Low muscle tone, also known as hypotonia, can be a condition on its own (benign congenital hypotonia) or can be a sign of an underlying problem that manifests with progressive loss of muscle tone, for example, in muscular dystrophy or cerebral palsy. Hypotonia is usually present at birth and is frequently diagnosed in early infancy where the baby appears floppy – has increased flexibility in their joints with poor posture.
Occupational therapists are aware of how low muscle tone disrupts a child’s development in that children have to work harder as they may tire easier, have difficulty sitting for longer periods of time and meeting developmental milestones.
In Theramoves courses, you will gain a further understanding about why increasing overall muscle tone in OT is so important as well as fundamental interventions and goals for OTs to implement to treat low muscle tone.
What is the role of an OT in treating low muscle tone?
Mobility and posture
To help children with hypotonia who present with delays in gross motor skills and coordination skills. Decreased muscle tone also causes problems with ligament and joint laxity. These factors combined will result in the child having decreased endurance, difficulty standing up or changing posture after being in one position for some time. The child has a waddling gait and experiences difficulty climbing stairs or climbing around the playground. The child’s sitting posture is observed to be stooped and requires significant leaning or back support to sit for longer periods. This factor should be taken into consideration when the child is in a classroom setting where they are required to be seated for long periods throughout the day.
The ‘w’ sit
Often children that have low muscle tone are also ligamentous laxity and their sitting is compromised. Therefore, they prefer to sit in a “W” position. This position entails the child sitting on their bottom with knees bent and feet positioned on the side of the hips. In this position, the child relies on the wide base made with their legs to compensate for their decreased core muscle strength that is usually in play during normal sitting position. Prolonged “W” sitting can cause furrowing out of the hip socket which causes the thighs to turn inwards, later followed by the knees. This turning later causes difficulty in movement as the ball of the hip joint does not attach properly to the socket. A child whose sole sitting position is the “W” may present with crawling and walking difficulty. Therapy entails encouraging and constantly reminding the child to sit in a criss-cross, side sit or long sit position.
The courses are suitable for:
- Occupational Therapists and Occupational Therapist Assistants
- Physical Therapists
Upcoming Low Muscle Tone Courses
- Early rate
Neuroplasticity for Pediatrics: How to Rewire the Nervous System and Simple Exercises to Promote Functional Outcomes
Treatment Techniques for Core Strength and Coordination (on-demand)
The Neuroplasticity Evaluation of the Pediatric Patient – How to Look, What to Do and Where to “Goal” (on-demand)
The role of an OT in treating low muscle tone, continued
Difficulties with oral motor development
Children with low tone are often seen with open mouth postures leading some to drool. This is a result of muscular hypotonia affecting the oral musculature where there is reduced oral lip seal and limited oral suction needed for swallowing hence, causing saliva to freely flow from the mouth. Reduced oral muscle tone particularly of the tongue also causes articulation difficulty that alters the child’s communication skills.
Handwriting and Drawing
The art of shaping and curving letters and shapes in writing requires a combination of numerous fine motor skills. These skills include the dynamic tripod grasp which combines the muscles of the palm and of the fingers in holding the pencil to bring out legible shapes and letters. Children that present with decreased muscle tone especially in their upper bodies/hands will have compromised graphomotor skills. Often the grasp is compromised as the child tries to find a way to hold the pencil usually unable to maintain a tripod grasp without some kind of gripper. They may press too hard or too soft when writing. These children also get tired quickly from writing and sometimes can’t keep up the pace in the classroom. In addition, the formation and legibility are usually also compromised.
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Hypotonia is a condition that hugely impacts a child’s developmental milestones. It is crucial for professionals and caregivers to be educated about it as identifying the condition at an earlier stage of life guarantees better outcomes and adaptations for therapy. Here at Theramoves we are dedicated to educating you on the latest approaches of rehabilitating children with low muscle tone.