Saturday, 17 February 2018

W-Sitting - What is it?

**** Please note - If you are concerned that your child sits in a w-sitting position on a long term basis, please seek advice from a trusted medical professional. ****

Prior to gaining L's ASD diagnosis, he would regularly sit with his legs in the shape of the letter "w." I'd often seen other children seated in this position as well but didn't really think anything of it, nor was I concerned about it.

L occasionally still sits in this position, especially when he has had a rough day, and I've since learnt that it really isn't the best position for children, or adults for that matter, to be seated in.

O also sits in this position on an occasional basis but not nearly as regularly as L does.



L's sitting position is a regular topic of discussion between ourselves and his Occupational Therapist. Over the past several years we, and his Occupational Therapists, have been doing a lot of work with L on sitting in other positions and on strengthening his core muscles.

So for those that aren't in the know, what is w-sitting?

W-sitting describes when a child is seated on their bottom, with their knees bent and legs splayed out to their sides in what looks like the letter "w." It looks awfully uncomfortable but L prefers this seated position to the more conventional crossed legged position. I've attempted to seat myself in w-sitting to demonstrate what it looks like and have had a lot of difficulty sitting down and getting back up - although this could be due to my age and lack of flexibility!

Children will often prefer a w-sitting position to sit in as opposed to other more challenging and tiring positions. The reason for this is that when seated in a w-sitting position a child does not need to engage their abdominal muscles. When seated in the more conventional cross legged position, a child must engage their abdominal muscles to stay upright.



When L sits in the w-sitting position we can see that his body appears to sag onto the floor. Now that we know what to look for, we can see that he doesn't engage his abdominal muscles at all. And he can sit in this position for longer periods of time with ease than other positions. When seated in the more conventional cross legged position, L tires easily as he has to engage muscles to stay upright. When seated in a cross legged position he needs to move around on a regular basis to offset the uncomfortable feeling that he gets from his tiring muscles.

Sitting in a w-sitting position provides a very stable base for the child's trunk and hips and therefore allows a child to move easily to play on the floor. However the movement is generally in a forward and backward motion as opposed to moving and turning from side to side. 

The tricky thing about the w-sitting position is that many typically developing children will, at some stage, sit in this position. What most parents, myself included prior to L's ASD diagnosis, do not realise is that excessive use of this position during a child's growing years may lead to future orthopedic problems.

One of the issues with the w-sitting position is that it does not allow or permit a child to perform trunk rotation, or twisting and turning, and lateral weight shifts, side to side motion, to reach toys on either side of the body.

The development of trunk rotation and weight shifts over to one side and to the other is vital in children as both assist in maintaining one's balance while running and walking as well as when climbing and playing on play equipment. It is also necessary for being able to cross our mid-line when writing, drawing, turning pages on books, dressing oneself and other similar skills.

Sitting in a w-position on a long term basis may cause orthopedic issues in a child's hips, knees and feet as well as tightness in the leg and hip muscles. I'd never made this connection until speaking with L's OT but it does make a lot of sense as the w-sitting position itself doesn't look like a natural position to sit in as the joints are bent in unnatural ways. Although in saying that L makes it look very natural!

If a child sits in a w-sitting position once in a blue moon, there is really nothing to be concerned about. However when it occurs on an ongoing basis, the child really should be re-directed to sit in a different position so that any potential issues with their joints and muscles are avoided.

So what alternatives are there I hear you ask and what are the benefits of other sitting positions?


Side sitting - This is when the child sits with bent knees and both legs are out to one side, one leg will be tucked under the child's bottom. If seated in this position, the child should really be encouraged to swap legs from side to side occasionally so that the muscles don't become tight on one side of their body. This position allows a child to maintain flexibility in their hips but it also forces a child to engage their trunk muscles!



Cross Legged sitting - This is the more conventional sitting position used by most children. They are seated on their bottom with their legs crossed in front of them. It is often referred to as "sitting with butterfly legs" or "criss cross apple sauce" legs! This is an ideal sitting position as it assists in stretching the muscles in the hips that can become tight with persistent w-sitting. It also assists in strengthening a child's abdominal muscles.


Circle Sitting - This is very similar to cross legged sitting however in this position the legs are not crossed but instead they form a ring in front of the body. Sitting in this position increases a child's base of support and therefore provides them with greater stability. This is a more stable position than cross legged sitting and is great for children when first learning to sit. Babies will often sit in this position to begin with as it is quite a natural way to sit.



Long Legged Sitting - This describes when a child sits with their legs straight out in front of them and slightly spread apart. Seated in this position can help in stretching a child's ham strings. It takes a lot of energy for a child to sit in this position if they are not used to it and if the child struggles to sit up tall or they need to lean back on their hands for support, it can be an indication that their hamstrings are tight.

Sitting against a wall - This position looks exactly like it is called. The child sits against a wall, or furniture, with their legs straight out in front of them. This position provides a child with the extra stability that they may need but also assists in stretching their ham strings.

We also encourage L to sit on a wobble cushion as he can move about if he needs to but he also needs to engage his abdominal muscles as he wiggles about on the cushion. He actually prefers to sit on the cushion as he sees it as a game! The wobble cushion is a win-win option - L has fun but he's engaging and strengthening his core muscles at the same time. Make therapy fun and children will want to participate!

As mentioned earlier, L's Occupational Therapists have been a god send in suggesting other options for L to sit in as well as other activities for L to engage in. We do still allow L to w-sit as he is incredibly comfortable in that position but it isn't on a long term basis. L is now at the point that when he does sit in a w-sitting position, he will often self correct.

And as mentioned earlier, if w-sitting occurs once in a blue moon there really isn't anything to worry about. It is a behaviour often seen in typically developing children. But as with other ASD traits, when it is an ongoing behaviour or action, that is when we need to be on the look out for options to redirect the child to use.

6 comments:

  1. Very informative post. These are small things but do make a difference in the long term. Thanks for sharing

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  2. This is really good to know as a teacher. I watch my kids sit like this all the time but have to ask everyone to cross their legs so they can all fit on the carpet together. I think it will be good to teach them as well so they are more aware of their own bodies. Thanks for sharing!

    Deb

    www.bookinspiredplay.com

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  3. This is quite an informative post. We weren't having much idea about W sitting. We knew it's not advised for kids to sit in W position but didn't know so many details about the same.

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  4. wish there were blogs like these when my kids were young. Oh well...grandkids.

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  5. This is so interesting! I would have never thought siting in the W position would be anything out of the ordinary.. will definitely be paying more attention to my little one!

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  6. I didn't know sitting W-shaped would ever be an issue. Thanks for the new info!

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