I have spent many years working with children with special needs and one of the most challenging activities for many of them to initially acquire is the ability to sit by themselves. Once they acquire the ability to sit their opportunities for inclusion increase dramatically. This is the reason why I find this to be a very important topic.
In this post, I will focus on the child over the age of 12 months, in this way you can easily know how to integrate the needed skills. Since all children with special needs are unique and possess different complexities I recommend you consult with your child's physical therapist before applying these activities at home. Your therapist can help you customize the activities to suit your child's needs.
The activities that I suggest are based on opportunities that with repetition will help your child gain the desired skill.
Today I want to share with you a list of the TOP 3 ways to help your child gain the ability to sit.
1) WHILE GETTING READY IN THE MORNING PRACTICE SITTING
I know that we have minimal time in the morning, but rethinking your strategy when getting your child out of bed can create an opportunity to practice a quick new skill. The bus comes in the morning, all the members of the house need to get up and dressed, teeth brushed, lunches ready and breakfast did prior to leaving the home. I know this can be very hectic.
Typically we need to help our children with special needs get dressed, by bringing them to the edge of the bed and holding their trunk up rather than laying them down to put the shirt on we are creating a new opportunity to learn how to sit. Now if every time your child needs to get a change of clothes, especially the shirt and you help him/her sit up while getting the task done, you are increasing the amount of daily practice for these skills. Remember a little can go a long way.
2) USE THE ADAPTED CHAIR TO PRACTICE SUPPORTING THE TRUNK
For this activity, you will be sitting in front of your child while he/she is on the adapted or regular chair with a back support and side railings. If your child's chair has chest straps take them off ONLY for the duration of the activity with supervision. Once you are done practicing with your child place the straps back. Place your hands lightly at the hips and/or trunk of the child, increasing and decreasing your support as you see your child respond to the given cues. This will assure that he/she won't fall but rather have some time to strengthen the trunk muscles with the support from the back from the chair and the side rails. Once the two of you are comfortable, engage in a nice conversation, or play the "I see, I see the game". Have a preferred toy available to actively engage and motivate your child to lift the head. Talking and/or singing also helps. My favorite is singing, sometimes I just can't help it 😄. This will help your child engage the trunk while moving forward and backward in an attempt to balance, maintain sitting, and be able to engage in the game with you. You are not just stimulating your child sitting skills but you are stimulating your child's cognition which is crucial for further progress.
3) PRACTICE SITTING ON A REGULAR CHAIR
When finding a chair to practice make sure the chair is not deep on the seat, as this will drop the pelvis backward and limit the ability to feel safe while sitting. Also, your child will be struggling with head control if the back of the seat is too deep. Find a seat in the home where the chair is not too big or too small. In the beginning, you want to make sure that your child can sit with a straight back and the back of the knees touch the corner of the seat. If the chair is too deep and doesn't allow for the back to touch the child place some pillows behind allowing them to touch his/her back to sit upright. Make sure you are sitting next to or in front of your child, this will be mostly for safety and/or in case he/she loses balance. For the first month, you will need to have your hands continuously on your child. Be sure to integrate the activity on a weekly basis, as your child needs continuous repetition for learning. When you start noticing that you don't have to hold your child as much, learning is happening, this is an exciting time.
All these activities provide a great amount of practice to reach the ability to sit. For the child that has not practice the skill of sitting with minimal support, sits regularly in a recline position, or has not sat upright on a regular chair, these three activities can initially be very challenging. Therefore, be very patient. But giving your child the opportunity to initiate this process will go a long way.
SHOULD YOUR CHILD USE AN ACTIVITY CHAIR?
For the children that have not practiced being upright, I recommend first practice sitting using an activity chair. The chair will allow for your child to be re-position back or forward when working up the tolerance to the straight sitting position. Observing the changes in blood pressure is imperative for children with minimal experience in sitting. This is the reason why consulting a physical therapist will be important prior to starting any new routine.
There are many different types of activity chairs in the market. The chairs can have many different setups allowing for growth and progress of the child's sitting ability.
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2. 3. 4.1.Tomato Soft Seater, 2.Rifton Hi/Lo Activity Chair, 3. Kaye Activity Chair, 4. Tumble Form Seater
These are not the only chairs in the market, there is a great variety of them. Above is just an example of what you could find.
I hope the information helps you. Remember Activity and Participation are KEYS to SUCCESS.
When you integrate the activity into your child's daily routine he/she can learn in a non-stressful way.
If you are looking for some additional help to help your child move forward give us a call today.
Karen L. Crilly PT, DPT, MAPT, CBIS
karencrillyphysio@gmail.com
https://www.facebook.com/KarenCrillyPhysio
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