As pediatric occupational therapists, a common questions we receive from parents is, “Why does my child constantly need to be moving?” or conversely, “Why does my child avoid playground equipment that other kids love?” The answer often lies in understanding vestibular processing — a critical but frequently overlooked sensory system that impacts nearly every aspect of a child’s development.

What Is the Vestibular System?

The vestibular system is our body’s “movement detection center.” Housed in the inner ear, it consists of fluid-filled canals and specialized structures that detect changes in head position, movement, and gravitational pull. This sophisticated system sends signals to the brain about:

• The direction and speed of movement
• Whether we’re moving or still
• Our body’s position in relation to gravity
• Our sense of balance and spatial orientation

Think of the vestibular system as your child’s internal GPS. It helps them understand where their body is in space and how it’s moving, all without having to consciously think about it.

Why Is Vestibular Processing Important for Child Development?

The vestibular system begins developing in utero (as early as 5 weeks gestation) and continues to mature throughout childhood. Research indicates that healthy vestibular processing provides the foundation for numerous developmental skills:

Physical Development

• Balance and coordination. The ability to maintain stability while moving or staying still.
• Muscle tone and postural control. The strength needed to sit upright for learning activities.
• Bilateral coordination. Using both sides of the body together (crucial for skills like riding a bike).
• Eye movements. The ability to track moving objects and shift gaze between near and far tasks.

Cognitive Development

• Attention and focus. The capacity to filter out unnecessary sensory information to concentrate on tasks.
• Spatial awareness. Understanding how objects relate to each other in space.
• Visual-perceptual skills. Critical for reading, writing, and mathematics.

Emotional Development

• Self-regulation. Managing emotional responses and energy levels.
• Confidence in movement. Willingness to explore the environment and try new activities.

A 2019 study published in Brain Sciences demonstrated that vestibular function is closely linked to cognitive performance in children, affecting attention, memory, and executive functioning skills.

Signs Your Child May Have Vestibular Processing Challenges

Children with vestibular processing difficulties typically fall into two categories: those who seek additional vestibular input and those who avoid it. Many children show a combination of both.

Signs of Vestibular Seeking (Underresponsivity)

• Constant movement—spinning, jumping, rocking, or swinging
• Difficulty sitting still during meals, classroom activities, or family gatherings
• Taking physical risks without recognizing danger
• Seeming to have “boundless energy” that never depletes
• Preference for fast-moving, intense playground activities

Signs of Vestibular Avoidance (Overresponsivity)

• Fear of heights or having feet off the ground
• Motion sickness in cars or on playground equipment
• Avoiding physical activities that involve balance challenges
• Appearing “clumsy” or cautious in movement
• Preference for sedentary activities
• Anxiety when surfaces change (like walking from carpet to tile)
• Fear of falling, even when risk is minimal

Additional Signs of Vestibular Processing Challenges

• Poor balance and coordination
• Difficulty with handwriting or manipulating small objects
• Problems with reading (as eye movements are affected)
• Delayed development of crawling or walking
• Confusion about left/right directionality
• Difficulty learning new motor skills
• Poor posture while sitting or standing

Conditions Associated with Vestibular Processing Difficulties

Vestibular processing challenges frequently co-occur with various neurodevelopmental conditions. Research shows that vestibular dysfunction is present in approximately:

• 70-85% of children with Autism Spectrum Disorder
• 40-60% of children with ADHD
• 90% of children with Sensory Processing Disorder
• 55% of children with Developmental Coordination Disorder
• 30-50% of children with learning disabilities

Additionally, children born prematurely or with a history of chronic ear infections may have a higher likelihood of developing vestibular processing difficulties.

How Cleveland Occupational Therapy Can Help

At Therapy & Wellness Connection, our occupational therapists use evidence-based approaches to assess and treat vestibular processing challenges:

Assessment

We begin with a comprehensive evaluation that includes:

• Standardized testing of sensory processing, including vestibular function
• Clinical observations of movement patterns, balance, and coordination
• Parent/caregiver interviews about daily functioning
• When necessary, collaboration with audiologists for specialized vestibular testing

Intervention

Our treatment approach is always individualized to each child’s unique needs but may include:

For Vestibular Seeking Children

• Structured “movement breaks” throughout the day
• Heavy work activities (pushing, pulling, carrying) to provide proprioceptive input that can help organize vestibular sensations
• Sensory diets that incorporate appropriate vestibular input at strategic times
• Activities that combine vestibular input with cognitive challenges to promote integration

For Vestibular Avoiding Children

• Gradual, gentle introduction to movement experiences in a supportive environment
• Adaptive strategies for managing challenging situations
• Therapeutic swinging with carefully controlled input
• Balance activities with appropriate supports to build confidence

For All Children with Vestibular Challenges

• Therapeutic equipment including swings, balance beams, therapy balls, and scooter boards
• Integration of vestibular activities into academic learning
• Parent education and home programming
• Collaboration with teachers to implement accommodations in school settings

Supporting Your Child at Home

While professional intervention is often necessary, there are many ways to support your child’s vestibular processing at home:

Safe Movement Opportunities

• Create obstacle courses that incorporate crawling, balancing, and spinning.
• Use playground equipment that provides varied movement experiences.
• Incorporate movement into daily routines (e.g., animal walks to the bathroom).

Environmental Modifications

• Provide seating that allows for movement (therapy balls, wobble cushions).
• Create a “movement corner” with crash pads, mini-trampolines, or indoor swings.
• Establish clear boundaries for when and where active movement is appropriate.

Communication Strategies

• Help your child recognize their own movement needs.
• Teach them to request movement breaks when needed.
• Use visual schedules to alternate between movement activities and seated tasks.

When to Seek Professional Help

Consider consulting with an occupational therapist if your child:

• Shows extreme avoidance or seeking of movement.
• Experiences vestibular signs that interfere with daily activities.
• Has difficulty participating in age-appropriate activities due to movement challenges.
• Demonstrates delays in skills that rely on vestibular processing.

Our Approach at Therapy & Wellness Connection

At Therapy & Wellness Connection, we believe in treating the whole child—not just isolated symptoms. Our Cleveland occupational therapists are specifically trained in sensory integration techniques and use a playful, engaging approach that makes therapy enjoyable for children.

We work closely with families in Northeast Ohio to ensure that therapeutic strategies are integrated into home and school routines, maximizing carryover and progress. Through our multidisciplinary team approach, we collaborate with speech therapists, physical therapists, and behavioral specialists to address all aspects of your child’s development.

Understanding your child’s vestibular processing needs can be transformative—not only for their physical development but for their emotional well-being and academic success as well. By recognizing the signs of vestibular processing differences and seeking appropriate support, you can help your child navigate their world with greater confidence and ease.

If you have concerns about your child’s movement patterns or sensory processing, we invite you to contact our team for a comprehensive evaluation. Together, we can create a path forward that honors your child’s unique sensory profile while building the skills they need to thrive.

Therapy & Wellness Connection – your connection to a life without limitations – provides occupational therapy to children in Akron, Cleveland, Brecksville-Broadview Heights and surrounding communities. We also offer summer camp, day programs, education services, vocational counseling and more. Call us at (330) 748-4807 or send us an email.

Additional Resources:

Sensory Processing and the Vestibular System, Griffin Occupational Therapy

More Blog Entries:

How Brecksville Occupational Therapy Helps With Handwriting, Focus, and School Readiness