12. Coordinating Motor Control – Volume I & Volume II (DVD)

Barbara Hypes, PT


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Product Description

Coordinating Motor Control – Volume I & Volume II

Barbara Hypes, PT 
DVD Description:

David is observed at 21 months and 5 years.  When these two DVDs are observed in sequence, it provides the opportunity for the observer to learn how the effects of hypotonia have impacted this child’s motor control as well as his learning in all areas.

VOLUME I:  Coordinating Motor Control – Treating a 21-Month Old
Length of DVD: 90 minutes

At the request of his therapist, this child’s parents volunteered to have him treated by the instructor at a course about treating children who have hypotonia.  This is the first and only time the child was seen by this therapist and he is working in front of a group of strangers.  All of these facts are important to keep in mind since the child is working with a new person and is in an unfamiliar environment.  The treatment session was videotaped and the family agreed to make it available to the treating therapist to be used for educating therapists in how to treat children who present with similar challenges to their motor systems.  At the time of this taping he is 21 months.  He has been creeping on hands and knees since 15 months and has mastered pulling to stand as well as cruising but he is not standing or walking independently.  He has recently been fitted with SMO’s (supra malleolar orthotics) to support the architectural integrity of his ankles and feet and these are available at this session.  He receives PT/OT/Speech through birth to three and parents note that he can become very upset at times during his therapy sessions, which they describe as willfulness when he is trying to avoid working or he is trying to get his way.  During this session we witness this child starting with the following patterns:

  • Strong ankle foot eversion to widen his base for increased stability.
  • Fisting in his hands during creeping and weight bearing.
  • Leaning strongly against a support causing poor postural alignment for standing.
  • Stacking his head and neck with decreased sustained co-activation in his shoulders.
  • Overuse of lumbar flexion as part of an extension thrust for weight bearing.
  • Mouth open with drooling secondary to the stacked head posture.
  • Significant scapular winging with decreased trunk co-activation.
  • Collapsed and stacked postures to stay in weight bearing.
  • Emotional collapse and avoidance of structure.

With therapeutic intervention he demonstrates some of the following changes:

  • Tolerating input to his body & integrating new motor control.
  • Attending to verbal, visual and tactile cues and interacting with others.
  • Practicing emerging independent standing control with good alignment.
  • Pushing into standing without using an extension thrust.
  • Catching himself when moving out of standing.
  • Keeping hands open to interact with toys rather than avoid.

VOLUME II:  Revisiting Motor Control – A Second Look at Age 5
Length of DVD: 90 minutes

David, his parents, and his private OT came to Milwaukee for a consultation when he was 5 years old.  This therapist had met David and his parents when he was 21 months old and he participated in a continuing education seminar as the child who received treatment in order to demonstrate the techniques being discussed.  That treatment session was recorded and developed into an educational DVD titled Coordinating Motor Control – Treating a 21-Month Old (Volume I).  David’s parents then arranged for a follow-up consultation at age 5, which was also filmed so the footage could be used to show the changes a child with hypotonia has made over a period of 3 years.  Where it would be helpful, activities were shown over several repetitions to allow the viewer to observe David’s success with following verbal, visual and tactile cues.  The DVD shows that the activities also become more complex, requiring greater integration once David understands the general concept that is being practiced.  Watching several repetitions allows the viewer to observe this integration and learning.  At the beginning of the session the parents shared some of the changes they saw and concerns they had over the past 3 years.  When observed, David is physically stronger and more independent but his motor delays persist.  While viewing his movement, it is apparent that the hypotonia is not the biggest obstacle to David’s acquiring more complex motor skills.  Instead, his processing is now the more obvious deficit.

Learning Objectives:

VOLUME I:  Coordinating Motor Control – Treating a 21-Month Old

The observer will:

  1. Learn how to problem solve the catalyst for use of extension thrust and toe standing in this child and how to help him give up these patterns.
  2. Understand the “pitched” posture and how this alignment in the hips and trunk allows the child to feel safe for standing, reaching and moving up and down.
  3. See how to modulate input to make it easier to tolerate without needing to take the input away or change the activity.
  4. See how to talk to the parents to help them understand home carryover activities and why these could help their son develop a greater understanding of his motor system.

VOLUME II:  Revisiting Motor Control – A Second Look at Age 5

The observer will:

  1. Learn how to help a child organize his motor system through heavy work as a foundation of stability for preparing him to perform fine tuned motor skills.
  2. Understand the dilemma between allowing a child to have free mobility vs. keeping them safe from injury when they demonstrate frequent falls and miscalculations.
  3. See in real time how many times an activity is repeated and when control becomes more difficult due to fatigue or lack of organization.

Educational Credits:

3 contact hours.  Certificates will be awarded.

Recognized by the NY State Education Department’s State Board for Physical Therapy as an approved provider of physical therapy and physical therapy assistant continuing education.   Approved for .3 CEUs.

color web&ppt TSI is an AOTA Approved Provider of continuing education. AOTA does not endorse specific course content, products, or clinical procedures. Approved by AOTA for .3 CEUs.


  • $120.00; includes DVD, post-test, and certificate of completion
  • Each additional viewer wanting CEUs: $25.00; includes post-test and certificate of completion.

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PLEASE NOTE: Certificates of completion will only be issued upon completion and return of post-test to TSI.