What is Muscle Tone?

Muscle tone is the term for the resting length of muscles in the body; or the length of the muscle before a Muscle-Tonecontraction. In low muscle tone (also called hypotonia), the resting length of the muscles is greater than average and causes hyperextension at the joints, or what some refer to as “double jointedness.” However, the term double jointed is misleading, as a person doesn’t actually have two joints, just increased muscle length and therefore increased flexibility at the joint. In high muscle tone (also called hypertonic), the resting length of the muscle is less than average, which causes the limbs to feel rigid and inflexible.

What causes variances in muscle tone?

Many individuals who are typically developing fall within a range of what is referred to as average muscle tone. However within that spectrum one may fall on the high or low end of muscle tone. Clinically significant high muscle tone in children is most commonly caused by in-utero stroke or brain bleeds, and cerebral palsy. Clinically significant low muscle tone in children is most commonly a symptom of various syndromes, other neurological conditions which are typically diagnosed within the first year of life, or an unknown cause (unknown causes of decreased muscle tone are typically not associated with other developmental delays or issues unlike the syndromes or neurological conditions)

How do I know if my child has high or low muscle tone?

High muscle tone in children is typically identified within the first 18 months of life. Your child may seem stiff or rigid in all limbs, on one side of his/her body, or in one half of the body (either the upper or lower extremities). Children with high muscle tone may have delayed gross and fine motor skill development, have difficulty “relaxing” his/her muscles, maintain a fisted hand beyond 6 months of age, or may present with very stiff legs that appear to move like scissors when standing or attempting movement.

Low muscle tone in children that impacts functioning is typically identified within the first 5 years of life. Your child’s limbs may seem floppy or loose, and he may often seem fatigued and prefer to lie down versus sit upright. She may also attain her motor milestones on the late end of average or later than average.

How can I help treat my child’s condition?

Children with high muscle tone will benefit greatly from physical and occupational therapy to stretch affected muscles and strengthen opposing muscles which then improves overall functioning. Compensation strategies to work with an affected limb can also be taught as the child ages. Botulinum toxin (commonly known as Botox), which temporarily paralyzes muscles, can also be helpful in children 18 months of age and older. Use of this treatment modality should only be completed in conjunction with occupational or physical therapy sessions, to most effectively utilize the benefits of this drug.

Children with low muscle tone will benefit greatly from physical and occupational therapy to strengthen muscle groups in order to decrease the impact of low muscle tone. This treatment also impacts overall functioning including coordination and attainment of motor skills.

Our approach at North Shore Pediatric Therapy

Our physical and occupational therapists are highly specialized to work within the pediatric population. We will first complete an evaluation to determine the impact muscle tone is having on your child’s motor and sensory skills. If deemed beneficial physical and/or occupational therapy services on a consistent basis will be initiated. A home exercise program will be created for your child that will be motivating and appropriate for your child’s needs. Parent/caregiver training will also be provided to ensure that the home exercise program is properly completed.

Client Reviews (23)

I completed my first FWII placement at NSPT in Bucktown. I had such a fantastic learning experience that truly helped me to grow my skills and experience. The staff at Bucktown was extremely welcoming and happy to teach, answer questions and allow me to observe outside my discipline to make this an even more well-rounded experience. The orientation/mentor program is great for students and makes heading into FW a much easier transition that sets you up for success. I had a great working relationship with my clinical instructor who helped me develop my treatment planning, documentation and intervention skills as well as teaching me a great deal about being a practicing OT in general! Overall, I couldn’t ask for anything more from a FWII experience!


I completed my Level IIA Fieldwork at North Shore Pediatric Therapy in Bucktown. I am so impressed by the organization of the student program and its emphasis on the reflection process. This reflection process has helped me develop clinical reasoning skills that are significant to treating clients. I also felt surrounded by a professional body of therapists that took on a mentor role, especially my supervisor. The gradual increase in case load was challenging yet manageable, providing me with client-centered intervention experience that will apply to my future endeavors as a therapist. Thank you, North Shore.


Our son Ian has been having sensory issues for a while & we were very pleased with the work that Ms. Dawn had been doing with him to help him deal with his processing issues. We were sad to leave NSPT due to a move out-of-state.

Stephanie Long

I completed my level II OT fieldwork at NSPT and it was a really positive experience. There is a multidisciplinary staff that are all eager to welcome and assist in the learning process. It is a really great location to learn about diverse applications of pediatric OT. All of the staff are passionate about what they do and have creative and exciting ideas to motivate children as they work on a wide variety of skills. NSPT is a wonderful placement for developing skills for pediatric OT and I am grateful to have had this experience!


We are incredibly fortunate to have Mrs. Ellyn’s influence. Even though we have only been here for 6 months, I am seeing a more able, more confident child. Mrs. Ellyn not only has helped gross and fine motor control, coordination and motor planning, but has helped set boundaries and attainable goals for my child. It is great to see him grow so strong.


I completed my final level II OT fieldwork at NSPT and had one of the best clinical experiences I could have expected. The entire staffs’ level of investment in their work motivated me to be creative while also working hard to deliver evidence-based research interventions. The successful stories I often heard from parents regarding their child’s growth reflects the passion and love each clinician at NSPT has for their job. I am so sad to have to say goodbye to the staff and the kids I’ve been working with for the past three months, and can’t express how grateful I am to have been placed here!

Mary Kate Mulry

My 5-year-old son has been receiving OT therapy at NSPT for 2 1/2 years. Could not be happier with his progress. Thank You NSPT!

Barnaby Wilde

My son (now 4) has been receiving OT at North Shore Pediatric Therapy in Glenview for almost a year. He receives a wide array of OT services including feeding therapy, core strengthening, fine-motor work, and balance activities. It is very encouraging to see the progress he has made and how much he enjoys his sessions. The OT truly listens to our concerns and provides us with plenty of resources and activities that we can work on at home to keep his progress going.

Jennifer N

North Shore Pediatric Therapy (NSPT) has changed our lives for the better! My six year old son was diagnosed with Sensory Processing Disorder when he was 3. Getting through a day was a difficult journey for the entire family until we began to get Occupational Therapy services (OT) for him. We see Ellyn, an OT at the Highland Park office, and she acts not only as an advocate for my son helping him strengthen his areas of weakness, but also as a great support system for me (mom). The entire NSPT team has been fantastic. I highly recommend them!


Our daughter is currently 3.5 years old. Since birth, we knew something wasn’t quite right. Her colic lasted nearly a year and when the colic broke, whining/crying/severe tantrums began. She was evaluated at 3 and 24 months by an OT for potential sensory processing issues and both came back inconclusive. We had her seen by a behavioral specialist as well as a developmental pediatrician. No one was able to help our struggled daughter or us. Until Dec 2013 when we came to North Shore Pediatric Therapy in Highland Park….we met Ellyn Kearney. She understood our daughter before she even met her. Ellyn has changed our lives and how we live day to day. Our daughter suffered from severe sensory processing issues despite being a healthy beautiful child. The progress noted from my child is remarkable. Thank you NSPT and Thank you Ellyn.


My 6 year-old son was diagnosed with High Functioning Autism/PPD-NOS around age 3 1/2 years old. After searching and looking for Occupational Therapy services we started coming to North Shore Pediatric Therapy in April 2013. We began seeing Shannon Phelan here at North Shore Pediatric Therapy in Bucktown for his OT services. We have seen a tremendous amount of growth in his OT Fine & Gross Motor skills: holding a pen/pencil, writing his letters and numbers and working on his Sensory Processing Integration. We are extremely pleased with our Occupational Therapist, Shannon and the entire North Shore Pediatric Staff. I would highly recommend coming here if you need Occupational Therapy services for your child.

Melinda V

I completed my Level II Fieldwork at NSPT in Bucktown in 2011. From the moment I walked in on the first day it was clear that NSPT created a supportive environment that would further my development as a professional and as an occupational therapist. The sense of community created a comfortable environment to collaborate with other disciplines. Not only was my clinical instructor invested in my learning, but so was the whole staff. Through this experience at NSPT, I found my passion for working within pediatrics. I increased my clinical knowledge, clinical reasoning and confidence during this time. I would highly recommend this site for occupational therapy students looking for a well-rounded and challenging experience.


I completed my second Level 2 fieldwork experience at North Shore Pediatric Therapy and could not have enjoyed my time more. I learned invaluable lessons about the world of pediatric occupational therapy all in a warm and welcoming environment created by staff members of all disciplines. I would highly recommend this fieldwork experience to anyone interested in working with children.


I was able to complete my Level 2 occupational therapy fieldwork at NSPT. It was a great experience! I was challenged educationally and clinically, and as a result came out of the experience with a greater knowledge about sensory integration, fine and gross motor skills, and how to evaluate and treat a wide variety of children in an outpatient setting. My supervisor and all of the staff made me feel welcome and a part of the team!


I completed my second Level 2 fieldwork at North Shore Pediatric Therapy in Glenview and Bucktwon in the Spring of 2012. I enjoyed my experience so much that I am now an employee at NSPT! Overall, I had a very positive yet challenging learning experience that supported growth in my clinical and professional skills. Not only did I grow my OT skills and knowledge but I was able to learn about and collaboate with many different disciplines including social work, physcial therapy, speech language pathology, neuropsychology, etc. NSPT is able to provide students a unique experience to learn how to treat the whole child to help them function at their fullest potential!

Sara Probasco

I had the opportunity to complete my Level 1C fieldwork experience at North Shore Pediatric Therapy Bucktown. I was incredibly impressed by the knowledge and professionalism of all the staff and their work with the clients and their parents. It was a wonderful learning experience for me and I highly recommend this site for any level 1 or 2 OT student interested in pediatrics. I wish I could have stayed longer.


My daughter who is now 1.5 years old and she started physical therapy when she was 6 months old and was discharged at 1 years old. We was reevaluated and needed therapy a few months later, and that’s when we met Marcy. She was very professional and compassionate towards my daughter. In the beginning hannah was very fearful of leaving my hands and had many meltdowns, a few weeks later hannah was eagerly jumping into Marcy hands. It only took a few months for hannah to come walking out to me in the office and it was a dream! Hannah is now meeting with devorah for speech and she’s absolutely great with it. I’ve recommend this place to friends and neighbors because hoe fantastic the staff and services are. Very highly impressed!


Our daughter saw Sarah Friedman in Glenview (now in Lincolnwood) for gross motor delay. Through our time with Sarah, she made tremendous progress. Sarah worked hard to keep our baby happy during sessions and cheered with us when she did her first roll and her first independent sitting session. We are so grateful for Sarah’s expertise and encouraging support. We still email her with questions and she happily responds. We highly recommend Sarah and the PT at NSPT!

Matt Galin

First of all I want to thank NSPT for allowing me to come to Glenview to have a clinical rotation with the pediatric population. My first two clinical rotations were with the geriatric population at a SNF and an outpatient orthopedic clinic. This has been a fantastic experience and I’m sad that I have to say good bye. I had the privilege to be overseen by Colleen McCloskey. She was very skilled and educated in her field. I was able to learn so much about the pediatric population, therapy techniques and interventions, as well as learn about other health professionals. She was consistently making sure I was constantly developing as a physical therapist. I also had the opportunity to work with other physical therapists when a kid cancelled or had extra free time. Each therapist ensured I was active in the therapy session. This allowed me to expand my knowledge by observing and learning other skills from a variety of people. Colleen was always active in my learning experience by providing me with great research articles and setting up an appointment to observe a company called Cranial technologies in which I was able to see the process of how helmets are created and adjusted for infants with plagiocephaly. Not only were the physical therapists great, so were the other professionals. Within the first two weeks I was able to interact in sessions with occupational therapists, social workers, speech therapists, and behavioral therapists. Everyone at NSPT made my experience fantastic with their personalities and overall attitude at work. This experience ensured that I look for a work environment filled with positivity and comradery like NSPT. Besides the great people at NSPT, I fell in love with pediatrics. I was able to treat infants to teenagers at the clinic. I was exposed to a variety of diagnoses including torticollis, spina bifida, idiopathic toe walking, cerebral palsy, and general gross motor delay for all ages. Each treatment was new and exciting. I never had to follow a specific routine which allowed flexibility and freedom, which I enjoyed. Each day was filled with laughter, fun, and a sense of accomplishment when I was working with the kids. I never had a day in which I didn’t smile. I am so happy and appreciative of this experience at NSPT. I have learned so much and I owe it all to Colleen and the other therapists at NSPT. Thank you again for these wonderful 10 weeks!

Shayla Seim

Flexible, professional and always encouraging our daughter to reach to levels at all times. Updated information on performance reviews and adjustments to therapy goals.


I want to start off by thanking you for affording me the opportunity to work/learn here at NSPT for the past 12 weeks, especially on such quick notice. I have wanted to do a pediatric clinical since I started PT school so naturally NSPT was an easy choice for me to make. The thing that really drew me to NSPT was the clientele. My other area of focus is outpatient adult orthopedics, and after looking over your site I realized that many patients at NSPT come in with orthopedic issues. Having no prior pediatric experience before attending this clinical, I felt that this would make for an easier transition. I was right. I have learned a lot here, from both Judy and all the other clinicians. The aspect of pediatric care that I initially had the most trouble with, and thus am most proud of, is client management. I have 3 younger siblings and many young cousins so I figured that I would definitely be able to handle pediatric PT. I was rudely awakened during my first couple weeks as I had trouble controlling the kids. I learned how to engage children better, focusing on building a positive report with them but at the same time not letting them act out. I learned how to persuade the kiddos to not only complete the exercises but REALLY WANT to complete them in a correct way. I learned how to better handle infants thanks to Judy. This clinical rotation also helped improve my organizational and planning skills as the clinicians have more responsibilities than other clinics I have been in. It was initially challenging trying to stay on top of all the paper work: progress notes, re-evaluations, initial evaluations, thank you notes, treatment session updates, intake info, managing the schedule independently, and responding to many parent e-mails. I am so grateful for everything I have learned here and I want to thank you everything who had a hand in placement here. I want to give a special thanks to Judy Wang for taking on her first student and being as patient as she was with me. She is a great C.I. and I’m sure that will only get better with more experience.

Nick Lefere

My son (now 4) has only been receiving physical therapy at North Shore Pediatric Therapy for about a month, but already we are seeing so much progress. My son took to his therapist immediately and so he views his sessions as a highlight of his week; his time to play with Miss Sarah is always a joy. He had trouble hopping, balancing, etc… and now he is gaining so much more strength and confidence in his own abilities. My son also has Type 1 Diabetes and I always know he is in good hands as Sarah is well versed in diabetes care and always asks about his blood sugar before his sessions. Thank you!

Jennifer N

Andrea is a wonderful Physical Therapist! Her work with our son is always engaging and fun for him. She is always very helpful with things we can do at home to help him improve and the exercises she does with him, he thinks are games, so he is more willing to do them more often. I’m so glad she is working with him, it is easy to see the improvements over a short period of time!