The vestibular system is a structure that is housed in the inner ear, very close to the auditory system. It is the sensory system that provides our brains with information about which way is up and which way we are moving. The vestibular system consists of the utricle and saccule, which process linear movements of the head and the force of gravity as well as the semi-circular canals, which process rotational movements
of the head.

The vestibular system has connections with the neck and spinal cord, the visual system and various areas within the brain. The main functions of the vestibular system include:

  • Generation of muscle tone against gravity
  • Balance
  • Spatial orientation and spatial memory
  • Head position
  • Postural control
  • Awareness of the body in relation to gravity
  • Eye muscle movements and visual tracking
  • Bilateral skill
  • Rhythm and timing
  • Emotional stability

When a child has vestibular system challenges they may demonstrate some of the following signs:

  • Difficulty maintaining straight, up right posture while sitting at a desk
  • Difficulty tracking an object smoothly across the visual field or shifting the eyes from one point to another.
  • Poor ball skills
  • Difficulty with reading, writing and/or maths
  • Poor balance – a child may fall more frequently
    than other children of the same age
  • Hyperactivity and distractibility
  • Clumsiness
  • Standing too close to others
  • Difficulty using two hands or both sides of the body
    e.g. cutting, tying shoe laces, riding a bicycle
  • Switches hands rather than having a hand dominance
    over the age of 6
  • Letter reversals
  • Challenges with rhythm and timing of movements
  • Delays in developing bowel and bladder control
  • Becoming anxious when off of the ground
  • Fear of falling or losing balance
  • Fearful of escalators and lifts
  • Dislikes having the head tilted in space
  • Avoids jumping down from a higher surface to a lower one
  • Avoids climbing or moving play equipment

An occupational therapist with additional training in sensory integration will be able to help a child to develop his vestibular system and to integrate its processing with all the other senses. This will enable the child to achieve goals of improved reading, writing, mathematics, social skills, balance and/or ball skills allowing them to demonstrate their true potential within all environments.

Participation in movement experiences such as jumping, climbing and swinging games that allow the head to move in different ways will support the development of the vestibular system. Movement can affect us in different ways. Slow rhythmic movements such as rocking in a hammock tends to be calming and soothing whereas fast movements with changes in direction such as roller coasters, dancing, riding a bike along a winding path with bends and turns, tend to be
activating and alerting.


  1. Ayres, A.J. Sensory Integration and the Child 25th Anniversary Edition, Western Psychological Services, USA, 2005
  2. Kahn, S. and Chang, R. Anatomy of the Vestibular System: A Review NeuroRehabilitation 32 437 – 443, 2013
  3. Handel, E.R., Schwartz, J.H., Jessell, T.M., Siegelbaum, S.A., and Hudspeth, A.J.  Principles of Neuroal Science 5th Edition, McGraw-Hill Companies Inc. USA 2013
  4. Kawar M.J., Frick, S.M., Frick, R. Astronaut Training: A Sound Activated Vetsibular-Visual Protocol For Moving Looking & Listening,  Vital Links USA 2005