Quadruped Position: Why it’s Important and 10 Fun Ways to Play!

Quadruped position.  We like to think of it as “the king of all body positions” in pediatric physical and occupational therapy.

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In quadruped position, we can get a lot of information about a child’s level of physical development.  And, in this position we can have kids engage in a ton of effective therapeutic play activities.

What is the quadruped position?

The answer is super simple…another reason we love this position – it doesn’t require any fancy equipment or any complicated set-up.

Quadruped is the simply the hands and knees position.  This is the position from which babies learn to crawl and the starting position for a whole long list of core strengthening exercises and stretches.

From the quadruped position, a skilled therapist can assess a child’s strength, balance, endurance, coordination, flexibility, and posture.   The ability to get into and maintain this position is also a great indicator about the integration of primitive reflexes.

Why is the quadruped position so important for development?

Quadruped positioning can promote so many important developmental skills including:

1 || Bilateral coordination

Bilateral coordination is the coordinated use of both sides of the body together to perform a task.  From the quadruped position, a child can use reciprocal (or alternating) patterns of movement using both sides of the body to move forward or backward in crawling.

2 || Strength

Maintaining the hands and knees position promotes neck and core strength, arm strength, and hand strength.  Being on all fours encourages co-contraction of the muscles of the arms, legs and core.  This means that the muscles that activate to move the body into flexion or extension are working at the same time.

3 || Balance

The quadruped position is a great place to work on balance.  A child has to shift her weight while maintaining the position to lift an arm and move it forward to reach for toys or initiate a crawling pattern.  This is a tricky balance challenge!!   Kids also use balance as they move forward and backward and in diagonal patterns in quadruped to transition into and out of sitting.

4 || Motor planning

This benefit of hands and knees positioning is huge!  As a child learns to reach for that toy or chase a ball across the floor, the brain has to figure out which arm goes first, followed by which leg.   The repetitive practice of crawling in quadruped provides the opportunity for this motor planning to become automatic, so the child doesn’t have to constantly think about how to move their body for everyday motor tasks like climbing stairs, running, getting up from the floor, and more.

5 || Weightbearing through the hands

Weight bearing on the hands is essential for the development of hand strength and also contributes to increased strength and stability in the shoulders.  Weight bearing in this position also provides a hefty dose of proprioception to the wrists, elbows, shoulders, hips and knees, contributing to body awareness.

6 || Integration of primitive reflexes

Playing and moving in an all fours position also contributes to the integration of primitive reflexes.  For example, as a baby puts weight through his hands in the quadruped position, the palm of the hand opens out and pressure is applied into the hand. This naturally inhibits the ‘palmar reflex ‘, which is what tends to keep a baby’s fingers curled in. When the palmar reflex is not properly integrated, it can affect the way a child learns to hold a pencil and form a comfortable grip when writing.

Now that you know the benefits of the quadruped position, let’s talk about how we can use this position to our advantage to promote developmental skills.

Quadruped: Ways to Play

Babies

Before learning the reciprocal crawling pattern, babies may get up into the quadruped position and rock back and forth or move constantly into and out of sitting.

A great way to encourage them is to put them on their hands and knees in front of a mirror or in front of a bright, interactive toy.  These enticing objects will also encourage your baby to reach out of this position, further developing their balance, body awareness and strength.

Preschoolers & beyond

By this age, kids are on the go and there is no way they are going to stay still in a quadruped position unless they are bribed!  How can we do this?  Fun games, toys, and movement activities!

1 || Animal walks and wheelbarrow walks

Try bear crawls or inchworms or wheelbarrow walks.

2 || Board games or card games

A hands and knees position is also a great position for a child to be in when he is playing a board game so that he has to shift his weight and reach — a great challenge for core strength and balance.  Check out some of our favorite therapy games for kids here!  Simple card games for kids like war can be played in an all fours position too!

3 || Yoga poses

Spinal balance pose or balancing table pose is a great balance and strength challenge for kids.  And cat/cow poses are awesome for stretching out the abdominal muscles and back.

4 || Follow the leader

Choose a leader and play follow the leader in quadruped.  Can kids move forward, backward, side to side, diagonally and even up/down stairs?

5 || Puzzles

Puzzles are great entertainment and the perfect toy for quadruped play.  Position the base of the puzzle further away from the pieces to encourage crawling to retrieve the pieces or place the base of the puzzle on a higher surface to work on transitioning between quadruped and sitting, kneeling, or standing.

6 || Toy cars/trucks

Driving toy cars and trucks around on the floor in quadruped is another great way to keep kids in this position for extended periods of time.  It’s also a great way to work on midline crossing!

Try a play carpet from IVI – our favorite is the Mini City Play Carpet!

7 || Blocks

Quadruped is a great position for play with building blocks and kids love setting up towers and then knocking them down!

8 || Coloring/drawing

In quadruped, have kids color or draw on large butcher paper or on pavement with sidewalk chalk – also great for midline crossing!

9 || Chores/jobs

Some household jobs and chores for kids can be done in a quadruped position.  Try gardening (digging in dirt, pulling weeds) or washing floors!

10 || Beach play

Looking for more fun ways to play in quadruped?  Go play at the beach!  Build sand castles (check out these DIY sand castle accessories!) or go on a search for beach glass or pretty stones.

For Virtual Sessions:

This is a great opportunity to educate caregivers about the importance of playing and doing activities in this position!  Showing the caregiver some of the options above during your session would be awesome for promoting carryover at home!