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Strength in All Sizes – By Shelley Mannell
When we think of strength, most of us don’t immediately think of babies. And yet as babies develop they move their bodies against gravity time after time, repeating and learning movements, strengthening muscles and neural connections, and expanding their ability to interact with the world around them.
Allison was 9 months old when I first met her and her family. She had a diagnosis of schizencephaly and it was apparent when we met that she had  difficulties in many systems. She lacked balanced strength in her neck, trunk and shoulder girdle and she could not hold up her head consistently, could not sit, and could not use her arms. What she could do was totally extend her body and she used this strategy frequently as her only means of changing her position and her only method of communication.
As a physical therapist I know that alignment of the axial skeleton is critical in determining the timing and activation of muscles. I also know that I can use my handling skills to facilitate a more optimal alignment and introduce new, more efficient movement patterns to my clients. So our work began, using a
combination of Neuro-Developmental Treatment skills and inner core unit strategies. As I offered new alignment and new movements through my hands, Allison began to experience them at multiple levels; at first only during our sessions, then gradually between therapy sessions at home with her family and
finally, spontaneously and independently in play. Each of these steps reflected an increase in her muscle strength and motor learning. She began to hold her head up  consistently and her total body extension decreased. Soon her head control and her eyes were strong enough that she could begin to make choices using her eye gaze and her total body extension decreased even further. During our sessions, Allison displays strength of determination to interact with the world and her new skills support her in this process. The strength of relationship that her entire family possesses supports all of us in our work together.
Allison is now 20 months old. She is rolling over and sitting with minimal support to play. She is beginning to be able to use her hands to play with toys. She can turn in circles on the floor and she has just begun to creep a few feet to explore her environment. Her ability to build strength in new movements impacts every aspect of her life. As her control in sitting has become stronger, she is interested in feeding herself and she has begun to work on this with her Occupational Therapist. As a direct result of the increased strength of her head and trunk control, her Speech Language Pathologist is now able to develop a total communication approach so Allison can express herself using vocalizations and gestures and an augmentative communication device.
In many areas, Alli is becoming stronger and with this strength comes her ability to be increasingly independent in her mobility, self care and communication.
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