The Impact of Alternative Seating During Classroom Activities
Carolina Pluta, OTS
Dr. Schmeltz, OTD, OTR/L, CLT
Slippery Rock University of Pennsylvania
Slippery Rock, Pennsylvania
Abstract
Purpose: The aim of this review is to determine the
most effective type of alternative seating for attention
in young students.
Design: A systematic literature review was
conducted.
Method: Peer-reviewed articles were analyzed
through electronic databases. The search focused on
studies published from 2010-2021. Scientific validity
of studies was assessed.
Results: Beginning with 428 articles, 15 studies met
the required criteria. Five key themes were
discovered within the analyzed articles. Results show
alternative seating was found to be effective in
maintaining attention in young school-aged students.

Wobble cushion

Methods

• Alternative seating was found to have a positive effect in
sustaining attention due to a positive relationship between
attention and physical stimulation that helps promote sensory
integration.
Five key themes were found within the articles:

• Systematic literature review
• Databases used:
• PubMed
• EBSCOhost
• Sage Journals
• Specific key terms used in the search included:
• “sensory integration activities”
• “dynamic seating”, “alternative seating”
• “movement therapy and sensation”
• “attention”, “focus”

•
•
•
•

Alternative/dynamic seating – Independent variables
Circle time – Most common setting
In-seat and on-task behavior – Improvement in attention
A-B-C intervention design – Over 60% of the studies
analyzed used this approach
• Social validity scale – Utilized to gather qualitative data

Stability Ball

Introduction
• Attention is an important academic skill that allows
students to thrive throughout their educational
journey.
• Due to advancing academic rigor, maintaining
attention may be challenging for younger students,
affecting their developmental ability.
• Teachers reported a challenging skill students face
is maintaining attention throughout classroom
activities.
• Students often exhibit difficulties in selective and
sustained attention.
• Attention difficulties are often expressed when
students are asked to attend with relevant stimuli
or engage in activities.
(Andrade et al., 2009; Bagatell et al., 2010; Cefai et al., 2013; Fisher et al., 2014; Hertzog et al., 2019; Krombach
& Miltenberger, 2019; Miller & Simmering, 2018; Seifert & Metz, 2016; Zaghlawan & Ostrosky, 2011)

PIO Question
“Which type of alternative seating is most effective in
improving attention in young students during classroom
activity?”

Results

Images of different
alternative seating
during table-task
activities.

T-Stool

Studies found integrating alternative seating during
classroom activities:
• Improved attention span
• Increased participation in longer in-seat durations during
on-task activities
• Enhanced engagement and enjoyment throughout tasks
• Reduced social, emotional, and behavioral problems
• Alleviated anxiety and depressive symptoms
• Decreased disruptive behavior
• Increased literacy skills
• Improved in the production of students due to alternative
seating in occupational therapy practices
(Bagatell et al., 2010; Cefai et al., 2013; Fedewa & Erwin, 2011; Gaston et al., 2016; Krombach & Miltenberger, 2019; Mccoy et
al., 2018; Merritt, 2014; Miller & Simmering, 2018; Seifert & Metz, 2016; Zaghlawan & Ostrosky, 2011).

Discussion
• Although there is evidence that states the benefits of
alternative seating for attention in young students, there is a
gap in the literature regarding what form of seating is most
effective.
Significance to Occupational Therapy
• Occupational therapists can incorporate alternative seating
within classroom environments across the world to promote
focus and successful learning outcomes, resulting in
improved academic skills and social advantages in all
students.