W-Sitting And Your Child’s Growth

“W-sitting” is a position that is too commonly used by children when seated on the ground. In this position, a child sits on their bottom, with knees bent, feet tucked under, and legs splayed out to each side in a “W” configuration. Because this position is so common, most adults do not realize that use of this position can have negative ramifications on children’s growth and development.

Negative Effects Of “W” Sitting:

The reality is that this position can cause orthopedic problems, delay development of postural control and stability, and delay development of refined motor skills. For these reasons, its use is strongly discouraged.

Excessive use of a “W-sit” during the growing years puts undue stress on the hip abductors, hamstrings, internal rotators and heel cords, leading to the possibility of orthopedic problems in the future. “W-sitting” can lead to hip dislocation, and for children with pre-existing orthopedic conditions , these conditions can worsen when major muscle groups are placed in shortened positions. The muscles begin to tighten, and this can lead to a permanent shortening of the muscle, which can affect coordination, balance, and development of motor skills.

The “W-sit” widens a child’s base of support, resulting in less need for weight shifting, postural control and stability as they are playing, moving and reaching than in other seated positions. In addition to resulting in decreased trunk control, the “W-sit” does not require as much trunk rotation, which helps develop midline crossing and separation of the two sides of the body needed for bilateral coordination. Good trunk control and stability, midline crossing and bilateral coordination are needed to develop refined motor skills and hand dominance. Children require the opportunities to develop more mature movement patterns in order to develop higher level skills.

How to prevent W-sitting:

It is best to prevent children from developing this habit. However, we all know children who have already established this as a preferred seated position. When possible, anticipate and catch it before you see your child move into a “W-sit”. If and when you do see your child in a “W”, consistently encourage her to adjust to a different position by saying, “Fix your legs.”

Consistency is key. Make sure children know what some of their other options are so they can choose an alternative. Functional seated positions that will allow the child to develop trunk control and mature movement patterns include “tailor sit” (also called “criss-cross”), “long sit” and “side sit”. It is important for parents to teach and encourage alternate seated positions at home, and teachers to teach and encourage their students to use alternate seated positions at school. This encouragement will have positive effects on a child’s growth and development of foundational skills.

When playing with a child on the floor, hold his knees and feet together when kneeling or crawling – it is impossible to get into a “W-sit” from there. The child will either sit to one side, or sit back on his feet, and from there he can be helped to sit over to one side. Try to encourage sitting over both the right and left sides to promote bilateral development. Using various patterns of movements and positions demand trunk rotation and lateral weight shifting.

If 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. Sitting against the couch while playing may be one alternative, as well as using a small table and chair. A therapist will have many other ideas based on each individual child.




 

Marissa Edwards

Marissa Edwards, M.S., OTR/L is a licensed Occupational Therapist at North Shore Pediatric Therapy. She graduated from Rush University in Chicago with her Master of Science in Occupational Therapy, and decided to focus her career in pediatrics. Clinically, she works with children birth to adolescent, with a variety of diagnoses impacting skill development and daily function. She enjoys working with all children, especially through providing sensory integration therapy.

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8 replies
  1. Stephanie Puryear says:

    Melissa, This is great article. Great job!

    I hope you don’t mind but I added it to my Pinterest account, under “occupational therapy” board with credits to your work of course.
    http://pinterest.com/sensorysteps/

    I work as a small business owner in the Northweest Suburbs and I am now trying to expand to Los Angeles.

    I also have a blog/website. Please feel free to check out: http://www.sensorysteps.net/

    Stephanie Puryear, OTR/L

    Sensory Steps, Inc. (Illinois and California)

    &

    Center for the Developing Mind (California)

    Reply
  2. Marie Read says:

    Thank you for this article. Our daughter with a brachial plexus injury has been sitting this way. Reading this one sentence made sense of why she’s doing this for me: “The “W-sit” widens a child’s base of support, resulting in less need for
    weight shifting, postural control and stability as they are playing,
    moving and reaching than in other seated positions.” I can see now how encouraging her to use other sitting postures can help with her arm development.

    Reply
  3. S. E. says:

    When I was a young child (3 or 4 years old), I had a lot of trouble walking due to poor development of my leg muscles. For a while, I had to wear what my doctor called a shoe lift in order to walk properly. My feet and legs were in pain a lot of the time, and I would often have to be carried if I was walking more than a block. I am not sure if “sitting in the W position” attributed to this, or if it was the other way around. I still sit like this, because I was never discouraged from sitting this way. It has always been uncomfortable for me to sit in any other position, but now that I’m older, I understand why all my child care training recommended teaching children not to “W-sit.” I have back and leg problems that seem to get worse when I sit this way. Even my own children told me I shouldn’t sit that way. My oldest, at three years old, told me not to sit like that, and when I asked why, his reply was, “It rots your legs.”

    Parents and teachers, please discourage your children and students from sitting this way. It probably won’t rot their legs, but it will cause them unnecessary pain when they’re older.

    Reply
  4. Dawn says:

    i continue to correct my daughter when she sits this way and have been since she was itty bitty….she’s 3 and she still sits this way until i correct her…i don’t know what more to do? just keep encouraging?

    Reply
  5. Heather says:

    My daughter is 2 and sleeps in the “w” position. It is very difficult to correct this. Of course, I move her legs while I’m awake but once I go to sleep she will sleep in the “w” position for who knows how long. It is every night and nap time. Any suggestions? At her 2 year old well visit, the dr checked her alignment and showed me how to determine if her hips were getting out of line. That’s really the only thing he said I could do at this time. Agree?

    Her hips are aligned at this time.

    Thanks,
    Heather

    Reply

Trackbacks & Pingbacks

  1. […] W-sitting is a common way to sit for kids with low muscle tone and/or low core strength.  Instead of their legs crossed in front of them, kids with low tone or low core strength will sit with their legs splayed out to the side.  W-sitting is a way for kids to widen their base of support so they feel more stable when sitting and reaching for toys.  However, W-sitting can cause strain on the hips, knees and ankles and can also lead to in-toeing. Many children are able to correct the w-sitting habit with just a reminder to sit “pretzel” sitting or “criss-cross applesauce”. […]

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