Weak Neck? Build Better Head Control While Leaning Back 🚗 | Pediatric PT for SMA #19

In this video, I work with Cillian 👨🏻‍🦰, who is 2 years, 3 months old, on building isometric neck flexion strength while integrating play and motivation. I’m Amy Sturkey 👩🏼, a retired pediatric physical therapist. In Cillian’s previous session, we worked on transitioning into sitting using a wedge. In this video, we focus specifically on helping him maintain head control during a graded backward lean. 📘 Cillian’s Medical & Therapy Background Cillian was diagnosed with Spinal Muscular Atrophy (SMA) through newborn screening. He received Risdiplam by day 5 of life until eligible for Zolgensma, which he received at 5 weeks of age. He restarted Risdiplam at 10 months of age. Cillian has also been diagnosed with: • Nystagmus • Cranial asymmetry • Scoliosis • Hip dysplasia Cillian began physical therapy at 3 months of age and currently receives: • Physical therapy • Occupational therapy • Feeding therapy 👉🏽 Watch the full Cillian playlist here: https://www.youtube.com/playlist?list=PLAkJbMrHyKjOBUy-rQKVN5ACa37e72liK 🚗 Session Focus Cillian is working on: • Isometric neck flexion strength • Upper trunk stability • Graded posterior control • Endurance during upright sitting • Maintaining head position during backward displacement 💡 What’s Happening in This Session Cillian is seated sideways on my lap, facing his spiral car track reward placed on a small bench. • My legs are extended, with one leg crossed over to support his lower hips. • I stabilize at his upper trunk — one hand in front, one behind. • I gradually lean him backward approximately 20 degrees. • He must hold his head upright without it falling posteriorly. • We count backward from 10 to create a predictable endpoint. The first attempt goes slightly too far — and he loses control. That feedback helps me adjust the angle to find the highest level he can sustain successfully. Counting backward from 10 provides clarity and structure. When you count down, the child knows exactly when the effort will end. There are no surprises. His reward? Sending cars down the spiral track 🚗 Near the end, while I am explaining the strategy to the camera, he looks at me and says, “Do your thing,” and returns to playing — fully expecting me to resume teaching. That moment reflects not just participation, but awareness of routine, audience, and shared roles within the session. 🧠 Why This Matters For a two-year-old, holding an isometric trunk and neck position against gravity is extremely demanding. At the gym, adults lean back and hold abdominal contractions with full understanding of the task. For a young child with SMA, maintaining that position while engaged in play requires: • Strength • Endurance • Motor planning • Attention • Trust • Motivation This is not passive positioning. This is active work layered into meaningful play. ⚠️ Important Note These videos are educational and are not a replacement for in-person pediatric physical therapy. Every child is unique. Please consult a licensed pediatric therapist before trying new exercises or positioning strategies. I cannot provide individualized treatment without an in-person evaluation. 🌐 Contact / Learn More Website: https://www.pediatricPTexercises.com Facebook: Pediatric Physical Therapy Exercises Email: amysturkey@gmail.com 📚 Books by Amy Sturkey, PT Children’s Educational Books (Amazon) • P is for Poop and Pee Accidents — https://www.amazon.com/dp/B0BLSRJ483 • A is for Anxiety — https://www.amazon.com/dp/B09LXQ3W6V • A is for Attention Deficit Hyperactivity Disorder — https://www.amazon.com/dp/B08QH9H5HR • C is for Cerebral Palsy — https://www.amazon.com/dp/B088TSJCYP • D is for Down Syndrome — https://www.amazon.com/dp/B079P8HH49 • A is for Autism — https://www.amazon.com/dp/B071F4FFTB Professional Pediatric Physical Therapy Books (Amazon) • Pediatric Physical Therapy Strengthening Exercises for the Hips — https://www.amazon.com/dp/0998156736 • Pediatric Physical Therapy Strengthening Exercises for the Knees — http://www.amazon.com/dp/0998156760 • Pediatric Physical Therapy Strengthening Exercises for the Ankles — https://www.amazon.com/dp/B08TX2ZCFD 💬 Captions / Accessibility Captions were reviewed and corrected for clarity and accuracy. To turn on captions: click CC To change languages: ⚙️ Settings → Subtitles/CC → Auto-translate → choose your language ⏱️ Chapter Timestamps 0:00 – Intro: Amy & Cillian 0:15 – SMA background 0:30 – Setup on lap and trunk support 0:55 – First attempt: too far back 1:15 – Adjusted angle with backward counting 1:45 – Graded posterior lean work 2:20 – Spiral track reward 2:40 – “Do your thing” moment 2:55 – Why counting backward helps 3:20 – Clinical takeaways 3:45 – Subscribe & notifications