Picture this: a dad swings his 6 month-old upside down, and she giggles and smiles from ear to ear. What doesn’t daddy know? He is stimulating her developing balance system and teaching her to love movement while they play.
When babies have motor delays, whether due to prematurity, illness, or a brain injury such as cerebral palsy, parents just don’t swing them around much. No wonder; if your child is on a feeding tube or has seizures, you feel very protective and a bit worried about what all the movement could do that isn’t healthy. Here is why these parents should make an effort to craft a safe but substantial vestibular program for their babies.
Every child needs movement to grow, and typically-developing babies start moving right away. By 4 months they have figured out how to roll, and by 8 months they are crawling or creeping away from us. This is great for mobility skills, but it also great for the vestibular system, which gives us a sense of balance and body/spatial awareness. In fact, it is really difficult to move if you don’t have a functioning vestibular system. Kids with motor issues aren’t moving themselves around the house all day long. They need adults to make a plan to be given more movement opportunities.
If all you are doing is working on exercises for mobility, and you haven’t thought about the sensory base of movement, then you haven’t given your little one everything she needs to make progress. Let’s talk about how to create your plan.
Safety is first, so any plan has to respect the fact that a child who isn’t used to moving much can be overwhelmed by a large increase in head movement out of a neutral, vertical position. Take it easy at first and watch for signs of neurological shutdown or overstimulation. A child who gets red-faced, or whose skin blanches, who avoids your gaze or becomes too quiet/cries, is probably overstimulated. Of course, some will just vomit on you. Message received.
Your pediatrician can tell you if you should support their neck even more than you would normally at their age. Discuss this idea with your pediatrician if you are very concerned about adding any movement to your plan. Children with Down Syndrome need to avoid extreme head/neck rotation unless your pediatrician is certain that their neck ligaments are not vulnerable. I treat all kids with DS as if they need that extra protection. Kids with brain injuries of any kind can be vulnerable to seizure activity, so I start off with slow movements and avoid any too-fast movement or a lot of position switches in one play time. Play doesn’t have to be long or intense to deliver more vestibular input. You aren’t going for the moon. Just add a little more vestibular input to their day than they normally receive.
What kids of movement? This is where you need to ask your OT about a plan. Rotary movement and inverted positions (upside down) are the most powerful. That means the most stimulating and the most difficult to handle easily. Linear movement, like swinging in an infant swing, is the easiest. I cannot tell you what your child needs, but I can tell you that is worth asking your therapist about what you can do in play to build vestibular processing.
When do you stop? I like to stop before I see signs of distress, then see if they ask for more fun with their vocalizations or facial expressions. I will give them more movement later if they seem to be doing well. Delayed signs that they got too much stimulation? Negative changes in feeding and sleeping, more fussiness. Babies will tell you what they think if you know how they communicate.
Good luck, and feed that vestibular system!
