On of my favorite ways to start an intervention sessions with young children is tipping them over backwards on a big ball.
The first time we do this activity it often takes quite a bit of persuasion to get the child to lie back on the ball and then lift the arms up past the head. And when I say a lot of persuasion I am not exaggerating.
The next step is to move the ball until their hands touch the floor and then bring them up again. Most often, even the most fearful children request one or more repeats of the activity.
What has been achieved?
This activity has provided the child with an opportunity to experience the excitement and pleasure that goes with doing a scary and dangerous activity. This is often an experience that children with a fearful temperament (behavioral inhibition) have not encountered before.
In this clip you see Will (aged 2) enjoying being tipped backwards. This is scary but also exciting.
Gravitational insecurity or a fearful temperament?
"Ayres (1979) specifically identified a unique subgroup of children with sensory integration dysfunction who exhibit excessive emotional reactions in response to changes in movement or head position as having a condition called gravitational insecurity. She identified symptoms that included fear of falling, fear of inverted head positions, inability to jump or have the feet leave the ground, inability to perform a somersault, and reluctance to lie supine.
Gravitational insecurity is conceptualized as a subtype of sensory integration dysfunction. It is characterized by decreased vestibulocerebellar functioning (primarily difficulty in processing information from the utricle and saccule of the vestibular system) and possibly decreased vestibular–ocular integration, which results in high arousal and apparently irrational limbic system–based fear responses to sudden or disorienting movement experiences (Ayres, 1979; Fisher & Bundy, 1989)." May Benson (2007)
Perhaps fearful behavior is better explained by a fearful temperament style
If a behavior can be changed by changing the child's appraisal of the situation, then it is difficult to argue the case for a sensory integration disorder.
Behavioral inhibition is a specific temperament trait first identified and described by Jerome Kagan in the 80’s. Children with an inhibited temperament are cautious, restrained and even fearful in response to unfamiliar people, objects and situations.
Inhibited children have a very active fear system. The regions of the brain that assess signals from within the body (such as body sensations) and information from the environment for the presence of potential threat or danger, are unusually alert and reactive. Things that are new, unfamiliar, different or difficult are interpreted as being threatening or dangerous. This creates a fear response and activates the body’s fear behaviors of fight, flee or freeze. Read more
Ayres, A. J. (1979). Sensory integration and the child. Los Angeles: Western Psychological Services.
May-Benson, T. A., & Koomar, J. A. (2007). Identifying gravitational insecurity in children: A pilot study. American Journal of Occupational Therapy, 61, 142–147.
Fisher, A., & Bundy, A. (1989). Vestibular stimulation in the treatment of postural and related disorders. In O. D. Payton, R. P. DiFabio, S. V. Paris, E. J. Protas, & A. F. Van Sant (Eds.), Manual of physical therapy techniques (pp. 239–258).