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Questions & Answers - Developmental Concerns
My grandson is 4-1/2 months old. I believe he has hypertone in his
upper body (he arches his back "stiff" when being held body-to-body)
that may be showing up in his legs now (he's starting to "scissor" - to
hold his mom's arms with his legs as his diaper is being changed). Is
there anything that can explain hypertonicity in layman's terms? A
pictorial of behavioral tendencies/assessments? An infant developmental
specialist in San Diego that's familiar with hypertonicity?
In response to your questions, let me start by saying that your keen
observations and reporting provided a clear portrayal of your grandson's
movement patterns. I believe that your observations warrant concern.
Hypertonicity is often called high tone, spasticity, hypertonia and
rigidity.
Movements will appear stiff and awkward because the
muscles may be tight, and tone is not balanced.
Hypertonic babies will arch their backs and will stiffly
extend/straighten legs. Babies with high tone will often
stand on stiff legs when given the opportunity. You may
also see him standing on his toes and scissoring his
legs tightly when held upright or during diaper changes.
Fluctuating tone will be a combination of low/weak tone
when resting and high tone/rigidity during active
movements. Whether you have high tone, low tone or
fluctuation, there is no damage to the muscles or
nerves; but it is the brain's inability to control the
muscles during movement. You need balance between all
muscle groups involved to have smooth, coordinated
movement.
As a therapist, I cannot diagnose, but I recommend that you
speak with your grandson's pediatrician as soon as possible. Ask
for a referral to either a pediatric neurologist or a
physiatrist for more extensive assessment. You can also seek out
early intervention
services (from birth to age 3) in your area
without a referral. Contact the Infant/Toddler Alliance in your
area for an evaluation. Your grandson does not need a diagnosis
to be evaluated for services. A physical therapist can help with
development of motor skills, and improve strength, posture and
range of motion. She can help you with how to handle your
grandson during daily care and play.
For now, position your grandson on his belly often. If he has
difficulty in this position, use a Boppy pillow or a small
blanket under his chest. Place toys in front of him to encourage
reaching. Promote hand-to-feet play (play 'patty-cake' with his
feet) when he is lying on his back and help him as needed. This
will help him to move in patterns opposite to the stiffness.
Back to: Therapist
Questions & Answers - Developmental Concerns