Leah K. Light, Au.D.
Gravity is the universal constant. It is the one thing we all must contend with on a moment-to-moment basis no matter our age, in fact, everything on earth is referenced to gravity. The first thing a newborn baby has to contend with outside of it’s protective womb is gravity and how to work with and against it: how to hold our head up with respect to gravitational forces, coordinate our core body with our head movements in relationship to gravity and finally how to use our limbs in combination with our head and our core. This seemingly simple process is much more complicated than it looks and is an essential piece in defining ourselves as individuals.
How balanced we are in our physical and motor coordination directly relates to how our sensory systems work together and how we process information. It greatly affects whether parts of our brain wire together or not. Our intelligence, personality, and how we interpret information is based upon our brain wiring, not its size or even the number of brain cells present. When we have an experience, we process multiple streams of information simultaneously. Our central balance center, which combines the brainstem, midbrain, and cerebellum, helps put information from the senses together while also coordinating our physical responses and reactions. Most of this processing is actually handled at a subconscious level. For example, at your birthday party you walk in, hear lots of noise and singing, see the crowd, decor and balloons, feel the warmth and smell the freshly lit candles burning as your favorite chocolate cake is placed in front of you. According to the Hebbian theory, when neurons, which are brain cells, in different parts of the brain fire together repeatedly in the same order, they wire together into networks. These distributed neural networks define our perception and higher levels of understanding. It’s how we ultimately process this entity called, “my birthday party.” It is also how we develop certain personality patterns.
Our balance system also works closely with the emotional centers of the brain that regulate fear and behaviors. Imagine running into an old high school friend at the grocery store and as the two of you are standing deep in conversation, you suddenly slip on the floor. Your balance system sends up a major red flag.Your body automatically goes into survival mode, bracing to break the fall by extending your arms and tensing your body. But what if your balance system doesn’t work properly? What if you can’t trust your body to react appropriately or fast enough to protect you from injury? After a while you will find yourself avoiding places where you might slip and fall or activities which could be dangerous for you. Your lack of balance can trigger anxiety about your body’s defense mechanisms failing, fear of getting hurt or overly concerned that others will poke fun at you for being inept.
Adults with balance issues often seek medical attention because they may have once had normal balance but lost it due to health issues. They are aware of the imbalance because they have experienced balance. However balance issues in children may often be overlooked and undiagnosed because they are expected to be a bit clumsy and their movements to be somewhat imprecise. After all, they are kids, right? At present, there is little known about what constitutes normal balance for younger children; but we do know that many who are seen for attention and behavioral problems are experiencing balance issues as well.Interestingly, they may be able to ride a bike or scooter without difficulty, fooling parents into thinking they have good balance. Often these children are described as having never walked and always ran. They use velocity or speed to stay upright, like a spinning top which falls when the spinning process ends; these children often fall over when they are asked to stand or sit without moving. The act of remaining perfectly still is the toughest balancing act of all.
Children with dyslexia and other learning disabilities may have poor coordination between the two sides of the body in addition to balance issues. This affects the scaffolding of their brain development and not only their physical balance, but the balance between the workings of the two hemispheres of their brains. The bridge that connects the two sides of the brain, the corpus callosum, may be underdeveloped from lack of use. When the corpus callosum is weak, the two sides of the brain don’t work well together and comprehension suffers. By the third or fourth grade, these children start to fall behind in school because the task demands require them to use both sides of the brain together more often for thinking, problem solving, written stories and explanations, and complex understanding of relationships. They may act immaturely, being overly sensitive and prone to meltdowns, and may need frequent repetition of information before it sticks. A tendency to be literal and a lack of understanding of sarcasm, humor, and idiomatic expressions are often a hallmark of children with weak connections between the two halves of the brain.
The effects of balance issues extend beyond our academic aptitude, intelligence and personality and can affect social interactions with others and responses to the environment. Each of us is our own reference point for the world around us. We have our own internal measurement system that helps us adjust to gravity, understand when we are moving in a straight line, or when we are turning. This system also helps us to create a map of our own bodies so that we know where each part is relative to other parts, as well as where we begin and end. When the balance system doesn’t function accurately, it affects our ability to understand our own boundaries as an individual being. For this reason, many children and even adults who have poor balance, may lack physical, and spatial awareness and have a tendency to invade another’s personal space due to a disconnect within themselves. Trying to explain what to touch and what not to touch may be pointless until they understand the boundaries of their own bodies.
How can we improve balance and our relationship to gravity? Although we may not always know why a person’s sense of gravity is not well developed, there are things that can be done to better establish it. While a neurologist can diagnose diseases which impact balance, it can be beneficial to seek other professional help in evaluating the three sensory systems that regulate balance: vision, the vestibular system, and the proprioceptive system, aka the information we get from our skin, muscles, and joints about our position. If one or more of these systems is not fully operational, it’s essential to find a way to engage the functioning ones to compensate. For example, children with chronic middle ear fluid, otitis media, often have trouble with balance. Once otitis media is ruled out, a hearing evaluation may be a constructive next step.For children, my recommendation is to have a pediatric audiologist perform the test to be sure that all parts of the ear, the outer, middle, and inner are working well. I highly recommend an evaluation by an audiologist with specialized training in diagnosis and treatment of Auditory Processing Disorders (APD) may be warranted for those children who are experiencing difficulty understanding what’s been said, learning to read, or following directions, even though their basic hearing sensitivity test is normal.
Having vision tested and getting appropriate eye care by a developmental optometrist, if needed, is another important consideration. These specialists do more than check visual acuity; they test for normal eye movement as well as eye coordination which are essential for staying focused and processing visual information.
Stimulating our proprioceptive system through tactile and deep pressure techniques is another step toward building a better balance system. Touch is often taboo in our society, but is a much needed sensory input. Children with poor proprioception often seek out touch by rubbing up against things, needing lots of tight hugs, and playing roughly.Others are opposed to touch and may react negatively, confusing parents who may feel rejected or put off because of their child’s withdrawal from loving, parental touches. An evaluation by a physical therapists and occupational therapist may be beneficial as they are trained in dealing with the balance system and addressing proprioceptive awareness. Weight bearing or resistance activities can help develop our proprioceptive system as well as stimulate our vestibular sense. Adults may benefit from regular massages, yoga, Pilates, or weight training to develop a better sense or proprioception.
As with most things that are worthwhile, building a better balance system takes time, energy and effort. Hopefully,the payoffs of being happier, more grounded, self-reliant, improved social skills, enhanced learning and comprehension, and better self-confidence and self-esteem are well worth the emotional, physical and financial expenditures of the journey.