33
Hip Angle Adjustment
Head Support
THE HEAD AND SHOULDERS:
After obtaining optimal pelvic, leg and trunk control, efforts are directed
to achieving head and shoulder girdle positioning. Any distortion of
central control will interfere with head and shoulder alignment and with
developing active control of the finer motor skills (the head, oral and
eye control, and the hands). The next task is to obtain the best position
of the head and shoulder girdle so that the child can better participate
in the environment.
“Ideal” head position is often very difficult to achieve as any distortion in
the intimate relationship between the head, neck and shoulder girdle
produces pathology in the other. Ideally, the head should be righted
with the eyes horizontal, and neutrally aligned on the neck. Mobility of
the head on the neck should be allowed within the range that the child
can control.
Some frequently encountered head problems are from, 1) floppy necks,
2) enlarged occiputs, 3) extensor hypertonus in the neck, 4) sidebend-
ing or rotation.
Helps with trunk stabilization
Facilitates bimanual hand use in the face of severe
weakness
Needs to be 10 to 15 degrees back from
vertical
Needs to be greater with high level paralysis
Decreases body weight on sitting area
Adjustable forward
and backward
Adjustable up and down
Contouring can be
customized by
pulling off cover
and fitting in new
foam shapes to
help support the
child’s head.
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