Your body’s
vestibular system is responsible for controlling your balance and posture. More than simply your “inner ear”, it is a complex system that involves multiple inputs, motor activities, and feedback from the cerebellum and cerebral cortex. You need it to function correctly for nearly every move you make.
For many people with Sensory Processing Disorder, their brains can’t coordinate the vestibular system correctly. Strongly-linked to these problems are issues with proprioception, which is the self-awareness of muscle movement and joint pressure. When these systems don’t function as they should, the effects can range from mild clumsiness to severe physical disability.
Treatments for these problems often include occupational therapy or medication, but nothing that can be considered a cure. For many, the diagnosis of SPD means a life-long struggle. But a program developed in Boulder, Colorado brings the hope of healing from this disorder.
Do You Feel What I Feel?
Your brain started learning how to process inertia and gravity’s pull when you were still in the womb. Five months after you were conceived, your mom’s daily activities provided stimuli to your newly-developed vestibular system. As mom walked around, laid down, or exercised, your brain soaked in the new sensory inputs, processing and categorizing what it experienced. After your birth, your brain coordinate motion with motor responses to help you turn over, crawl, sit up, walk, and beyond.
A baby was recently brought to the Sensory Learning Center by a very concerned mother. The mom had been on bed rest most of her pregnancy, and the baby’s vestibular system never got much stimulation. At eleven months after birth, the child could not crawl and had very weak trunk muscles. His vestibular system had simply never gotten the training it needed to help him develop motor skills.
My son, Caleb, also has vestibular and proprioception problems within a subset of SPD known as “sensory-seeking.” It is as though his ability to register motion, pressure, and even pain is significantly muted. As a result, he often seeks out extra stimulation in any number of ways. When he was a baby he loved to be swaddled at bed-time – it was the only way I could get him to sleep. When he was a toddler, I would often find him burrowed underneath the floorboard of his play yard, sleeping contentedly in a confined space. When he runs, he wind-mills his arms and claims it “helps him run faster.” He loves climbing trees or trying hand-stands to feel the deep pressure in his shoulder joints. His pain threshold is astonishing, which turns out to be a blessing in disguise because his vestibular problems often lead to mishaps. (I’ll spare you the details of what a simple bike ride can entail.)
There are days when Caleb gets more and more wound up as though he is stuck in some sort of sensory feedback loop. Sometimes the only thing that will help is to take him into my arms and squeeze him tight until he calms down.
The social side to these problems are ruinous. Recall that kids like Caleb often have vision and hearing problems that make it hard to keep track of everything going on in a classroom. Now add in a poor sense of personal space or body position, and a tendency not to notice bumping into things or people. Now toss in some ever-escalating sensory-seeking behavior. In a group of other children, Caleb is the proverbial bull in a china shop.
Kids like Caleb are often mislabeled as ADHD (and drugged accordingly) or simply seen as a trouble-maker. His last school teacher was convinced, in spite of the SPD diagnosis, that he was deliberately trying to stir up trouble for her. To be fair, my son has a fair bit of Tom Sawyer in him. Unfortunately, he was sent to the principal’s office far too often for what has behavioral appearances but neurological causes.
So what does a really smart kid do when he finds himself in trouble for things he didn’t even know he was doing? He gets paranoid, denies everything, tries to talk his way out of trouble, and learns to hate school. And this is just first grade. By the time many kids with SPD get to middle school, they have given up in a school system that seems hell-bent on punishing them and a society that shuns them.
I highly recommend the book “The Out-of-Sync Child: Recognizing and Coping with Sensory Processing Disorder, Revised Edition” for any parent who has (or suspects they have) a child with Sensory Processing Disorder. The book makes a strong case that medications and "behavior modification" cannot address the underlying neurological issues. It helps you understand what your child is experiencing, and offers very practical advice on what you can do to help them. Awareness of SPD is growing in public school systems, but many kids will only get the right help if their parents initiate the process.
Typical interventions for people with vestibular and proprioception problems include occupational therapy and learned coping mechanisms. There has also been experimentation with moving tables that are designed to help the brain become accustomed to motion. Although little formal research has been done in this latter area, there is a promising treatment that can make a big difference.
The Motion-Combo Hack
The third modality addressed in Caleb’s treatment at the Sensory Learning Center is the vestibular. While listening to the specially-adjusted headphones (see Part 2) and while looking at the colored lights (see Part 3), Caleb lies on a specially-designed motion table for 30 minutes at a time, twice a day, for 12 days. The table’s motion mimics that of a ferris wheel, proceeding in a circle either along the anterior-posterior axis (head to toe), or from side to side. The table surface remains parallel to the floor at all times.
Experiments have been done with motion tables in the past, and the research indicates that it can have a positive but limited effect on autistic children with major sensory issues. One study, “Learning Enhancement in an Autistic Adolescent (pdf)” examined the use of a motion table with an autistic teenager. The researchers (who were also the child’s parents) had their daughter Sandra sleep on a motion table at night. They found that her ability to learn new tasks was greatly enhanced during the time periods when the motion table was used. Since that time, several variations on the motion table have been developed for therapeutic use, like this one.
Unfortunately, the study found that when the motion table was no longer used, Sandra’s behavior and skills deteriorated rapidly back to their original state. It appeared that the use of motion therapy by itself had few lasting benefits after treatment.
The Sensory Learning Program, on the other hand, uses a motion table in combination with auditory and visual stimuli. The Center has found that their patients often have permanently-improved sensory processing, including that of the vestibular system. The program is intended to be a "one-time intervention." It would appear that this multi-sensory integration approach, done in a controlled manner, helps the brain coordinate and permanently connect sensory inputs more effectively then when they are exercised in isolation. Dr. Selwyn Super, a psychologist at the University of Southern California described the program in a 2005 paper:
“The separate sensory stimuli work together... by entraining the vestibular system with motion, stimulating the ocular system with colored frequencies of visible light which changes the firing pattern of the hypothalamus, and exercising the auditory system through gated vocal and nonvocal music... because each sensory modality uses a different coordinate system to represent space, the brain has to find an efficient way of interrelating these schemes in order to use cross-modal cues cooperatively.”
Remember the baby who couldn’t crawl because his mom had been on bed-rest during her pregnancy? He went through the same Sensory Learning Program that Caleb is going through. He was put on the table with the syntonic light for 30 minutes, twice a day for 12 days. By the end of the two weeks the baby was crawling all over the place with a vengeance, and I am told is now doing quite well. All the little guy needed was some controlled input for his brain to figure out how to coordinate his vestibular system. The syntonic (visual) component, as poorly understood as it is, played a critical role in this. Anyone who gets motion sickness from playing video games knows how interwoven your vision and balance really are.
Our hopes for Caleb is that his time on the table (with the audio and visual stimuli) will help his brain get the kinks in his vestibular system ironed out. The anecdotal reports from the Center indicate that the 12 days is enough for his brain to get started on the right path, and that improvements will continue after the treatment in the weeks and months that follow.
Marking Time
Caleb is now over half-way through the program at the Center, going once in the morning and then again in the afternoon. We make careful observations of his behavior, taking notes and watching how he relates to the world around him. It is too early to tell what kind of effect the treatment is having, but our hopes are high.
