Gravitational insecurity is seen often in autistic children, and is generally treated by OTs. Let me tell you about gravitational insecurity and why it’s important for us SLPs to understand.
If a child has gravitational insecurity, that child has over-responsiveness and anxiety with vestibular sensations. This child will fear everyday movement experiences that don’t seem to be related to their motor capacities. In other words, it’s not that the child doesn’t have the motor skills to safely engage in the activity, so the fear is not necessarily rational.
Signs of gravitational insecurity:
Child shows anxiety in response to vertical linear input, even gentle movement
Child has slow, guarded movements
Child avoids walking on surfaces that are unstable or different heights
Child is very cautious of movement
Child avoids moving head in new positions
Why do SLPs need to understand gravitational insecurity?
You may have heard my Eggs in a Basket analogy, and if you haven’t, here’s what you need to know.
I like to say every child has 3 baskets of eggs: Language, Body and Emotions. In order for a child to be in a place where they can process and learn, the child’s eggs have to be evenly distributed among all three baskets. For example, a child who is throwing a tantrum has all of their eggs in their Emotions basket - the child is fully focusing on their emotions, and therefore, is not able to attend to a conversation with you at that moment.
Say you put a child with gravitational insecurity on a swing in which their feet can’t touch the floor. This is a very anxiety-provoking activity for a child with gravitational insecurity. Because of this, all of the child’s eggs move to their Body basket - all the child can focus on at that moment is their body. The child is feeling too unsafe and insecure to be processing language. Therefore, this child would not benefit from a language activity while moving back and forth on that swing.
Being able to identify gravitational insecurity helps us to choose appropriate activities for our sessions. Rather than putting a child on a swing where their feet don’t touch the floor, we may choose a swing where the child’s feet DO touch the floor - we may choose NOT to swing the child at all, but allow the child to sit in the swing with his feet planted on the ground.
What should our sessions look like for a child with gravitational insecurity?
First and foremost, choose activities the child can tolerate. This typically means engaging the child in activities in which the child keeps their feet and body on the floor or close to the floor with limited movement.
We can *very gradually* increase movement demands, while carefully watching the child for signs of insecurity or anxiety.
We can stay very close to the child and give the child physical support, such as by keeping our hands firmly on the child’s hips so that the child knows we are there but we are not controlling the child’s body or making the child feel off-balance.
If you see kids with gravitational insecurity but don’t feel confident in knowing how to help the child, you can:
Ask the child’s OT so that you can learn more about what the child can or can’t tolerate in sessions, if there is something special (if anything) you should be doing in your sessions to address it, and ways that you can help the child feel secure during your session activities.
Choose activities in your session that are going to keep the child feeling safe and secure. You can leave the movement activities up to the OT, and instead choose activities in which the child can keep their body on or close to the ground.
Understanding sensory processing is an integral part of treating autistic children. If you're an SLP working with this population, check out my Sensory Processing & Self-Regulation Mini Course for SLPs, where I share my 7-step process for improving regulation and attention.
Jessie Ginsburg, M.S., CCC-SLP is the founder and CEO of Pediatric Therapy Playhouse in Los Angeles, and the creator of ASD from the Inside Out, an online course for SLPs working with young autistic children.