Vestibular Dysfunction in Schools
The vestibular sense perceives the movement of the head both positionally and in relation to speed. It perceives how we move against gravity. It’s also known as the ‘movement’ sense. Vestibular functioning is important for a child’s participation in play and socialization with other children. Vestibular dysfunction can present itself in many different ways in the school environment.
Here is how you may it see presented in your students:
A child with vestibular craving may present as: Doesn’t seem to get dizzy, Spin in circles and gets silly, Sits on the edge of the seat, Jumps and climbs on classroom furniture, Likes roughhouse play, Fidgets in chair, Doesn’t seem sit still, Movement ramps them up instead of calms them down
A child with vestibular underresponsivity may present as: Do not show fear or enjoyment with movement activities, Prefers tabletop or arts to sports and jungle gyms, Lack of participation in sports or gym games, Doesn’t explore new environments, Holds head up with hands when seated at desk
A child with vestibular overresponsivity may present as: Fearful of swings, slides, and ladders, Presents as static with very little movements of the head when seated, Feels nauseous or dizzy after the playground, Gets motion sickness in the car, Gets dizzy after watching videos, Doesn’t enjoy the swings, teeter totter, or merry-go-round, Shows extreme caution when moving around the classroom or new environments
Vestibular Classroom Strategies
Here are just some strategies to address vestibular differences in the classroom. It is not an extensive list of all things you can try, but a good start of strategies that can be incorporated into already established routines!
For cravers and under-responders:
· Seating adaptations (ball chair, wiggle cushions on chair or floor, wobble chairs, kneel, prone propped on floor, standing)
· Place materials/basket on back of chair instead of inside desk
· Place items needed on the floor to pick up
· Stack/retrieve school materials high on shelf
· Lay supine on the floor for independent reading
· Practice sustained yoga moves for Brain Breaks (down dog, cat/cow)
· Animal walks for transitions between stations
For under- and over- responders:
· Place school supplies at eye level
· Offer tabletop models of board work
· Use slant board
· Add glare blockers to screens; minimize screen time
· Prep child for transitions between centers or areas of the classroom
· Use chair with armrests
· Increased time for reading/writing assignments
Vestibular School Strategies
Here are some strategies to address vestibular differences in the school environment.
Remember, for best chance at carryover and to make the activities functional for the child, incorporate sensory strategies into already established routines and activities.
For cravers and under-responders:
· Re-shelve library books
· Swing, slide, climb on playground equipment
· Skip or hop during transitions around the school
· Access to moving musical instruments (maracas, triangle, tambourine, symbols, drums)
· Carry weighted basket or papers between rooms
· Dig in sandbox or ball pit
For under- and over- responders:
· Provide lunch choices at eye level
· Allow extra time or alternatives to gym games
· Set-up art materials on table prior to task
· Access to stationary musical instruments (piano, guitar, xylophone)
· Sit in middle to back of auditorium to decrease head tilt
Emily is a pediatric occupational therapist providing community and home-based OT services in the Greater Philadelphia area, PA. She is a mentor for School-Based Occupational Therapists, offering one-one-one sessions to grow in confidence and skills. Emily Marie OT LLC strives to empower all to achieve their full potential.