Vestibular Disorders in Children

It is normal for growing children to trip and fall, but if there are persistent issues with a child’s balance, it may indicate a disruption in their vestibular system. The receptors of the vestibular system, i.e. semicircular canals and otoliths, are located within the inner ear. From there, sensory information is received and directed to our central nervous system. Being one of the most complex sensory systems, the vestibular system is connected to our vision, sense of being upright (balance), postural control, emotional regulation, spatial awareness and sequencing.

The vestibular system’s main function is to help us maintain our balance, posture and steady vision during head movements. It also has a direct connection to our arousal level and fight/ flight response, which helps us to be alert to surroundings and stay focused on a task. 

However, vestibular issues and disorders are quite common among children. In babies, they can show up as developmental delays in sitting, standing, walking and other motor abilities. In children, they often manifest as poor balance and sensory integration issues that lead to falls and difficulties with high-level activities like hopping, skipping and walking on a balance beam.  Some children may even exhibit an aversion to activities that require them to lift up both feet from the ground, such as sitting on swings or exercise balls.

Besides causing delayed development and difficulty in balance, a disrupted vestibular system can also cause vertigo or dizziness, gaze instability, blurred vision, gravitational insecurity, an excessive need for movement, as well as challenges in coordination and sequencing. A child may not complain, or be unable to express the difficulties they encounter, but a vestibular disorder can have a significant impact on a child’s quality of life, development and psychological well-being.

Recognising vestibular problems in children

While symptoms may vary for each child, the most common symptoms of a vestibular disorder in children include:

  • Vertigo/ dizziness
  • Imbalance and clumsiness
  • Frequent falls
  • Motion intolerance
  • Delayed motor milestones
  • Abnormal eye movements
  • Difficulty navigating in the dark and/ or on uneven surfaces
  • Poor ball skills: difficulty to aim and/ catch ball
Assessing and treating vestibular disorders

If you believe your child may have balance and vestibular issues, it is best to get them screened by a healthcare professional like a physical therapist or an occupational therapist as soon as possible. Additional tests by a physician may also be necessary to screen for inner ear problems.

The therapist will assess your child’s vestibular functions including balance and motor skills to determine if they are functioning at an age-appropriate level. The therapist will then provide strategies for managing and rehabilitating your child’s vestibular issues through intervention programs and therapeutic exercises that can be done at a therapy centre, as well as prescribing home programmes to allow for opportunities for skill refinement every day. The interventions are individually designed to improve the child’s balance, postural control, reflex integration, functional vision and sequencing, depending on their needs which will result in better participation in daily activities, improved functional mobility, and safety in the long run.

If you have any concerns about your child’s vestibular system or overall development, don’t hesitate to reach out to us at The Energy Source. We’re here to help!

This article was reviewed by The Energy Source’s Principal Occupational Therapist, Jacqlynn Teong.

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