Vestibular Dysfunction and Motor Skills

I participated in a multidisciplinary team meeting the other day where we were discussing how a particular regular ed child (diagnosed with ADHD) presents in the classroom.  His mom described him as having "poor fine motor skills," and that he often seems "uncoordinated."  He also has several sensory processing "red flags" in that he is a sensory seeker (very busy and fidgety) throughout the day (which gets him into trouble at times), and he puts all kinds of things in his mouth to chew on.  In the classroom, however, this child can have very good handwriting at various times.  He participates in regular phy ed, and does fine, although he is not the top of the class with gross motor skills.  Further information from the mom revealed that this child was a late walker, and took quite a while to learn to ride a bike.

What the mom sees and suspects is that her child has motor skill deficits and that something strange is going on with his "eating."  What an OT would suggest is that yes, this child presents as being uncoordinated in comparison to peers, but that there is likely an underlying (or a few underlying) issues at hand that are sensory related.  The one I would like to focus on here is that I suspect that this child (among other things) is having difficulty with his vestibular system processing.

Vestibular dysfunction is the inefficient processing in the brain of sensations received through the inner ear.  The child with a vestibular problem has difficulty processing information about gravity, balance, and movement through space (K. Stock Kranowitz, 2005).  Vestibular dysfunction can present in a variety of ways, and it would take too long to go into detail about it, but kids with vestibular dysfunction can present as craving movement experiences, as this little guy does.  They can have difficulty using the 2 sides of their body together and appear to be uncoordinated, fidgety and clumsy. They can appear to have poor fine motor skills and have difficulty using fine motor "tools" (such as a pencil, crayons, eating utensils).  They can have difficulty being organized and carrying out a sequence of movements or events.  So, friends, the motor difficulties may just be the obvious, but to improve some of these skills, you have to also address the underlying problem, and that would be to help improve the vestibular processing.

What could you do at home or how can you help a child that you are working with address these types of issues?

• Work on improving balance and movement
• Work on bilateral coordination (using the 2 sides of the body together)
• Work on praxis or motor planning (sequencing motor tasks or movement with their body)

You can read more about Vestibular dysfunction in the awesome book, "The Out of Sync Child," by Carol Stock Kranowitz, or you can check out her website at: http://out-of-sync-child.com/

The above referenced material was from:

Stock Kranowitz, Carol.  (2005)  The out of symc child, recognizing and coping 

     with sensory processing disorder.  New York, NY: Berkley Publishing Group.

This guy has good balance and coordination- his vestibular system is in good working order.
(and, you gotta love the boots he's rocking!)

This little gal really struggles with balance and motor skills-  note the posture of her
arms and body as she tries to maintain her balance.