By physiotherapist Hannah Harboe
The theme of this Gonge Insights is vestibular (balance) training with dynamic training for highly sensitive children and how Build N' Balance can be used in training of this kind
A large proportion of the population is said to be highly sensitive. Hypersensitivity in the sensory apparatus can be significant to learning motor skills and the child's willingness to move. The child finds it difficult to separate incoming sensory impressions and tends to overreact to them.
When the vestibular system is overreactive, the child will find that he/she loses control and is afraid of falling even when he/she faces only minor balancing challenges. Movements to prevent falling are often exaggerated and the child is anxious and his/her movements in motor skills play and activity are much too careful.
In simple terms, sensitivity can be dscribed as the volume of sensory reception turned up higher than normal. The child feels, hears, tastes and reacts more strongly and more intensively.
A child who has these challenges is often resluctant to join in vestibular stimulating games and prefers sedentary games in small groups and more manageable spaces. The child is not challenged to experiment with physical and motor skills as often as other children and his/her motor skills development may be postponed as a result.
To ensure that the child's brain recognises and learns to automate a movement, the movement has to be performed repeatedly and the child should also experiment with the movement. An automated response is more efficient, more economical and less demanding on the brain's resources. The movement itself is of a better quality, i.e. flow and force are fluid and measured.
Vestibular stimulation is any type of stimulation, which requires that the body reacts to a movement, acceleration or change of direction in order to maintain balance.
For a detailed description of balance, see Gonge Insights no. 1.
Anne is a seven-year-old girl. She is socially polite and pleasant. She enjoys interacting with adults and play dates with one friend at a time. However, she withdraws and finds it difficult to participate in play in a large group. At school she is insecure and gets upset before a PE lesson. She says PE is smelly and there is too much noise. She always manages to stand at the back with all her classmates in front of them. She makes sure that she is not surprised when the other children start running and that se can see them before they get too close to her. There are many activities that Anne neither can nor will take part in. She dare not climb wall bars or slide down a slide. She cannot cycle, scoot or roller-skate.
Anne comes to me for training. We talk about my helping her so that her body no longer gives her as many shocks. The training is intended to give her self-confidence and willingness to take part in and have fun with sports and physical activities at school. When she trains with me, she does not have to compare herself with other children. She compares only what she dared to try and could do last time she was here and becomes aware that practice and repetition is what she needs to become more proficient and more courageous. Anne is afraid of being raised from the floor so we start by building a Build N’ Balance® trail of yellow tops and blue balancing planks. Anne must take three steps on each plank. Three steps ensure that she walks carefully and is aware her sense of sight helps her to keep her balance, and minimises her tendency to flail with her arms when she thinks she is losing her balance. If she does lose her balance, she is so close to the floor that she is able to regain balance by putting one foot on the floor.
When she has successfully completed the trail three times without losing her balance, we replace the yellow tops with red tops and raise the plank successively to the second and third ridge.
Then we make the trail more difficult. We position the planks at an angle and use the more demanding green and purple planks. Finally, we make the trail as difficult as possible and Anne helps to figure out how to position the planks to make the trail more challenging.
After each trail, I praise Anne for her bravery. She has to feel that she can manage and has control over the activity before we make it more difficult. When she comes to the next training session, Anne has thought out how she will put elements together to create a difficult trail. She experiments and tries out the trail to see how well she can do it.
Anne beams with pleasure and seems more selfassured and confident. The high point is when she tells me that now that, she can walk on a narrow plank at training without falling off it, she thinks that she can stand on a scooter without falling. We agree that she will try to learn to scoot with her Dad at the weekend.