How do I get this student to sit still?”. This is the question I am asked most often. Teachers report having to constantly redirect certain learners to sit still, sit down, sit up, and remain in your seat to prevent distracting and disrupting the entire class. 

When I observe students during seated instruction, I see a wide variety of restless behaviors.  I see children rocking, squirming, tipping chairs back and splaying their upper body across the table.  They are swinging their legs, sitting on their legs and wrapping their legs around the chair. 

On the carpet , I observe even more difficulty sitting still , they are constantly fidgeting, changing positions, rocking, squirming, rubbing their faces back and forth on their knees and some even doing almost a headstand type maneuver from the crisscross applesauce position. 

Often, it is not just the child with ADHD. I see these behaviors in about 50% of the entire class by the 7-minute mark of verbal/visual instruction. 

How can less than 10 minutes of seated time be too much for so many elementary students? Why can’t they sit still. 

This post explains why students with ADHD and many of their elementary peers are having difficulty remaining seated and provides actionable supports and strategies for decreasing the impact it has upon learning. 

Clarifying The Sitting Still Expectation 

It is important to understand that children are not required to just “sit still” in school. Children are expected to to stay seated AND perform a cognitive or motor task. 

Stay seated and look, stay seated and listen, stay seated and write, stay seated and read or stay seated and wait your turn.  Learners require a stable base of support to sit AND perform a cognitive or motor action. There is a vast difference between the gross motor requirements of supported sitting versus unsupported sitting. 

Unsupported sitting (sitting upright without support) is a developmental skill that requires significant gross motor development and muscular effort.  Unsupported sitting like sitting crisscross applesauce on the carpet is a developmental milestone that infants develop around 6-9 months. To sit upright without support AND perform a cognitive or motor action requires adequate core muscle strength, postural stability, and balance.  Children typically develop and refine core strength, stability, and balance in early childhood through active play. 

More and more learners have core instability these days due to an increase in time spent doing sedentary play activities. Without core stability, sitting unsupported is extremely challenging, and uncomfortable and learners will shift their weight, squirm, and move to compensate.  

Adults are often challenged in core stability. Try sitting “crisscross applesauce” for 10 minutes listening to an audiobook. Notice what you begin to do…

Supported sitting, at a properly sized desk with a chair gives the learner a stable base of support to use their upper body. Sitting with stability facilitates increased attention to academic learning because the children can focus on the teaching and not holding their bodies in a specific position.

However if a child is not seated properly at a desk, with their feet on the floor,  they are in fact  “ sitting unsupported ” which now requires substantial core muscle strength and may rapidly diminish attention span,  the quality of fine motor skills and will increase out of seat behavior. 

Why Students with ADHD Can’t Sit Still

Students with the hyperactive/impulsive and combined presentation of ADHD will have significant difficulty sitting still compared to their neurotypical peers. These students are expected to have persistent symptoms of hyperactivity-impulsivity that significantly interfere with or reduce the quality of occupational functioning.  To have this diagnosis,  these students must exhibit persistent difficulty with at least 5 of the below symptoms, three of them directly impacting sitting still expectations. 

• Squirms when seated or fidgets with feet/hands
• Marked restlessness that is difficult to control
• Appears to be driven by “a motor” or is often “on the go.”
• Lacks the ability to play and engage in leisure activities in a quiet manner
• Incapable of staying seated in class
• Overly talkative
• Difficulty waiting turn
• Interrupts or intrudes into conversations and activities of others
• Impulsively blurts out answers before questions complete

It is important to really understand that the “behavior” we see here is a symptom of the identified diagnosis. 

ADHD is a valid diagnosis, and just like every other diagnosis, there is a set of symptoms that identifies it. Not being able to sit still is a symptom, just like sneezing and congestion are symptoms of a cold. An individual with a cold cannot just simply stop sneezing, not even if they try really really hard.  They will need support for the sneezing symptom of the cold while it runs its course.  

Students with hyperactive-impulsive and combined presentations of ADHD exhibit substantial challenges remaining still for age-appropriate periods.  This is not an excuse, but an explanation of intent. They are not willfully disrupting the class, their parents cannot help, and they will have this problem until the hyperactivity lessens with age. I promise you that the child would prefer nothing more than to be able to sit still just like those other kids. Just like children with poor core muscle strength, they will need additional support to remain still when necessary.

Prioritize Learning Over Sitting Still 

Teachers and parents often try to work on “sitting still” with behavior incentive plans, after all, positive behavioral interventions are considered evidenced-based support for ADHD.  The problem is while the rest of the class doesn’t have to think about sitting still, the student with ADHD-H or ADHD-C  and/or poor core stability now does,( to earn a token, Dojo point etc.)  and the cost of fulfilling this requirement is going to be directly counterproductive to cognitive availability for learning.

Human beings cannot perform two cognitive tasks at once. Consciously controlling yourself requires cognitive effort. So if you’re thinking about sitting still then you’re not thinking about the lesson content.

We can prioritize learning over sitting position by providing support to the sitting expectation of the “sit and __”  so the student can rightfully use that energy for learning. 

Effective Evidenced Based Strategies for Students Who Can’t Sit Still

Ensure a Stable Base of Support 

Are their feet able to firmly touch the floor? Try writing, listening, and focusing while sitting on a bar stool with your feet loose in the air. 

When you are sitting on a chair and your feet do not touch the floor you are sitting without a stable base of support.  Students have to use their core muscles to stabilize, which causes them to become easily fatigued, and uncomfortable and use cognitive effort to compensate.  This can be especially difficult for students who may have difficulty with body awareness, core stability, or balance. 

The 90-90-90 Rule

The recommended seating position for a child is sitting with their hips, knees, and ankles all bent at 90 degrees.  Having their feet firmly on the floor provides information through the hips and spine to engage in an appropriate sitting position. Providing appropriately sized supportive seating makes an incredible difference in behavior, engagement, and attention. In fact, “properly fitted furniture is essential if children are to learn handwriting efficiently” (Henderson &  Pehoski, 1995).

However, providing every student with the perfect size desk/chair is easier said than done as children come in all different sizes and grow throughout the school year.  It is most challenging in special area classes ie. art classes, where you have various age/height learners using the space throughout the day. 

Proving footrests is the solution to this common desk sizing problem. Ensuring your learners’ feet rest firmly on the floor (footrest) will immediately reduce fatigue and improve attention, engagement, and behavior. 

Below are examples of footrests used by school-based practitioners including simple and cost-effective ways to DIY a footrest.

Like most school based occupational therapists we have a huge stock pile tips and tricks and items to ‘try first before the school orders more” in our therapy bag. Below are ideas and links to items I personally have used unless otherwise noted. Some have Amazon affiliate links meaning this website receives a tiny commission if you purchase them. 

• Bouncy Bands -: These are commercially available , durable and used widely in schools. 
• Pool Noodle Step: Cut a pool noodle and tape, bungee cord or zip tie to the legs of the chair at the appropriate height. These large rubber bands are a cost effective 120 of them for about $11. 
• Theraband Strip: Tie Theraband strips on the legs of the chair, using the roll you can do multiple chairs quickly. 
• Adaptive Foot Rest – Schools can purchase specially designed adaptive foot stools where the chair legs fit into holes, I do not personally own any of these because I have made my own. 
• DIY Foot Stool Box: I love this DIY that Patti Clark OTR (@elementary_ot) posted on Instagram. “Swinging feet means a swinging mind. Keep feet grounded in big school chairs by using a box and poking holes…”
• Textbook Stack: Stack up old textbooks and duct tape, add shelf liner to the stack for non-slip. 
• Plastic Bin: Put an upside-down plastic bin under the chair. 
• Maintenance Superstars: My school maintenance team once custom-made foot stools with holes to match the chairs for an entire classroom. ❤️ Don’t hesitate in asking your school maintenance team for help. 
• Monthly Recheck Tip: I recommend that teachers check the desk and chair heights during the first week to and then use the traditional monthly seat change time to recheck desk/chair height. 

Sitting Still at Carpet/ Circle Story Time

Notice when you call the kids to the carpet, the savage rush to get the coveted spots that enable you to sit up against a wall, back of the bookcase. These children are craving stability. Sitting unsupported requires significant core stability and gross motor development.

Younger children will move in and out of positions when sitting on the floor – that is natural and the way kids stay alert. Letting them get comfortable with boundaries will reduce extraneous cognitive load and effort needed for learning.

Teachers can give 2-3 sitting choices with visuals.

• Criss-Cross – requires the establishment of crossing midline, substantial trunk control, coordination, and balance, which many young children have not mastered…yet. Not to mention can be very uncomfortable with skinny jeans and high-top sneakers.
• Long Sitting: Child sits with their legs straight out.
• Mermaid Sitting: side sit with both legs tucked to one side 
• On Stomach: Child lays on stomach propping up with elbows.
• Recliner: Leaning back propped on elbows
• Discourage W sitting : Children may develop a habit for “W” sitting as a way to establish increased stability in their bodies when they cannot assume and maintain the criss-cross sitting position. “W” sitting compromises knee and hip joint positioning, inhibits trunk stability needed for sitting, and may impact the development of proficient hand skills. Teachers and parents should gently, but firmly discourage “W” sitting and provide an option below for increased stability. . 

Teachers can Use Flexible Seating to Increase Engagement

Some students simply need the wall or require more trunk support to remain upright and engaged while seated on the carpet. Below are commercially available floor seating options that provide trunk support and helps to alleviate some of the required postural endurance to stay in that position for longer periods of time.

• Bean Bag Chairs – Amazon link provided for small wipe clean bean bags.
• Stadium Seat – I found these on Amazon at a much lower prices then alternatives. Provides back support and can be stored easily.
• Scoop Rockers I use these all the time. They rock, just be careful of fingers under the chair.
• Weighted Lap Pads – Adding some weight to a child lap can increase awareness and stability. I made 4 of these ( for the price of one) for a classroom by placing a large bag of rice inside the pillow case and folding it over once, securing with velcro. Easy DIY with no sewing. Here is a link to the sparkle pillow cases.
• Adjustable Recliner Seat/Cushion- These are adjustable and currently on sale.

Provide Micromovement 

Many learners need to move to listen, look and learn. Evidence supports that adding micromovement to seated work will help the child remain seated and engaged for longer age-appropriate periods. 

• Fidgets- I recommend whole class availability of non-trendy items that can be manipulated with your hands while listening – ie., silly putty, kneadable erasers, spin rings, small play doh containers
• Weighted Lap Pads – Adding some weight to a child lap can increase awareness and stability. I made 4 of these ( for the price of one) for a classroom by placing a large bag of rice inside the pillow case and folding it over once, securing with velcro. Easy DIY with no sewing. Here is a link to the sparkle pillow cases.
• Move n Sit Cushions– adjustable with air
• Bouncy Bands – these are the most durable version. I have used large garbage pail rubber bands and Theraband as a more affordable options for whole classroom sets. will work on a tiny budget
• Foot swings – I do not have this one yet… But how cool!
• Theraband with threaded Tennis balls – linked is a roll of Theraband that will do multiple desks
• Tie or Theraband/Bungee cord across desk or chair legs with a cut Pool Noodle
• Straw Top Water Bottles
• Ball chair
• Wiggle Seat T Stool
• Doodling- doodle notes
• Add Movement to the lesson, book, story ect…
• Let Them Stand 

Provide Functional Movement Breaks

Movement is a natural method of self regulating that can increase engagement and attention to learning. Providing children with ample movement opportunities prior to and during seated work will increase the amount of time “sitting still” and increase cognitive availability for learning.

Class Wide Resets: 

• Brain Breaks 
• Assign Functional/ Purposeful Jobs
• Hand out papers , scissors and glue  
• Play Speed Ball

Provide Visual Boundaries and Environmental Prompts

• Carpet Squares
• Square Taped Around Desk to Stand In 
• Picture of a child sitting upright on desk that you can tap as a Cue
• Sign of cue ( non verbal ) to check yourself
• Pictures of Sitting Options for Carpet

Key Points

When a child demonstrates difficulty remaining seated during classroom instruction, that behavior has varying antecedents, that are very often due to skill-based performance difficulties. Behavioral incentives and verbal prompts for in-seat tolerance can be counterproductive to learning.

Students with ADHD – hyperactive/impulsive presentation can be expected to have difficulty remaining seated for age-appropriate periods of time, as a symptom of their diagnosis. Students who have not yet developed adequate trunk strength, balance, and postural stability will also exhibit significant difficulty sitting upright unsupported. 

Requiring the student to consciously attend to the compliance demand of trying to sit still without providing stability and support can and will decrease the cognitive availability for learning. 

Teachers and therapists can prioritize learning over sitting position by providing students with seating that increases stability to facilitate attention, engagement, and endurance. We can ensure students have regular opportunities for movement throughout the school day by adding micro-movements and functional movement breaks. We can provide seating choices that emphasize comfort, promote self-regulation and use visual supports and environmental cues to clarify seated expectations.

Share with all your teacher friends!❤️

References and Resource Links 

Click Here to Download Posters

Edit ** Click Here to Download an additional gender neutral version of Mermaid Sitting worded as side sitting.

Henderson, A., & Pehoski, C. (1995). Hand function in the child: Foundations for remediation. St. Louis, MS: Mosb

AOTA. (2011). Is Your Child Positioned for Success? [Brochure]. http://www.aota.org/-/media/Corporate/Files/AboutOT/consumers/Youth/School-Success.pd