Matthew
Developing Matthew’s sitting ability with the Early Activity System
Matthews’s sitting ability is inhibited by low tone in his trunk and poor head control as a result of his Hydrocephalus. When he is placed in round sitting Matthew can maintain the position for up to 30 seconds with limited saving reactions. Throughout the day he uses other equipment including a classroom chair, a standing frame and a sleep system. Matthew currently moves around on his back using his feet to push.
Clinical Assessment
Matthew cannot sit unaided. He has low tone in his trunk and his hips are often in an externally rotated position. In supine Matthew tends to bring his legs up into flexion and external rotation.
Approach
The primary aim of Matthew’s Early Activity System is to improve his head and trunk control by providing comfortable postural support and positioning. The Early Activity System must support the hypotonia in his trunk whilst strengthening his head control.
In the prone position Matthew can weight bear through his arms promoting head control and shoulder stability. This contributes to the aim of improving sitting posture. Rolls placed bi-laterally maintain Matthew’s legs in the correct position, this inhibits his pattern of hip flexion and external rotation and prevents contractures.
Side lying is used to improve Matthew’s confidence and address his reluctance to roll.
Outcome
Using the Early Activity System, Matthew has become stronger in sitting and kneeling, using his arms for support. He can maintain his head in midline for longer periods and is stronger in the trunk. This progress forms the basis for Matthew to develop transitional movements by linking these static positions together.
The Early Activity System has allowed Matthew to engage with his environment, and Matthew’s Mum is really enthusiastic about using the mat as she is so impressed with the sitting position it helped him achieve.
