In the literature, there are various positioning guidelines for children with impaired respiratory issues and hypotonia, but few discuss the treatment of positioning with a Swiss ball or therapy ball. Respiratory issues can be a challenging disorder to remediate, and the benefits of incorporating different seating methods for children with disabilities who are unable to sit independently may not be adequate to meet their postural movement needs (Reid, 1996).
The purpose of this case study is to evaluate the efficacy of sitting on a Swiss ball, rather than traditional horizontal seating as a treatment method. The principles of neuroplasticity in respiratory control are incorporated in determining if sitting on a Swiss ball will increase respiration function for maximum phonation time in three children ages four through six with a diagnosis of mild to moderate hypotonia. The treatment, in this AB-A-B single-subject design, was intensive in both respiratory production and session frequency (four times per week for four weeks).
The outcome revealed improvement in maximum phonation time when seated on a Swiss ball. An increase in attention and a decrease in fatigue were secondary results. Treatment effects were generalized to increased maximum phonation time when seated on a bench.
The results support using a Swiss ball to address respiration during typical therapy sessions in children with mild to moderate hypotonia. Increased attention with decreased fatigue appeared to be a positive component to this approach.