Should a 4 year old be able to do a sit up?

[Anonymous]

So DS has some regulatory/visual motor issues, but the OT also said that he must have low tone because he can't do an unassisted sit-up. Should a 4 year old be able to do that??

[Anonymous]

No. And that's not the way to diagnose low tone.

BTW, I'm not even sure that I can do sit ups, and I don't have low tone.

[Anonymous]

Thanks - the OT seems really hung up on the tone issue, which is weird because my ped thinks she's nuts. DS is really physically robust, isn't floppy (never was), doesn't tire easily, sits up straight when he plays, and is really strong. But she's now telling me he needs OT to "improve his tone."

[Anonymous]

My son is seven, very athletic, no physical issues ever. He can do sit ups now, and I know he could last year at 6/first grade. But when they tried them in gym in kindergarten/5 he really couldn't. He did sort of a roll to the side cheating kind of move. And I'm pretty sure a bunch of his peers in second grade still can't do sit ups (my son has ab muscles you can see - I think it's from all the gymnastic/monkey bar stuff he loves that makes him use all his core strength to flip his body up - regardless, it's not normal, even for his peers, let alone a four year old.)

[Anonymous]

My 5 yr old does not have low tone and she can not do a sit up.

[Anonymous]

My ds had an OT eval. The OT also said he had low tone. DS walked at 10 months. I am not an OT but I am pretty sure low tone kids don't do this. I completely lost confidence in her opinion after this.

[Anonymous]

Pediatric PT here. No he should not be able to do a sit up at this age. Kids are not expected to do a sit up until they are 6. He should however be able to lay on his back and lift his head off the floor for 10 or so seconds tucking his chin towards his chest. Tone is something that cannot be changed. It is how the muscle is wired at rest meaning that when a child is at rest it is how floppy/easy can you move the joints. If the child is low tone they are typically very floppy and it is very very easy to move the muscles. There is little resting muscle resistance. Normal tone if you well gives you some support and resistance and high tone you will feel a catch with any movement when you try to move the muscle. Hope this helps.

[Anonymous]

My 6 yr old DS had a 6 pack at 4--seriously. When he would cough or cry, he looked like he did 100 crunches a day. (DH looks like that at 42, too). He couldn't do a single one.

No, I don't think a 4 yr old should be able to do one--the head size/weight ratio to body length/weight/strength is still off. Hence the propensity for very young kids to tumble over and fall.

[Anonymous]

I'm a little tired of "mission creep" by OTs. I have a lot of respect for what OTs actually do, but they are not PTs.

[Anonymous]

I didnt know. so I just asked my 2 and 4 year old to try a sit up. My 4 year old couldn't, but my 2 year old can.

[Anonymous]

"My ds had an OT eval. The OT also said he had low tone. DS walked at 10 months. I am not an OT but I am pretty sure low tone kids don't do this. I completely lost confidence in her opinion after this."

FWIW, my DS also walked at 10 months (and met every gross motor skill milestone early), but he is clearly low toned.

[Anonymous]

Anonymous wrote:"My ds had an OT eval. The OT also said he had low tone. DS walked at 10 months. I am not an OT but I am pretty sure low tone kids don't do this. I completely lost confidence in her opinion after this."

FWIW, my DS also walked at 10 months (and met every gross motor skill milestone early), but he is clearly low toned.

What makes you think he has low tone?

[Anonymous]

Anonymous wrote:

Anonymous wrote:"My ds had an OT eval. The OT also said he had low tone. DS walked at 10 months. I am not an OT but I am pretty sure low tone kids don't do this. I completely lost confidence in her opinion after this."

FWIW, my DS also walked at 10 months (and met every gross motor skill milestone early), but he is clearly low toned.

What makes you think he has low tone?

I posted the first statement. My ds was getting an eval for sensory stuff. I never suspected him of low tone. He had total head control at 6 weeks and generally is an extremely muscular little guy. (after reading this thread I asked him to do a sit up...and he can. He is 4.5.) I have a couple of friends who children are low tone and none of them walked early or were very physical. In comparison, my ds is the opposite of low tone.

To PP, how can your ds be low tone yet meet the milestones? I am not being snarky or rude. I am very curious because it seems to me that low tone would be, in part, defined by late milestones.

[Anonymous]

"My ds had an OT eval. The OT also said he had low tone. DS walked at 10 months. I am not an OT but I am pretty sure low tone kids don't do this. I completely lost confidence in her opinion after this."

FWIW, my DS also walked at 10 months (and met every gross motor skill milestone early), but he is clearly low toned.

What makes you think he has low tone?"

The development pediatrician and three OT who have evaluated him. Plus, my own observations in seeing him chose to not sit upright, and sitting in other ways that low tone kids do.

[Anonymous]

My DS is low tone (diagnosed at Childrens by Doc of Physical Medicine) yet was early walker - 10 months. As the PP PT explained, your muscles at rest are less engaged than a regularly toned child, so my DS, who could run before lots of kids were walking, would also routinely fall when standing still (which is what prompted the eval at CHildrens - we started with neurology and ended up in physical medicine) and to this day (age 7) falls out of his chair almost daily at school. Your muscles can work fine when engaged but they are completely asleep when not engaged.