03/24/2026
WARNING: LONG POST
What do you do (in OT) for a child that enjoys climbing? I mean, climb anywhere? On top of tables in the classroom? On top of their mother's vehicle, while waiting for a verbal report from the session?
Climbing to the roof of a car or onto tabletops can indicate a child's need for high-intensity sensory input to help organize their nervous system. According to a sensory integrative framework, they are not "misbehaving" but rather attempting to find their "center" in a world that is ambiguous.
Here's a breakdown of the clinical "why" and how to customize OT sessions for a child who climbs a lot.
Clinical Observations and Impressions 1. Proprioceptive Seeking (or "Heavy Work" Hunger) They may have a high threshold for proprioceptive input. Climbing requires the brain to perform "heavy work" by contracting their muscles and compressing their joints to distinguish between their body and the surrounding environment. •
Impression: 1. Poor body scheme and awareness.The child seeks "maximal resistance" to feel anchored. 2. Vestibular Input And Verticality Climbing in a car presents a distinct vestibular difficulty. Moving their head through different planes of gravity (vertical and diagonal) regulates their neurological system's arousal. 3. Seeking linear and angular accelerations. The "height" can create a sense of clarity and control over the environment, making it feel safer than being at ground level.
3. Gravitational Insecurity vs. Seeking--Some children are afraid of leaving the ground, but some kids tend to be the reverse. They presumably have zero gravitational insecurity, which means their brain does not send "danger" signals when they are off balance. • Impression: Safety awareness comes second to the physiological demand for input. T
Tailoring OT Sessions: Strategic Intervention To reduce "unsafe" climbing (e.g., autos), provide "functional" climbing with comparable intensity. 1. High-intensity proprioceptive circuits Don't just offer them a swing; give them a task that takes their full effort. • Incline Crawling: Use a crash mat ramp or slide. Encourage them to "climb" up the slide with their hands and feet.
The "Sandwich" or "Burrito" technique involves applying deep pressure with heavy mats or a therapy ball to reset the system before and after climbing activities.
Structured Verticality Direct the child's demand for height to controlled surroundings. 1. Wall Bars or Rock Walls 2. Lycra Swings: A "cocoon" swing requires the user to utilize their own body weight to climb inside or pull themselves up the ropes. 3.
3. Environmental modifications (home/car) As the child climbs the automobile, the family requires a "bridge" strategy: • Before entering the automobile, give them 10 hard joint compressions or a "bear hug." Climbing the exterior helps them gain proprioception. • Use "Stop" signs or colored tape to create a "no-climb" zone, and a "Yes-climb" zone (e.g., a strong step stool or backyard dome). 4. Concentrate on postural control.
Climbing can hide underlying postural instability. Improve the child's core strength and "co-contraction" (holding a position against resistance) to enhance her stability without the need for excessive heights.
Please, talk to your occupational therapist with any questions.
Note: These are solely the opinions and thoughts of Ruth Waldrop, MAOT, OTR/L.
HAPPY LEARNING!
