Rethinking low muscle tone

[PamVersfeld]

Low muscle tone is often frequently used by therapists as a reason for a child’s movement dysfunction, and intervention is directed towards improving the muscle tone.

The problem is that there is no clearly defined way of defining or measuring low muscle tone. The diagnosis as it were is usually given when a child appears less able to effectively sustain an erect posture in sitting or standing, has delayed motor development or has difficulty performing age appropriate tasks.

I would like to suggest the physiotherapists stop using this term altogether and rather start to characterize a child’s movement difficulties more accurately by assessing to identify underlying impairments such as joint hypermobility, weakness, and specific difficulties with postural control and movement coordination.

For a more detailed discussion go to the rethinking low muscle tone page on the Skills for Action website

As a way of getting the debate going, here is a scenario of Xola, a 10 month old, infant who has been diagnosed as having low muscle tone.

At 10 months Xola cannot sit without some support. Her mom always supports her head when she picks her up, and Xola tends to lean into her mother when she sits on her lap. She is a shy child who is happy to interact with me when she is sitting on her mother’s lap. It took a little coaxing to get her to sit on the floor with support, and then played happily with the toys I provided banging them together, doing lots of shaking, looking at the toys intently, fingering them and bringing them to her mouth. She also enjoyed playing peek-a-boo with me.

Xola can roll over and on occasion will roll across the floor to retrieve a toy. She does not like being in prone, and does not push up into the hands-and-knees position.


What would your first thoughts be when you see this child? What would you assess? How would you go about getting some idea about the reasons for her delay in learning to sit independently.

Please post your ideas – and lets start talking. I will add more information on request.


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