What is it? W-sitting is a common sitting posture in children. It is a sitting position with knees bent, feet tucked under, bum on the floor between the legs and legs out to either side. When looking from the top it looks like a “W”. Although common, this position has negative effects and should be discouraged.
Why do they sit like this? If children have poor core strength to control their upper body, they might sit like this because it is more stable with a wider base of support. The child might also sit like this with a wide support so that less balancing is required.
Why is it bad? If you look at why the child is doing this, it eliminates what is difficult for the child, therefore, that skill isn’t developed and improved. This is a very stable position and the child might be hesitant to get out of it. This stands in the way of play and exploration. This negatively impacts the muscles and joints involved including the pelvis and hips. It prevents midline crossing and the two sides of the body working together (bilateral integration) leading to poor fine motor coordination in the long term.
When do we worry? This is a common position in children but we expect them to grow out of it around the age of 6. If the child plays solely in this position or if the child struggles with functioning then it becomes a problem.
What should you do? Encourage different sitting positions like sitting with the legs outstretched, side sitting, crossing legs or on a chair or stool. You can also try to determine the cause and work on things such as core strength.
I’m sure you are all aware of the new little garden promotion. If you’ve been living under a rock or actively rebelling against the idea, Checkers has a promotion where you get a seedling kit for every R150 you spend.
So what do plants have to do with occupational therapy? It’s AWESOME! This teaches children the concept of plants, knowing there are categories such as vegetables, herbs, flowers and fruits. It teaches children that the food you feed them doesn’t magically appear, there’s a long process before it gets to your plate.
Besides learning about the concepts, the actual planting process is exciting! The soil is in a strange round pod and once water is added it puffs up like magic! The child learns responsibility, these plants need to be watered very regularly, if they aren’t, the plant dies- as simple as that. This kind of cause and effect is vital to learn to take accountability. Checking to see if the seeds have come up, which plant grows faster, the types of leaves, the types of flowers, are all visual learning opportunities. You are bound to get doubles and this presents the opportunity for the child to use social skills to trade with friends.
The only thing I am a little disappointed in, is that the seeds come in a paper sleeve. This is to ensure the seeds are spaced well. I wish the children could see the seed, touch it, and compare it with the others. Fortunately, if you’re just as excited as I am, you will get doubles and have the opportunity to open one or two of these packets. Don’t get me started on the tools and toys available to accompany the seeds! I personally appreciate that the tools are functional and actually strong enough to use! The toys create an opportunity for pretend play and role-playing. I’m not saying go buy all the merchandise, just look for ways to take this opportunity even further to let the children learn as much as possible while having fun.
Hopefully readers have come to appreciate how essential occupational therapy is since I’ve waxed lyrical about OT’s every week. I hope I’ve convinced you by now, but do you know when it’s time to call in an OT?
Unfortunately, most people don’t know what occupational therapists do, this includes doctors, teachers and other therapists who refer to us when necessary. Educating parents, family members and friends can go a long way to get help to people who need it.
I can’t cover all fields of OT so I’ll focus on children... for now!
I recommend considering consulting an OT for assessment when a child displays one or more of the following symptoms: “Zones out” or daydreams often; Is very “busy” to the point that it affects function; Is over emotional or under-emotional; Displays defiant behaviour; Seems anxious; Has difficulty making friends; Is delayed in milestones such as sitting, standing and walking; Has difficulty learning things other peers are learning like potty training, riding a bicycle or cutting with scissors; Has extreme reactions to loud sounds, cannot cancel out unimportant, continuous sounds; “Doesn’t listen” when being talked to, cannot understand verbal instructions; Shows a strong aversion to people touching/kissing them and unexpected touch causes a severe reaction; Cannot tolerate being picked up, swinging or being moved around; Always chooses to keep still instead of doing physical activities; “Talkers” who can stall and talk themselves out of any challenge; Initiates an activity enthusiastically, struggles and immediately gives up.
Please keep in mind this is not a complete list of absolutely everything that needs treatment. Consult an OT if you have concerns instead of hoping it’ll just go away.
It might go away, yes, but it might also snowball into a very big problem. Early intervention is key. After all, OTs are so awesome, who wouldn’t want to be seen by one?
It has been suggested that people who are aware of their sensory systems and how to regulate themselves has a greater impact on success than a high IQ score.
We all know the basics: smell, taste, touch, sight and hearing. We also have two “unseen” senses: vestibular and proprioceptive. Our vestibular system in our ears helps us to balance, to know where our head is in space. Proprioception is the feedback from your muscles and bones to know where your body is in space. This helps you to know how hard to push, how far to reach and move. In most cases vestibular input (like jumping up and down) wakes you up and proprioception (like a tight hug) is calming. The magnificent part is, these senses are all interlinked. If one system is weak, the others compensate for it, think of a blind person with a sharpened sense of hearing. Without realizing it, you do things to regulate your system to keep yourself calm and alert. You know when a child “wipes” off a kiss at family meetings? The child isn’t being a brat, this child is sensitive to the light touch of a kiss and they remove this unsettling sensation by replacing it with deep pressure.
We each have our own sensory preferences. When you are upset, someone giving you a tight hug might be the best thing on earth, or maybe this sounds like your worst nightmare! Ever notice how you are very irritable and suddenly become hyper-aware of a label in your shirt? You might not realize why you’ve suddenly turned into the hulk yelling at your family when really the neighbour’s barking dog has upset you. Our sensory system is so much more than this quick description but I hope you’ve found it interesting. Try being more aware of your senses and the environment around you and what you can do to make it feel right.
A little known fact: Occupational therapists can work in the mental health sector.
We all know someone with depression, if you think you don’t, I can assure you, they just haven’t shared it with you.
So if a person with depression decides to seek out your support by taking the courageous step to speak out, please, for the love of all that is good, DO NOT say any of the following:
I know exactly what you mean!
I felt so sad last month and I get super depro over sad movies!
You just need to make up your mind to feel better.
Snap out of it!
But you have no reason to be depressed.
Have you tried chamomile tea/probiotics/standing on your head and singing “you are my sunshine”?
So many people have it so much worse than you do.
My aunt’s husband’s half-brother has depression and you are nothing like him!
I can go on with my list for days, but let me attempt being helpful instead.
Should a loved-one share how they are feeling, try saying something like this:
Thank you for sharing this with me.
I love you.
Is there anything I can do to help?
Would you like a hug?
Is there anything I can take care of for you? E.g. Shopping, driving kids around.
Please call me any time you need me.
If you don’t know what to say, don’t say anything.
Your loved-one might just need someone to sit with them. Be mindful that depression alters the person’s perspective, they don’t choose to feel this way, and they feel isolated and don’t know how to feel better. Your support and understanding could make the world’s difference.
I adore seeing a parent putting in effort to spend time with their child. I find it so special that they see the value in taking time from their busy schedule to build a relationship instead of just ensuring the child is “kept busy.”
Although I find it very special, the occupational therapist can’t help but wonder if the child really wants to go shopping with mommy or if she just desperately wanted that time with mom.
First off, well done for spending time with your child, now, let’s kick it up a notch. Imagine your husband has been working overtime for weeks and you rarely see each other. He promises you a date night to make up for it. You’re excited all week, get dressed up and… he takes you to the golf range. You go along with him because you love him but can’t help thinking of a hundred better things you could be doing together.
Similarly, your child might just enjoy your attention rather than enjoying going shopping or going to a coffee shop. I challenge you to let your child choose whatever he or she wants to do. Try not to limit it to things you want to do. Set boundaries e.g.: Something that isn’t too far away, costs less than x amount, won’t take longer than x hours. You will be able to turn down ideas that won’t work logically without breaking the enthusiasm.
Your child might surprise you by wanting something you’ll really enjoy. If your child is completely overwhelmed, give suggestions of activities you know they like for example reading a story, building a puzzle, colouring, baking or having a picnic. In this way you are building a solid relationship, showing that you care what they want and instil in them that quality time doesn’t have to be expensive or complicated.
Monday: Music lesson and tennis practice. Tuesday: Revue practice and reading class. Wednesday: Extra math classes. Thursday: Soccer or Netball practice. Friday: Art. Saturday: Sport matches. Sound familiar? I can imagine you are tired from shuttling your child to and from all these extracurricular activities, never mind how the child must feel!
The child has already struggled through 6-8 hours of school only to be put into more structured and pressurized situations. Then once the day’s activities are done, the daunting task of completing homework still lurks. Children, especially younger children aren’t meant to function in a classroom for so long and don’t get me started on homework! Unfortunately, there is nothing I can do as an occupational therapist to take on the entire school system, but I can make suggestions for the time at home. Now, don’t get me wrong, these activities are probably better for your child’s development than school. I feel children need to play. No, not playball, actual, do what you want, no rules, whatever you feel like play. Educational toys and puzzles are good too, but in moderation because the line can easily be crossed from a fun way to learn to another forced, stressful task.
I’m not saying pull your child from all afternoon activities, push them into the garden and lock the door. If these activities are the only way your child gets away from a screen, maybe a busy schedule is the better alternative. Tune into your child’s motivation regarding these activities. Consider why the child is unhappy and if there’s a valid reason. Maybe your child just didn’t inherit your musical skills or daddy’s love for sport, and that’s okay. Find activities your child enjoys and that adds value to his or her life and allow your child to find other things to do at home before starting homework. But don’t tell the teachers the occupational therapist said so!
The combination of Easter weekend and the school holiday has increased the amount of time parents and children spent together over the last few days.
Whether the whole family was squashed into the car for a holiday or just into your living room, this sudden “closeness” can test everyone’s patience! So to keep the children quiet and content they are handed the tablet, a movie is turned on or a new computer game is introduced. After all, they’re happy and you also get some peace right?
Technology has many advantages and opens up so many opportunities. Unfortunately, like everything in life, it does have a dark side or should I say blue side? It has been found that the blue light emitted from screens has a negative effect on the quality and quantity of sleep. It prevents the release of melatonin which is the hormone indicating the time for sleep. Experts suggest turning off electronics about an hour before bed. When children use electronics, they remain in the same position for long periods of time. They don't move around to exercise their muscles or experience their body moving through space and all the things I'm always carrying on about.
This sedentary lifestyle is also leading to an increase in childhood obesity. There may be many educational games that look brilliant but learning colours on a tablet doesn't compare to colours in the real world, fine motor exercise on a smartphone is no match to learning movement during play and the fantastic stories from movies aren't nearly as stimulating as your child's own imagination.
Banning electronics from the household is too idealistic. Face it, you wouldn't be happy about losing your phone either. I do suggest implementing time limits before we're all big blobs like the characters in Wall-E!
Let me start by saying: I am not a paediatrician, psychiatrist, neurologist or any kind of doctor. Thank goodness. I will never have to make the call whether or not a child should be prescribed Ritalin.
I am an occupational therapist. I see the effect of hyperactivity on the functionality of children and how difficult it can be for a family with a hyperactive child.
I find people are either strongly for or strongly against this medication. Ritalin can have different effects on children. In too large doses it has a severe effect, too little has no effect, just like Panado, water, literally anything we put into our bodies. It is important to work with your doctor to get the right dosage.
Now, Ritalin vs. Concerta: it contains the same ingredient, methylphenidate! The difference is Concerta is slow-release so multiple doses throughout the day isn’t necessary. So, it depends on you which works better for you.
The long-term effect of this medication isn’t known for sure. Studies have suggested that it can have a detrimental effect on children’s development if taken under the age of 23, as the brain hasn’t fully developed.
I agree Ritalin can have an impressive impact and it definitely has its place. Children need to be able to learn in school. If the foundation isn’t established well, school can be very hard. I just think there needs to be therapeutic intervention before medication is prescribed. Occupational therapy to improve attention and regulate sensory systems can be very beneficial to aid school performance. Basically, it’s a serious decision to make, not a miracle drug and quick fix, but can be wonderful when used correctly.
In the beginning of school, the teacher’s report lays a lot of emphasis on the child’s scissor skills. So, what’s the big deal? And should Jimmy be cemented at the table cutting up all your ‘Saries’?
Yes, it is important to learn how to use scissors, but this is actually an indicator of many factors coming together. Using scissors takes muscles in your arms and trunk working together and all the small muscles in the hand and fingers working hard. It takes visual skills, co-ordination, and bilateral integration (two hands working together.)
Stages in learning to cut:
1. Random snipping.
2. Free cutting of random shapes.
3. Cutting on a broad, straight line.
4. Cutting on a narrow, straight line.
5. Cutting on a curved line.
6. Cutting a simple, straight shape – square, triangle, rectangle.
7. Cutting a circle.
8. Cutting a simple outline of a picture.
Jimmy’s teacher says he can’t cut and you’re stressed. Cut it out (pardon the pun), it can be worked on. Games and projects involving tearing is a good place to start.
Play with playdough and even cut the playdough with blunt scissors.
Do fine motor activities such as screwing nuts onto bolts, beading, all those classic “good for you” games that involve picking up small objects and two hands working together.
So no, Jimmy doesn’t have to sit at the table and cut a stack of your old magazines, focus on the building blocks to get there instead. If it continues, take your child for assessment at an occupational therapist!