Ask the Expert
Can you walk us through the progression of your plan of care from eval through discharge? What do you look for before moving to the next step?
Carolyn B. Armstrong, PT, DPT, PCS responds:
First of all, we need to look at the impairment level starting with neck range of motion. We want to see how range affects neck posture in all developmentally appropriate positions. If the child is a newborn, you do not want to necessarily evaluate neck posture in the sitting position, but you will want to assess the neck posture in the supine position. As the child begins to achieve other motor milestones, continue evaluating neck posture. Look at the compensatory thoracolumbar curve. See if there are any other types of postural alignment problems. Make an assessment of visual neglect, upper extremity use, and asymmetric movement patterns. Then try to see if there is any altered midline perception. An assessment of visual neglect and visual field is so important, because going back to neurological development, if a child is only learning about what is on the left side of their body or the right side of their body, and not getting the other side, they are going to have problems with bilateral development and symmetrical patterns of movement that are necessary for locomotion. Click here to read more.
For more information on this topic, view the recorded live webinar Management of Congenital Muscular Torticollis and Cranial Positional Deformation in Infants.