Sensory Spotlight: Vestibular (Balance and Spatial Orientation)

This is the fifth installment in our Sensory Spotlight series.

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 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 seekers may:

  • Seem to be constantly rocking, spinning, swinging arms and legs, or fiddling with objects.
  • Appear to have hyperactivity or behavioral issues due to constant running, jumping, or climbing.
  • Love roller coasters, merry-go-rounds, and spinning in circles, but never seem to get dizzy.
  • Prefer to be upside down and always seem to be hanging off furniture or doing somersaults.

Support seekers by:

  • Encouraging use of stimulating playground equipment such as swings, monkey bars, and slides.
  • Buying sensory-rich toys and gym equipment for home, such as jump ropes, hammocks, sensory swings, and balance beams.
  • Working 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 sensory needs.

Vestibular avoiders may:

  • Avoid swings, merry-go-rounds, slides, and other playground equipment.
  • Feel off-balance or unsteady on slanted or uneven floors and tend to move extremely slowly as a result.
  • Become anxious when stepping over gaps in the floor or walking on transparent surfaces.

Support avoiders by:

  • Giving verbal queues regarding your surroundings and properly contextualizing the risks. (“There is a gap in the floor in front of the elevator, but it is smaller than your foot. You cannot fall in. Let’s step over it together.”)

Vestibular discrimination challenges may cause a child to:

  • Appear clumsy/uncoordinated or have poor posture.
  • Have poor depth or elevation perception.
  • Have difficulty determining head or body position and become easily disoriented.
  • Be unable to tell when he’s starting to fall and unable to catch himself.

Support discrimination challenges by:

  • Holding your child’s hand or arm while walking or playing to provide support and grounding.
  • Being cautious and attentive around bicycles, swings, climbing toys, and other playground equipment.

Sensory Spotlight: Tactile (Touch)

This is the fourth installment in our Sensory Spotlight series.

The tactile system is responsible for the body’s ability to perceive pressure, temperature, traction, and pain using receptors in the skin. Children with tactile processing issues may have an unusually high or low pain threshold and be very particular about the texture of their clothing, toys, and other surfaces.

Tactile seekers may:

  • Seek of frequent or prolonged physical contact with others.
  • Constantly touch or fiddle with various objects and surfaces.
  • Prefer tight, thick, or textured clothing.
  • Have a high pain threshold and not notice minor injuries.

Support seekers by:

  • Encouraging the use of fidget spinners, stress balls, and textured toys.
  • Encouraging play with sand, water, and sensory tables.
  • Providing a wide array of textures in toys, décor, and clothing.
  • Being conscious of your child’s high pain threshold and encouraging safe play.

Tactile avoiders may:

  • Dislike being touched, hugged, or kissed, even by parents.
  • Refuse to wear tight, scratchy, or “uncomfortable” clothing with seams or tags.
  • Dislike being messy or dirty and avoid playing in sand, dirt, or grass.
  • Dislike their hair or skin being wet and actively avoid swimming or bathing.
  • Avoid crowds and worry about being touched or bumped while playing.
  • Have a low pain threshold and cry or shout when brushing teeth or hair.

Support avoiders by:

  • Advising family and friends that physical contact is not desired.
  • Buying soft, loose fitting clothing.
  • Removing tags from clothing and turning uncomfortable items inside out.
  • Encourage using gloves or tools when engaging with unpleasant textures.
  • Introducing new textures slowly.

Tactile discrimination challenges may cause a child to:

  • Have difficulty distinguishing objects by feel.
  • Have difficulty gauging the temperature of objects or food.
  • Have difficulty performing tasks without looking, such as buttoning clothing or pedaling a bike.

Support discrimination challenges by:

  • Playing games that help your child identify objects by feel. Place a few household items in a “mystery bag” and have your child name the items without pulling them out of the bag. Once you see progress, add several groups of related items to the bag, such as school supplies or utensils, and have your child search for and identify related items.

Sensory Spotlight: Visual (Sight)

This is the third installment in our Sensory Spotlight series.

The visual system is responsible for the body’s ability to perceive and interpret one’s surroundings using visible light. Children with visual processing issues may have trouble recognizing slight variations in color or brightness, gauging the size and distance of objects, reading, or concentrating in bright, busy environments.

Visual seekers may:

  • Be attracted to shiny, moving, or spinning objects.
  • Be attracted to bright, flashing, or blinking light.
  • Prefer bright, busy or specific shapes, colors, and patterns.
  • Seek out stimulating movies and video games.

Support seekers by:

  • Scheduling time throughout the day to sing, clap, and make noise.
  • Providing a variety of colors and patterns in toys, décor, and clothing.
  • Encouraging play with toys and games that have flashing or blinking lights.
  • Encouraging play with flashlights or using nightlights at bedtime.
  • Allowing and encouraging a healthy amount of screen time.

Visual avoiders may:

  • Be bothered or overwhelmed by shiny, moving, or spinning objects.
  • Be bothered or overwhelmed by bright, flashing, or blinking light.
  • Prefer solid, muted colors and very simple patterns.
  • Avoid crowded, chaotic spaces and messy rooms.

Support avoiders by:

  • Being conscious of colors and patterns in toys, décor, and clothing.
  • Avoiding toys and games with flashing or blinking lights.
  • Turning lights down or off and keeping curtains or blinds closed.
  • Keeping lights on during screen time.
  • Encourage wearing sunglasses when needed.

Visual discrimination challenges may cause a child to:

  • Have difficulty recognizing or distinguishing between letters, numbers, and symbols.
  • Have difficulty judging the distance between himself, other people, and objects.
  • Have difficulty recognizing key characteristics of objects, such as size, shape, and color.
  • Have difficulty reading emotions or facial expressions.

Support discrimination challenges by:

  • Playing category and matching games to practice grouping like items together. (“Can you find everything in the room that is a circle? Every picture in this book that is related to sports or food? Every car on the road that is red?”)
  • Playing the “same or different” game to practice distinguishing between numbers, letters, and symbols. (“d and b, 5 and S, S and $–are these the same or different?”)
  • Playing outdoor games, such as catch or soccer, to practice coordination and gauging the distance between objects.
  • Having your child help with household chores that have a large visual component, such as matching socks or sweeping the floor.

Sensory Spotlight: Auditory (Sound)

This is the second installment in our Sensory Spotlight series.

The auditory system is responsible for the body’s ability to perceive, process, and understand sound. Children with auditory processing issues may be able to hear background noises others tune out or can’t detect, have a hard time controlling the volume of their own voices, or experience delays in their speech and linguistic development.

Auditory seekers may:

  • Seek out noisy or busy environments.
  • Make loud, repetitive, or specific sounds.

Support seekers by:

  • Scheduling time throughout the day to sing, clap, and make noise.
  • Allowing TV and games to be played at an increased, but safe, volume.
  • Keeping headphones or earbuds handy for quiet or boring times, like waiting in line or on long family car trips.

Auditory avoiders may:

  • Seek out quiet or secluded environments.
  • Be bothered by loud, repetitive, or specific sounds.
  • Be startled or frightened by unexpected sounds.
  • Be distracted by background noises others can’t detect.

Support avoiders by:

  • Scheduling quiet times and breaks throughout the day.
  • Encouraging use of earplugs or noise canceling headphones when needed.
  • Giving advanced warning of loud or unexpected sounds whenever possible.
  • Using a fan, white noise, or other soundproofing to muffle background noise.
  • Keeping headphones or earbuds handy for listening to calming sounds while in crowded, noisy environments.

Auditory discrimination challenges may cause a child to:

  • Speak too loudly or too softly.
  • Appear aloof, distracted, or detached from others.
  • Appear confused or unresponsive when given directions.
  • Have difficulty distinguishing between background and foreground noises.
  • Have difficulty distinguishing between similar sounding words (cat, rat, sat).

Support discrimination challenges by:

  • Teaching your child to use visual cues, such as signage or other children lining up at the door, to stay safe and know what to do next.
  • Collaborating with your child’s teachers on ways to reinforce key concepts and revisit lectures or lessons (share presentations, audio recordings, notes with key terms).
  • Playing the “same or different game” to practice telling the difference between similar sounding words. (“Ball and fall–are these words the same or different? Now you choose two words and try to trick me.”)

Sensory Spotlight: What Is SPD?

This is the first installment of our nine-part Sensory Spotlight series.

Sensory processing occurs when the brain receives and organizes information from external sources, such as light or sound, and internal bodily cues, such as hunger or balance. Individuals with Sensory Processing Disorder (SPD) do not respond to this everyday sensory information the same way most people do. They may feel bombarded or assaulted by even the smallest bit of stimulation, or they might be unable to recognize even very extreme sensations or changes in their environment. Studies suggest as many as 1 in 20 people have sensory processing issues, and symptoms are typically much more pronounced in children.

Children with SPD often have a hard time fitting in with their peer group. They might show signs of anxiety or depression, be withdrawn, struggle socially and academically, or appear clumsy. Many children have learned to cope with their symptoms in ways that might appear odd to others, such as rocking, constantly learning on walls or furniture, sucking on their thumbs or other objects, etc.

SPD is generally broken down into the three patterns and thirteen subtypes listed below. Keep in mind the exact symptoms will vary greatly from one individual to the next. Many people with SPD demonstrate a combination of sensitivities and seeking/avoiding behaviors, depending on their level of arousal and how familiar they are with their current environment.

Pattern 1: Sensory Modulation Disorder (SMD)

Sensory Over-Responsivity (Hypersensitivity) – Over-responsive individuals, or avoiders, are hyperaware of sensory input and may have extreme or upsetting reactions to even mild stimulation, such as crying out in pain while brushing their hair or gagging at very faint smells. Avoiders often feel overloaded and overwhelmed by everyday situations and may appear anxious, withdrawn, or defensive as a result.

Sensory Under-Responsivity (Hyposensitivity) – Those who are under-responsive have difficulties detecting and/or responding to sensory input in a timely manner. They might not notice that the lighting or temperature in the room has changed, for example, or that they’ve bumped into something and injured themselves. As a result, under-responsive individuals often appear distracted, dismissive, or clumsy.

Sensory Craving – Sensory cravers, or seekers, have a seemingly inexhaustible appetite for sensory stimulation, though they tend to become more keyed up and deregulated as they take in more input. Seekers usually demonstrate behaviors associated with Attention Deficit Hyperactivity Disorder (ADHD), such low impulse control and constant moving, fidgeting, bumping into things, or fiddling with objects.

Pattern 2: Sensory-Based Motor Disorder (SBMD)

Postural Disorder – Postural disorder affects the body’s ability to stabilize itself and maintain a sense of balance. Individuals with this subtype often have problems slouching or bad posture. They might also appear to be weak, move awkwardly, or have extremely low endurance.

Dyspraxia (Motor Planning Problems) – Those with dyspraxia have difficulty planning and performing new, nonhabitual gross and fine motor tasks. They might appear to have extremely poor hand-eye coordination, problems with concentration, and take much longer than their peers to learn a new skill.

Pattern 3: Sensory Discrimination Disorder (SDD)

Individuals with this pattern have difficulty recognizing and interpreting sensory information. They’re often unable to gauge the physical differences between objects, such as size, color, shape, or distance. They might be unaware of the pressure or force they’re exerting at a given moment and appear awkward, clumsy, and prone to spilling drinks or breaking toys.

SDD is further broken down into eight subtypes, one for each sensory system:

  • Auditory
  • Visual
  • Tactile
  • Vestibular
  • Olfactory
  • Gustatory
  • Proprioception
  • Interoception

We’ll be taking a deeper dive into each of these systems, including strategies for supporting children with SPD, as our Sensory Spotlight series continues. Stay tuned!

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