In this video, Amanda Martinage is going to discuss what is vestibular processing and what does dysfunction look like.
Vestibular processing is how our bodies interpret movement, whether or not you're moving, how quickly, and then in what direction we're moving in.
Amanda also talks about vestibular dysfunction — hypersensitivity and hyposensitivity and how these dysfunctions present. Hypersensitivity is an intolerance for movement. Hyposensitivity is having an increased tolerance for movement.
MARTINAGE: Hi. My name's Amanda Martinage, and I'm an occupational therapist. I work for Case Collaborative. And today for this teachable moment, we'll be discussing vestibular processing. And this is going to be the first of two teachable moments on vestibular processing.
Today, we're going to discuss what is vestibular processing, and what does dysfunction look like.
So first, vestibular processing, it is how our bodies interpret movement, whether or not you're moving, how quickly, and then in what direction we're moving in.
The functions of our vestibular system are number one, to help you develop a relationship with the earth. So it allows you to maintain an upright body position to support your visual system. So it's really the sense of safety, knowing that your feet are on the ground, that your body is upright, and how you're moving.
I have some examples of vestibular activities or experiences. There are some pictures and some actual experiences here today.
The first picture is of a little boy swinging. He's on a platform swing. But it could be any sort of playground swing, any sort of swing that just gets you moving. And it can be rotary, where you're going around in a circle, or it can be linear, where it's just back and forth.
The next picture is of a little boy on a scooter board. And you can decide how to ride a scooter board. Some of them are meant to just be on your belly, where you're using your hands and your feet to propel that scooter board. Sometimes you can sit on the scooter board, and just use your feet to kind of move. But you're getting that movement.
In the next picture, a little girl is doing a somersault. So just that movement of the upside down movement and rolling over your body is considered vestibular.
Sitting on a therapy ball, you can sit and bounce on it. You could roll on your belly and kind of walk out over that ball. These are all vestibular activities.
The next picture is of a little girl who's in a rocking chair. It can be a rocking chair that you see in this picture, where it's plastic and it's low to the ground, and the child sitting in it.
It could also be what you think of your grandmother, sitting in a rocking chair, or a mother holding their infant in a rocking chair.
And then one of the favorites these days are something called a web chair. And it's just basically this circular chair with kind of like a bungee cord web as the inside. And when you sit down on it, you kind of just fall into this — not fall — but you relax into the bungee of the chair. And it bounces a little bit. So you can get a little bit of movement from that bouncing.
And then the last picture is of a mini trampoline. Jumping is considered vestibular as well.
Some of the experiences that I have here today, first of all, I am sitting in an experience. So I'm sitting in your standard kind of office chair. And most of these chairs you can move side to side, get some rotary movement. Many of them you can swing back and forth and get some linear movement. But office chairs can be really a nice method of getting vestibular input.
Another example of different seating is this chair that kind of looks like it would be stable, except it has a rounded bottom. So when you sit on it, it kind of allows you to move while you're still sitting on a surface.
And these other two things are examples of some seat cushions. And they're purposefully under-inflated. What you do is you sit on them, and the only difference between the two of them is just the shape and the surface. But the point of them are both the same. When you sit on them, it allows you some movement in your chair, without actually having to get up and get that movement.
So oftentimes this is kind of a nice way of having a child be able to sit in their chair for a little bit longer. Because they can sit and get that movement right in their chair, versus getting up and moving around the classroom.
So those are some of our examples. Let's start talking about what vestibular dysfunction looks like.
The two general things that you'll see with vestibular dysfunction is children not feeling secure. Because they just aren't quite sure of their body position. They're not quite sure if their head is up, in what direction they're moving. And that impacts their security.
And because they're not feeling very secure, you can see some poor self esteem around that. Because they're not feeling confident in their abilities.
So the types of vestibular dysfunction that you can see, there are two different kinds, hypersensitivity and hyposensitivity. Hypersensitivity is an intolerance for movement. And under that there's a subset called gravitational insecurity. And we'll talk about the two separately.
The other one is hyposensitivity. And that's having an increased tolerance for movement. So you are moving around. You're seeing a lot more movement.
So what does that look like? How does it present? How do each of those different dysfunctions present? When you have hypersensitivity, where you're overly sensitive to movement, you're not liking to move all that much. And I can sympathize because I have a little bit of hypersensitivity myself.
So I get motion sickness. That's one of the biggest indicators of hypersensitivity. So children often dislike playground activities that involve swinging, spinning; excessive movement. Oftentimes you'll see children being cautious or slow moving, and they appear to be sedentary. When really it's just movement really bothers them, so they tend to stay still.
They often present as being hesitant to take risks, and look like they are uncomfortable in elevators or escalators, or on moving walkways. And experiencing that motion sickness is a big thing.
So under hypersensitivity is another kind of type of hypersensitivity called gravitational insecurity. And what that is, is an excessive fear of ordinary movement. So being out of an upright position or having their feet off of the ground is something that's really anxiety provoking.
So these individuals present as having an excessive fear of falling. They become anxious when their feet leave the ground. So you'll see this in activities like going up and down stairs. Because if you think about going down stairs, you have to pick one foot off the ground to go down to the next stair. And that's something that's very difficult.
These children are threatened by their head being inverted, or upside down, or tilted. And oftentimes you'll notice this with a lot of self-care activities. So if you think about washing your hair, you need to — you have the suds in your hair. And in order to rinse it without the suds getting in your face, in your eyes, you have to lean your head back and wash the suds out of your hair. So that can cause a lot of discomfort.
Another thing I think of little children will use that preschool method of putting their — to put their coats on, they have to bend over, put their hands into the sleeves, and flip. That would be very difficult for somebody with some gravitational insecurity.
The other, kind of the opposite end of that, hyposensitivity, children need increased movement. So these children are really seeking out input, seeking out movement in all sorts of ways. They are frequently jumping. They're rocking, they're swinging, they're moving all over the place. They're craving intense movement experiences.
So they're really assuming those upside down positions often. They're spinning. They come across as these thrill seekers. And they're not experiencing dizziness. So they really can move and move and move, and have no problems.
So that's what it looks like. I hope you found some of this information helpful. My name is Amanda Martinage. There is part two of this teachable moment. But I hope you enjoyed today's teachable moment.
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