Course:KIN355/2020 Projects/Unassisted Sitting
Defining the Concept and Its Importance
Unassisted sitting can be defined as when a child is able to “sit independently with hands freed from a supporting role” (Adolph & Franchak, 2016, p. 2). It is often one of the primary motor milestones reached by children and is expected to be achieved by approximately 6 months of age (Adolph & Franchak, 2016; Deffeyes, Harbourne, Kyvelidou, Stuberg, & Stergiou, 2009). When there appears to be a large delay in the child achieving motor milestones, including unassisted sitting, there may be reason to suspect deeper developmental issues (Holst, Jorgensen, Wohlfahrt, Anderson, & Melbye, 2015). To illustrate, it has been found that very low birth weight infants achieve the unassisted sitting motor milestone at a later age than their normal birth weight counterparts (Gabriel et al., 2009). It is necessary to have children reach and develop these motor milestones, as early movement ability sets the foundation for further development (Bredin, 2020b).
With regards to the importance of unassisted sitting in the context of childhood movement experiences, “new or improved motor skills bring...new or enhanced opportunities for learning and doing” (Adolph & Franchak, 2016, p. 1). Once a child learns to sit unsupported, they gain access to using their hands to touch and grab at the environment around them. It has been found that children who are able to sit unsupported have greater success with the individuation of objects, and the learning of their surrounding environment (Woods & Wilcox, 2013). As the child gains the skill of unassisted sitting, their opportunities for learning are broadened, given the freedom in their upper body to reach and touch, as well as their heightened eye level and ability to gaze at the world around them with more emphasis (Adolph & Franchak, 2016). They are afforded the opportunity to partake in play such as exploratory play, through which they are able to learn about their own bodies, as well as various objects and their environments (Bredin, 2020a). It is essential that individuals working with children understand the importance of the motor milestone unassisted sitting, as these motor behaviours may be encouraged by interacting factors, including the environment provided by instructors, or caregivers for the child (Adolph & Franchak, 2016). The development of unassisted sitting can have prolonged consequences, in that it may affect the child's further motor development, and have cascading effects on other domains of development, such as cognitive skill (Adolph & Franchak, 2016). Given that a “growing body of research indicates connections exist between action, perception and cognition in infants” (Cashon, Ha, Allen, & Barna, 2012, p. 802), the implications of these findings can be corroborated to the importance of unassisted sitting in children. In fact, unassisted sitting in children, and the learning of this motor ability has additionally been found to correlate with other cognitive processes and skills of the child, such as holistic face processing, exemplifying the impact that the development in this motor domain can have on additional developmental domains (Cashon et al., 2012).
Role in Childhood Development and Contemporary Considerations
Unassisted sitting has a great impact on childhood development and the development of proficient performance of movement. To begin with the foundation of the child’s ability to sit unassisted, posture is of the utmost necessity. This necessity is supported in a paper written by Kyvelidou et al., as it is stated that “during the acquisition of the simplest form of a skill, such as sitting, postural control is the primary goal to be successful” (Kyvelidou et al., 2009, p. 553). Posture is one of the most critical foundations that needs to be acquired for movement ability to be expanded and built upon (Adolph & Franchak, 2016). Postural control itself is the integration and interaction of multiple components of an individual’s central nervous system, making it complex (Kyvelidou et al., 2009). By a child reaching the motor milestone of unassisted sitting, not only are they demonstrating that they have built a foundation for posture, they are enabling themselves to continue to grow their strength and postural ability further. Frequently exhibited trajectories of development in children follow a pattern of “increasingly erect postures over an increasingly small base of support” (Adolph & Franchak, 2016, p. 2), showing that through each phase, unassisted sitting included, posture and musculoskeletal strength allowing the child to maneuver a shrinking base of support are being developed. This is one of the reasons as to why it is critical for children to reach the motor milestone of unassisted sitting, and why it is critical for educators and caregivers to facilitate the environment to foster this ability.
A primary reason as to why the development of this postural stability and the acquisition of unassisted sitting is so important to motor and other developments is because it enables the child to learn more from the world around them (Adolph & Franchak, 2016). Sitting upright enables the child to view the environment by which they are surrounded from a much higher vantage point, as well as frees their arms to enable them to reach for and touch objects (Adolph & Franchak, 2016). It has been found that once unassisted sitting has been achieved, “more sophisticated bimanual object exploration is possible because head, arms and hands are free to move” (Adolph & Franchak, 2016, p. 3). When a child is able to pick up or reach for an object, it allows for further exploration and learning, contributing to healthy development.
With regards to the physical development of the child and unassisted sitting, it has been hypothesized that a critical factor in a child learning to sit independently is their learning to control their thorax overtop of their pelvis in an aligned manner (Kyvelidou et al., 2009). This requires musculoskeletal development through the pelvis as well as the core of the child, as control of the upper body and the hold of this upright position must be maintained by activating this musculature. Not only does unassisted sitting require the development of musculature, but the acquisition of this skill contributes to further musculoskeletal development of the child through his or her environmental exploration, lifting objects and turning his or her head to take in novel sights.
One of the contemporary issues that individuals working with children should be aware of is the cultural differences that affect the age at which children are able to sit unassisted (Adolph & Franchak, 2016). It has been found that children born into cultures where it is common practice for mothers to routinely participate in exercise and massage rituals with their children are able to sit without support earlier, and with more stability, than children born into cultures where this does not take place (Adolph & Franchak, 2016). Prenatal environments such as intrauterine growth restriction, stress, and smoking may also play a role in later acquisition of motor milestones such as unassisted sitting, and so are important to be aware of (Holst et al., 2015).
Additionally, later unassisted sitting acquisition in children has been correlated with a greater central adiposity (Neelson, Oken, Taveras, Rifas-Shiman & Gillman, 2012). Although there are challenges to studying the concept, it is suggested that early activity and acquisition of motor milestones, such as unassisted sitting, may be associated with lower rates of obesity in children as well as other health outcomes (Neelson et al., 2012). Given the recent rise in childhood obesity globally, it is important for individuals working with children to support them in reaching these motor milestones to assist in fostering a healthy development.
Practical Applications
As mentioned above, unassisted sitting can develop in about 6 months of age (Adolph & Franchak, 2016; Deffeyes, Harbourne, Kyvelidou, Stuberg, & Stergiou, 2009). The most important prerequisite to developing this motor milestone is postural control (Kyvelidou et al., 2009). Posture can be defined as the integration and interaction of multiple components of an individual’s central nervous system to create generally a standing position (Araujo et al., 2017; Kyvelidou et al., 2009). Posture is the most critical foundations that needs to be acquired for movement ability to be expanded upon otherwise a child may delay motor skill acquisitions. In order to develop adequate posture, the infant needs to learn how to support the weight of their head (Saavedra, Donkelaar, & Woollacott, 2012). In early life, infants are mostly in supine or prone positions. The best way to develop head control and get out of these positions is by developing strength in the vertebral column as well as muscles of the arms and neck (Saavedra, Donkelaar, & Woollacott, 2012). This can be achieved through propped sitting, which is when a child is sitting on a flat cushioned/soft surface, using their hands, legs, feet, and buttocks to support the weight of their body (Coley, 2016). The child will not be strong enough to maintain posture independently or have the necessary head control to fulfil this yet so with the help of their arms and legs, musculoskeletal growth in these areas will assist in keeping their head and body upright. If the child wobbles and falls over, this is totally normal; just make sure the infant is comfortable with continuing as this is a necessary process where proprioception and body awareness are developed through wobbling (Saavedra, Donkelaar, & Woollacott, 2012). Proprioception is the perception or awareness of the position and movement of the body in the environment (Bredin, 2020c). Body awareness must be understood by the child in order to move forward with motor skill acquisition because it affords an opportunity to understand what balance and unbalanced means in relation to their own body, their own limits of what movements can and cannot be sustained, and knowing their position in space to support the head with the rest of the body. Once proprioception is understood and can work synchronously with postural control, then the infant can achieve unassisted sitting.
Unassisted sitting is the ability to "sit independently with hands freed from a supporting role" (Adolph & Franchak, 2016, p. 2). Some recommendations to develop this skill are as followed:
1) Tummy time
Dedicating time towards an infant laying on their stomach is an initial recommendation to get the child prepared for unassisted sitting (see image 1). This is a crucial first step because it allows for gross motor development, which will build a foundation for the rest of the motor milestones to come (Dudek-Shriber & Zelamy, 2007). The activity is targeted for infants who are less than 6 months old, where the main concern is to build the strength to maintain head control. The only equipment required is a soft surface for the infant to lay on as well as a toy or book of interest to the child. Having them lay on their tummy while doing an activity in that sustained position is the main objective and only instruction. Modifications can be range from different toys, activities, or surfaces. Once head control and postural support are strengthened through tummy time, the infant can move onto the next activity.
2) Crawling pathway
In order to build adequate postural control to develop unassisted sitting, the spinal cord along with the head must work in conjunction to maintain posture. This is an expansion to tummy time but is an active activity where the infant needs to crawl towards a toy, learning to use their hands, legs, and body to generate movement. The biggest indication to knowing when a child can sit independently is by judging their posture (see image 2). By using this crawling pathway activity, it will force the child to develop the necessary strength to crawl, combined with the ability to hold the head up, which can then be furthered advanced into propped sitting later. This activity will help with muscle development and head control which are skills that can be transferred into unassisted sitting. The target age is 5-8 months because tummy time should be experienced first before advancing. What is required for this activity to be successful are a soft surface, a toy at the target destination, and a parent or caregiver nearby for encouragement. This game can be done inside or outside and can be switched up with anything that interests the child enough to reach and move towards it.
Instructions: Identify a pathway that is safe for an infant to crawl on, preferably on a soft mat or carpet (see image 3). A toy that is of interest to the child is needed for the activity. Have the infant positioned on one end of the pathway and the parent holding the toy on the other end of the pathway. Begin to call at the infant to crawl towards the parent and toy until they reach the designated area. This activity is meant for the child to practice using their arms and legs while maintaining head support throughout the process of crawling, which will later help with unassisted sitting.
3) Stabilized sitting with dangling toy
As the infant shows progress with their balance and stability, the child needs to be sitting on the parent or caregiver’s lap and in an upright position for this activity. This way, the child will be supported with the help of their guardian and can develop strength in the spinal column without wobbling or falling over. The next step is to have a dangling toy, similar to a cat toy (see image 4), where it will intrigue the infant to reach forward. The purpose of this activity is for the child to sit upright, maintaining an erect posture where balance of the spine and head control can be advanced further. Next, by having a toy that is of interest to the child, it will encourage them to reach forward and try to grasp at it. This is especially beneficial because it will help the child understand what proprioception and body awareness are through wobbling, which will provide important feedback to the individual. Wobbling can be translated into proprioception knowledge as well as balance capabilities, therefore, will further the infant's understanding of where their body is in space while maintaining their position. Furthermore, having head control is crucial to unassisted sitting so this is an activity that will allow the child to sit upright, develop the necessary muscles to sustain this position, and eventually lead to sitting independently when the muscles are fully developed in the necessary areas. The target age is after 6 months or when spinal cord strength can be produced and maintained. The apparatus needed is a soft cushion that covers a big surface area (such as a bed or a sofa), a parent to hold and support the infant, and a dangly toy. A modification that can be made to this activity is by removing the dangling toy and using anything that will strike interest to the child and cause them to reach for the toy.
Instructions: Locate a cushioned area that the parent can sit in, preferably a bed or sofa. Have the infant sit on your lap and stabilize them by keeping them in between your arms. Use a dangly toy, hold it in front of the child. While shaking the toy, verbally encourage the child to try to reach for it, including production of additional stimuli that will attract their attention to try to grasp the toy. As their vestibular system is not developed yet, make sure to hold on and carefully watch the infant, making sure you assist them in maintaining an upright posture but still giving them a chance to develop balance independently.
4) Unassisted propped sitting
Once the infant gets more comfortable with these skills mentioned in the first three activities, it is necessary to decrease parental support. This can be done by encouraging propped sitting, while still being nearby, but removing physical assistance to the infant to sit upright (see image 5). To reiterate, propped sitting in when an infant sits on a cushioned flat surface, using their extremities as well as body to support their weight. Propped sitting is an indication that independent sitting will be developed in the mere future. With that being said, the purpose of this activity is to determine whether the previous games were successful in developing head control, postural support, and musculoskeletal strength to produce unassisted sitting. Not to mention, this activity leads to further independence for the child.
Wobbling will occur during this activity because the infant is still developing the strength to support themselves through proprioception. Subsequently, this will eventually lead to the ability to sit upright independently. Having a toy right in front of them also challenges them by creating feedback to maintain both posture and interaction with the toy. The target age for this specified activity is 8+ months. The equipment required is either a toy or book. Modifications depend on the child as anything that can be put in front of them. Similarly, physical support can be modified depending on the infant's ability to control their head and balance.
Instructions: Have the infant sit on a flat surface beside the parent. Support the child by having him or her close to the parent, making sure to gradually decrease the support that helps the child develop balance and postural control. Have a toy or book in front of the infant which will promote engagement with the object and the environment with their body. By decreasing support, it tests the capability of the child to independently maintain their posture and control the head's position with the rest of their body.
Tying it all together: Through this activities, your infant should develop the skill of unassisted sitting. This can be acquired through strengthening and development of postural control. Postural control is the rate limiter to independently sitting because it is a sitting position with hands freed from a supporting role. In order to undergo this motor milestone, the infant needs to understand a number of skills such as body awareness, balance, and postural control and how they are all involved with this motor activity. By following these suggested games, it will help with the development of unassisted sitting. Tummy time will help strengthening the core as well as the develop muscle in the arms and legs. The crawling pathway activity is an expansion of tummy time where it combines the musculoskeletal system with the central nervous system to facilitate movement. When these are coupled together, it strengthens the child's ability to keep its body upright. Moreover, in the stabilized sitting with dangling toy game, it gives the infant an opportunity to develop their postural control further by having them in a position where their body is erect while cultivating their understanding for proprioception. Lastly, through unassisted propped sitting, this is the final stage before developing the ability to sit unassisted because the parent can adjust the level of support given to the infant when sitting and allow the infant to independently practice the skill, therefore, setting the child up to sit and be independent.
Summary
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References
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