In this tut chunk

Active stretching exercises to improve neck flexion ROM 

Children who tend to sit with a flexed spine tend to extend the neck to bring the face vertical. This posture leads to tightness in the cervical extensor muscles and associated fascial structures. 

In these exercises the child lies with the head on a book to flex the spine. Arm movements against resistance are used to activate the neck muscles which have been placed on a stretch, providing a localized mobilizing effect. 

The thickness of the book will depend on the amount of neck flexion you want as well as the size of the child. Choose a height that give midrange cervical flexion and full upper cervical flexion. 

Lifting two water bottles

Exercise instructions 

Start position 
The child lies supine on an exercise mat with the head resting on a book. She is instructed the look down towards her tummy to get more flexion of the upper cervical spine.

The child's arms are next to her body and she holds a 500 ml plastic bottle filled with water in each hand.  

The child flexes the shoulder with the elbows in extension to bring the bottles directly above her head. and then lowers them to the floor again.

This movement is repeated 10 times. 

Remind the child to keep looking down towards her tummy. 

Lifting a large bean bag

In this exercise the child lifts a large beanbag with two hands from her chest to directly above her head. adjust the weight of the beanbag to allow 10 repetitions to fatigue (10 repetition maximum). 

Start position
The child lies with her head resting on a book and holds a 2 kg beanbag with both hands on her chest. Instruct the child to look down towards her tummy. 

The child lifts the bag up to a position just above her head with the elbows extended and then lowers the bag to her chest again. 

This action is repeated 10 times.