W-Sitting

Every picture my parents took of me sitting on the floor below the age of 4 years shows me "w-sitting". What is w-sitting? It is when the child sits on the floor with his knees bent and his ankles are right next to his bottom...as if he had been kneeling and then just relaxed the feet out to each side. It is termed w-sitting, because looking at the child from a "bird's eye" view, the legs look like the letter "W". It is not good on the knees, hips, or feet. In fact I have awful knees probably because I was a big time w-sitter! They squeak when I bend over or walk up the stairs. If I go to aerobics class or walk a far distance, my knees ache for the next 3 days to the point that I can't sleep without pain medicine. So, I am not a fan of letting a child remain in a w-sitting posture for long lengths of time. I am now in my 30s but was told back in my 20s to quit jogging and aerobics classes or my need for a knee replacement would be sped up. So, I stick to biking, pilates, and yoga....wow, do I miss the adrenaline rush of a nice jog!



W-sitting is a posture that babies and toddlers use briefly as they move in and out of various postures. Little ones move so quickly, you will often see them transition from crawling, to sitting, to kneeling, to standing, back down to the floor, etc. So, w-sitting is not bad in and of itself. It is only not a good position if the child remains in that posture for long lengths of time, such as while playing with puzzles or watching television for 10 minutes. It puts unnecessary pressure on the knee joints and contributes to pronated feet (caving in at the ankles and collapsing at the arch). It can alter a child's balance and even make their gait look funny, especially while they run. My daughter tended to want to w-sit as a baby and toddler, and I had to redirect her quite often. I took her to a co-worker (at the time) who was a physical therapist and she gave us stretches and used kinesiotape to help with leg alignment.



Why do children w-sit? Most of the children use this posture because it is easy...it is less work for the trunk muscles because it widens their base of support. Some kids just prefer it just because. But many kids prefer it because they have low muscle tone (AKA hypotonia) or muscle weakness. It is common to see children with developmental disabilities such as cerebral palsy and down syndrome w-sit. I think that my daughter and I have mildly low muscle tone so that is why we have both been w-sitters. It is not uncommon for me to walk into a daycare (I do early intervention OT in natural environments) and see typically developing children using this posture. It does make me cringe, and oh how I want to correct the child. But I can't if the child is not my client. I can however educate the daycare staff about how w-sitting is not a posture that benefits children's gross motor development.



The following are some suggestions that I have found beneficial in reducing w-sitting in a baby, toddler, or older kid.

• For a baby, just correct their posture by placing them in kneeling, criss-cross (AKA Indian style for those of us raised in the 1970s & 80s), or a side-sitting posture
• For toddlers and children, encourage them to sit at a kiddy table and chair while performing fine motor activities such as coloring and puzzles. It is almost impossible to w-sit in a chair
• While the child (not baby) is playing on the floor, have a stool, bench, or tray (like a "breakfast in bed" tray) available. Have the child slide his legs under the device. Because these devices have "legs" or sides, then it increases the chances that the child will sit with his legs out straight to the front of him.
• If the child is in the "terrible twos" stage or is the type who likes control, then give him choices. When you see him w-sit, say "Would you like to fix your legs by sitting criss-cross or legs to the front?"
• Make up a silly song as a reminder. I made up a song titled "Legs in Front" to the tune of Frere Jacque. Then, as I only hummed the tune, my daughter was reminded of correcting her legs out of w-sitting
• Place toys to the side of the child so he will need to reach out of his base of support. This typically encourages a child to side in a side-sit posture (both knees are pointed towards one side or criss-cross style.
• Try not to nag the child by constantly saying "fix your legs" or picking them up and placing them in another posture. I find it best to set up the environment for success by using some of the above-mentioned ideas. Don't redirect the child if he will only be in the w-sit position briefly...if you do, he will tune you out everytime you redirect him...not good!
• There are probably many other ways to help with w-sitting but these are some common ones that I use
• If it is severe enough of a problem, then the child probably needs a physical therapy evaluation. The PT may suggest certain stretches, therapy techniques, furniture, or shoes to help the child
• If the child has sensory processing delays in addition to the low muscle tone, then the child may benefit from an occupational therapy evaluation. At http://www.sense-ablebaby.com/ there is loads of information on sensory processing problems seen in babies and some ideas to help.