Proprioception

Just as our eyes and ears send information about what we see and hear to the brain, parts of our muscles and joints sense the position of our body and send these messages to the brain as well. We depend on this information to know exactly where our body parts are and to plan our movements. It also has a direct link to the way we grade our movement (i.e. apply the right amount of pressure or force).

Proprioceptive activities are often called “heavy work” as they involve pushing, pulling, resistance or wearing bearing. Proprioception has an important calming and regulating effect on all of our sensory systems. Proprioceptive input is known to release serotonin into the body, which is a “feel good” chemical that assists with mood as well as sleeping. Proprioception (and deep pressure) are an important part of any sensory based activity programme.

Everyday activity examples:

  • carrying/pushing heavy objects
  • crawling or crab/bear/wheelbarrow walking
  • pushing an adult in an office chair
  • pulling or pushing a sibling on a scooter or in a box
  • musical instruments; eg drumming, Boom whackers, percussion
  • push ups/chair/wall push ups
  • hanging from monkey bars
  • jumping in place, on a trampoline or on a bed
  • running or biking (better up hill)
  • lying on your tummy propped on elbows
  • activities that involve a ‘workout' for the mouth; eg chewing, crunching, sucking, blowing games

Proprioceptive resources and ideas:

  • obstacle course built with sofa cushions and other household objects
  • twister game
  • cosmic yoga
  • body sock or Lycra tunnel; encourages movement and provides resistance whilst pushing against the 4-way stretch Lycra
  • there are lots of ‘squeezy / stretchy' fidgets available online: squeezy bean keychain, theraputty available in a range of colours/resistance, make your own ‘squishy / stress' ball using flour and a balloon

Tactile (touch input)

The tactile system is our primary protective system. When a person receives tactile input dopamine is released into the body, which helps to wash away stress chemicals such as adrenaline.

Remember that deep touch is very different to light touch and produces different reactions. Deep touch can be very soothing, whilst light touch may be perceived as annoying or threatening (especially to children who are sensitive to tactile input). When providing deep touch make sure that you are giving enough pressure (this should be the amount you would give during a relaxing massage). Deep pressure can help to ‘calm' the system when children are sensitive to touch (ie. over responsive). For children who need more information to recognise touch input (ie under responsive) consider which activities will help to ‘wake up' their touch system.

Consider providing a ‘sensory' or ‘treasure box' for these children, so that they can access items to ‘touch and feel' throughout the day. This will help to provide a ‘just right' amount of sensory input, in a discrete and less distracting way.

Remember, many of the activities which involve using hands for tactile input, also help with fine motor/handwriting skills. 

Everyday activity examples:

  • kneading dough/playdoh
  • baking activities
  • water play in the bath
  • gardening

Always provide supervision during activities to ensure safety

Tactile resources and ideas:

  • encourage the child to explore ‘tactile tubs'
  • start with ‘clean', dry textures (pasta, rice, fabric, leaves). Hide objects inside to find
  • move onto ‘wetter' materials (Playdough, Waterbeads / Orbeez, Magic Sand)
  • then ‘messy' textures (finger paints, Playfoam, Gloop made with flour and water)
  • try different bath bars or foaming playdoh in the bath
  • remember to use gradual exposure when introducing activities, and always go at your child's pace!

Deep pressure resources

  • weighted lap pad, homemade neck roll
  • tight sports tops or sports compression tops
  • therapy ball or big pillow for squashing and squeezing
  • sitting on a therapy ball during activities is great for core/shoulder girdle strength, and also helps with regulation
  • try lying across the gym ball to gain additional deep pressure input
  • scalp massage brush (vibrating version also available)
  • bed sheet tucked in. ‘Fidgetbum' blanket, made from comfy, stretchy cotton fabric. ‘Sensory Bed Sock,' providing gentle compression

Important safety guidelines for weighted products:

  • no more than 10% of the child's weight
  • always used with supervision, no longer than 20 mins at a time
  • must be removed when the child is asleep
  • weighted products are contra-indicated for certain health conditions and would not be recommended in these circumstances

Vestibular Input (movement sense)

General movement principles; Calming = linear, rhythmical, rocking Alerting = changes in head position. Most movement is alerting, which means that a child who is over responsive to vestibular input can become easily overstimulated.

To help counteract this:

  • encourage active, child propelled and child controlled movements rather than passive movements
  • never spin, twirl or swing a child excessively
  • incorporate proprioceptive input alongside vestibular activities

Levels of vestibular input:

1. Up and down (lowest intensity) 

2. Front to back movement 

3. Side to side movement

4. Diagonal movement 

5. Arc movements (resembles the shape of a rainbow) 

6. Spinning 

7. Inversion / upside down (highest intensity)

A child who is under-responsive will need more input or may seek this out actively.

Everyday activity examples:

  • reaching between the legs from a standing position
  • playing on a sit and spin
  • spinning on a swing/in office chair
  • being thrown up and down in the air
  • using a scooter board
  • rocking chair or gaming chair
  • rolling over a therapy ball
  • magic carpet (use a blanket to drag the child around the floor in different planes of movement)
  • hammock (use a large blanket held on each end to swing the child)
  • forward rolls, hand stands, somersaults

Vestibular resources and ideas

  • bilibo; rocking and spinning for young children
  • swivel ‘egg' chair with hood
  • space hopper; provides vestibular and proprioceptive input
  • indoor / outdoor cocoon or hammock swing
  • play equipment at the park: swing, slide, climbing equipment, see-saw
  • zuma rocker chair
  • moving sit or wobble cushion

Developing interoception

This is our sense of knowing what is going on inside all parts of our body; when we are hungry, thirsty, have a headache, feel nervous; need the toilet.

Everyday activity ideas:

  • to increase body awareness; ask the child if they can point to the body part where they may be having a feeling, this will take lots of practice and repetition
  • to help develop awareness of when the child is hungry/thirsty, ensure regular meal/snack drink times so that their body learns a routine and starts to develop consistent signals (a reminder watch may be helpful)
  • verbally label everything; ie “you're eating, that means you're hungry” or “It's really cold out, we need to put our coats on”
  • ask your child to remember a sensation; “remember that time your stomach felt bad…” and what the solution was…..”we did some breathing exercises”
  • encourage noticing the difference between hot and cold temperature of food or warm and cold things to hold
  • other sensory systems can help develop interoception. For example; Heavy movements which involves stretching, pushing, pulling, resistance and traction (eg yoga, swimming, gymnastics)
  • discuss how different body parts feel after they have had a short burst on the trampoline, or of jumping up and down on the spot. “How does your heart feel? Do you feel hot or cold?

Interoception resources and ideas

  • useful book on Interoception, by Cara Koscinski. “Easy to read explanations followed by helpful ideas you can use immediately.”
  • ”what is Interoception” video
  • watches to support regular toilet and drink breaks include Vibratelite 3 (vibrating) and Cadex12 alarm (non vibrating)