Independent sitting requires strong neck, shoulder, and core muscles. It also requires balance and good proprioception (feedback from joints and muscles to your brain). Vision can also play a role in developing sitting skills. A key goal for sitting is to be able to use your arms, hands, legs, feet and head while in that position. This requires a lot of practice using and coordinating movements in various sitting postures.

In the earliest stages of development nondisabled children take anywhere from 4 to 9 months learning to sit independently. For children with significant disabilities this can be a much longer process. They need regular and systematic support to achieve this very important skill. Active Learning, because of its intensive focus on movement, can help work on this important skill outside of specific therapy time, increasing the practice time so necessary for the student. 

Your physical therapist is an invaluable support in developing a plan to work on sitting. Discuss strategies and activities that will meet your individual child's needs. Here are just a few ideas to show that working on sitting can be done in a variety of environments and activities:

    • Spend time working in prone on a Support Bench to increase core and shoulder muscle strength and improve head control. 
    • While positioned on his/her back, have the learner reach up for objects overhead using a Little Room, Mobile, or Echo Bucket. 
    • From lying or supported sitting, reach up and clasp an adult's hands to play hand games.

Practice being in an upright position is important. In addition to activities done while in supported sitting, use a HOPSA dress with the student and have varing surfaces (both texture and height) underfoot.

Balance is a part of sitting as well. Some children who have vestibular issues, may have great difficulty feeling secure in a sitting position. 

Activities to work on independent sitting might include:

    • sitting on an ESSEF board and playing with items on an Activity Wall,
    • shifting weight to maintain an upright position in a HOPSA dress, 
    • sitting in front of or in the lap of an adult and rocking side-to-side and forward-backward, or
    • lying on his back and coming to sitting with support (check with your PT about specific strategies).

Children with some vision can be encouraged to hold their heads up by placing visually interesting items on mobiles in front of them while they are in prone or supported sitting.

Some children because of cerebral palsy or other conditions may not ever achieve independent sitting.  Yet they may be able to improve their overall skills in this area if given plenty of opportunities to practice daily. Below are a number of examples of children sitting while engaging in a variety of activities.

Sitting in an Adapted Chair

Sitting on an Essef Board

Sitting with Legs Extended

Sitting with Back Against an Essef Board

Sitting on a Therapy Ball

Sitting on a Resonance Board

Sitting in a Chair

 

Sitting in an Adapted Chair

Photo courtesy of the Narbethong State School in Queensland, Australia.

A girl in supported seat with active learning materials on both sides. A young girl sits with legs extended in an adapted chair.  Her left hand rests on a wooden cage with balls inside.  Her right arm is positioned next to hanging metal chimes.

 

 

 

 Sitting on an ESSEF Board

Photo courtesy of the Narbethong State School in Queensland, Australia.

Boy sitting in Active Learning classroom. A boy sits on an ESSEF board with a position board in front of him.  A textured ball is under his left hand and a tray of colorful flashlights is located on his right side.

 

 

 

 

 

 Sitting with Legs Extended

Photo courtesy of the Narbethong State School in Queensland, Australia.

A girl sits independently in a Narbethong classroomA girl sits with her legs extended and a reflective "space blanket" on her lap.  A large mirror is positioned directly in front of her at a slight angle.

 

 

 

 

Sitting with the Back Against an Essef Board

Photo courtesy of the Narbethong State School in Queensland, Australia.

A girl sits next to a position board.

 A girl sits with her back against an ESSEF board, with her left hand resting on a position board with strands of different colored beads.

 

 

 

 

 

Here are some simple environments you can make to work on balance and movement while in a sitting position.

Sitting on a Therapy Ball

While the child is sitting on a therapy ball and bouncing, hang objects in front so the child can reach out to engage with them.

therapy ball dowel rod photo 1

 

 

 

 

 

 

 

 

Video demonstration of the therapy ball activity

Sitting on a Resonance Board

Position the child sitting on a Resonance Board with a variety of items that can be manipulated by taking out, putting in, taking apart, and so forth. This also allows the child to visually or tactually search for various items to play with, an important skill for orientation and mobility.

sitting act photo 1

Video demonstration of play while sitting on a Resonance Board 

Sitting in a Chair

sitting skates photo 1Place the child sitting in a chair with roller skates on his or her feet with massaging board and cookie sheet underneath.  As the child moves their legs (in a seated position), they can listen to and compare the sounds. They also can experience simply rolling their feet on the ground. The added weight of roller skates also helps to strengthen the legs. If you don't have skates, consider using shoes with taps or adding things to the bottom of the child's shoes, such as metal washers or coins, or tape soda cans to the bottom of their shoes. These can create great sounds!

Another variation is to use a chair with on wheels, such as an office chair, and let the child wear skates as you help push him or her along. The child can feel the vibration of the wheels on the floor or surface and the movement of the chair.  Of course it is always important to stay close to the child during this type of activity, when the chair is not secured.

 

 

 

 

 

 Video example of play with skates while sitting in a chair

Sitting on Drums

KaydenSittingDrumDescription: In this video we see a 5-year-old girl seated on a stack of two gathering drums. After playing with the drums, she is introduced to a Meinl Helix Bowl, which she explores.

 
Downloads: Transcript (txt) Audio (mp3)

 

Collage of Promoting Sitting