Hypotonia is a state of low muscle tone (the amount of tension or resistance to movement in a muscle), often involving reduced muscle strength.   Muscle tone refers to the muscles’ ability to sustain a contraction. Muscle strength refers to the muscles’ power.  Low muscle tone cannot be changed, but improving strength can compensate for the underlying low tone to help support the child through daily tasks and play.  The muscles tend to be squishy with excess mobility at the joints.  Although there is not a specific test that will identify low tone, the following characteristics are typically observed.

Characteristics of low tone:

• Joint hypermobility & instability
• Slouched sitting posture
• “W” sitting or sitting with a wider base of support
• Difficulty holding head upright (propping head with hand)
• Difficulty sitting for long periods of time
• Props self up with hand/arm while sitting on floor
• Tend to perform motor tasks with excess force or too little force
• Clumsiness or incoordination 
• Difficulty climbing, running, jumping, or hopping when compared to peers.
• Difficulty with age expected speech sounds
• Excess drooling or open mouth posture
• Difficulty chewing and feeding

Ways to improve strength:

• Pushing/pulling of heavy objects.
• Encourage climbing, rock wall climbing, monkey bars, and climbing/crawling/pulling up a slide.
• Use big movement/heavy work activities such as wheel-barrow, bear, crab, and hill walking.
• Practice jumping activities such as, double leg jump, frog jump, and side jumps.
• Treatment to strengthen and improve motor planning will help the child perform age appropriate skills.
• Community based activities such as swimming, gymnastics, tumbling and karate.

Having low tone isn't the end of the world.  However it can impact your child's ability to perform expected milestones and motor skills as expected for their age.  Try the above listed activities, along with any fun activities, that will strengthen your child's muscles.  If you have continued concerns about their tone and it's impact on their functioning, contact your local pediatric therapy clinic for an occupational or physical therapy assessment.