GM.A.9 PULLED TO SIT, ONLY SLIGHT HEAD LAG

Every time we sit up from lying, we need to be able to lift the weight of our head using our neck muscles. A baby’s head is very large in proportion to the rest of her body and it is hard work for her to keep it in line with her body when pulled to sit.

How to Assess

Method: Place the child on her back on a flat surface and pull her to sit, holding her hands and wrists. Score plus if your child can lift and hold her head in line with her body with only a momentary lag at the start of the movement. She may come up with her head tilting to one side. This is acceptable at this stage.

How to Teach

At this stage you have had a lot of practice as described in the previous item. It is important now that you give your child adequate warning of what you are going to do. Use a consistent word such as ‘sit’ or ‘up’. After you have given this direction, hold her wrists and wait for several seconds before you start to lift her, giving her a chance to help. Also practise going down to a lying position from a sitting position. Hold her wrists and slowly lower her, pausing just before she reaches the floor to make her work just that extra bit before she relaxes.

Positioning, Carrying and Playing

Games such as ‘Row, row, row your boat’ (each time leaning just a little further back) can be enjoyed by all the family. This is best done building in a ‘twist’ as you go back and forth. As your baby gains more control over her head, you may he tempted to carry her with her legs apart over your hip. Don’t (unless you have been advised to do so by a physiotherapist or doctor). Babies with lower tone all too often use legs wide apart to stabilise themselves. This prevents them from learning to use their trunk muscles effectively when they get to sitting, and stops them moving from sitting to crawling and kneeling positions. It is essential that low-toned children learn to use their trunk muscles for balance.

Continue to carry your baby in the crook of your arm, with your support as low down her trunk as possible. While you are carrying your baby in this way, rotate her legs towards you so that her body is twisted slightly. This rotation or twist is going to become extremely important in all the baby’s movement. It is an integral part of balance. Continue to pick up and put down in side lying. Your child need not of course continue to lie on her side. From here, help her into the desired position.