From day one... positioning is so important

Sharon Galitzer (Physical Therapist) by Sharon Galitzer (Physical Therapist) Additional Needs

Sharon Galitzer (Physical Therapist)

Sharon Galitzer (Physical Therapist)

I'm a pediatric physical therapist and also the sibling of an adult with special needs.

Young children and little ones who are not verbal may not be able to express their wants and needs.

So, as a physiotherapist who has seen many children, I wanted to share some observations I’ve had through my 25 years of practicing and tell you some things to consider when positioning your child.

When you wrap your baby in a swaddle or a onesie, in a stander, position a child in a wheelchair or a stander, where they may spend an extended period of time, our priorities are comfort and function.

However, other priorities should be to prevent skin redness, maintain good postural alignment and of course ensure that the child feels safe and secure.

Your child may or may not be able to tell you exactly what’s uncomfortable, and instead may be giving you cues that are both obvious and indiscernible.

Signs that your child may need to be adjusted include that your child may cry, arch their bodies or appear to be uncooperative, demonstrate decreased eye contact, rock or bang their bodies, or become combative.

Pediatric physiotherapists pay special attention to positioning in and on devices because the right position will support maximum functional abilities for the child, and decrease future musculoskeletal deformities.

Proper positioning is essential for: comfort, to facilitate active movement, maximize body proprioception, help with self-regulation and exploration, head support, good postural alignment, and prevention for skin breakdown and other musculoskeletal deformities.

I’m hoping to touch upon what your child may feel or think but may not be able to eloquate and articulate.

Your child may be thinking...

I feel like I’m falling through space because my swaddle is not tight enough.

I’m so tired of lying on my back.

I’d like to reach that toy however I can’t roll all the way from my back, I wish I was on my side.

I can’t lift my head off the floor because it’s so heavy; I wish I was propped up off the ground a little, like on a towel roll to help me lift it up. (Please refer to your physiotherapist for instruction)

My reclined seat is positioned too vertically; it’s actually more difficult for me to keep my head up this way.

I’m keep slouching down in my highchair/wheelchair/seat. It’s much more difficult to lift my arms and hands when that happens.

My back is hurting because I slid down in my seat; I wish someone would slide me back into place.

I’d like to see what it feels like to go faster when I move.

Please let me know where we’re going and that you’re going to move me before you’re going to move me.


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