Postural Disorder: Why is my child so lazy?
What is Postural Disorder?
Have you ever wondered why your child can never seem to sit up right? why they always seem to be laying down or leaning on furniture? They may have Postural Disorder.
Postural Disorder is a type of Sensory Processing Disorder. A lot of research has been undertaken in the area of Sensory Processing Disorders (SPD). Sensory Processing disorders are the main area of clinical research within the field of Occupational Therapy. Sensory Processing Disorders have been categorised and grouped following many clinical studies using factor and cluster analysis with well over 5,000 children with developmental difficulties. (Schaaf & Maillioux, 2015)
Depending on which theory you look at, SPD’s generally have three subtypes:
- Sensory Modulation Disorder
- Sensory Discrimination Disorder
- Sensory Based Motor Disorder
- Postural Disorder (PD)
- Bilateral integration and sequencing disorder (BIS)
- Somatodyspraxia (Dyspraxia)
Postural Disorder is thought to sit under the subtype Sensory Based Motor Disorder.
How do I know if my child has Postural Disorder?
Your child may present with the following:
- Leans on furniture or slouches a lot!
- Seems to like sedentary activities more
- Avoids movement
- Seems weak
- Falls over and have poor balance
- Can be anxious of movement
- Avoids sports
- Difficulties with fine and gross motor skills
- Gets tired easily
Postural Disorder is diagnosed by an Occupational Therapist with post graduate training in Sensory Integration Therapy.
What is the underlying cause for Postural Disorder?
Postural Disorder is thought to be caused by insufficient processing of vestibular (movement) and ocular (eye movement) input. The Vestibular system is a power house in terms of sensory processing and is responsible for letting us know where we are in relation to gravity; this helps us to keep our balance, it also informs our postural muscles and muscle tone. The Vestibular and Ocular system work well together to help us move safely through space without feeling dizzy or unstable. Our eyes send information to our brain via the Vestibular Ocular Reflex (VOR) which has the wonderful job of ensuring our visual field remains still when we move. Imagine how disorientating it would be if our visual field moved about when we were walking!
What difficulties can a child have with Postural Disorder?
Generally speaking, most children with Postural Disorder have poor posture and difficulties in maintaining their balance. They also get very tired as they have to work super hard to maintain a stable base of support. Often they will increase their base of support by leaning on furniture/ people/ objects and prefer to lay down when they have a chance.
Due to the extended effort of having to sit up straight in class, they tend to get very tired, which can affect their ability to focus and attend in class.
Due to possible difficulties in stabilising their visual field, they may be nervous of moving on uneven or moving surfaces such as escalators, travellators and uneven ground. Often sports involving other people moving at the same time can be extremely difficult as they can struggle to keep up with their friends, often finding it harder to process the other children’s movement as well as their own. They often opt out of sport or choose sedentary activities with less movement or physical challenge.
This can lead to low motivation to engage in sports, and a higher percentage of time sat down in sedentary tasks such as computer games and reading. It is important to note that these children are more at risk of weight gain as they tend to be less active.
Other difficulties include:
- Poor endurance for activities
- Low muscle tone
- Poor balance
- Poor body awareness
- Handwriting difficulties
- Fine motor difficulties
- Personal care difficulties (managing buttons and fastenings)
- Low self esteem
- Weight gain
What can I do about it?
The most important thing to do is to encourage movement and promote social participation! These children are at risk of being socially isolated in their youth as the main occupation for children tends to be play and other physical activities such as swimming, bike riding and exploring.
The main goals for helping a child with PD need to include:
- Improve overall core muscle strength
- Increase activity endurance
- Improving balance
- Increase access to sports
- Improve social participation
Improving core strength:
To improve core strength and postural control, you want to be doing lots of flexion (bending), extension (stretching up) and rotation (turning round) movements.
Increasing activity endurance:
Start off with adding exercise to your daily routine, maybe walking to school, walking to the shops rather than taking a car, going for a bike ride or a scoot at the weekends. After school, try trampolining for 10 minutes before dinner time rather than watching TV. Take the stairs where possible instead of a lift.
Children 7 years and older should be able to balance on one leg for 30 seconds. Practice each day, maybe when brushing your teeth! When your child can do 30 seconds with their eyes open, challenge them to shut their eyes and balance for 30 seconds! Get the whole family involved.
Increase access to sport:
Sports that are not team orientated and can promote postural challenge will be your best options.
- Swimming, particularly on your front is excellent for postural control and strength as it taps into the extensor muscles which help improve sitting posture.
- Climbing or bouldering is great for overall core strength.
- Horse riding
- Martial Arts
- Obstacle courses
Improve Social Participation:
Think about social experiences that involve movement. Look for clubs that offer access to some of the sports mentioned above and provide an opportunity for social opportunities.
Most of all have fun! Try to focus on participation rather than achievement in sports and promote social engagement to develop self-esteem and reduce isolation.
If you have concerns that your child may have Postural Disorder, and would like them to be formally assessed, contact me to book your assessment date.
Schaaf RC, Mailloux Z (2015). Clinician’s Guide for Implementing Ayres Sensory Integration: Promoting Participation for Children with Autism: Bethesda MD. AOTA Press
Collins B, Miller LJ (2012). Sensory Based Motor Disorders: Postural Disorder. Autism Asperger’s Digest.. July – August. p46-47.