What is Postural Control?

Postural Control refers to the ability to maintain a functional posture against gravity, while sitting or moving.  It involves the tension and strength of the muscles in the neck, shoulders, trunk and pelvis(hips), which provide a stable base to allow free movement of the arms, legs, hands and feet, and involves the balance system.

Postural control is necessary to allow us to carry out the same activity for an extended period of time, e.g. sitting at a desk, writing and eating.  It is also necessary for carrying out activities that demand movement and balance, e.g. dressing, walking, running, riding a bike, playing sport, etc.

When postural control is well developed, a child is able to sit with a good upright posture at a desk. The trunk and shoulders form a stable base for positioning and moving the arms so that the hands can be used to perform fine motor tasks effectively, e.g. handwriting. The head is held in an optimal position for looking at their work and around the class.

What is a good sitting posture?

·         Back upright

·         Body symmetrical

·         Hips and knees at 90 degree angles

·         Flat feet on floor

·         Forearm supported on desk

·         Non-writing hand free to assist

·         Adequate support from chair. 

You can facilitate a good sitting posture by ensuring that the chair and desk height are right for your child. You can adjust this by adding either a cushion on the chair, or a telephone book under the feet.

 What is poor postural control? 

Poor postural control can be caused by a variety of factors and children are commonly referred to as having low muscle tone or weakness in the core muscles. Children with poor postural control may present with:

• Difficulty maintaining an upright sitting posture and resting their head on their desk/hand/are when drawing, interfering with their ability to stabilize their page on the table.
• Wrapping their feet around the legs of the chair to provide additional support for themselves.
• W-sitting (sitting with in-turned hips, knees bent and feet placed next to the hips, in a W shape)
• Fidgety behaviour, as their core muscles tire of holding positions against gravity, and they find that moving and adjusting their position helps to 'build up' muscle tone. 
• Difficulty with balance
• Difficulty with gross and fine motor skills

 What are the effects of poor postural control?

• On the playground. Children with poor postural control use a lot more energy to keep their bodies upright and stable in order to carry out gross motor (physical) activities.  They will get tired more quickly than their peers and have difficulty with playground equipment and games.  These children may avoid going on playground equipment if they are scared that they might not manage or that they might fall.
• Fine motor skills. Poor stability in their bodies and shoulders impact on their ability to position and move their arms in order to use their hands freely during fine motor tasks, thus impacting on their fine motor skills such as handwriting and cutting.
• Concentration:  These children also use a lot of energy trying to keep their body upright while sitting at a desk. As a result, they get tired more easily and battle to concentrate or complete their work on time.
• Can’t sit still:  These children may also have difficulty sitting still as they constantly need to move around or change their position in order to “wake-up”, or re-activate their muscles.
• Eye strain: Children with poor postural control tend to hold their head close to the page while drawing, putting strain on their eyes, also causing their eyes to tire more easily during activities.