Gravitational Insecurity in Children: A survey of occupational therapists’ observations

To 1) quantify aspects of gravitational insecurity (GrI) including prevalence in Occupational Therapy (OT) clinics, age/sex profiles, identifying observations/tests, presenting signs/co-morbidities, therapeutic interventions, 2) Test specific hypotheses about vestibular dysfunction, Non-Comorbid cases and outcome profiles.

A mail/online survey of pediatric OTs

Responses of 109 OTs suggest Gri occurs in 0–5% of most pediatric OT populations. Children's climbing was most typically assessed. Gri may be more prevalent in girls than boys and in 3–6 year olds. Gri is associated with vestibular dysfunction signs more than with signs of other chronic childhood illnesses. Most frequent GrI comorbidities were Developmental Coordination Disorder and anxiety. GrI is treated with gradual linear-to-rotational movement and/or the Astronaut Training Program. Outcomes conform to a typical medical “rule of thirds”; about a third of children show little or no change, a third improve somewhat, a third improve greatly. About 26% of these children show post-treatment “craving” for previously avoided movements.

Validated Gri diagnostic tests are underused. Signs associated with Gri indicate vestibular dysfunction. Gri presents without co-morbidity in 6.5% of cases suggesting it is not a nosological artefact resulting from multiple combined comorbidities. Results provide hypotheses for future direct testing of children with Gri.