Activities for Training Infant Sitting
Training Lap Sitting[edit | edit source]
Training lap sitting starts by determining the level of support an infant needs to maintain their trunk and head erect and steady when sitting on a caregiver's lap.
- Observe how and where the caregiver provides manual support, and the infant's postural response to this support.
- Often a small adjustment of the caregiver’s support makes a big different to the infant’s ability to keep the head and trunk erect.
As shown in the image below, when sitting on the caregiver's lap, support can be provided at the level of the axilla, lower thorax, waist and pelvis.
You can also check the level of manual support the infant needs when supported in sitting on a flat surface. The following image shows manual support provided at the level of the axilla, waist and the pelvis.
Activities to Train Lap Sitting[edit | edit source]
After determining how much manual support an infant needs to sit erect with relative ease, you can explore ways to adapt the environment to encourage visual reaching and exploration, social engagement and reaching in different directions. These activities challenge the infant’s postural and balance responses.
If the caregiver is not providing support that allows the infant to keep their upper trunk and head erect and steady with relative ease, show them how to change their manual support in a way that provides more effective support.
If the infant is not able to hold their head erect, even with support at the axillae, adjust the position of the manual support to make it easier and possible to keep the head erect.
- Let the caregiver lean back a little so that the infant's head can rest against the caregiver's chest.
- Encourage the caregiver to adjust their manual support so that the infant can keep their head steady, but ensure the infant still has to put some effort into maintaining the position.
Providing an infant with something to look at usually stimulates the infant to put effort into stabilising their head. Engaging with someone who has an animated face and voice can captivate an infant’s attention and increase their effortful control.
Once the caregiver is able to support the infant to sit erect, hold their head up and look around, you can encourage the infant to reach for, and grasp, a toy or a moving hand.
Caregivers can move their hands, so that they are providing less support than usual. This challenges the infant’s abilities to steady their head. Providing less support when lap sitting, and as part of everyday handling and social interactions, also provides infants with an opportunity to practise maintaining a steady head and trunk in different situations.
Training Sitting on a Flat Surface with External Support and Arm Propping[edit | edit source]
Once an infant can maintain their head and trunk erect when sitting with manual support around the waist or pelvis, it is time to explore their ability to sit erect on a flat surface using external support. This can be provided by 10-15 cm high firm flat sofa cushions, foam blocks or boxes (see image below).
- A foam block or firm sofa cushion is positioned on either side of the child, with the block in contact with their buttocks and lateral aspect of their thighs and chest.
- Another block is positioned behind the child.
The raised surface on either side makes it easier for the child to use their hands to prop on. This helps keep the trunk erect and also increases the base of support (BOS) in a lateral direction.
Then, encourage the child to reach for toys, that are placed either on the support surface between their legs, or on the raised surface provided by the blocks.
Reaching to the side for toys within easy reach[edit | edit source]
Once the child can maintain sitting erect with lateral block support, start to encourage them to reach with one hand to toys placed within easy reach. Remember to alternate between the left and right side. As the child’s sitting stability and balance improves, progressions include placing the toys a little further away, sometimes further forwards and further back, which requires some trunk rotation.
Reaching further than arm’s length is achieved by a coordinated action between the trunk leaning in the direction of the intended reach, and lifting and extending the arm. This coordinated trunk-arm action is learned through repeatedly exploring different ways of getting the hand to the toy. It may involve many failed attempts and falls.
Falling is an important part of learning to balance in sitting[edit | edit source]
Falling happens when a child explores different strategies for extending their reach and, in doing so, sometimes moves their centre of pressure too close to the edge of their base of support. Typically developing infants do not seem to be to worried about falling.
Reducing the amount of external support[edit | edit source]
Sitting with block support is progressed by moving the blocks a small distance away from the pelvis and thighs. This removes the external support provided to the pelvis, so the child has to learn to maintain balance without external support. This may lead to an increase in falls to the side. However, the presence of the raised surface means that the distance of the fall is small and makes it easier for the child to push up on the arms.
Training Independent Sitting and Transitions to Prone Lying and Kneeling[edit | edit source]
Once the infant is able to sit without any external support, they should be provided with many opportunities to sit and play with a range of toys and other interesting objects of different shapes, sizes and weights.
- Start by placing toys in different positions but still within easy reach.
- The child’s ability to activate anticipatory and compensatory postural responses to maintain a steady upright position and maintain balance is challenged by picking up, moving and manipulating toys.
- As the child’s ability to reach for objects within easy reach improves, move the toys a little further away so that the child needs to combine trunk leaning or rotation with shoulder flexion to make contact with the toy.
- Backwards falls are still common, so it is useful to put a pillow behind the child.
Training Moving from sitting to prone kneeling[edit | edit source]
Infants move from sitting to kneeling in one of two ways.
- Reaching far forwards and taking weight on the hands.
- In this sequence of movements, moving the weight from the buttocks onto the hands and knees requires the momentum produced by a rapid forwards movement of the trunk.
- Rotation of the trunk and reaching across the body.
Importance of motivation to move and play with toys[edit | edit source]
An infant’s interest in interacting with toys and other interesting objects provides the impetus for learning to balance in sitting. Reaching actions create perturbing forces that are counteracted by anticipatory and compensatory postural responses that are important for maintaining balance. It is important to find the right toy to motivate the child to move in order to challenge their abilities and encourage persistence to achieve goals.
Resources[edit | edit source]
- Development of Sitting
- Newborn Perceptual Motor Behaviour
- Family Centred Early Intervention and Diagnosis
References[edit | edit source]
- Sangkarit N, Siritaratiwat W, Bennett S, Tapanya W. Factors Associating with the Segmental Postural Control during Sitting in Moderate-to-Late Preterm Infants via Longitudinal Study. Children. 2021 Sep 26;8(10):851.
- Pin TW, Butler PB, Cheung HM, Shum SL. Relationship between segmental trunk control and gross motor development in typically developing infants aged from 4 to 12 months: a pilot study. BMC pediatrics. 2019 Dec;19(1):1-9.
- Kretch KS, Koziol NA, Marcinowski EC, Kane AE, Inamdar K, Brown ED, Bovaird JA, Harbourne RT, Hsu LY, Lobo MA, Dusing SC. Infant posture and caregiver‐provided cognitive opportunities in typically developing infants and infants with motor delay. Developmental Psychobiology. 2022 Jan;64(1):e22233.
- Franchak JM. Changing opportunities for learning in everyday life: Infant body position over the first year. Infancy. 2019 Mar;24(2):187-209.
- Mlincek MM, Roemer EJ, Kraemer C, Iverson JM. Posture Matters: Object Manipulation During the Transition to Arms-Free Sitting in Infants at Elevated vs. Typical Likelihood for Autism Spectrum Disorder. Physical & Occupational Therapy In Pediatrics. 2022 Jan 9:1-5.
- Corbetta D. Perception, action, and intrinsic motivation in infants’ motor-skill development. Current Directions in Psychological Science. 2021 Oct;30(5):418-24.
- Soska KC, Adolph KE. Postural position constrains multimodal object exploration in infants. Infancy. 2014 Mar;19(2):138-61.
- Rachwani J, Santamaria V, Saavedra SL, Woollacott MH. The development of trunk control and its relation to reaching in infancy: a longitudinal study. Frontiers in human neuroscience. 2015 Feb 24;9:94.
- Kyvelidou A, Stuberg WA, Harbourne RT, Deffeyes JE, Blanke D, Stergiou N. Development of upper body coordination during sitting in typically developing infants. Pediatric research. 2009 May;65(5):553-8.
- Maki BE, McIlroy WE. The role of limb movements in maintaining upright stance: the “change-in-support” strategy. Physical therapy. 1997 May 1;77(5):488-507.
- Atun-Einy O, Berger SE, Scher A. Assessing motivation to move and its relationship to motor development in infancy. Infant Behavior and Development. 2013 Jun 1;36(3):457-69.
- Rachwani J, Soska KC, Adolph KE. Behavioral flexibility in learning to sit. Developmental psychobiology. 2017 Dec;59(8):937-48.