Why Some Kids Can’t Sit Still

A friend of mine approached me recently, concerned because her 5-year-old son’s teacher had suggested he needed to be evaluated by a psychiatrist for ADHD. The teacher colorfully described him as “inattentive” and “highly distractible” but “very smart.” Knowing that I work in pediatrics, my friend was desperate for a second opinion. I knew some of her child’s history, so I suspected a sensory integration deficit and gave her some pointers.

I’ve found that stories like these are common. If your child can’t sit still, it does not necessarily mean they have ADHD! These issues can be rooted in sensory integration deficits. The auditory-visual-vestibular triad is a powerhouse of sensory integration that aims to integrate sound, sight and body-in-space awareness into a cohesive package for optimum learning. Let’s examine each component a little deeper to see how they play a role in helping our kiddos learn.


The vestibular sense is located in the inner ear and informs posture and movement-in-space. The vestibular system also works closely with the deep core muscles that are responsible for upright posture. Without good information coming from the spinal and core musculature, kiddos may constantly fidget because it’s the only way they can tell how they fit into their environment.


Vision is more than just acuity (seeing clearly). Your visual system works closely with your vestibular system to orient body-in space, using the visual-ocular reflex. As referenced above, if a kiddo is slumped in his chair, his eyes will likely not be attending to the lesson.


In a classroom, there are multiple sources of sound – other children fidgeting or talking, an aide in the back of the room preparing for snack, other children just outside the door transitioning to their activities, etc. If a child’s body and eyes are not oriented to the teacher, his ears are certainly not oriented to the lesson. Thus, he is not listening to the information and can appear “inattentive.”

If the sensory powerhouse of the auditory-visual-vestibular triad is not functioning efficiently, or if there is a breakdown in communication from just one system, the child may appear inattentive, unable to focus or distractible because their body is not organized to receive the information in a cohesive and efficient manner.

It is always best to check with your pediatrician if you have questions or concerns about your child’s performance in the classroom. However, you can always talk to your Kids Creek occupational therapist about activities you can do with your child to help this system function more effectively to optimize learning.

Claire Whatley, MS, OTR/L

Image Courtesy Pixabay/Title Added

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