June 01, 2011


I’ve talked a little about Kalia’s delays. Right now I’d like to talk specifically about her gross motor delays…and what we’re doing to help. (I promise the title will make sense in a bit)

Kalia has hypotonia, along with pronated feet. First…what is hypotonia?

hypotonia – or low muscle tone – is not the same as muscle weakness. Hypotonia is treated with therapy, which can include physical, occupational and speech. Hypotonia can affect all areas of development (most common), or be isolated to just certain areas (ex: just affect gross motor skills). Prognosis of children with hypotonia vary greatly from child to child. With therapy, many can overcome it. (though hypotonia never goes away….once hypotonic, always hypotonic….you just learn to compensate)"

This hypotonia affects Kalia in many ways. She is just now getting where she can step up on & down from curbs without assistance. Her standing balance is much better now, though she still sways from time to time. She has low tone in her hands, which makes holding a spoon/fork & actually getting food into her mouth a challenge. It also affects her speech.

Now for the pronated feet explanation:

The pronated foot is one in which the heel bone angles inward and the arch tends to collapse. Children with low muscle tone can develop lax ligaments, which inhibit joint stability in the foot and ankle complex. Once the feet are pronated, the knees and hips also become misaligned. This means the muscles that move those joints no longer work efficiently, and it takes more energy for these children to do the same work as their non-pronated peers.

When Kalia first started seeing her physical therapist, she noted right away that her feet were pronated and ordered SMOs (orthotics) to help with alignment. Kalia used to get so tired trying to hold her feet in proper alignment, along with her hypotonia, that she wouldn’t want to walk anywhere on her own. Since getting the SMOs and having worn them for over a year now, we’ve noticed vast improvements. She has so much more energy, as the SMOs are doing a lot of the work keeping her aligned.


Now…for where the stitches come in…

Due to the hypotonia, Kalia often loses her balance. She cannot stop & turn on a dime, which is bad news when she’s chasing a boy on the playground and he suddenly turns around to chase her. She turned quickly to try to get away, lost her balance and fell smack-dab into a concrete slab.

After a quick trip to Urgent Care (and 4 adults holding her down to put 5 stitches in), and a popsicle,

she was back to her normal, crazy self!


  1. Glad to hear that you have some answers. Our 26 year old daughter was diagnosed at 1 year old that she had hypotonia and her feet also pronated. She did not speak until almost 4, did not take first steps until 2, and potty training never really completely came--she still has problems. Her hip does not rotate causing her to walk slightly abnormal. The orthopedist did not want to do surgery because didn't feel like it would achieve much and her neurologist also said that she had mild cp. With all this said she did go onto play basketball and was awesome winning over 100 trophies in several states (before 8th grade). Her physical therapist made a comment about our daughter when she was about 2 years old 'she will never be a basketball player.' I guess our daughter showed her. Yes, she had to practice way more than others. Our daughter made lots of improvements just as I am sure that Kaila will do.

  2. Oh, our daughter also wore orthotics for years.