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If You See Your Children Sit In This Position, Immediately Stop Them!

Who should not w-sit? For many children, W-sitting should always be discouraged. This position is contraindicated (and could be detrimental) for a child if one of the following exists:

There are orthopedic concerns. W-sitting can predispose a child to hip dislocation, so if there is a history of hip dysplasia, or a concern has been raised in the past, this position should be avoided.
If there is muscle tightness, W-sitting will aggravate it. This position places the hamstrings, hip adductors, internal rotators and heel cords in an extremely shortened range. If a child is prone to tightness or contractures, encourage anther pattern of sitting.
There are neurologic concerns/developmental delays. If a child has increased muscle tone (hypertonia, spasticity), W-sitting will feed into the abnormal patterns of movement trying to be avoided (by direction of the child’s therapist). Using other sitting postures will aid in the development of more desirable movement patterns.
W-sitting can also discourage a child from developing a hand preference. Because no trunk rotation can take place when W-sitting, a child is less inclined to reach across the body and instead picks up objects on the right with the right hand, and those placed to the left with the left hand.

Try sitting in various positions. Notice how you got there, got out, and what it took to balance. Many of the movement components you are trying to encourage in a child are used when getting in and out of sitting. Transfers in and out of the Q-position, however, are accomplished through straight-plane (directly forward and backward) movement only. No trunk rotation, weight shifting, or righting reactions are necessary to assume or maintain W-sitting.

How to prevent W-sitting. The most effective (and easiest) way to prevent a problem with W-sitting is to prevent it from becoming a habit it the first place. Anticipate and catch it before the child even learns to W-sit. Children should be placed and taught to assume alternative sitting positions. If a child discovers W-sitting anyway, help him to move to another sitting position, or say, “Fix your legs.” It’s very important to be as consistent as possible.

When playing with a child on the floor, hold his knees and feet together when kneeling or creeping on hands and knees. It will be impossible to get into a W-position from there. The child will either sit to one side, or sit back on his feet; he can then be helped to sit over to one side from there (try to encourage sitting over both the right and left sides). These patterns demand a certain amount of trunk rotation and lateral weight shift and should fit with a child’s therapy goals.

If a child is unable to sit alone in any position other than a W, talk with a therapist about supportive seating or alternative positions such as prone and sidelying. Tailor sitting against the couch may be one alternative; a small table and chair is another.