Paediatric Milestone series: Activities in Supported Standing
Before we discuss independent standing and standing up without using support, it would be appropriate to consider simple exercises when the child is standing at the couch, ottoman, coffee table, etc. In fact, this is quite a critical period for the child to master their body in space when trying to stand and balance at their support surface.
Once the child is up and standing at their preferred support surface, placing toys or any other item of interest just out of reach on the couch is an excellent activity to practice weight shifting and challenging the boundaries of their balance while they are well supported. During a single lateral reach, the child will shift their body and take more weight on the same-sided leg and foot. This simple and subtle movement is so important because this allows the child to unweight the opposite leg and foot. With progression and strengthening, complete lifting of the opposite foot from the ground will be achieved to reach even further. Mastery of this combination of weight shifting and balancing is incredibly important because this skill is absolutely necessary for walking; weight shifting onto a single leg, lifting the opposite leg, and progressing the unweighted leg and foot forward to walk.
For continued balance and strength development, encourage rotation and reaching away from their support. Start by using a toy on the couch or table and slowly pull the toy out of reach along the surface and more towards the side of the child to encourage reaching away from their support. Continue to repeat this to both sides and within their tolerance, ensuring to give breaks as needed. Gradually increase how far the child reaches in an arc around their reaching radius until they can almost reach behind by rotating at the trunk and waist with a hand still on their support. Again, this exercise is working their ability to weight shift and balance at the same time; however, with rotating and balancing as well, we are working on trunk strengthening with movement to build strong core muscles to support the trunk and upper body when it is time for standing and walking independently.
Of course, during these activities it is important to give plenty of positive reinforcement and feedback to demonstrate the importance and excitement of standing, reaching, rotating, and moving.
We will take another detour before we get to independent standing up; we will first discuss cruising along their support on the next blog post.
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