Starfish Therapies

January 8, 2017

Righting Reactions

What are righting reactions you may ask.  Righting reactions are the reactions that help bring our head, trunk, and body back to midline so we can keep our balance.  They help us to be able to stand on a boat, or a moving train.  They help us to regain our balance after we catch our toe on something, or to be able to walk across an unstable surface.  Basically they are pretty important.

Righting reactions start to develop right away.  That’s what head control is all about.  When a baby can hold their head stable, their righting reactions are easier.  That’s because their inner ear sends messages to the rest of the body about where it is in space.  If it’s not where its supposed to be, the body is able to begin the correction process it to bring it back to where it should be.

After head control, trunk control follows.  This allows your baby to sit up and not fall over.  Initially they are like that house of cards you may have built, they have to be in exactly the right position and you can’t even breathe on them or everything might topple.  But as they learn to react to the messages being sent about their position, and their muscles get stronger and react faster, they are able to play and pivot and reach and do all sorts of things in sitting.

Standing follows sitting (yes, there are other places that righting reactions work such as hands and knees but for this purpose we will move on to standing).  In addition to the head and trunk control there are three general reactions to help keep you in a standing position: ankle, hip, and stepping.  The ankle reaction is when you have a slight instability and sway just a bit at the ankle to find your middle again.  The hip reaction is for a slightly bigger and faster balance disturbances and you bend forward or backwards at your hips to keep yourself standing.  And lastly, the stepping strategy happens when you need to adjust your base of support (foot position) so that you can stay upright.

Hopefully this gives you a general idea of what our bodies do to keep us upright and what your child is working on as they begin to navigate through the developmental milestones.




April 25, 2012

Bilibo Chair – Developing Head Control


(didn’t have photo rights on the kiddo so a doll will have to do)

I must say I have to give credit to this idea to a parent.  I was working on head control with a kiddo and in order to isolate the head and neck muscles I had the kiddo in full flexion (her knees were bent up and her arms were around her knees).  From this position we were able to move in different directions allowing the kiddo to right her head and try to hold it stable while we were moving or standing still.  The full flexion not only allows isolation but it also allows her to recruit overflow from her other muscles to help with activating and maintaining contraction of her head and neck muscles. The full flexion position was getting a little challenging to maintain because she kept wanting to push her legs into extension so we stepped it up a notch and wrapped lycra around her while in this position so that it was easier to maintain and she was getting extra input into her body to help with proprioception and body awareness.

Even this position was a little challenging to maintain so that’s when mom had the idea to use the Bilibo chair.  It was perfect!  I could use the lycra if I wanted to provide extra input but it wasn’t necessary.  I had the kiddo sit in tailor sitting in the chair and I held her hands while we rocked the chair back and forth and side to side while working on head control.  The chair provides some support for the trunk and it allows the legs to remain in flexion.  You can change the alignment of the chair depending on how much support you want to provide at the trunk.

If your kiddo has head control, this is a fun chair to sit in because its an unstable surface so they have to work on trunk control, balance and righting reactions while they are in it!

What other ways have you used the Bilibo chair?  What other fun ideas have families helped you to come up with?

February 28, 2012

Developing Head Control with Pull to Sit

Pulling to sit can work on a baby’s head control as well as develop their core muscles such as their abs.  When they are lying flat on their back this will be the hardest position for them to control their head and neck muscles because they have to work fully against gravity.  In order to make it a little easier for them you can start them on an angle, such as your lap with your knees bent.

When you go to help them sit up using the pull to sit method you want to make sure they engage their whole body to help with the process.  I like to do this by holding their hands and giving a light tug in order to get them to engage their arms so that they will start ‘pulling’ themselves into sit.  Also by engaging their arms and other muscles they are using what I like to call ‘overflow’ to help engage the head and neck muscles. If your baby doesn’t engage their arms to help with the pulling up I would not continue with the motion.

You can tell how their head and neck muscles are developing over time by looking at how their head lag improves.  Head lag is how long it takes them to activate their head and neck muscles to lift their head up while they are pulling to sit.  As they get stronger they can activate their muscles closer and closer to being flat on the ground.  Eventually they will be able to activate immediately and all you are doing is guiding them up into the sitting position!

Another way to help these muscles develop is to do the opposite motion.  Early on it may be easier for them to engage their muscles as you start to lower them down.  They will automatically attempt to prevent themselves from ‘collapsing’ by activating their muscles to maintain their head position.  As you slowly lower them down to the ground it will get harder for them to hold their head up against gravity and it may drop back.  Until you know how long they can hold their head up you either want to have a support (like your legs) ready prior to being flat on the ground or  have a few pillows built up.

After a few repetitions of this your child gets better at it.  They may try to anticipate what they need to do and may stiffen up their whole body in order to try to ‘help’ you but they start to get the hang out of it and their head control gets better with each repeption because their muscles get more efficient at engaging and turning on when needed.

And, you can have fun with it such as playing games of peek-a-boo, or making funny faces or silly sounds.  What a great way for you to engage face to face with your baby while working on their gross motor skills!

For some older kids who are working on head control this can be a good way to help them as well.  You can also go extra slow at various points so they have to work at maintaining their head position as well as activating their muscles.  Another skill you may want to work on is once they reach the sitting position having them be able to hold their head in midline without it dropping forward once they are upright.

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