W-sitting is one of the many sitting positions that most children move in and out of while playing, but there are reasons it should be discouraged if your child is demonstrating a preference for it.
So why do some children tend toward W-sitting?
Young children need stability in sitting in order to play. They especially need to have a stable base of support at the center of their body when using their arms and hands to manipulate toys and other objects away from their body. W-sitting provides a wider base of support and therefore that added trunk/hip stability and balance control that they seek. In particular, children who are motor challenged resort to this sitting posture for that very reason.
It provides them the most stability that then allows more controlled manipulation of toys. What most of us don’t know, however, is that excessive use of this position during the growing years can lead to future orthopedic problems.
There are other problems as well. When a child W-sits, they are planted or “fixed” throughout their trunk. This will allow for play with toys in front of them, but does not promote trunk rotation (twisting) and lateral (side-to-side) weight shifts. Try it yourself. Sit in various positions. Note how you got there, got out, and what it took to balance.
Many of the movement components we encourage in children are used when getting in and out of sitting. Transitions in and out of W-sitting, however, are accomplished through forward and back movement only. No trunk rotation, weight shifting, or righting reactions are necessary to assume or maintain W-sitting. These important movements are also critical for balance while running and playing safely on the playground.
These same components also promote the ability to cross midline during writing and other table-top activities. Children who have difficulty crossing midline tend to pick up objects on their right with their right hand, and objects on their left with their left hand. This can delay the development of a true hand preference. Other sitting positions (i.e. tailor sitting, ring sitting, long-legged sitting) allow for rotation, weight-shifting, crossing midline and separation of the two sides of the body. These are important gross motor skills, but are also necessary for the support of fine motor skill development and hand dominance. So you see, continued reliance on W-sitting can prevent a child from developing more mature movement patterns necessary for higher-level skills.
While all children should avoid prolonged use of this posture, who is at particular risk?
- Children with orthopedic concerns – W-sitting can predispose a child to hip dislocation. If there has been a history or concern of hip dysplasia, this position should be avoided.
- Children with muscle tightness – W-sitting puts the hamstrings, hip adductors, internal rotators and heel cords in a shortened range. If a child is prone to tightness or contractures, encourage another pattern of sitting.
- Children with neurologic concerns/development delays – W-sitting will facilitate abnormal patterns of movement in children with hypertonia or spasticity (increased muscle tone). In children with hypotonia (decreased muscle tone), W-sitting will promote imbalanced muscle integrity around weight-bearing joints. Using other sitting postures will benefit the development of more desirable movement patterns.
So how do you prevent your child from W-sitting?
The most effective way to avoid a long-term problem of W-sitting is to prevent it from becoming a habit in the first place. If you see your child tending toward W-sitting, reposition them in an alternative sitting posture. This can be accomplished during transitions into sitting from kneeling or creeping on hands and knees by holding the knees and feet together as getting into W-sitting from here will be impossible. Your child will either sit to one side or back on his feet. He can also be assisted from there into ring or tailor sitting.
These are the patterns that demand a certain amount of trunk rotation and lateral weight shift. You can also use prompts such as, “Fix your legs” or “Where do your feet go?” If your child is unable to sit alone in any position other than W-sitting due to motor, muscle tone or orthopedic issues, talk to your Pediatric Therapies physical therapist about supportive seating or alternative positions such as prone, sidelying, tailor sitting against support or table and chair sitting.
While W-sitting can provide stability for some children, it is not an optimal posture and can result in later developmental difficulties. If you have concerns about your child’s motor performance or mobility, please contact Pediatric Therapies for answers. We’re here to help!