Which handling position is MOST appropriate for a 1-year-old child with cerebral palsy who has strong trunk extensor tone?

• A. Carrying the child in a sitting position
• B. Carrying the child over one's shoulder
• C. Keeping contact with the back of the child's head
• D. Picking the child up under the upper extremities

Answer: (A)

When trunk extensor tone is strong, the goal in handling is to support the spine in a flexed, midline position so the child can be stabilized and aligned. Carrying the child in a sitting position achieves this by giving a stable base at the pelvis and trunk, allowing your arms to gently support the torso and legs in a relaxed, flexed posture. This setup counters the tendency to hold the trunk in extension and helps maintain midline control during handling.

Carrying over the shoulder tends to place the spine and neck into a more extended position against your body, which can reinforce the extensor pattern. Keeping contact with the back of the head similarly encourages extension of the neck and spine, not supporting a flexed, midline posture. Lifting from under the upper extremities often provides less trunk stability and can lead to poor alignment or collapse of the trunk.

So, the seated carry is most appropriate because it promotes trunk control, midline alignment, and a more comfortable, stable handling position for a child with strong trunk extensor tone.