Many blogs are talking about the vestibular system of children The vestibular system is obviously important in looking at the development of children. It helps us orient our head against gravity (head righting), helps with gaze stabilization, postural adjustments, reflex integration, movement perception, the overall tone of our body (are we stiff? floppy?) and stabilizing the head.
The general symptoms of vestibular challenges include vertigo (feeling like you or objects are spinning around) or dizziness (unsteadiness, lightheadedness). Poor balance, nausea, headache, visual disturbances, hearing loss, pain in the ears can also be a part of vestibular disorders. It can be very fatiguing, and cause challenges with concentration, memory, and thinking. However, many times children cannot describe any of these symptoms very well.
Vestibular difficulties, however, can often be hard to recognize in children or can be part of other issues that parents notice, such as gastroesophageal reflux. Symptoms that can tie into vestibular system problems include a history of developmental delay or delayed integration of reflexes, low visual spatial abilities, hearing loss (although you can have vestibular problems without hearing loss), motion sensitivity, clumsiness or poor hand-eye coordination, nystagmus, history of seizures, history of vertigo. There may be a medical history of trauma or head-jarring sports, ear infections, migraines, meningitis, medications that affect the inner ear such as antibiotics or chemotherapy. Torticollis in infancy can sometimes precede vertigo and vestibular problems.
The vestibular system develops very early and by 8 weeks the embryonic inner ear is similar to an adult’s. The parts of the brain that work with the vestibular system are among the first part of the the brain to develop, and myelination of the vestibular pathways are completed within 16 weeks after birth. The vestibular system is developing most between ages 4-6 for more mature motor patterns, and inegrates with other sensory and motor systems like the visual, tactile, proprioceptive system by the age of six, but continues developing all the way through age 15.
The vestibular system provides the input for the motor control of the eyes. The vestibular-ocular reflex is usually adult- like by 6 months (which is what maintains stable vision on the retina when one’s head moves) and ties into eye movement. There is also a vestibulospinal reflex that stabilizes the head and body for automatic postural developments.
The main diagnoses for children with vestibular disorders is Childhood Paroxysmal Vertigo, which is the most common disorder for children ages 2-12, and often comes with a family history of migraines, motion sensitivity, and sometimes a prior history of torticollis. Benign Paroxysmal Positional Vertigo of Childhood usually is from whiplash types of injuries or injuries to the skull or neck, birth injuries, or inner ear or labyrinthine concussions. Less common conditions include Vestibular Neuronitis caused by bacteria or virus infections, or Meniere’s Disease of Children, which is an imbalance in the fluid of the vestibular system. Most blogs about the vestibular system are not referring to these specific conditions, however, but an overall sense of development or sensory challenges in which the vestibular system may play a part.
Children who have vestibular dysfunction often become overwhelmed by environments that are overstimulating or too fast. The largest part of parenting children with vestibular dysfunction is to observe and notice what, where, when things become overwhelming and learning how to help children. They may not want to be touched as it may make them feel even more dizzy, nauseous, or overwhelmed, and they may develop anxiety.
Developing the functionality of the vestibular system involves more than just spinning or hanging upside down or rolling. These types of things are important for overall gross motor development, and we know that the vestibular system develops strongly between the ages of 4-6. So, these gross motor activities, along with walking on different surfaces,wheelbarrow walking, activities with rhythm instruments, obstacle courses are wonderful but most components of vestibular system development also need a visual component.
Some of my favorite exercises actually involve things like having a target on the way and having a child commando crawl toward the target keeping the eyes on the target and then crawl backward once they reach the target still keeping their eyes on the target. I also like things like using an eye chart or letters on the wall and having the child walk toward the chart and call out different letters. Hitting a ball or balloon in the air and keep it off the ground is a great exercise as well.
Tell me about your experiences with vestibular system development!