Twenty-One Senses

Helping families with sensory sensitive children navigate typical environments.

Tag: vestibular

How to Support Vestibular Discrimination Disorder

by Twenty-One Senses TeamLeave a comment

Vestibular discrimination disorder affects one’s ability to interpret movement, including the speed and direction of one’s own body. It is one of the eight subtypes of Sensory Discrimination Disorder (SDD) and one of many manifestations of Sensory Processing Disorder (SPD). Learn more about SPD and its subtypes here.

See below for some ways to identify and support discrimination challenges.

Those with Vestibular Discrimination Disorder May:

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

How to Support Vestibular Discrimination Disorder:

  • Hold your child’s hand while walking 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.

Keep in mind that no two children are exactly alike, and most people exhibit both seeking and avoiding behaviors from time to time. If you think your child might be suffering from sensory processing issues, you should seek a professional assessment. The STAR Institute’s Treatment Directory is a great resource that can help you find therapists, doctors, and community resources in your area.

How to Support Vestibular Avoiders

by Twenty-One Senses TeamLeave a comment

Vestibular avoiders are highly sensitive to movement and tend to become overwhelmed by everyday activities such as play and travel. Avoiders often have extreme or upsetting reactions to even very mild stimulation. As a result, they can appear withdrawn or defensive and have trouble fitting in with their peers. They also frequently experience symptoms associated with anxiety disorders and engage in repetitive self-soothing behaviors.

See below for some ways to identify and support vestibular avoiders.

Vestibular Avoiders May:

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

How to Support Your Vestibular Avoider:

  • Don’t lift, tilt, or move your child without giving a warning.
  • Hold your child’s hand while walking 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 hiking or catch.
  • Teach your child to focus on a static point inside the vehicle to avoid motion sickness.
  • Work on calming strategies and develop a plan for how to exit overwhelming situations.
  • Provide a quiet place to lie down after motion sickness or headaches.

Keep in mind that no two children are exactly alike, and most people exhibit both seeking and avoiding behaviors from time to time. If you think your child might be suffering from sensory processing issues, you should seek a professional assessment. The STAR Institute’s Treatment Directory is a great resource that can help you find therapists, doctors, and community resources in your area.

How to Support Vestibular Seekers

by Twenty-One Senses TeamLeave a comment

Vestibular seekers are desensitized to movement and gravitational pressure and crave sensory stimulation via constant physical activity. Seekers may seem to need constant stimulation. However, they tend to become more deregulated as they take in more input. Many seekers experience symptoms associated with Attention Deficit Hyperactivity Disorder (ADHD), such low impulse control, inability to focus, and behavioral problems.

See below for some ways to identify and support vestibular seekers.

Vestibular Seekers May:

  • 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.

How to Support Your Vestibular Seeker:

  • Play with sensory-rich toys such as swings, bicycles, and trampolines.
  • Provide a variety of seating options, such as exercise balls, or bean bags.
  • Use footstools or resistance bands around chairs to provide stimulation while sitting.
  • Schedule regular times throughout the day to run in place, do push-ups, or do jumping jacks. This can be especially helpful when transitioning from 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 to your child’s needs.

Keep in mind that no two children are exactly alike, and most people exhibit both seeking and avoiding behaviors from time to time. If you think your child might be suffering from sensory processing issues, you should seek a professional assessment. The STAR Institute’s Treatment Directory is a great resource that can help you find therapists, doctors, and community resources in your area.

Sensory struggles during the winter months

Sensory Struggles in Winter

by Twenty-One Senses TeamLeave a comment

Winter is here! For many of us, winter is a time of outdoor play, indoor coziness, and creating memories with family and friends. However, winter can bring a whole new set of challenges and for families with sensory needs.

This month, we’re taking a look at some common sensory struggles in winter and offer a few suggestions for keeping your child regulated, engaged, and safe during the cold months. Have another tip? Let us know in the comments!

Challenge #1 – Outdoor Winter Activities

Winter games like sledding, ice skating, and playing in the snow are generally great for seekers, particularly: tactile, vestibular, and proprioceptive. However, children with sensitivities and discrimination issues often struggle with these activities.

Proprioceptive and tactile avoiders may be unable to tolerate cold wind on their faces, fast movement, or being close to other children. Visual avoiders may become overwhelmed by the glare of snow and ice. Finally, those with vestibular, proprioception and visual discrimination disorders may have difficulty walking on snow or ice and keeping a safe distance from other children. 

Tips and Tricks:

  • Ease your child into new activities. Hold his hand and practice walking on ice and snow, slowly pull him around the yard in a sled, and help him pack snowballs.
  • Practice new or scary activities at home. Skate on the kitchen floor in your socks, have a snowball fight with socks or stuffed animals, or race to put on your snow gear.
  • Break down overwhelming or scary activities into small, manageable steps. (“First we sit on the sled, second we push, and third we lean back and ride.”)
  • Experiment with outdoor games and activities that don’t require being in close proximity to others, such as geocaching, Pokemon Go, or simply making snow angels.
  • Be mindful of seeking behavior in activities like sledding, skiing, and ice skating. If your child is being unsafe, try to figure out the sensation he’s craving and help him find other ways to achieve it.
  • Wear sunglasses or baseball hats to reduce glare from ice and snow.

Challenge #2 – Winter Clothing and Dry Skin

Even children without sensory issues can struggle with winter clothing. For tactile avoiders, however, getting into winter gear can feel completely overwhelming: sweaters are itchy, boots are heavy, coats are bulky and restrictive. They may find dry, irritated skin to be extremely painful but, along with olfactory avoiders, be unable to tolerate certain lotions or skin care products. On the other hand, those with tactile discrimination disorder and interoception discrimination disorder may not notice cracked or bleeding skin.

Tips and Tricks:

  • Avoid clothing made out of bulky or scratchy materials like wool. Stick to soft, comfortable layers of fleece, cotton, or flannel, and remember to remove the tags!
  • Have your child try on and approve every piece of outdoor gear―coats, hats, gloves, you name it. If you can, buy extras of smaller items in case something gets lost.
  • Find alternatives to uncomfortable items. Experiment with earmuffs instead of hats, hand warmers instead of gloves, or snowboarding pants instead of snow bibs.
  • Apply moisturizer frequently, especially after bathing. If your avoider can’t stand lotion, experiment with body bars, coconut oil, shea butter, or aloe vera gel.
  • Stay hydrated by drinking water throughout the day. Add fruit slices, flavor packets, or seltzer to combat flavor fatigue.

Challenge #3 – Sensitivity to Cold and Heat

Not everyone experiences the sensations of winter in the same way. Tactile avoiders may feel unbearably cold while playing outside or uncomfortably hot in certain types of clothing. On the other hand, tactile seekers may love to play outside on very cold days, hold snow in their bare hands, or take extremely hot showers. Finally, those with tactile discrimination disorder and interoception discrimination disorder may be unable to feel extreme temperatures at all, making them susceptible to frostbite or overheating.

Tips and Tricks:

  • Check in with your child frequently, especially during outdoor play, to make sure he’s not become overheated or becoming too cold.
  • Ease your child into the colder temperatures. Use indoor sensory bins to help him get used to the texture and cold of ice and snow.
  • Be mindful of seeking behavior around extreme cold. Put time limits on outdoor play and make sure gloves, hats, and coats are being worn.
  • Combat feeling cold by taking warm baths, heating up towels or clothes in the dryer prior to dressing, and making hot chocolate after playing outside.

Challenge #4 – New Foods and Smells

For most of us, winter means tweaking our diets to include more hot and multi-textured meals like stews, soups, and crockpot dishes. Many fruits and vegetables are out of season and will have a significantly different taste or texture than they do in the spring and summer. All of these changes can be extremely upsetting to gustatory avoiders and tactile avoiders. In addition to struggling with new foods, olfactory avoiders may be bothered by cleaning, cooking, and other household smells they might not notice when the windows are open.

Tips and Tricks:

  • Introduce new foods slowly and methodically. See our previous article for a step-by-step guide.
  • Have your child help plan and prepare meals. This will get him familiar with new smells, textures, and ingredients without having to taste them.
  • Know your child’s favorite foods and have a way to make them inside. For example, you might buy a George Foreman grill or grill pan to make burgers or hot dogs.
  • Be conscious of cleaning, cooking, and other strong or unpleasant household smells. Open the windows when possible and keep the house well-ventilated.

Challenge #5 – Staying Active

We all have different reactions to being cooped up inside on a cold winter day. Vestibular seekers and proprioceptive seekers may become manic and start bouncing off the walls, while vestibular avoiders and proprioceptive avoiders may become withdrawn and almost completely sedentary. No matter whether your child is seeking or avoiding, engaging in regular physical activity is critical for relieving anxiety, improving concentration, and transitioning between activities.

Tips and Tricks:

  • Schedule times throughout the day to do jumping jacks, stretch, or run in place. This can be especially helpful when transitioning into a new activity.
  • Have a designated area of the house where “rough” play is okay. Include things like pillow forts, obstacle courses, and crash pads, trampolines, etc.
  • Play family games that involve lots of movement, such as Twister, I Can Do That!, and The Floor Is Lava!
  • Have your child help with chores that involve executive functioning and proprioceptive input, such as snow shoveling and carrying groceries or laundry.
  • Experiment with different seating options that increase movement and concentration, such as yoga balls, foam rollers, and balance beams.

Combat boredom by bringing tents, pool toys, and other outdoor equipment inside. Experiment with alternatives to outdoor games, like the Hover Soccer Ball.

Challenge #6 – Changes in Routine

Like any significant disruption, the changes in routine brought on by winter break can be difficult for children with special needs. Without external timekeeping cues such as what class they’re in or where the sun is in the sky, children with interoception discrimination disorder often have difficulty knowing when to eat, when to sleep, and when they need to use the restroom. 

Tips and Tricks:

  • Prepare your child for any changes in routine. What exactly will be changing? What will stay the same? Are there new cues can he look for to know what to do next?
  • Set timers or alarms throughout the day to remind your child when it’s time to eat, use the restroom, or shift to another activity.
  • See our article for building good transition habits for more tips on establishing routines, creating rituals, and managing expectations.

Sensory Spotlight: Vestibular (Balance and Spatial Orientation)

by Twenty-One Senses TeamLeave a comment

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. You can read more about how the vestibular system works on the STAR Institute’s website.

See below for a quick guide on identifying vestibular seeking, avoiding, and discrimination issues in children.

Vestibular Seekers May:

  • 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.

Vestibular Avoiders May:

  • Don’t lift, tilt, or move your child without giving a warning.
  • Hold your child’s hand while walking 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 hiking or catch.
  • Teach your child to focus on a static point inside the vehicle to avoid motion sickness.
  • Work on calming strategies and develop a plan for how to exit overwhelming situations.
  • Provide a quiet place to lie down after motion sickness or headaches.

Those with Vestibular Discrimination Disorder May:

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

Sensory Spotlight: What Is SPD?

by Twenty-One Senses TeamLeave a comment

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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