Mark displayed increased extensor tone in supine, with his neck in hyperextension, shoulders retracted and elevated, legs straight and ankles plantar flexed.
Mark did not tolerate side lying and fussed in response to changes.
Head support was needed when holding Mark in sitting or at one’s shoulder.
Mark held his left hand in a fisted position.
Mark was frequently fussy and preferred to be held most of the day.
Mark’s therapist uses the wedge and lateral rolls to elevate Mark’s head and shoulders, in addition to a roll to maintain hip and knee flexion. In addition small rolls were placed on either side of Mark’s trunk under his shoulders to bring his scapula forward. This position gave Mark experience and practice of a functional position. Mark quickly learned to reach with both arms for a toy suspended above his chest, visually focusing in the midline. At 4 months old (right) Mark displays decreased extensor tone and functional use of his hands in the midline, playing with a toy.
At 5 months old (left) Mark plays in side lying. Mark’s family also used the Early Activity System for positioning during sleep for a short time as Mark had a preference for lying on the right side of his head whilst sleeping on his stomach. By positioning Mark to sleep on his left side for this time, he now shows no preference and his head has become more symmetrical.
At 9 months Mark has progressed to sitting up with the help of the sitting support. As he gains head control this component helps Mark to sit with a padded therapy bench in front of him. This gave him the opportunity to push up on his forearms to help him maintain an erect posture, providing upper extremity weight bearing and strengthening. This was important as Mark was not yet able to weight bear through his forearms in prone at this stage, as he fatigued rapidly due to the weight of his head.
Left, Mark is upright using the sitting support and reaching up to activiate his toys. As Mark gained head and upper trunk control, he was able to sit without the support of the padded bench, freeing his arms to engage in play.
At 18 months Mark has made significant progress, from gaining head control right through to independent sitting (far right). Mark’s therapist reports that "the Early Activity System was instrumental in his progress, providing positions that allowed Mark to use his vision and hands functionally, while providing the 'just right' amount of support to the trunk and neck."