strategies for vestibulr diferences

VESTIBULAR OVER-RESPONDERS

Behaviors that you will see when a child is over responsive includes:

• Get nauseated when riding in a car.
• Get upset when handed from one person to another.
• Don’t like playground equipment. (climbing, swinging, sliding) 
• Avoid chasing games and team sports. 
• Get upset if pushed or moved.  
• Gravitational insecurity.
• Fearful of swings, slides, merry-go-rounds, see-saws.
• Dislikes new movement activities and will have difficulty learning it.
• Fears heights, climbing, stairs and escalators.
• Does not like when head is upside down or reacts fearfully when being put on his/her back for diaper changes.
• Avoids balancing activities like walking on a balance beam or handstand.

Try these things to offer calming vestibular input: 

1. Slow, rhythmic movement:  Moving is very disturbing to children who have vestibular over-responsiveness. Keep things slow until they build up tolerance and confidence. Rhythmic means consistent and predictable of same rhythm. Think of a swing gently swaying back and forth or a metronome that musicians use to keep accurate timing. 

2. Linear movement (one direction):

UP/DOWN:  Up and down movement is the easiest to tolerate (start here).

SIDE TO SIDE:  Side to side (lateral movements) are next.

FORWARD AND BACKWARD:  This can be scary if done with speed, so take it slow. 

ROTARY: This is alerting and can be dysregulating. Use with caution with over-responders.

3. Slow movement with deep pressure:  Slow and steady wins the race with these kiddos.

4. Predictable movement: Predictable means we know it is coming; we can count on it happening. 

5. Ground Level balance activities before moving to higher surfaces. 

6. Stabilize the body: For example, give adequate foot support, make sure the sitting surface is large enough, let them hold on to something. 

7. Make the movement functional (like play): 

Example

-Ball rolls under the sofa or changing table...see if they can get low and reach under.

-Lift the child up to turn off the lights.

-Bounce on adult leg rather than a therapy ball.

-Hold hands while singing "A tisket a tasket..." and moving in a circular pattern.

-Play "up/down" going slow, medium then fast by slowly changing velocity and letting the child have input about how fast or slow they want to go. 

-Hold the child close while moving in a circle.

-Bouncing while sitting on a ball.

-Crawling or walking up ramps.

-Moving in a wagon at different speeds, forward and backward or side to side.

-Holding on to the child (allowing them to sit in your lap) to do down sides or swing to help them feel stable and secure.

VESTIBULAR UNDER-RESPONDERS

Behaviors that you will see when a child is under responsive includes:

• These children are moving all the time. 
• Fidget
• Get up from desk/chair and in general have a difficult time with sitting still or sitting tasks.
• Impulsive
• Does things fast
• Poor regard for safety
• Attention to task is limited due to frequent need to move.
• They want to spin and don't get dizzy
• Like to be inverted or upside down.

These children need to get more input with increased frequency. You want to fill their bucket. Try these strategies:

1.  "IN SEAT BEHAVIOR": Stopping the movement in children with an under-responsive system can cause you to get other behaviors that may be worse. Instead of STOPPING it, provide it in a different way such as through rocker seats or wobble cushiohs, therapy ball chairs or Bilibo seat. 

2. OFFER FREQUENT MOVEMENT OPPORTUNITIES: Let the child be the one to "go get the...: or "take this to..." so that it has a functional purpose.

3. GET OUTSIDE AND OFF THE DEVICE: These kids need to move. Being inside and mindlessly watching a scree is not productive for their sensory systems.   

4. PROVIDE MOVEMENT THAT INCORPORATES OTHER SENSORY SYSTEMS:  Music and movement activities since you can imitate movements and have you follow them and it becomes more organized and multi-sensory. Movement and tactile input such as walking on a variety of textured surfaces or playing with a variety of textures using hands.

5. OFFER MOVMENT THAT IS CALMING TO THE SENSORY SYSTEM: Linear movements, up/down movements and side to side movements that are slow, rhythmical, and predictable help to regulate the body. Rotary and inversion of the head will dys-regulate and over-arouse the sensory system creating a bigger problem. It's not that you shouldn't do these types of activities, just know that if you do it you will need to take some time afterwards doing sensory calming activities afterward. 

6. OFFER WEIGHT OR FRICTION WHEN PLAYING: Slowing the "fast mover" down can be as simple as having the pull a wagon over a grassy surface rather than a cement surface. Proprioceptive input through weighting can support more body awareness and help to decrease movement speed over time as the child begins to fatigue. Again, this incorporates more than one sensory system. 

7. ROCK WHILE READING A BOOK: If you want the child to pay attention you may need to offer movement while sitting. 

8. GET THEM MORE INVOLVED IN SELF-CARE:  Passively sitting while being dressed, bathed or groomed is not recommended. Have the child help with getting things they need, showing them where to push or pull-on clothing to get dressed, put the toothbrush in their hand for a while, and let them help you cut things up for snack or meal. 

9. STAND TO DO TASKS: Invest in a toddler tower. Toddler towers are enclosed, elevated structures that allow children to play safely at counter height while reducing the risks of falls. Widely used in Montessori education, these structures promote independent learning and encourage the development of practical life skills. 

10. USE INDOOR SWINGS OR CLIMBING EQUIPMENT: Get indoor swings, pods or platforms that are free standing or mounted to a beam in the ceiling to support the child's need to move. See examples in products section below. 

11. CLOSE EYES:  Have the child close their eyes during a movement activity. This can add intensity.

12. INCREASE THE SPEED: This too can support increased intensity of input to fill the child's bucket.