The Vestibular System

As an OT, I recommend swinging for a lot of my kids. I often wonder if teachers think I'm nuts for how much value I place on swinging (and other activities that elicit vestibular input). As a mom, I have seen, firsthand, the beautiful turnaround in my own baby by pressing into vestibular input. My son, "G", has demonstrated hypersensitivity to vestibular input since birth. I wish I would've known then what I do now about the value of movement and the signs and redflags that something was going on. But, I'm extremely grateful that we've come to a place that things are very nicely integrating for him now and that I have insight to share with all of you, because this is the good stuff! Bear with me as things will get somewhat technical as we venture into the inner ear to understand this form of sensory input, but this is the stuff you won't want to miss!

What is vestibular input?

Vestibular input is the way that our body helps understand and coordinate movements and balance. Vestibular input is first detected within our inner ear and can be thought of as the 7th sense (last week, we talked about proprioception being the 6th sense, so we can dub vestibular input as the 7th).

Basically, the inner ear contains three canals (the semicircular canals) that help detect movement and change in head position. The ability of our inner ear to detect these movements and send signals to the brain to make sense of it all is an extremely important part of child development. Remember that pyramid I've shared twice now? Yep. Vestibular input is another foundational component for a child to develop higher level skills like attention, problem solving, eye hand coordination and overall behavior.

The inner ear: Semicircular canals

The vestibular system is really quite fascinating and extremely detailed (in ways that we won't get into) but the basic concept behind them are that we have semicircular canals in the inner ear of both ears. The system works in tandem with a canal in each plane- an anterior plane, posterior plane and a lateral plane. As fluid shifts through a canal on each side, it moves tiny hairs which detect the changes in head placement, and the speed at which these changes occur.

Also extremely important to this system is that it coordinates eye movements with change in placement of your head, involuntarily providing a "righting" reaction for your eyes as your head shifts. This keeps the visual world nicely in balance.

The semicircular canals are the reason why when we spin TOO much, the fluid in the inner ear can't quite settle back down as quickly as your body can and we feel "dizzy", you can see another person's eyes "bouncing" as they try to find a balance or you might stumble and fall because your vestibular system isn't catching up yet.

Dysfunction of the vestibular systems

Just like many of the other senses, poor integration and dysfunction can take on two forms for vestibular function: hypersensitivity (avoiders) and hyposensitivity (seekers). Here are some indications of each:

Hypersensitive vestibular systems appear in children (or adults) who:

• appear resistant or even fearful of swinging or climbing on playground equipment (like slides and merry-go-rounds)

• skip crawling

• prefer stationary tasks

• appear to move cautiously

• easily lose their balance

• avoid stairs or appears fearful or uncoordinated

• fear elevators or escalators

• refuse to participate in novel movement activities without physical support from an adult

• appear weak or floppy

Hyposensitive vestibular systems appear in children (or adults) who:

• are described as hyperactive (constantly moving to activate their vestibular system)

• appear to be able to spin or ride amusement park rides without ever getting dizzy

• engage in rocking or other rhythmic behaviors

• have trouble sitting still

• crave upside down positions

• swing very high without fear of falling

• enjoy spinning in circles

**If you have a child who strongly fits into either of these categories (whether it be your own child or a student in your classroom), please consider reaching out to your primary physician or occupational therapist to determine if an OT evaluation is warranted to address sensory needs

A personal journey

As I mentioned previously, "G" has demonstrated a fair amount of difficulty with vestibular processing. He demonstrated nearly every symptom that I listed in the hypersensitive category of vestibular input. He was terrified of quick movements. He was NOT that baby or toddler that you could throw into the air and make him giggle- it was shear terror for him. He never crawled; rather he scooted on his butt (which I now understand that it was because putting his head in a different position was just too scary). He used to sob irrationally on elevators and forget escalators- those were entirely out of the question. He would get SO MOTION sick every time we traveled. There were daily struggles; sensory sensitivities that he had to fight every single day.

He was so fearful of everything, beyond what most children are fearful about. So much so that family and friends would gently question us- whether something was "wrong" with him, if he should be "tested for something". I remember feeling that I was so fortunate that I had a foundation in sensory processing and child development to be certain that there were no red flags for any developmental concerns or other diagnoses like Autism Spectrum Disorder or even mild CP or something of that nature. But, dang if I didn't lose it a time or two, crying hysterically over the fear, the concern, the judgement, the frustration and the solid doubt that I was missing something or failing him somehow.

What I did know, was that somewhere beneath all that fear, I trusted that I knew my child. And what I knew was that this was a hypersensitive kid. What he needed was trust in me that I could be a safe place for him to quietly and gently explore at his own pace while I provided countless opportunities for his vestibular system to develop. Overtime, he as improved in these areas tremendously, but every once and again something new will pop up and scare him because his system is still maturing. For instance, this summer, we went on vacation to the beach and he was TERRIFIED of the ocean. Crying hysterically (seriously it was heartbreaking to watch the complete panic on his face) because he thought the ocean would wash him and me away. He told me later that he was scared because "the waves move me". He refused to even swim in the pool for two days after going to the ocean. I realized that the visual motion of attentively watching the ocean waves roll in and out as he looked down was making him extremely dizzy and insecure. What others see as stubborn and irrational, I see as frightened, insecure and in need of love, gentleness and empathy.

By gently, slowly, steadily and consistently doing a few things that pushed him to try new things, to activate his vestibular system on a regular basis, he now demonstrates very few vestibular hypersensitivity symptoms. He loves to swing now, he plays soccer, hangs from the monkey bars, goes down the twisty slides, loves swimming, playing T-ball and all sorts of other activities that would have scared him in the past. He's also a brilliant little genius and I need to carry Google around with me at all times to keep up with him.

Here's what I learned through that journey that maybe will connect or give you boldness for yours: 1. Momma bear instincts are pretty accurate. Trust your gut that you know your child best. 2. Be fierce in advocating and providing for your child the in the way that works best for you AND them. 3. "Different" isn't something to be feared; it's empowering to understand what "different" means for each of us and 4. Change and outcomes occur with quiet perseverance, persistence, trust and wisdom- so educate yourself!

Sensory Inspired Applications for Vestibular Input Activities:

SWING: at the child’s pace. They know their threshold for input. Children who are avoiding of this type of movement may need to start slow (don’t push, encourage small tolerance overtime to build trust and security) whereas children who are seeking vestibular input may need to swing high and often to meet their thresholds. Your goal for these children is to promote safety but understand that they will be much more adventurous than YOUR comfort zone

YOGA: you will learn quickly that I LOVE yoga (not for myself- I prefer a sedentary, sensory avoiding lifestyle LOL!!) but yoga is GREAT for kids. It hits that deep pressure, proprioceptive stuff that we talked about last week, it gets the head in a different position, which promotes vestibular input AND it teaches kids to maintain postures that promote self-regulation and calming

ANY PLAYGROUND equipment: exploration of playground equipment changes head positions, teaches balance and promotes risk taking. In particular, merry-go-rounds, slides, monkey bars and hanging upside down on bars are great for vestibular activation

SPINNING: sit n’ spins, office chairs, merry-go-rounds etc. “Twirling” your child as you dance. Tire swings, summersaults, cartwheels, etc are also great for spinning movements.

ROCKING: Playing row, row, row your boat, rocking in a rocking chair or sitting in a rocking saucer

RUNNING and JUMPING are also great vestibular input. Use your creativity here and get those kids moving ;)

As always, this information and these suggestions are merely for promotion of the general development of our own children or children in our classrooms. If you notice something that seems fairly far from the "norm", please contact your physician or OT for further recommendations.

Also, if you see your kids engaging in vestibular activities or find good ways to promote them, snap a pic and send it to me or tag me in it! I love seeing our kids at PLAY <3