Moving in Prone

All children need to spend time on their tummies.  The American Occupational Therapy Association shares in Tummy Time Tip Sheet the following information:

TUMMY TIME is an important activity for your baby’s development and is endorsed by the American Academy of Pediatrics (AAP). Because the AAP recommends that babies sleep on their backs for safety reasons, babies need enough supervised Tummy Time during the hours they are awake to strengthen head, neck, and upper body muscles. Tummy Time helps to build the strength and coordination needed for rolling over, crawling, reaching, and playing. Remember that all babies benefit from Tummy Time, including newborns.

A young girl moves up into a crawling position while playing in prone on a Resonance Board with various materials.

A young girl moves up into a crawling position while playing in prone on a Resonance Board with various materials.

Children with multiple disabilities, especially those with visual impairments, may not spend enough time on their tummies.  This impacts their development. A prone position is used as a child begins to move towards being able to crawl. This position also helps the child to develop muscles in the neck, shoulders, and torso. One way to encourage movement in a prone position is to place a child on his/her tummy on a Resonance Board. You can utilize various materials placed near hands feet, arms, legs, and head to encourage movement.  

Activities in Prone

Here are some pictures of students at the Narbethong State Special School in Australia working in prone in a variety of learning environments. 

A young boy positioned in prone in a hammock swing plays with an Elastic Board.
A young boy positioned in prone in a hammock swing plays with an Elastic Board.
A young boy positioned in prone on a Support Bench explores Mylar with his legs and feet and uses his hands to explore various objects in a metal bin.
A young boy positioned in prone on a Support Bench explores Mylar with his legs and feet and uses his hands to explore various objects in a metal bin.
Four children positioned on Support Benches around a bin of  various types of balls in a bin.
Four children positioned in prone on Support Benches around a bin of various types of balls.
A young girl plays with various objects on a Resonance Board while in a prone position.
A young girl plays with various objects on a Resonance Board while in a prone position.
A young girl positioned in prone on a Resonance Board is surrounded by various items to explore.
A young girl positioned in prone on a Resonance Board is surrounded by various items to explore.

This is a good activity when a support bench is unavailable, however as the support bench has a solid surface under the chest and abdomen, it will better help to promote development of back muscles, extending the back instead of causing flexion of the back.  The soft and flexible characteristics of the therapy ball promote a kyphotic position (or rounded position) of the back.  It is important to recognize which equipment will better meet the long term needs of the child.  When possible, a child that cannot sit up independently would benefit from use of the support bench instead of using equipment that has a soft or cushioned base of support, as it will offer greater opportunity to work on strengthening appropriate muscles of the back, neck and head.

A child is positioned in prone over a therapy ball while she plays with objects on a Velcro Board.
A child is positioned in prone over a therapy ball while she plays with objects on a Velcro Board.
Two children positioned in prone on scooter boards play with Velcro Board and Elastic Board.
Two children positioned in prone on scooter boards play with Velcro Board and Elastic Board.

 This is a great activity, but pay close attention to the position of the children.  Due to the width of the scooter boards, one arm can have the shoulder joint off the board to allow for free movement.  The other shoulder must rest on the scooter board – thus blocking the movement of the shoulder joint and preventing free movement of this arm.  The support bench would allow for the same activity – with free movement of both shoulder joints – thus allowing free movement of both arms.  When you notice these small differences you learn how to change or alter the environment to provide the best opportunity for the child to be active.    

Patty Obrzut Demonstrates Working in Prone Using a Resonance Board

In the video below, you will see Patty Obruzut demonstrating how the smallest movements cause something to happen for the child. Two melamine plates are placed under her head, so they clatter when moved.  The other plates can be interacted with through banging, scratching, or pushing the plates or the beads. The elastic board can be explored by grasping or plucking the strands.

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Support Bench

Dr. Nielsen developed specific equipment, the Support Bench, to focus on development in prone.  The Support Bench encourages strengthening of the muscles of the head, neck and back while allowing complete movement of the arms, hands, legs and feet.   

Kassidy on a Support Bench

Kassidy is positioned on a Support Bench and is interacting with a small hand-held vibrator that Patty Obrzut holds for her.

Jack Participating in a Science Lesson Using a Support Bench

In this video we see Jack positioned on a Support Bench with various materials that are associated with plants such as water, soil, and seeds.

 

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