Robynne,
My son Alex is 2 and he's just started standing. He can physically do it but he hates it. In fact, every time he stands, it makes him gag and retch. I showed this to his pediatrician and she thinks it might be an inner ear issue. I think it's a sensory thing. Alex has had severe reflux and vomiting since day one. He has moderate hypotonia and significant gross motor delays. He has an OT but she said she has never experienced something like this before. My question to you is have you seen this before and what should be be doing to help get rid of it?

Thanks so much for your help.

Hi Brittany;

Alex is precious and has an infectious smile J I see that he is 100% j-tube fed from your thread, but I have some other questions regarding his history. Was he a term baby or was he premature? Is he being followed by a neurologist? Does he just have significant gross motor delays or is he developmentally delayed in general (i.e. language, social-emotional, self-help, fine-motor)? Has he had a history of upper respiratory infections, ear infections, or sinus infections? Does he have a Nissen Fundoplication?

I must say I could agree with you and your pediatrician, however, I do not know your son’s history. The vestibular sense of the inner ear responds to body movement through space and change in head position. It automatically coordinates the movements of one's eyes, head and body. If this sense were not functioning well, it would be difficult to try to walk without falling. The vestibular sense is central in maintaining muscle tone, coordinating the two sides of the body, and holding the head upright against gravity. The vestibular system can be thought of as a foundation for orientation of the body in relation to surrounding space, or if it makes sense, where your body is in space.

To answer your question, yes I have seen this before. What is important to rule out is 1. Are ear infections (possibly from reflux) causing vestibular problems?
2. Is there something neurological causing your son’s inability to balance/walk? This would be a question for your pediatrician or neurologist. Alex has moderate hypotonia and severe GERD. It is going to take him longer to walk than peers his age. If his vestibular sense is affected, I highly recommend you take him to an OT who specializes in sensory integration dysfunction. Alex should receive treatment that focuses on vestibular and proprioceptive activities. You do not have to have a SI certified OT, but one who does specialize in this area. Again, not knowing Alex’ history, it is difficult for me to pinpoint what may be going on. Please write back if you have any further questions J

Robynne

Thanks so much Robynne for your reply. It was very helpful. To answer some of your questions, Alex was 100% j-tube fed up until about 6 weeks ago when he was finally able to handle bolus feedings in his g-tube. Now he is 100% g-tube fed. He does has a history of fluid in his ears, not infections but just fluid, and this past Friday they put in bilateral ear tubes. His delays are scattered. His fine motor, social skills and language comprehension skills are normal. He has delays with gross motor, self-help and talking.

I think I am going to look up an OT with those special qualifications. Its just that I know he can physically stand but it's so uncomfortable for him that he doesn't want to do it. He also wont roll over or sit up on his own. I always thought it was motor planning but now that you are talking about his vestibular system, I'm wondering if that plays a role.

Thanks again for the help.
Brittany

Here are some more answers to your questions. He was full term with a good birth weight. He is followed by a neurologist who has labeled him as having moderate hypotonia of unknown origin. He had one sinus infection that was treated with antibiotics. He does not have a nissen. Besides the horrific vomiting, his health has been okay.