Vestibular (Balance & 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 visually or performing fine motor tasks. 

The vestibular (balance) sense is a function of the inner ear and usually works in conjunction with other senses. 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.

See below for a quick guide on identifying vestibular (balance) issues as a seeker, avoider or sensory challenged and how you can help support your child with these struggles.

Vestibular Issues May Appear As | How to Support Vestibular Issues | Learn About the Other Senses

Vestibular Issues May Appear As:


  • Appear to have hyperactivity or behavioral issues. 
  • Constantly be in motion—running, jumping, spinning, or climbing on furniture, etc.
  • Love being upside down and spinning in circles, but never seem to get dizzy.
  • Engage in fast, impulsive, or unintentionally rough movement while playing.
  • Have trouble concentrating while sitting or be unable to sit still for even short periods of time.


  • Seeks sedentary activities, such as video games or reading.
  • Avoid swings, slides, monkey bars, or other gym and playground equipment.
  • Feel unsteady and off-balance on slanted, uneven, or transparent floors.
  • Become anxious or fearful when tilted backwards or are unable to touch the ground. 
  • Have motion sickness or headaches after intense movement.

Discrimination Challenged

  • Have poor spatial awareness or depth perception.
  • Appear clumsy or uncoordinated.
  • Have poor posture or jerky, awkward movements.
  • Have difficulty determining their head or body position
  • Unable to determine their speed and direction of movement.
  • Have difficulty distinguishing right vs. left and may not appear to have a dominant hand.
  • Unable to tell when they’re starting to fall and are unable to catch themselves in time.

How to Support Vestibular Issues:


  • Encourage playing with sensory-rich toys such as swings, bicycles, and trampolines.
  • Provide a variety of seating options, such as exercise balls, bean bags, or rocking chairs.
  • Use footstools or resistance bands around chairs to provide stimulation while sitting.
  • Schedule regular times throughout the day to run in place, do pushups, or do jumping jacks. This can be especially helpful when transitioning form one activity to another.
  • Work with an occupational therapist to develop a sensory diet—a set of physical activities that can be done at home and are tailored specifically to your child’s needs.


  • Don’t lift, tilt, or move your child without first giving a verbal or visual warning.
  • Hold your child’s hand while walking or balancing to provide grounding and support.
  • Use a footstool if your child’s feet can’t comfortably touch the ground while sitting.
  • Provide calm alternatives to playground activities, such as playing catch or hiking.
  • Provide PE alternatives that don’t involve height, such as pushups or army crawls.
  • Avoid motion sickness by teaching your child to focus on a static point inside the vehicle.
  • Provide a quiet place to lie down and engage in deep pressure techniques, such as head compressions, after motion sickness or headaches due to intense movement.

Discrimination Challenged

  • Hold your child’s hand while walking or balancing to provide grounding and support.
  • Be cautious and attentive around bicycles, swings, and other playground equipment.
  • Play games to practice telling the difference between right and left, forwards and backwards, etc. (“Watch me spin in a circle—am I turning to the right or left? Now you try turning to the right.”)
  • Play games to practice balancing and preventing falls. Have your child sit in on a bicycle while you stand in front with a firm grip on the handle bars. Slowly tilt the bike in either direction and have him/her practice placing the correct foot down before falling.

Read more about the vestibular system on the STAR institute’s website.