Need to know: Understanding the vestibular sense

The vestibular sense, also known as the sense of balance, is located in the inner ear and is responsible for detecting changes in head movement so that we can orient ourselves in space and understand our body’s movements and position. 

The vestibular system doesn’t work independently, it relies on tactile (touch), auditory (hear), and visual (see) information to give us our spatial orientation. It also has the important task of modifying and coordinating information received from other systems, similar to a traffic controller, directing each sensation where and when to go or stop.

Why it’s important

Children with neurodevelopmental differences are more likely to experience specific challenges with their vestibular system which impact sensory integration. These children may have difficulties performing activities that require movement or maintaining muscle tension during movement (low muscle tone), leading to issues with fine motor skills such as writing, gross motor coordination such as running, and oral motor skills such as speech and eating.

Vestibular processing issues can often be seen when a child is required to complete tasks at home and at school where they need to coordinate both sides of the body at the same time. For example, a child may have difficulties:

• Holding paper and cutting
• Reading and copying off a whiteboard
• Engaging in sports activities
• Getting dressed
• Packing their bag
• General chores

Problems with the vestibular system can also lead to sensory processing difficulties, which can be especially challenging for children with neurodevelopmental differences. Children affected by poor vestibular processing may be perceived as inattentive, lazy, inflexible, overly anxious, controlling, or seeking attention. They may also have social difficulties, as they may feel vulnerable in unpredictable situations.

These children may experience sensory overload or under-responsiveness to stimuli, which can make it difficult for them to process and interpret information from their surroundings.

Under-responsive

A child who is under-responsive needs more input than their peers to feel the effects on their bodies. They can often seek additional vestibular input by crashing or falling, swinging or spinning. You might also notice the following:

• More accidents because of clumsiness
• The ability to spin without feeling dizzy 
• Excessive movement
• Inability to sustain listening without moving or rocking
• Head banging

Over-responsive

A child who has an over-responsive vestibular system is more likely to perceive gravity more intensely and small movements such as stepping off an escalator can make them anxious. This can result in a fear of playground equipment, as well as going on elevators. You might also notice the following:

• Avoiding movement at all costs
• Frequent car sickness
• Dizziness or nausea caused by looking at moving things
• Difficulty walking on uneven ground or stairs

Poor vestibular processing can also have an impact on a child’s social and emotional well-being. If your child has vestibular dysfunction, they may experience frustration or feel discouraged by their struggles and may avoid physical activities or social situations as a result. It is important to be understanding and adjust your expectations to match their current abilities. With the right support and interventions, it is possible to improve vestibular processing and help your child to build their coordination and balance skills.

Tips & strategies

If you are concerned that your child is experiencing problems with their vestibular system, it is important to seek the advice of a healthcare professional. An occupational therapist can work with your child to develop their coordination and balance skills. In the meantime, there are several ways in which you can help your child:

Visit different types of playgrounds – encourage your child to try out equipment that involves balance, such as climbing or playing on a balance beam. Swinging and spinning can also help to develop the vestibular sense, but be mindful of your child’s limits. In some situations, you might want to sit them on your lap so they feel secure.

Ride a bike or scooter – if your child can’t ride a bike yet, remove the pedals and let them use it as a balance bike. This still allows your child to practise coordinated balance and movement.

Encourage jumping – the jumping motion is important in developing the vestibular sense. You can try inviting your child to a jumping jack competition or encourage them to use a jumping rope or try a trampoline. There are small trampolines for indoor use if you can’t access a larger outdoor version.

Rolling or moving on a peanut ball – these balls are small and shaped like a peanut so that your child can lie on their stomach while keeping their hands and feet on the ground to move forwards and backward.

Use sensory toys and tools – sensory toys and tools, such as weighted blankets or fidgets, can help your child regulate their sensory input.

Try a weighted backpack – if your child is anxious about using steps, elevator or escalator try using a weighted backpack that is about 5 – 10% of your child’s body weight.

It is important to be patient and understanding when supporting your child with any activity that challenges their vestibular sense. It may take time and trial and error to find strategies that work best for your child.