Thursday, February 21, 2013

Sensory Week - The Proprioceptive System

Does your child seem "clumsy", bump into things, have difficulties motor planning how to get dressed in the morning, seem "lost in space", or use way too much force when writing or coloring. If you are shaking your head "yes", then the receptors within his or her muscles, joints, ligaments, tendons, and connective tissues, which comprise the proprioceptive system may not be working properly.

Proprioception comes from the latin word proprius meaning "one's own" and perception. Proprioceptive awareness refers to one's ability to understand where you are in space via these receptors.  It allows children to know the location of their limbs, the position of their joints, the speed and force with which their muscles are moving. It occurs consciously, at the thalmic and cortical level, and unconsciously, in the cerebellum. When these receptors are not working properly, children may exhibit proprioceptive dysfunction. 

When controlling motor movements, proprioceptors:
  • Guide the timing of motor actions
  • Fine tune the spatial awareness needed
  • Map out the initiation and execution (initial body position and outcome of movement)
  • Determine how much force to use
  • Determine the timing and force differently during fast, high pace movement and slow, weak movement
Proprioceptors allow us to have coordinated interaction with our environment.

As mentioned above, children with inhibited proprioceptive awareness, may exhibit some of the following:
  • Difficulties motor planning activities (figuring out how to put on a shirt or how to skip)
  • Challenges figuring out how much force to use during activities (they may break toys or write too hard)
  • Children may bump into things such as the couch, or desks within the classroom
  • Show difficulties organizing tasks
  • Exhibit decreased postural tone during functional tasks - difficulty maintaining postural muscles and responses providing a sense of security
  • Seek out large amounts of proprioceptive input (these are often times seen as aggressive behaviors) - bumping/crashing into things, hitting, biting, banging, banging one's head, pushing
  • They may be hyporesponsive (underresponsive) to touch 
  • Children may also enjoy chewy, hard foods over soft foods 
Now, let's go back to the handwriting task discussed in my previous post discussing The Vestibular System. When children have decreased proprioceptive awareness, they have difficulties with grading how much pressure to use when writing (they often write too dark) and often times hold the pencil squeezing it very tightly. This causes quick fatigue. Without their vision, their muscles are unable to provide feedback as to where they are positioned on the paper. They have decreased body position in their desk and often times decreased posture. With all of these challenges a child with proprioceptive dysfunction may be facing, imagine how difficult it is to take in what they are learning and writing about. They are concentrating so hard on holding the pencil, sitting upright, figuring out where to write on the paper, learning the content may get lost and emotional lability or frustration may be exhibited. 

Intervention strategies that assist to improve proprioception:
**Please note, these are just suggestions. If you feel that your child or one of your students has proprioceptive dysfunction or sensory integration dysfunction, it is important to discuss this with your doctor or naturopathic doctor and seek out professional help from an occupational therapist** 
  • Engaging in heavy work activities - Moving chairs/desks around the room, carrying heavy books to the office, assisting to carry laundry or groceries
  • Tug of war games, pushing/pulling games
  • Wall push-ups
  • Wheelbarrow walking
  • Crab Walking
  • Play with resistive play-doh or putty
  • Pull the child on a scooter with an old tire tube, make sure that the child is pulling as demonstrated by elbow flexion during the scooter ride
  • Climbing - up the slide, on playground equipment, up a ramp (on feet, crabwalking or wheelbarrow walking)
  • Use weighted items - weighted vests or snakes (use 5% of the child's body weight as a guideline for weighted vests), weighted blankets (you can use 10% of the child's body weight plus 1lb - because the child is lying and not bearing the weight, you can use more weight than a weighted vest),  play with weighted bean bags
  • Chewy tubes or chewlery for oral motor proprioceptive input
  • Gum or resistive foods
  • Squishing between couch cushions
  • Make your child into a burrito or taco wrapping them tightly in a blanket - you can also add stuffed animals and weighted bean bags inside
  • Going through a resistance tunnel or pushing a small therapy ball through a resistance tunnel
  • Tai-chi
  • Yoga
  • My favorite - lots and lots of tight hugs and squeezes!

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