Therapy, therapy: Proprioception

As I’ve mentioned before, one of the senses Maddy has low registration of is proprioception. What is that, you ask? I’ll do my best to explain it to you (of course, if any OTs are reading this, feel free to clarify anything that needs it).

Proprioception is the sense of how our body parts are oriented in space (relative to other body parts). It is the sense that lets us know how much effort or resistance is needed in movement (to say, hold a cup). Someone who has low registration of proprioception might hold the cup too hard and crush it, and wouldn’t be able to drink without looking at their hand and cup (so they can see where their hand is relative to their mouth).

Stimulating proprioception can send calming messages to the brain. It can lower arousal levels and reduce the cumulative effect of ‘sensory attacks’ to help regulate a child with SPD’s behaviour. Proprioception is what helps to regulate Maddy. When working on her tolerance of other senses, we always pair it with proprioception to prevent a melt down from occurring.

Maddy has learned how to compensate her need for proprioceptive sense by seeking it out in some very clever (and at times, frustrating) ways. To name a few:

• Pushes other kids/animals or hits them hard – remember this?
• Pushes away from us while we hold her
• Banging her toys together
• Kicking her toys away from her
• Prefers to stand rather than sit
• Kicks her feet against anything she can – the arms of chairs, bars on her high chair and stroller, our laps, the floor
• Sleeping on her stomach with her bum up in the air
• While sitting, leans forward and rests her body against her legs and her head on the floor
• Intense attachment to her soothers

Now, I know what you’re thinking… all kids do those things. That is true, many kids will do some of these things, as all people have sensory quirks. What you have to remember is that children with SPD have more of these behaviours than non-SPD children, so much so that it disrupts their daily life. For example, if a baby only ever kicks her toys away from her (and then proceeds to cry when they’re no longer there to kick and provide some sensory input), how will she ever learn how to play with toys? Or, if a baby can’t sense at all where their arm is in relation to their other arm, legs, or head, how are they expected to crawl? Furthermore, if someone always needs to be looking at their feet to make sure they’re upright to walk, how would they ever learn to walk? I know it’s tough to wrap your head around if you feel your proprioception as a typical person would, but this is actually what it would feel like to be in Maddy’s body right now.

So what are we doing about it? A lot. It would take way too much time to list all of the incredible ways OT is helping Maddy with proprioception, but here’s a few: playing and eating in a laundry basket, pushing against a ball, and Eric and I do joint compressions for her (she also likes head compression). Here we are using object permanence (to get Maddy to lift objects) as part of Maddy’s therapy:

Perhaps you’ve already figured this out, but the therapy techniques I’ve described are all to create additional and firm joint compression so Maddy can actually feel it. I do this at least every couple of hours each day, sometimes more depending on how she’s taking to it. Before she goes down for a nap or bed at night, I spend a half hour working on getting her to feel her proprioceptive sense so that she can sleep more soundly. It’s exhausting trying to keep up with this and the other techniques we use to address her other senses, but we’re continuing to make progress with therapy – and boy is it rewarding!