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The Mighty Vestibular System

presented by Tracy Stackhouse

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Disclosure Statement:

Financial: Tracy Stackhouse receives compensation from MedBridge for this course. There is no financial interest beyond the production of this course.

Non-Financial: Tracy Stackhouse has no competing non-financial interests or relationships with regard to the content presented in this course.

Satisfactory completion requirements: All disciplines must complete learning assessments to be awarded credit, no minimum score required unless otherwise specified within the course.

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This course provides the fundamentals for understanding how to harness the power of the vestibular system to influence optimal outcomes when vestibular-based intervention is indicated. A basic overview of vestibular function and anatomy, as well as central nervous system interaction is provided. Vestibular functions will be traced from the receptor through the primary and associated processing pathways. The content will include information on how to directly assess vestibular function as well as the common physiological, postural, ocular manifestations that need to be included in assessment. Vestibular processing is a quiet, pivotal foundation, critical in the ASI approach, and often a missing link underlying neurodevelopmental progress. Treatment considerations to produce effective improvements in specific vestibular symptoms (dizziness, motion perception difficulties) as well as the direct products of vestibular processing, (balance, bilateral coordination, postural/ocular control, motor timing and coordination, visual motor/perceptual skills, etc) are provided. These considerations are extended to include associated modulation-based difficulties, including a grounded sense of self within the context of person/environment/other/task, and as functional abilities related to vestibular processing are provided.

Meet Your Instructor

Tracy Stackhouse, MA, OTR/L

Tracy Stackhouse is a clinical pediatric occupational therapist who has specialized in working with children, adults, and families affected by fragile x syndrome (FXS) and Fragile X related conditions since the late 1980s. Through this work, first at Children's Hospital in Denver, continuing at the UC Davis MIND Institute, and now at the nonprofit center…

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Chapters & Learning Objectives

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1. Why The Vestibular System Is So Mighty

The focus of this training is to deepen understanding of the vestibular system, a system so mighty that it is at the crux of understanding ourselves and the world around us. This chapter introduces what will be covered, identifying the frame of reference (ASI) as well as general terminology. The review will include the functional neuroanatomy and how the sensory information is integrated into key adaptive functions including postural control, motion, equilibrium, spatial orientation, and arousal modulation The course will include general information for assessment and treatment planning. This topic is important for pediatric OTs, as vestibular processing, together with the somatosensory system, form the focal foundation for Ayres' Sensory Integration (ASI) Theory.

2. Receptors: Anatomy Structure and Functions

This chapter provides detailed information about the location, structure, and function of the vestibular apparatus. The vestibular labyrinth includes semicircular canals and macular receptors, the utricle and saccule. The location in the inner ear, the bilateral partnering of the right and left labyrinthine structures, and their relative position in the head are reviewed so that the information received by these structures can be visualized for enhanced clinical reasoning in a vestibular-based intervention approach.

3. Pathways and Functions

Vestibular information is carried via the eighth cranial nerve through central vestibular pathways. The organization of the pathways as they move into the brainstem and then share information across the CNS is presented such that the structure/function relationships are more apparent. This allows the clinician to visualize receptors through pathways to adapt function and increase precision in clinical reasoning for enhanced treatment planning.

4. Adaptive Integrative Functions of the Vestibular System

The vestibular system is mighty, in part because it is structurally and functionally integrated into such a wide range of adaptive functions. This chapter reviews the sensory modulation and sensory discrimination aspects of vestibular contributions to postural/ocular functions, body control, gravity management, balance, and equilibrium, laterality, coordination, spatial, and temporal processing, problem solving, executive functions, social cognition, stability of self, affect/arousal/attention/action regulation systems, and emotional regulation. This range of adaptive capacities ties to Ayres’ theory of vestibular integration being necessary for daily occupational performance and that when difficulties arise, identifying how the vestibular function may be involved allows for proper treatment.

5. Clinical Application of Vestibular System Information

A general idea of basic postural, ocular, balance, spatial, and timing aspects of vestibular integration and how they can be addressed in formal assessments, clinical observations, and within treatment for increasing power and precision and maximizing outcomes is provided in this final chapter.

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