Know the Signs: 6+ months

6+ months: Sitting

6-12 months: Sitting

Description

Evaluate sitting without support at 6 months and getting into sitting position at 9 months, or until achieved.

What does sitting posture for a weak child look like?

Discussion

When evaluating sitting, look for continued progress through achievement of sitting skills: e.g., whether child can sit without using hands to prop self up; use both hands to hold a toy while sitting; maintain sitting when reaching for objects; and get in and out of sitting independently.

Tip: Have a child reach for and hold a toy to evaluate ability to sit without propping. Assess the quality of the transition from supine to sitting (for example, rotating up to sit versus rolling to prone and pushing up to sit).

Red Flag
A child who does not sit independently (i.e., un-propped and without requiring his/her hands for support) by 7 months or get into a sitting position by 9 months needs further evaluation.

Therapist Response to Red Flag

Communicate specific concerns about sitting (in context of overall development and relevant environmental factors) to the family and referring provider. Provide evidence for weakness rather than poor coordination as a cause for the delay. Encourage a referral to a specialist (consider pediatric neurology) for a diagnostic evaluation.

Specialist Response to Red Flag

Draw a CK and refer for diagnostic workup.

Download a pdf of the Surveillance and Referral Aid for Therapists and Specialists. This Aid includes signs of weakness by age, red flags and warning signs for muscle weakness, and referral recommendations.