Vestibular (Balance and Spatial Orientation)


The vestibular system is responsible for the body’s sense of balance, motion, and spatial orientation. Children with vestibular processing issues may appear clumsy or hyperactive. They may also have issues tracking objects with their eyes or performing fine motor tasks.

The vestibular sense is a function of the inner ear and usually works in conjunction with sight. For instance, you’re able to ride in a car without feeling dizzy or nauseous because your vestibular and visual systems are sending matching signals to your brain; motion sickness occurs when these signals become mixed. The sensation of moving up or down in an elevator is an example of your vestibular system working in isolation.

Vestibular Seeking Vestibular Avoiding
  • Fidgets and needs to be in constant movement (rocking, spinning, swinging, etc.)
  • Engages in impulsive and sometimes inappropriate behavior (running, jumping, or climbing indoors)
  • Seems to always be running
  • Loves spinning in circles and merry-go-rounds, but never appears dizzy
  • Prefers to be upside-down
  • Loves roller coasters and other amusement park rides
  • Appears clumsy and uncoordinated; trips when walking or climbing stairs
  • Often moves slowly and cautiously
  • Avoids swings, merry-go-rounds, and other playground equipment
  • Dislikes being upside-down
  • Displays fear or anxiety when walking over gaps in the floor or on transparent floors (elevator gaps, glass floors or steps)
  • Feels uncomfortable or off balance on slanted/non horizontal floors
  • Slouches, holds head up with hands
  • Did not like to be placed on stomach as a baby
How to Support How to Support
  • Encourage safe climbing, swinging, and spinning on playground equipment.
  • Encourage crawling, doing jumping jacks, jumping rope, and balancing on a beam or low wall.
  • Allow your child to safely hang upside down (on monkey bars or off the edge of the couch).
  • Develop and maintain a sensory diet (a set of physical activities tailored specifically to your child).
  • Encourage using sensory swings, rings, or hammocks.
  • Acknowledge your child’s discomfort and patiently work to reduce anxiety.
  • Provide support/grounding when walking by holding your child’s hand or arm.
  • Be cautious and attentive around swings, slides, and other playground equipment.
  • Be aware of your surroundings and give your child verbal queues. (“There is a small gap in the floor in front of the elevator.”)
  • Discuss your surroundings and properly contextualize the risks. (“The gap is smaller than your foot. You cannot fall in. Let’s step over it together.”)

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