Today I interviewed Abbey Kent, PT, DPT. Abbey is the physical therapist in the Jane & Richard Thomas Center for Down Syndrome at Cincinnati Children’s Hospital Medical Center. I am lucky enough to work with her daily and learn from her expertise!
Abbey, I’ve often heard you recommend using a small bench to work on sitting for children who don’t walk. You call it “bench sitting.” So what is bench sitting?Bench sitting is when a child sits on top of a hard surface for support. The surface could be a bench, stack of text books, or step. The feet are flat on the floor and knees are bent at a 90 degree angle. From this position we are able to work on trunk control while the child puts weight through their feet.
Why is it important to learn to sit on a bench/step?
By sitting on a bench, a child is able to learn to control their trunk – the middle of their body – in a static or still position. Once the child gains stability sitting still, then we begin to work on control during activities. This is called dynamic sitting. We progress to dynamic sitting by shifting the child’s weight as they reach side-to-side, forward, or by playing with an object in their hands. This allows the child to feel their own weight shifting and gain balance while in a supported position. Static and dynamic sitting skills are the building blocks for standing and eventually, walking.
I have a little bench for my toddler. How should his legs and feet be positioned?
We want the child to sit supported with their feet flat on the floor, in a neutral position.
To start, choose a firm, flat surface. I prefer something hard over a couch cushion or pillow. This provides the child’s pelvis more stability. We want their bottom to be positioned at the edge of the surface with their feet flat on the floor. A key to this activity is to have their knees bent at a 90 degree angle which prevents them from locking out their knees. If a child locks their knees they push backward. This makes it difficult to learn and maintain this position independently.
So my child is able to sit without my support on a bench. What’s next?
The next step is teaching the child to reach or rotate while sitting. I like to use small objects that are easy to grasp such as infant keys, link-a-doos, or other lightweight toys. It’s important to have easy fine-motor tasks (grasping with the palm) paired with a new gross motor task (e.g. dynamic bench sitting). Some of the challenges I present a child while bench sitting include:
– Having the child lean forward to grab toys from the floor, then sit back up to regain balance
– Transferring a toy from one hand to the other, then placing the toy in a bucket
So how does sitting prepare a child to walk?
A good way to initially work on sit-to-stand is from the bench sitting position. Once the child has learned to bench sit and perform different movement activities I like to change things up. Have the child bench sit on a small 4-6 inch surface facing a coffee table. Position the child a few inches back from the chest-height surface making sure to place a motivating toy near the edge of the table. This will encourage the child to lean forward and pull up to get the toy. If your child is struggling rising from a lower bench sitting surface (4-6 inches), start from a higher surface (8-10 inches) and gradually decrease the height. This pull-to-stand from bench sitting is a good way to build the strength and endurance needed to stand independently starting from the floor.
Are there other ways to use a small bench?
Yes! Another trick I use is this: Have your child get into the crawling position but place their hands on the bench and their knees on the floor. Having the hands elevated 4-6 inches allows the child to shift their weight back toward their bottom and heels. As a child masters this skill make the bench surface smaller (1-2 inches) until the child is able rest their hands and knees on the floor. To make the skill more challenging, have your child reach for small toys with one hand.
Abbey thank you so much for talking with me today!
You’re welcome! And now…DIY Benches! Recently we found a bunch of phone books and have been on a roll making these adorable – and functional – benches.
(All pictures submitted by and used with permission of the child’s guardian. Copyright 2012 Let’s Talk DS)