Shayna Gavin, Splash Principal Physiotherapist
Do we worry about w - sitting?
Why do children use w - sitting?
Children who w - sit often do it because it's a stable position, requiring little muscle activity, so they can free up their hands to play or eat. Some children use it to be steady so they can think, communicate and be social.
There's a lot of great info and ideas in this article from the Inspired Treehouse about children who w - sit.
We keep an eye on children who w- sit and monitor how they learn to move.
In w- sitting children can't shift their weight to reach out to the side or across their body (the midline), nor develop balance reactions to control this. Often cihldren using w - sitting have difficulty in controlling their trunk or hips, or balance reactions, or generating enough muscle activity to keep them upright. Often children with 'low tone' use w - sitting because it's one way for them to get upright and stable to play or eat or communicate.
It can be an indicator of developmental issues if a child has difficulty using other sitting positions as well as w - sitting. Getting an opinon from a paediatric physiotherapist who works with children with neuro - developmental queries can be helpful to get ideas for learning a variety of sitting positions and balance reactions.
Notice a child's strengths
It's good to note that if a child is using w - sitting exclusively, it does mean they've been able to problem solve to find a way to sit upright and free up their hands! And if that's the only way they can do it at that time, then well done for working it out. That's definitely a strength.
Learning what's next
And as always, once something is learned we then want to help the child move on to the next stage. In this case it would be other sitting positions that allow for balance reactions, shifting weight to the side, and reaching out to the side or across the midline.
Other sitting positions we like to learn include:
cross- legged sitting ('pretzel' sitting in the USA)
sitting on a low bench or stool
The Inspired Treehouse has a free printable handout about w - sitting you might find useful.
I do have 2 things to add that I think are important:
1. Participation is the most important goal.
We never take something away without giving the child another option.
eg. If w - sitting is the only way a child can currently sit up, then we aren't going to stop them just yet. We'll help them develop the components of movement they need to be able to sit in a variety of positions.
2. Fear of problems down the track is not my main reason for changing w - sitting
Yes, we are interested in shifting w - sitting because we want a child to develop more variety and control over their movement. But I'm not terribly concerned that it could lead to flat feet. (There is some association between low tone, w - sitting and flat feet. That doesn't necessarily mean that one thing caused the other). We also used to worry that w - sitting stretched the inner knee. From what I've learned over the last few years in speaking with orthopaedic surgeons, this doesn't seem to happen. (Important to note that I don't have a good scientific study to prove either of these points definitively).
So yes, we would like to say goodbye to w - sitting.
But we want to do it:
when the child has another sitting option they can function in to participate in their environment;
to help them develop balance, weight shift and reaching to the side and across the midline in sitting on the floor and at a table. These skills in sitting have transfer to dynamic balance skills in: standing; reaching; walking on different surfaces; throwing, catching and kicking balls; climbing on the playground equipment; playing sport... You name it :-)
Shayna Gavin is a physiotherapist who is passionate about helping babies, children and young people learn functional skills so they can participate in life at home, school and in their community. Recognising that children do best in their own environments, she visits homes, schools, and leisure activities from football fields to ballet classes. She also has daily aquatic physiotherapy sessions available at two private swimming schools in Moonee Ponds and Greensborough, Melbourne. She combines principles of paediatric physiotherapy, Neuro Developmental Treatment / Bobath, motor learning, Sensory Integration and swimming teaching to address the individual needs of each child and their family. She loves providing professional development to physiotherapists, allied health and education professionals, allied health assistants and swimming teachers.