The vestibular system (inner ear balance mechanism) helps us maintain awareness of positioning of our bodies when for example we are walking, running or riding in a vehicle. This sense is linked to other systems such as vision (eye and the muscles and parts of the brain that work together to let us see). It helps children with many activities including learning to crawl, jumping up and down, writing, and following an object with their eyes. 

Each child receives and processes vestibular information differently. Some children are hyposensitive to vestibular input and need constant input such as swinging and jumping. On the contrary, some children are hypersensitive to vestibular input and dislike movement and balance activities. 

There are the four patterns of sensory processing: low registration, sensation seeking, sensory sensitive and sensation avoiding. 

Low registration: A child with low registration does not recognize or process all of the incoming sensory information, and they do not compensate by trying to gain more sensory input to meet their needs. They may seem uninterested, and inattentive to their surroundings.  

Sensation seeking: A child classified as sensation seeking does not recognize or process all of the incoming sensory information, but contrary to low registration, they actively try to gain this sensory input to meet their needs. They may be hyperactive, touch others often or engage in unsafe activities like jumping from heights. 

Sensory sensitive: A child classified as sensory sensitive feels overwhelmed by sensory information, but they do not actively try to avoid the overstimulation, instead they may just display frustration. They may be easily distracted, and irritable, cautious, and uncomfortable in loud or bright environments. 

Sensation avoiding: A child that is sensation avoiding feels overwhelmed by sensory information and will actively avoid the stimulation. They may run away from loud, busy environments, cover their ears when overstimulated by noise, or wear gloves to avoid touching certain materials such as paint. 

Hyposensitivity 

Children who have low registration or are sensation seeking may require extra vestibular input in order to process sensory information and their environment.

If a child has a low registration pattern for vestibular processing they may: 

• Be described as clumsy, often falling over, tripping and losing their balance. They may have to look at the floor while walking.
• Be able to spin in circles for a long time without becoming dizzy.
• Have a poor awareness of safety such as running into objects without noticing. 
• Be unable to follow moving objects, such as cars with their eyes. 

If a child has a sensation seeking pattern for vestibular processing they may:

• Be described as a risk taker and fearless. They may jump from high heights and spin in circles fast on the swings at the park. 
• Enjoy a large amount of bouncing, jumping and spinning without becoming nauseous or dizzy. They may be described as having too much energy. 
• Enjoy thrill seeking activities, such as roller coasters. 
• Rock back and forth while standing or sitting.
• Love being upside down. For example, while on the monkey bars at the park.

Case example:

Marwan is a 5-year-old boy. His teacher at school has observed that he likes to climb on top of the desks in his classroom and jump off them. They worry about Marwan’s safety constantly in the classroom but can’t seem to stop this behaviour from occurring. Marwan’s teacher has expressed this concern to his parents, who claim he behaves similarly while at the playground. He likes to jump from the top of the slide down to the ground. He also enjoys being spun on the swing repeatedly. He never seems to become dizzy or nauseous after this. Marwan’s parents and teacher decide to work together collaboratively with Marwan to come up with a solution for this unsafe behaviour. 

Marwan has a sensation seeking pattern for vestibular processing. He requires a large amount of vestibular input and constantly seeks it out by jumping from high heights, engaging in unsafe activities and spinning. 

Strategies to assist a child with hyposensitivity for vestibular processing:

• Have your child jump on a trampoline, or an air mattress.
• Allow for your child to bounce on large exercise balls, with physical support from an adult at their waist or hands.
• Play on the swings at the park.
• Encourage your child to play spinning games using a desk chair that spins.
• Incorporate rocking activities into your child’s daily routine. This can be done with the help of a rocking chair and can be very calming for children. As a game, you can try being a rocking horse for your child. You can get on your hands and knees, have your child sit on your back and rock back and forth. 
• Teach your child to use playground equipment correctly. You can go down the slide with them or swing on the swings with them. 
• Use songs to teach your child body awareness. You can make this fun by adding in dance moves that require energy. For example, teach your child the song “Head and Shoulders, Knees and Toes.” 

Hypersensitivity 

A child classified as sensory sensitive or sensory avoiding may become easily overwhelmed by vestibular input and avoid this input.

If a child has a sensory sensitive pattern for vestibular processing they may: 

• Dislike sleeping on a bed or cot above the ground due to a fear of falling off. 
• Become frustrated and anxious while on a roller coaster or ride such as a merry-go-round.
• Dislike many sports including soccer, basketball, and swimming. 
• Be afraid of heights and having their feet off the floor.
• Dislike being rocked.
• Easily and frequently become motion sick or dizzy. This may happen in car rides, or at the park. 

If a child has a sensory avoiding pattern for vestibular processing they may: 

• Avoid using the playground equipment at the park. Instead they may prefer to sit and play in the grass or sit on a bench. 
• Avoid activities that involve running, spinning and jumping. They may be less active than other children their age. 
• Refuse to go on any roller coasters or rides such as a merry-go-round. 
• Easily becomes motion sick or dizzy. This may happen in the car or at the park. 

Case example:

Harshita is a 6-year-old girl. Harshita’s teachers are concerned that she does not have many friends at school. They report that she spends her time in recess alone sitting in the grass. Her peers like to play on the playground and play games such as hopscotch and four-square. Her teachers and peers have tried to engage with her outdoors however, she tends to run away and hide whenever the activity involves heights, being upside down, or vigorous movement. 

Harshita has a sensory avoiding pattern for vestibular processing. She is hypersensitive to vestibular stimuli, such as jumping, being upside down and running and responds by avoiding activities that involve these stimuli. 

Strategies to assist a child with hypersensitivity for vestibular processing:

• Provide your child with a safe space to enter in the event they become overwhelmed with vestibular input. This can be a small tent or even a quiet room which will enable them to feel safe and regulate their emotions. 
• Slowly desensitize the child by incorporating rocking, spinning or swinging activities into their routine within their comfort zone. It is important to note that if you choose to do this you need to do it very slowly. Provide the child with as much support as possible. For example, you can use a rocking chair with your child. Initially, you can go in the chair with the child and talk with them about what they are experiencing. Then slowly you can remove yourself from the rocking chair working within their comfort zone. 
• Provide the child with alternate activities during recess or outdoor times. For example, you can play board games with them outside. 
• To incorporate more physical activity into the child’s routine, use activities that are active, but do not have fast and unpredictable movements in them. For example, you can go for a walk, throw a ball together, have children hold a parachute and gently move it up and down, garden together or play a treasure hunt game outside. 
• While sitting in class, at the dinner table or in the washroom, ensure that the child’s feet are on the floor. If they are in a higher chair, provide them with a stool to rest their feet on. 
• Allow for the child to sit in the front of a vehicle or bus to prevent motion sickness, if safe.