The purpose of the present study was to compare the effects (short and long-term) of head position training with auditory feedback (AFB) and without it (NAFB) on the head control of children with cerebral palsy (CP). Six children (2.5 to 5 years old) were randomly assigned to two groups that were trained three times a week over two four-week training periods. Each group was trained with and without AFB, in a reverse order (cross-over). The children in group 1 received the AFB (buzzer) during the second training period, where as for the children in group 2, the AFB was given during the first training period. Each child was trained with a head position trainer (HPT) mounted on a helmet; the HPT was used to monitor the head position and to inform the child of his or her performance during group training sessions. The length of time the children were able to hold their head within a pre-set angle (time in zone) was used to describe their performance during training sessions and during the post-tests made at different times (up to one year) after training. Although AFB training was found to be more effective than NAFB training, our finding that head control could also be improved during the NAFB training period suggests that factors other than AFB (stimuli related to the group setting and to the helmet) are also likely to contribute to head control learning. Although three of the six children had the capacity to maintain the improved performance (carry-over) up to one year after training, no carry-over effects were displayed by the two children whose performance was closely dependent on the presence of the AFB. The role of auditory and other stimuli implicated in postural training is discussed in terms of training strategies designed to promote the best carry-over effects. The findings of the present study not only suggest that stimuli other than AFB might contribute to head control learning but also indicate that too much dependency on auditory feedback might interfere with carry-over effects and the generalization process.

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