Monthly Archives: June 2018

Vestibular Sensitivities: When Car Rides, Swings, Slides, and Strollers Are a Struggle

Posted on

What is the vestibular system?

The vestibular system refers to the nervous system’s mechanisms for registering and interpreting movement and relation to gravity. Structures in the inner ear (including hairs, crystals, fluids, and small organs) receive information about movement and balance to send to our brains to help us understand our relationship with gravity. The vestibular system is our body’s primary way to organize sensory information, so abnormalities in how we integrate this information can affect how we perceive information from all our other senses. Some children can’t get enough vestibular input, and actively seek out jumping, climbing, and swinging. Other children are hypersensitive to vestibular input and may become irritable, scared, or avoidant with simple activities such as being laid down for a diaper change or lifted in the air. For hypersensitive children, small amounts of movement may feel as exaggerated as riding a rollercoaster.

In severe cases, children with vestibular hypersensitivities may experience gravitational insecurity, characterized by emotional responses movements which are extremely disproportionate to a realistic possibility of falling. These children may avoid physical tasks, try to keep their feet on the ground, and become extremely upset with unexpected movements. Due to their unreliable relationship with gravity, their brains are wired to perform protective responses against the danger they perceive. These children may try to flee the situation, freeze and shut down, or fight and tantrum until the perceived danger subsides.

Children with vestibular sensitivities often have trouble tolerating the following activities:

  • Car Rides:In a moving car, your child’s eyes (and inner ears) send messages to his or her brain that imply a moving body. However, feedback from the proprioceptive (body in space) system tells the child that he or she is sitting still. This disagreement between the sensory systems can cause children to feel uncomfortable, dizzy, or motion sick. Try “dimming” the intensity of the visual input to the brain by having the child wear sunglasses in the car, helping the vestibular system feel more at ease. If your child’s feet dangle from the car seat, try building up the floor of the car with heavy books or a foot stool. Having the feet planted on the floor provides feedback to the child’s brain that he or she is grounded to one spot. Using a weighted lap pad or blanket in the car can additionally provide calming sensory feedback to the nervous system. Be sure to take plenty of breaks to stretch, move, and feel the feet on firm ground during longer car rides!
  • Stoller Rides: Hairs and fluids in the structure of the inner ear shift position with acceleration and deceleration, which provides intense vestibular stimulation. This starting and stopping is typical of stroller rides. However, the inner ear fluid stabilizes when speed is maintained. Initially, try pushing your child’s stroller at an even and steady pace, minimizing the number of times you start and stop moving. As your child becomes more accepting, try slowly increasing the number of gentle starts and stops per ride to build tolerance for vestibular changes.
  • Playing on Swings: Swinging provides changes in head position that create a variety of intense vestibular input to the inner ear structures. Children who are unable to tolerate swinging may feel left out or lonely at the park. Start by watching videos and reading books where children are enjoying swings, pointing out that swings can be fun! Feel free to sit on the swing and demonstrate gently swinging at the park. Never force your child on a swing. Instead, gently encourage the child to explore the swings with your emotional support. Going to the park at a low-traffic time may help your child feel more comfortable. Start with swings that are low to the ground and encourage your child to sit on the swing using his or her own feet to walk forwards or backwards any amount. Provide plenty of positive feedback as they try new and more brave explorations. Share your pride in the child’s success, but try not to exaggerate reactions of fear or surprise if he or she tries something unexpected.
  • Playing on Slides: For children with vestibular sensitivities, the mere thought of going to the park or using the slides can be anxiety provoking. You can ask your child’s OT to create a personalized story about going to the park, so your child knows what sensory experiences to expect. Start simple! Encourage your child just to be in the presence of a slide. Next, you can encourage the child to touch it by placing a preferred toy on the slide. Start exploring small “baby” slides before attempting big, bumpy, or spiral slides. Eventually, you and your child can sit on the slide together before sliding just a few inches to the bottom. Make sure these experiences are pleasant and reward baby steps with plenty of praise!

Natalie Machado, MS, OTR/L
Occupational Therapist

References:

Biel, L., & Peske, N. (2009). Raising a sensory smart child: The definitive handbook for helping your child with sensory processing issues. London, England: Penguin Books, Ltd.

Photo credit: Sarah Pflug via burst.shopify.com

How to Expand Your Child’s Play!

Posted on

Play is highly correlated to your child’s cognitive and speech and language development and is a great way to bond with your little one! Many parents are challenged by how to play with their little one and get involved in their world. Not only is learning to play important, but equally important is the expansion of your little one’s play.

Some toddlers get “stuck” in wanting to play with a toy in only one or two ways. Toddlers who play with a toy in a limited number of ways are showing us that they do not quite understand the function or multiple functions of a toy. Take for example a child who only moves a car back and forth on a table. This little one is showing us they understand that the car can move, but they are not yet aware of all the other things we can do with that same car. We can drive the car up the couch, it can crash or fall, the car can get gas or a car wash, pick up pretend toys and animals, or take us to different places like the grocery store or to see friends and family.

Why Do We Want to Expand Play?

Expanded play shows us your little one’s expanded understanding of the world. Play allows adults to label and model actions that your child is completing, in turn, helping your child’s speech and language skills develop.

The higher levels of play your little one demonstrates, the more they understand their world and the more language they have. If a child is playing with an object in just one way, there is a limited amount of words we can use to talk about that play interaction. For example: Your little one hands you a ball. You could say: “Ball!” “Look, ball.” “Red ball.” “Big ball.” If your child throws a ball to you, you can add “Throw ball.” “Bounce!” “Go ball!” “My turn!” “Your turn” and so much more. By expanding from showing to playing, there are SO MANY more words we can use to support your little one’s vocabulary development!

Tips for Expanding Play:

  1. Get on your child’s level:Sit on the floor or at the table together so you are physically at the same level as your child. Being on the same level also increases your eye contact and is easier to share attention with your child.
  2. Follow their lead:If your kiddo is playing with a car, you play with a car too! Try finding another of the same toy so you each have a toy and you don’t have to take turns.
  3. Add ONE play idea at a time:Sometimes we get a little over-zealous showing our kids 50 different ways to do something—it can be overwhelming. Remember expanding play is a gradual process and each child learns at their own pace. Your little one might need you to show something once or they might need some more help to copy your play—that is okay. Start by adding ONE step. Your child shows you a ball. You roll the ball back to them. Once your child is imitating one action, show them something new (try bouncing the ball)!
  4. Keep your language simple: We want to say one word above what our child is saying. If your little one says, “Ball” add an action word to describe how you are playing: “Ball go!” “Bounce ball.” etc. If your little one isn’t saying anything yet, just label the object or the action, or even just make a silly sound (slurping if you’re playing with a pretend cup)!
  5. Don’t force it:If your little one is getting frustrated that you are changing their play, show them one more time and move on. We want to keep play fun, exciting, and enjoyable for both of you! If your little one abandons an activity, move with them or take a short break and join them later to play again.

For more info on play and play milestones, check out some of PlayWorks’ previous blog posts:

Play in speech and language therapy: http://playworkschi.wpengine.com/toddlers-speech-therapist-playing-child/

Toy guide for babies through toddlers: http://playworkschi.wpengine.com/toy-guide-babies-toddlers/

Jessie Delos Reyes, MA, CCC-SLP
Speech-Language Pathologist

Image: https://www.sheffield.ac.uk/news/nr/want-to-boost-your-toddlers-development-put-a-toy-chicken-on-your-head-1.485117