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.

Teaching Your Sensory Sensitive Child to Ride a Bike

Spring has sprung, and it’s time to break out the bikes! Learning to ride a bike is a right of passage for many children, and it’s a skill they can take with them their entire lives.

While SPD and other sensory issues present some unique challenges, you can help your child feel safe and confident by breaking the process up into small, simple steps and allowing him to go at his own pace. Below is a method we’ve found successful with our own children–feel free to use it as a starting point and modify as needed.

Above all, stay positive and remember to celebrate the small victories. Good luck!

Sensory Challenges

The Issue: Sensory Overload

Becoming irritated or overwhelmed by physical sensations like the wind blowing in his face, uncomfortable safety gear, or the sight of objects whizzing by quickly

What to Do

Let your child pick out his own helmet and pads and add extra cloth or padding if needed. Introduce new textures and sensations slowly.

The Issue: Vestibular Processing

Problems with balance, motion, or spatial orientation, such as feeling out of control, unsteady, or too far away from the ground

What to Do

Consider getting a tricycle, scooter, or balance bike first. Practice balancing and moving with speed before making the leap to a regular bike.

The Issue: Motor-Based Problems

Difficulties maintaining stamina, determining the order in which to make certain movements, or coordinating different muscle groups

What to Do

Break new skills down into small, simple steps and use repetition to reinforce new concepts. Physically guide your child through the process.

The Issue: Sensory Discrimination

Inability to properly gauge the distance between objects, the different shapes of street signs, or how much force is being used to pedal or turn

What to Do

Practice telling the difference between the shapes of two signs, the distance between two toys, or whether  he’s going fast or slow. Make it a game and have him try to “trick” you.

The Issue: Fear

Meltdowns, anxiety, or refusal to practice caused by any of the above issues

What to Do

Be supportive and patient. Make sure your child is regulated before you begin, and allow him to go at his own pace.

Note

Learning to Ride

  1. Have your child sit on the bike and stand directly in front of him so he can see everything you’re doing and knows you’re in control. Slowly move the handlebars left to right, back and forth, so he can both see and feel the movement.
  2. Have him practice getting on and off the bike while you continue to hold it steady.
  3. Slightly tilt the bike in either direction, as if it’s going to fall, and have him practice “catching” himself by leaning and putting his foot down on the correct side.
  4. Continue to hold the handlebars and have him practice getting on and off as you tilt. Make sure to practice on both sides until he’s comfortable.
  5. Stand behind the bike and repeat step #3 using the balance bar. When he’s comfortable with his footing, start tipping the bike farther–just enough so that he must catch himself.
  6. Use the balance bar to push the bike slowly forward. Have him practice steering while you keep the bike upright and steady. Move on to pedaling and braking when he’s mastered steering.
  7. Continue to hold on, but encourage him to go faster. Make a game of seeing if he can “make Mommy/Daddy run.” Let him be completely in control of speed and stopping. 
  8. Tell him you can let go whenever he’s ready–and when he tells you to let go, do it! Practice pedaling and stopping over and over until he doesn’t fall and can confidently control the bike on his own.
  9. Start working on turns. Place cones or toys in a parking lot or other open space and have him weave around and through them. Focus on slowing down and making wide swings around objects, and move the objects closer together as he gets comfortable.

Have another suggestion? Let us know in the comments!

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!

Additional Resources:

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