The first year of life includes many motor skill transitions and is a critical window of opportunity for babies who are born with muscle weakness, alignment problems, and fragility. Physical therapy should begin as soon as it is evident that the infant has weakness or motor skill delays when compared with other infants of the same age. This might be first noticed because the baby cannot hold up his or her head independently or sit without support until later than most other children. Treatments for such problems are often aimed at proper positioning and placing children in positions that encourage their use of certain muscle groups. Proper positioning elicits specific antigravity muscular effort, which is the basis for learning to sit and stand later on. Babies with large heads will face additional challenges and limitations in developing the ability to move against gravity.
An infant or child with weakness or motor skill delays should be working for brief periods daily or at least five days a week to improve muscle strength and motor skills. In the process, the child gains endurance and independence in self-care activities. Treatment should not be confined to “therapy hours” only. Very short exercise efforts during the day, as short as 5 minutes, will often result in improvement more quickly than one hour-long session once or twice a week. Depending on the child's age, the interventions can take several forms, including positioning, specific exercises, and developmental activities such as standing in a standing device. Ideally, the activities would be integrated naturally into the child's day by family members and care providers. Playtime can be purposeful, but it should still be fun for parent and child.
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