What's wrong with W-sitting?



W-sitting is when a child sits on their bottom with their knees bent and feet positioned outside of their hips. In this position child sits on his bottom and knees are bent, feet tucked under and legs are splayed out to side, what looks a “W”.



In this position child’s base of support (BOS) is wider and his centre of gravity (COG), is lower allowing for increased stability through the pelvis and trunk.
Children find this position convenient for play as they do not have to work on maintaining their balance while concentrating on the game or task in hand.



                     Why is W-sitting problematic for children?


While sitting in this position, children cannot achieve active trunk rotation, and cannot shift their weight over each side. Weight shifting and trunk balancing are important aspects for developing core strength and midline crossing skills (essential for handwriting and hand dominance).
Due to affected midline crossing development, bilateral coordination is also affected, the skill essential for doing two handed activities such as skipping, throwing, catching, kicking, buttoning, doing laces or ties.

                               Consequences of W-Sitting


•    Hips and leg muscles to be shortened and tight.

•    Back or pelvic pain

•    Pigeon toed walking or in-toeing (feet turned in while walking)

•    Flat foot

•    Difficulties performing two-handed activities (e.g., buttoning)

•    Poor hand preference or dominance (e.g., handwriting difficulties)

•    Lack of cross body movements (e.g., throwing, catching)

•    Limited trunk movements (e.g., copying from the whiteboard)

•    Likelihood of hip dislocation (if child has hip problems)


                             Strategies to prevent/improve W-sitting


PRONE SITTING
Children do W-sitting when core strength is an issue. Reduced core strength causes poor posture and over-compensation of other muscle groups.

The following strategies can be helpful minimising W-sitting posture: -

1.Encourage a child to sit in different ways, such as: -
•  Prone position (on stomach and forearms)

•    Criss-Cross Sitting (Crossed Leg Sitting)

•    Side Sitting (alternate sides)

•    Long Sitting (feet straight out front)


CRISS-CROSS SITTING
2.Ask the child to get up and bring something from next room such as cushion, favourite toy or game.

3.Remind the child to “fix their legs” whenever you see them sit in a W position.
SIDE SITTING

4.Alternate ways to sit such as a beanbag, low chair, pillow, to sit on, or suggest him to lie on his tummy.

5.Exercises such as stomach crunches, the plank can be beneficial in improving core strength.

6. Anticipate and catch it before the child tries to sit in W-sitting.

LONG SITTING
7.Offer the child a small chair or stool as an alternative to sitting on the floor.









We should expect young children to move in and out of positions when sitting on the floor - that is natural and the way kids stay alert and learn to manage their bodies in space. Just as one size does NOT fit all, one sitting position will never accommodate the sitting needs of all children. Young children learn best when their bodies are safely and comfortably positioned!



References:

American Journal of Occupational Therapy: http://ajot.aota.org/


The Pathways. Org: https://pathways.org/

Image source: Google images