Positioning
Are you wondering why your child needs a variety of positioning options? Or why they should be in a stander even if they may not be able to stand unassisted? There are several benefits to good positioning, including:
Making eating and drinking easier for your child
Making it easier for you to care for your child
Making it easier for your child to interact, play, and communicate with you and their peers
There are additional benefits to standing for all children, even those who cannot stand by themselves, including:
The development of stable hips
If children do not stand, their hips won’t develop properly which may lead to easy dislocation
The development of strong bones
A child who doesn’t stand will have weaker, less dense bones that break more easily
The stretching of leg muscles to prevent contractures
It’s good for breathing and blood circulation
It assists in emptying the bladder and bowels
It can help reduce stiffness and uncontrolled movements in the legs
If you have questions on your child's positioning at home or at school, please contact the school PT!
For more information on the importance of positioning as well as equipment used for positioning, check out this website HERE.
Click the arrow at the bottom of each picture to learn more about different positioning options for your child
Supine (lying on their back)
Head should be in the middle and comfortable if child is unable to move it
Body/spine should be straight, support with rolled towels if needed
Bend the hips to release tension in lower back and release stiffness in the legs, add support under the knees to help with positioning Keep legs open and uncrossed using a pillow for support if needed
Keep legs open and uncrossed using a pillow for support if needed
Feet should be as close to a standing position as possible, if they push down talk to a therapist about ankle/foot orthoses
Shoulders and arms should be forward and supported, use a rolled towel or positioning aid if necessary
Side Lying
Head should be supported so chin is level (in the middle with the head and spine in a straight line)
Back support should be given from the top of the head down to the feet
Bottom leg should be straight
Top leg should be bent at the knee and supported with a pillow or blanket, so the knee is level with the hip (this helps prevent hip dislocation and reduces stiffness in the legs)
Lower arm and shoulder should be brought forward so they are not trapped beneath your child
Both arms should be forward encouraging hands to come together
Prone (lying on their stomach)
This position is not for all children. It could make breathing difficult or reinforce pushing back with their head. Talk to a therapist before using this position.
The head should be in a straight line, encourage your child to lift their head and look at something in front of them on the floor (toy, sibling, etc.)
Legs should be straight, not crossed, with straight hips
Arms should be in line or slightly in front of shoulders, ensure the towel or wedge pillow used to keep your child in position comes up to their armpits to help the arms stay forward
Encourage your child to open their hands and push down on them if possible (if too stiff, continue to help each time they are in this position)
Standing (using a standing frame)
Back should be straight, support with a rolled towel on either side if necessary
Hips should face the front
Feet should be firmly on the ground, including heels, with the toes facing forward
If you can easily move your child’s feet, there is not enough weight on them, you should adjust the frame
If feet are in a poor position, don’t stand until your child has been assessed and fitted with orthotics
Arms should come forward onto the tray which should be at chest height
Sitting in a Chair, Stroller, etc.
Head should be upright and back should be straight
Child should be sitting with their butt all the way to the back of the seat
Legs must be supported
Feet must be supported
Arms should be slightly forward and in front of their body
Sitting with Parent/Caregiver
Head and back should be supported if child cannot hold their head up
Chest and hips should be supported if child can hold their head up to help with head control
Child should be sitting straight and using muscles to keep themselves upright
Bend hips to at least a right angle to prevent child from slipping off your lap and help keep their back in a proper position
Support the feet if possible
Shoulders should be slightly forward so hands are in front of the body for exploring objects and playing with toys