Gravitational Insecurity in Children: A Survey of Occupational Therapists’ Observations

Michael Potegal, Whitney Osborne Pfaff, Elizabeth Kroker

Research output: Contribution to journalArticlepeer-review


Aims: 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
Method: A mail/online survey of pediatric OTs
Results: 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
Conclusions: 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 multip
Original languageEnglish (US)
Pages (from-to)3-=37
JournalIndian Journal of Physiotherapy & Occupational Therapy
Issue number2
StatePublished - 2018


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