Young children develop gross motor skills in a typical progression:

•         lying and rolling
•         pushing up
•         sitting up
•         crawling
•         pulling to stand
•         standing independently
•         cruising
•         walking
•         running
•         jumping

Early skills such as sitting and standing are very important to help with trunk stability (also called postural control), development of strong bones and joints (especially the hip joints) and visual, social and cognitive development. Some young children with low muscle tone are unable to sit independently or to stand due to poor postural control. This also may also affect fine motor development such as speaking and eating.

Surestep’s TLSO

To help with sitting and standing, either in a stander or with assistance, Surestep has a special back brace called a TLSO (thoraco-lumbar-sacral orthosis). Made from the same unique, flexible plastic as our Surestep SMO, this back brace uses compression to help support your child.  This support provides appropriate alignment of the pelvis and the trunk so your child can work toward independent sitting and standing.  Better alignment of the trunk often means better alignment of the head and neck. I’ve also found that both speech therapists and occupational therapists love the results children get with the Surestep TLSO.  Parents and patients like this brace because it’s more comfortable and less bulky than other custom fabricated TLSOs.

A couple unique characteristics of the Surestep TLSO set it apart from other TLSOs often used with children. When sitting up, we need to be able to adjust our trunk stability as we move our weight from one side of our pelvis to the other.  We call this a pelvic weight shift.  It becomes really important for walking, but is developed early in life.  Sitting upright without hands and leaning across the body to actively use arms/hands requires the ability to successfully shift the body weight over without falling.  These subtle movements through the trunk are called balance reactions.  To develop balance reactions, the brain needs to know where the body is in space in relation the arms and legs.  This is called proprioception.  As the child develops postural control through balance reactions and proprioception, he develops strength in the muscles of his back, shoulders and hips.  The Surestep TLSO encourages the development of balance reactions, proprioception, and helps your child use his trunk muscles instead of just propping him up in a more rigid system.

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