Compared to the size of the rest of its body, an infant’s head is large at birth. A study by the Association for the Advancement of Automotive Medicine, published by the U.S. National Library of Medicine and the National Institutes of Health, noted that while a newborn baby is just 5 percent of an adult’s weight, the newborn’s brain is 25 percent of what its adult size will be.

Their heads are heavy, and it takes a while for babies to lift (starting at about 1 month) and then to hold their heads up high (about 3 months old), said Parenting magazine.

For a typically developing infant, that timetable is fine: The developing ability to hold up its head coincides with activities such as gazing at adoring parents, tracking the dog as it romps past, and focusing on objects to be reached for and grabbed.

But holding up their heads can be much more challenging for children with mobility-related disabilities, and the ramifications of missing that milestone can have a ripple effect on development.

Head Positioning & Engagement

Gabriel Romero is the VP of Sales & Marketing for Stealth Products.
“What we absorb comes from our eyes and our ears,” he said. Romero referenced a questionnaire that Stealth Products once conducted: “We did a survey with teachers that asked, ‘How do you engage with your students?’ They all said, ‘Eye contact. Those are the students I engage with.’”

The flip side of that tendency — to engage with those who engage with us — is that children unable to make eye contact might not get the attention they need to optimally learn and grow.

A child who habitually leans heavily to one side, Romero pointed out, might not hear well on that side. Children who constantly look upward might learn more about ceiling tiles than about their peers. Children who constantly look downward might only learn to tell people apart by the shoes they wear.

“It isn’t facial recognition,” Romero said. “It is things within their visual perspectives that they recognize. Like, ‘Look, there’s the UPS driver; I can see his boots.’”

It’s All About Head Positioning (& Support)

Romero contended that “headrest” doesn’t duly describe the equipment required by clients with complex positioning needs. Instead, he prefers “head positioning and support.”

“You have corrective positioning, and you have support positioning,” he said. “In corrective positioning — I’m starting to see scoliosis.

I’m starting to see a shoulder drop. Positioning for kids is so important, especially for kids with disabilities. You’re trying to get alignment, because if you don’t, misalignment will start to happen with the pelvis, then you have pelvis locking. And now this child is just beat. They’re trying to hold themselves up, gravity isn’t assisting them, and then they’re falling down.”

Once the child is seated properly, the goal is head support, which might be achieved, for example, by placing the head support component slightly below and underneath the head to cradle or “cup” it.

“Our neck is looking for a place to rest,” Romero said. “We need support. If there’s ‘cupping’ in the back, then that’s their support. If they need to be active, they can look around. But if they need to rest, [the cupping] offers support.”

Romero said he knows many seating professionals focus on positioning the pelvis first. But he sees head positioning as an equally important component of a successful seating system.

“This is where I get into arguments,” he said. “The pelvis is so important, but gravity still takes over. Wherever the head goes, the body is going to go. Everything has a domino effect within seating, the way I see it.”