Whether you live in the city or the ‘burbs, you almost certainly use a stroller for your infant or toddler. Even parents who use slings or carriers for “baby wearing” find themselves needing a stroller at some point. Why are strollers a problem for children with low muscle tone? The answer is simple: sling seats and ineffective safety straps.
Strollers, especially the umbrella strollers that fold up into slim spaces, have a sling seat, not a flat and firm seat. Like a hammock or a folding lawn chair, these seats won’t give a child a solid surface that activates their trunk. When a child sits in a sling seat, they have to work harder to hold their body in a centered and stable position.
Why is that important when you are transporting your child in a stroller? Because without a stable and active core, your child will have to work harder to speak and look around. A child with low muscle tone or hypermobility that is in a sling seat may be inclined to be less active and involved, even fatigued from all that work to stay stable. It could appear that they are shy or uninterested, but they might be at a physical disadvantage instead. A collapsed posture also encourages compensations like tilting the head and rounding the back. Will it cause torticollis or scoliosis? Probably not, but it is certainly going to encourage a child to fall into those asymmetrical patterns. Kids with low tone don’t need any help to learn bad habits of movement and positioning.
Safety strap location and use in many strollers is less than optimal. There are usually hip and chest straps on a stroller. Some parents opt to keep them loose or not use them at all, thinking that kids are being unnecessarily restrained. I think this is a mistake for kids with low tone.
Good support at the hips is essential when a child with low tone sits in a sling seat. It is their best chance to be given some support. Chest straps are often not adjusted as the child grows. I see two patterns: Straps too low for an older child, and straps too high for a younger one. The latter issue usually occurs when parents never adjusted the straps after purchase. They left them in the position they were in from the factory. Make sure that the straps are tight enough to give support but not so tight that a child is unable to move at all. A child that is used to sliding forward may complain about having their hips secured so that they can’t slouch, but they will get used to it.
You may have to reposition a child with low tone from time to time you go about your errands or adventures. They often don’t have the strength or body awareness to do so themselves. They could be in a very awkward position and not complain at all. Check their sitting position as you stroll along. Good positioning isn’t “one and done” with these kids, but doing it right will benefit them while they are in the stroller, and also when they get out!
Looking for more information that could make things easier for your child and for yourself? Parents of children with special needs often neglect their own bodies in service of their children. This is a shame, and there are things you can do to make your life easier while caring for your child. Read How An Aging-In-Place Specialist Can Help You Design an Accessible Home for Your Child and Universal Design For Parents of Special Needs Kids: It’s Important for You Too!.