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17 The maneuvers of PT for a baby and a small child

A baby's (0 - 6 months) positional treatment for the superior and posterior canals is done holding him/her in the lap. The baby's head, neck and the rest of the body is supported by the adult's hands and body. The maneuver for the horizontal canal is done on the bed and the baby is supported by a hooded swaddle. A baby's sense of balance is smaller than that of an adult but the canals may be narrower so the duration of a baby's maneuvers is only a little shorter. Because a baby's muscles are small and they haven't been affected too much by the DSB all the three maneuvers can be done the first time. Because the positional treatment of a baby requires caution, contact me for further advice and instruction, please.

The following instructions can be used with a child (over six months of age) who is able to sit until he/she is able to do the maneuvers more independently, perhaps at the age of 6 – 7. Estimate that the duration of each maneuver is about 12 seconds. The pauses between the maneuvers are shorter than with adults: about one minute.  Have a book, music or toys to spend the pauses with.

Change the right – left order and the mutual order of the superior and posterior maneuvers every time as follows:

LR= first the left canal, then the right canal

RL = first the right canal, then the left canal

1. superior canal LR, posterior canal RL, horizontal canal LR

2. posterior canal LR, horizontal canal RL, superior canal LR

3. horizontal canal LR, superior canal RL, posterior canal LR


The starting position for the maneuver of the superior canal for a small child

You are sitting on the edge of the bed, your legs and feet about 30 cm off the bed, so that you can bend your left knee. Have your feet steadily on the floor and lift the child on your left thigh near your knee. The child is sitting astride and you support him/her with your left arm and hand by putting them on the belly-side of the child from the left upwards to the right shoulder. You direct and support the child's head with your right hand during the maneuver

The maneuver of the left superior canal for a small child

You rotate the child's head about 15º to the right and bend it about 15º to the left and bow with the child down until the child's top of the head faces the floor. Without stopping raise the child's head and upper body again upwards about 60º from the level, straighten his/her head upright. Simultaneously, soon after reaching the lowest point move the child off your thigh onto the floor into a sitting position. Stop on the floor for about 10 seconds. The child stands up, leaning against the bed when necessary or you hold him/her in a standing position for a moment. Pause.

The maneuver of the right superior canal for a small child

You rotate the child's head about 15º to the left and bend it about 15º to right and bow with the child down until the child's top of the head faces the floor. Without stopping raise the child's head and upper body again upwards about 60º from the level, and simultaneously straighten his/her head upright. Simultaneously, soon after reaching the lowest point move the child off your thigh onto the floor into a sitting position. Stop on the floor for about 10 seconds. The child stands up, leaning against the bed when necessary or you hold him/her in a standing position for a moment. Pause.

The starting position for the maneuver of the posterior canal for a small child

You are sitting on the edge of the bed both your feet steadily on the floor. The child is sitting on the bed next to you on your left facing the other end of the bed. You support the child with your left arm and hand on the back side from the left up to his/her right shoulder. You direct and support the child's head with your right hand during the maneuver. 

The maneuver of the left posterior canal for a small child

Rotate the child's head about 30º to the right (note: a mirror image from you) and at the same time lower the child's upper body and head backwards about 60º down from the level and without stopping raise again the child's upper body and head up to 60º from the level when you straighten the rotate of the head and simultaneously sit up. stop in the siting position. Pause.

The maneuver of the right posterior canal for a small child

Rotate the child's head about 30º to the left (note: a mirror image from you) and at the same time lower the child's upper body and head backwards about 60º down from the level and without stopping raise again the child's upper body and head up to 60º from the level when you straighten the rotate of the head and simultaneously sit up. stop in the siting position. Pause.

The starting position for the maneuver of the left horizontal canal for a small child

You put the child lying on his/her back with the child's left side near the edge of the bed and the upper body on a hand towel. You wrap his/her upper body in the towel with the child's left arm inside the fold of the towel. You put your right hand under the back of the child and your right hand under his/her head which you rotate 90º  to the right from the child.

The maneuver of the left horizontal canal for a small child

You lift the child's head a bit with your right hand and start rotating it horizontally first up and then down. Simultaneously your left hand pushes the left side of the child gently and rotates the child's body down so that the child's nose touches lightly the mattress. Then you rotate and lift the child into an upright/standing position on the floor near the side of the bed. Stop. Pause

The starting position for the maneuver of the right horizontal canal for a small child

You put the child lying on his/her back with the child's right side near the edge of the bed and the upper body on a hand towel. You wrap his/her upper body in the towel with the child's right arm inside the fold of the towel. You put your left hand under the back of the child and your left hand under his/her head which you rotate 90º  to the left from the child.

The maneuver of the right horizontal canal for a small child

You lift the child's head a bit with your left hand and start rotating it horizontally first up and then down. Simultaneously your right hand pushes the right side of the child gently and rotates the child's body down so that the child's nose touches lightly the mattress. Then you rotate and lift the child into an upright/standing position on the floor near the side of the bed. Stop. Pause.

When the baby is healthy and satisfied: eats and sleeps pretty regularly, grows evenly, babbles, moves and plays by and large according to his/her level of development the TSB has succeeded.

The following chapter 18 Is anything else needed?