#51 - What is the Vestibular System for Children?

The vestibular system is one of our “hidden senses.” When I say hidden senses, I’m referring to our three internal senses that don’t really get as much attention as they should. They are our vestibular sense, proprioceptive sense, and interoceptive sense.

If you’re joining us for the first time - Hi! Welcome to the podcast. We’ve spent the past couple weeks introducing the hidden senses and really diving into that proprioceptive sense. After listening to this episode, you may want to head over to episodes #49 and #50 to get the full scoop.

Today we’re focusing on that vestibular sense, which leads us to the question…

What is the Vestibular Sense?

To put it as simply as possible, the vestibular sense is our sense of head and body movement. In other words, it tells us if, when, and where we are moving. 

This input comes from fluids, hairs, and crystals in our inner ear. When our head moves, the fluids, hairs, and crystals shift and that’s how our brain knows that we are moving. 

But Why Is the Vestibular System Important?

Even though we don’t usually need to pay attention to it all the time, the vestibular system is constantly working to help our day go smoothly. This sense is SO important, especially because it is crucial for helping us with our stability and balance - keeping us safe. For example, to be able to keep your balance when you lean over, your brain needs  to know that you leaned over, so it can adjust your muscles accordingly. If it doesn’t pick up that your head has moved, your muscles won’t adjust, and you’ll likely fall down. 

Vestibular system difficulties can be really scary. For example, if you’ve ever heard of someone getting vertigo…this is related to the vestibular sense. When your vestibular sense isn’t functioning as efficiently as it should, it can lead to challenges with dizziness, motion sickness, balance challenges, coordination issues, and challenges sitting still. 

What does this have to do with my child or my client?

Many children with sensory processing challenges experience underlying vestibular challenges that often go unnoticed. For example, a child who is vestibular seeking (aka a child who is looking for more vestibular input), is often pegged as a troublemaker in the classroom because they have a hard time staying seated. But in fact, their body and brain is just desperately trying to get the input it needs to stay organized, and instead they’re getting in trouble for it. 

On the other hand, a child who is hypersensitive to vestibular input may avoid playing with other kids on the playground and going on the swing, and may even have meltdowns when you try to encourage them to. Adults may get frustrated because you just want them to play and have fun, and you feel like they need the movement, but if they get dizzy from this movement, why would they want to do it? They’re actually protecting themselves by avoiding it. Unfortunately, kids often have a hard time verbalizing why exactly it is that they’re avoiding or seeking an activity, which leaves us needing to do the digging.

When it comes to working with children, my goal is usually to figure out how exactly their vestibular system is functioning. I do this by asking families targeted questions like - does your child get motion sickness? Do they never seem to get dizzy? Are they constantly moving? Or do they avoid movement? 

I also observe how a child moves. Do they prefer slow rocking movements? Do they want to be hanging upside down? What kind of movement are they preferring and looking for? Or, do they tend to sit more still and avoid movement as much as possible?

If there’s concerns, I want to figure out what kind. Is it a sensory modulation issue? Meaning, does their brain need more or less vestibular input to be it’s happiest? Is it a discrimination challenge? Meaning are they having a hard time determining the specifics. For example, can they not tell when their head moves, or in which direction? Is it leading to sensory based motor challenges like difficulty with posture, balance, and coordination? 

It’s really important to get into those nitty gritty details so we know exactly what’s going on in their body. Only when we know this information can we sufficiently support them and choose the right strategies. Of course, the strategy that gets the most attention on social media is vestibular input.

What is Vestibular Input?

Essentially, vestibular input means that that vestibular sense is getting activated. So usually, it means that we are shifting the fluid, hairs, and crystals in the inner ear by providing some type of head movement. Either intentionally through specific input, or even unintentionally by just going about our usual day.

Vestibular input is given to help specifically with sensory modulation. So it helps regulate a child’s sensory thermometer. When we talk about sensory modulation, we’re referring to how a person’s body responds to sensory input. Some people are more sensitive to it, while other people need a ton to feel their best.

For someone who is sensitive to input, we’re usually going to try to offer less, or less intense input. For someone who requires more, we’re usually going to offer more or more intense input.

For example: for our sensory seekers - our kiddos who are actively seeking and looking for lots of sensory input, they may love doing obstacle courses that require a lot of jumping, and crashing, and spinning. 

For kids who are more sensitive to input, they may prefer slow movements that go in the same direction, like going in a car. Every kid and every body is going to be so different.

Vestibular input is tricky though. And one that I tend to be really cautious with, because you can absolutely over-do it, and lead a child to become dizzy, nauseous, and more.

So I prefer that children lead us in what feels good for their body, instead of telling them how much or what to do. And I always start really small and see how they respond. Of course, make sure to chat with your own personal medical team if you’re going to change how much input your child is getting. I personally always recommend talking to your personal occupational therapist.

So why do I say that vestibular input gets the most attention on social media? Well, there’s all these posts about types of vestibular input, which is great. But input isn’t always the answer. For example, sometimes there’s something going on in the inner ear that needs to be addressed by the medical team (that’s why it’s important to chat with your doctors and rule things out).

On the other hand, if a child is having a hard time knowing which direction their head moved, more vestibular input might not always be the answer. It might be that you need to break it down, use feedback, and help them be able to tell the difference.

If it’s causing motor challenges, then again more input isn’t always the answer. Instead, we may need to slow it down and help them learn movements step-by-step. 

And that’s why I feel SO strongly about education. Both for parents and for therapists. Because even when you’re going to occupational therapy and they’re leading you, YOU NEED to understand what they are doing and why.

1: Because your understanding is pivotal to your child’s success. I can’t tell you how many posts I see on facebook groups where moms and dads are considering stopping therapy because it just looks like they’re kid is playing. To be honest, with a good therapist it SHOULD look like playing, it should be fun for your child. They key though it that under this play, the therapist has a goal that they are working on. But if you aren’t educated on what that goal is, and why the therapist is doing what they’re doing, you may think nothing’s happening. Furthermore, this understanding helps you not only ask better questions, but carry over what they ask you to at home.

And

2: Because we’re all human and your therapist might not be picking up on something. I’ve been pretty vocal on this podcast about how as an OT we don’t receive all the sensory education you think we do in school. A lot of it is self-led as we take courses. So don’t assume your therapist knows it all. Educating yourself will help you be more informed in advocating for and supporting your child.

And as you know I would LOVE to help you with that education, because sensory is my jam.

If you’re ready to learn more about the vestibular sense, the proprioceptive sense, and the interoceptive sense, and the major impact these hidden senses have on your child’s daily functioning … then you NEED to take a peek at my 45-minute Hidden Senses mini-course, which is being released NEXT WEEK. 

I’m going to take you even deeper into all these senses, break down the different types of challenges your child may be experiencing, and of course leave you with simple, practical strategies you can use at home. 

Understanding these senses really does open up a new window into your child's behavior. When these senses aren't in sync, daily tasks can feel impossible, and stress and meltdowns can become overwhelming.

So join me back here next week where I’m going to share an extra special discount code with you to celebrate its launch for ONE WEEK ONLY. 

I’ll see you then!

References: https://sensoryhealth.org/

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