74 HOME INSTRUCTIONS

1. Sit child over your leg. Your hands should be on child's knees (see Figure 1).,

2. Press down firmly on knees and release. Do this several times.

3. Bend child forward at hips so head is in front of knees.

4. Encourage child to stand up. You may assist by placing your hands on child's sides and gently lifting upward (see Figure 2).

5. Slide your hands down child's hips to stabilize body. Intermittently press down on hips (see Figure 3).

Child will assist in coming to a stand and will be able to maintain an erect posture.

1. Child will push back instead of up.

2. Knees will pull together, legs will "scissor," trunk will become rigid, or hips will bend and knees will go back.

75 HOME INSTRUCTIONS

To encourage child to shift weight forward when coming to a stand

1. Place child sitting of a stool.

2. Hold the arms straight at the elbows with thumbs rotated upward (see Figure 1).

3. Slowly bring the body weight forward (see Figure 2).

4. Bring the body weight up as you encourage the child to stand (see Figure 3).

The child will stand in a smooth movement.

1. Child will not be able to bend hips.

2. Back will arch as child stands.

76 HOME INSTRUCTIONS

To increase hip muscle strength

1. Place child in a kneeling position.

2. Place your hands over the child's hips as pictured below.

3. Press down firmly and release. Do not allow the child's hips to bend.

Child will hold hips straight while maintaining a kneeling position.

Child's hip will bend or child will arch back.

77 HOME INSTRUCTIONS

Knee Stance

1. Place child in kneeling position at a table that is mid-chest level.

2. Give child play activities that encourage reaching forward and sideways with one or both hands.

Child will have the ability to reach objects without failing.

Child will prop on table or the hips will bend.

Special Instructions

78 HOME INSTRUCTIONS

Weight Shifting in Knee Stance

To encourage weight shifting while kneeling

1. Place child in a kneeling position as pictured below.

2. Place your hand over the child's hip.

3. Gently push child's hip sideways so that child must shift weight onto the opposite knee. Do not allow the child's hip to bend.

Child will be able to shift weight from side to side without losing balance.

Child's hips will bend.

79 HOME INSTRUCTIONS

To encourage balance in kneeling

1. Place child in a kneeling position. You should kneel behind the child, placing your ^ands on the child's hips.

2. Gently push child slightly forward (see Figure 1).

3. Allow child to regain balance.

4. Gently pull child backwards (see Figure 2).

5. Again allow child to regain balance.

Child will be able to maintain balance in kneeling.

Child will throw head and arms backward or arch backward in attempt to maintain balance.

80 HOME INSTRUCTIONS

Kneel to Half-Kneel

To encourage child to come from kneeling to half-kneel

1. Place child in kneeling position. You should kneel behind child with your hands on child's sides (see Figure 1).

2. Gently pull one hip to side and down so that child's weight is on that knee (see Figure 2).

3. Child may bend opposite hip and bring leg forward. If child does not do this, assist as shown in Figure 3.

Child will be able to come to half-kneeling position.

Hip on weight-bearing leg will sag or other knee will roll in.

81 HOME INSTRUCTIONS

Balance in Half-Kneel

To aid child in maintaining balance in a half-kneel position

2. Encourage child to reach upwards and sideways for toys. You may place your hands over child's hips or the upright knee if child needs extra stabilization for balance (see Figure 2).

Child will be able to maintain balance in this position while playing.

Upright knee will pull in or hips will bend.

Special Instructions

82 HOME INSTRUCTIONS

To encourage child to bear more weight on one leg

1. Stand child in front of a small step, support at hips.

2. Slowly shift weight to one side and assist child to step up with the other leg.

3. Gradually increase size of step so child must bear more weight on straight leg.

Child will bear more weight on straight leg.

1. The child will collapse when one leg is bent.

2. The child will try to keep weight on bent leg.

83 HOME INSTRUCTIONS

To encourage child to bear weight on one leg

1. Stand child slightly more than an arm's length away from a wall. 2. Have child place arm against wall so that child is leaning toward the wall.

More weight will be placed on the leg next to the wall.

1. Child will shift hip so that the leg next to the wall is not bearing weight.

2. Trunk will shorten on side next to wall.