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Head Control

Children with cerebral palsy often have poor head control which is generally managed through positioning and specialist equipment. However, while head control is a desirable developmental and therapeutic outcome, little is understood about how it develops and why its acquisition may be delayed. As head control precedes reaching, grasping, the visually controlled manipulation of objects, and sitting (Simon et al 2014), a clearer understanding of its development and the consequent impact of a delay will assist therapists in planning and delivering more effective, targeted occupational therapy interventions

This paper critically reviews the surprisingly limited literature on the topic and seeks to provide clarity around head control by unravelling the complex interaction of neuromotor, sensory and cultural influences and evaluating the impact of these on the further motor, sensory and functional development of children with cerebral palsy.

Following the developmental journey from the first intrauterine head movements at 7.5 weeks gestation (Lee & Galloway 2012) to the dramatic adaptation to the extrauterine environment at three months of age (de Lima-Alvarez et al 2014), therapists will be asked to reconsider their strategies for assessment and intervention if development is arrested before this milestone is achieved. This has particular relevance for occupational therapists as the delay affects reaching, balance, trunk control, vision, feeding, and positioning. Take home messages include the need for closer assessment of head control, wider multi-disciplinary involvement, and how we might need to challenge generally accepted postural management strategies to avoid negatively impacting on function in special seating.
Click on the title full article on the Implications of Head Control with children with CP.
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