Therapy Explained - Positioning

A lot of people have asked what Asher's physio and occupational therapy entails and I usually answer with a much shorter answer than is required to give it justice (you'll see why below). I decided here is the place to really get into it, and also explain ways you can help when you are interacting with him. It's a lot of reading to get into at once, so I will break it down into a few different posts. 

Here we go with the first installment. 

Positioning

For now, the most important thing is how we handle Asher. We want to make sure that some of the less than ideal habits he is developing as a result of his high tone are suppressed as much as possible, and so we hold him/interact with him in ways to ensure his body is always positioned in the best way. For instance, his right arm has two bad tendencies - to either point out in front of him, like he is a super hero in flight, or to fly out behind him, like his arm is said superhero's cape (nice metaphor for my superhero, eh?). When holding him, we make sure he keeps his arm loose and at his side or slightly in front of him, ensuring there is no strange rotation. When he is comfortable this is easy to do, but when he is working hard he gets into his awkward positions, so part of the solution is to make sure he is comfy and relaxed and not straining for any reason.

In addition to his arm, he has a tendency to bring his right leg up, bent at the knee, close to his body. When he does this he also rotates his hips to turn them with his leg. Again, when he is relaxed this is not an issue, but when he is focussed on a task it tends to happen. When holding him or playing with him, we make sure he keeps that leg long and loose. His hamstrings seem to be a bit tight, so he likes to sit with his legs slightly bent.

In sitting, we also encourage him to use his core by giving him the least amount of support required (sometimes it is as little as fingers on his thighs if he is relaxed; other times he needs our hands around his waist). We make sure he doesn't curve his spine and is sitting in the most upright position he is capable of. We also make sure his bum is right under him, sitting directly on his sit bones.

Basically, if he is in a position that doesn't look "normal", we are trying to discourage it. We have lots of ways of doing so, for instance, gently shaking that extremity to loosen it, rubbing his back or sternum or ribs to encourage him to straighten his spine (depending on how he is bending), along with talking to him and reminding him to relax (this will become more and more important as he gets older and can remind himself to have a "quiet body" as our physio refers to it.

Any of these things are helpful when you are playing with him, so if it isn't obvious to you, please ask us. This aspect of his therapy is the way you can be the most helpful when you are with Asher.

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For more on Asher's therapy, see posts on exercises, gear, and eating.