Free Guide | The Top 10 Vestibular Exercises For Your Child

Introduction

The vestibular system helps us understand if we’re moving, how fast we’re moving, and in what direction we’re going. Activities like swinging, running, and jumping stimulate this system. But children with Autism Spectrum Disorder (ASD), Attention-Deficit/Hyperactivity Disorder (ADHD), and Auditory Processing Disorder (APD) may be more (or less) sensitive to movement than others.

This article, written by SoundSory’s clinical staff, will teach you about the vestibular system and what it’s used for. We’ll discuss what it may look like if your child’s vestibular system is not working properly, along with exercises that can strengthen it. By creating our multi-sensory music and movement device for children, we have developed a unique expertise in sensory integration. This means we know firsthand how important it is to do these exercises safely. Read on to learn about the 10 exercises that can strengthen your child’s vestibular system.

Key Take-Away Messages

What are vestibular exercises for children with Autism, ADHD and APD?

Vestibular exercises stimulate the vestibular system, which helps us to know whether we are still or moving, and which direction we are moving in. They are particularly important for children with Autism, ADHD, and APD, as children with these conditions are oversensitive or under sensitive to movement. It’s important to proceed with caution when starting vestibular exercises with your child. If your child becomes easily overstimulated by vestibular input, seek advice from an occupational therapist before continuing with these activities. Benefits of vestibular exercises: Help improve balance Boost motor control Enhance stability and posture Minimize strong reactions to vestibular input Points to remember: Start slow Look for side effects such as nausea, dizziness, anxiety, or blood pressure changes Honor your child’s preferences Consult an occupational therapist Our top 10 vestibular exercises for your child include: The sky earth stretch Downward dog X stretch Spin in a circle Log rolling Head tilts (back to front) Head tilts (side to side) Inch worm Chair drops Sword pulls

The 40-day Soundsory® program offers a wide range of in-program vestibular exercises. Soundsory® can boost kids’ neurodevelopment by pairing enhanced rhythmic music with holistic, whole-body exercises.

What are vestibular exercises?

Our vestibular system plays a key role in interpreting movement – this includes direction, speed, and whether the movement is with or against gravity. When we move our head, information is received through the vestibular system in the inner ear. Vestibular exercises are any movements that stimulate this system.

Vestibular exercises are particularly important for children with Autism, ADHD and APD, as children with these conditions are often oversensitive or under sensitive to movement.

It’s important to proceed with caution when starting vestibular exercises with your child. If your child becomes easily overstimulated by vestibular input, seek advice from an occupational therapist before continuing with these activities.

Vestibular input activities can help your child with a wide range of challenges: balance and stability, dizziness or nausea during or after movement, posture, reluctance to take part in movement, bumping into things regularly, headaches, and sensitivity to rocking, spinning, or swinging movements.

Why is the vestibular system important for your child?

When your child’s vestibular system is working as it should, they will feel balanced and able to move around easily. When it’s not working properly, here are a few symptoms you may notice in your child:

• Poor balance [1]
• Dizziness or nausea [2]
• Craving rocking or swinging movements [3]
• Poor posture [4]
• Signs of physical distress during movement activities (sweating, pale skin, dilated pupils) [5]
• Bumping into things more than others [6]
• Reluctance to take part in movement activities [7]

Research shows that practicing vestibular exercises is effective at improving balance control in children. [8] Vestibular exercise therapy can also help to improve stability and posture in children with vestibular difficulties. [9]Sensory therapy can also help to improve stability and posture in children with vestibular difficulties. [2]

Expert’s Guide to the 10 Best Vestibular Exercises

The Soundsory® music program is a great way to get your child’s vestibular system working. To continue working on vestibular development, you can try these expert-approved exercises, too.

In our experience with children who experience vestibular sensitivity, we’ve found that layered instructions can help increase your child’s confidence. For all of our exercises, we’ve included three different versions of the exercises. These consist of: 

• An original version, which is ideally how the exercises should be completed. 
• A modified version for children who find motor skills a bit more challenging.  
• A simplified version for children who struggle with more complex motor skills and directions. 

The original and modified versions go through instructions for you to guide your child through the exercise, and the simplified version has instructions for you to follow so you can support your child. 

1. Sky earth stretches

Original: Stand up tall with your arms out above your head. Stretch your arms and fingers up to the ceiling. Then bend forward and fold in half. 

As your child stretches all the way up, they also activate their proprioceptive system. This system controls awareness of where the body is in space. They use postural skills to lift their body back up to standing, and they can practice grading muscle movements by doing the exercise slowly.

Modified: Sit on a chair and lift your arms above your head, then bend forward and place your elbows on a chair. 

Simplified: Help your child lift their hands above their head, then help them to bend forward slightly to touch their knees. 

How this helps:

• These movements focus on head position changes, which activate the vestibular system and help your child’s brain register movement and spatial orientation.
  
• Stretching upward and folding forward also supports proprioceptive input, building awareness of body position in ways your child might not typically move.
  
• Children with postural challenges may benefit from improved trunk control and better head/body coordination.

2. Downward dog

Original: Get on all fours, placing your hands and feet on the ground. Extend your legs and try to get them as straight as possible. Keep your head between your arms while looking down toward your feet. 

This works your child’s vestibular system because their head is inverted. It also works their proprioception skills and core muscles as they hold their body in position. 

 Modified: Get on all fours, placing your arms out in front of you. Keep your head between your arms and leave your knees bent on the ground, then push back like you’re going to sit while keeping your arms outstretched in front of you. 

Simplified: Encourage your child to kneel on all fours and look down toward their knees. 

How this helps:

• This encourages safe movement of the head as your child slowly moves their body into position by coordinating with the movement of their upper and lower body.

• By bearing weight through the hands and legs at the same time, this improves strength and also offers proprioceptive input.

• Going deeper into this position offers a good stretch to the legs, encouraging greater flexibility.

3. X stretch

Original: Stand like an ‘X’ with your arms out above your head, and legs slightly over hip width apart. Then fold over, keeping both arms extended, and reach your left arm to your right foot. Stand up, and repeat with your right arm reaching to your left foot. 

This exercise works the vestibular system as your child bends forward and crosses their midline. By encouraging your child to look at their hand and foot during the exercise, they can also work on their visual skills. 

Modified: Stand like an ‘X’ with your arms overhead. Take your right arm to your left knee, looking down but not fully bending over. Repeat to the other side. 

Simplified: Demonstrate hands overhead to your child and encourage them to copy, or use stickers to match. 

How this helps:

• The X stretch not only encourages downward positioning of the head but also requires your child to laterally move their head. This is an added challenge!

• This exercise emphasizes bilateral coordination and midline crossing, which further integrates the body’s sensory system and helps both sides of the brain communicate with one another.

• By incorporating eye movements into the exercise, this also helps your child’s visual-motor skills and hand-eye coordination.

4. Spin in a circle

Original: Stand with your arms out to the side and look at a point on the wall (door knob, picture, sticker). Slowly turn in a circle five times to the right, then five times to the left. Repeat if you’re not feeling too dizzy. 

Modified: Stand with your arms out to the side and look at a point on the wall. Slowly turn five times to the right, pause for 10 seconds, then five times to the left. 

Simplified: Encourage your child to stand with their arms out to the side and look at a point on the wall. Using tactile cues if needed, encourage them to turn in a circle once, then pause, a second time, then pause, and a third time, then pause for 10 seconds. If not too dizzy, repeat in the opposite direction. 

How this helps:

• Spinning requires your child to shift weight to various parts of their body as they keep their head in the same position and their body upright.

• Moving around in a circle will also help your child anticipate and plan their movements to stop at the right time.

• This can also strengthen visual skills, helping your child develop depth perception each time their eyes need to readjust to new surroundings.

5. Log rolling

Original: Lie on your back on the floor and roll 5-6 times in one direction. Pause for a few seconds, then repeat 5-6 times in the other direction.

Modified: Lie on your back on the floor and roll onto your front, then roll onto your back again. Repeat 10 times. 

Simplified: Get your child to lie on their back on the floor. Guide them through rolling 5-6 times in one direction and back again, or back to front 10 times. 

How this helps:

• Rolling in this manner allows a child to determine spatial awareness and keep all of their body in movement at the same time, in alignment with their head.

• Log rolling is great for a child’s core strength, as it requires them to keep their tummy tucked to roll properly.

• This movement helps integrate reflexes, which further benefits each of the body’s sensory systems.

6. Head tilts (back to front)

Original: Stand in one spot and slowly look up to the sky, while tilting your head back. Then, slowly look down to the ground while tilting your head forward. 

Modified: Sit in a chair, look up to the sky, then return to neutral. Then look down at the ground and return to neutral.

Simplified: 

Use gentle tactile cues or a visual cue (e.g,. their favorite toy)  to help your child look up and down.

How this helps:

• Head tilts address the vestibular system in perhaps the most direct way: by getting your child used to sensitive but crucial movements of the head.

• In particular, back-to-front head movements will come up naturally when your child is eating, playing outside, getting dressed, and working on tabletop tasks such as writing and cutting.

• By completing these head tilts in standing, your child will get more used to stimulating the vestibular system during activities such as sports and other gross motor tasks.

7. Head tilts (side to side)

Original: Stand up and look straight ahead. Slowly tilt your right ear toward your right shoulder, then your left ear toward your left shoulder.

Modified: Sit on a chair and look straight ahead. Slowly tilt your right ear toward your right shoulder, then your left ear toward your left shoulder.

Simplified: Use tactile cues to guide your child’s head left and right, such as your hand or a soft toy on their shoulder. 

How this helps:

• Head tilts address the vestibular system in perhaps the most direct way: by getting your child used to sensitive but crucial movements of the head.

• In particular, side-to-side head movements will come up naturally when your child is shaking their head to express disinterest, looking at friends around them, checking for cars before crossing the street, and more.

• By completing these head tilts in standing, your child will get more used to stimulating the vestibular system during activities such as sports and other gross motor tasks.

8. Inch worm

Original:

From standing, slowly fold in half and place your hands on the ground. 

Modified: 

Instead of standing, do this exercise on all fours. Take 2 steps forward with your hands, then 2 steps with your feet. Repeat 5 times.

Simplified: On all fours, lift one hand and then the other. Then lift one leg and then the other, all without moving from the spot you’re in. Repeat this 3-5 times.

How this helps:

• The inchworm helps with hand-eye coordination to keep everything moving smoothly.

• This exercise requires your child to keep their head mostly still in an upside down position as they move. The vestibular system picks up on even the tiniest of movements, so this offers it a big challenge!

• Neck strength, upper body strength, and postural control are also addressed by this exercise.

9. Chair drops

Original: While sitting in a chair, fold in half to touch your feet on the ground. Repeat this 10 times, at a gentle pace. 

Modified: While sitting in a chair, fold in half to touch your ankles. Pause, then repeat 8 times. 

Simplified: While sitting in a chair, fold in half to touch your shins or knees, pause for 3 seconds, then repeat 5 times. 

How this helps:

• Placing the head upside down allows new spatial orientation while the chair allows your child to be assured they won’t fall. This is a good starter activity for vestibular stimulation!

• This encourages flexibility by helping your child gradually reach further and further.

• Chair drops encourage core strength and then some by having your child’s bottom remain in the chair while their upper body makes a big stretch.

10. Sword pulls

Original: Standing upright, use your right hand to pull a pretend sword from your left hip and reach up to the sky with your right hand (and imaginary sword).  Look up to your hand as you’re reaching up. Repeat 10 times with each hand. 

Modified: Standing upright, use your right hand to pull a pretend sword from your left hip and reach up to the sky with your right hand (and imaginary sword).  Look up to your hand as you’re reaching up. Repeat 5 times with each hand. 

Simplified Sitting upright in a chair, use your right hand to pull a pretend sword from your left hip and reach up to the sky with your right hand (and imaginary sword).  Look up to your hand as you’re reaching up. Repeat 5 times with each hand.

How this helps:

• Your child is not very likely to perform diagonal head movements on their own, especially if they have vestibular sensitivity. This helps the body get used to a lesser-assumed head position.

• This is another exercise that promotes sensory integration by incorporating midline crossing, hand-eye coordination, and bilateral integration.

• By adding in big upper body stretches, sword pulls also help with posture and core strength.

How to Practice Vestibular Therapy Exercises Safely: Expert Tips

• Start slowly: As with any new exercise, children may tolerate vestibular exercises well or have some difficulty getting used to them. The best way to approach vestibular exercises is to begin slowly and thoughtfully.
• Watch for signs of overstimulation: Some children have strong adverse reactions to vestibular exercises. This may result in nausea, dizziness, sweating, skin paleness, headaches, or anxiety. If any of these occur, it’s best to stop the exercises altogether. Be aware that nausea and headaches may start a few hours after the exercises, while the other signs, like sweating and dizziness, usually show up right away.
• Honor your child’s preferences: Always respect your child’s wishes if they don’t feel comfortable trying a certain activity. This may be the case for backward and circular movements, as these movements can take some getting used to. Children may also be anxious about exercises that take them off the ground (such as walking on a balance beam) or involve unstable surfaces (such as wobble boards). This is known as gravitational insecurity, which means it’s not as simple as overcoming their anxiety. You can make children with gravitational insecurity feel more comfortable by giving them something to hold onto during these exercises.
• Consult a pediatric occupational therapist (OT): If your child avoids these activities or demonstrates any of the reactions above, talk to an occupational therapist. They can develop a specific plan to address these concerns.

Conclusion

Children with Autism, ADHD, motor delay, and APD often struggle with vestibular input. For these children, vestibular exercises are a great way to start addressing those issues in a way that they feel comfortable. Another fantastic way to work the vestibular system is the Soundsory® program, which combines full-body movement exercises with rhythmic music. This 40-day program includes auditory exercises, cerebellum exercises, and training for many other aspects of your child’s neurodevelopment.

FAQs About Vestibular Exercises

Are vestibular system exercises alerting or calming?

Vestibular activity can be either calming or alerting, depending on the movement and the child. It can be hard to find the perfect amount of vestibular input for your child, mostly because their sensitivity can change from day to day.

Your child’s vestibular system detects all movements, but there are a few types of movement that particularly stimulate it. These include rocking, spinning, and swinging.

What happens if my child’s vestibular system is working too hard?

The amount of vestibular input needed is different for every child, and also different for the same child at different times. If your child has difficulty with vestibular activities, they may become very tired, overly energetic, or possibly even tearful.

What can I do if my child has difficulty handling vestibular input?

If your child appears to be overstimulated following vestibular activities, follow the input with proprioceptive activities. We’ll explain below what proprioceptive activities are and give some examples.

What’s the difference between proprioceptive and vestibular exercises?

While the vestibular system tells us whether we are moving or not, the proprioceptive system gives us information about our body position. For example, if we walk along a street, our vestibular system tells us our head is moving through space. Our proprioceptive system tells us that our legs are moving, too, so our brain lets us know that our whole body is in motion.

How many times a day should you do vestibular system exercises?

To start, it’s best to practice these exercises once each day. As your child gets more used to the exercises, they should be able to slowly work their way up to three times per day.

How long does it take for vestibular exercises to work?

If your child practices these exercises as often as their therapist told them to, they should see changes in 6 to 8 weeks. You may notice small improvements sooner than that. But it will take a bit longer for your child to easily complete vestibular exercises and naturally tolerate activities like swinging and running without problems.

References 

1. O’Reilly, R. C., Morlet, T., Nicholas, B. D., Josephson, G., Horlbeck, D., Lundy, L., & Mercado, A. (2010). Prevalence of vestibular and balance disorders in children. Otology & Neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology, 31(9), 1441–1444. https://doi.org/10.1097/MAO.0b013e3181f20673 
2. Szirmai A. (2010). Vestibular disorders in childhood and adolescents. European Archives of Oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology – Head and Neck Surgery, 267(11), 1801–1804. https://doi.org/10.1007/s00405-010-1283-2 
3. Napa Center. (n.d.). Understanding Vestibular Input & Its Role in Sensory Regulation. Retrieved from https://napacenter.org/vestibular-input/ 
4. Lim, S. B., Cleworth, T. W., Horslen, B. C., Blouin, J. S., Inglis, J. T., & Carpenter, M. G. (2017). Postural threat influences vestibular-evoked muscular responses. Journal of Neurophysiology, 117(2), 604–611. https://doi.org/10.1152/jn.00712.2016 
5. Farhat, R., Awad, A. A., Shaheen, W. A., Alwily, D., Avraham, Y., Najjar, R., Merchavy, S., & Massoud, S. (2023). The “Vestibular Eye Sign”-“VES”: A new radiological sign of vestibular neuronitis can help to determine the affected vestibule and support the diagnosis. Journal of Neurology, 270(9), 4360–4367. https://doi.org/10.1007/s00415-023-11771-6 
6. Smith, L. J., Pyke, W., Fowler, R., Matthes, B., de Goederen, E., & Surenthiran, S. (2024). Impact and experiences of vestibular disorders and psychological distress: Qualitative findings from patients, family members and healthcare professionals. Health Expectations : an international journal of public participation in health care and health policy, 27(1), e13906. https://doi.org/10.1111/hex.13906 
7. Dunlap, P. M., Sparto, P. J., Marchetti, G. F., Furman, J. M., Staab, J. P., Delitto, A., Klatt, B. N., & Whitney, S. L. (2021). Fear avoidance beliefs are associated with perceived disability in persons with vestibular disorders. Physical Therapy, 101(9), pzab147. https://doi.org/10.1093/ptj/pzab147 
8. Medeiros, I. R. T., Bittar, R. S. M., Pedalini, M. E. B., Lorenzi, M. C., Formigoni, L. G., & Bento, R. F. (2005). Vestibular rehabilitation therapy in shildren. Otology & Neurotology, 26(4), 699–703. https://doi.org/10.1097/01.mao.0000169051.69254.85 Ebrahimi, A. A., Jamshidi, A. A., Movallali, G., Rahgozar, M., & Haghgoo, H. A. (2017). The effect of vestibular rehabilitation therapy program on sensory organization of deaf children with bilateral vestibular dysfunction. Acta Medica Iranica, 55(11), 683–689. https://pubmed.ncbi.nlm.nih.gov/29307157/