1. When a child cries during exercise, does it mean that it hurts?
Crying in a child (during exercise) has several causes. :
1. In newborns up to the 6th week, a common cause is their insufficient thermoregulation. If such a small child is undressed for a longer period of time, they will get cold and quite logically this discomfort will manifest itself in crying. The solution to the problem will be the use of gel pads, which will offer thermal comfort and the undressed child will have a similar feeling to when you put him in a bathtub with warm water.
2. Another relatively common cause is the so-called "positional uncertainty of the child's body" - this means that a child who is motorically immature does not have the ability to control the center of gravity of his body. If such an immature child is placed on a flat mat, he will begin to show instability, spreading his arms in an attempt to find stable support. Such a state is unpleasant for him and he expresses his displeasure by crying. If we hold him in our arms, thereby creating stable support for him, he will completely calm down. During the actual exercise, the child reflexively raises the legs, raises the head, and steps forward, and this of course also increases the feeling of positional insecurity and leads to an anxious crying reaction.
3. Probably the most significant source of crying in children during Vojta Method therapy is incorrect communication with the child. Children up to about one year of age have a so-called "omnipotent" way of communicating, they dictate "how and when to talk". The child actually initiates, directs and also ends communication. This is an innate non-verbal pattern. If the child practices Vojta Method "clumsily", does not communicate with him, does not receive an "explanation" that nothing bad is happening, then he becomes insecure, tense and cries. It is through crying that he demands an explanation and assurance that the parents have the situation under control. It is necessary to communicate with the child constantly during the exercise, even if he is not in the mood for exercise (neither of them). Creating a positive atmosphere without nervousness is very helpful. Regular exercise also helps the child get used to the load, both psychologically, physically, and in terms of his biorhythms.
4. If the source of crying is pain, then it is in EVERY case a mistake, pain creates a defensive reaction that disrupts reflexive exercise, moreover, crying caused by pain persists even if the child is in his arms, such crying also has a different characteristic and parents quickly recognize that it is a "serious cry", with which the child signals danger.
2. Before I learn the exercises properly, can I harm the child?
Even not completely correct exercises are very important, both for the child, who gradually starts to get used to them, and for the mother (father), because there is no other way to learn the exercises well. However, exercises that are not performed perfectly are not harmful in any way.
3. Is the exercise difficult – can one person do it?
For a small child under one year old, one person can do it without any problems. If there is a supportive father or grandmother in the family, then of course taking turns in the exercise will be very helpful.
4. Are any special aids used?
So far, no aids are used, except for those I have started to introduce, i.e. balls, elastic bandages (available at medical stores), inclined planes. I plan to use thermal gel pads and some other aids.
5. Is the Vojta method suitable for everyone?
There are a number of indications for the Vojta methodology, in young children these are mainly motor development disorders (central coordination and tone disorders - muscle tension), conditions after birth fractures of the clavicle, underdeveloped hip joint nuclei, head posture predilection (inability to turn the head to both sides), in older children posture disorders, scoliosis, etc. are common. In adults, the Vojta methodology is also used for a wide range of musculoskeletal disorders. In young children, caution is necessary in children with proven and unstable epilepsy.
6. In what cases is it better to interrupt exercise for a few days (illness, vaccination...)?
Exercise must be interrupted for 3-4 days after vaccination, especially if a reaction occurs (fever, drowsiness, fatigue); common illnesses (colds, viral diseases) require interrupting exercise only if the fever persists and the child is tired, otherwise exercise can be continued without restrictions.
7. What happens in the body during exercise?
In the body, the stimulation of reflex zones on the body triggers (i.e. a specific response is generated by the stimulation) a “repair program” /see below/. In the 1950s, MUDr. V. Vojta discovered the general laws of a child’s motor development from birth until the time of independent movement. He studied these laws in order to find a rehabilitation methodology suitable for children who were affected by a motor system disorder (most often after cerebral palsy). He knew that normal motor development has its own laws that every healthy child must go through. However, since he was a brilliant observer and a great neurologist, he discovered that even physically disabled individuals go through a development process that results in a so-called pathological motor stereotype. We carry normal motor stereotypes with us into adulthood as part of our genetic makeup. Pathological movement patterns are also “hiddenly carried” in memory traces. Disorders of the musculoskeletal system, both during development and in adulthood, then enable the triggering of a pathological stereotype. It can be said that physiological (i.e. healthy) movement stereotypes are something like “operational programs” for the brain for the basics of movement (turning, standing up, walking and grasping). We can compare them to the operating programs of a computer – for example, Windows – if these do not work, no “special applications” of movement will work either. This developmentally younger and also more fragile “operational program for physiological basic movements” can be disrupted somewhere, for example by a stroke or an operated joint. In that case, the brain uses developmentally older operating programs (we can compare them to a DOS program). However, these only know pathological movement stereotypes. This primitive DOS is either not able to trigger “superstructure applications of movement programs” at all (e.g. jumping, dancing, playing the piano and other acquired and learned movement skills), or it triggers them in various distorted and incorrect ways, which is immediately visible in the resulting movement. The goal of every rehabilitation is actually to return to the developmentally younger “Windows” and thus enable the re-launch of complex movement applications in a completely normal form.
The brilliant thing that Dr. V. Vojta discovered was that there is something like a “backup repair program” in the brain from birth, with which nature has equipped us. This ability can generally be attributed to other so-called self-healing mechanisms of the body, such as the healing of a broken bone or damaged skin. For the normal and successful course of the healing process of, for example, a bone fracture, it is necessary to meet conditions proven in practice, i.e. fixation of bone fragments, rest, and no strain. Also, for the “start-up” and successful course of treatment of a musculoskeletal disorder with the help of that backup program, it is necessary to meet certain conditions known so far. I would like to emphasize that the current state of knowledge in this area is probably at the level of Madame Curie’s companions, when they observed with amazement the healing fractures on the first X-rays.
However, it has already been proven in practice that in order to start the correction program, it is necessary to bring the body into a predefined position and, by stimulating some of the many "trigger reflex zones" on the body, to induce reflex (uncontrolled by the will) movement. We can distinguish two types of these movements, namely reflex crawling and reflex rotation, which have grown into several modifications over time. Practically speaking, this is an isometric movement, as if we had "frozen" the actual movement at a certain stage. This achieves much greater efficiency thanks to the temporal and spatial summation of stimuli that go back to the brain. Thanks to this feedback, the correction program is able to "add missing, disrupted or damaged "files and libraries" to the brain Windows in order to activate the "basic operational programs for movement" to the maximum extent possible. These are necessary for physiological movement stereotypes, and thus subsequently enable the launch of superstructure and complex "application programs" of movement.
The treatment method was named "Vojtova" after its creator and began to be used with great success, initially only with young children who were at risk of motor development disorders. Thanks to the incredible plasticity of the brain, this corrective program is capable of correcting even severe motor disabilities.
8. How long after a meal can I start exercising with my child?
You can exercise relatively soon after the child has eaten. For small, fully breastfed children up to 3 months, you can start exercising after about 15-20 minutes. For older children who already have a solid diet, it is better to wait 30 minutes. Exercise only slows down the digestion of food, as a larger amount of blood is distributed to the muscles. Vojta's methodology has a significant effect on the entire digestive tract, as it significantly normalizes the muscle tone of the smooth muscles in the wall of the stomach and intestines, thereby facilitating the movement of food in the digestive tract and subsequently improving stool emptying. The blinking of small children when starting to exercise is corrected relatively quickly due to the above-mentioned effect.
9. What time is the best time to exercise for the last time so that the child is not tired from the whole day, or on the contrary, does not get excited by the exercise and then have trouble falling asleep?
Practice shows that it is advisable to do the last exercise before the child's evening bath, which leads to the child's overall calming and pre-sleep relaxation.
10. How do I know when I should start exercising with my child? Will I know it myself, or is a visit to the doctor necessary?
Every mother has an innate feeling for how her child's development should proceed. She subconsciously monitors his or her manifestations, especially:
- the strength, richness and clarity of the vocal expression of crying, humming and whining
- the muscle tension, "how the child behaves in your arms"
- how the child lies on the mat, whether he or she bends back
- how he or she raises his or her head, whether he or she walks
- whether his or her hands are relaxed from fists, how he or she grasps toys
If the child's expression does not correspond to the mother's innate expectations, she or he becomes restless and anxious, and begins to seek help and explanations. Dr. Vojta had great respect for this innate maternal instinct and never underestimated it or trivialized mothers' concerns. Above the door of his office he had written: "MOM IS ALWAYS RIGHT". This is also why he developed a methodology for early diagnosis of impending motor disorders. So if a mother is concerned about "something" in her child's development, which she is often unable to describe precisely, then it is absolutely necessary for her to seek professional help. Real professional help, not soothing nonsense about "the child is lazy", that "he will grow out of it", that "every child is different". Such and similar talk only indicates that the relevant pediatrician is not able to properly examine the child in terms of psychomotor development, is not able to clearly determine what stage of development the child is in and why he behaves in such and such a way, and does not know the developmental screening according to which he would very reliably distinguish whether the child is developing completely normally or whether he has some deviation in development. Deviations can basically be divided into:
– mental development disorders (e.g. Down syndrome)
– physical development disorders, so-called central coordination and tonus disorders
– mixed-type disorders
Of course, it is also necessary to find out what degree of disorder it is, i.e. very mild, mild, moderate and severe.
A mother who comes for an examination with a suspicion that her child's development is not quite right should in no case be put off by some vague statement, but should assertively demand clear and professionally based answers. After all, this is what she pays her pediatrician for. If she does not receive such an answer, it is her duty to seek professional help from another doctor. In the book I am preparing, I will try, with your help, to create a kind of "instruction" on how to make sure that development is proceeding completely according to physiological norms and also "instruction" on how to recognize in the most reliable way possible whether the child is at risk of a possible developmental motor disorder.
11. When can you start exercising with your baby?
If necessary, you can start exercising soon after birth (2-3 days).
12. When is the latest time to start exercising with a child?
I don't fully understand the question, but it can be said that if a child has a disorder, of any type, then postponing it is bad, because the chance of normalizing the disorder (or significantly reducing it) is reduced. During the first year, the maturing brain is very "plastic", Dr. Vojta used to say that the brain is "pregnant" with possibilities. The developing brain matter is able to form many replacement connections that allow covering and sometimes completely removing even a serious defect. Defect both in the sense of anatomical disorder, i.e. destruction of part of the brain tissue, e.g. postpartum hemorrhage into the brain, or damage due to neonatal jaundice, etc., and also functional disorders, i.e. failure to create a sufficiently functional neuronal network, which is necessary for the functioning of an otherwise anatomically intact brain. In other words, the sooner you start exercising, the better.
13. Why does a child cry during one exercise and then over time have a lot of fun with the same exercise?
At the beginning of the exercise, the child has "positional uncertainty" which irritates him, repeated exercise creates brain connections that allow the child to "control his center of gravity" in the position and thus the feeling of uncertainty that causes anxiety and subsequent crying disappears. On the contrary, once the child is confident in the position, he "has fun" by being able to perform a number of new "fun" movements that previously made him nervous. It could be compared to learning to ride a bike. In the first hours, the child is also very uncertain, often with anxiously dilated pupils, but as he gradually masters balancing, coordinating pedaling and steering the bike at the same time, he experiences a feeling of euphoria from the new movement possibilities...
14. How long will I have to exercise with my child? When can I stop exercising?
Exercise is meaningful until the child's development is completely normalized. This is of course individual and is related to the type and degree of the disorder. How quickly normalization is achieved also depends on the time when the exercise was started. The earlier the disorder is detected and the exercise is started, the faster the normalization of motor development is, and unfortunately, the vice versa.
15. What would be the consequences if I did not exercise with my child?
The consequence of neglect is of course also completely individual and would depend on the type and degree of the disorder. Central moderate and severe coordination and tonus disorders most often develop into some type of cerebral palsy. Cerebral palsy is a serious developmental disorder of the motor skills of the musculoskeletal system, into which the child "matures" without timely diagnosis and subsequent intensive therapy. Of course, there are very serious, most often combined disorders, which have a poor prognosis even with good care, but fortunately this is a very rare occurrence.
Very mild and mild disorders tend to disrupt the so-called "automatic body control" and these children experience disorders noticeable when standing and also when walking, when the walking stereotype is disrupted by internal rotation of the hip joints with simultaneous turning in of the toes. A frequent consequence is disruption of the correct development of the longitudinal and transverse arches of the foot. Other serious developmental disorders that subsequently appear if early care is neglected are defects in posture:
- turning the toes inward
- internal rotation of the knee joints (legs in an "X")
- forward movement of the pelvis
- increased curvature in the lumbar region
- sagging and bulging of the abdominal wall, often combined with loosening of the middle tendon coupling of the rectus abdominis muscles and susceptibility to umbilical and abdominal hernias
- protruding shoulder blades and forward rotation of the shoulders
- chest configuration disorders, most often its plunging and subsequent disorders of the coordination of the respiratory stereotype
- sideways curvature of the spine - i.e. scoliotic development
– forward head movement
– a disorder of the lower jaw posture in the sense of damage to the automatic closing of the mouth, which is simultaneously caused by the displacement of the lower jaw to the back, causing a false overbite and a bite disorder of the teeth with their increased caries – children then often prefer to breathe through their mouths.
This is therefore a whole range of developmental disorders that manifest themselves gradually during growth.
In addition to these so-called gross motor disorders, disorders of the development of fine motor coordination sometimes also manifest themselves subsequently. These include difficulties with writing, reading (poor coordination of eye muscles and speech organs), manual clumsiness, e.g. when learning to play musical instruments. It is very likely that developmental disorders of gross and fine motor skills also contribute to the emergence and subsequent maintenance of so-called “mild brain dysfunctions”.
16. Who can show me the exercises?
Vojta Methodology therapy is by law strictly reserved for the competence of erudite physiotherapists who have completed a three-year (bachelor's) or five-year (master's) education and have also completed postgraduate studies in Vojta Methodology. Not doctors, sports trainers, masseurs or other professions. Taking part in therapy is a responsible matter and therefore it is necessary to approach it from both sides.
17. What is the best time to exercise? (after a meal, before a meal…)
Exercise is suitable about 15 to 30 minutes after a meal, depending on the child's age. It is very important to create a daily routine where the child will exercise regularly; this way the child will adapt more easily, create a habit and a biological stereotype that will help him tolerate exercise better. Regularity is a very important factor in success. It helps if the daily routine is made in writing and followed like a school timetable.
18. Is it true that a child who practices the Vojta method becomes physically capable earlier? (climbs, walks, etc. earlier)
Yes, it turns out that children, especially those with very mild and mild developmental disorders, have accelerated maturation of brain structures due to the influence of the Vojta method, creating richer neural networks that are the basis for good performance and capacity of the brain as such. It is not uncommon for these children to stand and start walking before the 10th month, their motor coordination and dexterity are very developed. The degree of gross motor maturity is also reflected in faster maturation of fine motor skills (hand dexterity, mature manipulation of toys, drawing, etc.) and in overall better psychomotor development (more active use of speech, musicality, better ability to establish social contacts, etc.).
19. Does Vojta Method exercise help with increased salivation in young children? And if so, up to what age of the child?
Exercise normalizes all movement stereotypes,
at any age. Increased salivation is a disorder of the automatic swallowing of saliva, it physiologically appears in young children up to about 3 months, then the ability to continuously swallow the saliva produced occurs and thus prevent its spontaneous outflow from the mouth. In central coordination disorders in the first year of a child's life, the persistence of spontaneous salivation often occurs as a result of a disorder of automatic coordination of swallowing. The persistence of spontaneous salivation is also a major problem in mentally disabled children. Properly conducted exercises can achieve correct automatic swallowing of saliva in these children, even in older age. In adults, this problem can occur after a stroke, and with this disorder, quality exercises can also achieve the return of the impaired function of swallowing saliva.
20. Can exercise have a negative impact on a child's psyche? He does something he doesn't want to do, something he finds unpleasant and unnatural...
Previous research has shown the opposite, i.e. that children who were forced to practice Vojta's methodology had a better relationship with their parent who practiced with them than with the parent who did not participate in the exercise. It is not easy to explain why this is the case, but the child perceives in his unconscious that the practicing parent does not want to harm him in any way, but rather the opposite. And although the child often defends himself and rebels during the exercise, he is also participating in the creation of a strongly positive relationship. From the perspective of his immature ego, the non-practicing parent is less interested in him than the parent who practices with him. During and after the exercise, the child is also often comforted, and this happens mainly through intense physical contact, which is very important for the creation of a future positive relationship.
21. What are the side effects of exercise?
Vojta's method of exercise has been used for more than 50 years and the side effects of exercise observed so far have been basically positive. In addition to its own focus on normalizing gross motor disorders, it has a proven positive effect on higher nervous functions, including cognitive ones, such as normalizing stereognosia (the ability to identify an object only by touch), normalizing fine motor disorders (writing, drawing, etc.), normalizing reading disorders, and normalizing hyperactive manifestations in children with LMD disorders. The normalization of strabismus (crossed eyes), which is caused by poor coordination of the eye muscles, is often noted.
22. Is regularity of exercise important?
Regularity of exercise is very important. It is very important to create a daily routine when you exercise regularly with your child, so the child will adapt more easily, create a habit and a biological stereotype that helps him tolerate exercise better. Regularity is a very important factor in success. It helps if the daily routine is made in writing and followed like a school timetable.
23. How many times a day and how long to exercise?
The exercise schedule is individual and depends on the child's age and the type of disorder. In general, it can be said that for small children up to one year old, it is appropriate to exercise 4 times a day, for older children 1-2 times a day. The exercise time, which starts with small infants, is approximately 0.5 minutes and the stimulation is gradually extended to 1 minute, meaning the duration of one exercise on one side. It is of course necessary to exercise symmetrically on both sides. For older children, the stimulation time can be increased individually to 2-3 minutes.
24. Can I overload my child with excessively long exercise?
Yes, if the exercise were to last for an excessively long time, then it would certainly lead, like any other physical effort,
to overload.
25. If I stop exercising for a while, does this mean that I will disrupt the already formed stereotypes and return to the beginning as if?
This is a somewhat more complicated question. For young children under one year of age, when basic movement stereotypes are being formed very intensively (standing up, automatic standing, stereotype of walking and grasping), it is absolutely necessary to ensure the continuous development of these basic motor skills. Therefore, it is recommended to stop exercising only for the necessary time, i.e. after vaccination and at elevated temperatures. In the first year, thanks to the plasticity of the brain, there is a great chance of normalizing a number of musculoskeletal disorders. In older children who already have the "basic motor skills" ready, both physiological and
substitute (pathological), a pause in exercise is no longer such a deficiency. In older children, exercise rebuilds, improves, optimizes, and fine-tunes the stereotype that has already been formed in some way. If the "foundations and rough masonry" have already been laid, this will remain built, even if construction stops for a while. However, if the pause is too long, then the physiological stereotype that has already been built could gradually "erode" and be replaced by a pathological stereotype.
26. Are the results of the exercises permanent?
Yes, the results of the exercises can be considered permanent, as they are created by changes in the brain tissue (creation of a denser network of neurons and their richer connections), which is manifested by the normalization and tuning of the control of movement stereotypes, and then also by changes in the musculoskeletal system by correct centering in the joints and correct adjustment of the automaticity of the body posture (creation of ideal curvatures of the spine, position of the pelvis, shoulder girdles, etc.).
27. How to make exercise more enjoyable for a child?
First of all, it is necessary to create adequate external conditions that will make the child comfortable. For infants, it is primarily about thermal comfort, because their thermoregulation is still insufficient and they quickly get cold. In the place where they exercise, it is very beneficial to increase the temperature to 24-26 degrees during the exercise. It is also necessary to ensure a calm and relaxed atmosphere; it is completely inappropriate if older siblings disturb and demand the attention of the exercising mother. Equally unnerving and inappropriate are the pitiful lamentations of grandmothers over the "torment of the bug" of their grandchild. If your loved ones are unable to help you, arrange for them not to interfere. The place where you exercise (table or changing table) must be stable, supported by a soft mat (exercise mat) and hygienically covered on top, for example, with a PVC tablecloth. For older children, the comfort of the exercise can be improved by playing a CD with favorite fairy tales or music.
28. Which muscles are affected by exercise? Exercise can affect drooling, urination, poor sucking technique during breastfeeding, etc.
Exercises using the Vojta Method affect absolutely all muscles in the body, including such muscle groups as the tongue muscles, oculomotor muscles or sphincters. Exercises also normalize all movement stereotypes, at any age. Increased salivation is a disorder of the automatic swallowing of saliva, it physiologically appears in young children up to about 3 months, then the ability to continuously swallow the produced saliva occurs and thus prevent its spontaneous outflow from the mouth. In central coordination disorders in the first year of a child's life, persistent spontaneous outflow of saliva often occurs due to a disorder of the automatic coordination of swallowing. Persistent spontaneous outflow of saliva is also a big problem in mentally disabled children. With properly conducted exercises, it is possible to achieve normal automatic swallowing of saliva in these children, even at an older age. In adults, this problem can occur after a stroke, and with this disorder, quality exercises can also help restore the impaired function of swallowing saliva. Bedwetting in older children is a complicated psychosomatic problem and its cause is not easy to determine. For some children, it is appropriate to use exercises using the Vojta Method. Poor sucking technique in infants is caused by a disorder of the sucking and swallowing stereotype. It is most often related to a central coordination and tonus disorder. With exercise, these simple stereotypes are adjusted quite quickly and allow the child to drink without problems and later also feed on thicker food. If this disorder persists, feeding becomes a stressful matter for the child, because the feeling of hunger forces him to drink, but due to the broken stereotype, he often chokes. Swallowing solid food then becomes an even greater problem. Disturbed stereotype of eye movement muscles leads to various forms of childhood strabismus. This disorder can also be easily influenced by exercises that normalize muscle tension of the eye movement muscles and their mutual coordination.
29. Does the child always have to be completely undressed? Is it okay to wear just a diaper?
When exercising, it is best if a small child under one year old is completely undressed and nothing interferes with their movement. Clothing or a diaper touches and rubs against the skin, thus causing sensory stimulation that negatively affects the reflex exercise. For older children, it is appropriate to exercise in underwear.
30. If the child does not respond during the exercise (does not raise his legs), does this mean that he is exercising incorrectly? Or he does not respond during the exercise, but does when he is subsequently dressed.
You probably mean the reaction of raising the legs during exercise in the supine position (reflex rotation I.). The child's reaction to stimulation is individual and depends on the state of the disorder and also on the developmental stage in which the child is. "Practice" of muscle tension may take place and the response to stimulation is minimal in terms of movement. In any case, it is necessary to constantly consult the reactions with an erudite therapist who manages the treatment and recognizes whether a change is needed, e.g. adjusting the position so that the legs are off the support.
30. If the child does not mind the exercise at all (does not cry), is it worth practicing several times in a row?
On the contrary, it is advisable for the child not to cry during the exercise. If optimal conditions are created, then the child's crying is also minimal, see the answers to question no. 1. The repetition of the exercise should be followed according to the chosen treatment procedure, optimally 4 times a day for infants.
31. The child twists during exercise - should he straighten up?
Exercises induce basic movement stereotypes, turning and crawling. These also contain a torsional (twisting) component of movement. If we induce it, it is a physiological process. However, so that the twisting is not too strong and does not interfere with other movement components (bending, stretching, etc.), it is desirable to perform the exercise on a mat that will prevent the child's body from twisting. That is, exercise without a diaper or blanket, but rather exercise on a sleeping mat.
32. During the exercise, eye contact should be established – the child turns his head in different directions – do you have to “go” to him all the time or is it enough to talk to him and not deal with it? It
is very important to establish eye contact with the child during the exercise. Non-verbal communication significantly helps the child to orientate himself in the situation. Head turning during the exercise occurs both spontaneously and due to a reflex stimulus. It is not necessary to “go” to make contact; the child will “return” to make contact on his own. It is necessary to maintain talking to the child as much as possible throughout the entire stimulation period.
33. One arm should be close to the body during the exercise – is it enough from the shoulder to the elbow or the whole arm?
You probably mean the position of the arm during reflex rotation I. (position on the back). In principle, it is enough to lightly hold only the arm (the part from the shoulder to the elbow) close to the body.
34. Exercise 4 times a day – if there are doctors on one day and you don't have time to exercise that many times, should you exercise even more the next day?
Exercising 4 times a day is optimal, if for serious reasons you can't keep up with the number of repetitions, it's a good idea to continue normally on the following days. Excessive repetitions could overload the child. It is important to try to optimize the organization and planning of time so that the interruptions in exercise are as small as possible.
35. If a child has a pacifier during the exercise, they don't react much. As soon as it falls out, they lift their legs a lot more. What is it - they stop focusing on the pacifier and perceive the exercise?
Yes, it can probably be caused by focusing on sucking on the pacifier. However, if the child is calm during the exercise with the pacifier, then definitely leave it with them. Reflex stimulation takes place anyway and the child also gets oral satisfaction from sucking.
35. Is the order of the exercises important? A – or does it matter which one you start with and which one you finish with? B – or does it matter whether you exercise the left side first and then the right side?
From the perspective of the child's expectations, it is appropriate for the exercises to have a certain order, both between the time intervals during the day and also the course of the exercise itself. In these matters too, it is necessary to follow the recommendations of the therapist who is supervising the exercises