The Vestibular System

We have all heard about our five senses: sight, touch, taste, smell, and hearing; but did you know that we have another sense? This sense is known as our vestibular sense. It involves the interpretation of movement, specifically the movement of our head.

Let’s take a look into how our vestibular system works. We have an organ in our inner ear that contains fluid. When our head moves, this fluid also moves, moving small hairs inside this organ. This movement of fluid, and in turn the hairs, sends signals to our brain and lets us know which direction we are moving and how fast we are moving.

Often, vestibular input is used to stimulate our systems, leaving us feeling energised and ready to go. Think of the exhilaration you feel when coming off the swings, or perhaps a roller coaster. This is an extreme case, but the example can be used to best describe how our vestibular sense puts us into a state of alert. In contrast, slow, rhythmical movements also produce vestibular input but can be calming. When we rock a baby to sleep, we are using vestibular input to calm the system.

Children can have no difficulties with the vestibular system, can be seeking of the input, or avoidant to the input.  When a child seeks vestibular input, we refer to them as having a high threshold. Children who avoid the input are known as having a low threshold.

A child with a high threshold seeks out vestibular input. This goes beyond just enjoying spinning or swinging, but leads to the child looking for this movement even during their everyday activities. A child who rocks on their chair in class, or spins their body from side to side when waiting in line could be showing vestibular seeking behaviour. Children with vestibular seeking behaviour may struggle to concentrate in class as they require additional movement before they are in their optimal band of arousal (i.e. having received enough sensory input to take in and retain information).  Generally, a child with this seeking behaviour needs more movement than other children to get into this arousal band, and they therefore seek this movement themselves.

Children with a high vestibular threshold who demonstrate seeking behaviour are often misdiagnosed as having ADHD, while children with a high vestibular threshold who do not seek the behaviour can be misdiagnosed with ADD. It is therefore important for a child’s sensory systems to be evaluated and addressed before a formal diagnosis is made.

In contrast to a high threshold, a child with a low threshold will avoid vestibular input. This means they will become distressed if they are on the swings and will avoid this playground apparatus completely. They are often prone to motion sickness as their brain interprets this movement as threatening, making them feel ill. They may feel disorientated when going on escalators. Children with vestibular sensitivities may show signs of anxiety in their everyday lives. This anxiety comes from being overstimulated from vestibular input on a frequent basis.

If you feel your child is seeking or avoidant of vestibular input, this can be addressed. A sensory qualified occupational therapist seeks to reduce seeking behaviour, or to allow a child to tolerate vestibular input if they demonstrate avoidant behaviour. This is done in a protective, sensory environment where they are able to explore with different sensations so that their brain registers the input effectively.

It is possible to help your children at home if they are struggling with their vestibular system; however, it is important to note that there is a risk of overstimulating your child. Signs of overstimulation include feeling sleepy, yawning, getting hiccups, becoming extremely energetic, or becoming tearful. If this happens, it is important to stop the vestibular input and to give your child deep pressure, such as a hard hug or a pillow fort. Crunchy foods are also beneficial to help your child calm down. The most important thing to remember if your child is having a sensory meltdown is to be patient with your child.

A child who struggles with movement should be encouraged to try new movements. Remember, the child will be nervous so will best move if they are in control. For example, getting the child to push themselves on the swing instead of you pushing them will make them feel more secure as they will have a better idea of what movement they can expect on their body.

A child who is seeking movement should be exposed to this movement before they are expected to do a table top task. Winding themselves up to spin on the swing, or being spun around by a parent is a good way to get vestibular input. Remember, vestibular movement comes from the movement of the head. A child will increase the amount of input they get if their head is upside down instead of upright. When allowing your child to move, remember to look out for signs of overstimulation and to give deep pressure if you see these signs.

I hope this article gives you some insight into the vestibular system, and that you feel empowered to help your child if you identify any difficulties.