W-Sitting, by SouthPaw's OT/writer Deanna Macioce

This article was sent in Paw Print, which is the e-mail newsletter of of South Paw at http://www.southpawenterprises.com/
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The W’s of W-Sitting

Deanna Macioce, MS, OTR/L 


We have all seen those toddlers who are playing with cars or dolls in the common position of “W-sitting”.  And since we see it so often in young children, we may not see it as worrisome, however for many children if left unaddressed long-term “w-sitting” could lead to some overall developmental issues.  With that said, this month’s focus is not to alarm, but to increase an awareness while providing some useful and tactical information for parents, teachers and therapists of the many children who find the position of “w-sitting” comfortable.

Although this is a common position to find a toddler sitting in, it comes with many implications of why it is not good.   For those children who move in and out of the position for short periods of time, it can be looked upon as just a typical playing position that the child will outgrow.  However, for many of the children we see in the therapy world, it can have a greater effect on a child’s overall development  “W-sitting” inhibits exploration, does not allow for proper strengthening of the trunk, and keeps children confined to play only in midline. Effects of long-term “w-sitting” include hamstring tightness and tibial torsion and even hip dislocation. In addition, because it inhibits trunk rotation it also causes overall decreased balance and trunk control.  The lack of trunk mobility causes children who utilize this position on a regular basis the inability to cross midline and explore as much during play.
 
One of the most common reasons children hang out in this position is low tone.  Early on when children begin to crawl, you often find them stopping in the “w” position regardless of tone issues because they require a wider base of support at this stage.  However, as they get stronger, you should be able to see them transition into a proper ring sitting position with ease.  For the children who present with lower tone, they still require a wider base of support and will utilize a “w” due to ease, comfort, and stability.  In addition, many of the children who do “w-sit” also present with tighter hamstrings, making it difficult and uncomfortable to sit in long sitting, “crisscross applesauce”, or ring sitting.

Ways to naturally work on correcting this it to utilize a toddler chair for sitting activities as much as possible, encouraging a 90-degree position of the hips and knees. When using larger chairs where the child’s feet do not touch the ground, the use of a stool will help obtain this position.  Many children will be able to correct this position with verbal cuing, so you may often hear a parent, teacher or therapist use the phrase, “fix your legs” to cue the child to choose a different sitting position.

Ultimately, to help children move out of this position, choosing activities that strengthen the trunk and improve overall stability are beneficial.  Those would include things such as the use of an exercise ball, yoga, and balance activities.

Exercise/therapy ball activities are great for trunk strengthening; from performing activities while sitting on the ball that encourage trunk rotation to using the ball for completing sit-ups, these are excellent ways to engage trunk muscles and work on balance.  Activities performed in high kneel, such as drawing on a draw erase board or completing a bean bag target throw activity will also nicely engage that trunk muscles for strengthening.  In addition, using a balance board for activities in sitting, such as completing a puzzle, or standing to play catch or Zoomball will also achieve this.  Kid yoga programs, including Yogarilla from Super Duper are a fun way to introduce children to the overall core strengthening and attention improving art of yoga.

For those low tone children with tight hamstrings, performing leg stretches or utilizing target toss activities with obtaining bean bags from the floor or low stool with straight legs will help to loosen up the muscles.  In turn, you find children are able to maintain the position of “criss-cross applesauce” with more ease.

Therefore, although “w-sitting” is very common among all children, similar to nail biting, it is one of those habits that if addressed early can really making a difference in overall development, especially for children with lower tone. 

 

Jul 23, 2012 | Category: Occupational Therapy | Comments: none

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