When we think about children growing strong, we often focus on arms and legs. But one of the most important—and often overlooked—parts of development for kids is core strength development. The core includes the muscles of the abdomen, back, and hips, and these muscles play a major role in posture, balance, movement, and everyday activities.

What Is Core Strength Development?

Core strength development refers to how children build strength and control in the muscles that support the spine and pelvis. These muscles help children sit upright, stand steadily, and move with coordination. Strong trunk muscles provide a stable base for the arms and legs to work effectively. Healthy trunk development supports many areas of a child’s growth, including:

• Posture – Sitting and standing upright without fatigue
• Balance and coordination – Staying steady during play and movement
• Motor skills – Improving crawling, walking, running, and jumping
• Fine motor skills – Helping with writing, drawing, and feeding
• Breathing and endurance – Supporting proper breathing patterns

Children with weaker trunk muscles may tire easily, slouch when sitting, or struggle with coordination and balance.

How Does it Develop?

Over time trunk strength develops gradually as children grow and move:

• Infancy: Lifting the head, rolling, and sitting with support
• Toddlerhood: Sitting independently, standing, walking, and climbing
• Preschool years: Improved balance, jumping, and coordinated play
• School age: Better posture, endurance for sitting, and complex movements

Each stage builds on the previous one, making early movement and play especially important. Every child develops at their own pace. However, there are some signs suggesting a child may have a delay in core strength development, such as:

• Difficulty sitting upright without support
• Frequent slouching or leaning on furniture
• Poor balance or frequent falls
• Fatigue during play or seated activities
• Trouble with tasks like handwriting or dressing

If parents notice these concerns, discussing them with a pediatric physical or occupational therapist can be helpful. Early intervention can greatly improve strength, coordination, and daily function.

The good news is that PLAY is the best way to build core strength. Simple, fun activities at home can make a big difference:

• Tummy time for infants
• Crawling, climbing, and floor play
• Sitting on the floor instead of always in chairs
• Dancing, yoga, or animal walks
• Playing on playground equipment like swings and climbing frames

These activities strengthen trunk muscles naturally and encourage confidence in movement. For more information and activities to try at home to build core strength, visit Pink Oatmeal.

The development of core strength in kids is a vital foundation for a child’s overall growth. Strong core muscles support movement, learning, and independence. By encouraging active play and healthy movement from an early age, parents can help their children build a strong, stable base for lifelong physical development.

When we think about AAC (Augmentative and Alternative Communication), often we think of the idea of alternative communication. We think of children who are non-speaking or minimally-speaking and are learning another (alternative) system for communication such as American Sign Language or use of a Speech Generating Device (SGD). This is often an iPad or tablet with a robust communication software installed. Other common AAC systems include picture exchange systems, buttons, switches, and low-tech talkers with pre-programmed phrases. But how do we use these systems to augment communication? When might a speech therapist recommend trialing AAC as a form of augmented communication for people capable of spoken communication?

            By definition augmentative means to increase or have the power to increase, highlighting the ability of AAC to increase communication. Most of us use forms of augmentative communication throughout our day without even realizing it. Talking with our hands, using gestures and facial expressions, and writing a text instead of placing a call are all ways in which people augment communication.

Sometimes, though perhaps not as often as we should, speech therapists may recommend AAC systems for individuals with seemingly typical or functional spoken language skills for communication. Often referred to as part-time AAC users, these people often have functional spoken language expression, but may require use of an SGD due to limited speech clarity, difficulty with word finding, or when the brain is overwhelmed and it is difficult for the individual to access the higher cognitive functions like language.

Augmentative Communication Resources

Check out this episode of Two Sides of the Spectrum podcast. You can hear more from a part-time AAC user about their experience. You can also learn more about the six primary communication functions of AAC here.

In Montana, we have a great program called MonTECH. MonTECH is a statewide program that helps Montana residents find, try, and access assistive technology. They offer free consultations, equipment loans, training, and low-cost financing options to improve daily life, work, and mobility. You can see some of the low, mid, and high tech AAC options available to Montana residents through MonTECH here.

If you’ve ever noticed your child sitting on the floor with their knees bent and feet tucked out to the sides—forming a “W” shape—you’re not alone. This position, known as W-sitting, is very common in young children. As occupational therapists, we get asked about it all the time.

What Is W-Sitting?

W-sitting is when a child sits on their bottom with their knees bent in front of them and their feet positioned outside their hips, creating a “W” shape.

Why Do Kids W-Sit?

Children often choose this position because:

• It gives them more stability
• It requires less core strength
• It feels comfortable and familiar

Is W-Sitting Bad?

Occasional W-sitting is not a problem. However, if it becomes a child’s preferred or constant position, it may impact development over time. From an occupational therapy perspective, frequently sitting like this can affect:

• Core strength
• Balance and coordination
• Posture
• Ability to rotate the trunk (important for play and later skills like writing)
• Using both sides of the body together
• Crossing Midline

When Should Parents Pay Attention?

You may want to monitor it more closely if your child:

• Almost always sits in a W position
• Has difficulty sitting in other positions
• Seems a bit clumsy or off-balance
• Avoids reaching across their body
• Tires easily during play

What Can Parents Do?

Parents can help by encouraging other sitting and play positions. These positions could include criss-cross, side sitting, tall kneeling, and long sitting (legs straight out.) It is also beneficial to keep practice fun and encouraging to the child. Parents can build strength through play with activities such as climbing at the playground, crawling games, obstacle courses, playing on hands and knees, and sitting on small chairs of stools. Gently prompting your child with cues such as “fix your legs” with a light, encouraging tone can help guide your child.

When to Seek Support

If W-sitting is frequent and paired with other concerns (like delays or coordination challenges), an occupational therapist can help assess underlying skills and provide simple, effective strategies. W-sitting isn’t something to panic about—but it’s something to be aware of. Think of it as a small signal that your child may benefit from building strength and stability.

Hand-eye coordination is the connection between what the eyes see and how the hands respond. This skill plays an important role in a child’s development. It forms the foundation for fine motor skills such as feeding or drawing, as well as gross motor skills like catching a ball or climbing on playground equipment.

For many children, hand-eye coordination develops naturally through play and exploration. However, some children may struggle with timing, accuracy, or using both hands together. When this happens, activities like sports, playground games, or crafts can become frustrating, and children may begin to avoid active play.

How Pediatric Therapy Supports Hand-Eye Coordination

Pediatric physical therapists and occupational therapists often work together to help children build stronger coordination skills. Therapy focuses on more than just catching or throwing. Therapists also help children strengthen the muscles needed for movement, improve visual tracking, and practice planning coordinated actions.

By supporting these underlying skills, therapists help children move more confidently and successfully during everyday activities.

Why Early Support Matters

Early support can make a meaningful difference for children experiencing coordination challenges. When children receive help early, they are more likely to avoid frustration and gain confidence in their movement abilities.

With practice and support, children begin to develop smoother and more accurate movements. Their bodies learn to anticipate and respond to challenges with better control. Strong hand-eye coordination allows children to explore their environment, participate in play, and build confidence that supports lifelong movement and learning.

Visual schedules are a simple yet powerful tool that helps children understand and complete daily routines by showing each step of a task using pictures or icons. Just like adults use reminders and checklists, visual schedules for children provide a clear and predictable sequence to follow, supporting learning, confidence, and independence.

At their core, visual schedules display the start and end of a task using visuals such as photos taken with a phone or simple clip art. These visual cues help children understand what comes next—whether they are brushing their teeth, completing homework, or transitioning between activities. Because they rely on pictures and symbols instead of only verbal directions, visual routine schedules can benefit children of all ages, abilities, and developmental levels.

Why Visual Schedules Help Children

One key reason to use them is that they support consistent routines and reduce anxiety during transitions. When a child knows what to expect, moving from one activity to the next becomes smoother and less overwhelming. Visual supports also allow children more time to process language. This can be especially helpful for children who struggle with verbal directions alone.

Visual schedules are often used as a support strategy for children with learning and thinking differences, such as autism, ADHD, and other developmental differences. However, they can be helpful for any child learning daily routines. Over time, these tools can build self-confidence and independence, allowing children to complete tasks with less prompting from adults.

Where to Use a Visual Schedule

Visual schedules are extremely flexible. You can use them at home, in school, or in therapy settings. They can be tailored to fit almost any multi-step activity. For example, schedules help guide children through dressing, washing hands, toileting, bedtime routines, and more. These types of routines also help children develop sequencing skills. These skills are essential for completing tasks in order and understanding how daily activities fit together.

How to Use a Visual Schedule

To introduce a visual schedule, start with just a few key steps. Gradually add more as the child becomes comfortable with the routine. Children can check off steps once they are complete or simply follow the sequence with adult support.

Using praise, encouragement, and consistency makes visual schedules even more effective. Over time, children begin to rely on the visuals themselves rather than adult reminders. This helps them develop stronger independence and confidence in completing daily tasks.

Social-emotional development, or psychosocial development, involves understanding how a child’s emotional, social, and psychological processes change over time. With the surge of social media and a rise in behavioral problems among children, there has been greater attention and awareness of this topic. Sorting through all of the information is overwhelming, and understanding what your child needs can be complicated. To help with this process, let’s identify some terms.

Social-Emotional Skill or Psychosocial Development

The developmental process of social-emotional growth is often marked by “milestones.” The information is based on theories and research from various fields of health and medicine. When a child demonstrates a delay in or fails to meet milestones, there may be a recommendation for further assessment by a skilled clinician.

Behavior

Behavior is the way in which one conducts oneself, especially towards others. As children develop, we describe behaviors in terms of milestones or stages. Behavior identification will change when a child’s or family’s actions or emotions become problematic. Psychiatrists, psychologists, counselors, and therapists (behavioral, occupational) provide consultation when problematic behaviors emerge. A child’s social-emotional development and regulation abilities influence behavior.

Regulation

Often referred to as self-regulation, this is the process of predicting and adapting to sensations, emotions, thoughts, and actions to support the self in all daily activities. For example, an infant’s ability to self-soothe, a toddler’s ability to cooperate, or a child’s ability to follow directions rely on self-regulation skills. A child who can predict situations and adapt to the demands of a moment is self-regulating. Self-regulation is a building block needed for social-emotional development. Regulatory abilities change as we develop, so treatments vary by age group. Occupational therapists and mental health providers provide consultation to assess and support children’s self-regulation.

Social-Emotional Learning

There are several frameworks and programs that address the 5 core components. The design of these programs is to meet the needs of the general public. Local schools are embedding these programs into their curricula. Assessment of a child’s individual skills is not mandatory at this level. If developmental markers or behavioral concerns arise, a skilled clinician may recommend an assessment of social-emotional learning skills.

Throughout the lifespan, social-emotional development changes; the goal of therapy is to support families and children in understanding how these skills emerge and interact. Therapy embeds positive mental health promotion within it work.