in a chair
(90-90-90)

Question 8

What does extensor tone look like when a child is sitting in a chair

Answer 8

Extended hips and knees, extended head, lifting torso from chair

Question 9

What does flexor (low) tone look like when a child is sitting in a chair?

Answer 9

Child will be bent forward in chair

Question 10

If you have a child with fine motor deficits and low tone what should you address first?

Answer 10

Address Positioning (Proximal Stability before Distal Stability)

Question 11

If you have a child with oral motor deficits and low tone what should you address first?

Answer 11

Address Positioning (Proximal Stability before Distal Stability)

Question 12

What is hypertonicity?

Answer 12

Increased tone or tightness - typically extensor tone/posture
-Leads to limited ROM

Question 13

What is hypotonicity?

Answer 13

Low tone or weakness - typically slumped posture
-Leads to being hypermobile

Question 14

How can OT’s support positioning with supportive/adaptive positioning during dressing with children?

Answer 14

-Promote flexion: Supine/Quadruped increases extensor tone
-Side Lying: makes moving limbs and dressing easier

Question 15

What are supportive/adaptive positioning techniques for children during toileting?

Answer 15

Reducer Rings - improves balance on toilet

Question 16

What are supportive/adaptive positioning techniques for children during bathing?

Answer 16

-Hammock Chair: Fully supports during bath
-Trunk Support Ring: Gives trunk stability
-Inflatable Bath Collar: Used while in supine orprone position

Question 17

What positioning devices help promote upright sitting and standing?

Answer 17

Corner & Bolster Chairs, Supine & Prone Standers

Question 18

What are NDT/Handling Techniques?

Answer 18

They use sensory input such as deep pressure and UE weight bearing with the body in good alignment to:
-Inhibit spasticity
-Inhibit primitive reflexes
-Facilitate normal movement patterns