Twenty five children diagnosed with benign congenital hypotonia (BCH) between infancy and 2 years of age were examined at 6 to 8 years of age and compared to 26 controls, matched for sex, age, and weight, in a study at the School of Occupational Therapy, Hebrew University-Hadassah Medical School, and Child Development Institute, Jerusalem. Sensory, visual-perception, visual-motor integration, and behavioral measures were similar in the 2 groups, but the BCH group showed impairments in gross motor performance, bilateral coordination and strength on the Oseretsky Test of Motor Proficiency, despite recovery of near normal muscle tone. 
COMMENT. Children diagnosed with benign congenital hypotonia in infancy should be reexamined at intervals through early childhood and should receive extended occupational and other therapy to build muscle strength, balance, and coordination. Hypotonic infants may appear to recover near normal tone by 6 years of age but demonstrate clumsiness and generalized muscle weakness on tests of motor proficiency. My own clinical experience would substantiate these findings. Whereas the office neurological examination appears normal, the mother complains that the child lacks normal stamina, tires easily on extended walks, and often wants to be carried. The symptoms described are sometimes suggestive of a possible myasthenia.