The Vestibular System: A Tale of Two Movements

The playground. It’s the best of times, it’s the worst of times. It’s the place where some find joy in climbing, swinging, sliding, and bouncing. It’s also the place where others see dread at the thought of such madness.

The playground can be a polarizing place. It’s where the movement seekers can challenge their limits. Meanwhile, the movement avoiders look for solace at a nearby bench until it’s time to go home. Why the divide? There is one system to blame and it’s the one that lets us know exactly where we stand in the world.

What is the Vestibular System?

Named for the chambers in the inner ear where there are trio of fluid-filled passageways, the vestibular system is responsible for sensing where our head is in all planes of movement. It lets us know where we are in relation to gravity: upright, lying down, upside down, if we are moving or still, how fast we are going and in which direction.

With this information, the vestibular system signals to the other sensory systems to make necessary adjustments to maintain balance, posture, and to stabilize the head and neck during movement.

Although this sense is not typically taught with the five basic senses to children, it doesn’t make it less important or less needed for proper development. It is the first sensation the fetus experiences prior to birth and as the other senses develop, the vestibular system helps them integrate appropriately. So when activated, the system operates like a light switch in the brain, arousing the body to complete the day’s activities.

How Important is the Vestibular System?

The vestibular system has its hand in pretty much all the sensory systems. Here are a few of its functions:

  • Influences the visual and auditory functions to understand the environment and makes appropriate adaptive adjustments
  • Guides coordinated movements in mental and physical activities that involve space and time, such as reading and writing
  • Holds precision and timing in gross and fine motor movements necessary in rhythmical activities, like jump roping or dribbling a ball
  • Orients where we are in space as well as where objects are in relation to one another (spatial relations)
  • Differentiates what comes before or after, sequencing components, and providing appropriate timing and rhythm in actions, such as speech and language
  • Modulates mood due to its associations with the limbic system (where motivation, emotions, and memory are resides)
  • Maintains a stable visual alignment despite the position of the head, neck, or body
  • Acts as a gravity detector, stimulating muscles for an erect upright posture. Eyes facing toward the horizon is an optimal position for the brain
  • Provides synchronicity of muscle actions so that we can stop, start, and continue movement

When the system is operating correctly, we move confidently in our environment. If we stumble or fall, we can pick ourselves back up and make adjustments not to do it again. We can also adapt and engage with unsteady structures, uneven surfaces, or things that move us (like escalators, elevators, people movers, or vehicles where we are not driving).

However, if the vestibular system is not operating correctly, it feels like we’re in constant motion with no true hold of where we are. Difficulties may present themselves in:

  • Movement/balance – uncoordinated and awkward movements
  • Visual – difficulties focusing on a moving or stationary object, or fixating on an object while in motion
  • Auditory – difficulties with processing language, resulting in communication, reading, and writing challenges
  • Muscle tone – low muscle tone, appearing slouchy or lethargic; tiring easily
  • Midline orientation – difficulties working on tasks in front of them using both hands; difficulties coordinating both sides of the body.
  • Motor planning – difficulties learning or generalizing a new skill
  • Emotional security – disorganized, difficulties calming themselves down, having low self-esteem and feeling like they “can’t do it.”

The Over-Responsive: So Moving it’s Sickening

An over-responsive kid won’t like movement because even the smallest amount of it (like turning their head too fast) can overload them. Movement can make it difficult to process where they are and how to respond appropriately. Fast rapid motion can be stressful, especially if they are not in control of it. This explains why some children can get car sick, especially when riding in the back seat. Rotary (spinning) movement is the worst, leading to dizziness, headaches, tummy aches, and nausea. Even watching someone participate in such movements can make them feel sick. Carnival rides, anyone?

Tipping or bending backwards can also make a child feel like they are falling and losing all connection to the ground. This is because their visual system can’t counter this feeling of instability since they can’t see their feet on the floor. Movement where feet are off the ground (such as swinging) can be difficult to tolerate as the change in the center of gravity may cause a flood of new overwhelming sensory information. Where’s the ground? Am I falling? Will the impact of this fall hurt me? Will I live to tell my tale?

The Fearful: Dear Gravity, I Don’t Trust You

We all have a relationship with gravity. However, with a vestibular system that is over-responsive, the result is gravitational insecurity. This is an abnormal fear of excessive movement, not being in an upright position, or having their feet off the ground due to falling or the possibility of falling. This isn’t something they can get over easily as falling is a genuine primal fear. If a child has an over-responsive vestibular, all movement is scary with the thought that they will not survive, resulting in a flight-fight-fright response. They try to avoid or manipulate situations to dodge unpredictability and any kind of movement outside of their control, sometimes resulting in meltdowns. Their mistrust of gravity may extend into mistrust of where they are, their actions, their environment, and those around them. Think of people who are scared to fly on airplanes, or are afraid of heights.

The Seeker: Ready or Not, Here I Come

Go to any playground or amusement park. You can find them, the thrill seekers and daredevils who want to challenge their bodies and put gravity to the test. Unlike the majority of us who need a little dose of movement to get us going, these kiddos crave fast intense input for long periods of time to modulate their system. They’re the ones who want to go on the tallest, highest, fastest ride at the theme park. They’re the ones on the monkey bars hanging upside-down, swinging high and fast on the swing set, spinning really fast on the merry-go-round, or who climb to the very top of the jungle gym. They move quickly and impulsively, often without good body awareness or coordination (think of a pinball machine…that’s them).

What Can We Do to Help?

The vestibular system is one of the more primitive and powerful senses we have and must be addressed with caution. Too much input or movement for someone who is over-responsive can be traumatic.

Low and Slow –It’s best to introduce the fearful with some slow, rhythmical movement like a rocking chair. You may want to start them sitting on your lap or with their feet on the ground. Start with moving back and forth, then side to side, and then in circular motions (not rotary). As they get more comfortable, you can begin to have their feet slightly brush the floor or have them sit next to you. When they become secure with this, you can start exploring other directions of movement such as up/down, alternating positions (rather than sitting, try laying down), different speeds, and intensity.

Communication is Key – Always communicate with your child regarding movement. Do not impose something that may be too much for them. If they like it, continue it. If they want a little more input, provide it. If they want to stop, honor it.

Pair It with Proprioception – Vestibular input can be a lot to take in. If that’s the case for your child, activate the proprioceptive system (responsible for body and spatial awareness). This can be done with big bear hugs while or after swinging, holding onto a bar while jumping on a trampoline, or pushing off the wall when rolling in an office chair.

Safe and Secure – As your child becomes more confident with movement (or they are already there), ensure that the environment is safe for them to explore and engage in. If they want to jump, make sure their landing pad is soft and cushy. If they want to climb up a ladder, let them know that you are there to catch them if they fall. If they want to slide, show them that you are there at the bottom…you know, just in case.

Add It Throughout the Day – For the movement seekers, they will need to satisfy their vestibular system frequently. Therefore, scatter movement activities throughout the day. It can be completing tasks that require frequent running up and down the stairs, doing homework while sitting on an exercise ball, or reading a book while fidgeting or with their head hanging off the edge of their bed.

Things to keep in mind:

  • Most vestibular input occurs during start/stop phase of movement. Think of swishing a glass full of fluid and then stopping. The splash of the fluid up against the glass is the vestibular input we experience.
  • Fast start/stops are disconcerting, like slamming on the brakes.
  • Slow rocking is soothing and calming (which is why we rock babies to calm them).

If you think your child may have a vestibular issue that affects their daily routine and participation, don’t hesitate to seek guidance from an Occupational Therapist who is trained in sensory integration.


Sources:
Barker, Laura, MA, OTR. Sensory Processing: Behavior, Memory and Learning. Live lecture. Children’s Healthcare of Atlanta, Atlanta GA. 2012.

Kranowitz, C. (2005). The Out-of-Sync Child: Recognizing and Coping with Sensory Processing Disorder.  New York, NY: A Perigee Book.

Kranowitz, C. (2003). The Out-of-Sync Child Has Fun: Activities for Kids with Sensory Processing Disorder.  New York, NY: A Perigee Book.

Mauro, T. (2006). The Everything Parent’s Guide to Sensory Integration Disorder. Avon, MA: Adams Media.

Understanding Sensory Processing Disorder: Vestibular System“, Shannon Phelan. North Shore Pediatric Therapy.

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