63 HOME INSTRUCTIONS

Lateral Tilt Over Roll

1. Place child sitting on a roll. Support by holding child by arms as pictured in Figure 1.

2. Slowly tilt child to one side. When child begins to respond by turning head, assist the child to an upright position. Repeat in opposite direction (see Figures 2 and 3).

Head will remain erect.

Head will flop over in direction of tilt. Back, neck, or shoulders will become stiff.

64 HOME INSTRUCTIONS

Rotation to Hand Support Over Roll

To increase trunk relaxation, improve balance reactions, and enable child to bear weight on hands.

1. Place child in sitting position over a roll. Support child by placing one of your hands on child's chest. Place your other hand on child's leg (see Figure 1). Note: If you are going to tilt child to the right, place your right hand on chest, left hand on leg.

2. Slowly tilt child sideways while turning the trunk toward side of tilt. Arms should be forward (see Figures 2 and 3).

3. Continue to tilt and rotate downward until child is supporting weight on hands. Elbows should be straight and hands open. The leg you are holding should be straight (see Figure 4).

Child will assist in going from sitting position to bearing weight on extended arms. Child will assist in returning to sitting position.

1. Child will hyperextend neck, back, or shoulders.

2. Child will collapse to side of tilt.

3. Arms will become stiff, either rigidly extended or bent with hands fisted.

65 HOME INSTRUCTIONS

Tilting on Roll Forward and Back (for Trunk)

To develop trunk control

1. Place child on roll in front of you.

2. Support at the hips or thighs as needed (see Figure 1).

3. Tilt child forward (see Figure 2).

4. Tilt child backward (see Figure 3).

1. Child will straighten back but tuck chin when tilted forward.

2. Child will bend forward when tilted backward.

1. Child will arch back.

2. Child will collapse forward when tilted.

3. Child will lose balance.

66 HOME INSTRUCTIONS

Tilting on Roll Sideways (for Trunk)

1. Place child on roll in front of you.

2. Support at the hips or thighs as needed (see Figure 1).

3. Tilt sideways (see Figures 2 and 3).

1. Child will curve trunk.

2. Child will maintain head upright.

1. Child will lose balance.

2. Child will hold on to roll with hands and will not use trunk.

67 HOME INSTRUCTIONS

Playing Forward on Roll

To help child learn to keep back straight while bending at hips

1. Place child straddling a bolster with feet flat on the floor.

2. Support at hips if needed (see Figure 1).

3. Provide toys in front of child for play.

4. Encourage child to lean forward to play and return to sitting (see Figure 2).

Child will be able to maintain trunk stability and movement while playing.

Child will bend trunk and not at the hips.

Special Instructions

68 HOME INSTRUCTIONS

Reaching Sideways on Roll

To encourage weight shift and reaching

Instructions
1. Place child straddling a roll, support the hips or lower trunk as needed.

2. Have child reach up and to the side for a favorite toy just beyond child's ability to grasp. Then allow child to get the toy (see Figure 1).

3. Repeat on opposite side (Figure 2).

Child will shift weight to the side and rotate the trunk.

1. The child will become stiff.

2. The arms may bend at the elbow and shoulders pull back.

3. The child will fall in the direction of the toy.

69 HOME INSTRUCTIONS

Side-Sit Prone Over Roll

To encourage isolated head control

1. Place child in side-sitting position next to roll.

2. Support the child's legs with one hand and support the arm and shoulders with the other.

3. Gently bring the upper trunk over the roll.

1. Body will become stiff.

2. Child will arch head back.

3. Child's head will flop forward.

70 HOME INSTRUCTIONS

Sitting on a Ball

To improve head and trunk control in a sitting position

1. Place child in a sitting position on a ball.

2. Support child by placing your hands under the arms as pictured in Figure 1.

3. Slowly and gently tilt child backwards and to the side (see Figure 2).

4. Encourage child to pull head and body forward. You may do this by holding a favorite toy a short distance away (see Figure 2).

5. Give child plenty of time to respond to the tilt.

Child's head will turn and tilt forward. Child may reach for toy.

Child's head will flop backward or to the side.

71 HOME INSTRUCTIONS

Tilting on Ball Forward for Trunk (Control from Behind)

To encourage straightening of the trunk with tucking of the head

2. Support at the hips or lower trunk (see Figure 1).

3. Gently and slowly roll the ball forward (see Figure 2).

Child will straighten the trunk and tuck chin.

Child will become stiff and arch backward.

72 HOME INSTRUCTIONS

Tilting on Ball Sideways and Back for Trunk (Control from Behind)

To develop trank control

1. Place child sitting on a ban.

2. Support child by holding at the hips.

3. Gently and slowly roll the ball to the side and wait for a response (Figure 1).

4. Gently and slowly roll the ball backwards and wait for a response (Figure 2).

1. The trunk will adjust as the support is shifted.

2. The child wiII maintain head in an upright position.

73 HOME INSTRUCTIONS

Tilting on Ball for Trunk (Control from Front)