W-positions is one of many sitting positions that most children move
into and out of while playing, but it’s a four-letter word to some
parents. Why is it presumed to be ok for some children and forbidden for
playing in these other sitting postures, children develop the trunk
control and rotation necessary for midline crossing (reaching across the
body) and separation of the two sides of the body. These skills are
needed for a child to develop refined motor skills and hand dominance.
is not recommended for anyone. Many typically developing children do
move through this position during play, but all parents should be aware
that the excessive use of this position during the growing years can
lead to future orthopedic problems.
Why do children W-sit? Every
child needs to play and children who are challenged motorically like to
play as much as anybody. They don’t want to worry about keeping their
balance when they’re concentrating on a toy. Children who are frequent
W-sitters often rely on this position for added trunk and hip stability
to allow easier toy manipulation and play.
in the W-position, a child is planted in place or “fixed” through the
trunk. This allows for play with toys in front, but does not permit
trunk rotation and lateral weight shifts (twisting and turning to reach
toys on either side). Trunk rotation and weight shifts over one side
allow a child to maintain balance while running outside or playing on
the playground and are necessary for crossing the midline while writing
and doing table top activities.
easy to see why this position appeals to so many children, but
continued reliance on W-sitting can prevent a child from developing more
mature movement patterns necessary for higher-level skills.
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
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.
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.
are neurological 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.
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
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.
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 side lying. Tailor sitting against the couch may be one
alternative; a small table and chair is another.