A series of early intervention tutorials from Firefly and Flying Start’s Nick Mant, PT

Part 1. Starting strong - 3 essential early positions
             1.1: Back Lying (Supine)
             1.2: Tummy Lying (Prone)
             1.3: Side Lying
Part 2. Sitting pretty - transitioning from the early positions
             2.1: Sitting and Side Sitting
             2.2: Lying to Sitting   
Part 3. Moving on - kneeling and crawling positions
             3.1: Kneeling and 4-point kneeling
             3.2: Transition sitting to 4-point kneeling   

Side Lying

Side lying is an essential position in early static play but also as a transitional position (it helps us move from one position to another, for example, we move through side lying when we learn to roll; we also use it to move from lying to sitting).

Learning side lying is essential for developing the early movement for side-sitting which is another essential transitional position we will discuss later. As a static position it helps us to bring hands together without having to fight against gravity, lifting them above our head or having them trapped beneath us.

This will encourage early play with single hands and both hands at once.

Common difficulties

Side lying can be a difficult position to maintain. Balancing on the side of the body can increase tone because it is more challenging for your child. Children with raised tone may push their head back further, preventing them from looking at their hands for play.

Children with low tone will struggle to keep their hips in a side lying position as they will have a tendency to roll forwards or backwards. At first we are aiming to support the legs a little bent at the hips (hips semi-flexed) with back support up to the shoulders, and the head looking forward at the hands. When able we will move the back support to free the shoulders.

In that position we can play reaching games in front and behind.

A picture is worth a thousand words, so let’s have a look.

Solutions 

Early side lying can work on upper limb skills. Support as pictured with a strap to help control pelvis and roll keeping head forward, will make this easier for baby to do.

As baby improves in side lying we can lower the support to keep the pelvis on its side freeing the top half of the trunk. This will allow games reaching forward and backward.

Aims

Maintaining side lying initially will help a child learn how to use their hands in the mid-line of the body, as they are not having to hold them up against gravity to bring them together. Children can also see their hands more easily in this position.

Moving in side lying with pelvis supported, as pictured, reaching forward and back will develop the muscles and movement patterns needed to learn how to roll.

Using the Playpak we have gone through the earliest postures to help the child learn skills needed to maintain positions but also move between and become more active within them.

Back lying (supine) and tummy lying (prone) positions and the movements we have encouraged in them, have allowed us to develop productive movements to learn to roll. These will link up to later skills in sitting and kneeling. It is important to remember though, that I often work with children who will not develop in this way.

We may progress no further than these lying postures for some time, or skip individual positions due to other factors, for example, over-extension of the head and back meaning we would avoid tummy time.

However as I know how important the early development skills are, I will work on as many as possible with the child, even if I know they will not reach certain milestones to ensure the best possible building blocks are in place for them to succeed at more challenging postures and abilities.

Continue on to Part 2 to learn about transitioning from the early positions.

 

Part 1 Webinar!

Nick talked us through his early intervention tutorials live over a series of webinars in March and April 2016.

Part 1: Starting strong in 3 essential early positions is available below.

 

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