Asymmetry in Posture of individuals with ID and ASD Habitual, relational or domino causality?


The purpose of this blog post is to introduce an art concept of “contrappostos” that can be used to describe unique characteristics of abnormal standing posture. This single word used in art describes accurately a position where central of body mass is shifted onto a single leg to create illusion of stability and comfort while posing for an artist.  The pose is described as standing with most of the body weight placed on one foot so that the shoulders and arms can twist easily at the horizontal plane at the pelvis, hips and ankles. This similar pose is habitually adopted by some individuals with Intellectual Disability and Autism Spectrum Disorder which may be their way to  preserve energy and to increase stability in standing. 

In the case of individuals with disabilities, this repeated weight shifting over the same leg over a long period of time, has long term negative postural consequences to the body, especially during developmental stages.  The weight bearing leg becomes functionally short, while the other leg (“longer”) seeks to adapt the difference in leg length at the hip, knee and ankle/foot regions. This “appearance” of leg length discrepancy often alerts caregivers to seek medical help.  The complexity of this “contrapposto” like pose which has a relational and a domino causality requires physical therapy intervention.  Treatment requires more than simply adding a lift under the heel of the short leg to even up the posture.  The use of this verbiage “contrapposto” will increase recognition and awareness in relation to postural issues with these individuals.