• Hannah OT

Vestibular spinners and movers explained

Today I'm going to talk about what can be observed when a child is seeking or avoiding vestibular input. You'll remember from my previous post that the vestibular system is so much more than just simply your sense of balance. It controls the smooth movement of our head and therefore informs both the visual and auditory systems.

As I have said previously it is not always as simple as being a seeker or an avoider, and many people are a combination of the two or you may only see this type of preference in dysregulated moments. For example, as a general rule I am not afraid of heights or averse to spinning, however if I am particularly stressed I become avoidant of such vestibular input and it can make my state of hyper-arousal worse. I once suffered a panic attack when I was pregnant, and it had nothing to do with being up high, but the very fact that I was up high caused me to panic even more. My daughter on the other hand loves to spin, loves heights and will often be seen hanging upside down on the sofa as her position of choice. When she becomes under aroused, spinning is something which alerts her and she thoroughly enjoys. In fact, even my little one will spin and spin until she falls down in a fit of laughter. Whereas even when having to spin whilst salsa dancing, I've often had to stop because I've begun to feel light headed or sick - as my cup is pretty full when it comes to vestibular input, I am perfect to have around at a theme park as I'm happy to bag sit whilst all you thrill seekers go on the rides, all I ask is that I'm fed on the hour with enough junk food for the trouble:-)

What do seekers of vestibular feedback look like?

These are children who seek movement, frequently change position, enjoy hanging, rocking and spinning off or on anything. You'll often find their choice dance move is to spin and can be seen physically rocking whilst sitting and swaying whilst standing. Sometimes these movements are very obvious and sometimes very small and subtle. I have also seen children enjoy the shaking of their heads, they love the feel of being dizzy and will more often than not be thrill seekers - love high and steep slides and will be desperate to get passed the 1.2 metre mark at the fair when they are able to go on the rides, I know my older one has waited for this moment for many years!

Interestingly, even though these children love and seek movement you can sometimes find that they are travel sick. This seems counter-intuitive as surely if they love movement then they will love car journeys, particularly bumpy ones? Perhaps or perhaps not, it will depend on the individual child and why they are seeking vestibular feedback:

a) They could have difficulty modulating vestibular input - they are either receiving too much or too little input in this system.

b) They could have difficulty discriminating the input - recognising vestibular input from other input in their environment.

If children struggle with discriminating input then as soon as their body recognises they've had too much input they may have already thrown up. This is similar with children who seemingly spin and spin and never get dizzy - their body may not recognise early enough that they have reached their limit and this can end up in a child suffering a 'vestibular hangover' for up to three days or more. This is why it is really essential to prepare children for car journeys - a simple sensory circuit or lots of heavy work can prepare their sensory systems and can prevent them from becoming car sick. In addition, after lots of vestibular activity it is really important to support your child's system in recovering. To recover after lots of vestibular input it is essential to follow up with lots of proprioception - deep pressure is particularly effective at calming a child and restoring their internal balance after a good workout. This is primarily why when completing a sensory circuit you should do so in the correct order and complete a full circuit: alerting, organising and calming.

In addition, children who seek vestibular input very often are not getting enough feedback from their environment regarding where their head is in relation to gravity. Because of this, a child may struggle with their visual perception - find reading particularly difficult, struggle to copy from a board or focus their attention on two things at the same time. They may also find writing tricky, not just because they struggle to maintain good writing posture, but also because writing demands good hand eye coordination which demands a strong level of processing in the vestibular system. This pattern of difficulty is one I have found in my own child and I have developed ways to compensate for this through completing writing tasks in a tummy time position - a tummy time position encourages the development of core strength, and stimulates the vestibular system which informs postural control and alertness. I have worked with a class of secondary children in a special needs school (all of whom struggle to maintain a good writing posture, form letters and maintain a level of alertness to focus) on this, and their teacher was amazed at the results! Through encouraging 15 minutes of tummy time in every lesson she found that their focus improved and this had a knock on effect on their willingness to engage and their level of output.

My daughter finds maintaining a tummy time position hard - she has done since she was a baby which is the very reason she bum shuffled rather than crawled. We therefore have agreed that during this time she will write two sentences supporting herself, and the rest using a wedge - I purchased this on amazon for a reasonable price, but you can always use a rolled up towel or small pillow to support your child's upper torso (just below their armpits):

What do avoiders of vestibular feedback look like?

These children are very much the opposite of seekers, they will not enjoy swinging, slides, theme park rides, will often not like heights or going backwards (reclining in a dentist chair seems to be a good measure of this), may appear overly still and be reluctant travellers - these children are very likely to be travel sick and that is because they are particularly sensitive to motion. In addition, these children are likely to become dizzy very quickly and therefore will probably be the one shouting to slow down the roundabout, whilst your seeker will be the one running alongside it to speed it up - again another point of contention if you have siblings who are chalk and cheese!

Movement break ideas for your seekers:

1) No swing swing time - swinging without a need for a swing:

2) Swiss ball walking - ensuring that balance is maintained. In the following video I have put this into a game designed to encourage development in mid-line crossing (crossing right to left and left to right), target practise, knowledge of left and right, bilateral integration (using of two sides of the body at the same time, motor planning (planning of movement and completion from A-B) and core strength (building up of tummy muscles):

3) Balance board - these are really cheap £8-11 on amazon - my daughter loves hers and they work really well as 5 minute movement bursts, and can also be used during learning activities at this time or as part of an obstacle course.

4) Row row row your boat - for an older child who this song is too juvenile for you could always do these movements in isolation (rock, sway and row):

5) Period of spinning around, rolling across the room or hanging upside down on the sofa.

After all of these activities please ensure that you follow up with some deep pressure - a tight hug, self massage or a particular favourite of mine a full body Swiss ball roll: ask your child to lie on their tummies and roll the Swiss ball over them, pressing firmly down.

That's all from me this evening - tune in tomorrow for some ideas around supporting your tactile avoiders and seekers.

Hannah OT:-)

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