Treatment of the Child with Hypotonia.

The purpose of this videotape is to serve as a teaching tool for therapists working with children with hypotonia, and to help parents of such children to better understand their children's therapy.

Two children of different ages (2 1/2 and 8 1/2 years) and with different diagnoses and degrees of hypotonia are shown in therapy with Barbara Hypes, who is also the producer of the tape. A clear, well-paced, voice-over narrative and pleasant, nonintrusive piano music are enhancements. A short introduction cites some of the potential problems associated with hypotonia. Although the risk factors for perceptual and cognitive delays are not discussed, important techniques and their goals in the neuromuscular and musculoskeletal areas are listed.

The brief background information for each child is well chosen and provides a basis for understanding the interventions that are used. The session with 2 1/2-year-old Carolyn has especially clear visual and verbal descriptions of therapeutic movements, so that therapists viewing the videotape know where, how, and what is being done. In this segment, interventions are described in detail, including hand placements and techniques. Hypes' use of her own body, including interactive use of toys and her seemingly facile communication with Carolyn via sign language, is artful.

Both sessions impart important information in difficult areas. One of the problems in treating children with multiple deficits is decision making related to sequencing that incorporates interventions proceeding from basic preparation for stabilization, coordination, strength, balance, alignment, and control to functional carryover in activities of sitting, standing, walking, and self-propulsion of a wheelchair. The use of each piece of adaptive equipment is explained related to the children's deficits, and to home programs.

This videotape could be incorporated in educating physical therapists and physical therapist assistants, which includes hands-on experience and didactic instruction. Experienced pediatric physical therapists and physical therapist assistants will appreciate the treatment fluidity and the opportunity for review and repertoire expansion.

Dorothy Schattner, PhD, PT Montclair, NJ

Dr Schattner is a pediatric consultant specializing in developmental disabilities and has done academic and clinical teaching.