Thursday, July 7, 2016

Therapy Tip: Helping the Busy Child Sit

Welcome to Therapy Thursday! This is the day that I share a tip based upon my experience as a speech-language pathologist and a mother of a child with special needs.

Today's tip is:

Helping the Busy Child Sit

Ever try to work with a child who just won't sit down? You can't finish a book with him. You can't get them to finish a puzzle. You can't get them to engage with you in play for more than a couple of minutes. Maybe they won't even sit for a meal. A child who won't sit or stay in a general area can be difficult.

Sitting or being in one small area is important so that the child will:
-Engage socially with another person
-Improve attention span
-Improve listening skills
-Have an opportunity to watch and learn from an adult model
-Learn an important social skill that will transfer to other settings (sitting for church or a restaurant)

In early intervention play-based therapy, I want a child to be near me. I don't necessarily need them to sit on their bottom for the entire session. But, I do need them close to me so I can model language and play skills. Most children can sit for short periods of time in speech therapy sessions with little to no problems.

But then there's some that just struggle. I do not like to physically hold the child on my lap or on the parent's lap. Usually, the child who doesn't like to sit doesn't like being held either, so this is usually not a good option. So, here are some things that I try to help the child be more success at sitting and engaging while using a hands-off approach.

1. A small blanket or towel
Set a small blanket or towel on the floor as a visual boundary of where the child is expected to stay. The rule is that the toys stay on the blanket or towel. If the child gets up and moves, the toys stay on the blanket. This teaches them pretty quickly where the boundaries are. I prefer to use the family's blanket or towel that they have available and use the same one every week. I have had a good response from this method!

2. Position yourself for success
Sometimes the easiest way to keep a child in one place is to position them in a specific spot in the room. If there is a corner in the room or even a couch sectional, use this to your advantage. The child goes into the corner area. Toys or other small objects/furniture can also be used if needed to help enclose a small space for the child to help them stay put.

Using a blanket with a couch sectional to create a space

3. Toddler seats
Many children have a variety of small seats in their home available. High chairs, booster seats, and small recliners are some things I have seen and used in a family's home. Some people feel making a toddler sit to engage in play is unnatural and therefore not an appropriate method for early intervention therapy. Obviously, I don't feel this way. Children need to learn to sit so they can have success in outings with the family such as restaurants or shopping carts. If the child has no interest in sitting in their seat, you might try the seat in a different room in the house. I try to do something the child will think is fun in the seat like painting or play-doh to help them forget they might be annoyed by sitting. If the seat causes the child to cry or tantrum, then it's not a useful method.

4. Balls, boxes, etc.
While the previous three are my usual go to methods. I have known some therapists to use a big, therapy ball to position the child on top of while doing activities. I am not good at balancing kids on balls while doing another task. But, I have used a medium sized box in therapy sessions. Yes, I know that sounds strange. But, once in awhile I will have a child that loves to sit in a cardboard box. We color on the box and throw flashcards in and out of it. Sometimes, the best methods for sitting are the ones you stumble upon. I often carry my stuff in small plastic totes. They are the perfect height for a toddler to sit on. Similarly, some children have little wagons or swings. These are other good ways to help build up a child's tolerance to sitting.

Look around your house, the solution to helping your child learn to sit might be right there! Be patient and set realistic expectation. Five minutes might be a reasonable goal at first. Then you can track the time and work on increasing it.

Therapy Thursday is for educational purposes only and not intended as therapeutic advice.

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