Is My Child Hypotonic? Hypotonia Symptoms Diagnosis and Treatment

My child turned 3 years old last November. I try very hard not to compare her to other children as all children develop at their own rate. But my child is...well...behind.

There, I said it.

She weighs a mere 24 lbs, is very petite and speaks no more than 2 words together. All other words are mumbles. Pure jargon that is understood by her and her alone.

My girl developed late in all aspects of growth and milestones. As a friends baby would be crawling along happily at 9 months, mine would be sitting. Just sitting. First words of "momma" or even "hi" were not of her capacity. Finally she began to motor about the house after one year and miraculously walking at almost 2. But her speech was ever-lacking.

I admit, I never really thought much of it until at her 3 year check-up. I made excuses that I must be just answering for her and she may not communicate her needs because I anticipate them for her. But, the doctor was concerned. We were then referred to Help Me Grow.

Help Me Grow is a service provided by the State to evaluate and assess possible developmental delays in children. Once a diagnosis of delay is founded, they refer your child to the appropriate help.

I was a bit reluctant to call this service as I personally did not want to admit there was a problem with my child. No parent does, but in time I obviously did and it was the best call I ever made.  

A Speech Therapist, Physical Therapist and an Occupational Therapist came into my home and evaluated my daughter. It was found she is highly intelligent, but is most likely plagued with Hypotonia.

Hypotonia is defined as low muscle tone. Low Muscle tone I asked? How? She is so active! That's the misconception.

Hypotonia is not lack of muscles or muscle weakness. It is the resistance to movement in a muscle. Hypotonia is best explained in this example:

If your child jumps from a stair, they will land in the frog position. Why? Their muscles cannot respond at a high enough rate to keep them on two feet. The resistance of the muscle to stay upright is not there.

The symptoms of my daughter having Hypotonia would have and did go unnoticed until Help Me Grow intervened. The symptoms my daughter has are:

• Delayed Speech
• Walking on the inside of her feet
• W-sitting (knees are bent at an angle leaving legs behind as the shape of a W (afemoral anteversionka)
• Frog landing
• Head remaining back as lifted from lying position
• Inability to deliver bowels naturally

Hypotonia presents itself through numerous symptoms and is usually diagnosed at birth or shortly thereafter. The most noticed symptom is the "rag doll" baby. Because of the resistance to movement the infant is seen to be floppy or soft in its movements.

Other symptoms are:

• Delay in Gross Motor Skills and Fine Motor Skills
• Speech Delay
• Slow development of sense of balance
• Breathing Problems (short of breath or 'loud' breathing)
• Difficulty swallowing (can't breast of bottle feed for long periods)
• Problems with mobility and posture
• Lethargy
• Weak ligaments and joints
• Poor reflexes

Your child could also experience bowel difficulty. As with all symptoms, if you see your child having even one of these issues, contact your Physician for evaluation and follow-up.

Here is the problem. Hypotonia is not an overall diagnosis, unfortunately it is a sign or symptom to the greater cause.

The cause of Hypotonia may stem from a traumatic event, environmental factors or an underlying CNS (central nervous system) disorder, genetic disorder, or muscle disorder.

Hypotonia has been associated with Cerebral Palsy, Muscular Dystrophy,Trisomy 13 and Downs Syndrome, just to name a few.

Numerous tests are available to determine cause and diagnosis Hypotonia.

• Computerized Tomography (CT)
• Magnetic Resonance Imaging (MRI)
• Electroencephalogram (EEG)
• Chromosome Karyotyping
• Spinal taps
• Electromyography (EMG)
• Muscle Biopsy

Treatment, as with any condition, depends on the severity and overall underlying cause. For now, my daughter receives Physical and Speech Therapy until the Neurologist defines a better treatment. Whatever the reason, whatever the severity, your child is not a 'special needs' child due to Hypotonia.

Your child is truly special...with needs.