Proprioceptive and Vestibular Senses- What are they?

I was so proud of my son today- he just turned 9 years old and he roller skated for the first time all by himself.  They tightened the wheels, but he was brave and he did his best.  He even tried the game limbo.  He’s never wanted to try it before and after we learned about the additional senses and his body awareness, or lack thereof,  I was able to understand his reasoning for not wanting to try.  These seeming little accomplishments are truly big ones for him!   It built his confidence up that much more today and he wants to go skating again.  Yes- a small victory was won today!

Below is an excerpt from a great article I found online:

“What Proprioception Does

We all have receptors in our muscles that tell us where our body parts are. For example, if you raise your hand, you know that your arm is over your head. You don’t have to think about it or look in a mirror. But kids with poor proprioception may think their arm is over their head when it’s really straight out in front of them.

What the Vestibular Sense Does

The vestibular system includes the parts of the inner ear and brain that help control balance, eye movement and spatial orientation. It helps keep you stable and upright. Children with vestibular issues may not know where their body is in space. This can make them feel off balance and out of control.”

Click the link below to read the full article.

Trouble with motor skills.

 

Sense of Relief

I ran across this article in the support group.  Very informative.

What Is Sensory Processing Disorder?

It usually happens in the preschool years. You notice that your toddler seems to have an unusual aversion to noise or light. A teacher observes that, compared to other kids her age, your daughter is clumsy and has difficulty with fine motor skills like wielding a pencil. You’ve noticed that she is very, very picky about shoes, which are often deemed too tight, and clothes that are “too scratchy.”

More baffling — and alarming — to parents are their children’s meltdowns over things like their faces getting splashed or being dressed. Or a child might crash into walls (and people), touch everything or put inedible items, including rocks and paint, into his mouth.
These behaviors are all signs of problems with what’s known as sensory processing, found in children who have difficulty integrating information from their senses. In its extreme form, when it interferes seriously with a child’s functioning, it’s called Sensory Processing Disorder, or SPD, although it’s not recognized by the psychiatrists’ bible, the Diagnostic and Statistical Manual.

Sensory issues are associated with autism because they are common in children and adults on the autism spectrum, though most children with SPD are not on the spectrum. They can also be found in those with ADHD, OCD and other developmental delays — or with no other diagnosis at all. In fact, a 2009 study suggests that one in every six children has sensory issues that impede their daily functioning, socialization and learning.

What parents often notice first is odd behavior and wild, inexplicable mood swings. For instance, a first-grader may do fine in a quiet setting with a calm adult. But place that child in a grocery store filled with an overload of visual and auditory stimulation and you might have the makings of an extreme meltdown.

“These kids’ tantrums are so intense, so prolonged, so impossible to stop once they’ve started, you just can’t ignore it,” notes Nancy Peske, whose son Cole, now 13, was diagnosed at 3 with SPD and developmental delays. Peske is coauthor with occupational therapist Lindsey Biel, who worked with Cole, of “Raising a Sensory Smart Child.”

Another response to being overwhelmed is to flee. If a child dashes out across the playground or parking lot, oblivious to the danger, Peske says that’s a big red flag that he may be heading away from something upsetting, which may not be apparent to the rest of us, or toward an environment or sensation that will calm his system. This “fight-or-flight response is why someone with SPD will shut down, escape the situation quickly, or become aggressive when in sensory overload,” she says. “They’re actually having a neurological ‘panic’ response to everyday sensations the rest of us take for granted.”

Children, teens and adults with SPD experience either over-sensitivity (hypersensitivity) or under-sensitivity (hyposensitivity) to an impairing or overwhelming degree. The theory behind SPD is based on the work of occupational therapist Dr. A. Jean Ayres. In the 1970s, Dr. Ayres introduced the idea that certain people’s brains can’t do what most people take for granted: process all the information coming in through seven — not the traditional five — senses to provide a clear picture of what’s happening both internally and externally.

Along with touch, hearing, taste, smell and sight, Dr. Ayres added the “internal” senses of body awareness (proprioceptive) and movement (vestibular). When the brain can’t synthesize all this information coming in simultaneously, “It’s like a traffic jam in your head,” Peske says, “with conflicting signals quickly coming from all directions, so that you don’t know how to make sense of it all.”

What are these two “extra” senses in Dr. Ayres’ work?
Proprioceptive receptors are located in the joints and ligaments, allowing for motor control and posture. The proprioceptive system tells the brain where the body is in relation to other objects and how to move. Those who are hyposensitive crave input; they love jumping, bumping and crashing activities, as well as deep pressure such as that provided by tight bear hugs. If they’re hypersensitive, they have difficulty understanding where their body is in relation to other objects and may bump into things and appear clumsy; because they have trouble sensing the amount of force they’re applying, they may rip the paper when erasing, pinch too hard or slam objects down.

The vestibular receptors, located in the inner ear; tell the brain where the body is in space by providing the information related to movement and head position. These are key elements of balance and coordination, among other things. Those with hyposensitivity are in constant motion; crave fast, spinning and/or intense movement; and love being tossed in the air and jumping on furniture and trampolines. Those who are hypersensitive may be fearful of activities that require good balance, including climbing on playground equipment, riding a bike, or balancing on one foot, especially with eyes closed. They, too, may appear clumsy.

To help parents determine if their child’s behavior indicates possible SPD, Peske and Biel have created a detailed sensory checklist that covers responses to all types of input, from walking barefoot to smelling objects that aren’t food, as well as questions involving fine and gross motor function, such as using scissors (fine) and catching a ball (gross). The SPD Foundation also offers a litany of “red flags.” The list for infants and toddlers includes a resistance to cuddling, to the point of arching away when held, which may be attributed to feeling actual pain when being touched. By preschool, over-stimulated children’s anxiety may lead to frequent or long temper tantrums. Grade-schoolers who are hyposensitive may display “negative behaviors” including what looks like hyperactivity, when in fact they’re seeking input.

Peske sums up the way sensory issues can affect kids this way: “If you’re a child who is oversensitive to certain sensations, you are not only likely to be anxious or irritable, even angry or fearful, you’re likely to be called ‘picky’ and ‘oversensitive.’ If you rush away because you’re anxious or you’re over-stimulated and not using your executive function well because your body has such a powerful need to get away, you’re ‘impulsive.’ If you have trouble with planning and executing your movements due to poor body awareness and poor organization in the motor areas of the brain, you’re ‘clumsy.’ Because you’re distracted by your sensory issues and trying to make sense of it all, you may be developmentally delayed in some ways, making you a bit ‘immature’ or young for your age.”

Amid this confusion, there may be relief for more than a few parents in recognizing what may be causing otherwise inexplicable behavior — and in the potential for kids to get help in the form of specialized occupational therapy and what are called sensory gyms.

“When I describe sensory issues to parents whose kids have it,” Peske says, “the usual reaction is ‘Oh, my gosh, that’s it!’ They’ve been trying to put a finger on ‘it’ for many months, even years! The sense of relief that they finally know what ‘it’ is is humongous.”

Child Mind Institute’s Speak Up for Kids is an annual public education program held during National Children’s Mental Health Awareness Week (May 6-12, 2012) aimed at ending the stigma, lack of awareness, and misinformation that cause children to miss out on treatment that can change their lives.

This story is part of Speak Up for Kids, an annual public education program held during National Children’s Mental Health Awareness Week (May 6-12, 2012).

Posted: 05/10/12
Written by Beth Arky.

Ayres Sensory Integration® – Catching it early.

 

alex name

Our son’s entire world is before him.

Please, find below more information in regards to SPD.  Early intervention is critical.

Sensory Processing, Ayres Sensory Integration®, 
Administration of Sensory Integration, and Praxis Test (SIPT)

Sensory Integration (SI) refers to how our brain takes in information through all of our senses (sight, sound, taste, touch, movement).  SI helps us understand who we are, where we are, and what is happening around us. It is also called sensory processing.

Children with sensory challenges may have:

  • Extreme reactions to sound, taste, touch, movement
  • Difficulty with attention
  • Negative reactions (tears, tantrums, refusal to participate) to activities other children enjoy
  • Difficulty following directions
  • Difficulty changing from one activity to another
  • Decreased social skills

These children may also be:

  • Clumsy or uncoordinated
  • Destructive or rough with people / objects
  • Impulsive and unsafe
  • Constantly moving o
  • or have difficulty sitting still 

The value of early diagnosis

If you spot the red flags of SPD in your infant or toddler, the case for seeking immediate diagnostic services is powerful.

  • Early diagnosis leads to early intervention. The sooner an accurate diagnosis is made, the sooner intervention can begin. Many children and their families suffer needlessly for years because of sensory issues that could have been addressed if a sound, professional evaluation had determined that Sensory Processing Disorder was present and treatment had begun sooner.
  • Early diagnosis increases the chances of successful intervention. The immature brains of younger children are more “plastic,” which enables them to change more easily. This makes intervention more effective for them. Older children still benefit but the benefits may take longer to achieve and may be based on cultivating coping skills rather than on modifying the brain, as early intervention is believed to do.
  • Early diagnosis lays the groundwork for better school experiences. Children who receive intervention at younger ages–as infants or preschoolers–acquire the skills they will need to succeed in school sooner and usually have better experiences once they enter school. This is why federal law requires and funds the screening and, if indicated by the screening, multidisciplinary assessment of preschool-aged children with suspected disabilities.
  • Early diagnosis can prevent secondary problems from developing. Children who perceive themselves as “failing” at activities that most children perform effortlessly are at risk for other problems such as social difficulties, academic under-achievement, acting-out behaviors, and/or low self-esteem and self-confidence. When children are diagnosed and treated at younger ages, they are more likely to escape this defeating cycle.
  • Early diagnosis provides correct labeling for unusual behaviors. Because of their atypical behaviors, children with SPD often attract negative labels such as “aggressive,” “withdrawn,” “weird,” “hyper,” “out of it,” and others from peers and adults. With early diagnosis, these behaviors get labeled early for what they really are–symptoms of an underlying neurological disorder. Undeserved and undesirable stereotyping, punishment, and other consequences are minimized or avoided.
  • Early diagnosis improves family life. The stress on the families living with sensational children can be devastating. The understanding that comes with diagnosis helps parents avoid such common traps as assigning blame to each other for their child’s behavior or disagreeing over discipline. A diagnosis also gives parents an explanation they can use to address the criticism and disapproval that is often directed at them as well as their child.

– from Sensational Kids: Hope and Help for Children With Sensory Processing Disorder (SPD) by Lucy Jane Miller, PhD, OTR

Sensory Integration Praxis Testing (SIPT)

The Sensory Integration and Praxis Test (SIPT) is a comprehensive assessment tool developed in 1989 by A. Jean Ayres, PhD for children 4.0-8.11 years of age.  The test was created to assist us to understand why some children struggle with learning and/or display negative behaviors which are not explained by other diagnoses.

TEST CATEGORY ASSESSES PROBLEM AREAS ADDRESSED
FORM and SPACE
Space Visualization Visual manipulation of objects. Reading, writing, ADL’s, navigation.
Figure Ground Visual figure ground. Poor organizational skills, losing place when reading, doing math or worksheets.
Manual Form Perception Shape recognition, bilateral stereognosis. Dressing, sports, tasks not requiring vision.
VISUAL MOTOR
Design/Copy 2-D construction (pencil test) and motor planning. Reading, writing, math.
Construction Praxis 3-D construction (block design). Negotiating self thru space, object construction.
Motor Accuracy Visual motor control of preferred and non-preferred hands. Writing, sports, crossing mid-line.
TACTILE DISCRIMINATION
Finger Identification Finger recognition through touch. Fine motor difficulties, weak grasp.
Graphesthesia Finger recognition through form. Drawing, writing.
Localization of Tactile Stimuli Tactile localization. Body awareness, tactile modulation.
VESTIBULAR PROPRIOCEPTIVE PROCESSING
Kinesthesia Perception of joint position and movement. Clumsy, rough with others and objects, breaks objects.
Stand/Walk Balance Static and dynamic balance, EO/EC. Poor balance, sports, position of self for function, poor endurance.
Post-Rotary Nystagmus Reflexive response (VOR) of eyes or rotation. Move/spins lots or avoids movement, car sick, vertigo.
BILATERAL INTEGRATION AND SEQUENCING
Bilateral Motor Coordination Replicating smooth and coordinated bilateral hand/feet patterns. Functional use of both sides of the body for sports, writing, play.
Sequencing Praxis Replicating sequences of hand movements. Multi-step directions, avoids sports, reading, writing.
Space Visualization Preferred hand and contra-lateral hand use. Crossing mid-line, handedness, reading, writing.
PRAXIS
Postural Praxis Imitation of postures. Avoids new tasks, slow to learn new motor skills, lacks creativity in play.
Oral Praxis Imitation of oral movements. Speech production, feeding issues.
Praxis on Verbal Command Following 2 and 3 step verbal commands. Auditory processing, following directions.
(http://simplestrokestherapy.com/services/sensory-integration-praxis-testing/)

Grandma’s Vacuum

Before learning of SPD we never understood why our son would love to visit with Grandma and work.  Work at vacuuming her floors.  ha – I know it sounds strange and we were so baffled, he enjoyed and loved to vacuum.  Of course we went right along with it – ha- go ahead, honey – sure – you can vacuum all you want.  Grandma appreciates her floors being so clean!  While vacuuming he was calm and he did really well -so, why stop him?   Right?

alex running to grandmasAfter learning about SPD…we understood why vacuuming was so important to our son.

Proprioception is the process by which the body can vary muscle contraction in immediate response to incoming information regarding external forces, by utilizing stretch receptors in the muscles to keep track of the joint position in the body.

Proprioception and kinesthesia, the sensation of joint motion and acceleration, are the sensory feedback mechanisms for motor control and posture. These mechanisms along with the vestibular system, a fluid filled network within the inner ear that can feel the pull of gravity and helps the body keep oriented and balanced, are unconsciously utilized by the brain to provide a constant influx of sensory information. The brain can then send out immediate and unconscious adjustments to the muscles and joints in order to achieve movement and balance.

Proprioception, also often referred to as the sixth sense, was developed by the nervous system as a means to keep track of and control the different parts of the body. An example that enables one to best understand this sensory system is one showing what happens if this sensory system is no longer there. A normal person is able to move a finger, knowing where and what the finger is doing, with little effort. The normal person could just volunteer the finger to move back and forth and proprioception would make this an easy task. Without proprioception, the brain cannot feel what the finger is doing, and the process must be carried out in more conscious and calculated steps. The person must use vision to compensate for the lost feedback on the progress of the finger.”   (www.spdaustralia.com.au)

The vestibular sense, or movement and balance sense, gives us information about where our head and body are in space. It allows us to stay up right while we sit, stand, and walk.

This is so hard to comprehend that all of these years the reason our son has been falling, which we thought was attention seeking, why he seemed to never be coordinated, why he spilled seemingly everything, why he couldn’t learn to move his arms properly and to kick his feet to swim, why it was so difficult for him to pedal and to steer his bike at the same time, why he couldn’t tie his shoes, why he never wanted to play soccer or basketball like his big brother, or why he couldn’t move his pieces on a game-board with us all being nervous the whole board was going to be knocked, why he ran and crashed into things, slammed into things, broke his toys, and so much more was because of his lack of proprioception and his vestibular sense.  It all makes so much sense now.  What a relief – really.  Although poor little, guy, I cannot image how he feels not having the sense of body awareness.  We feel unconsciously the gravitational pull – he doesn’t feel it like we do.  His foot may be moving forward but, he’ll miss that step -he tries -but, not knowing if he landed it or not….until.  Can you imagine?  I can’t.  How scary it must be.

So, back to Grandma’s house and him working so hard to keep those floors spotless.  While he was pushing and pulling that semi-heavy vaccum cleaner he was stimulating his own proprioceptive sense by compressing his joints and working his muscles and regaining his sense of awareness.  He relearned the positions of and the sense of his limbs and head and he was always so very calm after vacuuming…and now we know why.

Also, now our son’s OT begins each session with the 2 below and I now understand why:

1) cuddle swing and (helps to organize and regulate the sensory system)

2) joint compression (regains body awareness)

It has made such a big difference learning this “exercise”, if you will, joint compression, to help our son feel more confident and to gain his body control.   (The cuddle swing is in the making for his daily use in the house.)

It has been such a blessing learning and understanding our son…even if it has taken 7 years.  We hit the top of the mountain and it is now a downward slope for him – easier – even if he has to have a vacuum in hand.  😉