The Alexander Technique with Jill Payne

Cerebral Palsy and AT: working with baby Sasha

It's unusual to be asked to work with a baby, so I was delighted to have an opportunity to work for several weeks with Sasha, a baby boy of 5 months, with cerebral palsy.  His parents, Kate and Martin, wanted to try the AT to address his symptoms of extreme muscular tension, and I agreed to see Sasha before he began therapeutic treatment at home.  
In four lessons over three weeks in March, 2010,
we observed marked improvements in his condition.

Medical assessment showed that Sasha's mental development was good but his physical development was poor.  He had trouble going to sleep, staying asleep, and became very distressed when not held or when travelling.  His sleep was disturbed by twitching; it started when he fell asleep and woke him up.  This was getting worse as he got older.  He could not bend his arms so had never raised his hands to his mouth, and was unable to sit up or roll.

Lesson 1. 
In his first lesson Sasha was alert and actively looking round the room, sometimes strongly pulling his head back.  He was rigid in both arms while his back and legs were floppy.  He sat on Kate's lap while I put hands on him, sitting by them.  I gently worked on his arms, shoulders and hands, carefully taking each in turn.  His arms gradually became less tense and were able to bend.     

I gently cradled the back of Sasha's head in one hand, supporting it to deter his tendency to brace it back.  He resisted this at first but only in this first lesson.  We worked for about 15 minutes before he became restless and we arranged a lesson for the next week.   

Kate:  "Tonight Martin and I witnessed something incredible.  I mentioned Sasha's sleep twitches.  They affect him every time he falls asleep, unless he is feeding.  Tonight he fell asleep in Martin's arms without one twitch!  He woke up once and again fell asleep peacefully in my arms.  It certainly seems that you had a positive effect on him!"  

The twitching did not return for several days and Sasha began sleeping for 3 or 4 hours at a time.  This was the longest he had slept to date. 

Lesson 2.   With Sasha on Kate's knee I worked first on his arms which soon relaxed.  He was happily looking around and at me, pulling his head back less than before.  The work involves gentle hands-on contact to his head, arms and torso to effect muscular release, with Kate frequently moving him around to pacify him.  We did 20 minutes' work today.  

Kate:  "When we got home, Sasha was kicking and reaching out for things so fluidly that I rang my mum to tell her!  He had his knees up to his belly, which I have never seen him do before.
That night Sasha fell asleep while feeding and then woke up after two hours as he has a blocked- up nose.  However, although he was clearly irritable and uncomfortable he did not twitch at all!  Progress indeed."

Once again the twitching did not resume until several days after the lesson.   

Lesson 3.   Sasha had a good sleep the previous night and these are more frequent since we began his lessons.  Today I worked on his arms and hands, cradling the back of his head in one hand as before.  After 15 minutes' work Sasha was looser in his neck and limbs and had more natural movement. 

I was able to give Sasha 25 minutes' work to his arms, hands, head and neck before he became restless.  Kate said this is the limit of his attention for anything.  It was a good lesson and Sasha seemed more contented and less easily distressed.

Kate: "After today's lesson Sasha lifted the fingers of his left hand to his mouth for the first time".  
His sleep pattern continued to improve after the lesson.

Lesson 4.   Although Sasha was unwell with a blocked-up nose he slept for 7 hours last night, the longest ever.  Good nights' sleep are common for him now (and his parents too).  We did 15 minutes today.

Sasha has always needed carrying, rocking and moving about to stop him from crying.  This is very tiring and stressful for Kate and she told me that before starting these lessons she had been finding the situation hard to cope with.  She describes Sasha now as "a much happier baby" and is sure the lessons have made a difference. 

Kate: "When we left you we stopped at Sainsburys.  Sasha insisted I carry him in one arm while balancing a basket of shopping with the other! Half way round I felt him start to get twitchy. I rushed my shopping and went to the checkout, by which time he was twitching a lot.  He stopped twitching and when I looked down, he was asleep!  I was amazed that he had fallen asleep with all the noise and light in Sainsburys."

"I went to Bromley with my mum.  We took Sasha in the pram (which he hates!) My mum said Sasha was really tired and maybe I should feed him so we could put him asleep in the pram (a far more pleasant alternative to putting him in there awake!)  My mum was holding him over her shoulder while we talked about it, and when I looked he was peacefully asleep.  He slept in the pram all the way home."

This shows that the change in Sasha's ability to sleep normally has continued to improve since the first lesson.

April 2010  The family were moving house and it was unsettling Sasha.   After the move we couldn't arrange a lesson for a few weeks so Kate kept me informed of any changes.