Proprioception:The Position Sense

Apart from five basic senses (vision, auditory, touch, olfactory and gustatory), we have three more hidden senses called as Proprioception, Interoception (recently discovered) and Vestibular Sense. 
The following discussion is about our proprioceptive sense and how it works in typical and atypical children.Awareness about one’s own body position happens due to this sixth sense is known as proprioception.

Proprioception is also called as “position sense” since it tells us, where we are we sitting, standing, lying or walking in relation to any object or surrounding. The word Proprioception comes from Latin word, “proprius” meaning “one’s own”. This sense supports a child to regulate their responsiveness to sensations. 

This sensation occurs when our muscles move or work.Consequences of poor proprioceptive functioning are the poor academic achievement, lack of self-care skills, difficulties in self-regulating emotions, attention and stress.

To know more about proprioception, let’s consider a simple example.

Suppose, you are blindfolded and asked to ascend and descend stairs you have never seen. Now your eyes do not have any experience or measurement of these stairs.The depth of every stair is unknown that can actually help your body to go up and down without falling or tripping. It is obvious that your balance will lose while doing this activity.

So what role does body play to protect you?

To be careful and protect you from falling, your hands will try to search and hold railing or any other external support. 
Your dominant foot will step forward slowly and attempt to judge how much is the height of the first stair so that you can climb the second step easily, with a swift movement. 
As you will climb further, your body will be confident enough to take steps confidently and instantaneously with controlled balance. 
Moreover, descending stairs will be easier for you now since the body can easily judge and feet can measure the steepness of staircase.

So how does this all happen?

This all happens because of our Proprioceptive sense! It is a hidden sense, that carries sensory information telling us about our own body’s movements and positions. It allows the brain to understand body's position, posture and place in relation to surroundings and other individuals.
Whether we are standing under the tree, over the bed, in the sand or on the top of the cliff, this unconscious awareness happens due to this sense.

Being able to walk in the dark room without losing balance control, typing without looking at the keyboard, driving a car without looking at brakes and other components, or performing ballet will not be possible without this sense.

This sense is the foundation for our body postures and actions. It makes us feel where are we sitting standing or lying in relation to our surrounding.

Consider, while sitting on the chair, how does our body know, where it has to sit? How much our knees need to bend according to chair’s height? Is chair comfortable or not?This all work is done by Proprioceptive sense.

It informs body about direction, velocity and force needed by one’s body
for doing any task. Finely graded movements, body coordination and body scheme are some of the areas that are affected due to lack of proprioception.Heavy work activities are calming for these children.

The functions of proprioception are to increase body awareness and contribute to motor control and motor planning (praxis). Children with poor proprioceptive sense have poor body awareness which causes difficulties in carrying out a gross motor and fine motor activities such as playing football, get dressed, zipping a jacket, buttoning a shirt or doing handwriting tasks.

Characteristics of poor prop (short form used by OTs) sense can be easily observed within the classroom or home setting among SPD (Sensory Processing Disorder) children such as, they would slap feet on ground while walking, or hold pencils too tightly to make a clear impression, or that the points break, there can be erasure holes on sheet producing messy work.

Unlike typical children, atypically developing children are not able to judge space around themselves. They might bump into other people or objects.  They may enter into other person’s intra-personal space which is considered weird and uncomfortable by most of the people. Such a child might be considered strange however reason behind this action is not his intentional bad behaviour but the lack of body awareness. 

People's strange reactions cause anger,depression and emotional liability in the child since he is not doing all this deliberately or intentionally but indirectly trapped by his own body.

The perception of judging ordinary tasks such as the weight of a coffee mug, holding a pencil efficiently in order to write, poor balance while standing, tripping while walking, difficulties in planning actions are some of the examples of poor proprioception. 

Moreover, children with poor proprioception usually slip from their chairs while sitting in classrooms or other settings. These children have affected body positions and difficulties in organising their sensations therefore falling is usual. Providing Wobble cushion or wobble wedge provides combined tactile-proprioceptive input helping the child to sit appropriately. Moreover, it helps in preventing slouch and increases attention on the task. These resources can be purchased from different websites such as Amazon  at cheaper prices.

Other weighted items such as weighted vests or weighted lap pad provide calming effect on the child. They support child to stay in place and focus well
on given task.

Other classroom activities to can be Brain Gym and yoga exercises to improve child’s focus in academics. Mediation has very calming and long lasting effect.

Sensory Diet designed by Occupational Therapist is essential to be incorporated in child’s schedule specifically to meet the needs of the individual's own nervous system.  Its purpose is to help the person become more focused, adaptable and skilful.  It is the combination of alerting and calming activities that helps in organising child’s behaviour and needs.

Home activities can include jumping on a trampoline, riding scooter or bicycle, participation in running, jumping, hopping activities, obstacle courses, sand play, hopscotch play, gymnastics, horse riding.