By: Julie Wilson, PT
During the development of motor skills, children experiment with many new and varied sitting positions. The first experience in sitting is usually on the lap of an adult. Soon use of varied car seats, carriers and swings enters the picture. As muscle development occurs, by around 6-7 months the typical child begins to experiment with sitting positions on the floor that reflect the level of independence and muscle control. Early floor sitting can be with legs in a “ring” with feet close together, one knee bent/one knee straight or sitting “tailor style” with feet crossed and close to the body. Each different sitting position reflects how much muscle control of the trunk the child has developed. Children usually move in and out of all the sitting positions easily as they begin to explore the environment.
One floor sitting position is known as “W” sitting. The child actually sits with the hips between the legs and feet. This happens in typical development and the child easily alternates it with other sitting positions. If a child always prefers W sitting and never explores other options, this is a red flag for parents or caretakers that there could be a delay in the development of muscular control of the trunk. W sitting is not recommended for anyone as it can lead to future orthopedic problems in the spine, hips, knees and feet. If used extensively, it can also disrupt development of upper body strength and control which can affect school performance and precise use of the hands.
The reason children may prefer “W” sitting and overuse it is usually because they do not want to worry about balance and stability. The legs in “W” position provide good, mechanical stability as it is unlikely that a child will fall over. The child becomes “planted” on the floor which allows use of the hands for play without having to balance. However, due to the position of the legs, rotating the body or moving from side to side to reach for toys is blocked. Rotation of the body and weight shifts to the side are what develop balance skills to allow mature walking, running, jumping and skipping to appear. They also help the child learn to cross the midline which is essential for learning to write and read.
Continued reliance on W sitting can also negatively influence the maturation of the shape of the bones to the final adult shape and joint positions. It can predispose hip dislocations, muscle tightness and further movement problems. For children with disrupted movement, it further reinforces abnormal patterns of movement leading to bad habits that are difficult to correct. W sitting can discourage development of a hand preference as the child may pick up items on the left with the left hand and on the right with the right hand which discourages use of the hands across the midline.
Independent moving in and out of W sitting is in a straight forward/backward movement. No balance is required from the trunk as the hands are usually on the floor for support until the W position is reached. The child may “bunny hop” with the arms moving forward together at the same time rather followed by both legs “hopping forward “ at the same time rather than develop true crawling on hands and knees with the arms and legs alternating. If the child does not properly crawl, there is a higher risk of poor balance in large motor skills, higher risk of poor eye/hand coordination and fine motor skills and a higher risk for problems with reading and writing in school.
If you notice that your child is overusing W sitting or failing to sit with the legs in other positions, encourage verbally and with hands-on help if needed to move them into other positions. Try to eliminate W sitting as soon as you notice it and stay consistent to correct it by helping into other positions. Saying positive cues like, “Legs in front!” or “Fix your legs!” will have better results than saying “Don’t sit like that!” Use of a small table and chairs can also be more well received and is usually enjoyed by most kids. Be sure your child is reliable to not fall off the chair by using a positioning/safety belt if needed. When playing with your child on the floor, hold the feet together which will encourage sitting towards one side or moving from side to side rather than pushing straight back into W sitting. Be sure to go over both the left and right sides when practicing this. If your child cannot sit alone on the floor in any position other than W sitting, be sure to talk to your therapist to find an alternative seating plan.
Avoid getting into a power struggle with your child while trying to offer other positions for sitting. A successful and independent sitting position must be provided if taking away W sitting if that is the only independent sitting position your child has on the floor. Distracting your child to a really fun activity will help make the transitions easier. Using a sticker chart or other reward when your child will “self-correct” with a verbal cue to a better sitting position can also have positive results. Making it into a fun and successful adventure will put smiles on the faces of all!