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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Fine Motor Skills

Does your child have difficulty with fine motor skills such as writing and cutting? If so, then you'll probably find my next series of posts helpful. I'm going to be providing some resources, tools, and tips that will help with the development of fine motor skill and/or visual motor skills.

You may be wondering what the difference is between these two terms. Fine motor skills are the coordination of small motor movements in the hands and fingers that allow us to manipulate small objects with precise control. Fine motor movements usually occur in coordination with vision. This ability to coordinate motor movements with visual information is called visual motor skills.  

In order to be adept with visual motor skills, your child needs good vision and a strong foundation. That foundation begins with the stability of the trunk, shoulder, and neck muscles, also known as postural control. Development occurs from the trunk outward. For example,  a baby learns to roll over and sit up before they gain skilled control of their arms and hands. So if a child is having problems with visual motor skills, it's likely that they have some weakness or incoordination in the trunk, shoulders, and/or neck. That's why it's so important for infants to be exposed to plenty of tummy time from the first days of life. Tummy time and crawling play a big role in the strengthening of the important muscles that lay a strong foundation for future fine motor skills.

You can spot trunk weakness by noticing if your child frequently slumps with a rounded posture when sitting. You can also have your child lie on his stomach and ask him to stretch his arms and legs out and "fly like superman". If he has trouble assuming or maintaining this position, it's likely that there is some weakness in the trunk, shoulders and neck (also called the core muscles). Another good test of upper body strength is to "wheelbarrow walk" your child. See if he can propel himself without his arms collapsing while you hold him at the ankles or knees. An inability to do so also indicates muscle weakness.


If there is an issue with core weakness and incoordination, there are activities and exercises that your child can carry out that will strengthen these muscles. For the best result, at least 3 of these activities should be completed at least 3 times per week.


                                          Core Exercises

• Play tug-of-war by holding each others hands, or use a towel, rope or therapy band.
• Rowboat Game-You and your child sit on the floor facing each other and put your feet together. One of you lean back onto the floor without letting go of the other's hands, and the other pulls the partner back up, and continued.
• Play "Frog" by squatting, hopping, and squatting again.
• Crab Walk- Sit on the floor and place your hands on the floor behind you and lift your bottom off of the floor by pushing up. Propel yourself around the room like a crab.
• Wheelbarrow Walks- Holding child at the knees or the ankles.
• Squat to Stand- Stand up from a squatting position with arms outstretched, keeping heels on the floor and repeat. 
• Airplane - lie on your stomach and lift your head, arms and legs. Hold the position for as long as you can.
• Rocker- lie on your back, bend your knees and wrap your arms around your legs. Rock yourself back and forth.
• Traditional Sit-Ups- provide support at the ankles.
• Ball toss- have your child lie on the stomach on the floor, or over an ottoman. Have them pick up a ball and toss it into an empty box or garbage can. You can eventually use a slightly weighted ball or light wrist weights. 

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AND the winner of the 16-inch therapy ball is "Hetha" or Heather, former middle school teacher turned full-time mom. Please contact me ASAP so I can ship this out to you. Congratulations!

Sensory Processing Disorder Subtypes

As I wrap up this series on sensory processing, I’m going to talk a little about some of the “terminology” that is used in the classification of the particular subtypes of Sensory Processing Disorder (SPD). Each of the subtypes has particular characteristics/symptoms, and it is important to remember that most children with SPD don’t fall neatly in to one classification. Most have a combination of symptoms from the different subtypes. One term that is important to know as you start to read about the subtypes is “registration”.  Registration means the awareness of incoming sensations from the environment. Someone who under-registers sensory input (such as auditory, visual, touch, pain, and/or movement) needs more of that input in order to be aware of it. For example, if you under-register input, it is sort of like you are wearing gloves, earplugs, or sunglasses, etc.

If you over-register input, the input seems much more intense than it actually is. Sensory defensiveness falls under the category of over-registration, for example, touch can feel painful, and one can be over-aware of sounds and light.

A list of the subtypes of SPD follows with a brief description of each:

Sensory Over-Responsivity- A child with this subtype “over-registers” sensory input, and is easily overwhelmed by input, such as movement, sound, touch, smell, and taste. The body reacts by developing a fight or flight reaction. If the child develops a “flight reaction”, they might be classified as “sensory avoiding”. In that case, the child often attempts to control the amount of sensory input coming into his system, by withdrawing or holding hands over the ears).

Sensory Under-Responsivity- Children with this suptype “under-register” input and often appear lethargic. In school, these children may slump in their desk, and may not sense pain, pressure, or temperature as others do, but despite this, they will not crave or seek out sensory input.

Sensory Seeking/Craving- Children with this suptype also “under-register” input, and need or crave deep touch or pressure in order to “feel” input. These little ones often demonstrate behaviors such as pinching, biting, and hitting in order to seek out sensory input.

Dyspraxia- Praxis is the ability to plan out action for motor activities. With dyspraxia, a child has difficulty planning, coordinating and recognizing new or unfamiliar movements, and often appears clumsy and has difficulty sequencing any new motor movements.

Postural Disorder- A child with this subtype has low muscle tone throughout the body, and weakness in the core muscles, such as the trunk, shoulders, hips and back. These little ones often find it difficult to sit up straight in their desks at school and pay attention to task.

Sensory Discrimination Disorder- Children with this sub-type have difficulty recognizing and interpreting differences or similarities in specific types of sensory input. For example, they often have trouble distinguishing between similar items such as a nickel and dime, or a ping-pong ball and a golf ball.

As I said earlier, most children diagnosed with SPD don’t fall neatly into one of these subtypes, but exhibit certain symptoms from one or more of the categories. The most important thing to remember, is that dealing with SPD on a daily basis can affect one’s quality of life, and interfere with the ability to engage in the classroom activities, which impacts learning. If this is the case, it’s time to seek out a therapist trained in the treatment of SPD.

photostock photo from freedigitalphotos.net

Reference:

http://spdfoundation.net/

AND, the winner of the 2-CD "Calming" set drawing is....Martianne! Congratulations!!!