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ss triple helix - summer 2016,  help with learning to walk

help with learning to walk

Treating children with muscle tone issues can mirror God's compassion says Peter Sidebotham.

As a paediatrician, I am often referred young children who are delayed in their development, including those who are slow in learning to walk. This may just be a mild developmental delay, the child taking time to acquire the skills and confidence or motivation to walk. Sometimes there is an underlying medical disorder preventing them from acquiring those skills. These children typically fall into one of two broad groups: those with low muscle tone (hypotonia) and those with high muscle tone (hypertonia).

Children with hypotonia have weak, floppy muscles which are unable to support their weight effectively. We find this, for example, in children with Down syndrome. Those with hypertonia, such as children with some forms of cerebral palsy, have stiff, inflexible muscles. They find it equally difficult to walk, but for different reasons: their muscles, though stiff, are still weak, and they cannot easily achieve the coordination and balance to stand upright.

When I am assessing a young child's ability to stand and walk, I need to provide support and a stable base so that the child feels secure. In order to do this, I typically sit or kneel on the floor, with the child sitting between my legs, back to me. When the children sit like that, they feel secure and safe. Hypotonic children are held stable and seem somehow to gain confidence and motivation; those with high muscle tone often relax, enabling me to move their legs and assess the muscle strength.

Once I have the child properly relaxed, I will gently lift it to a more upright position, the trunk still supported against me, my arms around the waist, to keep the child from falling. In that position, the child can feel secure and is able to take some weight on the legs, perhaps even taking some preliminary, supported steps.

I often think of God being like that with me. In my spiritual development, I may feel weak and hypotonic, unable to stand up in the face of difficult challenges. Or I may try too hard, my hypertonic spiritual muscles getting in the way of my attempts to go forward. I may feel insecure and afraid of falling or getting things wrong, or I may have already been hurt by life's events and be feeling a bit bruised and battered. In all these situations, I picture God as a heavenly paediatrician, holding me securely in his embrace, giving me the strength and courage to take those first, tentative steps.

That is the picture conveyed by Hosea's passionate words of God's love for the people of Israel: 'It was I who taught Ephraim to walk, taking them by the arms'. 1 God is someone we can trust, who will not let us fall. Secure in God's loving embrace, we can step out, even into the hardest of situations.

Peter Sidebotham is Associate Professor of Child Health, Warwick.

References
  1. Hosea 11:3
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