Very poor posture, what has worked to improve your dc's posture?

[Marne]

OT went to see dd2 at school last week, she said her posture is really poor, dd2 kept slumping when sat on the floor, was fidgiting and struggling to sit. She offten went down on her elbows and led on the floor.

She has week trunk muscles and neck muscles which we are working on with help from OT, we have been given a wedge cushion to try for a week (if it works the school will buy one). She struggles to sit up in the car (in her car seat), she seems to be getting worse but it almost looks like she's being lazzy (slumping around). Is there anything else we can try? what has worked for your dc's?

Would something like horse riding help?

sounds like you need some help from a physio to strenghten muscles which will improve posture. Any physical play will help: playgrounds, swimming etc etc

If it is that hard for her to sit then they should be giving her a chair with proper support (my ds has a BRookman chair provided by OT) which is fully adjustable and helps him support himself so he can work. On the floor they can give her a corner chair to help her. If she is struggling to sit then all her energy is going into that and not into learning. Doesn't sound like a wedge cushion will be enough.

We have the same with ds1. He has general hypotonia, but is particularly weak in his trunk and upper body - he has really poor core strength. He's much the same at school, slumping, curling up on his seat, lying instead of sitting if he gets the change. His preferred position for writing or eating etc (basically anytime he has to sit up at a table) is to support himself by using one hand on the back/side of the seat to hold him up.

I felt so guilty when we found out, as we had absolutely no idea and were constantly telling him off for slouching, slumping and laying around the place.

In order to improve his core strength we were advised to get him a wobble cushion (wedge didn't work for him as it just kept tipping him forwards) and a wobble/balance board to use at home. We also had some private pilates lessons for him, which were fantastic and definitely helped, but were expensive and we've met a lot of resistance getting him to practise the exercises at home. He did it for a month or so, but then flatly refused.

The OT that assessed ds said any exercise that requires balance is automatically working on core strength and suggested a martial art might be good for ds. Dh is supposed to be going to family Tae Kwon Do with him, but has so far failed to organise it. I'd like to try him with Tai Chi, but can't find any classes for children locally. Personally, I think horse riding would help, I know from my own experience that it really strengthens the core.

Its also important that they can put their feet on the floor or have a footrest, so that they can position themselves correctly.

I have just discovered when he was doing his homework this evening, that if I put two cushions behind him, he sits much better at the dining table and doesn't feel the need to hold himself up, so we're going to see how that goes for a while.

I'd love to buy ds one of these ball chairs to use at home, as not only would it help him to sit to the table, it would work on his core strength at the same time. Unfortunately, there's no room for it in our house.

Could you take her to horse therapy? We have taken DS since he was 2 and it has really helped for this.

We bought a TrippTrapp highchair at age 5.10 for DS for home and it has revolutionised meal times and home work as his feet have a solid base. Carpet time and assembly though are still a work in progress as we have the same problems with lying on the floor and fidgeting which he gets in trouble for. We do a lot of gym ball work in conjunction with our private SIT OT. Will also be looking at RDA. He goes to trampolining club also which is strengthening him up soooooooooo slowly gradually

Thank you for you posts, we have to try the wedge cushion for a week but have been told to use a weighted lap pad too (too keep her still) but we havn't got a weighted lap pad , i can't afford to buy one, the OT said she will make one. We have a wobble cushion but she wont sit on it but is happy to stand/balance on it.

I will see if i can find riding therapy near us, she loves horses (has sat on a few before) so would enjoy it.

We have a gym ball which she loves. The ball chair looks good and we have been recomended a triptrap (just trying to find a 2nd hand one), Ot keep telling us to try tings and buy equipment but its costing a fortune, most of her DLA is going on equipment and sensory toys that OT has recomended to us.

Retained reflexes exercises will most definitely help but you may need to find somewhere where is done near you. Have some reading here especially on the ATNR and STNR for the neck and there is a link for the postural reflexes. DS went from 92% disfunction to 65% in 6 months with very simple exercises done 10 mins every day.

IndigoBell has also had great results with RRT amongst others here.

We found that horse riding was fantastic.We went to riding for the disabled it only cost £5 a seesion and was well worth it.Also swimming is good as well as therapy bench work and peanut ball work

Riding for the disabled, definitely. Has a HUGE waiting list, so get onto it today! Swimming is a bit beyond DD1 but just lots of walking and going up and down stairs is a help; I find she needs a certain base level of strength/fitness to get the max out of the specific exercises. Your OT should be buying you a breezi (the SN equivalent of a TT which has various optional postural attachments, DD1 has the lap belt to stop her slouching in it) not recommending you buy a TT yourselves. .

thank you, it sounds like we are already doing a lot, she is swimming every day at school and loves it. With have 2 OT's (one is a training so they work together), one is really good and offers us things to take home, the other is a bit tight and tells us to buy things (which we cant afford even with dd2's DLA). i might be able to stretch to a few riding lessons and if she likes it i have a friend with horses (who might be able to help, let us ride one of her horses).

DS has hypermobility and poor muscle tone. The Special Tomato seat was recommended for him. But, like you Marne we are having to fund all equipment ourselves (we're saving up for it) so I can't say if it actually works, but it certainly looks like it will!

ballet.
horse riding.
gym ball.

look at breezi chairs too (same as tripp trapp) - is there a reason ot aren't providing?

dd2 started with a heathfield for school, but ended up with what looked like a regular classroom chair but with pelvic supports - again, provided through physio/ ot.

there are loads of physio exercises that are great for improving trunk. anything kneeling on one knee with the other foot on the floor (rolling balls/ playing catch) is good - same for standing on one foot with the other one on a step/ box. alternating, obv.

These things don't come cheep do they .

OT seem to charge for anything they give us , i think they suppy some of the bigger equipment. They expect school to pay for a wedge cushion for her and anything else that helps her sit still. I have just spent a fortune on blowing toys and a vibrating thing (not sure what its called), luckily i found them cheeper on e-bay then the sn toy web sites. I love the look of the peanut (she would love one) but again it costs too much .

ds wears a second skin suit which is provided by physio on nhs. quite a few children in his school have been wearing them and posture and muscle tone has improved. Ds is in a wheelchair he has CP and his muscle tone is poor which had lead to scoliosis of the spine. Since he has been wearing the suit which looks a bit like a wet suit his posture and muscle tone has improved its worth talking to your physio about weather it will be suitable for you child.They are also know as jobskin.

Is it the peanut ball you like the look of? I got one from ebay that wasn't too expensive. Like you, we have to pay for all of the bits and pieces that we haven't had a benevolent grant for. Have you tried the family fund or Caudwell charity for a grant?

the thing with second skin stuff is that it isn't really improving residual tone - it's just reinforcing what you've got. dd2 wore a suit for a couple of years and whilst it helped whilst she was wearing it, it made no difference to her trunk control when she wasn't. much better to make improvemets where you can.

often it is a juggle between providing support and encouraging development (we have had this discussion many times with ot/ physio re seating). if you give a child too much support, then you aren't improving musle tone (although you may be enabling, for example, better hand function/ fine motor). if you don't provide supportive seating because you want to work the core, you're improving trunk tone, but you aren't helping fine motor development. such a juggling act.

i wouldn't personally recommend second skin etc for otherwise active kids - much better to concentrate on decent physio and improve core strength rather than relying on external support. different ball game for wheelchair users.

(dd2 has cp)

Yes, its the peanut ball that i though she would like, we have a gym ball but she tends to roll off of it and bang her head (whilst rying to use it when i'm out of the room) and she's a bit small for the one we have, the peanut ball looks a better shape and she could do her 'reaching for toys' whilst lent on it. I will have a look on e-bay.

Bargain peanut here

Thank you, thats a great price , dd2 will love it.

DD aged 5 does gymnastics, ballet and swimming - all recommended by physio/ot.

Also provided with a breezi chair by OT service (looks like a tripp trapp)

DD loves sitting in in - very stable for eating and colouring. Big hit with classmates who come to tea aswell.

re: the second skin; we found the main benefit of a dynamic splint was to improve awareness and feedback, making her more aware of the affected limb (hemiplegic so we had a lycra splint on the left arm) & more confident using it. We found that effect wears off, though, so it's not a permanent thing, we'll do a few months with and a few months without. They're damn hot things in summer, so that's a good time for a break!

Dd does horse-riding, trampolining and karate (although she's not so keen on karate and is making noises about quitting soon). She finds the hore-riding hard work, but she does enjoy it and the interaction with the horse is a big part of that. She's not been going long enough to see massive changes, but she no longer complains of her back hurting when she has to straighten up on the horse, so there is definitely some improvement there. I wouldn't have thought of it if the OT hadn't recommended it.