Southern California

Regional DIR® Institute

Postural Control
November 20, 2009
DIR Basics
 When we look at supporting relationships, one aspect
to consider is how well the child’s sensory and motor
patterns connect to his emotions.
 The sensory system informs the motor system (with
input from the limbic system) on what actions to take.
 A developmental task is for the sensory system to
hook up with the motor system, and emotions are the
link.
 “Affect is Action”…Lois Gold
 Engaging Autism, 2006, Chapter 11,
Postural Control for Functions
 Can sequence purposeful gestures and actions, to
obtain desires,
 1.Simple physical actions to indicate desires
 2.Physically mirror gestures
 3.Physically imitate gesture
 4.Imitate physical actions with purpose
 5. Obtain desires
 6.Problem solve steps with body to move in space
to interact with people & objects
 for exploration
 for function & purposeful use of toys
 for self help
 for back and forth interactions with family and
peers
 (# ___steps) recorded
 The body is the body ego…Freud
 Your body is the first tool you learn how to use…Gil
Foley, 2006
 Body—Tripod and Visual System -–Camera
 Your body dictates how well the “picture” is taken….
(and visa versa!)
 The input into the visual system from a shaky tripod
(body) will not be robust, the child will likely have a
restricted range in one or more areas of praxis.
(ideation, planning, sequencing, execution,
adaptation) Adapted from Lois Gold, OTR/L
Examples
 A hypersensitive baby who turns away from the
source of sound (including mother’s voice). A
hyperaroused system creates an adaptation of
turning away.
 An under reactive baby who may not interpret the
sound of the voice as salient enough to “tell” the
motor system to turn towards the caregiver.
 A child with POSTURAL DELAY might adequately
process the sounds coming from the caregiver, but
not be able to support her motor actions, properly
organizing her response. Chapter 11
DMIC Reference for following slides
 Behavioral Indicators of Sensory
Discrimination Challenges by sensory
systems
 Visual, Auditory, Tactile, Proprioceptive and
Vestibular
 Pages 91 and 92 DMIC
Contributions to Motor Challenges
 Postural Challenges
 Difficulty stabilizing the body during
movement to meet the demands of the
environment.
 Can include poor stability in the trunk, poor
righting and equilibrium reactions, poor trunk
rotation or poor ocular control. (eye tracking)
 Difficulty maintaining a good standing or
sitting position, or maintaining posture to
perform a task.
 Postural control patterns:
 Tendency to avoid moving around and dislike
of unexpected movements
 Tendency to be physically active but lacking
control and safety awareness
 Behavioral Indicators: ICDL DMIC page 93
 Postural challenges can occur with or without
a motor planning disorder, often observed
with dyspraxia…bilateral riding a bike, or
rhythm.. clapping to a beat.
Clinical Example
 4 y.o. child with advanced language
capacities and isolated herself socially
 Awkward, peer skills underdeveloped and
looked like an ASD child
 Poor postural control/ central vision led to
isolation from peers, odd behaviors
 Were the peer skills deficient or
underdeveloped?
 This is the underpinning of constrictions in
milestones 2,3 and 4.
 This child had weakness in her body, (very
poor upper body postural control) always
preferred solitary activities sitting down and
never experienced power in her body.
 Power (range) in body = power (emotional
range) Power Rangers!
 PT and OT important part of tx