Balancing Act: If I Can’t Sit Up, I Can’t Play 
Imagine that you are a 3-year-old, sitting at a table or on the floor at circle time, and you have trouble maintaining your balance without holding yourself up. How well would you be able to use your hands to explore and play? For children with mild to moderate motor challenges, the right adaptive chairs and equipment can make a big difference in how well they’re able to play, eat, and join in learning activities.

This article from Young Exceptional Children, Adaptive Sitting for Young Children with Mild to Moderate Motor Challenges: Basic Guidelines, describes sitting postures that are commonly seen in young children with motor delays, and shows how these postures can limit a child’s engagement. It includes photos and diagrams on correct sitting postures, and shares common positioning challenges and strategies. The Division for Early Childhood (DEC) and Sage Publications have enabled free access to this article through Saturday, Jan. 31, 2015.

Loosen up! Help for Baby’s Tight Neck 
Infant torticollis is a relatively common condition, especially in newborns. It can occur when one of the large muscles that run on each side of the neck (from the back of the ears to the collarbone) becomes tight, weakened, or thickened. This can cause the baby’s head to tilt and make it difficult for him to turn his neck. Here are some strategies that home visitors can teach families. These simple ideas can be incorporated into a baby’s daily routines.

• Tummy time: While on the floor, place toys in the opposite direction of the baby’s tight side. Attract his attention to the desired side by blowing bubbles, activating musical toys, or placing an infant safety mirror within his view.
• Rolling: Change the baby’s clothes on the floor, and then encourage her to roll towards her tight side by asking a sibling or parent to make funny faces or sing songs from that side.
• Play: Use interesting toys, bubbles, or music to attract the baby to face away from his preferred side.
• Feeding: When bottle feeding, position the bottle so that baby needs to look away from her tight side. Encourage her to finish the bottle in this new position.
• Sleeping: Place the baby so his preferred side is to a wall, away from “the action.” The baby will want to turn his head to see what is going on, exercising the necessary muscles.

The Early Intervention Strategies for Success Blog from the Virginia Early Intervention Professional Development Center has even more activities and video clips that demonstrate how therapists help babies with torticollis. If a baby continues to have significant issues turning her neck and head, guide the family in talking with their health care provider. The baby may need more intensive support from a physical therapist.

Important note: Home visitors and early interventionists may provide coaching for families on how to support a baby who has torticollis, but they should never attempt to stretch the muscles in a baby’s neck unless they have been trained by a physical therapist or a physician.

Three Great Ideas
This month we talked with Tricia Catalino, assistant professor in the School of Physical Therapy at Touro University Nevada and vice chair of the American Physical Therapy Association. We asked her for three favorite tips to help teachers collaborate with a child’s consulting therapist in Head Start classrooms, and this is what she said:

1. Before the consulting therapist’s visit, note the classroom activities and routines where the child requires the most support to participate. Invite the therapist to schedule an observation during this time. Share the classroom rules, routines, expectations, and other pertinent information about the child. This helps the therapist arrive better prepared for collaboration.
2. Schedule a regular time to meet with the child’s therapist to discuss successful (and not so successful) strategies. Meetings can be short, but the more regular the better to build cooperative, collaborative relationships.
3. With the parents’ consent, share photos and videos with the therapist. For example, show how the child sits, stands, or moves from place to place. The therapist can provide photos of a similar child positioned in an adaptive chair to show you how the child in your classroom can be supported.

Check out a 15-minute In-service Suite
Would you like a tool that helps you plan your teaching opportunities? Activity Matrix: Organizing Learning throughout the Day describes how you can use an activity matrix to organize your instruction on the children’s learning objectives and Individualized Education Program (IEP) goals throughout the day’s activities, routines, and transitions. This suite includes video examples, a slide presentation, and Tips for Teachers handouts. It’s available on the Early Childhood Learning and Knowledge Center (ECLKC).

Back to Sleep—Front to Play
The importance of placing infants on their backs to sleep has been well established since the early ’90s, but if a baby spends too much time on her back she can develop a flat spot on her head (plagiocephaly). Tummy time is when babies are held, carried, positioned, or played with on their tummies. Time spent in different positions also helps babies to:

• Strengthen the muscles in their upper body, neck, and shoulders
• Prevent tight neck muscles
• Build the strength and coordination they need to roll, sit, and crawl

For more tummy time tips, read: Early Head Start Tip Sheet No. 41 Tummy Time and Infants from the Early Head Start National Resource Center; Tummy Time Tools: Activities to Help You Position, Carry, Hold and Play with Your Baby from the Children’s Healthcare of Atlanta; and A Child Care Provider’s Guide to Safe Sleep from Healthy Child Care America. For relevant recommended practices, read Safe Sleep Practices and SIDS/Suffocation Risk Reduction from the National Resource Center for Health and Safety in Child Care and Early Education. It includes all of the guidelines from Caring for Our Children: National Health and Safety Performance Standards – Guidelines for Early Care and Education Programs, 3rd Edition.

The 29^th Annual Zero to Three’s National Training Institute takes place in Ft. Lauderdale, FL, at the Westin Diplomat, Dec. 10–12.

The 12^th Annual National Training Institute on Effective Practices takes place in St. Petersburg, FL, at the Renaissance Vinoy Resort and Golf Club, April 21–24.

The Head Start Disabilities Services Newsletter is produced monthly by NCQTL. Email Kristin Ainslie at ncqtl@uw.edu to submit questions or suggestions for future newsletter topics.

Select this link to view previous Head Start Disabilities Services Newsletters on the ECLKC.