Sitting is a very important developmental milestone and allows a child to be upright independently for the first time in their life. It is also a very challenging skill to learn for some children. Sitting requires a child to learn how to keep their head and trunk upright while maintaining a bent position at their hips. This is a more mature and difficult motor pattern than when a child is keeping their whole body bent or conversely keeping their whole body in extension (like standing). It is very important for children to learn dissociative movement patterns like sitting and crawling because they help build the foundation for higher level coordination and mobility skills.
Prop sitting is the first skill that will likely emerge when a child is getting ready to sit. This type of sitting involves a child sitting on their bottom with both of their palms on the floor in front of them. Prop sitting typically develops around the age of 4-5 months old. In the prop sitting position a child will have their neck extended to keep their eyes looking ahead but their back will mostly be flexed. A child starts to develop extension strength in a cephalocaudal (head to buttocks) manner and you will start to see their upper back (thoracic spine) start to straighten out and then their lower back (lower thoracic and lumbar spine) straighten out.
A child needs to be able to activate their trunk flexors (muscles in the front of the body) and extensors (muscles along the back) at the same time and in a balanced manner in order to sit fully upright. This is called coactivation and involves the agonist and antagonist muscles (muscles on each side of the trunk) working together to keep the trunk stable. If a child can activate these muscles together without one side overpowering the other then the child can learn how to sit upright with their hands off of the floor. Independent sitting skills emerges between 5-7 months old.
If your child is having difficulty maintaining their balance in sitting, don’t panic – try these exercises to help strengthen their tummy, back, shoulder and hip muscles so that your child can thrive in this new upright position. If you have any questions please feel free to contact me.
The exercise below is one that I give to almost all of my patients. It is so important for a child to develop rotational based movement patterns and for them to strengthen their postural muscles – and both of these can be accomplished with the floor to sit transition exercise
This exercise is great for strengthening all of the muscles in the trunk – if your child has weakness throughout their entire trunk you can practice all of these positions. If you child is only weak in the flexor muscles (the muscles in front of their body) you can focus on tilting them slightly backwards to get them to better engage their flexors.
The next exercise is a great exercise for children who are just starting to work on sitting activities. This activity allows them to place weight through their forearms to help stabilize their trunk while they develop enough strength to keep themselves upright. My favorite trick is to use an amazon box – placing a child’s feet and legs inside of the opening and having the child rest their arms on the top of the box.
