Friday, October 7, 2011

Prevent W-Sitting

I work as an occupational therapist in the school system, and I cringe every time I see a student “w-sitting”. Are you familiar with the term “w-sitting”? This is when a child sits on the floor with his knees bent, his bottom on the floor, and his lower legs splayed out on either side of his bottom. Just imagine if the child were in a tall kneeling position, spread his ankles apart, and plopped down on his bottom. If you look at a child sitting in this position from the top down, the legs form the letter “w”. (As you can see, I've worked with a student who found a way to "w-sit" on a therapy ball...Yikes! Of course, I got him out of this position right after I took the photo!)

During normal development, babies sometimes briefly move in and out of “w-sitting” when transitioning from one position to another, and this is nothing to worry about. The problem occurs when the little one remains in that position for an extended period of time, for example during floor play or while watching television. Staying in this awkward position for too long puts excessive pressure on the knee, hip, and ankle joints. Constant exposure to this position can lead to future orthopedic problems, such as poor posture, tight hamstrings, or even hip dislocation.
Why do children w-sit? Many children sit like this because it feels more stable than other sitting positions. Because the “w” position of the legs widens the child’s base of support, the trunk or core muscles don’t have to work as hard to keep the child upright. Children with hypotonia, or low muscle tone tend to prefer the stability of “w-sitting”. This is not good, because when in this position children tend to avoid shifting their weight and rotating the trunk while playing. Weight shifting and trunk rotation play an important role in balancing, crossing midline and using both hands together, skills that provide the foundation for hand preference and the development of fine motor skills.
Here are several suggestions that you may find helpful in reducing “w-sitting” in youngsters:
  • With babies, alter their position to kneeling, side sitting, or sitting cross-legged.
  • With toddlers and preschoolers, have them to sit in an appropriately sized chair that is pulled up to a small table for fine-motor activities such as playing with blocks or coloring.
  • Give the child an alternative by saying “would you rather sit like this or this?” and demonstrate appropriate seating positions.
  • Use a low tray as the work surface and have the child position her legs straight out in front of her under the tray.
  • Use a verbal or gestural cue to remind the child by saying “sit nicely”, or “legs in front”. This keeps it positive, rather than saying, “don’t sit like that”.
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1 comment:

  1. Could you please provide a link to a peer-reviewed article on W-sitting? I haven't been able to find anything on PubMed. Thank you!