Question

A 2-year-old child has hypotonia resulting in developmental delay. Currently, the child has good head control, can roll from supine to prone, and shifts weight from side to side in prone. One of the intervention goals is for the child to master movement in a quadruped position. Which facilitation activity is MOST BENEFICIAL to include as part of the initial intervention for progressing toward this goal?

Have the child reach for a toy with alternating hands while lying in prone over a therapy ball that is 31 inches (78.74 cm) in diameter.
Place the child in a hands-and-knees position on the floor while providing stabilization at the pelvis.
Position the child in prone on a wedge cushion on the floor to provide joint approximation on propped arms.

Answer 1

The most beneficial initial intervention activity for a 2-year-old child with hypotonia to master quadruped movement is to have the child reach for a toy with alternating hands while lying in prone over a therapy ball.

Step-by-step explanation:

Facilitation Activity for Mastering Movement in Quadruped Position

For a 2-year-old child with hypotonia aiming to master movement in a quadruped position, one of the most beneficial initial intervention activities is to have the child reach for a toy with alternating hands while lying in prone over a therapy ball. This activity encourages weight shifting, which is beneficial for head control and balance development that are precursors to quadruped movement. Using a therapy ball can also help in engaging multiple muscle groups and promoting the strengthening necessary for the child to stabilize in the quadruped position.

Moreover, the dynamic nature of the activity on an unstable surface like a therapy ball can enhance proprioceptive input, contributing to motor learning and neurological development. In contrast, although placing the child in a hands-and-knees position on the floor provides stability, it may be a more advanced position that the child is not yet ready to perform without assistance. Additionally, positioning in prone on a wedge cushion provides joint approximation but lacks the dynamic movement challenge presented by the therapy ball.