09/10/2026
When a child’s tone changes during therapy, are we looking only at the motor response?
Or are we also asking what is happening in their nervous system?
For some children with cerebral palsy, there may be years of experiences that have shaped how their nervous system responds to touch, movement and unfamiliar situations.
NICU admissions.
Surgery.
Painful procedures.
Repeated physical contact they could not always predict or control.
So when we notice increased tone, bracing, withdrawal or disengagement, there may be more information in that response than we initially realise.
That is where I want us to become curious about nervous system state.
What might this child be anticipating?
Do they know what is about to happen?
Do they feel safe enough to participate?
Can they communicate stop, wait or not yet?
Co-regulation. Predictability. Narrating before touch. Offering choice where we can. And a warm therapeutic relationship.
These are not separate from therapy.
They are part of creating the conditions that support movement, engagement and participation.
And if this is something you’re seeing in your own caseload, we’ll be exploring these kinds of clinical questions in the next LIVE SenseUp Masterclass on 20 October:
Sensory Features in Diagnostic Groups: Physical and Motor Challenges
Through the SenseUp Lens, presented by Kerry Evetts, Practicing OT | MOT and SenseUp Founder.
🙂➡️ https://www.senseup.org/2026-sensory-features-in-diagnostic-groups-physical_disability/
I’ve also explored this further in my new blog:
How does unexpected touch inadvertently create trauma in some children with cerebral palsy?
https://www.senseup.org/unexpected-touch-trauma-cerebral-palsy/