Therapists often recommend these well-designed seats for kids that need solid foot support, but even the best hip and chest strapping doesn’t always mean that a child is actively using their feet for postural control.
As a young therapist, I used tape, foam, and towel rolls everywhere, as if I was creating a modern sculpture. For the most part, all I got for my effort was frustration. Food and force tend to make short work of the most ingenious wedges and supports on a chair that is used for feeding. Then I got older and smarter, and decided to make this a lot easier on everyone.
I wanted to share my easiest strategy for helping children place their feet on a foot plate and keep them there: shoes!
The little guy in the “before” photo has generalized low tone and hypermobility. His pelvis is reasonably stable using the existing straps on the chair, and he is able to reach forward to finger-feed, partially activating his trunk and hip musculature. But those feet just tapped away on the footplate, and his legs remained extended at the knee through most of the meal. He is too little to respond to any verbal prompts for posture, but not completely addicted to gaining sensory input though his feet. He is there for the food, and the foot movements were his way of gaining sensory input and entertaining himself!
Just putting on his tiny boat shoes gives him some “grip” on the foot plate, and he stayed in this position for the rest of the meal with our repositioning his body at all! He still has to develop some hip control so his knees don’t move laterally as he reaches forward. Using shoes with non-skid soles is an easy hack to help him get some distal stability without constantly touching and repositioning him. Kids that get a lot of therapy and need almost total help for toileting and dressing really start to hate all our manhandling after a while. This limits how much handling an adult needs to do to help a child use this type of chair correctly.
If you still get too much sliding around, my first thought is to check the height of the footplate. If your child grew a bit, the footplate may need to be lowered. Or you could try Dycem The Not-So-Secret Solution for Your Child With Motor And Sensory Issues: Dycem. This non-skid matting is easy to clean and is super-grippy. It works as a seat mat as well. If your child’s hips are stable, their feet can be more effective in supporting their posture. You can buy it without being a therapist; it is available on Amazon!
Need another chair for play? Read The Cube Chair: Your Special Needs Toddler’s New Favorite Seat!
This gives parents and therapists an idea that requires very little effort and can deliver immediate results!
Does your child W-sit? Are you wondering why it is discouraged by your therapists and what to do about it…today? Read Three Ways To Reduce W-Sitting (And Why It Matters)!
Looking for more information on managing hypermobility in young children?
I wrote an e-book just for you!
The JointSmart Child: Living and Thriving With Hypermobility Volume One: The Early Years is a new e-book, filled with practical strategies to improve your child’s safety and independence every day. I provide methods to pick out the right high chair, the best way to teach utensil use and dressing, and how to make your home safer for your child. There are chapters on building your communication skills so that you can get the most support from your family, your babysitter or nanny, even better results from your child’s doctors! There are forms that you can fill out to provide caregivers with the essential information they need to help your child, and forms that help you strategize your goals for school meetings and doctor’s appointments.
Wondering how you are going to deal with potty training?
Check out my e-book, The Practical Guide to Toilet Training Your Child With Low Muscle Tone. There is so little useful advice out there for parents of children with hypotonia! My book as checklists and specific strategies for pre-training, choosing equipment such as seat inserts, and covers the sensory and social/emotional consequences of low tone as it relates to learning this important life skill.